Objective To explore the damage effect of sonoporation on the prostate of rabbit,while opening up the blood-prostate barrier by microbubble mediated sonoporation.Methods Fifteen male New Zealand white rabbits were randomly divided into 3 groups:ultrasound (US) group,microbubble (MB) group,ultrasound and microbubble (US+MB) group.Ultrasound was insonated directly on the prostate.Optical microscope,electron microscope and apoptosis index (AI) with TUNEL method were applied to trace the changes of the prostate of rabbit under different conditions.Results There was no significant change in prostatic tissues of group US and MB under the optical microscope.Cytoplasm and nucleoli were stained equally,cells of glandular epithelium were intact and formed orderly.Glandular cavities in these two groups were change very slightly.Glandular epithelium cells of Group US+MB were organized optical under the optical microscope,and there was a mass of eosinophilic liquid in the glandular cavities.Vascular endothelial cell were intact and formed orderly and swollen mitochondria were observed under the electron microscope in MB group and US group.Swollen mitochondria,tight junctions among gland cells were opened,and infiltrated erythrocyte could be found under the eletron microscope in US+MB.AI of group US+MB was markedly higher than that of group US and group MB (P<0.01),and AI of group US was higher than that of group MB (P<0.01).Conclusions Microbubble mediated sonoporation causes damage in the prostate tissue of rabbit,while opening up the blood-prostate barrier with an increased permeability of the prostate.

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.

Objective To investigate the value of spleen stiffness measured by transient elastography (FibroScan,FS) for diagnosing esophageal-gastric varices in liver cirrhosis patients.Methods A total of 259 cirrhotic patients in Tianjin Third Central Hospital from Apr 2011 to Apr 2012,and 30 healthy controls were enrolled.All the patients and controls were evaluated for spleen and liver stiffness by FS and 201 cirrhotic patients also underwent gastroscopy for the diagnosis of esophageal-gastric varices.By using gastroscopy as the gold standard,the receiver operating characteristic (ROC) curves of three parameters including spleen stiffness,liver stiffness and platelet/thickness of spleen were delineated for different disease stage.The areas under curves (AUC) were used to evaluate the value of these parameters in the diagnosis of esophageal-gastric varices.Results The spleen and liver stiffness values in cirrhotic patients were (44.64 ± 22.27) kPa and (24.27 ±18.89) kPa,respectively,while those in healthy controls were (20.94± 14.78) kPa and (6.12±5.77) kPa,respectively,which were both lower than cirrhotic patients (P＜0.05).The stiffness values of liver and spleen both increased with higher Child-Pugh scores.And the liver stiffness values were different among groups (F=0.068,P =0.000),while the spleen stiffness values in patients with Child-Pugh A and B were different from that in patients with Child-Pugh C (P＜0.05).In patients with moderate or serious esophageal-gastric varices,the spleen and liver stiffness values were significantly higher.The ROC curve analysis showed that the AUC of spleen stiffness,liver stiffness and platelet/thickness of spleen in the patients with moderate to serious esophageal-gastric varices were 0.918,0.749 and 0.743,respectively.The corresponding optimal cut-off values were 50.7 kPa,20.1 kPa and 1.65.The AUC,sensitivity and specificity of spleen stiffness were all higher than liver stiffness and platelet/thickness of spleen.Conclusion Spleen stiffness measured by transient elastography is a valuable parameter for non-invasive diagnosis of esophageal-gastric varices in cirrhotic patients.

Objective To explore the imaging characteristics of neurologic complications associated with the enterovirus 71 ( EV71 ) epidemic by analyzing 25 cases and reviewing the literature. Methods Twenty-five cases of hand-foot-mouth disease with neurologic complications during the recent EV71 outbreaks of Hainan province were studied for the clinical features and imaging findings, and literature were reviewed.Results In 5 cases, acute flaccid paralysis associated with EV71-infected hand-foot-mouth disease was related to the linear high signal in the spinal cord on sagittal images. Two cases showed symmetrical, welldefined hyperintense lesions in the spinal cord on T2WI transverse. Strong enhancement of the ventral horns and root was seen on the contrast-enhanced axial T1WI. In brainstem encephalitis, all lesions presented with significant hyperintensity on T2WI and hypointense on T1WI in the posterior portions of the medulla oblongata, midbrain, and pons. The manifestations of aseptic meningitis (AM) on MRI have no characteristics, but subdural effusion, meningeal enhancement and hydrocephalus can be the indirect signs of AM. Conclusions MRI is an effective method to investigate neurologic complications associated with the EV71 epidemic. Posterior portions of the medulla oblongata and pons, bilateral ventral horns of spinal involvement are characteristic findings of enteroviral encephalomyelitis.

Objective To study the effect of age on the recurrence-free survival rate after hepatic resection for hepatocellular carcinoma(HCC)and the relationship between microvessel density (MVD)and recurrence of HCC in the elderly. Methods　Severty one cases of elderly patients with HCC were analyzed retrospectively with 352 cases of non-elderly HCC patients as control,and the effect of age on the recurrence-free survival rate was studied.The expressions of CD34 and endocan in HCC tissues were detected by immunohistochemistry in 30 elderly and 30 non-elderly patients.Results　The 1-,3- and 5-year recurrence free survival rates were 75.7%,43.0% and 43.0% in the elderly group respectively,which were higher than those in the non-elderly group(53.6%,38.5% and 33.4%,respectively,Log Rank value=10.25,P＜0.05).The positive rate of alpha fetoprotein (AFP)in the elderly group was 47.9%,which was lower than that in the non-elderly group(62.2%)(X2=23.68,P＜0.05).The median survival times in the high CD34-MVD group and high endocan MVD group were shorter than those in the low CD34-MVD group and low endocan-MVD group(260 d vs.850 d,360 d vs.800 d,Log Rank value was 22.18 and 20.56 respectively,both P＜0.05).Conclusions　The long-term prognosis of hepatic resection for HCC is better in elderly patients than in non-elderly patients.The recurrence of HCC in the elderly is closely related with angiogenesis.

Objective: To observe the difference in anti-inflammatory effect between living rhino horn and rhino horn by the method of comparative research to provide the experimental basis for the replacement of rhino horn by living rhino horn.Methods: The anti-inflammatory effects of living rhino horn and rhino horn were studied by the methods of paw edema in rats, cotton ball granuloma in mice, auricle swelling and peritoneal dye penetration.Results: Compared with that in the model control group, the foot metatarsus swelling degree at all time points in high (440 mg·kg-1) dose group and middle (220 mg·kg-1) dose group of living rhino horn and three doses groups of rhino horn showed statistical differences (P＜0.05 or P＜0.01).The high dose group (700 mg·kg-1) and middle dose group (350 mg·kg-1) of living rhino horn and rhino horn could significantly reduce the weight of cotton ball granuloma in mice (P＜0.05).Three doses groups (700, 350 and 175 mg·kg-1) of living rhino horn and rhino horn could significantly reduce auricle swelling in mice induced by xylene (P＜0.05 or P＜0.01).The absorbance of Evansan in the abdominal cavity in the middle dose group (350 mg·kg-1) of rhino horn and the high dose group (700 mg·kg-1) and middle (350 mg·kg-1) dose group of living rhino horn was significantly reduced (P＜0.05 or P＜0.01).There was no significant difference in the anti-inflammatory effect between living rhino horn and rhino horn at the same dose.Conclusion: Living rhino horn and rhino horn have a certain anti-inflammatory effect.The anti-inflammatory effect of living rhino horn is similar to those of the rhino horn, and living rhino horn can be used as a substitute of rhino horn.

Objective: To investigate formalin-induced inflammatory nociceptive response and Fos expression of interbrain following stellate ganglion block (SGB) in rabbits. Methods: Catheters were inserted closely to right stellate ganglia in rabbits.One week later,twenty-four rabbits were randomly divided into three groups of 8 each:sham group,SGB group and control group,receiving 0.5ml of normal saline,3% formalin and 3% formalin stimulation by intraplantar injection into the right front paw, respectively. ten mins before stimulation,0.5ml of 0.25% bupivacaine was administered via the catheter in SGB group,while 0.5ml of normal saline in sham group and control group. Nociceptive response was observed for 60min using weighted pain score. Local inflammatory response was measured by histopathology, the expression of Fos of interbrain was measured with immunohistochemistry 2 hours after stimulation. Results: Formalin-induced nociceptive behavior in phase 2 and local inflammatory response were relieved following SGB; the average numbers of Fos-positive neurons of hypothalamus in SGB group was lower than that in control group( P 0.05). Conclusion: SGB suppresses formalin-induced Fos expression of hypothalamus.

Adult ; Arteries ; anatomy & histology ; Asian Continental Ancestry Group ; Female ; Humans ; Larynx ; anatomy & histology ; blood supply ; Male ; Microsurgery

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05).Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.

Continuing medical education is an important task of military medical universities,which undertake a large amount of education and training of medical officers.This article made a survey of some military medical officers and put forward some suggestions in order to sum up experience and lessons and provide a reference for the education in the future.