Objective To test using musculoskeletal ultrasound (MSUS) to observe uncovertebral joints (UJs) and to explain the ultrasound images of UJs and their adjacent tissues,especially the vertebral artery (VA).Methods MSUS was used first with human skeletons and cadavers to localize the UJs and VA on the MSUS images with the aid of implanted needles.MSUS was then used with a patient clinically diagnosed with cervical spondylosis of the vertebral artery type (CSA) to detail the image of a normal UJ and its relationship with the adjacent tissues,especially the VA.Whether there was a lateral spur from the uncinate process (UP) was assessed to try to establish a method for measuring osteophytes.Results During the examination the patient was in supine,the neck was elevated 15cm with a pillow and was at 45 degrees of rotation to the contralateral side.The probe was placed at the medial border of the sternocleidomastoid muscle.When the longitudinal section of the common carotid artery was shown,the probe was slowly moved laterally until the VA first appeared,and then was moved up along the VA.Once the VA entered the transverse foramen,moving the probe slightly allowed the UJ behind the VA to be seen between two transverse processes.The UJ thus lies between two transverse processes,that is,between the lateral margins of two vertebral bodies and outside the intervertebral disc.The echo of the lateral border of the UP is on a straight line with the echo of the lateral margin of the vertebral body,with the VA in front of the line.It was noticed that the image of a UP with lateral osteophyte formation crossed the line and reached closer to the VA.The transverse diameter of the UJ was measured as the distance from a line cutting the lateral cortical margin of the cervical vertebra to the outer cortical margin of the lateral UP.Conclusion MSUS can clearly show the UJ and its adjacent tissues,especially the VA.It can be used to assess and measure UJs with lateral osteophyte formation.

Objective To study the feasibility of the Fe3O4-loaded lipid perfluorooctylbromide nanoparticles (Fe3O4-PFOB) for enhanced ultrasound imaging.Methods The Fe3O4-PFOB nanoparticles,incubated with RAW264.7 macrophage cells,were monitored by microscope and ultrasound.Twelve SD rats were randomized into two groups,Fe3O4-PFOB group and PFOB group.Ultrasound imaging of rats' liver was performed before and after intravenous injection of the contrast agents.The liver echogenic intensity was quantified by DFY ultrasound quantified system analysis.Results Incubation of the Fe3O4-PFOB nanoparticles with macrophages resulted in the uptake of Fe3O4-PFOB by macrophages.Macrophages loaded with Fe3O4-PFOB exhibited enhanced echogenicity in vitro.In in vivo imaging,Fe3O4-PFOB produced better and prolonged ultrasound enhancement of rats' liver compared to PFOB nanoparticles.Conclusions Fe3O4-PFOB nanoparticles could enhance ultrasound imaging and may potentially serve as a multimodal probe for ultrasound,CT and MR imaging.

Objective To observe the response of the guiding vane to axial flow pump by testing two types of miniature axial flow pump,which have been developed by our group in recent years.Methods Two types of axial flow pump were tested in a mock circulation apparatus.Results The outputs of the two types of miniature axial flow pump all attain 5L/min against the pressure of 13.332kPa,which is enough for left ventricular assistance.The outputs are similarly related to their pre-load and after-load pressure.In this study,the guiding vane does not produce a significant affection on the hydrodynamic characteristic of the axial follow pump.Conclusion The guiding vane may be neglected in the design to improve the blood compatibility of a axial flow pump heart assist device.

To test the hypothesis that dermal fibroblasts (DF) are an important source of cytokines which elicit major changes in hepatic synthesis of acute phase reactants(APRs). Metkods: Condi-tioned medium(CM) from human DF challenged with bacterial lipopolysaccharide (I,PS) was collected andIL-10 and IL-6 levels were measured- The ability of DF conditioned medium(fLPS) and dexamethasone(Dex) to mediate an hepatic acute phase response was tested on rat hepatoma H4 cells- Various concentra-tions and combinations of CM (?LPS), recombinant IL-6 (rhIL-6) and Dex were tested for their abilitiesto stimulate albumin, Q,-acid glycoprotein (AGP), a,-antitrypsin (AT) and transferrin mRNA synthesis.Results: LPS stimulated IL-6 production by DF and Dex inhibited this producti0n. IL-6 and CM+LPS in-hibited the production of albumin mRNA,while the expression of AT and AGP 0ccurred 0nly with CM+LPS+Dex. However,IL-6 alone had an inhibitory effect 0n albumin and transferrin mRNA producti0n.Dex maximized the effects 0f lL-6 and CM, and was essential f0r AGP gene expression. C0nclusion: (l)LPS-treated human DF can secrete IL-6, but not IL-101 (2)DF may als0 pr0duce other cyt0kines whichmodulate hepatic pr0tein synthesis during the acute phase response l (3) Dex inhibits IL-6 production byDF, but enhances its ability to stimulate the acute phase response.

Objective To prepare the liver targeting nano-liquid perfluorocarbon ultrasound contrast agent and observe its general characteristics;to observe the targeting combined effects of the human liver cells L02 and the targeted ultrasound contrast agent ;to evaluate the gathering imaging effects of the targeted ultrasound contrast agent. Methods Amine method was used to prepared asialoglycoprotein Gal specific ligand polylysine (Gal-PLL), rotary evaporator and sonicated liquid fluorocarbon were used to prepare nano lipid ultrasound contrast agent. Human liver cell L02 were cultured, the combined effects were observed according to the reacting time of the cells and the targeted nano-lipid ultrasound contrast agent. The nanolipid ultrasound contrast agent and the degassed_ water_ were loaded into cysts and their ultrasound imaging effects were observed by ultrasound diagnostic apparatus Philips iU22. Results The particle size of the liquid fluorocarbon nano-targeted lipid ultrasound contrast agent was extremely small, uniform, cylindrical and spherical. The cysts in vitro showed that the side of the targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent showed high echo. Conclusions The targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent can be effectively targeted to the human liver cells L02 due to carrying home-made Gal-PLL. The targeted ultrasound contrast agents can be imaging by ultrasound and be confirmed in vitro.The size of the contrast agent was small, therefore, it can be considered an ideal ultrasonic molecular probe and achieve the ultrasound molecular imaging in cell level.

Objective To explore the effects of alanyl-glutamine (Ala-Gln) dipeptide supplemented parenteral nutrition (PN) on the short-term outcomes in critically ill adult patients.Methods In this retrospective study,we reviewed the clinical data of critically ill adult patients who were treated by standard PN from January 2006 to December 2011.The length of stay in intensive care unit (ICU-LOS),incidences of infections and multiple organ dysfunction syndrome (MODS),and mortality were compared between the group of Ala-Gln dipeptide supplemented PN (intervention group) and the group of PN without Ala-Gln dipeptide (control group).Results Finially,617 cases were enrolled in the study,including 312 cases in the control group and 305 cases in the intervention group.The ICU-LOS was significantly shorter in the intervention group than that in the control group [(17.2 ± 6.5) d vs.(16.1 ± 5.3) d,P =0.011).Compared with the control group,the incidences of infection (42.9％ vs.33.1％,P =0.011) and MODS (46.5％ vs.38.0％,P =0.030) and the mortality (34.9％vs.25.9％,P =0.014) in the intervention group patients were significantly lower.Conclusion Ala-Gln dipeptide supplemented PN can improve the short-term outcomes of critically ill adult patients.

Objective To investigate the size and diversification of peripheral nerve measured by high frequency ultrasound in di-abetic peripheral neuropathy patient .Methods The endings of the medial branch of deep peripheral nerves(DPN) were interrogated by high frequency ultrasound and nerve electrophysiology ,and the nerve conduction characters were studied in a cohort of 150 clini-cally diagnosed diabetic peripheral neuropathy patients and a control group of 100 healthy volunteers .At the sametime these cases underwent electrophysiological examination .Results Distinct echoic appearances were consistently detected between the DPN nerves of diabetic peripheral neuropathy patients and healthy volunteers .The sensitivity rate of high frequency ultrasound and nerve electrophysiological examination in diagnosis of diabetic peripheral neuropathy were 91 .33% and 74 .67% ,and the specificity rate were 91% and 82% .Conclusion High frequency ultrasound may play a role in the diagnosis of diabetic peripheral neuropathy .

Objective To explore the impacts of different nutrition support methods on short-term outcome in critically ill adult patients. Methods We retrospectively reviewed the clinical data of 1503 critically ill adult patients who needed nutrition support in an mixed intensive care unit (ICU) of a tertiary care university hospital from January 1994 to December 2009. The complication of nutrition support, length of stay (LOS) in ICU, morbidity of infection and multiple organ dysfunction syndrome (MODS), and mortality among different nutrition support methods were compared. Results The Nutritional Risk Screening (NRS) scores of the enrolled patients were no less than 3. LOS in early enteral nutrition (EN) patients were significantly shorter than those in not-early EN patients (P ＜ 0. 001) and parenteral nutrition (PN) patients (both P ＜ 0. 001). Infection rate (P ＜ 0. 001),morbidity of MODS (P ＜ 0. 001) and mortality (P ＜ 0. 001) were significantly lower than those in not-early EN and PN patients. LOS of patients receiving PN rich in glutamine (Gln) was significantly shorter than that in conventional formula (P = 0. 0000). Morbidity of infection (P= 0. 0252) and MODS (P = 0. 0030), mortality (P =0. 0305) were significantly lower than that of conventional patients. LOS of patients receiving intensive insulin therapy (IIT) was significantly shorter than that of controlled group (P = 0. 0000). Morbidity of infection (P =0. 0001) and MODS (P = 0. 0237) and mortality (P =0. 0427) were significandy lower than those of controlled group. Conclusions Nutritional risk is prevalent among critically ill adult patients. Early EN, PN of rich in Gln,and receiving IIT can shorten LOS, decrease morbidity of infection and MODS, and improve prognosis among these patients.

ObjectiveTo study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.ResultsIn experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.

Objective To prepare lipid-coated ultrasound microbubbles containing 10-HCPT(HLM) and explore the antitumor effects on mice xenografed H22 solid tumor using the technique of ultrasound-mediated HLM destruction. Methods Sixty-four tumor-bearing mice were radomly divided into A and B groups. Each group was divided into four groups again and administered respectively by tail vein with HI.M, non-drug-loaded microbubbles,10-HCPT and saline once a day. Ultrasound irradiation was applied on the tumor sites immediately after injection. After 7 days of consecutive treatment, all mice in group A were sacrificed and the tumors were harvested to measure weights. The tumor inhibition rate was calculated by weights. The tumor microvessel density (MVD) was detected by immunohistochemical staining. The tumor growth curve was depicted according to volumes. The survival time of mice in group B was recorded. Results The tumor inhibition rate was the highest in HLM group while this group's MVD was the lowest. Survival time in HLM group and 10-HCPT group were obviously longer compared with the control group,while no statistic difference was observed between the two groups. There was no statistic difference between the group of non-drug-loaded microbubbles and the control group. Conclusions Ultrasound irradiation mediates HLM destruction so that the drug is released from the vihicles at the same time, which can significantly enhance the tumor inhibition effect of 10-HCPT on the H22 tumor. This technique is expected to be adopted as a novel tool for liver cancer chemotherapy.