Objective To develop a method for simultaneous determination of 4 compounds in Zhizhu Pills by HPLC.Method Reversed-phase HPLC was used to determine the content of the compounds such as hesperidin,naringin,neohesperidin and atractylenolideⅠ.The column was symmetry C18(250 mm?4.6 mm,5 ?m) with temperature of 30 ℃.Methanol-0.095 %phosphoric acid solution served as the mobile phase by gradient elution.The wavelength of detection was set at 283 nm and 224 nm.The injection volume was 10 ?L and the flow rate was 1.0 mL/min.Results Hesperidin,naringin,neohesperidin and atractylenolideⅠin Zhizhu Pills can be isolated completely.Three batches of samples were determined and the recoveries of naringin,hesperidin,neohesperidin and atractylenolideⅠwere 98.81 %(RSD=1.11 %,n=6),100.63 %(RSD=1.90 %,n=6),99.32 %(RSD=1.44 %,n=6) and 99.65 %(RSD=1.53 %,n=6) respectively.Conclusion This method is accurate,reliable and with good reproducibility.It can be used for the quality control of Zhizhu Pills.

Objective To investigate the clinical value of multiple-slice spiral CT (MSCT) in identifying apical hypertrophic cardiomyopathy (AHCM) with giant negative T wave.Methods Sixteen patients with AHCM and giant negative T wave (AHCM group) underwent MSCT,electrocardiogram,echocardiography,coronary angiography and left ventriculography.Thirty patients without myocardial hypertrophy were enrolled as control group.Measurement results of two groups were compared.Results MSCT confirmed all patients with AHCM,but echocardiography missed 10 patients.In the end of diastole phase,left ventricular apical thickness (LVA) was (21.3 ± 3.6) mm and LVA/left ventricular posterior wall thickness (LVPW) was 2.2 ± 0.4 in AHCM group,which was (8.5 ± 1.6) mm and 0.9 ± 0.2 in control group.The level of LVA and LVA/LVPW in AHCM group were significantly higher than those in control group (P ＜0.01).Conclusion MSCT is a accurately diagnostic modality for AHCM with giant negative T wave,and the cardiac anatomy,function and coronary artery are also assessed simultaneously.

Objective To propose a MR scoring methods for spatium perilymphaticum gadolinium opacification and explore the value of their diagnosis of Meniere' s disease. Methods Fifty-one asymptomatic and 65 symptomatic patients with Meniere's disease were enrolled in this study.MR imaging ofspatium perilymphaticum after intratypanic gadolinium injection were analyzed with following scoring method.　( 1 ) Semicircular canal not visualized equal to score 0 ; some visualized equal score 1 ; full visualized equal　score 2.(2)There were high-signal and low-signal in the vestibule,low-signal areas above the lateral　semicircular canal plane equal score 6 ; low signal areas down to lateral semicircular canal plane equal score　3 ; no higher signal in the vestibule area equal score 0.( 3 ) Basal turn of cochlea:full visualized equal score　3; part visualized equal score 2; scala vestibule of basal turn smaller than scala tympani equal score　1 regardless of full or visualized in basal turn; no visualized equal score 0. Medial turn of cochlea:full　visualized equal score 2 ; part visualized equal score 1 ; no visualized equal score 0.Apical turn of cochlea:　visualized equal score 1 ; no visualized equal score 0. One radiologist scored all cases with double blind.　SPSS 17.0 software was used to conduct multiple independent-samples nonparametric tests,multivariate　Logistic regression, and ROC curve analysis. Evaluate the sensitivity and specificity for diagnosis of　Meniere's disease with the scoring system. Results ( 1 ) Meniere's disease summation score 0 to 12,median 9 (quarter spacing 4.5 ) ; no symptoms group summation score 15 to 18,median 17 (quarter spacing 3),two group differences has statistics significance (Wilcoxon rank and inspection U =-9.118,P =0.00).(2)Based on summation score for the diagnosis of Meniere's disease,tangent point was 14.5,Youden index 0.969,specificity 100.0％,sensitivity 96.9％.( 3 ) Let cochlear,vestibular,semicircular canal scoring for association variable,Logistic regression model:LogitP =61.216 - 7.381 × vestibular -3.056 × canal,based on the P value of ROC curves,diagnostic cut-off point 0.651 (vestibular ≤ 3 or semicircular canals ≤ 4 points ),Youden index 96.9％,specifisity 100.0％, sensitivity 96.9％.Conclusions Perilymphatic space of gadolinium contrast MR score in distinguishing Meniere's disease have practical value,any case meet one of following point could be diagnostic:( 1 ) Perilymphatic space of gadolinium contrast MRI total less than 14.5 ; (2) Vestibular low signal areas down more than lateral semicircular canal plane,namely vestibular score value ≤3;( 3 )Semicircular Canal scoring value ≤4.

Objective To develop a flow cytometrie assay to for diagnosis of X-Linked Hyper.1gM Syndrome(XHIM).Methods Heparinized peripheral blood obtained from patient,mother and a healthy control was diluted with RPMI- 1640(unstimulated control)or with RPMI-1640 containing 15μl PMA(1 rig/μl)and 6 trl ionomycin(50 ng/μl)(stimulated cell).Using directly labeled antibodies,we have examined CD40 ligand levels on CD3+ CD8- lymphocyte surface,and CD69 levels on CD;lymphocyte Surface to determine whether the cells were activated.Results CD69 levels on CD3+ lymphocyte surface from stimulated group and from unstimulated group were above 96% and below 3%,respectively.CD40L levels Oil CD3 CDs-T lymphocyte surface from stimulated group were 0.8% (patient),60.04%(mother) and 62.87%(healthy contr01).CD40L levels on CD3+ CD8-T lymphocyte surface from unstimulated group were 0.88% (patient),4.15%(mother)and 5.51%(healthy contr01).Conclusion This flow cytometric assayis accurate and convenient,which Can be used in neonatal screening.

Stroke is a hi-attack rate,hi-multilation rate and hi-death rate disease.More than 70 percent patients with stroke remain functional disturbance,which destroy their quality of life and bring them heavy burden.The early multidisciplinary rehabilitation treatment,rehabilitation care,family rehabilitation training and application of new technology are the major strategies in kinds of rehabilitation treatment on stroke patients.The clinical researches have showed that the effect of multidisciplinary rehabilitation treatment is obviously better than simple treatment.So these therapeutic regimens have wonderful prospect and valuable generalization.

Objective To explore the contrast perilymphatic MRI characteristics of inner ears with sudden hearing loss with vertigo.Methods Forty three patients with sudden hearing loss with vertigo and 35 patients with unilateral tinnitus diagnosed by the department of Otolaryngology-Head and Neck Surgery were retrospectively included.Forty eight ears (38 ears with unilateral sudden hearing loss and 10 ears in 5 cases with bilateral sudden hearing loss) were regarded as sudden hearing loss group,35 asymptomatic ears (the opposite ears of the unilateral tinnitus ears) as control group.Thirty eight opposite ears of the 38 unilateral sudden hearing loss ears and 35 ears of the control group showed normal in the pure tone audiometry exam.One hundred and twenty one ears (48 hearing loss ears,38 opposite ears of the 38 unilateral sudden hearing loss ears and the 35 control group's ears) underwent contrast perilymphatic MR exams,0.4 to 0.5 ml gadolinium hydrate diluted with saline was injected through the tympanic membrane,twenty four hours later,three-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence was performed using a 3.0 T MRI scanner.After the contrast perilymphatic MR exam,success in the exam was judged through the raw image.The signal intensity ratio (SIR) of cochlea basal turn and homolateral brain stem was quantitatively calculated.The SIR difference of 48 ears with sudden hearing loss and 35 asymptomatic ears in control group was analyzed by t test.The SIR difference of the 38 unilateral sudden hearing loss ears and the contralateral asymptomatic ears was also analyzed.The presence of endolymphatic hydrops was judged.Results The contrast perilymphatic MRI of 121 inner ears with intratympanic gadolinium injection were all successful.Endolymphatic hydrops were observed in 12 sudden hearing loss ears with the occurrence rate of 25％(12/48).The SIR of basal turn and homolateral brain stem of the sudden hearing loss ears (2.062±0.907) were lower than the SIR of the control groups' asymptomatic ears (2.703± 0.640) with significant difference between them (t=3.619,P=0.001),the SIR of basal turn and homolateral brain stem of the unilateral sudden hearing loss ears (1.941 ±0.860) were also lower than the SIR of the contralateral asymptomatic ears (2.411±0.670) with statistical difference between them (t =3.270,P=0.002).Conclusions Endolymphatic hydrops were observed in sudden hearing loss with vertigo.The SIR of the cochlea in sudden hearing loss ears were lower than that of the asymptomatic ears,indicating the abnormal permeability of the round window membrane.

Objective To establish a canine model with acute thrombo-embolic pulmonary hypertension monitored by echocardiography. Methods Simulated the pathophysiologic process of acute thrombo-embolic pulmonary hypertension in human, the canine model was developed. The femoral vein puncture and the right heart catheterization to monitor pulmonary artery pressure were operated guided by echocardiography, while the autologous blood clot was injected to the contralateral femoral vein. The criteria of model was the pulmonary artery systolic pressure was higher than 30 mmHg. Results Echocardiography can accurately guide the placement of right heart catheterization and ancillarily observe the pressure testing of pulmonary artery. Of twenty seven healthy experiment dogs, twenty four models with acute thromboembolic pulmonary hypertension were successfully developed. The successful rate was 88.9 %. Conclusions This canine model with acute thrombo-embolic pulmonary hypertension guided by echocardiography is easy to operate and its repeatability is good.

Objective To explore the agreement of anterior chamber angle examination by slit lamp optical coherence tomography (SL-OCT) and gonioscope.Design Case series.Participants Thirteen patients with primary glaucoma (26 eyes) and 8 normal persons(16 eyes).Methods Anterior chamber angle was measured with SL-OCT and gonioscope in turns for temporal,nasal,superior and inferior quadrant.Results of two methods were analyzed and the data were analyzed with Pearson correlation coefficient and Kappa value.Main Outcome Measures Anterior chamber angle.Results The Pearson correlation coefficient of the two methods was 0.86(P=0.00)and the Kappa value is 0.75 (P=0.00).The specificity and sensitivity of detecting occludable angle were 94.7% and 89.4%.Conclusions Anterior chamber angle examination with SL-OCT and gonioscope are well consistent.The specificity and sensitivity for SL-OCT in detecting occludable angle is satisfying.SL-OCT can be regard as an objective assistant method for the diagnosis of angle closure glaucoma.

Objective To evaluate the hemodynamic changes in patients with middle cerebral artery (MCA) stenosis pre- and post-stenting by transcranial color-coded and pulsed-Doppler sonography.Methods Thirty patients with middle cerebral artery stenosis were included.Two-dimensional,color-coded and pulsed-Doppler sonography were used to monitor the morphologic and hemodynamic changes of the MCA before,in the middle of,and after the endovascular stenting operation.All patients were verified by digital substract angiography.Results The hyper-echoic stent grafts and also the size and location of the stent were clearly shown by two-dimensional ultrasonography in 28 patients.The systolic,diastolic and the timeaveraged maximal flow velocities significantly decreased both instantly and 3 - 7 d after the stenting.Specifically,the systolic peak flow velocity of the MCA dramatically decreased immediately after the stenting [(151.43 ± 25.14) cm/s vs (286.13 ± 57.38)cm/s,P ＜0.05],and showed a further decrease after 3 - 7 d [(108.80 ± 9.95) cm/s vs (151.43 ± 25.14) cm/s,P ＜0.05].Conclusions Transcranial color-coded and pulsed-Doppler sonography could be used to evaluate the hemodynamic changes after MCA stenting,and could be considered as the first choice of method for evaluating the therapeutic outcome of stenting.

Objective To investigate the clinical value of circumferential strain and strain rate in estimating the carotid elasticity. Methods Thirty-five consecutive patients of hypertension were enrolled in this study as the patient group and 36 healthy volunteers whose ages were matched with the patient group were included as controls. The intima-media thickness(IMT) of common carotid arteries of both the patients and controls were measured using RF-Data technique of ultrasound vascular measurement and the following traditional parameters reflecting common carotid elasticity were obtained: pulse wave velocity (PWV),arterial compliance (AC). While the new parameters reflecting vascular strain including endovascular longitudinal strain(EN-LS), endovascular circumferential strain(EN-CS), endovascular longitudinal strain rate(EN-LSR) ,endovascular circumferential strain rate(EN-CSR), adventitial longitudinal strain(EP-LS),adventitial circumferential strain ( EP-CS ), adventitial longitudinal strain rate ( EP-LSR ), adventitial circumferential strain rate(EP-CSR) were collected using the technique of X-strain. All the corresponding parameters were compared between hypertensive group and controls. The correlations between elasticity and hemodynamic parameters were analyzed. Results In the hypertension patients,PWV was higher while AC,EN-CS,EN-CSR,EP-CS and EP-CSR were lower than that of the control group( P ＜0.05). No significant differences were detected in the longitudinal strain and strain rate. In the hypertension group,AC correlated positively with PWV, while EN-CS, EN-CSR, EP-CS and EP-CSR correlated negatively with PWV and positively with AC. Conclusions Circumferential strain and strain rate conform well to the mechanical principle and the characteristic anatomic and histological structure of the vessels and may be used to reflect the early changes of the vascular elasticity.