The contrast-enhanced ultrasound(CEUS) been equipped in most commercial ultrasound system, is a newer technology which could evaluate the blood flow of soft tissue. It could not only make qualitative and semi-quantitative analysis, but also the quantitative analysis could be acquired. At present, it has been applied on cardiovascular imaging and tumor perfusion assessment in clinical. The clinical usage of CEUS in rheumatoid arthritis(RA) was summarized in the paper which included its common clinical type, dose of ultrasound contrast agent and various method of usage described. Besides, the paper not only introduced the evaluation of the synovitis in RA with the parameters resulted from CEUS, but also illuminated the progress of the researches. Through compared these parameters, indexes and methods, this summary revealed the limitation and application value of CEUS to RA, and more exploration need be done in future.

Objective To evaluate the feeding effect of semi-demand feeding and abdominal massage on the feeding process, feeding performances and clinical safety (including the time of returning to birth weight, feeding tolerance, apnea). Methods A total of 120 preterm infants that met inclusion criteria of the study were randomly assigned to three groups, and each group had 40 cases. Control group:received standard feeding care. Semi-demand feeding group: received 5-10 minutes of oral motor intervention every time before feeding(including oral stimulation and non nutritional sucking), then decided feeding methods according to its consciousness behavior state. Semi-demand feeding combined abdominal massage group: received both semi-demand feeding and abdominal massage before feeding. Observed and recorded the three groups′ transition time, whether there were statistically significant differences in feeding performance and clinical safety. Results The feeding transition time was (11.55± 4.69), (10.98±3.85), (8.50±3.87)d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=6.088, P=0.003). In terms of feeding performance, the feeding efficiency were (7.27 ± 2.65), (9.74 ± 2.63), (9.52 ± 2.13) ml/min, the feeding proficiency were (66.31 ± 14.51)%, (76.64 ± 12.46)%, (82.26 ± 10.65)%, the volume transfer were (63.99 ± 11.02)%, (80.16 ± 14.41)%, (84.97 ± 11.16)% in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=12.189, 16.383, 31.959, all P < 0.01).Among the clinical safety, the time of restoration of birth weight were (10.55 ± 1.99), (9.28 ± 1.77), (10.05 ± 2.46) d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences(F=3.759, P=0.026). The incidence of feeding intolerance were 50.0%(20/40), 40.0%(16/40), 22.5%(9/40), and there were significant differences(χ2=6.613, P=0.037). The incidence of apnea were 37.5%(15/40), 20.0%(8/40), 15.0%(6/40), and there were significant differences(χ2=6.093, P=0.048). Conclusions The combined intervention methods could accelerate the feeding process, improve feeding performance as well as reduce the incidence of feeding intolerance and apnea. Hence, semi-demand feeding combined abdominal massage is a recommended choice for clinical use.

The characterization and management of oral and maxillofacial spaces infections in diabetic patients were studied in order to determine the pattern of this clinical condition and formulate a management plan.There were 31 cases with average age of 61 years(s=9);the mean hospitalization time was 14 days(s=6);the average fasting blood glucose level on admission was 10.4 mmol/L.Of the 31 patients 20 were multiple-space infections and 11 were single-space infections.13 patients had major complications during admission.Odontogenic infection was the most common cause of the space infections.Streptococcus viridians and staphylococcus aureus were common organisms(5/19,4/19)identified through pus and/or blood cultures.Early surgical incision and drainage,perfect blood glucose control,intravenous antimicrobial therapy,preventing asphyxia and managing major complications are necessary and effective approaches for the management plan.

Different human thyroid carcinoma cell lines were treated with all-trans retinoic acid(RA). RA could inhibit cell growth,improve iodide uptake and increase some thyroid specific genes and retinoid acid receptor(RAR)mRNA expressions in FTC-133 cells.However,RA had no effect in C643,HTH74 and XTC. UC1 cells.These findings indicate that different thyroid carcinoma cells display diverse responses to RA.

Objective: To investigate the association between frailty and type 2 diabetes mellitus (T2DM) using a bidirectional two-sample Mendelian randomization (MR) analysis, so as to provide the evidence for the prevention and control of frailty and T2DM. Methods: Frailty status was assessed using the Fried Frailty Score (FFS), with aggregated data sourced from 386 565 European samples in the UK Biobank. The T2DM data were obtained from the summary results of genome-wide analysis published by the Diabetes Genetics Replication and Meta-analysis Consortium, excluding the UK Biobank data, including 455 313 European samples. Eligible single nucleotide polymorphism site were selected from the FFS and T2DM summary data as instrumental variables. The bidirectional MR analysis was performed using the inverse-variance weighted method. The heterogeneity was assessed using the modified Cochran Q test. The horizontal pleiotropy of instrumental variables was examined using MR-Egger regression. The robustness of the results was evaluated using the leave-one-out method. The bias was tested using funnel plot. Results: The forward MR analysis revealed a statistically significant association between increased FFS and an increased risk of T2DM (OR=2.280, 95%CI: 1.169-4.447). The reverse MR analysis showed a statistically significant association between T2DM and increased FFS (β=0.026, 95%CI: 0.012-0.041). Both bidirectional MR results were robust, with no horizontal pleiotropy of the instrumental variables was found (all P>0.5); and the funnel plots did not show significant basis. Conclusion The study found a bidirectional causal association between frailty and T2DM.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .

Objective:To investigate the normal sonographic anatomic characteristics of the pectoralis major and the clinical value of ultrasound in diagnosing the extent and location of the pectoralis major tears.Methods:High frequency transducer was used in scanning the pectoralis major.The ultrasono-graphic images of 40 normal pectoralis major were obtained from 20 healthy volunteers with both sides. Longitudinal and transversal views were performed and stored.The distal tendon was identified in the transverse plane coursing superficially to the long head of the biceps brachii tendon inferior to the level of the subscapularis tendon.Eighteen cases of pectoralis major tears were analyzed retrospectively,with MRI,surgical and ultrasound follow-up results correlation respectively.Results:High-frequency ultra-sound could clearly show the anatomic orientation of the normal pectoralis major.The fibers converge was like a fan into three laminae that twisted upon each other at 90°before coalescing into a single tendon of insertion.In the study,1 8 patients of pectoralis major muscle tears [average age:(37.2 ±1 5.6)years] sustained injuries during weightlifting,basketball and impact.Three of the eighteen patients had MRI re-sults;nine had surgical correlation;six were followed by ultrasound.Eleven were injured on the left side,and 7 on the right side.Seven were involved in the distal tendon (1 in sternal head,2 in clavicular head,4 in both sternal and clavicular head),five were involved the musculotendinous junction,6 were involved muscle belly.Twelve cases were partial-thickness petoralis major tears(4 in the distal tendon, four in the muscle tendon junction,4 in the muscle belly),with the partial fiber intact,echogenicity de-creased and the internal structure disordered;6 cases (3 in the distal tendon,1 in the muscle tendon junction,2 in pectoralis major muscle belly)were completely disrupted,with fiber fracture and retrac-tion,accompanied with or without hematoma formation.Conclusion:High-frequency ultrasound can clearly show the anatomic structure of the pectoralis major.Ultrasonography can diagnose the pectoralis major tears with the extent and location of injuries,and can be used to help the clinical treatment.

Objective To assess the efficacy and safety of various spectrum lasers in the treatment of acne vulgaris. Methods Based on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Library (2009, 6 issues), PubMcd, Embase, China Biomedical Literature Database, China Journal Full Text Database, Chinese Scientific Journals Full Text Database. Retrieval time was up to June, 2009. Randomized controlled trials (RCTs) of lasers for acne vulgaris were included. Results Twelve RCTs totaling 367 patients were included. Because the lack of clinical homogeneity, only descriptive analysis was conducted. Acne lesion counts improved significantly with laser therapy. Adverse effects were limited to transient erythema and edema at treatment sites. Treatment-related pains were well tolerated. Conclusions Current evidence demonstrates that all type lasers in treating acne vulgaris is safe and efficacy. However, higher quality RCT research would be needed to verify the effects and status of lasers on acne vulgaris.

The metabonomics method was used to study the intervention effect of Psoraleae Fructus and Myristicae Semen in "Ershen pill" on the changes in serum endogenous metabolites in spleen-kidney Yang deficiency diarrhea rats before and after processing, screen out differentiated metabolites related to spleen-kidney Yang deficiency diarrhea and explore the metabolic patterns related to spleen-kidney Yang deficiency diarrhea and the processing synergy mechanism of Psoraleae Fructus and Myristicae Semen in "Ershen pill". Efforts were made to detect SOD and MDA of each group, test rat serum metabolic fingerprints in different stages by using GC-MS, analyze by PCA and PLS-DA methods and screen out potential biomarks through VIP and t test. The results revealed that "Ershen pill" could enhance the level of SOD and decrease the level of MDA and identified 10 differentiated metabolites related to spleen-kidney Yang deficiency diarrhea. Compared with the model group, all of metabolites recovered to varying levels after being intervened with "Ershen pill", with the best effect shown in the "Ershen pill" IV group (salt-processed Psoraleae Fructus + bran-roasted Myristicae Semen). It is speculated that that Psoraleae Fructus and Semen Myristicae in "Ershen pill" show a synergistic effect by inhibiting peroxide, improving aglucolipid, amino acids and energy metabolism, with multiple target sites.
Animals ; Chemistry, Pharmaceutical ; Diarrhea ; drug therapy ; metabolism ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Energy Metabolism ; drug effects ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Metabolomics ; Myristicaceae ; chemistry ; Psoralea ; chemistry ; Rats ; Rats, Sprague-Dawley ; Spleen ; drug effects ; metabolism ; Yang Deficiency ; drug therapy ; metabolism

AIMTo identify the main metabolites of hydrochloride 4-methyl-piperazine-1-carbodithioc acid 3-cyano-3,3-diphenyl-propyl ester (TM208) in rats.

METHODSRat feces, urine and plasma samples were collected after ig 500 mg x kg(-1) TM208, then the samples were extracted and concentrated using ethyl acetate. The treated samples were analyzed by HPLC-ESI/ITMSn. The structures of metabolites were elucidated according to the rules of drug metabolism and disposition in vivo and the characteristic fragmentation behaviors of TM208 in ESI-ITMSn.

RESULTSEight phase I metabolites were identified existing in rat feces, five of them were also found in rat urine and plasma, but no phase II metabolite was found.

CONCLUSIONThe HPLC-ESI/ITMSn method is rapid, highly sensitive and specific and it is suitable for the identification of TM208 and its metabolites in rats.

Animals ; Antineoplastic Agents ; blood ; metabolism ; urine ; Chromatography, High Pressure Liquid ; methods ; Feces ; chemistry ; Male ; Molecular Structure ; Piperazines ; blood ; metabolism ; urine ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Spectrometry, Mass, Electrospray Ionization ; methods