Objective To evaluate the value of dynamic grey-scale enhanced ultrasonography in the differential diagnosis of hepatic tumors.Methods Twenty-four patients with 25 hepatic solid lesions were examined by dynamic enhanced ultrasonography with a bolus injection of Levovist (400 mg/ml). Results All lesions were confirmed by operation and pathology, including 16 hepatocellular carcinomas (HCC), 3 hepatic hemangiomas (HCH), 1 inflammatory pseudotumor of liver (IPL), 2 focal nodular hyperplasias (FNH) and 3 angiomyolipomas (AML). Twenty-five lesions were variously enhanced on grey-scale ultrasonogram after injection of Levovist except for IPL. The lesions with HCCs were enhanced early in the arterial phase and disappeared quickly in portal phase. The lesions with HCHs were enhanced slowly in the peripheral region of the lesion. The FNH and AML were also enhanced early in arterial phase, but disappeared slowly in delay phase. If the hepatic lesions showed the earlier enhancement in arterial phase and fast disappearance in portal phase on contrast enhanced ultrasonogram were regarded as a criterion of malignant tumor, the sensitivity, specificity and accuracy with contrast enhanced ultrasonography in the diagnosis of hepatic malignant tumor were 94%(15/16),89%(8/9)and 92%(23/25), respectively. Conclusions The dynamic grey-scale enhanced ultrasonography is a useful technique in the differential diagnosis of hepatic tumors.

Objective:To provide support of medical equipment under the event of an emergency. Methods: Research and analysis Reasons and influencing factors, key problems and the characteristics of state of daily reserves of medical equipment and medical equipment emergency procurement. Results: Established a guarantee mechanism for medical equipment under the event of an emergency. Conclusion:The mechanism effectively improves the hospital medical equipment management level, and plays a huge role in dealing with all kinds of sudden events and emergency tasks.

Objective To probe into the clinical value of left atrial(LA) volme tracking method (LAVT) on the assessment of left atrial function in patients with hypertension. Methods Thirty-one patients with hypertension and 31 control subjects were involved. Images of apical two-chamber and four-chamber views were obtained by two-dimensional echocardiography. LA maximal volume (LAVmax), LA minimal volume (LAVmin), LA presystolic volume (LAVpre), systolic LA filling rate (dv/dtS), early diastolic LA emptying rate (dv/dtE) and late diastolic LA emptying rate (dv/dtA) were derived using LAVT. LA passive emptying volume(LAVp), LA passive emptying fraction(LAVpEF), LA active emptying volume(LAVa), LA active emptying fraction (LAVaEF), LA total emptying volume (LAVt), LA total emptying fraction(LAVtEF) were calculated. All volume measurements were corrected to body surface area (LAVI). Results There were significant differences in the LAVImax, LAVImin, LAVIpre, LAVpEF, LAVIa, LAVIt,dv/dtS, dv/dtA between hypertensive patients and control subjects(P <0.05~0.001), but no significant differences were found in the LAVp, LAVaEF, LAVtEF,dv/dtE between the two groups. The LAVImax has shown significant positive correlation with LAVIp, LAVIa and LAVIt(r = 0.588~0.812, P <0.001). LAVaEF has shown positive correlation with the LAVtEF(r = 0.833, P<0.001), whereas LAVpEF has not(r = 0.420, P <0.01). There was a significant positive correlation with LAVImax and LAVIpre(r = 0.908, P <0.001), LAVIpre and LAVIa(r = 0.689, P <0.001) ,dv/dtE and LAVIp(r = 0.690, P <0.001),dv/dtA and LAVIa(r = 0.600, P <0.001). Conclusions In hypertensive patients,left atrial reservoir function and booster pump function increase, while left atrial conduit function decreases. LAVT has a potential ability to evaluate left atrial function.

Objective To compare enhancement features of hepatic tumors on SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT.Methods SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT were performed on 49 patients with 54 focal liver lesions,including 29 primary liver carcinomas,4 metastatic liver tumors,11 hepatic carvernous hemangiomas,7 focal nodular hyperplasias,2 focal fatty sparing,1 cirrhotic.Results Contrast-enhanced ultrasonography and helical CT showed consistent results in demonstrating hemodynamics of hepatic tumors.In the differentiating of malignant tumors and benign tumors,the sensitivity,specificity and accuracy of contrast-enhanced ultrasonography were(90.9)%(30/33),(90.5)%(19/21) and(90.7)%((49/54)),respectively.Those of contrast-enhanced CT were(90.9)%(30/33),(95.2)%(20/21) and(92.6)%((50/54)),respectively.Conclusions Both of the two imaging methods are valuable for differential diagnosis of liver tumors.

The aim of the study is to evaluate the feasibility and safety of Bispectral index (BIS) monitoring in pediatric radio frequency catheter ablation. One hundred and six children aged 0. 6-12 years, scheduled for radio frequency catheter ablation, were randomly divided into two groups. In group A patients received BIS monitoring during the operation (n = 50), and the group B received modified Observer's Assessment of Alertness/Sedation (OAA/S) scaling (n = 56). The anesthesia was maintained with propofol target-controlled infusion. The intraoperative propefol target concentration was adjusted to maintain the BIS values between 55-65 in group A and OAA/S scale about 1 in group B respectively, The heart rate (HR), mean arterial pressure (MAP) and pulse oximetric saturation (SpO2) were measured before anesthetic induction, 1 min after induction, catheter puncturing and the end of operation respectively. The requirements of propofol, the times of supporting ventilation and recovery, the respiratory depression, nausea and vomiting postoperatively were also recorded. The intraoperative HR, MAP and SpO2 showed no differences between two groups, but the requirements of pmpofol, the times of supporting ventilation and recovery were less in group A than that of group B (P<0.05). All children didn't have nausea, vomiting and respiratory depression. The results suggest that in pediatric radio frequency catheter ablation, BIS monitoring has the advantages of timely adjustment of anesthetic depth, reducing anesthetic requirements, shortening the time of recovery, so as the perioperative safety can be improved.

Objective To study the transfeetion efficiency and safety of liposome microbubble(LM)on red fluorescent protein(RFP)in vitro and in vivo under ultrasound mediated gene transfection(USMGT)conditions.Methods Plasmids containing RFP were added to cultured Hela cells followed by ultrasound (US)exposure with LM.Different concentration of LM,US intensity and exposure time were optimized.Transfection efficiency was evaluated by fluorescent microscopy and FACS.Cell viability was verified by propidium iodide assay.In transplanted tumors in vivo study,LM and plasmid(P)were injected into the nude mice followed by US exposure(P+LM+US group).Nude mice undergoing plasmid injection alone(P group),plasmid injection and US exposure(P+US group)and plasmid and LM injection(P+LM group)were used as controls.Frozen section and histological examination were conducted and RFP expression was evaluated.Results LM and US exposure significantly increased transfeetion efficiency in cultured Hela cells (P＜ 0.01).Transfection efficiency was the most prominent under the condition of US intensity of 1.0 W/cm2 with 6%LM,duration 3 min.No apparent cell damage was found in the all groups.In transplanted tumors,strong RFP was seen in P+LM+US group.It was significantly higher than in any other groups(P＜0.0 1).No tissue damage was seen histologically.Conclusions LM could enhance USMGT effectively without causing any apparently adverse effect in vitro and in vivo.This method would be a novel,effective,safe non-viral gene transfection method and provide an alternative to current clinical gene therapy.

Objective To investigate the effect and safety of self-made blenderized diet used for nutritional support treatment in the ICU critically ill patients with diabetes. Methods 74 ICU critically ill patients with diabetes were randomly divided into two groups:study group and control group. The self-made blenderized diet were given to the patients in study group and enteral nutrition to the patients in control group for nutritional support treatment for four weeks. Then glucose metabolism, various nutrition indicators and gastrointestinal dysfunction were observed in these two groups. Results The fasting blood glucose and fructosamine levels were decreased significantly,while the nutritional indicators was significantly higher after treatment than at baseline in all patients. There was no significant difference in the levels of fasting blood glucose, postprandial glucose, fructosamine and nutritional indicators between two groups after treatment,so were the incidence of the hypoglycemia and gastrointestinal complications. Conclusion The self-made blenderized diet was a good enteral nutrition support therapy for ICU critically ill patients with diabetes which had a considerable effect, but more cheaper,and practical compared to the enteral nutrition emulsions.

Factor V ; Factor V Deficiency ; Female ; Humans ; Infant, Newborn

This study was aimed to observe the promotion effect of wound healing retention enema for postoperative anal fistula by modifiedWu-Wei Xiao-Du(WWXD) decoction, in order to explore its mechanism. A total of 60 patients who met the inclusion criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Patients in both groups were diagnosed as simple low anal fistula and treated with low anal fistula incision. The retention enema of 30 mL modified WWXD decoction or complexHuang-Bai fluid were given once a day for postoperative dressing changes. Detailed observations and scores were made on wound exudate, color, and itching around the anus. The comparisons were made on carrion off time, new epithelium time, rate of wound-reducing, wound healing time, and the total clinical efficacy 21 days after operation. The results showed that the wound exudate on the 7th and 14th postoperative day was better than that of the control group. There was no significant difference on the 21st day between two groups. The wound color of the treatment group was better than that of the control group on the 7th and 14th postoperative day. The itching around anus of the treatment group was better than that of the control group on the 7th, 14th and 21st postoperative day. The carrion wound off time and new epithelium time of the treatment group were earlier than that of the control group. There was no significant difference on the rate of wound-reducing. There were no significant differences on the total clinical efficacy 21 days after operation as well as the total average healing time of both groups. It was concluded that modified WWXD decoction can shorten the inflammation phase, reduce the wound exudate and itching, promote early carrion fall and as well as the wound healing.

BACKGROUND:There is no clear conclusion on whether the lung cancer stem cels can induce to spheroid formation and have tumorigenicity. OBJECTIVE: To observe the spheroid formation induced by human lung adenocarcinoma cel line SPC-A1 and the tumorigenic ability of lung cancer stem cels. METHODS:SPC-A1 at proliferating phase was cultured in serum-free DF12 culture medium, and then recombinant human insulin-like growth factor-1, recombinant human epidermal growth factor, and recombinant human fibroblast growth factor-10 were added to induce spheroid cels. Immune fluorescence detection and PCR amplification were done to understand the expression of stem cel associated markers. NOD-SCID immunodeficient mice were subcutaneously implanted with lung spheroid cels to observe the tumor growth.In vivo fluorescence imager was used for radiography. RESULTS AND CONCLUSION:After 5-10 days, lung spheroid cels were harvested. RT-PCR results showed that lung spheroid cels were positive for CD24, CD221, CCSP and SP-C. In addition, the lung spheroid cels and purified CD24+, CD221+ lung cancer stem cels were both positive for TTF-1 of lung stem cels, OCT4 and Nanog of embryonic stem cels and TTF-1 of Bmi-1 lung stem cels. The fluorescence detection showed that over 80% lung spheroid cels expressed CCSP and OCT4; SPC-A1 cels had the characteristics of alveolar type II cels, and also expressed SP-C protein, but only about 5% of the cels expressed CCSP and OCT4. At 50 days after subcutaneous implantation of lung spheroid cels, in vivo fluorescence imaging showed that the diameter of tumor in mice was 1 cm, indicating human lung adenocarcinoma cel line SPC-A1 can induce the spheroid formation, and lung cancer stem cels rich in the cel spheres have the tumorigenic ability.