Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in evaluation of the protective effect of edaravone injection in rabbit skeletal muscle ischemia-reperfusion injury.Methods Thirty healthy New Zealand white rabbits were established a model of skeletal muscle ischemia-reperfusion injury in left hind limb and randomly divided into the experimental group and control group.Edaravone was injected with the dose of 1.5 mg/kg at the time of 30 minutes before reperfusion in the experimental group,the control group were given an equal volume of physiological saline.Blood samples were collected respectively at the times of pre-ischemia,post-ischemia and 24 hours after reperfusion for detecting creatine kinase(CK),lactic dehydrogenase(LDH),and CEUS parameters such as peak intensity(PI),time to peak (TTP) and area under the curve(AUC) were measured at the same time.Pathological examination was carried out after the rabbits were sacrificed.Results ①Serological tests:compared to before the blocking of blood supply,the content of CK and LDH after the blocking were significantly increased (P ＜ 0.01);compared to before or after the blocking,the content of CK and LDH at the time of 24 hours after reperfusion in the two groups were increased,and was lower in the experimental group than the control group.(②CEUS:compared to before the blocking,PI,TTP and AUC in each group were significantly increased after the blocking and at the time of 24 hours after reperfusion(P ＜0.01);compared to those in the control group,PI and AUC in the experimental group were decreased at the time of 24 hours after reperfusion,but there was no significant difference in TTP(P ＞0.05).③Correlation analysis:there was a good correlation between PI,AUC and CK,LDH (r =0.87,0.81,0.86,and 0.80,respectively).④Pathological analysis:muscle fibers were swelling with no stripes,partial fractures and interstitial edema and a large amount of inflammatory cells were infiltrated in the control group,while muscle fibers were almost normal with a small amount of inflammatory cells infiltrated in the experimental group.Conclusions Edaravone injection before reperfusion can obviously improve rabbit skeletal muscle ischemia-reperfusion injury,and CEUS can be used to observe these changes directly and effectively.

Objective To summarize the cases of surgical treatment of patients with patent ductus arteriosus (PDA),atrial septal defect(ASD),or ventricular septal defect(VSD) after failure of congenital cardiac catheterization(CCC).Methods From January 2000 to December 2013 in our hospital 26 patients were retrospectively studied,follow-up results recorded for each patient by telephone and outpatient follow-up review.Results There were no deaths.The average age of the patients was (18.8 ± 17.9) (3.0-67.0) years old.The median time of the intervals between interventions and surgeries were 14 days(2 hours to 5 years),the median length of hospital stay were 10 days(7-21 days),median cardiopulmonary bypass time was 67minutes (0-206 minutes),the median blocking time 40 minutes (0-90 minutes),the median time of mechanical ventilation 8.5 hours (2.0-88.0 hours),median ICU stay one day (1-6 days).The average follow-up were (93.0 ± 49.3) months (7.0-182.4 months).Surgical results were satisfactory.Conclusion Interventional treatment of congenital heart disease (CHD) is safe after all,but should strictly the indications controlled,the operations completed by skilled doctors.If there are complex complications,surgical intervention should be concerned,and the results are satisfactory.Patients after CCC should be followed up regularly.

Objective To investigate global cerebral blood flow perfusion in fetuses with congenital heart disease (CHD)by three-dimensional power Doppler ultrasound (3D PD).Methods The vascular index (VI),flow index (FI)and vascular/flow index (VFI)in the global cerebral were prospectively compared in 1 12 fetuses with CHD and 1 12 normal fetuses using 3D PD.Correlations between the 3D PD indices and neurodevelopment scores were assessed.Results Compared with the controls,the VI,FI and VFI of the global brain were significantly increased in fetuses with hypoplastic left heart syndrome (HLHS) and left sided obstructive lesions (LSOLs)(P <0.001).The mean psychomotor development index (PDI) and mental development index (MDI)scores were significantly lower than normal (P < 0.001 ).FI was positively correlated with PDI (r =0.342,P =0.029)and MDI (r =0.339,P =0.030).Conclusions Global cerebral blood flow perfusion was significantly increased in most fetuses with CHD and had association with neurodevelopment scores.3D PD ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling.

Objective To investigate the consistency of the results detected by different types of blood cell analyzer in the blood center .Methods On the basis of the calibration in each analyzer ,with the analyzer obtaining the excellent result in participating the external laboratory quality assessment hosted by the Ministry of Health as the reference ,the fresh blood samples were adopted to analyze other analyzers .Results For the analyzers after conducting the comparison ,the consistency and accuracy of the detection results were ensured .Conclusion After calibration in different types of blood cell analyzer ,the differences exist in the detection re‐sults .Periodically conducting the comparison among different types of instrument has very practical significance .

phological changes in rat liver tissues. TLR4 and NF-κB expression in the liver tissues were measured by im-munohistochemistry . The results showed that compared with the normal group , the serum levels of transaminase ( ALT , AST ) and endotoxin of the model group were higher ( P < 0 . 01 ); and the degree of liver pathology injury was significantly increased; the TLR4 and NF-кB expression were increased (P < 0.01). Compared with the model group, the serum levels of transaminase (ALT, AST) and endotoxin of the experimental group were lower (P < 0.01), the degree of liver pathology injury was significantly lighter; the TLR4 and NF-кB expression were significantly lower (P < 0.01). It was concluded that the WYJDHY granules has a good role in the prevention and treatment of liver injury of rat model of hepatic failure IETM through the downregulation of liver expression of TLR4 and NF-кB in rat liver tissues , reducing serum levels of endotoxin , which may be one of the mecha-nisms on hepatic failure treatment .

Objective To summarize the methods and experience of surgical treatment of abdominal aortic aneurysm.Methods The clinical data of 12 patients with abdominal aortic aneurysm treated in our hospital from August 2010 to December 2014 were analyzed retrospectively.All patients were diagnosed by B ultrasound,CT,MRI and DSA,and the surgical treatment plan was established.Open surgical resection and artificial vascular graft were performed in 8 cases and endovascular repairing other 4 cases.Festlts All the operations were performed successfully with no perioperative mortality.One case of type Ⅱ internal leakage and 1 case of pulmonary infection were observed.Conclusions The importance attached to perioperative treatment and strict selection of indications and treatment can increase the safety of the surgical performance of abdominal aortic aneurysm.

Objective To explore the application value of quantitative analysis of tissue diffusion by ultrasound elastography in evaluating the evolution of achilles tendinopathy and indirectly reflecting the feature of tendon biomechanics.Methods Rabbits underwent 0.1 ml (group M) or 0.3 ml (group S)collagenase or 0.2 ml saline (group C) injection.The percentage of area displaying blue (％AREA) in the area of interest was measured by the diffusion quantitative technique of ultrasound elastography at baseline and 1,3,7 and 14 days after model.The achilles tendon was obtained for pathological examination to observe the changes of collagen fibers and tested to measure the maximum tensile load by the universal testing machine.Results (1) The ％AREAs in group M and S at 1,3,7 and 14 days after model were smaller than those in group C (P ＜0.05),and reached its lowest value at 3 days after model.％ AREA in groupSwas significant lower than that in group M at 3 or 7 days after model (P ＜0.05).(2) The maximum tensile loads in group M at 1,3 and 7 days after model were smaller than those in group C (P ＜0.05),but there was no significant difference between group M and C at 14 days after model (P ＞0.05).The maximum tensile load in group S was significant lower than those in group M and C after model (P ＜0.05),and arrived its lowest point at 3 days after model.(3) The ％AREA was positively associated with the maximum tensile load of achilles tendon (r =0.87,P ＜0.001).Conclusions Ultrasound elastography can dynamically monitor the evolution of achilles tendinopathy and reflect the biomechanical state of achilles tendon.

Objective To retrospectively review the history and development of radiotherapy quality assurance ( QA) in the Affiliated Cancer Hospital of Fudan University, and to report the primary experience and evolvement of an entire QA workflow management. Methods The multidisciplinary QA team has implemented an entire QA workflow management process in the Radiotherapy Center using the failure modes and effects analysis ( FMEA) and plan?do?check?act ( PDCA) tool since April 2015. Treatment data of approximately 6000 patients before and after implementation were compared. Results The error rate was reduced from 17% to 09% after using the entire QA workflow management. Conclusions Entire QA workflow management effectively improves the accuracy and safety of radiotherapy.

Objective To investigate the clinical outcome and prenatal diagnosis feasibility of fetal congenital cardiac diventiculum.Methods The data of 12 fetuses with congenital cardiac diventiculum were retrospectively reviewed.The prenatal and postnatal medical records,including the characteristics of diverticulum,presence of abnormalities,karyotype and the outcomes of each pregnancy were collected.Results The overall incidence of cardiac diventiculum was 0.03％ (12/40 564) and the rate of incidence between left and right ventricle was 2 ∶ 1.Mean size of diventiculum was (69.75 ± 28.73)mm2,mean diameter of the diventiculum neck was (3.58 ± 0.80) mm and mean thickness of diventiculum wall was (1.54± 0.29)mm.Seven cases (58.4％) as an isolated malformation,5 cases (41.6％) combined with cardiac defect and extracardiac abnormalities,2 cases (16.7 ％) with chromosomal abnormalities.Five cases underwent termination of pregnancy,1 case died in uterus and 6 cases were born live.The mean follow-up periods was (62.33±-36.52)month.Of the 6 follow-up cases,4 cases (66.7％) remained asymptomatic,one case underwent drug therapy because of arrhythmia and one case combined with VSD underwent operation.Conclusions Echocardiography could be an useful tool to demonstrate and monitor congenital cardiac diventiculum prenatally and postnatally.The outcome of cardiac diventiculum depends on the size,progression,and the combined abnormalities and complications.

AIM To determine the contents of arillanin A,tenuifoliside A and tenuifoliside C in raw Polygalae Radix (root barks),Polygalae Radix duramen,Glycyrrhizae Radix et Rhizoma-processed Polygalae Radix,waterboiling Polygalae Radix and honey-processed Polygalae Radix.METHODS The analyses of 50％ methanol extracts from samples were performed on a 30 ℃ thermostatic Kromasil C18 column (250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ formic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 330 nm.RESULTS The contents of three oligosaccharide esters were the highest in raw Polygalae Radix,followed by those in honey-processed Polygalae Radix,and those in water-boiling Polygalae Radix were the lowest.These constituents also existed in Polygalae Radix duramen,but their contents were lower than those in root barks.CONCLUSION The ester bonds of oligosaccharide esters in Polygalae Radix may be hydrolyzed during processing,followed by the generation of small molecular organic acids.The medication of whole Polygalae Radix (root barks and duramen) can be taken into consideration in clinical practice to reduce toxicity and enhance efficacy.