Objective To investigate characteristics and ultrasonic imaging of the nano-scale ultrasound-enhanced contrast in vivo. Methods Nano-scale microbubbles were prepared by machine vibration and low speed centrifugation. The surface morphology and average size distribution of microbuble were measured. The contrast-enhanced effect of the hahn-scale microbubbles in the normal rabbit liver was observed,and compared with micro-scale microbubbles. Results The nano-scale microbubbles had a good shape and uniform distribution by light microscope and transmission electron microscope, with average diameter of 623.4 nm and surface electric potential of 1.3 inV. The contrast imaging study in vivo showed the nano-scale microbubbles could significantly enhance ultrasonic imaging of rabbit livers, which had no obvious difference with micro-scale microbubbles. Conclusions The nano-scale ultrasound contrast agent is stable and effective for the enhancement of ultrasound imaging, which is based on development of miniaturizing targeting ultrasound contrast agent.

Objective To study the relationships between serum intedeukin-18(IL-18)and resistin for predicting intraamniotic infection.Method Serum levels of IL-18 and resistin were measured in 43 pregnant women with intraamniotic infection (infection group)and 40 normal pregnant women(control group).Results The level of IL-18 in infection group[(38.7±10.4)μg/L]was higher than that in control group [(23.5±5.6)μg/L],there was significant difference between two groups (P＜0.01).The level of resistin in infection group[(24.84±5.32)μg/L]was higher than that in control group[(17.3±5.15) μg/L],there was significant difference between two groups(P＜0.01).The levels of resistin and IL-18 were correlated in pregnant women with intraamniotic infection(r=0.61,P＜0.01).Conclusion Detecting the levels of IL-18 and resistin in pregnant women can identify intramnniotic infection.

Objective To observe the clinical effect and complications of intravenous immunoglobulin(IVIG)in the treatment of severe adenovirus pneumonia(SAP)in children. Methods Clinical data of 210 hospitalized children with SAP from June 2009 to June 2011 were retrospectively analyzed. Patients were divided into IVIG group (109 cases) and control group (101 cases) to compare the therapeutic effects, duration of fever, length of stay in hospital, duration of mechanical ventila-tion, and complications between the two groups. Results There was no difference in the severity of illness on admission and un-derlying diseases between the two groups. Both groups were given antiviral, antibacterial and comprehensive supporting thera-py, and in the IVIG group IVIG 250-400mg/(kg.d) were administered for 3-5 d. The mean hospital stay and fever time of the IVIG group were significantly shortened comparing to that of the control group, and the time of mechanical ventilation on the IVIG group is less than that of the non-IVIG group. Incidence rate of pleural effusion, atelectas is, myocarditis and toxic enceph-alopathy in the IVIG group is lower than the control group, and the cure rateand effective therapy of the IVIG group is higher than control group, all of the difference was statistically significant (P<0.05). No adverse drug reaction was observed. Conclu-sions IVIG is safe and effective in the treatment of SAP in children.

Objective To explore the targeting homing capacity of bone-marrow derived mesenchymal stem eells(MSCs) on rabbit myocardial ischemia by intravenous injection of MSCs under the mediation of diagnostic ultrasound and microbubble. Methods Density gradient centrifugation and adherent culture method were used in the isolation and cultivation of MSCs. MSCs were labeled with DAPI. Rabbit myocardial infarction(MI) models were builded by totally ligation of left anterior descending branch of coronary artery. DAPI labeled MSCs were implanted by intravenous injection with or without the mediation of diagnostic ultrasound and microbubbles. Forty-eight hours after cell transplantation, the hearts of MI rabbits were made of frozen section and observed under fluorescent microscope. The DAPI positive cells were counted in the MI and border area of rabbit heart and compared between two groups. Pathological changes of MI area were observed with HE staining under light microscope and transmission electronic microscope. Results The number of DAPI positive cells in MI and border area of rabbit in both groups were counted under fluorescent microscope. There were more DAPI positive cells in the MI area in ultrasound + microbubble + MSCs group (213.2±26.5) than that in the intravenous injection group (146.8±18.78, P<0.01). There were erythrocytes leaking out of the vessels in MI area in HE staining section under light microscope in ultrasound + microbubble + MSCs group while there were nearly none in the intravenous injection MSCs group. The intercellular space of endothelial cells of the vessels wall was increased and serum component leaked out of the vessel wall in ultrasound + microbubble + MSCs under transmission electronic microscope. Conclusions The targeted homing capacity of BM-MSCs in the MI area of rabbit heart can be enhanced under the mediation of diagnostic ultrasound and microbubbles.

Objective To explore the value of diagnostic ultrasound mediated microbubble destruction in improving the myocardial perfusion and left ventricular systolic function when cooperated with the mecsenchymal stem cells(MSCs) transplantation in rabbit myocardial ischemia. Methods One week after myocardial ischemia (MI) modeling,36 rabbits were divided into 3 groups,the control group(group Ⅰ) ,intravenous injection of MSCs group(group Ⅱ) and ultrasound + microbubble + MSCs group (group Ⅲ). Myocardial contrast enhancement (MCE) was performed and quantification analysis of anterior wall was assessed with Photoshop. Left ventrieular systolic function was assessed with M-mode echocardiography and bi-plane Simpson's method. CD34 expression in heart was detected with immunohistochemisty(IHC). Western blotting was applied to detect the level of VEGF in three groups. Results The differences of gray scale analyzed with histogram of Photoshop in anterior wall of ischemia myocardium between the group Ⅰ and group Ⅱ or group Ⅲ were significant,and P value was 0. 032 and 0. 000 , respectively. There were significant differences of FS between group Ⅲ (30. 43±4.09)% and group Ⅱ (26.29±2.93)%, P<0.01, and similar to group Ⅰ (19.28 ± 2.84)%. The difference of EF(%) between group Ⅲ and group Ⅱ was significant [(61.5±5.8 vs 53.6±4. 71), P<0. 05] ,or markedly significant between group Ⅲ and group Ⅰ [(61.5±5.8 vs 42.6± 5.0), P <0.01]. EF(%) assessed with bi-plane Simpson's method was significantly increased from (34.64 ± 4.59) in group Ⅰ to (41.78 ± 4.21) in group Ⅱ and (48.6±3.96) in group Ⅲ. The expression of CD34 assessed with immunohistochemistry was the highest in group Ⅲ. The level of VEGF with western blotting in group Ⅲ was significantly higher than other two groups. Conclusions It is an efficacious transplantation means of MSCs infusion under the ultrasound mediated microbubles destruction in improving the myocardial perfusion and cardiac systolic function.

Objective To explore serum levels of visfatin and high-sensitivity C-reactive protein (Hs-CRP) in patients with polycystic ovary syndrome (PCOS), as well as their clinical significance. Methods Ninety patients with PCOS and 30 ovulating healthy women with body mass index (BMI) less than 25 as controls were recruited. PCOS patients were divided to two groups, 48 in obese group with BMI≥ 25 and 42 in non-obese group with BMI<25. Serum level of visfatin was measured by enzyme-linked immunosorbent assay (ELISA) and that of Hs-CRP was assayed by immunoturbidimetry in all participants. Oral glucose tolerance test (OGTT) and insulin sensitivity were assessed in PCOS patients only. Results ①Obese and non-obese patients with PCOS beth presented markedly higher serum levels of visfatin and Hs-CRP than those in controls (t=11.35, 8.46, 10.43 and 8.25, respectively, P<0.05), and levels of visfatin and Hs-CRP were higher in obese group than those in non-obese group (t=7.74 and 6.38, respectively, P< 0.05 ). ②Univariate analysis revealed that serum levels of visfatin and Hs-CRP positively correlated with BMI and homeostasis model assessment insulin resistance, respectively (P<0.05) and serum level of visfatin positively correlated with that of Hs-CRP (P<0.05). Conclusions Chronic inflammation possibly exists in patients with PCOS, which may cause their serum visfatin and Hs-CRP levels increased.

Background:Child-Pugh score(CPS)and albumin-bilirubin(ALBI)score have important predictive value for the assessment of survival of patients with hepatocellular carcinoma(HCC). Aims:To investigate the predictive values of CPS and ALBI score for radiation-induced liver disease(RILD)and long-term prognosis in patients with HCC receiving stereotactic ablative radiotherapy(SABR). Methods:A total of 152 HCC patients receiving SABR from June 2006 to June 2012 at Baoji Central Hospital were enrolled. CPS and ALBI score were determined,and the predictive values of CPS and ALBI score for RILD and prognosis were compared. Results:In 152 patients with HCC,CPS-A was noted in 119 patients, CPS-B in 33 patients;ALBI-1 was noted in 60 patients,ALBI-2 in 86 patients,ALBI-3 in 6 patients. The 5-year overall survival rate was significantly higher in CPS-A patients than in CPS-B patients(46.2% vs. 15.2%,P <0.001). Significant difference in 5-year overall survival rate was found among patients with ALBI-1,ALBI-2 and ALBI-3(P =0.002). CPS grade(HR=1.38,95% CI:1.18-1.94,P=0.008)and ALBI grade(HR=1.68,95% CI:1.32-2.03, P=0.003)were independent risk factors for 5-year survival of patients with HCC. RILD was found in 20 cases(13.8%) within 4 months after SABR. AUC of ALBI for prediction of RILD was significantly higher than that of CPS(0.784 vs. 0.611,P=0.028). Patients with CPS-A and ALBI< -2.76 were less likely to develop RILD after SABR(2.4%). Conclusions:ALBI can effectively predict the occurrence of RILD and long-term survival of HCC patients after SABR.

Objective To establish the methodology of combining BOLD and 1H-MRS for investigating correlation between the deactivation in medial prefrontal cortex (MPFC) and gamma-aminobutyric acid (GABA) concentration by acupuncture at LI4 (Point Hegu),and to optimize the experimental technique and procedure.Methods Twenty healthy adult volunteers were enrolled.During fMRI-BOLD scanning,each subject received acupuncture at right LI4 (Point Hegu).MRS scanning was based on MEGA-PRESS sequence,and ROIs were located at bilateral MPFC.The task BOLD fMRI was block design,including 3 stimulations (30 s) with 2 intervals (2 min).Then MRS scanning was performed before and after BOLD.The quantitative values of the BOLD positive and negative activations (Pm) and GABA concentrations were calculated.Results All 20 subjects completed BOLD fMRI scanning,and met the postprocessing requirements.MRS images of 9 subjects with good image quality were included in analysis.Among all 20 subjects,positive activation (Pm=1.17± 0.16) was observed in 9,while negative activation (Pm =-1.31 ± 0.17) was observed in 11 subjects.The GABA average values before and after the acupuncture were (19.93 ±1.04) nmol/L and (20.04±0.81)nmol/L,respectively,and the average amplitude between post-and pre-acupuncture was (0.11 ± 1.60)nmol/L.Conclusion The success rate of this method for quantitative study of brain function established multimodal-functional (BOLD-fMRI and MRS) was acceptable,and the multimodal brain function changes as well as the quantitative values were observed in the brain region during acupuncture.Combined BOLD and MRS quantitative method is feasible for testing acupuncture response in the brain.

Objective: To investigate the impact of intensified maintenance therapy on the prognosis of children and adolescents with advanced lymphoblastic lymphoma (LBL) . Methods: Retrospective analysis on the treatment results of children and adolescents with stage Ⅲ and stage Ⅳ LBL who underwent BFM-NHL-90/-95 regimen without prophylactic radiotherapy. The intensified therapy group included the patients admitted from 1998 to 2005, while others were classified as the non-intensified therapy group. Patients in the intensified therapy group were intravenously treated with "etoposide phosphate plus cytrarabine" and high-dose methotrexate alternately per 2.5-3 months in addition to the oral chemotherapy with 6-mercaptopurine and methotrexate during the maintenance phase. Results: A total of 187 LBL patients were enrolled. The rates of 5-year event free survival were (76.9 ± 5.8) % and (77.9 ± 4.3) % (χ²=0.249, P=0.617) respectively, in the intensified therapy (n=52) and the non-intensified therapy groups (n=135) , while the rates of 5-year overall survival of them were (78.8 ± 5.7) % and (79.8±4.1) % (χ²=0.353, P=0.552) , respectively. Stratified by stage, immunological type as well as risk stratification, the rates of long-term survival were similar between the two groups. During the maintenance phase, the rates of grade Ⅲ and Ⅳ myelosuppression in the intensified therapy and the non-intensified maintenance groups were 55.8% and 18.5%, respectively (χ²=25.363, P<0.05) . Conclusion Intensified maintenance therapy failed to improve the prognosis of patients with advanced LBL.

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.