The value of color Doppler flow imaging (CDFI) and intravenous contrast-enhanced ultrasound (CEUS) for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation (OLT) underwent CDFI. The following parameters were measured: peak systolic velocity (PS), resistance index (RI) and Doppler perfusion index (DPI) of the hepatic artery (HA), time average velocity (TAV) of portal vein (PV) and velocity of hepatic vein (HV) in different stages postoperation. And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls. The results showed that: (1) In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls (P<0.05), PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls (P<0.05); (2) When the hepatic artery thrombosis (HAT) occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; (3) While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; (4) The incidence of biliary complications in liver transplantation was increased when DPI was reduced; (5) Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; (6) In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.
Bile Ducts/pathology ; Contrast Media/*administration & dosage ; Hemodynamics ; Hepatic Artery/pathology ; Infusions, Intravenous/*methods ; Liver Transplantation/*adverse effects ; Liver Transplantation/*methods ; Liver Transplantation/ultrasonography ; Perfusion ; Postoperative Complications ; Ultrasonography/*methods ; Ultrasonography, Doppler/*methods

This study examined the effect of P85 (a pluronic block copolymer) and microbubble (MB) ultrasound contrast agents under ultrasound irradiation on gene transfection and expression. The pEGFP plasmids that can encode enhanced green fluorescent protein (pEGFP) served as a report gene and were mixed with different concentrations of MB/0.05% (w/v) P85. Then the plasmids were transfected into human hepatoma G2 (HepG2) cells. The HepG2 cells treated with MB/P85 or without treatment were exposed to ultrasound (US parameters: 1 MHz, 1.0 W/cm(2), 20 s, 20% duty cycle). Twenty-four hours later, the transfection efficiency was assessed by fluorescence microscopy and fluorescence activated cell sorting (FACS) analysis. The cell viability was evaluated by Trypan blue exclusion test. The results showed that the gene transfection efficiency in HepG2 cells under ultrasound irradiation was significantly higher than that without ultrasound irradiation. HepG2 cells in the MB or P85 group in the absence of ultrasound expressed less amount of green fluorescent protein. The expression efficiency reached (22.14±3.06)% and the survival rate was as high as (55.73±3.32)% in the 30% MB plus P85 group. It was concluded that MB and P85 in the presence of ultrasound can enhance gene transfection and expression.

Objective To observe the effects of electroacupuncture at Ganshu (BL18) and Zusanli (ST36) on depression state and gastrointestinal motility and relevant protein expressions in brain of rats with stress-induced depressive functional dyspepsia. Methods Totally 48 Wistar rats were randomly divided into normal, model, electroacupuncture (EA) and sham-operation group, with 12 rats in each group. Depressive functional dyspepsia model was established by chronic unpredictable mild stress protocols. From day 15 to day 28, the EA group was given electroacupuncture at BL18 and ST36, and the sham-operation group was stimulated by electroacupuncture at 1/3 and 2/3 of the tail. Body weight test, open field test and sucrose preference test were measured on day 0, day 14 and day 28. After 14-day administration, gastric residual volume and intestinal propulsion rate of semisolid paste were detected. The expression of βCaMK inⅡ lateral habenulas and BDNF in hippocampus were measured by Western blot. Results Compared with the normal group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus decreased significantly both in the model group and sham-operation group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas increased significantly (P<0.01). Compared with the model group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus increased significantly in EA group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas decreased significantly (P<0.01). Compared with the sham-operation group, the expression of βCaMKⅡ in lateral habenulas decreased significantly, the expression of BDNF in hippocampus increased significantly in EA group (P<0.01). Conclusion Electroacupuncture at Ganshu (BL18) and Zusanli (ST36) can improve depression and gastrointestinal motility of rats with depressive functional dyspepsia, which may be related to the inhibition of βCaMK inⅡ lateral habenulas and the activation of BDNF in hippocampus dyspepsia.

OBJECTIVE To analyze the disease spectrum and the epidemiologic characteristics of fever patients,providing effective and precise medical service for them.METHODS The disease spectrum and the epidemiologic characteristics of 9376 cases of fever or intestinal disease patients from Oct 2007 to Mar 2008 were analyzed retrospectively.RESULTS Among those patients with fever,there were 57.99% patients with respiratory infection,followed by 18.60% cases with gastroenteritis,12.74% cases with infection at other sites and 4.59% cases with tonsillitis.The fist priority was given to the patients with severe syndromes and acute onset.CONCLUSIONS Fever cases usually have complicated disease history,with an easy-to-change character of disease status. This study will provide some clues to improve our future medical service for fever patients.

Objective To explore the therapeutic results of percutaneous microwave ablation for patients with recurrence primary liver cancer after surgery and the factors influencing the survival after ablation therapy.Methods 102 patients who underwent hepatectomy for primary liver cancer in April 1998 to December 2010,and subsequent microwave ablation for recurrence hepatocellular carcinoma,were enrolled.Long term survival rates and prognostic factors after ablation were analyzed.Results The 1,3,5,and 7 year overall survival rates after ablation were 73.5％,53.5％,40.5％ and 17.7％.The 1,3,and 5 year overall survival rates for patients within one year recurrence after hepatectomy were 63.3％,38.9％,and 27.1％,respectively,which was significantly lower than that for patients after this time period in which the 1,3,and 5 year overall survival rates were 86.3％,72.3％ and 63.0％,respectively (P =0.003).Univariate analysis revealed that recurrence tumor size more than 3 cm,multiple tumors,poor Child-Pugh score,and AFP level ＞100 μg/L were risk prognostic factors of overall survival for patients who underwent ablation.Multivariate analysis identified multiple tumors,poor Child-Pugh score,and AFP level ＞ 100μg/L were the factors affecting overall survival.Conclusions Microwave ablation is of high clinical application value and is an effective minimally invasive treatment for recurrence hepatocellular carcinoma.Microwave ablation is equally effective when used in late recurrence,single tumor and tumor size≤3 cm.

OBJECTIVE:To optimize the processing technology of rehmanniae radix praeparata. METHODS:Using transfer rates of catalpol,rehmaionoside D,acteoside,isoacteoside,polysaccharide as indexes for comprehensive score,heating tempera-ture(pressure),heating time and heating times as investigating factors,L9(34)orthogonal test was used to optimize the processing technology of rehmanniae radix praeparata,and verification test was conducted. RESULTS:The optimal processing technology of rehmanniae radix praeparata was as follow as heating temperature of 125 ℃,pressure of 150 kPa for twice,2 h every time. The comprehensive scores of 3 batches of samples were 0.6985,0.6755,0.7016 in the verification test,respectively,RSDs were less than 5%(n=3). CONCLUSIONS:Optimized processing technology is simple,stable,feasible,and can provide reference for in-dustrial production of rehmanniae radix praeparata.

Objective To research the effects of drought stress on activity of key enzyme in saikosaponin biosynthesis and saponins content in Bupleurum chinense; To reveal response of Bupleurum chinense to drought stress from protein level. Methods Bupleurum chinense was cultivated in potted water control experiment with 70%–80%, 60%–70%, 40%–50% and 20%–30% saturated soil water contents. The enzyme activities of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGR), isoprenyl-based coke (IPPI), farnesyl pyrophosphate synthase (FPS) and β-carotenoid synthase (β-AS) of six months and one year old Bupleurum chinense were measured. The contents of saikosaponins a and d in samples of different soil water contents were determined by HPLC. Results When the saturated moisture was 40%–50%, the enzymatic activities of HMGR, IPPI, FPS and β-AS were the highest, followed by saturated moisture 60%–70%、70%–80% and 20%–30%. The trend of saikosaponin was similar to that of the activity of key enzyme. Conclusion 40%–50% soil saturated water content can significantly increase the activity of the key enzymes in the saikosaponin synthesis pathway. The saponin content and enzyme activity show a significant positive correlation, indicating that under drought stress, Bupleurum chinense regulates the synthesis of saikosaponin by regulating the key enzyme activity of saikosaponin synthesis pathway to respond drought stress.

With the improvement in new drug clinical trials, our hospital has participated in more and more international multi-center clinical trials. Meanwhile, problems arise in carrying out these trials.We here analyzed these problems and put forward some measures for improvement.

Objective To investigate the relationship of gene transfection efficiency with different ultrasound exposure time and different dose of microhuhble,and to find the appropriate ultrasound parameters for gene transfection. Methods Plasmid encoding enhanced green fluorescent protein(pEGFP) was chosen as a report gene and HepG2 cells were chosen as research object. The HepG2 cells plus pEGFP and different dose of microbubble were exposed to ultrasound(1 MHz,0.5 W/cm2) with varying time. Twenty-four hours later, the expression of EGFP in the cells was observed by fluorescence microscope,the transfection efficiency was assessed by FACS and the cell viability was observed by trypan blue exclusion. Results The expression of EGFP in all experimental groups was different,and the approving transfection efficiency was got by ultrasound exposed for 20 s when the dose of microbubble was 60 μl. Conclusions With fixed ultrasound frequency and power, different transfection efficiency was got when the exposure time and dose of microbubble were different. The appropriate parameter was 20 s,60 μl, which can supply information for further study.

Objective To explore the effects of P85,microbubbles and ultrasound on plasmid DNA skeletal muscle gene transduction of mice in vivo. Methods Plasmid encoding green fluorescent protein (GFP) ,which conjugated with 0.05% P85 and/or microbubbles, 10% Optison,was injected into the tibialis anterior(TA) muscle of mice with or without ultrasound irradiation (1 MHz, 1 W/cm2 2 min,20% duty cycle). Mice were killed 1 week after injection. The TA muscles were removed and snap-frozen immediately in isopentane cooled by liquid nitrogen and sections 7 μm thick were cut at intervals. One set of sections mounted with DAPI were used to assess the transfection efficiency by counting the number of GFP-positive fibers under fluorescence microscopy,and the other set of sections were stained with haematoxylin and eosin to assess the tissue damage area. Results The P85 and Optison significantly enhanced the plasmid DNA skeletal muscle gene delivery in vivo separately (P<0.01, P<0.05).Ultrasound exposure could significantly enhance the efficiency of P85 induced gene delivery(P<0.01) but not of Option(P>0.05).The gene delivery efficiency induced by P85 was higher than that by Optison no matter with or without ultrasound irradiation(P<0.01). When the P85 conjugated with Optison, they could further significantly enhance gene delivery efficiency with ultrasound exposure (P<0.01). Meanwhile, ultrasound exposure could increase the muscle damage areas in the groups with microbubbles (P<0.01). Conclusions The P85,microbubbles and ultrasound exposure display synergistic effect to enhance plasmid DNA transduction in skeletal muscle of mice in vivo.