Objective To establish the quality standard for Tongluo Tangtai Granules. Methods TLC was applied to the qualitative identification of Rhizoma Coptidis, Semen Sinapis Albae and Radix Scrophulariae, and HPLC was applied to the quantitative determination of berberine in the prescription. Results Rhizoma Coptidis, Semen Sinapis Albae and Radix Scrophulariae could be detected by TLC, the spots were clear and there was no interference for the negative sample. A good linearity of berberine was showed in the range of 0.037 29-2.610 3 μg (r=1.000 0). The average recovery of berberine was 98.85%, and RSD was 0.70% (n=6). Conclusion The methods are simple, sensitive, accurate with good reproducibility. It can be used for the quality control of Tongluo Tangtai Granules.

Objective serous endotoxin(ET) were measured to determine the relationship between serous endotoxin and differ‐ent type of intestinal obstruction in children .Methods 25 inguinal hernia patients and 43 intestinal obstruction patients were classi‐fied into control group(n=25) ,incomplete intestinal obstruction (n=20) and complete intestinal obstruction group without necrosis of intestine (n=23) according to degree of obstruction .Serous endotoxin were measured in different time (the day of admission ,one day after admission or ,preoperation and one day postoperation ) ,and t test is used to determine the difference between them . Results ET in different group was(6 .53 ± 14 .96) ,(4 .40 ± 1 .15) ,(4 .20 ± 1 .20) ,(4 .09 ± 1 .31) ,(3 .70 ± 1 .46)EU/mL ,respec‐tively .There were no difference between each group .Conclusion ET examination suggests there is no difference between different type of intestinal obstruction in children and endotoxemia is not found in intestinal obstruction according to the results .

ObjectiveTo study the effect of continuous blood purification (CBP) on the multiple organ dysfunction syndrome(MODS). MethodsContinuous blood purification were used in 33 patients with MODS. Results Among 33 patients,24 mended and 8 died. The scores of Acute Physiology And Chronic Health Evaluation (APACHE Ⅱ) and MODS obviously declined(P<0.05), as well as the BUN and blood Cr (P<0.05), but the bilirubin did not (P>0.05). The haemodynamic variables were stabilized during CBP and no obvious side-effect related to CBP was found. ConclusionThe therapy of continuous blood purification can improve the prognosis to the patients with multiple organ dysfunction syndrome. The patients were able to bear at the quality better.

Objective To measure left atrial appendage (LAA)in patients with atrial fibrillation using Flexi Slice imaging by real time 3D transesophageal echocardiography (TEE),and compare with common multiplane TEE.Methods Forty-six patients with atrial fibrillation were performed 2D and real time 3D TEE.Zero degree,45°,90° and 135° plane were acquired by 2D TEE and Flexi Slice remolding. Maximum and minimum values of ostium of left atrial appendage were acquired in the short axis view of LAA by Flexi Slice remolding.Results Compared with 2D TEE,values acquire by Flexi Slice in measurement of LAA ostium showed no significant difference(P >0.05).The depth measurement by Flexi Slicein 45° and 90° plane showed significant difference with 2D TEE (P-values were successively 0.045, 0.002),and in 0 and 135° plane showed no difference.All values measured by 2D TEE and Flexi Slices showed significant correlation.Bland-Altman plot showed that 94.29% of plots were among limits of agreement,which was (-2.5 mm,2.9 mm).The maximum values of LAA ostium values ranged from 30° to 160°,among which 87% (40/46 cases)distributed between 90° and 1 50°,and minimum values ranged from 0°to 160°,among which 85%(39/46 cases)distributed between 0°and 60°.Conclusions Measurement of LAA can be well achieved by Flexi Slice imaging,which showed significant advantage compared with 2D TEE.

Objective To explore the value of echocardiography in percutaneous left atrial appendage (LAA)closure for stroke prevention in patients with nonvalvular atrial fibrillation during procedure and for short-term follow-up.Methods Twenty patients were enrolled to undergo percutaneous LAA closure with the LAmbre device.Rheumatic valvular diseases were excluded by transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE)before the closure procedure.TEE was performed during the procedure for the trans-septal puncture and the release of the closure device.Combined TEE with angiographic measurements,guidance for the optimal device size was provided.The closure effect and procedure-related complications were observed immediately by TEE and also evaluated by TTE at 1-day and 1-month follow-up.Results All patients underwent LAA occlusion successfully.TEE color Doppler evaluation have shown nine patients with complete closure immediately,one with a ≤ 1 mm residual LAA leak,and ten with a 1 -3 mm jet.There were no other complications during the procedure.One day after the closure,small pericardial effusions were observed for three patients while two of the three were free of the pericardial effusion at the 1-month follow-up.During the short-term follow-up,no damage was found at any anatomical structures near LAA due to the closure process,and there was no significant difference of cardiac function before and after the procedure.Conclusions With the guidance of TEE,the successful rate of percutaneous LAA closure procedure was preferable and the occurrence rate of compliance was acceptable. And TTE played an important role in patients'short-term follow-up.

ObjectiveTo evaluate the value of bispectral index(BIS) monitoring during sedation in the ICU.Methods60 patients in ICU were randomly divided into three groups. By transfusing propofol and midazolam with injecting pump, the BIS of groups Ⅰ,Ⅱ and Ⅲ were controlled within 75～85, 65～75 and 55～65, respectively. ResultsCompared with the pre-sedation, there was no remarkable change in the patients of groups Ⅰ and Ⅱ after sedation(P>0.05)while there was remarkable change in the patients of group Ⅲ(P<0.05).The average score of Ramsay in groups Ⅰ, Ⅱ and Ⅲ were 2.2, 3.4 and 4.6 while the dose of propofol were (9.54±2.43) μg/kg·min, (12.69±3.12) μg/kg·min, (14.18±2.91) μg/kg·min and the dose of midazolam were (0.23±0.09) μg/kg·min, (0.25±0.07) μg/kg·min, (0.28±0.11) μg/kg·min, respectively.ConclusionThe application of BIS can make good judgement in the sedation, which showed different choices to different needs to obtain optimistical sedation effect.

Objective To evaluate the usefulness of speckle tracking imaging(STI) for assessment of left ventricular(LV) and right ventricular (RV) functions in patients with isolated disease of right coronary artery.Methods 45 cases were diagnosed as single right coronary lesions given echocardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison.The twodimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view.Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software.Results In the patients who had right coronary lesions but did not happen myocardial infarction,the strain(S) values in the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid segment of RV free wall was lower( P ＜0.05).In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid and apex segments of RV free wall were lower ( P ＜0.05).And the LV global longitudinal strains were lower in the two groups (P ＜0.05).Conclusions STI is a new and useful technology for assessment ventricular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.

Objective To create a three-dimensional speckle tracking imaging (3DSTI) multiparameter analysis model to improve the diagnostic efficiency of obstructive coronary artery stenosis.Methods One hundred and four patients with chest pain were divided into two groups:coronary heart disease(CHD) group (61 patients) and control group (43 patients) according to the result of selective coronary angiography (SCA).The two groups' clinical data and echocardiographic parameters were aquired,including mitral flow E and A velocities,E peak deceleration time,isovolumic relaxation time (IVRT),mitral annulus velocity e' and a' peak in diastolic and s' peak in systolic by tissue Doppler imaging (TDI),and left ventricular ejection fraction (LVEF).The global longitudinal peak strain (2D-GLPS) by two dimensional speckle tracking,global longitudinal peak strain (3D-GLPS),circumferential peak strain(3D-GCPS),radial peak strain (3D-GRPS) and area peak strain (3D-GAPS) were acquired.Results For conventional parameters,there were no significant difference between the two groups.Compared with control group,TDI e' peak,3D-GRPS decreased,significantly E/e',2D-GLPS,3D-GLPS,3D-GAPS,3D-GCPS increased significantly (P ＜0.01).For single parameter,area under the ROC curve (AUC) were successively 3D-GAPS(0.766) ＞ 3D-GLPS(0.746) ＞ 2D-GLPS(0.746) ＞3D-GRPS(0.727) ＞ s' (0.703) ＞E/e' (0.688)＞3D-GCPS(0.686).AUC for single and multi technology were successively p-Union(0.856)＞p-3DSTI(0.772) ＞ p-TDI (0.757) ＞ p-2DSTI (0.746).Conclusions 3DSTI together with multi-parameter analysis model can significantly improve the diagnostic efficiency of obstructive coronary artery stenosis.Area strain is an independent predictor of obstructive coronary artery stenosis.

Objective To investigate the consistency of the anatomical parameters of left atrial appendage (LAA) based on three-dimensional transesophageal echocardiography (3D-TEE) and CT of 3D print datasource by the post-processing of DICOM data.Methods Sixty-three patients with atrial fibrillation in our hospital who underwent 3D-TEE and cardiac CT examination were selected and the original DICOM data of the LAA were obtained.The volume images of LAA were acquired by the postprocessing of Mimics software.After measuring and evaluating the anatomical parameters,the differences of parameters between TEE and CT were compared and the consistency of the two methods was evaluated.Results The data of 63 patients with atrial fibrillation obtained by 3D-TEE and CT were successfully post-treated and the detailed anatomical parameters of LAA were obtained.Morphological parameters:the Kappa values of the anatomical shape and opening shape of the LAA based on the 3D-TEE and CT data were 91.0%,69.3%,respectively.Measurement parameters:the area,perimeter,long axis,short axis of ostiums of LAA,and depth of LAA by CT were larger than those by 3D-TEE(all P<0.05).The post-processing results showed that 57 patients (90.5%) had significant bending of LAA′s main lobe in the 3D-TEE group and CT group,the difference in the measurements of the angle of the first bend and the distance from the first bend of the LAA to the orifice of the 57 cases between by 3D-TEE and CT were no statistical significance (P>0.05).LAA′measurements of 3D-TEE was concordant well with CT′s by Bland-Altman analysis.Conclusions In agreement with CT,3D-TEE can also be used as a datasource for 3D printing by evaluating spatial morphology of the LAA.

Objective To. investigate the effect of electroacupuncture at acupoint Zusanli (ST36) on the liver injury during the early stage after bum in rats. Methods Forty adult male SD rats weighing 220-250 g were randomly divided into 5 groups ( n = 8 each) : group sham operation (group Ⅰ ) ; group burn (group Ⅱ ) ; group acupoint at Zusanli (ST36) (group Ⅲ ); group non-acupoint stimulation (group Ⅳ ) and group ST36 + alphabungarotoxin (alpha7 nicotinic acetylcholine receptor antagonist) (group Ⅴ ). Rats were subjected to 3rd degree burn covering 30% of the total body surface area. Rats were resuscitated with lactataed Ringer's solution according to Parkland formula (4 ml/kg per 1% body surface area) immediately after burn. Bilateral acupoints Zusanli were stimulated with constant voltage (3 V, 3 Hz,2ms) for 20 min 3 times a day for 2 days starting immediately after resuscitation in H and V groups. In group V alpha-bungarotoxin 1.0 μg/kg was administered iv immediately after fluid resuscitation before acupuncture. In group Ⅳ same electric stimulation was performed at a point 0.5 cm lateral to Zusanli. The animals were sacrificed at 48 h after burn. The content and expression of high mobility group box 1 (HMGB1) protein in liver were measured. Liver specimens were obtained for microscopic examination (with light and electronic microscope). Results Compared with group Ⅰ , hepatic HMGB1 protein level significantly increased in Ⅱ and Ⅳ groups. There were significant ultrastructural changes in the liver in burn rats in group Ⅱ and group Ⅳ. Electric stimulation of ST36 significantly attenuated the histologic changes in the liver and decreased the hepatic HMGB1 protein level in group Ⅲ . Pretreatment with specific alpha.7 nicotinie acetylcholine receptor antagonist alpha-bungarotoxin reversed the beneficial effect of electroacupuncture at Zusanli. Conclusion Electric stimulation of acupoint ST36 can ameliorate liver injury during the early stage of burn by activating alpha7 nicotinic acetylcholine receptor-mediated pathways for anti-inflammation.