Objective To investigate the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) in the treatment of acute cholecystitis.Methods A retrospective analysis was performed for the clinical data of 81 patients with acute cholecystitis who underwent ultrasound-guided PTGBD in General Hospital of Lanzhou Petrochemical Company from March 2013 to February 2016.The changes in related parameters after the placement of drainage tube were analyzed.The t-test was used for comparison of continuous data between groups.Results All the 81 patients underwent a successful one-time puncture.After the surgery,1 patient experienced tube dislodgement and 2 experienced obstructed bile drainage,while no patient experienced serious complications such as bleeding,bile leakage,and hemopneumothorax.Within 12 hours after surgery,there was a significant improvement in pain in the right upper quadrant and significant reductions in the major axis and radial width of the gallbladder (t =13.28 and 9.54,P =0.023 and 0.041),as well as significant reductions in white blood cell count and neutrophil count (t =8.70 and 8.03,P =0.028 and 0.034).Of all patients,38 achieved symptom remission after the placement of drainage tube and refused selective surgical treatment,and 43 underwent cholecystectomy within 3 months after surgery.Conclusion PTGBD is simple,convenient,visible,and safe and can effectively reduce patients' pain,increase the success rate of the treatment of acute cholecystitis,improve patients' clinical outcomes,and reduce the incidence of complications.It also provides the conditions of selective surgery for critically ill patients with acute cholecystitis,and therefore,it holds promise for clinical application.

Aim To explore the effects of apigenin on A?_ 25-35 induced injury in primary cultured hippocampal neurons.[WTHZ]Methods[WTBZ] The primary cultured hippocampal neurons were exposed to 10 ?mol?L-1 A?_ 25-35 for 24 h after pretreatment with the apigenin of concentrations of 5,10,20,40 ?mol?L-1 for 2 h;then the survival rate of hippocampal and SOD activity were examined;we also analysed the expression of apoptosis-related gene bcl-xl with Western blot.Result The survival rate of hippocampal neurons were decreased after pretreatment with 10 and 20 ?mol?L-1 apigenin for 2 h,the increases of Mn-SOD activity and bcl-xl protein expression were also observed.Conclusion Apigenin has the bioactivity of protecting the neuron from cytoxic induced by A?_ 25-35 in cultured hipocampal neurons as estrogen.The mechanism is likely related with activating the SOD and increasing bcl-xl protein expression,which plays a pivotal role in protecting cells from apoptosis.

Objective To prepare the HPV genotyping control materials. Methods Three hundred cervical smears with different HPV genotypes were collected and detected by surface plasmon resonance and sequencing. The primers for specific genotype were designed according to GenBank. The recombinant plasmid was constructed through PCR amplification, ligation and transformation. Thirty recombinant plasmids were identified through PCR amplification, sequencing, and the sequences were compared using BLAST. Results The collected HPV infectious samples contained 30 different genotypes including HPV 6,16,18 and so on.The fragment sequences of PCR amplification were concordant with the designed. The fragment sizes of the other types ranged from 1 500 to 2 000 bp except HPV CP8304. And the 30 recombinant plasmids identified by PCR were concordant with the target. The identity of BLAST was 99%. In the fragment of 1500 bp in length, 11 bases were inconsistent with the reference sequence. Conclusions Genotyping control materials were developed successfully. The human papillomavirns genotyping control materials covered all the most common types and included 14 types with high-risk, 3 types with medium-risk and 13 types with low-risk.

ObjectiveTo explore the sonographic features of gouty arthritis.MethodsThe sonographic features of gouty arthritis were summarized by retrospectively studying the sonogram of 19 joints of 5 patients.ResultsFive the first metatarsophalangeal joints,8 knees,2 ankles,2 elbows and 2 wrists were investigated.Out of 19 joints,17(89.4％) had double contour signs,a hyperechoic and irregular band over the superficial margin of the articular cartilage.Joint effusions were seen in 13 of 19 joints (68.4％).Multiple hyperreflective foci could be seen in the joint fluid,which were obvious by shaking the probe.In 19 joints,11 (57.9 ％) had proliferation of the synovium identified,and proliferative synovium were revealed as hyperperfusion or hypoperfusion by color Doppler ultrasound.In one knee,the synovium proliferated obviously with involved area about 5 cm × 2 cm,and hyperechoic aggregates with acoustic shadow could be seen in it.Articular cartilage became irregularly thin and the hyperechoic outline of subchondral bone cortex became rough or even broke in 6 of 19 joint (31.6％).H omogeneous,hyperechoic aggregates with or without acoustic shadow in the soft tissue around the joint were seen in four joints (21.1 ％).Three in these 4 joints exited bone cortex erosions adjacent to aggregates.ConclusionsGouty arthritis has some specific sonographic features,ultrasound maybe usefully discover this disease in early period.

ObjectiveTo evaluate the value of uhrasonography for arthrocentesis in the hip and the advance of the femoral head/acetabulum as the puncture location in patients without sonographically obvious joint effusion.Methods Forty-three patients diagnosed with ankylosing spondylitis or osteoarthritis were included,82 hip joints were involved and received ultrasounded-guided intra-articular injections.The puncture site was the joint space between the femoral head and the acetabulum.The times,depth,procedure time,side effects and complications of each injection were recorded.ResultsAll 82 hips could be explicitly displayed.The depths from the skin surface to the joint space were (3.4 ± 0.9)cm (left)and (3.1 ± 0.8)cm (right),respectively.Overall,100％ of hip joints were punctured successfully,and 95.1％ of them were succeeded with the first arthrocentesis.The procedure time was (287.9 ± 45.8) s.No side effects or complications were observed.ConclusionsThe sonographic technique could be used as a primary method of image guidance for performing hip arthrocentesis and the joint space between the femoral head and the acetabulum could be a choice of target location for the patients without joint effusion.

Objective To evaluate the charateristics of biliary stricture after orthotopic liver transplantation(OLT) by ultrasound. Methods Diametes,thickness,characteristic echo of bile were observed by ultrasound in 41 patients with biliary stricture after OLT,and the results were compared with those of 46 patients without biliary complication after OLT.Results The diameter of intrahepatic bile,thickness of bile,incidence of intrahepatic bile dilation or hyperechogenicity in biliary stricture patiens were higher than those in patients without biliary complication,there were significant differences between two groups(P＜0.05).Conclusions The series of ultrasonographic character such as bile dilation,thickeness or hyperechogenicity of biliary wall,thin of bile duct are available to diagnose biliary stricture.

Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (CUS) in the localization and definition of different types of uterine myomas.Methods With real-time CEUS technique, 56 patients with uterine myomas proved by pathology were observed. The accuracy between CEUS and CUS in the localization and definition of different types of uterine myomas was retrospectively analyzed. Results The accordance rates of CEUS and CUS in the diagnosis of total uterine myomas, intramural myomas, submueous and subserous myomas were 94.6% (53/56) vs 73.2%(41/56),99.3%(31/32) vs 78.1%(25/32) and 91.6%(22/24) vs 66.7%(16/24),respectively,and in the definition of number and margin of myomas were 92.8 % (104/112) vs 80.30% (90/112) and 91.9 (103/112) vs 78.6 % (88/112). The accordance rates of CEUS and CUS in the diagnosis of typical uterine myomas were 95.8% (23/24) and 87.5% (21/24),and in the diagnosis of atypical uterine myomas were 93.8%(30/32) and 62.5% (20/32),which were different in statistics (P<0.05). Conclusions CEUS is better than CUS in revealing the number and margin of different types of uterine myomas. The accordance rates of CEUS were higher than those of CUS in the diagnosis of different types of uterine myomas and atypical uterine myomas. CEUS may be a new technique in the localization and definition of uterine myomas.

BACKGROUND: Enthesitis is the most important pathologic change and one of the characteristic manifestations of spondyloarthropathy(SpA). However, its clinical manifestations lack specificity, and medical imaging techniques become an important auxiliary means in its diagnosis. Currently, ultrasound has been applied to examine the entheses of patients with SpA abroad, but so far there is no investigation about the ultrasonic manifestations of entheses in healthy volunteers.OBJECTIVE: To comprehend the acoustic imaging manifestations of entheses in healthy volunteers, and primarily investigate the feasibility of ultrasound in detecting entheses and the possible impact factors of acoustic imaging manifestations.DESIGN: A nonrandomized inter-controlled trail.SETTING and PARTICIPANTS: A total of 30 young healthy workers and medical students who worked or studied in the Third Affiliated Hospital of Sun Yat-sen University were included in our study, including 22 male and 8 female. None of them suffered from any arthropathies or chronic low back pain.INTERVENTION: High frequency and Color Doppler ultrasound were adopted to detect 540 entheses of 30 healthy volunteers, the entheseal thicknesses were compared respectively according to left and right sides, as well as the gender. X-ray was used to inspect if there were any abnormal findings at the attaching bones.MAIN OUTCOME MEASURES: The thickness, the echo inside entheses, the entourage, the attaching bone and the entheseal blood flow were detected.RESULTS: In normal entheses, there was a little lower but equal resonance, in which there was clear funicular fibrin resonance but without blood signal. Most entheses had a little higher membrane resonance, which was clearly divided from entourage. The surface of attaching bone was smooth and continuous. The mean thickness of the lower insertion of rectus femoris tendon, the upper insertion of patellar ligament, the lower insertion of patellar ligament, the lower insertion of tibial collateral ligament, the lower insertion of fibular collateral ligament, the insertion of Achilles tendon and plantar aponeurosis in male volunteers were(0.50 ±0.06), (0. 50 ±0. 07),(0.42±0.04), (0.20±0.03), (0.38±0.04), (0.52±0.07)and (0. 32 ±0.03) cm respectively, while the mean thickness of the corresponding insertions in female volunteers were (0.44 ± 0. 04), (0. 46 ± 0. 03 ),(0.39±0.03), (0.19±0.02), (0.32±0.02), (0.41±0.06)and (0. 28 ± 0.03) cm respectively. All entheses except for the lower insertion of tibial collateral ligament were thicker in male than in female( P ＜ 0. 05 ),but there were no significant differences in the thickness between left and right insertions ( P ＞ 0. 05 ). Calcification, erosion and hyperplasia of the attaching bone or increasing blood flow were found in 11 entheses of 8 volunteers(2.0% of all the 540 entheses detected) . There were 15 items of abnormal signs all together. Some of the abnormal sites had traumatic histories.CONCLUSION: The thicknesses are almost the same in the corresponding insertions between left and right sides, but the thicknesses of most insertions in male are thicker than those in female. Stature, body mass and exercise might impact on entheseal thickness. Trauma can cause abnormal acoustic imaging manifestations of entheses. Ultrasound is an available approach to detecting etheses.

Objective To evaluate the image quality and radiation dose of prospective electrocardiography-triggered coronary 320-slice volume CT angiography with different kV, and the feasibility of coronary scan with ＜ 1 mSv radiation dose.Methods Eighty consecutive patients were randomly divided into two groups equally.The tube voltage according to paradigm was 100 kV in group A and 120 kV in group B.All raw data in group A was reconstructed by the software AIDR in CT system to create a new group named as A1. Such parameters as the mean intraluminal attenuation (SI),noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),effective radiation dose(E) and image quality score measured in group A were compared with those in group B.The values such as SI,SD,SNR,CNR,image quality scores were compared between group A and group A1.The significance of group B and group A1 was compared in SI,SD,SNR,CNR,image quality scores as well.Results E in group A was significantly lower than that in group B[ E =(0.67 ± 0.18) mSv in group A vs.E =(3.08 ± 1.04) mSv in group B].The value of E in group A was decreased by 78％ compared to group B(t =- 14.30,P＜0.05 ).There was no significant difference in mean image quality scores between two groups(4.57 ± 0.57in groupA vs.4.59 ± 0.59 in group B,t=-1.17,P＞0.05).The values of SI,SD,SNR,CNR in group A were (570.8 ±131.5)HU,25.1 ±6.9,24.5 ±9.1,19.8 ±6.1.And the values of SI,SD,SNR,CNR in group B were (460.6 ± 14.3) HU,15.1 ±3.6,31.7 ±7.7,29.3 ±6.8.The values of SI and SD in group A were significantly higher than those in group B(t =4.49,8.18,P ＜0.05). The values of SNR and CNR in group A were lower than those in group B (t =-4.24,-6.19,P＜0.05).The valuesofS1,SD,SNR,CNR,image quality scores in group Al were (557.9 ±24.5) HU,21.1 ±6.0,27.7±10.0,23.4±7.8,4.60 ± 0.56.There was no difference in the SI and the image quality scores between group A and group A1 ( t =1.09,- 1.90,P ＞ 0.05).Conclusions 320-slice volume CT with 100 kV tube voltage and prospective ECG-triggered technique can reduce the radiation dose to less than 1 mSv and obtain optimal images in diagnosis of coronary arterial diseases.

BACKGROUND: Spondyloarthropathies(SpA) are a group of interrelated disorders that involve the spine, peripheral joints, and tissues around or outside the joints. SpA are most common in young males, and both the incidence and the mutilation rate are very high. It is important to evaluate the disease activity of patients with SpA since the evaluation can help in therapeutic selection and prognostic prediction of SpA. But up to now there still has not been a widely clinically acceptable criterion to evaluate the disease activity of SpA.OBJECTIVE: To study the worth of color Doppler(CD) in assessing the disease activity of patients with SpA.DESIGN: Non-random and self-control clinical study based on the patients.SETTING: All patients recruited in this study were from department of rheumatology of the Third Affiliated Hospital of Sun Yat-sen University. And all the ultrasonic examinations were conducted in the department of ultrasound of the same hospital.PARTICIPANTS: Thirty(24 males and 6 females) patients with SpA who met the European SpA Study Group criteria for the classification of SpA issued in 1991 and consented to be examined by CD were included.METHODS: CD was used to determine the blood perfusion at 18 major entheses of lower limbs of each patient with a semi-quantitative method. Blood sample was also taken from the patients for the examination of erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) . The disease activity of the patients was also evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).MAIN OUTCOME MEASURES: To observe the inter-correlations between entheseal blood perfusion, ESR, CRP and BASDAI.RESULTS: 80% of the 30 patients were detected to have positive perfusion in at least one enthesis of the 18 examined entheses, and all together 84 entheses were found to have positive perfusion among the 540 entheses being detected(positive rate 15.6% ) . The sum of entheseal perfusion detected in all the 18 sites was statistically correlated with the sum of patients' ESR,CRP, BASDAI respectively with the correlation coefficients of 0. 658, 0. 428and 0. 821 (all P ＜ 0.05) . ESR and CRP were also statistically correlated with BASDAI and their correlation coefficients were 0. 675 and 0. 368(Both P ＜ 0.05) . The sum of perfusion detected in the 18 entheses sites was correlated with BASDAI better than ESR or CRP was.Detecting the.entheseal perfusion by CD can help to determine the disease activity of patients with SpA, and then to guide selecting therapeutic strategy. It is also important for following up and prognosis.