OBJECTIVE:To observe the efficacy and safety of spraying mannatide and 5-fluorouracil in anocelia during sur-gery of lung cancer based on the adjuvant chemotherapy. METHODS:Totally 114 patients with lung cancer radical surgery were randomly divided into observation group(59 cases)and control group(55 cases). There were spraying mannatide(40-80 mg)and 5-fluorouracil(500 mg)in the observation group;and nothing drugs were sprayed in control group. The patients higher than phaseⅡ were treated by adjuvant chemotherapy after surgery for continuous 2 cycles,21 d as a cycle. The clinical data was compared, including amount of bleeding and drainage,hospital stay,complications,toxicity,KPS score,body weight changes,immune func-tion,survival rate and recurrence rates between 2 groups. RESULTS:There were no significant differences among the amount of bleeding and drainage,hospital stay and complications in the 2 groups (P>0.05). The nausea,vomiting,leucopenia,the KPS score,improvement of total effective rate,and improvement rate of body mass,immune function,survival rate in 1 and 2 year (s),recurrence rate and time within 2 years in observation group were significantly better than control group,with significant dif-ferences(P<0.01 or P<0.05). CONCLUSIONS:Spraying mannatide and 5-fluorouracil can reduce the toxicity in anocelia during surgery of lung cancer based on the adjuvant chemotherapy,improve the immune function and survival rate,reduce recurrence rate and prolong the recurrence time.

Objective To study the serum levels of proinsulin(PI),insulin(INS),proamylin(PA) and amylin(AMY) in abnormal glucose metabolism individuals and to explore the relationship between PI and insulin resistance(IR) and between PA and islet beta cell function.Methods Totally 79 subjects who received Oral glucose tolerance test(OGTT) and insulin release test in our department from March to May 2008 were divided into 4 groups according to the results of OGTT,that is,normal group,impaired glucose regulation(IGR) group,T2DM 1[fasting blood-glucose(FBG)15 mmol/L) group.All subjects underwent examination of anthropometry and serum bio-chemical indicators,HOMA-IR and HOMA-B were calculated.Results No significant difference was found in the serum levels of PI or AMY among the 4 groups,but the level of PA,PI/INS and PA/AMY among the 4 groups did have significant differences(P

Objective To assess the value of three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in evaluation of hepatic arteries variants.Methods Both two-dimensional contrast-enhanced ultrasonography (2D-CEUS) and 3D-CEUS were used to assess 30 patients including living donor candidates and patients with upper abdomen tumors.The reference standard was operation or CTA or DSA or MRA,and the accuracy for detecting hepatic artery variants provided by the two methods was evaluated.Arterial anatomic types were defined by using Michels classification.Results The total accuracy for detecting hepatic artery anatomy types by 2D-CEUS was 40.0% (12/30),while 83.3% (25/30) by 2D-CEUS.For convention anatomy types the accuracy on 2D-CEUS and 3D-CEUS were 40.9%(9/22)and 90.9%(20/22),respectively.The difference was statistically significant (P<0.05).For anatomy variants types the accuracy on 2D-CEUS and 3D-CEUS were 37.5%(3/8)and 62.5%(5/8),respectively.No significant difference between these two methods was observed.Conclusion 3D-CEUS was a new method in diagnosis of hepatic arteries anatomy types with practical clinical value in evaluation of the living liver donors.

Objective To assess the value of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in evaluation origin of segment Ⅳ feeding artery in living liver donors. Methods 3D-CEUS were used to examine 20 living liver donors. The origin of segment Ⅳ feeding artery were evaluated by two radiologists who blinded to other imaging information. The findings obtained on operation and (or) CTA were used as the reference standard. Results Segment Ⅳ feeding artery originating from left artery, both left and right artery, proper hepatic artery were demonstrated on 3D-CEUS in 13, 1 and 2 patients,respectively. 3D-CEUS accurately depicted the origin of segment Ⅳ feeding artery in 16(80%) patiens.Conclusions 3D-CEUS could be a useful method to demonstrate the origin of segment Ⅳ feeding artery in preoperative evaluation for LDLT.

Objective To investigate the feasibility and methodology of detecting the microcirculation of hilar bile duct wall with contrast-enhanced ultrasound (CEUS). Methods Sixteen patients after orthotropic liver transplantation(OLT) were studied. The dosage of contrast agent(SonoVue) was set for 2 groups: 1.5 ml and 2.4 ml. Each group was composed of 8 patients. The imaging quality of CEUS were retrospectively analyzed and divided into 3 grades: good, ordinary and bad. There were 2 patients received retransplantation. Their morphologic features of hilar bile duct wall in baseline ultrasound (US) and CEUS were compared with those in pathological examination. Results Biliary perfusion could be displayed by CEUS continuously,real-timely and clearly. The imaging quality was good in 8 cases(50%), ordinary in 6 cases (37. 5%) and bad in 2 cases(12. 5%). There was no significant difference between the imaging quality of 1. 5 ml and that of 2. 4 ml group ( P = 0. 78). Conclusions The imaging quality of hilar bile duct wall in CEUS is good enough to detect its microcirculation. There is no significant difference between the imaging quality of 1. 5 ml and that of 2.4 ml group.

Objective To evaluate the usefulness of baseline ultrasound(BUS) and contrast-enhanced ultrasound(CEUS) in diagnosis of portal vein(PV) patency and to explore the indication of CEUS. Methods The diagnostic capability of BUS and CEUS were assessed in 64 cases according to definition of PV on BUS,which was divided into high, moderate and low definition. Results Thirty-five patients with portal vein thrombosis(PVT) and 29 patients with normal portal vein were confirmed. The diagnostic accuracies by using BUS and CEUS were 93.1% and 96.6% with high definition of PV,56.3% and 87.5% with moderate definition,and 68.4% and 89. 5% with low definition, respectively. Conclusions In the case of high definition of PV,the validity of diagnosing of PV patency with BUS may be similar to that with CEUS,thus introduction of CEUS would probably not be necessary. Otherwise CEUS is recommended.

Objective To prepare targeted nanoscale lipid ultrasound contrast agent and study the targeting function in vitro.Methods After the biotinylated monoclonal antibody Herceptin was prepared,the biotinylated degree and immunological activity were determined.Then biotinylated antibody was attached to the surface of nanoscale lipid ultrasound contrast agents by avidin-biotin system to prepare the targeted nanobubbles.The targeting function was studied by observing the combination ability of the targeted nanobubbles with SKOV3 cells in vitro,non-targeted nanobubbles as controls,and observing ultrasound imaging in vitro.Results About 16 biotin molecules were coupled to each antibody in average,and the immunological activity of the biotinylated antibody didn't decrease compared with the free one(P ＞0.05).SKOV3 cells were combined firmly and surrounded regularly by red dyed targeted nanobubbles,while control groups were negative.Ultrasound imaging could be significantly enhanced by targeted nanobubble binding to SKOV3 cell slides,the other two control groups were negative.Conclusions Nanoscale ultrasound contrast agent and antibodys can be combined firmly by avidin-biotin system to produce the targeted nanobubbles,which have strong targeting function in vitro and significantly enhanced ultrasound signal.

Objective To tested the passive targeting of nanobubbles penetrating tumor vascular endothelial cells gap.Methods Twenty female BALB/c nude mice subcutaneously bearing human ovary cancer SKOV3 were devided into two groups:group A (ultrasound imaging) and group B (frozen sections:B1 and B2).DiI labled nanobubbles and microbubbles were prepared and adjusted into the same concentrations.Group A:Microbubbles and nanobubbles of 35 μl were injected into the tail vein of every mouse respectively (1.5 h interval).Ultrasound imaging were acquired.Group B:Nanobubbles and microbubbles of 10 μl were injected into the tail vein of mice in Group B1 and Group B2 respectively.Heart perfusion by PBS or 0.9％ normal saline was carried out 1.5 h after bubbles injection to clear the free bubbles in blood circulation.And the tumor and muscle of right lower limb were immediately cut off for frozen slices (3 μm),which were stained by Hoechst 33342 to mark the nucleus.Images were obtained with a confocal microscope.Results In vivo ultrasound imaging,the time to peak and clearance time of nanobubbles were longer than those of microbubbles,whereas the intensity of enhancement was lower than microbubbles.Frozen sections showed:with the confocal laser scanning microscopy imaging,quite a number of DiI-labeled nanobubbles existed in the intercellular space of SKOV3 tumor,whereas there were few nanobubbles in skeletal muscle sections.In the control,rare DiI-labeled microbubbles were observed in tumors and skeletal muscle.Conclusions Self-made lipid nanobubbles were small enough to pass through the tumor vascular endothelial gap,namely achieve the tumor passive targeting.

Objective To assess the inlfuence of depth on liver stiffness measurement with real-time shear wave elastography (SWE) and determine the optimal depth for SWE in liver. Methods SWE of liver was performed on 89 healthy volunteers between May 2012 and November 2012. The depths of each liver were varied from 0 cm to 7 cm (from the liver capsule) in 1 cm increment and there were 8 depth groups in total. Then the elastic modulus of liver in each depth group were measured three times by SWE. The body mass index (BMI) and the distance from body surface to liver capsule were documented. The success rates and the mean elastic modulus of each group were calculated. Results The success rates of 0-7 cm were 0, 98.9%(88/89), 98.9%(88/89), 98.9%(88/89), 71.9%(64/89), 24.7%(22/89), 3.4%(3/89) and 0, respectively. The success rates were highest in 1 cm, 2 cm and 3 cm groups but signiifcant decreased with the increasement of depths in 4 cm, 5 cm and 6 cm groups ( 3 cm vs 4 cm, χ2=25.94, P<0.001; 4 cm vs 5 cm, χ2=39.68, P<0.001;5 cm vs 6 cm,χ2=16.79, P<0.001). The mean elastic modulus of 1 cm, 2 cm, 3 cm, 4 cm and 5 cm groups were (4.77±0.99), (4.68±0.99), (4.76±0.95), (5.19±1.10) and (5.41±0.95) kPa, respectively. The mean elastic modulus of 4 cm and 5 cm groups were signiifcant higher than those of 1 cm, 2 cm, 3 cm groups (4 cm vs 1 cm, t=-2.85, P=0.005;4 cm vs 2 cm, t=-3.49, P=0.001;4 cm vs 3 cm, t=-2.76, P=0.006;5 cm vs 1 cm, t=-3.13, P=0.002;5 cm vs 2 cm, t=-3.66, P=0.000;5 cm vs 3 cm, t=-3.05, P=0.003). In the group of 4 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (20.70±2.87), (22.07±2.42) kg/m2 and (1.45±0.25 ), (1.60±0.29) cm, respectively. In the group of 5 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (19.82±2.76), (21.49±2.72) kg/m2 and (1.35±0.21), (1.54±0.26) cm respectively. The BMI had no signiifcant difference between the successful and unsuccessful groups (t=-2.83, P=0.108 for 4 cm;t=0.77, P=0.709 for 5 cm), but the distance from body surface to liver capsule was signiifcantly different (t=26.51, P=0.012 for 4 cm;t=79.57, P=0.004 for 5 cm). Conclusions The success rates and elastic modulus were different at different depths. SWE should be performed at the depths of 1-3 cm from the liver capsule.

Objective To investigate the role of contrast-enhanced ultrasound(CEUS) for detection of hepatic artery stenosis(HAS) in recipients following orthotopic liver transplantation(OLT). Methods CEUS was performed in 50 OLT recipients (42 men and 8 women) with abnormal liver function test and/or abnormal findings on color Doppler ultrasound(CDUS). Digital subtraction angiography (DSA), computed tomographic angiography(CTA) or follow-up CDUS was used as the reference standard. The degree (mild,narrowing rate＜50 %; moderate, narrowing rate 50 % ～ 75 %; severe, narrowing rate＞ 75 % ), location and type (single or multiple) of HAS were evaluated. Moderate and severe stenosis were defined as substantial stenosis. Results CTA or DSA depicted substantial HAS in 39 patients, 8 patients with mild HAS or normal HA were depicted on CTA,and the remaining 3 patients were diagnosed as non-substantial HAS on clinical and CDUS follow-up. CEUS depicted substantial HAS in 38 cases. Moreover,CEUS corrected falsepositive findings on CDUS in 9 of 50 cases(18.0% ). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CEUS in diagnosing HAS were 90.0% ,92.3% ,81.8% ,94. 7% and 75.0%,respectively. Conclusions CEUS is able to provide comprehensive information including presence,degree,location and type of HAS, which may facilitate the further interventional procedure or surgical treatment.