Objective Using coded harmonic angiography to observe hepatocellular carcinoma blood perfusion features,further assess this modality clinical value in qualitative diagnosis of liver malignant tumor.Methods Through left forearm vein bolus injection of fluorine-carbon contrast agent,35 patients with 41 hepatocellular carcinoma lesions were examined with coded harmonic angiography,intratumoral vessel enhanced time,vascularity,blood perfusion were observed.All patients were simultaneously videotaped before and after contrast.Results It was about 15～20 s after the injection of contrast agent when the enhancement of tumor had just commenced,peak time about 60～90 s and persistence time about 240～300 s.Lesions were more obviously enhanced than normal liver tissue,several tumor vascularity was displayed from border to center,contrast agent gradually centripetal filled-in,formed "weeping-willow" echo.Pressed and rimlike peripheral vessel developments were earlier than normal liver tissue.Conclusions Coded harmonic angiography could real-timely display hepatocellular carcinoma blood perfusion,which has an important clinical value in qualitative diagnosis of liver malignant tumor.

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.

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.

Objective To explore the feasibility of evaluation of hepatic fibrosis using the tissue dispersion quantitative analysis software based on ultrasonic elastography. Methods Forty-six chronic liver disease patients were examined by tissue dispersion quantitative analysis software. There were 11 characteristic quantities of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value,standard deviation of relative strain value,area ratio of low-strain region ( AREA%) , complexity, kurtosis, skewness, contrast, entropy, inverse different moment,angular second moment,correlation. The 11 characteristic quantities were compared with pathological stages of hepatic fibrosis. Results The characteristic quantities had statistically significant differences except kurtosis and correlation in the analysis of variance and correlational study with pathological stages ( P < 0.05). The AREA% had the highest related coefficient ( r = 0.725). The ROC curve was made by AREA% ,the areas under the ROC curve were 0. 865 ,0. 880 and 0. 886. Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of stages of hepatic fibrosis. The AREA% has the highest relationship with pathological stages of hepatic fibrosis and good diagnostic value.

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.

Purpose To evaluate the relative bioavailability of a domestic sustained-release metformin tablets (SRM) compared against an immediate-release metformin tablets (IRM) using a multiple-dose,two-way crossover design after a single-dose study. Methods Eighteen healthy adult male volunteers,aged 18 to 22 years (mean,20 years),weighing 55 to 76 kg (mean,64 kg) and with height ranging from 166 to 180 cm (mean,173 cm),and blood glucose levels from 4.0 to 5.9 mmol/L (mean,4.3 mmol/L) participated in the study.The concentrations of metformin in plasma were determined using a ion-pair liquid chromatographic method. Results In single-dose study,the mean residence time (MRT),Tmax,and apparent elimination half-life (T1/2) for SRM were significantly longer and Cmax significantly lower than the corresponding values determined for IRM.The similar results were also demonstrated in multiple-dose study.The mean values of the relative bioavaibility of SRM compared with IRM in two administration ways were (85.95±0.97)% and (86.44±7.88)%,respectively.The single-dose and multiple-dose administration of the 90% confidence interval for the ratio of the logarithmic transformed AUC values of SRM over those of IRM were calculated to lie between 0.83 and 0.88,0.83 and 0.89,respectively,being within the acceptable bioequivalence limit of 0.80～1.25. Conclusion SRM was of the characteristic of sustained-release pharmacokinetics.The relative bioavailability for single dosing was similar to that of multiple dosing,and both of the administration ways demonstrated bioequivalence in absorption between SRM and IRM.

Objective To evaluate the clinical value of artificial hydrothorax combined with one-lung ventilation to aid ablation treatment of liver carcinoma in the hepatic dome.Methods Twenty-one patients with liver carcinoma located in the hepatic dome and affected by the lung gas were enrolled.Double lumen endobronchial intubation anesthesia was used and thoracical tube was used to apply artificial pleural effusion.The lesions'ultrasound image were recorded for the patients without artificial hydrothorax,or with artificial hydrothorax only and artificial hydrothorax combined with one-lung ventilation.Ultrasound images were reviewed and scored as 1-5 according to the clarity and completeness of the lesion.Ablation efficacy and adverse reactions were recorded in the follow-up.Results Twenty-one patients were successfully applied artificial hydrothorax and one lung ventilation.The average normal saline used for artificial hydrothorax were (738± 260)ml.The ultrasound score for not using artificial hydrothorax,using artificial hydrothorax only and artificial hydrothorax combined with one lung ventilation were 1.13 ± 0.35 (1-2),3.00 ± 0.85 (2-5) and 4.53 ± 0.64(3-5),respectively,statistical difference was found between each method(P ＜0.05).Artificial hydrothorax combined with one-lung ventilation had much higher ultrasound score than the other 2 methods.No complication related to artificial hydrothorax or one-lung ventilation was found.CT/MRI at one month after ablation showed that all the lesions were completely ablated.In the follow-up for 2-14 months on average,1 case of local tumor progression and 1 case of intrahapetic relapse were found.Conclusions Artificial hydrothorax combine one-lung ventilation could effectively enhance ultrasound image for the lesions in the dome whose acoustic window was affected by lung gas.

Objective To analyze the double contrast-enhanced ultrasonography (DCUS) features of periamupullary carcinoma for enhancing the ultrasound diagnostic value of the disease.Methods The DCUS and clinical data of 40 patients with periampullary carcinoma confirmed by histopathology were reviewed.Results (1) The displaying rate of the lesions and the judgment of lesion location was statistically higher on DCUS than that of ordinary ultrasound (P ＜ 0.05).(2) DCUS features of periampullary carcinoma:the size of most lesions was less than 30 mm except for 1 case in which no lesion was found; In 100％ (39/39) of the lesions,the morphology did not change with duodenum movement ; In 64.1％ (25/39) of lesions hyperenhancement or isoenhancement was displayed in the arterial phase,with low enhancement in the venous phase; In 87.2％ (34/39) of lesions homogeneous enhancement was displayed; In 95％ (38/40) the bile ducts were moderately or severely dilated.The lesion locations and whether the lesions projected into the duodenal cavity or not were statistically different between the three different types of periampullary carcinoma (P ＜ 0.05).The lesions projected into the duodenal cavity of duodenum were more commonly seen in papillary carcinoma and ampullary carcinoma than distal common bile duct carcinoma.The lesion size,whether the lesion morphology changed or not with duodenum movement,enhancement level,enhancement homogeneity,the degree of bile duct dilatation,whether there was pancreatic duct dilatation or not were not statistically different between the three different types of periampullay carcinoma (P ＞ 0.05).Conclusions DCUS is an effective way to show periampullay carcinoma,and is helpful to diagnose periampullary carcinoma and distinguish the three different types of periampullary carcinoma.

Objective To analyze the reasons of focal liver lesions that difficult to detect by conventional ultrasound ultrasound-CT/MR fusion imaging.Methods 101 lesions which were confirmed by pathology or clinical diagnosis standards were recruited in the research.All of them were difficult to detect by conventional ultrasound but CT/MR display clearly.Ultrasound-CT/MR fusion imaging was used to observe the size,location and internal echo of the lesions,as well as the background of the surrounding liver parenchyma.Results All cases were successfully registrated,the registration time were 2-6min [(4.1 ±0.6)min].For these 101 lesions,93.1％(94/101) of which the diameter ≤20 mm,56.4％ (57/101) were located in hepatic segments near the diaphragm (such as S2,S4,S7,S8),78.2％ (79/101) were internal isoecho,and 79.2％(80/101) in the background of liver cirrhosis.Conclusions The important reasons that focal liver lesions detected difficult by conventional ultrasound includes:lesion size,location,internal echo and the hepatic background.

OBJECTlVE To investigate the myocardiaI toxicity of doxorubicin on the myocardium of rabbits and mechanism. METHODS Doxorubicin 2 mg·kg-1 was injected once a week for eight weeks. After discontinuation of doxorubicin,observation was performed for another 8 weeks. Every weekend, uItrasound examination,cardiac catheterization,angiotensinⅡ(AngⅡ)Western bIotting and pathoIogi-caI examination were performed to anaIyze eject fraction( EF),maximaI rate of rise of Ieft ventricuIar pressure(+dp/ dtmax ),AngⅡexpression IeveI,apoptosis index(AI)and the structure of the myocardium. RESULTS At the 7th injection,EF decreased( P ﹤0.05),but reached the bottom vaIue at the 8th injection. At the 3rd injection,Ieft ventricuIar +dp/ dtmax decreased( P ﹤0.05)and reached the bottom vaIue one week after withdrawaI. After that,it increased and reached a high vaIue six weeks after withd-rowaI. But it was stiII Iower than before administration. At the 2nd injection,AngⅡ expression increased (P﹤0.05). At 1 week after withdrawaI,it reached the top vaIue,but than decreased and reached a Iow vaIue six weeks after withdrowaI,but was stiII higher than before administration. At the 1st injection,AI increased( P ﹤ 0.05). At 1 week after withdrawaI,it reached the top vaIue,but then decreased and reached a Iow vaIue 5 weeks after withdrawaI. But it was stiII higher than before administration. CONCLUSlON Doxorubicin cardiac toxicity can induce an eIevated IeveI of myocardiaI AngⅡ,possibIy associated with increased aIdosterone and myocardiaI tension. Increased Ang Ⅱ may induce further myocardiaI structuraI damage and ventricuIar remodeIing through the ROS and caIcium imbaIance.