In order to meet the requirements of ultrasound bone density measurement, we designed a sofware based on Visual Studio C+ + 2008. The software includes interface design, acquisition and control, data processing and parameter extraction, data storage and printing. Excellent human-computer interface (HCI) will give users a convenient experience. Auto gain control (AGC) and digital filter can improve the precision effectively. In addition, we can observe waveform clearly in real time. By using USB communication, we can send control commands to the acquisition and get data effectively, which can shorten the measuring time. Then we calculated the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Patients' information can be accessed by using XML document. Finally, the software offers printing function.
Absorptiometry, Photon ; instrumentation ; Bone Density ; Humans ; Information Storage and Retrieval ; Software ; Sound ; Ultrasonics ; methods ; User-Computer Interface

This study was aimed to optimize the extraction technology of Shu-Feng Ding-Chuan(SFDC) granules in the Huang-Qin(HQ)group by Box-Behnken response surface methodology(RSM).With three major characteristic components (baicalin,praeruptorin A and solid content in extraction liquid),the effects of four factors,such as the concentration of ethanol,the dosage of ethanol,the duration of extraction and the extraction times,were investigated by the single factor experiment.Then,the range of parameters of key factors was further studied and explored by Box-Behnken RSM.The results of single factor experiment and Box-Behnken design showed that the optimum preparation conditionswere 8-fold 70% ethanol,extracted for 2 times,with 1.0 h per each time.Under these conditions,the transfer rates of baicalin and praeruptor in A were 89.57% and 87.90%,respectively.And the transfer rateof solid content was 32.35%.It was concluded that the single factor experiment combined with RSM can be used in theoptimization of extraction technology for SFDC granules in the HQ group.This technique wasstable and feasible,which provided scientific evidences for the industrial production.

Objective To investigate the effects of dexmedetomidine on acute lung injury induced by hind limb ischemia-reperfusion in rats. Methods Sixty healthy male Wistar rats were randomly allocated into 4 groups: group C(control), group I-R(ischemia-reperfusion), group Pre-Dex(dexmedetomidine)and group Post-Dex. The morphological changes of the lung tissues were observed under light microscope , and polymorphonuclear neutrophils (PMN) in alveolar septum were counted. Meanwhile, lung coefficient, arterial partial PaO2, lung levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interleukin (IL)-10, and malondialdehyde (MDA) were measured. Results Rats in the I-R group were resulted in the damage of the lung tissues. The rats in group Pre-Dex and group Post-Dex were featured with obvious mild lung injury. TNF-α、IL-6、IL-10 and MDA in lung levels were significantly increased in group I-R , Pre-Dex and Post-Dex. TNF-α, IL-6 and MDA in the lung were significantly decreased in group Pre-Pex and group Post-Dex. IL-10 was increased in group Pre-Dex and group Post-Dex. Conclusions Inflammatory response and oxidative stress are involved in the pathogenesis of acute lung injury induced by hind limb ischemia-reperfusion in rats. Dexmedetomidine attenuated the lung injury through anti-inflammation and anti-oxidation.

Objective To investigate the inhibitory effect of blocking PI3K/AKT pathway by wortmannin on hypoxia-inducible factor 1α (HIF-1α) and the effect on the expression of glycolysis associated genes in human esophageal carcinoma cell lines TE1 and TE13,and to analyze the relation between PI3K/AKT-HIF-1α pathway and glycolysis in esophageal carcinoma cells. Methods Esophageal carcinoma cell lines TE1 and TE13 pretreated with wortmannin (2 μmol/L) were incubated under normoxic and hypoxic conditions.And each cell line was divided into four groups.The expression of HIF-1α and glycolysis associated genes GLUT-1,LDHA and HK-Ⅱ at protein level were measured by.Western blot.The expression of HIF-1α,GLUT-1,LDHA and HK-Ⅱ at mRNA level was determined by real-time PCR. The activities of LDH and HK-Ⅱ and lactic acid (LA)concentration in the culture supernatant were tested with spectrophotometer method.Results Under normoxic condition,HIF-1α was expressed in TE1 cells and the expression of HIF-1α was inhibited by wortmannin (2 μmol/L),the most significant inhibitory effect was at 12 hours,therefore 12 hours was selected for the subsequent hypoxia experiment.Compared with untreated cells,the expression of HIF-1α、HK-Ⅱ 、GLUT-1、LDH-A at protein level significantly decreased in TE1 and TE13 cells after pretreated with wortmannin (P ＜ 0.05),and the expression of HIF-1α、HK-Ⅱ at mRNA level significantly decreased (P＜ 0.05).Under normoxic and hypoxic conditions,the HK-Ⅱ and LDH activities in TE1 and Te13 esophageal carcinoma cells significantly decreased after treated with wortmannin compared with untreated cells (P＜0.05).Under hypoxia condition,the enzyme activity increased in untreated cells (P＜ 0.05). Under normoxic and hyp0xic conditions,the lactic acid concentration in the culture supernatant obviously decreased in cells treated with wortmannin compared with untreated cells (P＜ 0.05). Under hypoxia condition,lactic acid concentration increased in wortmannin treated cells (P ＜ 0.05). Conclusions Under normoxic and hypoxic conditions,wortmannin decrease lactic acid concentration through inhibiting the expression of HIF-1α and glycolysis associated genes, which indicate PI3K/AKT-HIF-1α pathway was closely related to glycolysis in esophageal carcinoma cells.

Objective To compare the short- and long- term effects and safety of endoscopic balloon dilatation vs. placement of specially designed reclaimable self-expanding anti-reflux esophageal stents for achalasia. Methods A total of 129 patients with achalasia were divided into 2 groups to receive either endoscopic scopic balloon dilatation(,l=63)or endoscopic placement of specially designed reclaimable self-expandinganti-reflux esophageal stents (n = 66). The dysphagia symptom scores were recorded before and 1-month,6-month and 12-month after the procedure, respectively. The change in width of esophagus, procedure related complications, length and costs of hospitalization were also analyzed. Results Dysphagia symptom score was significantly decreased after the treatment in both groups (P < 0.05). The effective rates evaluated at 1-month, 6-month and 12-month after the procedure in balloon dilatation group were 100. 0% , 96. 7% and 91.5% , respectively, which in stenting group were 100.0% , 98. 0% and 97.1% , respectively. There was no significant difference in changes of symptom score at 1-month and 6-month after treatment between the 2 groups (P > 0.05) , while at 12-month after treatment, the decrease of symptom score in stenting group was significantly higher than that in balloon dilatation group (P<0. 05). After the treatment, the significant widening of the stricture and narrowing of the dilated esophagus were achieve in both groups (P < 0.05),while no significant difference between these 2 groups was observed in changes of width (P > 0. 05). Procedure related complications in balloon dilatation group included esophageal perforation (n =1) and upper gastrointestinal bleeding (n=4) , which was not occurred in stenting group, but complications included hyperplasia of granulation tissue (n = 1), stent dislocation (n =2) and defulvium (n = 1) was observed inthe latter group. The length of hospitalization was similar in 2 groups (P > 0. 05) , and the cost of hospitalization in stenting group was significantly higher than that of balloon dilatation group (P < 0. 05). Conclusion Compared with endoscopic balloon dilatation, the specially designed reclaimable self-expanding antireflux stents is a more ideal method for achalasia, with similar short-term effect, but better long-term effect and safety.

This study was aimed to establish an HPLC method for the content determination ofepimedin A, epimedinB,epimedinC,epimedium glycoside,baohuosideI in epimedium flavonoids capsule. The elusion was performed on an Eclipse Plus C18column (250 mm× 4.6 mm, 5μm). The mobile phase was composed of acetonitrile and water with a gradient elution. The flow rate was set at 1 mL·min-1. The detection wave length was set at 270 nm. The column temperature was 25℃. The results showed that the linear ranges of epimedin A,epimedinB,epimedinC,epimedium glycoside,baohuosideI were 3.10-62.00μg·mL-1, 5.70-114.00μg·mL-1, 9.14-182.80μg·mL-1, 15.20-304.00μg·mL-1, and 1.56-31.20μg·mL-1, respectively. The correlation coefficientr was more than 0.999 3. The average recoveries were 101.06% (RSD = 1.05%,n = 6), 100.78% (RSD = 1.08%,n = 6), 99.17% (RSD = 1.14%,n = 6), 100.23% (RSD = 0.68%,n = 6), and 99.09% (RSD = 1.30%,n = 6), respectively. This experiment was precise, reproducible and stable. It was concluded that the method was simple and accurate, which provided a certain reference value for the multi-component assaying of epimedium flavonoids capsule.

Objective To evaluate the prophylactic effects of propranolol, propranolol plus endoscopic variceal ligation (EVL) and propranolol plus endoscopic sclerotherapy (EVS), and to determine the most effective combination for secondary prevention of esophageal variceal bleeding.Methods After hemostasis, a total of 78 patients with esophageal variceal bleeding were randomly assigned to receive propranolol (propranolol group), propranolol plus EVL (ligation group) or propranolol plus sclerotherapy (EVS group), with 26 in each group.All patients were followed up for 12 months, and the rates of variceal re-bleeding, mortality, portal hypertensive gastropathy (PHG), re-occurrence of esophageal varices and formation of gastric fundus varices were compared among different groups.Results During the 12-month follow-up, the rate of re-bleeding in EVL group (30.77%) was significantly lower than those of the EVS group (42.31%) or propranolol group (53.85%) (P<0.05).The occurrence of PHG and fundal varices in patients of EVL group was similar to that of propranolol group, which were both lower than that of EVS group (P<0.05), but the re-occurrence of esophageal varices in EVL group was significantly higher than that of EVS group (P<0.05).Conclusion EVL plus propranolol might be the most effective therapy for secondary prophylaxis of esophageal variceal bleeding.

Objective To evaluate the efficacy and safety of covered metallic stents in the management of proximal esophageal strictures.Methods Retrievable covered self-expanding metallic stents were inserted individually in 43 patients with malignant strictures of the proximal esophagus.Main outcome measures included improvement of dysphagia,sealing of fistula and complications were evaluated.Results A total of 45 stents were placed in 43 patients,with a success rate of 95.6％ (43/45) at the first stent placement attempt.The dysphagia score improved significantly from 3.3 ± 0.6 to 1.8 ± 0.9 (P ＜ 0.001),with 18 having an excellent response and 25 having a good response.Improvement rate of dysphagia was 95.6％ (43/45).Fistula sealing was achieved in 7 of 9 patients (77.8％).Early complications included severe pain (n =5),mediastinal emphysema (n =1),moderate fever (n =9) and collapse of the proximal end of the stent (n =1),while late complications included migration (n =3) and tissue overgrowth (n =6).Conclusion Retrievable covered metallic stent placement is effective and safe for the palliation of obstructive dysphagia and sealing of fistulas in malignant proximal esophageal strictures.

Objective To investigate the effect of different frequencies of endoscopic ultrasonography (EUS) on diagnosis of duodenal submucesal lesions. Methods A total of 210 elevated duodenal lesions detected by routine endoscopy in 201 patients were examined by EUS at different frequencies according to lesion features and image clarity. Endoscopic resection was applied in 27 lesions with informed consents,and pathological findings were compared with the results of EUS. Results The accuracy of EUS was 81.4% (22/27). Ultrasound of low frequency was superior in displaying overview of lesion and was more suitable for lesions larger than 1.5 cm in diameter or lesions of hyperecho. On the other hand,ultrasound of high frequency was more reliable to reveal minute structures and could be employed in scanning lesions smaller than 1.5 cm in diameter. Combination of different frequencies of ultrasound could provide more details in larger lesions. Conclusion Application of appropriate frequency or combined frequencies of ultrasound in examination of elevated duodenal lesions is beneficial to achieve more accurate diagnosis.

OBJECTIVEApplication of real-time shear wave elastography (SWE) measurement of patients with Chronic severe hepatitis B and liver cirrhosis of the liver stiffness, aimed to explore SWE can evaluate the existence of liver cirrhosis patients with esophageal varices (EV) and its severity.

METHODSAccording to the results of gastroscope, 256 cases of patients with chronic liver disease and cirrhosis of the liver can be divided into no EV group,mild EV group,moderate to severe EV group,analysis between groups in patients with liver stiffness, portal vein,spleen vein diameter, the correlation of liver fibrosis indexes and the degree of esophageal varices.Using receives operating characteristic curve (ROC) and area under curve of ROC to evaluate each index prediction ability.

RESULTSCompare the liver stiffiness, portal vein,spleen vein diameter had statistically significant difference in the no EV group, mild EV group,moderate to severe EV group, (F values are respectively 137.86,44.77,73.88, P < 0.05), Patients age, type IV collagen, larninin, hyaluronic acid had no statistically significant difference in the no EV group and mild EV group (P > 0.05) and had statistically significant difference in the other two groups (P < 0.05). Patients with gender, pro-collagen type III N-terminal peptide (PC III NP) had no statistically significant difference in the three groups (P > 0.05). Correlation analysis showed that portal vein, spleen vein diameter, type IV collagen, laminin, hyaluronic acid showed significant positive correlation (P < 0.05),highest correlation was liver stiffness and the degree of esophageal varices, correlation coefficient of 0.689 (P < 0.01). PC III NP and the degree of esophageal varices, liver stiffness showed no correlation (P > 0.05). Liver stiffness area under the ROC curve is 0.923, with a strong ability to predict than the portal vein and splenic vein diameter, LN, IV-C, HA, PCIII NP. Liver stiffness more than 7.55 kPa, diagnose mild EV sensitivity 90.5%, specificity 60%.Liver stiffness more than 18.85 kPa,the sensitivity of the diagnosis of severe EV 82.4%, specificity of 90.5%.

CONCLUSIONSSWE liver stiffness measurement was predicted the existence of the EV and the severity of liver disease patients and effective inspection method, can be used as evaluation of liver disease patients with esophageal varices non-invasive indicator of the initial screening.