Objective To evaluate the value of real-time enhanced-ultrasonography (EUS) in the diagnosis of hepatic tumor. Methods Twenty-nine patients with 34 hepatic solid lesions were examined by real-time EUS,including 16 primary liver malignant tumors,4 metastatic liver tumors,5 focal nodular hyperplasias (FNH),and 9 hemangiomas. All the cases were confirmed by histopathology. The ultrasound unit (Esaote Megas) with real-time EUS technique was used. The contrast agent used was SonoVue (Bracco,Italy). Results After injection of SonoVue,all the lesions were variously enhanced on real-time ultrasonogram. A holistic inhomogeneous enhanced pattern with quick disappearing was mostly detected by real-time EUS in hepatic malignant tumors,a peripheral and centripetal enhanced pattern was mostly shown in hamangiomas,and a radial centrifugal enhanced pattern with homogeneity and quickly was observed in FNHs. If the lesions with enhancement in arterial phase and disappearing in portal phase after injection of SonoVue were regarded as a sign for malignant liver tumor,the sensitivity,specificity and accuracy in the diagnosis of liver cancer with real-time EUS were respectively 95%(19/20),100%(14/14) and 97% (33/34). Conclusions The dynamic enhanced fashions and various enhanced features in various hepatic tumors will be reflected by real time EUS,which improves the accuracy of ultrasonography in the diagnosis of liver tumors.

Objective To investigate the diagnosis of hepatic tumors by contrast-enhanced color Doppler ultrasonography. Methods Thirty-two patients with known focal liver lesions(diameter 11-112 mm,mean 43 mm) were studied with color Doppler flow imaging(CDFI) before and after injection of 2.4 ml SonoVue at the concentration of 5 mg/ml. The pathological diagnosis included 13 benign lesions and 19 malignant ones. Analysis was performed on signal intensity of intratumoral vascularity,time of enhancement duration,resistant index and maximum velocity of intratumoral arterial blood flow. The data were compared between benign and malignant lesions. Results Before injection of SonoVue,intratumoral blood flow could be detected among 53.8 %(7/13) benign lesions and 78.9 %(15/19) malignant tumors. However these detection rates went up to 76.9 %(10/13) and 100%(19/19) respectively after administration of SonoVue. Significant difference between benign and malignant tumors was observed in time of enhancement duration. Furthermore RI showed significant difference between benign and malignant lesions.Diagnostic accuracy of hepatic tumors increased from 75.0 %( 24/32 ) to 90.6 %(29/32) after enhancement. Conclusions The clinical results showed the ability of contrast-enhanced CDFI in reflecting the blood supply of the hepatic tumors,demonstrating the high sensitivity and specificity of the technique,which could be of great value to the diagnosis of hepatic tumors.

AIM To establish the HPLC fingerprints of flavonoids in Ziziphi spinosae Semen and to determine the contents of two constituents.METHODS With spinosin as a reference peak,the HPLC fingerprints of ten batches of samples were established.The analysis of methanol extract of flavonoids in Ziziphi spinosae Semen was performed on a 30 ℃ thermostatic Agilent TC-C18column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ acetic acid flowing at 1 mL/min in a gradient elution manner,and the detection wavelength was set at 280 nm.RESULTS There were ten common peaks in the HPLC fingerprints,eight of which (vicenin-Ⅱ,glucosylvitexin,isospinosin,spinosin,6'-pyridyloylspinosin,6'-p-hydroxybenzoylspinosin,6'-feruloylspinosin and 6'-p-coumaroylspinosin) were identified.Spinosin and 6'-feruloylspinosin showed good linear relationships within the ranges of 15.00-40.00 μg and 5.00-14.00 μg,whose average recoveries (RSDs)were 100.5％ (1.6％) and 100.4％ (1.6％),respectively.CONCLUSION This accurate,simple and reliable method can be used for the quality control of flavonoids in Ziziphi spinosae Semen.

Objective To compare enhancement features of hepatic tumors on SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT.Methods SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT were performed on 49 patients with 54 focal liver lesions,including 29 primary liver carcinomas,4 metastatic liver tumors,11 hepatic carvernous hemangiomas,7 focal nodular hyperplasias,2 focal fatty sparing,1 cirrhotic.Results Contrast-enhanced ultrasonography and helical CT showed consistent results in demonstrating hemodynamics of hepatic tumors.In the differentiating of malignant tumors and benign tumors,the sensitivity,specificity and accuracy of contrast-enhanced ultrasonography were(90.9)%(30/33),(90.5)%(19/21) and(90.7)%((49/54)),respectively.Those of contrast-enhanced CT were(90.9)%(30/33),(95.2)%(20/21) and(92.6)%((50/54)),respectively.Conclusions Both of the two imaging methods are valuable for differential diagnosis of liver tumors.

At present,corresponding cell-free parasite DNA molecules (CFPD) has been detected in serum,plasma,urine,saliva and other bodily fluids of a variety of the patients with parasitic diseases.Due to its high specificity and sensitivity,the CFPD shows a strong advantage of noninvasive diagnosis and continuous monitoring,etc.in parasitic diseases.This article namely reviews the current research of CFPD in the patients with parasitic disease at home and abroad in recent years,so as to provide new ideas for the development direction of parasitic disease diagnosis in the future.The current related problems are discussed in the mean time.

Objective Sodium-bile acid cotransporter plays an important role in the development of Echinococcus.The present study aimed to clone sodium bile acid cotransporter gene in Echinococcus multilocularis (EmSBACT5) and to analyze the bioinformatics of its coding protein.Methods EmSBACT5 gene was amplified by reverse transcription RCR (RT-PCR) technology and its nucleotide sequence was sequenced.Bioinformatics softwares were used to predict and analyze the physical and chemical properties, hydrophilicity/hydrophobicity, transmembrane domain, post-translational modification sites, structural domain, secondary structure, tertiary structure, subcellular localization and biological functions of the coding protein.Results The complete open reading frame was amplified with 654 bp in length, encoding 217 amino acids.The homology of the nucleic acid sequence and amino acid sequence of EmSBACT5 gene were 98% and 96% with the published SBACT5 in Echinococcus granulosus (EgSBACT5) respectively.Protein analysis results showed that the molecular formula of EmSBACT5 protein was C1141H1797N273O284S11.Its relative molecular mass was 24240 and isoelectric point was 8.99.There were 9 post-translational modification sites and 4 typical domains.Alpha helical, β-sheet, β-turn and random coil accounted for 29.95%, 31.80%, 7.83% and 30.41%, respectively.This protein was a hydrophobic membrane protein and was mainly located in the cytoplasmic membrane, and it might play a role in the processes of material transport and signal transmission.Conclusion The EmSBACT5 gene was cloned successfully and the informatics characteristics of its coding protein were obtained, which provides basic information for prevention and control of echinococcosis.

Purpose To implement lower artery angiography in patients with peripheral arterial occlusive disease, and to investigate the feasibility of lower extremity gemstone spectral CT angiography in improving image quality.Materials and Methods Forty-eight patients suspected with lower extremity arterial occlusive diseases were randomly divided into research group and control group. Research group (24 cases) were carried out gemstone spectral CT angiography (CTA) scan and control group (24 cases) were scanned with multi-slice spiral CT (CTA). The CT value of the common iliac artery, popliteal artery and its branches was measured and contrast to noise ratio (CNR) were calculated in both groups. The images were evaluated independently by 2 senior physicians based on a 5-level evaluation standard.Results The CT value of common iliac artery, popliteal artery, anterior tibial artery and the CNR in research group were all higher than those in control group (t=8.7, 7.9, 12.6 and 17.2,P<0.01), but the background noise was lower than that in control group (t=1.5,P<0.01). The scores of two image quality accessed by physician 1 and 2 were 110:90 and 111:93 respectively with statistical difference (Z=-7.6 and-8.0, P<0.01).Conclusion The image obtained by gemstone spectral CT optimal single energy image technique is much better than that by conventional multi-slice spiral CT in lower extremity angiography.

Objective To investigate insula cortex activation evoked by stimulating different acupoints of lower extremity.Methods Twenty healthy male right-handed subjects were recruited to receive functional magnetic resonance imaging(fMRI)examination with a whole-body 3T Siemens Trio system for whole-brain imaging.Participants were at rest during scanning and were instructed to relax with their eyes closed,without falling asleep.A blockdesigned method was applied for acupoint stimulation.The examined acupoints on the right lower extremity were stimulated,respectively,resulting in 4 experimental conditions.Stimulation was performed by brushing the subject's skin over each acupoint with a sponge at a frequency of approximately 2 Hz.Images were analyzed using SPM5 software package.Group analysis was performed with the mixed-effects model.Small volume correction was used to investigate insula cortex activation under each condition at a threshold of P ＜ O.01,with a 6-mm radius centered on the local maxima of activation in insula cortex.The scope of insula cortex was determined with SPM anatomy toolbox.Results All the examined acupoints induced activation in contralateral insula cortex.Activation clusters evoked by different acupoints presented various types of locations and shapes,and all of them located in the posterior part of insula cortex.Activation in the ipsilateral insula cortex was not found for all examined acupoints.Conclusions Stimulating lower extremity acupoints can activate posterior insula cortex.This effect may promote the recovery of dysphagia via several mechanisms including facilitating the initiation of swallowing,improving oral and pharyngeal sensation,and reducing taste disturbance.

Objective To compare enhancement features of primary hepatocellular carcinoma(PHCC)and recurrent hepatocellular carcinoma(RHCC) on.contrast-enhanced ultrasonography(CEUS). Methods CEUS was performed in 56 patients with 70 RHCC and 83 patients with 93 PHCC. The enhancement features of these two groups of hepatocellular carcinoma were compared. The time used for the enhancement material to arrive the lesion(Ta ), that used for the lesion to become isoechoic(T1 ) and hypoechoic relative to the surrounding hepatic parenchyma(To) were analyzed. The echogenicity change between the lesion and the parenchyma was observed during arterial phase,portal phase and delayed phase. Results The time used for the lesion to become hypoechogenicity of RHCC and PHCC was (104.0 ± 51.8)s, (85.5 ± 43.0)srespectively,there was significant difference between the two groups( P = 0.010). There were 24 (34.3 % )cases of RHCC and 16 ( 17.2% ) cases of PHCC becoming isoechoic during portal phase,the former rate was significantly higher than the later one( P = 0. 012). Conclusions There is significant difference between PHCC and RHCC in the performance of CEUS,this is useful for the early diagnosis of RHCC.

Objective To evaluate the value of contrast-enhanced ultrasonography(CEUS)in the diagnosis of hepatic artery complications after liver transplantation.Methods Thirty-seven patients suspected of hepatic artery complications were examined by CEUS.Contrast agent was SonoVue and low mechanical index harmonic CEUS was performed.Results CEUS helped significantly improve flow visualization in hepatic artery(100%).After contrast agent injection,mean contrast material arrival time was(16.1±5.5)s in hepatic artery and(19.3±4.6)s in portal vein.The diagnostic accuracy of hepatic artery thrombosis(HAT)was improved from 86%(30/35)to 100%(35/35)with CEUS.In the HAT group,contrast material arrival time in portal vein was(13.6±4.6)s,shorter to that in group without HAT(P＜0.05).Hepatic artery pseudo-aneurysm was also showed in 2 patients with CEUS after liver transplantation.Conclusions CEUS is a useful technique in improving hepatic artery visualization,which contribute to diagnose hepatic artery complications after liver transplantation.