This study was aimed to investigate structured approach of traditional Chinese medicine (TCM) symptom information. Combining results of the Chinese Symptomatology Research and literature review, this study proposed a dual structure model of symptom. A total of 440 symptoms, which were screened out from the Chinese Terms in TCM and Pharmacy, were used for symptom structured attempt. The results showed that 9 symptoms and 9 attributes were identified, 201 main concept words of symptoms were extracted, and 420 symptoms with the dual structure model were structured. It was concluded that structural information model of TCM symptoms proposed in this study was feasible. However, the research methods and results are exploratory, which requires further verification.

Objective To observe the changes in fibrinolytic factors in rats with pulmonary thromboembolism (PTE) after recombinant prourokinase ( rPro-UK) treatment and its significance .Methods PTE was induced in male Sprague-Dawley (SD) rats by injecting heated 125iodine-labeled fibrinogen(Fib) autologous thromboemboli into external jugular veins.Twenty-eight rats were randomly assigned into following groups (7 rats each):①healthy control group;②PTE 5 d group,the rats in which were sacrificed at 5 d after the PTE model was made; ③ PTE3d receiving rPro-UK thrombolytic treament groups including multibolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of a lower dose 0.25 mg/kg and rats were sacrificed 2 h after the last injection at the same time as PTE5d group) and single bolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of 0.5 ml saline and rats were sacrificad at the same time as the former group ).The rats were quickly sacrificad at the fixed time through carotid bleeding and plasma samples were reserved for analysis of uroki -nase-type plasminogen activator (u-PA), urokinase-type plasminogen activator receptor (u-PAR), fibrinogen (Fib) andα2-antiplasmin (α2-AP) .Results ①Plasma concentrations of u-PA and u-PAR were increased were significantly in rPro-UK multibolus treatment sub group than in PTE 5 d group(Pu-PA <0.05,Pu-PAR <0.01)and rPro-UK single bolus treatment sub group(Pu-PA <0.01,Pu-PAR <0.05),correlated with the thrombolysis rate in rPro-UK multibolus treatment sub group (ru-PA =0.766,P<0.05;ru-PAR=0.785,P<0.05).② No difference of plasma Fib and α2-AP was seen between Pro-UK treatment groups and PTE 5 d group(P >0.05).Conclusion ① Plasma levels of endogenous u-PA and u-PAR are increased at different time points after PTE and are further enhanced after Pro-UK treatment, which promotes endogenous fibrinolysis and thrombus lysis .This is probably related to increased synthesis and secretion of endothelial cells which may be a key thrombolytic mechanism of Pro-UK.②Absence of systemic activation of the fibrinolytic system in Pro-UK multibo-lus treatment sub group means that the regimen is feasible and Pro-UK is fibrin specific .

Objective To estimate the value of diffusion weighted imaging with background body signal suppression(DWIBS)in tumors of intestinal tract and metastasis.Methods 15 cass with tumors of intestinal tract underwent MRI and DWIBS examinations.Four of them underwent CT scan.Results All primary tumors were showed by conventional MR sequences and DWIBS.DWIBS showed that 4 cases had the invasion of placenta percreta,5 cases had transcoelomic metastasis in abdominal cavity and 5 cases had lymphatic metastasis,while the conventional MR sequences showed the invasion of placenta percreta in 10 cases,the invasion of fat interspace in 8 cases,transcoelomic metastasis in abdominal cavity in 3 cases and lymphatic metastasis in 3 cases.Conclusion DWIBS is better than the conventional MR sequences and CT in detecting the primary tumor of intestinal tract,transcoelomic metastasis in abdominal cavity and lymphatic metastasis.However,the conventional MR sequences and CT is better than DWIBS in detecting the invasion of placenta percreta and fat interspace.

Objective To investigate the features of quantitative analysis and parametric imaging of contrast-enhanced ultrasound (CEUS) in renal clear cell carcinoma (ccRCC).Methods Ninety-seven pathologically confirmed ccRCCs underwent conventional ultrasound and CEUS.Both quantitative parameters and dynamic vascular pattern (DVP) reconstructure were analyzed with Sonoliver software.Four types of DVP curves were described with type Ⅰ (Unipolar +),type Ⅱ (Bipolar + /-),type Ⅲ (Bipolar -/+) and type Ⅳ (Unipolar-),while the DVP parametric images,similarly,were divided into four types,with type Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.Results As for the parameter of CEUS,there were statistical differences in maximum intensity (IMAX),area under the curve (AUC) and mean transit time (mTT) (P ＜0.05) and no statistic differences in rise time (RT) and time to peak (TTP) between ccRccs and peripheral renal parenchyma.Concerning of DVP of ccRCCs,type Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 58.8％ (57/97),11.3％ (11/97),10.3％ (10/97) and 19.6％ (19/97) respectively.As for each type in DVP parametric images,the percentages were 58.8％ (57/97),11.3％ (11/97),8.2％ (8/97),21.7％ (21/97),respectively.Conclusions Quantitative analysis and parametric imaging can depict different features of vascularity in ccRCCs and improve the diagnosis of the tumors.

Objective To investigate the usefulness of acoustic radiation force impulse (ARFI) elastography for noninvasive evaluation of liver fibrosis in rats.Methods A total of 70 male Wistar rats were included in the group for dimethylnitrosamine (DMN)-induced liver injury,and 10 saline-injected rats were used as normal control.Hepatic injury was induced by a single intraperitoneal injection of DMN at a dose of 50 mg/kg of body weight.Several rats in the group with DNM injected and the normal control group were randomly selected and sacrificed at each of the following post-injection time:day 5,7,10,14,21,24,and 28.And their livers were taken for pathology analysis.All the rats underwent ARFI elastography before sacrificed in order to acquire a shear wave velocity (Vs) to represent liver stiffness.Correlation between Vs and the histological finding was analysed.ResultsAmong 58 successfully modeled rats,9,13,14 and 12 rats were found to be with S1,S2,S3 and S4 of liver fibrosis pathologically,respectively.And 10 rats were found to be with severe inflammatory activity without any fibrosis.Values of Vs increased with the stage of liver fibrosis ( P ＜0.05).There was a significant correlation between Vs and stage of liver fibrosis ( r =0.947,P =0.000).The areas under ROC curve for the diagnosis of fibrosis S≥S1,S≥S2,S≥S3 and S=S4 were 0.983,0.995,0.999 and 0.964,respectively;for the cutoff values of Vs were 1.59 m/s,2.13 m/s,2.33 m/s and 2.51 m/s,respectively,the sensitivity was 95.8％,92.3％,100％ and 84.6％,and specificity was 100％,100％,96.9％ and 95.6％,respectively.The values of Vs in the group with severe inflammatory activity were significantly higher than those in the control group ( P =0.000).ConclusionsARFI has a relatively high value in the evaluation of liver fibrfosis in rats,while severe inflammatory activity may affect its accuracy.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in preoperative classification for hilar cholangiocarcinoma. Methods Forty-six patients with 46 hilar cholangiocarcinoma were diagnosed by surgical pathology in Zhongshan Hospital of Fudan University from January 2007 to April 2013. The echogenicity difference on conventinal ultrasound and CEUS were compared with chi-square test. The accuracy of conventinal ultrasound and CEUS for evaluating invaded bile duct, detective rates for portal vein invasion and displaying rate of metastatic hilar lymph nodes were compared with chi-square test or Fisher’s Exact test according to the golden standard of operative exploration. Results On CEUS, 82.6%(38/46) and 91.3%(42/46) hilar cholangiocarcinoma were hypoechoic in portal vein phase and delayed phase respectively, while 63.0%(29/46) hilar cholangiocarcinoma were isoechoic on conventinal ultrasound with vague margin. The clearly displaying rates were 37.0%(17/46), 84.8%(39/46) and 91.3%(42/46) in conventinal ultrasound, portal vein and delayed phase of CEUS and the echogenicity was signiifcantly different. The evaluation accuracy of hilar cholangiocarcinoma invading bile duct was improved from 80.4%(37/46, conventinal ultrasound) to 100%(46/46, CEUS) significantly (χ2=7.882,P=0.005). Portal vein invasion were found in 9 cases during operative exploration and the detective rates on conventinal ultrasound and CEUS were 78%(7/9) and 89%(8/9) without signiifcant difference (P=1.000). Metastatic hilar lymph nodes were found in 8 cases and the displaying rates on conventinal ultrasound and CEUS were the same (75%, 6/8) without signiifcant difference (P=1.000). Conclusions CEUS could signiifcantly improve the clearly displaying rate of hilar cholangiocarcinoma and improve the evaluation accuracy for invaded bile duct comparing with conventinal ultrasound.

Objective To explore the enhancement pattern and characterization of hepatic hemangionmas with contrast enhanced ultrasound (CEUS).Methods A total of 44 patients with 49 nodules preliminary diagnosed of liver hemangioma were included in this study.For each nodule,the enhancement pattern,level,and dynamic change of CEUS were evaluated,and the features of hemangionmas were groups as echoic and compared with those on CEUS.Results All hemangiomas enhanced in arterial phase with centripetal progression in venous and late phase on CEUS,among which 41 lesions showed peripheral nodular enhancement while 8 showed peripheral rim-like enhancement.The whole-tumor enhancement pattern was seen in 13 lesions and part-tumor enhancement was shown in 36 lesions.The performance of part-tumor was independent of tumor echoic and hypoechoic tumors mostly presented to be whole tumor enhancement pattern.During portal venous and late phase,42 lesions showed hyperenhancement,while 7 lesions showed isoenhancement.Conclusions CEUS can suggest the enhancement dynamic characters of hepatic giant hemangionmas and reveals the relationship of grey-scale echoic and enhancement pattern of hemangiomas.It is important to diagnose the hepatic giant hemangionmas for CEUS.

Objective To compare the hemodynamics features of recurrent hepatocellular carcinoma between contrast-enhanced ultrasonography (CEUS) and contrast-enhanced MRI (CEMRI).Methods Forty three recurrent hepatocellular carcinoma lesions in 39 patients were evaluated by CEUS and CEMRI.All lesions were proved by operation or needle biopsy.The dynamic enhancement and washout process on CEUS and CEMRI were analyzed.Results On both two methods,all lesions showed hyperenhancement.Among which,30.2％ (13/43) lesions showed hyperenhancement during arterial phase and no washout was found during portal venous phase,37.2 ％ (16/43) lesions hyperenhanced during arterial phase and washout during portal venous phase.During late phase,the enhancement of 60.5％ (26/43) lesions decreased and 7.0％ (3/43) lesions showed no washout on CEUS or CEMRI.The overall concordance ratio between two methods was 67.4％ (29/43).Difference of hemodynamics features between CEUS and CEMRI was not statistically significant.Conclusions CEUS can accurately display the hemodynamic features of recurrent hepatocellular carcinoma,and enjoy high consistence with CEMRI.

Objective To investigate the discriminant analysis model of gray-scale ultrasound (GSUS),contrast-enhanced ultrasound (CEUS) and the combination of them in the differential diagnosis of benign and malignant thyroid lesions and the diagnostic values.Methods Ultrasound images of 211 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape (X1),orientation (X2),interior echogenicity (X3),halo sign (X4),and microcalcification (X5),as well as 6 CEUS indicators including relative arrival time of microbubhles in the periphery (X6) and interior (X7),peak periphery (X8) and interior (X9)echogenicity,peripheral ring-enhancement (X10),homogeneity of enhancement (X11).The diagnostic models with their values of GSUS,CEUS and the combination of them were explored by discriminant analysis.Results The discriminant analysis function of GSUS in the diagnosis of thyroid benign and malignant lesions was g1 (X) =0.715 X1+0.276X2 + 1.028X3 +1.197X4 +0.923X5-2.202 with the diagnostic value 86.3％,the discriminant analysis function of CEUS was g2(X) =-0.392X6 +0.541X7-0.117X8 +0.562X9 + 1.173X10 +2.200X11-1.956 with the diagnostic value 89.1％,and the discriminant analysis function of the combination of GSUS and CEUS was g3 (X) =0.418X1 + 0.173X2 + 0.626X3 + 0.558X4 + 0.183X5-0.476X6 + 0.474X7-0.071X8 + 0.399X9 + 0.985X10 +1.639X11-2.530 with the diagnostic value 91.0％.Conclusions GSUS and CEUS were valuable in the differential diagnosis of benign and malignant thyroid lesions,and the combination of GSUS and CEUS was most valuable.

Objective To preliminarily evaluate the feasibility of elastography point quantification (ElastPQ) technology in the determination of liver stiffness as well as its impact factors.Methods Amount to 235 patients with liver neoplasms underwent liver stiffness measurement in the right lobe of liver using an ultrasound scanner (iU Elite,Philips).ElastPQ values were obtained and compared with the liver fibrosis stage (S),the grade of necroinflammatory activity (G) and steatosis assessed histologically as well as gender and age.The factors related to ElastPQ values were explored by stepwise regression in multiple linear regression analysis and the regression equation was established.Results In the multiple linear regression model of ElastPQ values,liver fibrosis and necroinflammatory activity were associated with ElastPQ (P ＜ 0.05) while other factors including age,gender and hepatic steatosis had no effect on ElastPQ statistically (P ＞0.05).The equation of linear regression was ElastPQ =1.205S + 1.075G + 4.537.Conclusions ElastPQ technique is a reliably noninvasive tool in the liver stiffness measurement.Liver fibrosis and necroinflammatory activity are the main factors affecting liver stiffness measured by ElastPQ.