AIM: To establish an identification method of Fritillaria based on near-infrared diffuse reflectance spectroscopy(NIRDRS). METHODS: Seven certified Fritillaria,i.e.,F.przewalskii Matim,F.cirrhosa D.Don,F.unibraacteate Hsiaaoet.K.C.Hsia,F.thunbergii Mig,F.pallidiflora,F.ussuriensis Matin and F.kupehensis Hsiaet K.C.Hsia,and three fake "Fritillaria",i.e.,F.thunbergii Varchekiugensis Hsiaet K.C.Hsia,Tulipa edulis and Iphigeniaindica were dried,grinded and sieved before their NIRDRS spectra were detected.Cluster analysis,convolution transform-visualization-similarity analysis were further employed to(identify) the NIRDRS of the ten herbal medicines. RESULTS: The zero-order NIRDRS spectra of the ten herbal medicines were too similar to be identified respectively.The cluster analysis helped differentiate the three fake "Fritillaria" from seven certified Fritillaria,but the identification between the certified Fritillaria remained dissatisfactory.The convolution transform-visualization-similarity analysis magnified and then quantified the minute differences between the certified Fritillaria,which significantly improved their identification. CONCLUSION: NIRDRS is a direct,non-destructive analytical method of solid samples.Coupled with information treatment techniques,DIRDRS provides a new identification method of crude traditional Chinese medicines.

Objective To explore the therapeutic effect of endoscopic treatment for common bile duct stricture secondary to chronic pancreatitis.Methods The clinical data of 58 patients with common bile duct stricture secondary to chronic pancreatitis diagnosed between January 2007 and January 2014 were retrospectively analysed.Results A total of 58 patients with common bile duct stricture secondary to chronic pancreatitis underwent 157 endoscopic procedures with placement of 204 polyethylene stents.The mean time of stenting was 12.2 months(3-33 months).After treatment,stricture disappeared in 20 patients(34.5％),with a mean stenting period of 7.8 months(3-22 months).Treatment was successful in 37 patients(63.8％),with a mean stenting period of 9.5 months (3-22 months),and was incompletely successful in 12 patients (20.7％) with a mean stenting period of 19.8 months(12-33 months).Nine patients(15.5％) referred to surgery were considered a failure of endoscopic therapy.Conclusion The endoscopic treatment of common bile duct stricture due to pancreatic edema or pancreatic cyst is effective.Endoscopic treatment is a safe,effective and minimally invasive method for common bile duct stricture secondary to chronic pancreatitis,which can be the first option.

Objective To survey and analyze medical postgraduates' ideological and political awareness to provide evidence for improvement of ideological and political education.Methods By using the self-made questionnaire a survey was conducted among 1 199 medical postgraduates from April 1,2013 to April 10.The questionnaire included general condition,politics status,religion,collective consciousness,learning goals,the view about the construction of ideological and political education counselor team,etc.Advice and suggestions were given according to the analysis of the results.Results A total of 1 169 valid questionnaires were collected.Among all the members,the communist party members and league members account for 33.7％ and 47.6％,respectively; 92.5％ of the students had no religious beliefs; 15.1％ served as departments cadres,6.4％ served as universitylevel cadres; 41.3％ of the students thought their tutors care for them very much,and 66.9％ of the students could communicate with tutors weekly; 38.9％ of the students complained the main pressure came from family,while 24.2％ thought the main pressure came from the employment pressure; 47.5％ thought it was very necessary to establish a professional counselor team.Conclusions The survey is scientific and reasonable,providing a reliable basis to improve our postgraduate education.Most medical postgraduates have a firm and correct political position,and their world oudook and outlook on life are basically stable.However,there are many problems needed to be solved immediately.Considering the particularity of graduate education,it is necessary to reinforce the professional counselor and tutor team and further explore the medical postgraduates' ideological and political awareness education to promote the development of postgraduate education.

Objective To evaluate the movement function of the left ventricular short-axis with parameters (velocity, acceleration and relatively force) measured with improved anatomical M-mode ultrasound. Methods Sixteen patients with myocardial ischemia coronary heart disease who had taken percutaneous transluminal coronary intervention (PCI) were enrolled. All patients were divided into two groups: group A, single major vascular stenosis (n=8);group B, more major vascular stenosis (n=8). M-mode curves of short-axis sections at mitral valve level, papillary level and apical level were recorded, then the peak myocardial velocities, acceleration and force of the systolic phase, early-diastole phase and end-diastole phase were measured at the post processing station. Results The variety ranges of average velocity and acceleration of the three levels during systolic phase were higher than that during diastole phase. The changing rate of velocity and acceleration in group B was higher than that in group A. Conclusion The new parameters that are measured and calculated with anatomical M-mode ultrasound can reflect the movement functions of coronary heart disease patients taken PCI.

This paper is aimed to evaluate the accuracy and influence factors about quantitative assessment of valve regurgitation using flow convergence (FC) method with real-time tri-plane echocardiography. By an in vitro model made by ourselves we observed the areas of the FC of the regurgitant orifice under different diameters with the real-time tri-plane echocardiography. The effective regurgitant orifice areas (EROA) and the flow rate were calculated under different pressure gradients, instrument gain and color Doppler surveying range. The results were compared with the real size of the regurgitation orifice and flow rate. In 4mm, 6mm, and 8mm diameter of the regurgitant orifice, the instrument gain and color Doppler surveying rage have not significant influence on the measurement result of flow rate (P = 0.384, P = 0.903). But the measurement result of flow rate was increased following the pressure gradient augment (P = 0.00). While in the regurgitant orifice with diameter 2mm the measurement result of flow rate was influenced by the instrument gain but was not influenced by the pressure gradient or color Doppler surveying range (P = 0.55, P = 0.39). The measurement result of EROA was correlated well with the real regurgitant orifice area (r = 0.99). Using FC method with real-time tri-plane echocardiography to quantitatively assess the valvular regurgitation is simple and feasible. But it should be noted that the pressure gradient and diameter of regurgitant orifice have shown their influence on the results.
Blood Flow Velocity ; physiology ; Blood Volume ; physiology ; Computer Simulation ; Echocardiography, Three-Dimensional ; methods ; Heart Valve Diseases ; diagnostic imaging ; physiopathology ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Models, Cardiovascular

Objective To assess the values of automated breast volume scanner (ABVS) for differentiating of benign and malignant breast masses.Methods A total 174 breast masses in 148 patients were subjected both to conventional handheld B-mode ultrasound (HHUS) and ABVS examinations.The masses were defined as five categories of benign,probably benign,equivocal,probably malignant,and malignant with each method.The results of ABVS and HHUS were compared with pathology.By using the definitive diagnosis and the five levels of suspicion categories,receiver operating characteristic (ROC) curves were drawn to evaluate their diagnostic results.In addition,the diagnostic accuracy for breast masses of futures including retraction phenomenon and hyperechoic rim in coronal plane of ABVS was evaluated.Results The area under the ROC curve of ABVS (0.927) was larger than that of HHUS (0.903) (Z =2.256,P =0.024).The specificity and the positive predictive values both reached to 100％ and false positive rate was 0 with retraction phenomenon,and the specificity and the negative predictive value were 88.89％ and 94.51％ respectively with hyperechoic rim in coronal plane of ABVS.Conclusions ABVS plays an important role in the clinical practice.The retraction phenomenon and hyperechoic rim of breast masses in coronal plane of this new modality have high specialty for differentiating malignant from benign breast masses.

The clinical analgesic effect of electro-acupuncture (EA) stimulation (EAS) on breakthrough pain induced by remifentanil in patients undergoing radical thoracic esophagectomy, and the mechanisms were assessed. Sixty patients (ASAIII) scheduled for elective radical esophagectomy were randomized into three groups: group A (control) receiving a general anesthesia only; group B (sham) given EA needles at PC4 (Ximen) and PC6 (Neiguan) but no stimulation; and group C (EAS) electrically given EAS of the ipsilateral PC4 and PC6 throughout the surgery. The EAS consisting of a disperse-dense wave with a low frequency of 2 Hz and a high frequency of 20 Hz, was performed 30 min prior to induction of general anesthesia and continued through the surgery. At the emergence, sufentanil infusion was given for postoperative analgesia with loading dose of 7.5 μg, followed by a continuous infusion of 2.25 μg/h. The patient self-administration of sufentanil was 0.75 μg with a lockout of 15 min as needed. Additional breakthrough pain was treated with dezocine (5 mg) intravenously at the patient's request. Blood samples were collected before (T1), 2 h (T2), 24 h (T3), and 48 h (T4) after operation to measure the plasma β-EP, PGE2, and 5-HT. The operative time, the total dose of sufentanil and the dose of self-administration, and the rescue doses of dezocine were recorded. Visual Analogue Scale (VAS) scores at 2, 12, 24 and 48 h postoperatively and the incidence of apnea and severe hypotension were recorded. The results showed that the gender, age, weight, operative time and remifentanil consumption were comparable among 3 groups. Patients in EAS group had the lowest VAS scores postoperatively among the three groups (P<0.05). The total dose of sufentanil was 115±6.0 μg in EAS group, significantly lower than that in control (134.3±5.9 μg) and sham (133.5±7.0 μg) groups. Similarly, the rescue dose of dezocine was the least in EAS group (P<0.05) among the three groups. Plasma β-EP levels in EAS group at T3 (176.90±45.73) and T4 (162.96±35.00 pg/mL) were significantly higher than those in control (132.33±36.75 and 128.79±41.24 pg/mL) and sham (136.56±45.80 and 129.85±36.14 pg/mL) groups, P<0.05 for all. EAS could decrease the release of PGE2. Plasma PGE2 levels in EAS group at T2 and T3 (41±5 and 40±5 pg/mL respectively) were significantly lower than those in control (64±5 and 62±7 pg/mL) and sham (66±6 and 62±6 pg/mL) groups. Plasma 5-HT levels in EAS group at T2 (133.66±40.85) and T3 (154.66±52.49 ng/mL) were significantly lower than those in control (168.33±56.94 and 225.28±82.03) and sham (164.54±47.53 and 217.74±76.45 ng/mL) groups. For intra-group comparison, plasma 5-HT and PGE2 levels in control and sham groups at T2 and T3, and β-EP in EAS group at T3 and T4 were significantly higher than those at T1 (P<0.05); PGE2 and 5-HT levels in EAS group showed no significant difference among the different time points (P>0.05). No apnea or severe hypotension was observed in any group. It was concluded that intraoperative ipsilateral EAS at PC4 and PC6 provides effective postoperative analgesia for patients undergoing radical esophagectomy with remifentanil anesthesia and significantly decrease requirement for parental narcotics. The underlying mechanism may be related to stimulation of the release of endogenous β-EP and inhibition of inflammatory mediators (5-HT and PGE2).

Objective The present study is to investigate the distribution of endogenous sulfur dioxide (SO2) in severe acute pancreatitis (SAP) rats.Methods Thirty-two SPF male Sprague-Dawley rats were randomized (random number) into sham operation group,SAP rat 3 h group (SAP 3 h),SAP rat 6 hgroup (SAP6h),SAP rat 12 hgroup (SAP 12 h),n=8 in each group.The SAPmodel rats were induced by retrograde cholangiopancreatic infusion of 5％ sodium taurocholate.Rats were sacrified 3 h,6 h or 12 h after treatment.,then we collected pancrease,liver,lung,kidney and serum.The SO2 concentration in each tissue or serum was detected by enzyme-linked immune sorbentassay.Results The concentration of SO2 in tissues of pancreas (1.72 ± 0.14) μmol/g,liver (1.62 ± 0.11) μmol/g,lung (1.65 ± 0.11) μ.mol/g,kidney (1.12 ± 0.06) μmol/g or serum (16.80 ± 1.27) μmol/g in SAP 3 h rats was not significant compared with the sham operation group (P ＞ 0.05 in each group).The SO2 content in the pancreas (1.89 ± 0.17) μmol/g,liver (1.92 ± 0.16) μmol/g,lung (1.91 ± 0.15) μmol/g,kidney (1.30 ± 0.10) μmol /g and serum (14.93 ± 1.00) μmol /g of SAP 6 h was significantly increased compared with sham operation group (P ＜ 0.05 each group).The content SO2 in the pancreas (2.31 ± 0.23) μmol /g,liver (2.22 ± 0.15) μmol /g,lung (2.17 ± 0.07)μmol /g,kidney (1.55 ± 0.15) μmol /gand serum (18.88 ± 1.56) μmol /g of SAP rats reached the peak 12Hafter treatment and was significantly higher compared with the sham operation group (P ＜ 0.05).Conclusions The increase of SO2 concentration in SAP might be,at least in our present opinion,involved into the pathogenesis of SAP rats.

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on postoperative cognitive function in the patients undergoing thoracic surgery.Methods One hundred and twenty patients undergoing lung cancer thoracotomic radical resection were randomly divided into hydrochloride penehyclidine composite ulinastatin group(HU group),hydrochloride penehyclidine group(H group),ulinastatin group(U group)and control group(C group).The arterial blood was collected for detecting OI,TNF-α,IL-6 and IL-8.The serum levels of S-100β and NSE were detected.The MMSE scores were evaluated.Results Compared with the H group and U group,the levels of TNF-α at T3-4 in the HU group were decreased,and the levels of IL-6 and IL-8 at T2-4 were decreased,while OI was increased(P＜0.05).Compared with the H group and U group,the serum levels of S-100β and NSE at T5-8 in the HU group were decreased(P＜0.05);compared with the H group and U group,the MMSE scores at T6-7 in the HU group were increased(P＜0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin could reduce the inflammation reaction during one lung ventilation in thoractomy and improves the postoperative cognitive function.

To investigate the clinical features and outcome of severe pneumonia after allogeneic hematopoietic stem cell transplantation for malignant hematological disease, the clinical features of severe pneumonia, including symptoms, signs, blood-gas analysis and thoracic X-ray change were observed, the clinical therapeutical outcome is also evaluated. The results showed that after treatment with antibiotics or antibiotics + antiviral drugs or antibiotics + antiviral drugs + glucocorticosteroids, as well as mechanical ventilation, pulmonary changes in 17 patients with sever pneumonia completely disappeared, 1 case died. In conclusion, early diagnosis and proper treatment for complicated pneumonia after allogeneic hematopoietic stem cell transplantation can decrease the mortality.
Adolescent ; Adult ; Female ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Pneumonia ; diagnosis ; etiology ; therapy ; Transplantation, Homologous