Objective To observe ultrasonographic features and the value of ultrasonography in diagnosing duodenal bulb ulcer combined with perforation.Methods The ultrasonographic features of duodenal bulb ulcer combined with perforation were studied retrospectively in 25 patients.The detection rate of duodenal bulb ulcer,peritoneal cavity free air,ascites and abdominal lumps were recorded and compared with those of X-ray examination.Results Color Doppler ultrasound before operation found 21 patients with duodenal bulb ulcer combined with perforation,18 with peritoneal cavity free air,25 with ascites and 14 with abdominal lumps.X-ray examination showed peritoneal cavity free air in 21 patients,but no ascites and abdominal lumps were found,let alone the direct features of duodenal bulb ulcer.Conclusion With regard tO duodenal bulb ulcer combined with perforation,color Doppler ultrasound can not only display peritoneal cavity free air as well as X-ray,but also show ascites and abdominal lumps,even duodenal bulb ulcer itself.Color Doppler ultrasound can make up the deficiency of X-ray examination,and is a valuable method in diagnosing duodenal bulb ulcer combined with perforation.

Objective To explore the application value of contrast-enhanced ultrasound(CEUS) in evaluating the effect of neoadjuvant chemotherapy(NAC) on breast cancer.Methods Image features of 80 breast cancer patients with neoadjuvant chemotherapy were observed and analyzed by CEUS.In the process,the changes of primary foci before and after neoadjuvant chemotherapy and the changes of qualitative and quantitative indexes of blood perfusion were evaluated.The correlation between qualitative change and pathological response was also studied.Results The change of focus size measured by CEUS was higher than that of conventional ultrasound before and after neoadjuvant chemotherapy(P ＜0.05).However,there was no significant difference between the two measurements before NAC(P ＞ 0.05).All the qualitative observation indexes of the ultrasound contrast after NAC revealed obviously benign conversion(P ＜0.05).Among them,the pathological response was closely related to the changes of the enhancement degree,the distribution of the contrast agent,the order of the contrast and the contrast mode.After NAC,the perfusion parameters of the lesions showed slowly crawl and slowly retreat,low enhancement and the diminished total amount of microcirculation perfusion.Conclusions Before and after neoadjuvant chemotherapy,the changes of the lesion size deteted by CEUS were more close to the pathological evaluation than those detected by conventional ultrasound.The benign outcome of qualitative and quantitative indexes of the CEUS was more obvious than the changes of the lesion size,which had practical value for guiding the neoadjuvant chemotherapy for breast cancer,especially the CEUS indexes related to pathological assessment.

The aim of this study is to investigate the protection effect of tanshinone IIA (Tan) against triptolide (TP)-induced liver injury and the mechanisms involved. Acute liver injury was induced by intraperitoneal injection of TP (1 mg x kg(-1)) in mice. The activities of AST, ALT and LDH in serum and the levels of GSH, GST, GSH-PX, SOD, CAT and MDA in liver tissue were detected. The histopathological changes of liver tissues were observed after HE staining. Nrf2 translocation in liver tissue was detected by Western blotting, and real-time PCR was used to measure the expression levels of GCLC, NQO1 and HO-1 mRNA. The results showed that pretreatment with Tan significantly prevented the TP induced liver injury as indicated by reducing the activities of AST, ALT and LDH (P < 0.01). Tan pretreatment also prevented TP-induced oxidative stress in the mice liver by inhibiting MDA and restoring the levels of GSH, GST, SOD and CAT (P < 0.05). Parallel to these changes, pretreatment with Tan could attenuate histopathologic changes induced by TP. Furthermore, the results indicated that Tan pretreatment caused nuclear accumulation of Nrf2 as well as induction of mRNA expression of antioxidant response element (ARE)-driven genes such as GCLC, NQO1 and HO-1. These results indicated that Tan could protect against TP-induced acute liver injury via the activation of Nrf2/ARE pathway.

Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.

Objective: To observe the manifestations of focal thyroiditis and papillary thyroid carcinoma (PTC) of conventional ultrasound and real-time shear wave elastography (SWE). Methods: Ultrasonic data of 36 thyroditis patients and 100 PTC patients (50 with Hashimoto's thyroiditis [HT]) confirmed pathologically were retrospectively analyzed, and the performances of conventional ultrasound and Young's modulus value were compared. Results: All thyroid nodules in 136 cases were solid. No significant difference of nodules' location, number, diameter, morphology nor internal calcification was found (all P>0.05), while statistically significant differences of obscure boundary, internal echo and aspect ratio>1 were detected between focal thyroiditis and PTC (all P<0.05). There was no difference of Emax, Emin and Emean of Young's modulus value between focal thyroidtis and PTC (all P>0.05), nor between patients with and without HT (all P>0.05). Conclusion: The ultrasonographic manifestations were somehow different between focal thyroiditis and PTC, being helpful to differential diagnosis. SWE showed no significant differential diagnostic value for focal thyroidtis and PTC, which was not obviously affect by combination of HT or not.

Objective To discuss the degenerative factors, the spinal segment distribution, and the mechanism in hyperextension injury of cervical spine. Method Eighty-nine patients with hyperextension injury of cervical spine were retrospectively analyzed by observing the degenerativelesion, the spinal cord segment with high signal in T2WI, and the location of facial trauma. Results Fifty-eight cases showed the disc hemiation which was the most common lesion, followed by 8 cases showing the calcification of the posterior longitudinal ligament. Besides, 7 cases presented the developmental stenosis of spinal canal, and also, 6 cases showed disc hemiation combined with the yellow ligament hypertrophy. The intervertebral level of the spinal cord with high signal in T2WI were distributed as follows:4 cases were at C2/3, of which onesuffered the forehead trauma; 12 cases were at C3/ 4, of which 10 had the forehead trauma, and one had the zygomatic trauma; 12 cases were at C4/5, of which 5 had the forehead trauma, one had both the zygomatic and the forehead trauma, and one had both the forehead and with the lower jaw trauma; 11 cases were at CS/6,of which 3 had the forehead trauma, 3 had the zygomatic trauma, and 2 had the lower jaw trauma. The location of the spinal cord with single high signal in T2WI did not correspond with the intervertebral disc level in 4 cases. For 10 cases the high signal in T2WI was found at two discontinuous segments. For 2 cases the 1 high signal in T2WI was found at over two segments. For 6 cases the high signal in T2WI was found at over three segments. Conclusions Disc hemiation is the most common underlyding factor in cervical hyperextension injury. The spinal level with high signal in T2WI was correlative to the impacted facial site. The shear force at the inflection point with or without the anterior-posterior compression force accounted for the cervical hyperextension injury.

Objective To investigate the expression of inflammatory mediators in renal tubular epithelial cells in patients with diabetic nephropathy (DN) and to explore the possible clinicopathological significance. Methods Twenty-three patients with DN diagnosed by renal biopsy and 10 patients with renal cell carcinoma undergone nephrectomy were allocated into DN group and control group, respectively. The renal expression of NF-κB p50, NF-κB p65, NF-κB p65 mRNA, MCP-1, OPN, α-SMA, and FN was detected by immunohistochemical or in situ hybridization assay. Serum creatinine, urinary N-acetylglucosaminedase (NAG), urinary albumin and 24-hour urinary protein were detected. The correlation between these inflmmnatory markers and clinicopathological data were analyzed. Results (1)Among all the 23 DN patients, granular degeneration of the renal tubular epithelium, focal tubular atrophy, infiltration of inflammatory cells and interstitial fibrosis were apparent, and none of these were found in control group. (2) Immunohistochemical and in situ hybridization assay showed that, compared with control group, expression of these factors increased significantly in renal tubular cells or interstitium in DN patients, and expression of α-SMA or FN was not found in tubular epithelial cells. (3)Statistics assay showed the tubular NF-κB p65 protein expression was correlated with all of the following factors: NF-κB p50 protein (r=0.792) and NF-κB p65 mRNA (r=0.763), tubular MCP-1 (r=0.825) and OPN (r=0.869) expression, interstitial α-SMA (r=0.327) and FN (r=0.432) expression, proteinuria(r=0.710), estimated glomerular filtration rate (eGFR) (r=-0.728), and urinary NAG (r= 0.930), P<0.01 respectively. Conclusion Tubular inflammation may play a role in the pathogenesis and progression of DN.

Objective To study on whitening and anti -aging effect of ginseng saponin and its safety.Methods Whitening effect:using vitamin C as the control drug, the inhibition rate of tyrosinase was determined.Anti senescence effect: the aging model of D-was established, and the DPPH was applied to the skin of the rat's neck, and the drug was prepared by 2 times a day.Skin safety evaluation: the skin changes of the skin of the ginseng saponins were observed after the skin was given ginseng saponin and control drugs.Results When the concentration of ginsenoside was 7 mg/mL, the inhibition rate order was, the water solution of vitamin C >ginsenoside nano >ginsenoside aqueous solution ; In the aging model, the surface of the elastic fibers and the skin surface was parallel to the skin, but the elastic fibers were arranged in a more tortuous and non parallel to the skin;DPPH free radical scavenging effect order was, Vitamin C aqueous solution>ginsenoside nano>ginsenoside aqueous solution, and with the dosage of ginsenoside increasing, the efficiency of ginsenoside DPPH scavenging free radical increased significantly;Skin safety evaluation results showed that ginseng saponin nanometer milk smeared skin, no redness, irritation and other phenomena occured.Conclusion Ginseng saponin nanometer milk has obvious whitening effect, and can not cause damage to the skin, is safe and reliable.

This study is to investigate the protection effect of schisandrin B (Sch B) against oxidation stress of HK-2 cells induced by cisplatin and the mechanisms involved. HK-2 cells were cultured and divided into different groups: solvent control group, cisplatin exposure group, positive group, Sch B treatment group. Cell viability and toxicity were evaluated by MTT and LDH assay. GSH level and SOD enzymes activities were also measured. DCFH-DA as fluorescence probe was used to detect ROS level by fluorescence microplate reader. Nrf2 translocation was detected by Western blotting. Real time Q-PCR was used to detect expressions of NQO1, HO-1 and GCLC mRNA level. The results showed that Sch B could significantly inhibit the decline of cell viability induced by cisplatin treatment (P < 0.05) and the protective effect was in a dose dependent manner. Furthermore, Sch B treatment significantly inhibited the increase of ROS level induced by cisplatin and reversed the decrease of GSH level (P < 0.05). When Sch B concentration was up to 5 micromol x L(-1), SOD enzyme activities were also enhanced significantly compared with that of the cisplatin group (P < 0.05). It was shown that Sch B could cause nuclear accumulation of Nrf2 in association with downstream activation of Nrf2 mediated oxidative response genes such as GCLC, NQO1 and HO-1. These results suggested Sch B could protect against the oxidative damage of HK-2 cells induced by cisplatin via the activation of Nrf2/ARE signal pathway.

Objective To evaluate the risk factors of massive blood loss in resection of giant liver hemangioma.Method The clinical data of 141 patients who underwent giant liver hemangioma resection were retrospectively studied.These data included general physical condition,laboratory tests,radiologic findings,and various surgical parameters.The patients were divided into the massive blood loss group (＞ 1 000 ml,n =27) and the minor blood loss group (≤1 000 ml,n =114).Logistic regression was performed to determine the risk factors of intraoperative massive blood loss.Results The average diameter of the liver hemangioma was significantly greater in the massive blood loss group than that in the minor blood loss group [(21.7 ± 8.5) cm vs.(14.1 ± 5.3) cm,P ＜ 0.05].The incidences of preoperative leukopenia,anemia,thrombocytopenia and prolonged prothrombin time were higher in the massive blood loss group than that in the minor blood loss group (48.1％ vs.16.7％,37.0％ vs.11.4％,25.9％ vs.3.5％,22.2％ vs.3.5％,respectively,all P ＜ 0.05).Hepatic hemangioma with compressed hepatic veins,inferior vena cava and porta hepatis were more frequently found in the massive blood loss group than in the minor blood group (55.6％ vs.14.9％,44.4％ vs.14.0％,55.6％ vs.12.3％,respectively,all P＜0.05).Logistic regression analysis demonstrated a diameter of hemangioma greater than 15 cm was a risk factor of intraoperative massive blood loss during surgical resection.Conclusions Giant hepatic hemangioma may cause disorders in the hematological and coagulation systems.Compression of major hepatic vessels raised technical difficulty and risks in surgery.Hemangioma with a diameter greater than 15 cm was recognized as a high-risk factor of intraoperative massive blood loss.