Objective Using coded harmonic angiography to observe hepatocellular carcinoma blood perfusion features,further assess this modality clinical value in qualitative diagnosis of liver malignant tumor.Methods Through left forearm vein bolus injection of fluorine-carbon contrast agent,35 patients with 41 hepatocellular carcinoma lesions were examined with coded harmonic angiography,intratumoral vessel enhanced time,vascularity,blood perfusion were observed.All patients were simultaneously videotaped before and after contrast.Results It was about 15～20 s after the injection of contrast agent when the enhancement of tumor had just commenced,peak time about 60～90 s and persistence time about 240～300 s.Lesions were more obviously enhanced than normal liver tissue,several tumor vascularity was displayed from border to center,contrast agent gradually centripetal filled-in,formed "weeping-willow" echo.Pressed and rimlike peripheral vessel developments were earlier than normal liver tissue.Conclusions Coded harmonic angiography could real-timely display hepatocellular carcinoma blood perfusion,which has an important clinical value in qualitative diagnosis of liver malignant tumor.

Astragali Radix (AR), known as Huangqi in China, is one of the most popular herbal medicines learnt worldwide to reinforce Qi (the vital energy). AR is traditionally prepared from the dried roots of Astragalus membranaceus or A. membranaceus var. mongholicus. It has been reported to have cardiotonic, hepatoprotective, hypotensive, immunostimulant, anti-aging, anti-oxidative, antidiabetic, and anti-inflammatory activities. The bioactive compounds were found to be flavonoids, saponins, polysaccharides, amino acids, and some trace elements. The present paper reviews the studies on AR including history, phytochemistry studies, pharmacological functions, and clinical application in recent years.

Objective To evaluate the prevalence of NI in the SICU at our hospital. Methods 181 NI patients in the SICU were retrospectively analysed during Jan 1996～Dec 2000.Results The average NI rate was 9.81%. The major sites of NI were respiratory tract(36.96 %),thoracic/abdominal cavity(25.47 %)and bloodstream infections(9.32 %).The difference in major pathogens of infections in different sites reached statistical significance. For respiratory tract, thoracic/abdominal cavity and bloodstream infections,bacteria were the most common pathogens. Fungi were the moat frequent isolate from urine and stool. Mixed infection proportion was 52.25 %. The most common pathogens were Enterococci, Methicillin resistant Staphylococci、 Pseudomonas Aecruginosa、Escherichia Coli、Candida Albicans and Candida Tropicalis. Conclusions The most common pathogens of NI in SICU are different in different infection sites. The pathogens were complicated and most strains are antibiotics resistant. So it is important to establish NI control and to understand the changes of pathogens so as to prevent the infection.

Objective To investigate the role of intra-operative and percutaneous three-dimensional contrast-enhanced ultrasonic cholangiography (3D-CEUSC) in the diagnosis of biliary anomalies. Methods Diluted SonoVue, an ultrasonic contrast agent, was injected into the cystic duct of 13 living liver donors via a cannula for intra-operative 3D-CEUSC, while injection via a T tube or a PTCD tube were done in 14 patients for percutaneous 3D-CEUSC. The maximum branching order of the intra-hepatic bile ducts, the percentages of display of the first-, second-, and third-order intra-hepatic bile ducts, and the rates of detection of biliary anatomical anomalies were evaluated. Results The median of the maximum branching order of the intra-hepatic bile ducts shown was fourth-order on intraoperative 3D-CEUSC and third-order on percutaneous 3D-CEUSC, respectively. The difference was significant (P=0.01). From the first- to the third-order of intra-hepatic bile ducts, the percentages of display for intra-operative 3D-CEUSC were 100% (23/23), 96.2% (50/52) and 82.7% (86/104),respectively, while they were 100% (24/24), 94.6% (54/56) and 60. 7% (68/112) for percutaneous 3D-CEUSC. The differences were not significant when comparing the first- and the second-order branches of intra-hepatic bile ducts as shown either on intra-operative or percutaneous 3D-CEUSC (P=1).The percentages of display of the third-order branches using intra-operative 3D-CEUSC was higher than that of percutaneous 3D-CEUSC (P＜0. 0001). Three biliary anatomical anomalies were detected by intra-operative 3D-CEUSC and 4 anomalies were detected by percutaneous 3D-CEUSC. All of these anomalies were confirmed by X-ray cholangiography. Conclusion Both intra-operative and percutaneous 3D-CEUSC could diagnose biliary anatomical anomalies accurately. These procedures may become important techniques to evaluate the biliary anatomy in hepatobiliary surgery pre-operatively or intraoperatively.

Objective To study the clinical significance of the injury and functional change of hypothalamic-pituitary-adrenal (HPA) axis after acute severe traumatic brain injury (TBI) in the rats.Methods A total of 60 adult healthy male Spraque-Dawley rats were randomly (random number) divided into 3 groups (n =20 in each group):sham operation group,model group and treatment group.The TBI models of rats were established by Feeney' s method.A low dose of dexamethasone (0.6 mg/kg) was injected into the abdominal cavity 20 minutes,24 hours and 48 hours after injury in treatment group,while rats of sham operation group and model group received equal volume of normal saline instead.All the rats were injected 1 μg adrenocorticotropic hormone (ACTH) into the abdominal cavity.The related parameters were detected at four time points,3 hours,12 hours,24 hours and 72 hours after cerebral contusion.The plasma corticosterone (CORT) and ACTH levels were measured by chemiluminescence.The hypothalamic,pituitary and adrenal of the rats were taken out for observing interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) expression detecting by immunohistochemical techniques at 72nd hour after TBI.One-way ANOVA and SNK-q test were used to analyze the results with SPSS 17.0 software package.Results The levels of ACTH and CORT on 3rd hour of model group raised remarkably compared with that of sham operation group,then they reduced gradually.The levels of CORT were lower than that of sham operation group at every time points after ACTH stimulation test (P ＜0.05 or P ＜0.01).The levels of CORT at all time points of treatment group were changed remarkably compared with that of model group.However,the ACTH levels of treatment group on 24 h increased slightly than that of model group.And the tendency of them was similar to model group (P ＜ 0.05 or P ＜ 0.01).The number of the hypothalamus and pituitary cells which express IL-6 and TNF-α in model group was more significantly increased when compared with that in sham operation group (P ＜ 0.01),while the number of this kind of cell in treatment group was significantly decreased than that in model group (P ＜ 0.01).The number of the adrenal cortex cells which express IL-6 in treatment group was more significantly decreased when compared with that in model group (P＜ 0.01),while the number of this kind of cell in model group was significantly increased than that in sham operation group (P ＜ 0.01).However,there was no significant difference of the TNF-α between all the groups (P ＞ 0.05).Conclusions Functional change of adrenal occurs early in the severe acute traumatic brain injury rats,and the response of adrenal to ACTH decreased as time goes by.Low-dose,short-course dexamethasone can delay the pathological changes,reduce the inflammatory response of HPA axis and increase the sensitivity of adrenal response to ACTH.

Objective To evaluate the feasibility and accuracy of three-dimensional ultrasound-ultrasound (3DUS-US)automatic image fusion technology based on electromagnetic positioning.Methods The experimental phantom was constructed to acquire ultrasonic images by agarose gel and additives,which was used as the experimental object.3DUS imaging with free-hand and real-time ultrasound imaging automatic registrations were performed based on electromagnetic positioning.To investigate the effect of 3DUS-US image fusion under different scanning speed by free-hand,the fast and slow groups were designed. In addition,a junior operator and a senior operator performed 3DUS-US automatic registrations,and recorded the operating time and registration error,respectively.The repeatability between two operators was analyzed.Results The macroscopic appearance,stability and ultrasonic image of the phantom met the demand of this research.The success rate of 3DUS-US automatic image fusion technology was 100%(40/40).The slow group's registration error distance was (1 .44 ± 0.64)mm,which was obviously lower than the fast group's (2.56±0.53)mm,the difference was statistically significant (P <0.001).There were no statistically differences of the registration error and operating time between the two operators (P =0.508,P = 0.5 1 7 ).Conclusions The technology of 3DUS-US automatic registration based on electromagnetic positioning was feasible and accurate,which is worth applying into the clinical treatment.

Lots of traditional Chinese medicine (TCM) shares the same Chinese common names "Doukou". Because of similar Chinese names, appearances, functions and original plants, there are still no compromise on the original plants of "Doukou" up to now. Moreover, "Doukou" referred to more than one source of species, that is, it might refer to the Chinese crude drug derived from different plants during different historical periods. In order to identify the original botanical plants of "Doukou" during different historical periods and the relationship between these "Doukou", new bencaological studies of TCM under the name "Doukou" were carried out, which included the studies on literal description, image description, market investigation and systematic botanical research. A suggestion was made to change the Chinese name "Doukou" (Amomi Fructus Rotundus) to "Baidoukou".
Documentation ; Drugs, Chinese Herbal ; classification ; history ; History, 15th Century ; History, 16th Century ; History, 20th Century ; History, Ancient ; History, Medieval ; Medicine, Chinese Traditional ; history

Achyranthes bidentata and Achyranthes aspera are saponin and steroid rich medicinal plants, used extensively for therapeutic treatments in Traditional Chinese Medicine (TCM) and Ayurveda. A. bidentata is reported to be one of the rare and extensively exploited medicinal plant species that face the issue of being endangered. Finding qualitative substitute with identical phyto-constituents contributing to similar composition and pharmacological benefits wil help in reducing the burden of exploitation of the natural habitats of such plants. In the present study, a comparative metabolite analysis of the whole drug and specific tissues isolated by laser micro-dissection (LMD) was carried out for both the selected species, by use of ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF MS). The results of the study indicate that the cortex and the medullary ray tissues are rich in their content of steroidal and saponin con-stituents such as (25S)-inokosterone-20,22-acetonide, ginsenoside Ro, bidentatoside II and achyranthoside B. Metabolite profiling of the whole tissues of both the species indicates presence of identical constituents. Thus, it is inferred that A. bidentata and A. aspera can be used as qualitative substitutes for each other.

Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.

Objective To explore the adverse reactions of contrast-enhanced ultrasound and treatments of the adverse reactions. Methods 6035 patients examined by contrast-enhanced ultrasound were closely observed in the process and 20 minutes after the examination. The occurrence and clinical manifestations of adverse reactions were recorded. The patients were gave symptomatic treatments. Results Two of 6035 patients experienced mild adverse reactions related with contrast-enhanced ultrasound. The incidence rate was 0. 031% (2/6035). No moderate or serious adverse reaction occurred. The two patients recovered well after symptomatic treatments. Conclusions The contrast-enhanced ultrasound has high safety and low incidence rate of adverse reaction. Patients should be under close observation in the process of contrast-enhanced ultrasound. The symptomatic treatments should be gave in time.