Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

Objective To evaluate the imaging features of hepatic epithelioid angiomyolipoma (EAML) on contrast-enhanced ultrasound (CEUS). Methods The imaging features of pathologically proved hepatic EAML lesions in 17 patients who had undergone baseline ultrasound and CEUS examinations were evaluated retrospectively. Results All of the cases were single lesion.70.6% (12/17) of the lesions were hypoechoic on ultrasound and 82.4% (14/17) of the lesions were heterogeneous.Flow signals were detected in 88.2% (15/17) of the lesions and 82.4% (14/17) of the lesions showed ringlike or arc arterials peripherally on color Doppler flow imaging (CDFI).The value of RI was 0.38-0.56.On CEUS,all lesions exhibited remarkable hyperenhancement in the arterial phase. 29.4% (5/17) of the lesions showed branched enhancement,70.6% (12/17) of the lesions showed diffusely entire enhancement.Strong ring-like enhancement peripherally was detected in 29.4% (5/17) of the lesions.88.2% (15/17) of the lesions were detected homogeneously enhancement during the peak period on CEUS. Washout of contrast agent and hypoechogenicity to surrounding liver tissue during portal or late phase were observed in 41.2% (7/17) and 64.7% (11/17) of the cases retrospectively.Conclusions The combination of real-time CEUS and baseline US can improve the correct diagnosis of hepatic EAML.

Objective To explore the characteristics of contrast-enhanced ultrasonagraphy(CEUS) of sarcomatoid hepatocellular carcinoma ( SHC ) . Methods Fifteen lesions identified pathologically from 15 patients were included in this study . Among them ,9 lesions had completely sarcomatoid change and 6 lesions had partially sarcomatoid change . Totally 8 lesions were in the small size group with maximum diameter＜ 50 mm and 7 lesions in the big size group with maximum diameter ≥ 50 mm . The CEUS performance was observed and analyzed . Results In the arterial phase of CEUS ,9 lesions in the group with completely sarcomatoid change showed rim hyperenhancement and 6 lesions in the group with partially sarcomatoid change showed whole hyperenhancement , the difference between the two groups was statistically significant ( P ＜ 0 .001 ) . However ,the difference of CEUS performance between small size group and big size group was not statistically significant ( P ＝ 0 .608 ) , all the lesions showed hypoechogenecity in portal and(or) late phase of CEUS . Conclusions The difference of performance on CEUS is not related to the size of SHC ,but to the degree of sarcomatoid change within the tumor . SHC with completely sarcomatoid change shows rim hyperenhancement and SHC with partially sarcomatoid change shows entire hyperenhancement in arterial phase on CEUS .

Objective To analyze the typical contrast-enhanced ultrasound ( CEUS ) enhancement characteristics of hepatic focal nodular hyperplasia ( FNH) within 3 cm ,and to discuss the diagnostic value of CEUS in small FNH lesions . Methods Forty-eight cases of FNH were retrospectively studied . All lesions were confirmed histopathologically after surgical resection . CEUS examinations with SonoVue were performed to characterize the enhancement patterns of lesions in 5 minutes . The whole wash in and wash out enhancement procedure of lesions were recorded and analyzed . Results All FNH lesions displayed a rapid hyper-enhancement in arterial phase by CEUS ,39 lesions of which showed spring-like enhancement ;8 lesions showed spoke-like enhancement ;1 lesion showed dendritic enhancement . 6 .3% (3/48) of the lesions showed central scar ,and feeding arteries was found in 52 .1% (25/48) lesions . According to echogenicity shift of the lesions in various phases ,20 .8% (10/48) FNH showed fast-in and slow-out" ,64 .6% (31/48) showed fast-in and synchronous-out" ,and 14 .6% (7/48) showed fast-in and fast-out" . According to fast-in and synchronous-out" or fast-in and slow-out" by CEUS ,the accuracy rate of benignity reached 85 .4% (41/48) . According to any of the spring-like enhancement ,spoke-like enhancement ,central scars or feeding arteries ,the accuracy rate of diagnosis of FNH within 3 cm reached 97 .9% (47/48) ,and 81 .3%(39/48) of which were diagnosed through spring-like enhancement . Conclusions CEUS is helpful in diagnosis of FNH within 3 cm by showing various characteristic enhancement patterns ,and spring-like enhancement is the most important sign in diagnosis of FNH less than 3 cm . CEUS has high diagnostic value for FN H less than 3 cm .

Objective To investigate enhancement appearance of hepatic focal nodular hyperplasia(FNH) at real-time gray-scale contrast enhanced ultrasonography(CEUS),and evaluate the value of CEUS in the diagnosis of FNH. Methods Thirty-four patients (36 lesions) with histologically proved FNH were examined by ultrasonography. Appearance on conventional ultrasonography and the enhancement pattern on CEUS were investigated. Results Thirty-six lesions were mostly hypoechoic.39% (14/36) of lesions had peripheral hypoechogenic circle. Color Doppler flow imaging showed a asteroid-like or spoke-and-wheel pattern in 65% (20/ 31) of lesions.Three enhancement patterns were observed in the early arterial phase: whole-enhancement pattern (28%, 10/36), gushing-spring enhancement pattern (44%, 16/36), and spoke-and-wheel enhancement pattern (28%,10/36).The frequency of central scar on CEUS was 17% (6/36), and detection rate of central scar by CEUS compared with pathology was 40% (6/15).Regarding one of the features (gushing-spring enhancement, spoke-and-wheel enhancement and scar) as standard of FNH, the coincidence of CEUS in this group was 78% (28/ 36) ,which was significantly higher than that of conventional ultrasonography 28% (10/36).Conclusions CEUS can be as a important method for diagnosing FNH.

Objective To probe the correlation between the short-axis diameter(SD) of coagulation necosis and the microwave power(P) using a new type of internally cooled microwave antenna in ex vivo and in vivo liver model.Methods Fourteen microwave ablations were performed in swine livers ex vivo and canine livers in vivo under the microwave powers of 30-90W and the durations of 10 min and 20 min, respectively.The short-axis diameter(SD) and the long-axis diameter(LD) of the coagulation were measured.The difference of SD, LD and SD/LD in swine liver ex vivo and canine liver in vivo were compared.The relationship between the SD and microwave power was analysised using linear regression model.Results Under the same conditions,the SDs and LDs of the coagulations of canine livers in vivo were smaller than those of swine livers in ex vivo (P <0.01).There was such a higher linear relationship(r = 0.96-0.99, P <0.01) between the SD of coagulation and the power in vivo liver model as the results acquired in ex vivo.Conclusions Although the blood flow decreased the SDs of the coagulation of microwave ablation in liver in vivo, but there was still a higher linear relationship between SD and microwave power.

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 explore the potential value of contrast-enhanced ultrasonography (CEUS) in diagnosis of renal pelvic carcinoma. Methods The ultrasonogram of conventional ultrasound and CEUS were analyzed retrospectively in 22 patients of renal pelvic carcinoma proved pathologically. The size, echo, boundary and color flow signal of renal pelvic lesions were observed with conventional ultrasound. The enhancement modality and phase of tumors were also observed with CEUS, including wash-in and wash-out time, as well as the perfusion appearances. Results The maximum diameters ranged from 1.5 cm to 8.5 cm in 22 renal pelvic tumors. Conventional ultrasound detected flat mass in 7 tumors, irregular mass in 15 tumors; the same side hydronephrosis in 11 patients. Color Doppler flow imaging (CDFI) disclosed fairly rich flow signal of 5 tumors, a small amount of flow signal around tumor in 9 tumors and no-flow signal in the rest tumors. CEUS detected the cortical phase enhancement in all renal pelvic tumors, including synchronously enhancement in 8 tumors and delayed enhancement in 14 tumors. In peak time, hypoechogenicity compared to the normal renal cortex was showed in 18 tumors, hyperechogenicity in 3 tumors and isoechogenicity in 1 tumor. Fast wash-out in medulla phase was displayed in 20 tumors, isochronously wash-out in 1 tumor and delayed wash-out in 1 tumor. The diagnostic accuracy of the conventional ultrasound and CEUS was 63.64% (14/22) and 81.82% (18/22), respectively. Conclusion CEUS can depict blood flow supply and improve the diagnostic rate of renal pelvic carcinoma.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of focal liver lesions before microwave ablation. Methods One hundred and seven patients with 128 focal liver lesions underwent CEUS and color Doppler flow imaging (CDFI) before microwave ablation therapy. The diagnostic performance of CEUS and CDFI was compared with pathologic findings through biopsy. Results The sensitivity, specificity, positive and negative predictive value, accuracy of CEUS for diagnosing liver lesions was 98.35% (119/121), 100% (7/7), 100% (119/119), 77.78% (7/9) and 98.44% (126/128), respectively, higher than those of CDFI (P＜0.001). According to CEUS, 119 malignant lesions were treated with timely microwave ablation, while unnecessary microwave ablation was excluded for 7 benign lesions. Conclusion CEUS is useful in the characterization of focal liver tumors before microwave ablation, and is helpful to reduce the misdiagnosis and mistreatment of the patients.