Objective To explore the automated identification and diameter measurement methods for inferior vena cava (IVC) based on clinical ultrasound images of IVC. Methods An automated identification and localization method based on topology and automatic tracking algorithm was proposed. Tracking algorithm was used for identifying and continuously locating to improve the efficiency and accuracy of measurement. Tests were conducted on 18 sets of ultrasound data collected from 18 patients in intensive care unit (ICU),with clinicians' measurements as the gold standard. Results The recognition accuracy of the automated method was 94.44％ (17/18),and the measurement error of IVC diameter was within the range of±1.96s (s was the standard deviation). The automated method could replace the manual method. Conclusion The proposed IVC automated identification and localization algorithm based on topology and automatic tracking algorithm has high recognition success rate and IVC diameter measurement accuracy. It can assist clinicians in identifying and locating IVC,so as to improve the accuracy of IVC measurement.

Proto-Oncogene Proteins c-akt/metabolism* ; Butyrates ; Ligands ; Glucose ; Receptors, G-Protein-Coupled/metabolism* ; Glycogen Synthase Kinases/metabolism* ; Glycogen Synthase Kinase 3 beta ; Phosphorylation

Objective:To explore the wild medicinal plant species and utilization of Hasi mountain nature reserve,in order to provide the references for reasonable utilization and protection of the medicinal plant resources in this area. Method:The survey was conducted based on the technical scheme of the Fourth National Survey on Chinese Material Medica Resources. By consulting literature,collecting medicinal plants specimen and visiting survey area,researchers collected and summarized the wild medicinal plant species, and analyzed the results of reserves. Result:The results showed 7 varieties in 247 kinds of wild medicinal plants in Hasi mountain nature reserve,which belonged to 161 genera in 61 families;by the medicinal parts of all wild medicinal plants,the whole plant of a total of 124 species could be used,accounting for 48.82% of the total species,by traditional Chinese medicine efficacy, antipyretic herbs were the majority,accounting for 32.68% of the total. In addition,there were 8 kinds of rare and endangered wild medicinal plants,such as Ephedra sinica,Gentiana dahurica and Epipactis helleborine. Conclusion:Hasi mountain nature reserve has rich wild medicinal plant resources,and is an important part of medicinal plant resources and protection areas of Jingyuan county and Loess Plateau. However, because they are serious affected by incontinent excavation and insect pest,efforts shall be made in scientific protection and rational development.

Inter-individual heterogeneity in drug response is a serious problem that affects the patient's wellbeing and poses enormous clinical and financial burdens on a societal level. Pharmacogenomics has been at the forefront of research into the impact of individual genetic background on drug response variability or drug toxicity, and recently the gut microbiome, which has also been called the second genome, has been recognized as an important player in this respect. Moreover, the microbiome is a very attractive target for improving drug efficacy and safety due to the opportunities to manipulate its composition. Pharmacomicrobiomics is an emerging field that investigates the interplay of microbiome variation and drugs response and disposition (absorption, distribution, metabolism and excretion). In this review, we provide a historical overview and examine current state-of-the-art knowledge on the complex interactions between gut microbiome, host and drugs. We argue that combining pharmacogenomics and pharmacomicrobiomics will provide an important foundation for making major advances in personalized medicine.
Anti-Infective Agents ; pharmacology ; Biodiversity ; Humans ; Microbiota ; Pharmacogenetics ; Precision Medicine ; Toxicogenetics

Objective To explore the application and effects of quality control circle activities on the compliance rate of upper limb functional exercise in elderly patients after permanent pacemaker implantation. Methods The application of quality control circle was used to analyze the causes, so as to find out the real cause of low compliance of upper limb functional exercise in permanent pacemaker implantation elderly patient including lack of accessary for upper limp training excise, the lake of education materials pacemaker for upper limb functional training after implantation without image, the lack of upper limb function exercise knowledge after pacemaker implantation in nurses, fear of pacemaker shift and bleeding, 5 aspects of team coaching patients with upper limb functional exercise, according to it due to the development of effective countermeasures which organized the implementation of standardized management. Results After the implementation of quality control circle activities, the follow-up rate of upper limb functional exercise in elderly patients increased from 57.89% to 100.00% before permanent pacemaker implantation, and the difference was statistically significant (P< 0.05). The goal of the event rate increased to 151%, and progress rate of 72.74%. Conclusions The application of quality control circle can improve follow-up rate in permanent pacemaker implantation in elderly patients after upper limb functional exercise, the upper limb function, and the quality of life of patients, as well as the members of quality control techniques, professional knowledge, communication and coordination, team spirit, and ability to explore problems were improved.

Objective:To study the clinical effects of percutaneous transluminal angioplasty (PTA ) versus stent implantation (ST)after PTA for the treatment of femoral and popliteal artery lesion resulted from arteriosclerosis obliterans.Methods:One hundred and three patients (1 1 9 limbs)treated for femo-ral and popliteal artery lesion resulted from arteriosclerosis obliterans for ten years were reviewed,of whom 60 limbs were treated by PTA and the other 47 by PTA combined with stent implantation.Results:Among the 60 limbs of the PTA group,there were 22 limbs involved only in femoral and popliteal artery;1 3 limbs combined with iliac artery lesion;1 7 limbs combined with infrapopliteal artery lesion;8 limbs combined with iliac and infrapopliteal artery lesion.Among the 47 limbs of the ST group,there were 1 8 limbs involved only in femoral and popliteal artery;8 limbs combined with iliac artery lesion;1 5 limbs combined with infrapopliteal artery lesion;6 limbs combined with iliac and infrapopliteal artery lesion. There was no significant difference between the two groups on age,sex,concomitant disease,ankle bra-chial index(ABI)before treatment and Rutherford classification (P>0.05).The patients’Trans-atlantic inter-society consensus (TASC)C/D was lower in the PTA group than that in the ST group (58.3%vs. 76.6%,P=0.047).The follow-up periods were 48.0 (5.0,1 08.0)and 40.0 (3.0,96.0)months respectively (P=0.064).Compared with the PTA group,the ST group had a better short-term total effective rate (93.6% vs.80.0%,P=0.044)and a higher cost [(33 882.7 ±8 695.6)yuan vs. (1 7 754.8 ±3 654.2)yuan,P<0.001 ].The short-term marked effective rate of the ST group was higher than that of the PTA group,but the difference was not significant (31 .9% vs.21 .7%,P =0.231 ).There was no significant difference between the two groups on short-term efficiency,and compli-cation rates (58.3%vs.58.3%,P=0.724;1 .7%vs.2.1%,P=1 .000).There was no death during perioperative period and no short-term deterioration in both the groups.The long-term marked effective rate was lower and the deterioration rate was higher in the ST group than that in the PTA group,but the difference was not significant (8.5% vs.1 5.0%,P=0.381;1 4.9% vs.5.0%,P=0.081 ).There was no significant difference between the two group on long term total effective rate,accumulative limb salvage rate and reoperation rate (66.0% vs.66.7%,P=0.939;94.7% vs.94.1%,P=0.884;31 .9% vs.31 .7%,P=1 .000),and the 1 to 1 0 years primary and secondary patency rates were similar (P=0.837,P=0.622).When compared based on TASC classification,TASC A/B patients in the ST group had a higher short-term marked effective rate,a higher short-term total effective rate and a higher long-term deterioration rate than those in the PTA group,but the difference was not significant (36.4%vs.24.0%,P=0.353;1 00.0%vs.88.0%,P=0.322;1 8.2%vs.4.0%,P=0.21 6).TASC C/D patients had a similar result (30.6%vs.20.0%,P=0.307;91 .7%vs.74.3%,P=0.050;1 3.9%vs.5.7%,P=0.226).Both TASC A/B and TASC C/D patients in the ST group had a similar accumu-lative limb salvage rate with that in the PTA group (90.9% vs.90.6%,P =0.920;97.1% vs. 94.1%,P=0.796).Conclusion:Stent implantation can increase the cost and short term effective rate at the same time and is not superior to PTA on the long term effective rate and limb salvage rate for femo-ral and popliteal artery lesion resulted from arteriosclerosis obliterans.

Objective:To analyze correlation factors of hemodynamic damage after carotid artery stenting.Methods:In this study, 66 cases (71 lesions) who undertook carotid artery stenting were col-lected and the correlation factors of hemodynamic damage were analyzed .Results:Hemodynamic damage emerged in 23 cases (32.4%), of which, 11.3%developed hypotension.The distance between bifurca-tion and lesions (P=0.002 0), plaque distribution (P=0.000 2), plaque character (P=0.001 9), post-dilation ( P =0.002 6 ) were associated with hemodynamic damage by single factor analysis . However, only eccentric plaque (P=0.015 3) and calcified plaque (P=0.009 7) were associated with hemodynamic damage by multiple factors analysis .All the patients could reach stable circulation by drugs during operation , and no cerebral ischemic events ( transient ischemic attack or stroke ) and cardiovascu-lar ischemic events happened .Conclusion: The distance between bifurcation and lesions , eccentric plaques, calcified plaques are correlation factors of hemodynamic damage .

Objective:To study the morphology of middle cerebral artery ( MCA ) M1 segment .Me-thods:We selected the MRA data of 794 MCA (400 of the left side and 394 of the right side ) from Ja-nuary 1, 2011 to June 30, 2011 consecutively and analyzed the morphology of the MCA M 1 segment in axial, anteroposterior and lateral view , measured the length of the M1 segment, and analyzed the simila-rity of the left and right side M1 segment morphology .Results:In axial, anteroposterior and lateral view , the MCA M1 segment showed C-shape >L-shape >S-shape .In axial view , it was about 373 ( 47%) M1 segment performance for the C-shape, of which 340 (42.8%) M1 segments showed bowing to the dorsal side, only 33 (4.2%) M1 segments showed bowing to the ventral side .In anteroposterior view, it was about 322 (40.6%) M1 segments of the performance of the C-shape, of which 262(33.0%) M1 segments showed a bowing to the superior , 60 (7.6%) showed bowing to the inferior .The similarity of the left and right MCA M1 segments was 27.2% (114/419) in axial view and 42.7% (179/419) in anteroposterior view.It was more similar in anteroposterior view than in axial view .Along with the increase of age, in the axial view, L-shape converted to C-shape very obviously, but only mildly elevated in S-shape .In anteroposterior view , the L-shape converted to the C-shape or S-shape along with the increase of age.Conclusion:The different morphology of MCA M1 segment in axial and anteroposterior view may be involved in the development of intracranial atherosclerosis .

Objective To evaluate the technique of selective portal vein embolization before hepatectomy and its value in the preparation of major hepatic resection for those with insufficient future remnant liver.Methods From Jan 2008 to July 2012,6 patients who suffered from hepatic tumors underwent selective ipsilateral portal vein embolization (PVE) due to insufficient future remnant liver volume (FRLV) before second-stage major hepatic resection.Results Technically,all six PVE were completed successfully with only minor liver function damages.The average FRLV increased from (474.33 ± 89.19)cm3 to (722.67 ± 151.51) cm3 (t =-5.587,P =0.003).The average tumor burden (total tumor volume)increased from (134 ± 181) cm3 to (270 ± 346) cm3 (t =-1.64,P =0.16).Five cases underwent secondstage major hepatectomy 6 weeks after PVE,while in 1 case a resection attempt was abandoned because of uncontrolled tumor growth during the period.During the follow-up period (median 37 months),1 died,4 survived,2 were tumor-free.Conclusions Selective portal vein embolization is a safe and effective method to induce hepatic hypertrophy in the appropriate clinical setting.Before PVE,hepatic tumor should be controlled beforehand with chemotherapy or TACE to ensure the scheduled second-stage hepatectomy.

Objective To investigate the effect of folic acid on the DNA methylation of tumorrelated genes promoters in healthy human peripheral blood mononuclear cells(PBMC). Methods Ten healthy volunteers were divided into two groups, and were randomized to receive either 5 mg folic acid (n=5)or placebo(n = 5) , one time per day for 3 months. The serum folic acid concentration was detected with chemiluminescence enzyme immunoassay kit before and after the intervention. The methylation statuses of five tumor-related genes promoter, including oncogenes c-myc, c-Ha-ras,tumor suppressor genes p16INK4A, E-cadherin and mismatch repair gene hMLH1 in PBMC were detected by bisufite sequencing. Results After folic acid intervention, the level of serum folic acid increased significantly in intervention group (t= -4. 739,P<0. 05) , however no significant difference in control group. After three-month folic acid intervention, the level of methylation of oncogene c-myc promoter increased from 4%, 3. 3%, 4. 1% before intervention, one week after intervention, one month after intervention respectively to 8%(t= -4. 079,P<0. 05), while no significant change in placebo taken group. Before and after the folic acid intervention, there was no significant difference of DNA methylation of other tumor-related genes promoter, including c-Ha-ras、E-cadherin、p16INK4Aand hMLH1. Conclusion Folic acid intervention can up-regulate DNA methylation of oncogene c-myc promoter, but can not affect the promoter methylation status of tumor suppressor genes E-cadherin,p16INK4Aand hMLH1.