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 investigate the safety and efficacy of ultrasound-guided thermal ablation in the treatment of rare liver tumors.Methods Clinical data of 9 patients with rare liver tumors who underwent ultrasound-guided thermal ablation from January 2012 to December 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 9 cases (14 lesions),2 patients were male and 7 female,aged (42±12) years on average.All the patients underwent ultrasound or contrast-enhanced ultrasound-guided puncture and thermal ablation of the tumors.The ablation effect was evaluated immediately by contrast-enhanced ultrasound during the operation.The incidence of postoperative complications was observed.The complete ablation rate was evaluated by CT or MRI at postoperative 1 month.Results 11 lesions were treated with common ultrasound-guided thermal ablation and 3 lesions with contrast-enhanced ultrasound-guided ablation.The intraoperative complete ablation rate was 100％ (14/14),and the rate at postoperative 1 month was also 100％ (14/14).No ablation related complications was observed.During the follow-up,no local tumor progression or intrahepatic and extrahepatic tumors recurrence was observed in all patients.Conclusions For rare liver tumors,ultrasound-guided thermal ablation can achieve the effect of complete ablation,providing a new therapeutic option for the patients.

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 evaluate the application value of fusion imaging in intraoperative instant curative effect evaluation of thermal ablation for primary liver cancer (liver cancer). Methods Forty-six patients with liver cancer (71 lesions in total) undergoing ultrasound-guided thermal ablation in the Third Afifliated Hospital of Sun Yat-sen University between December 2014 and March 2015 were recruited in this prospective study. Forty-two patients were males and 4 were females, aged between 36 and 82 years with a median age of 54 years. The informed consents of all patients were obtained and the local ethical committee approval was received. After thermal ablation, clinical efficacy was preferentially assessed by contrast-enhanced ultrasound (CEUS)-computed tomography (CT)/magnetic resonance imaging (MRI) fusion imaging technique for all liver cancer lesions. If the fusion imaging was not successfully performed, simple CEUS was utilized for evaluation. According to the evaluation methods, the patients were divided into the fusion imaging group and CEUS group. The lesion size, supplementary and complete ablation rates in two groups were observed. The lesion diameter between two groups was compared using Z test and the ratio was compared using Chi-square test or Fisher's exact probability test. Results Fusion imaging was utilized for instant curative effect evaluation in 25 patients with 31 lesions, and simple CEUS was used for evaluation in 26 cases with 40 lesions. In the fusion imaging group, 58%(18/31) of the lesions were≥20 mm in diameter, signiifcantly higher compared with 30%(12/40) in the CEUS group (χ2=5.638, P<0.05). The supplementary ablation rate in the fusion imaging group was 52%(16/31), signiifcantly higher than 22%(9/40) in the CEUS group (χ2=6.489, P<0.05). The complete ablation rate was 100%(31/31) in the fusion imaging group and 95%(38/40) in the CEUS group , and no signiifcant difference was observed (P=0.501). Conclusions Both fusion imaging and simple CEUS are important methods for intraoperative instant curative effect evaluation. Fusion imaging has higher accuracy for the relatively large lesions and help to enhance the complete ablation rate.

ObjectiveTo investigate the subsequent therapy and its effect for local tumor progression (LTP) of primary liver cancer after thermal ablation.MethodsClinical data of 22 patients with LTP of primary liver cancer after thermal ablation in the Third Afifliated Hospital of Sun Yat-sen University between January 2008 and December 2012 were retrospectively analyzed. Among the patients, 17 were males and 5 were females with the age ranging from 38 to 77 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. A total of 30 lesions of LTP in the 22 patients were included in this study. The lesions were divided into the single treatment group (n=21) and the combined treatment group (n=9) according to the different subsequent therapies. Patients in the single treatment group were treated with single method of radiofrequency ablation (RFA) or microwave ablation, while patients in the combined treatment group were treated with transcatheter arterial chemoembolization (TACE) or percutaneous ethanol injection combined with RFA. Appropriate auxiliary means of thermal ablation, such as artiifcial pleural/peritoneal effusion, one-lung ventilation and ultrasonography were utilized in both groups. The complete ablation rate of tumor and complication incidence rate in two groups were compared. The rate was compared using Chi-square test or Fisher's exact probability test.ResultsSeventy-three percent (22/30) of the lesions were treated with auxiliary means. The complete ablation rate was 90% (19/21) in the single ablation group and 7/9 in the combined treatment group, and no signiifcant difference was observed between two groups (P=0.563). No serious complication was observed in two groups.ConclusionWith the application of various auxiliary therapies, single thermal ablation may achieve the therapeutic effect as good as the combined treatment for the LTP lesions of primary liver cancer after thermal ablation.

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.

ObjectiveTo investigate the clinical value of CT/MRI-CEUS image fusion in ablation of primary liver cancer (PLC).MethodsA total of 171 PLC patients undergoing radical thermal ablation in the Third Afifliated Hospital of Sun Yat-sen University between April 2010 and February 2014 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 171 patients, 151 were males and 20 were females with the average age of (53±11) years old. Patients underwent radiofrequency ablation (RFA) or microwave ablation (MWA). CT/MRI-CEUS image fusion was used to immediately evaluate and guide the supplementary ablation during the operation. The success rate of CT/MRI-CEUS image fusion operation, the rate of intraoperative immediate supplementary ablation and incidence of postoperative complication were recorded. The complete ablation rate was assessed according to the enhanced CT/MRI results 1 month after ablation. According to intraoperative ablation conditions, the patients were divided into the satisfied ablation margin group and the unsatisfied ablation margin group after the ablation. The patients of two groups were followed up for 12 months to monitor the progression of local tumors. The local tumor progression rate of two groups was compared using Kaplan-Meier method and Log-rank test.ResultsFor the total 200 lesions, the success rate of CT/MRI-CEUS image fusion operation was 86.0% (172/200) and the immediate supplementary ablation rate was 16.9% (29/172). There were 108 lesions with satisifed ablation margin and 64 lesions with unsatisifed ablation margin. No treatment-related death was observed and the incidence of complication was 1.2% (2/171). The complete ablation rate was 100.0% (172/172), which was conifrmed by the enhanced CT/MRI after operation. The 1-year cumulative local tumor progression rate in the satisifed ablation margin group and the unsatisifed ablation margin group was respectively 1.9% and 6.5%, and no signiifcant difference was observed (χ2=2.16,P>0.05).ConclusionCT/MRI-CEUS image fusion technique can evaluate and guide the ablation for PLC immediately, and thus can enhance the complete ablation rate.

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

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.

OBJECTIVETo make a comparative study on wild and cultivated Astragali Radix in Wuchuan, Neimenggu where is one of the geo-authentic producing areas of Astragalus membranaceus var. mongholicus.

METHODThis comparative study focus on shapes and properties, microscopic features of transverse section and powder of roots, qualitative evaluation of wild and cultivated Astragali Radix.

RESULTWild Astragali Radix had a cylindrical main root, 2 or 3 root branches, dark brown color and many lenticels on the root bark. Cultivated Astragali Radix had a long cylindrical root, few root branches, yellowish white or light brown and fewer lenticels on the root bark. The differences of microscopic features were that the number of cork cells layers in wild Astragali Radix was bigger than that in cultivated Astragali Radix; stone cells were only observed in wild Astragali Radix; distinct annual rings in the xylem were only existed in cultivated Astragali Radix. The results of qualitative evaluation reveal that the contents of major active isoflavonoids and saponins in wild Astragali Radix are higher than those in cultivated Astragali Radix.

CONCLUSIONThere are some diagnostic differences in the main microscopic features of transverse section and powder between wild and cultivated Astragali Radix. The contents of major active isoflavonoids and saponins in wild Astragali Radix are higher than those in cultivated Astragali Radix. Our study provides important scientific evidence for reasonable and effective uses of wild and cultivated Astragali Radix in Wuchuan, and also provides a reliable basis for the quality control of Astragali Radix.