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Considering the fact of rapidity and concentration of aging of population, Chinese government has regarded it as an important strategic issue. However, how to get a dignified ending still a big problem for the old age today. This article tries to explore the possibility of advance care planning (ACP) approved under the background of aging of population in China based on general report of Chinese government deal with aging of population and existed facts. Though the researches on this topic have grown rapidly, the government legal system is still close to it in this moment, and in the process of practice constantly, it will be a perfect research. It is certain that the legislation of ACP in China will has a long way to go, but in the view of the advancement of death with dignity, palliative care, we still can predict a bright future of ACP.
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Objective To study the effect of high intensity focused ultrasound(HIFU)ablation on microvessel density(MVD)and vascular endothelial growth factor(VEGF)in rabbit hepatcocellular carcinoma (HCC)models.Methods The VX2 t umor cells were planted in the hepatic left-central lobe on 30 rabbits.All animals were divided into two groups randomly:HIFU group(n=25)and control group(n=5).The MVD and the expression of VEGF in the HCC was detected by immunohistochemical SABC methods in control group and 0,1,3.7,16 d after the operation in HIFU group.Results The MVD and the expression of VEGF in the HCC tissue after HIFU treatment in the HIFU group were decreased significantly as compared with those in the control group (P＜0.01).However,there was no significant difference in MVD and the expression of VEGF in the HCC tissue after HIFU treatment in the HIFU group among the different time points(P＞0.05).Conclusions HIFU treatment can effectively destroy the micovessel,repress the neovascularization and reduce the blood supply of the HCC.
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Objective To evaluate the value of contrast-enhanced ultrasound in superficial lymphadenopathy. Methods Ninty-four superficial enlarged lymph nodes were studied by 2-dimensional, color Doppler ultrasound, and contrast-enhanced ultrasound. Then the contrast-enhanced images were analyzed by Philips Q-LAB software. All the results were compared with pathological diagnosis. Results For the 94 superficial lymph nodes examined,44 were benign,33 were metastases and 17 were lymphomas. The sensitivity, specificity,and accuracy of contrast-enhanced images were 84% ,74% and 790//oo respectively. Contrast-enhanced ultrasound examination showed intense homogeneous enhancement in 39 of 44 benign lymph nodes; high or low homogeneous enhancement in 25 of 33 and 7 of 33 in metastases respectively;intense homogeneous, and scarce enhancement in 6 of 17 and 9 of 17 in lymphomas respectively. Time-intensity curves showed that compared with metastasis lymph nodes and lymphomas, benign lymph nodes had higher peak intensity and larger area under the curve (P<0.01). Conclusions The diagnosis accuracy was significant increased when contrast-enhanced ultrasound was test against conventional ultrasound. The character of contrast agent enhancement and Q-LAB time-intensity curves provide valuable diagnosis information for differential diagnosis of benign,metastasis lymph nodes and lymphomas.
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Objective To evaluate the value of diagnosis and treatment of fallopian tube patency by using hysterosalpingocontrast sonography (HyCoSy) with SonoVue and transvaginal ultrasound for infertile women. Methods Two hundred and twenty-two infertile women were examined by HyCoSy-SonoVue to observe flowing condition in womb and fallopian tube,the results were compared with hydrotubation, X-ray hysterosalingography(HSG) and laparoscopy(hysteroscopy). Results In the 222 cases,73 cases were both side of fallopian tube patency, 72 cases were single fallopian tube patency, 13 cases were single partial obstruction,60 cases were both side of fallopian tube pinning,4 cases were both partial obstruction. There was a significant difference on pregnancy rates between the HyCoSy-SonoVue and hydrotubation (P 0.05). There was no difference on diagnostic rates of fallopian tube pateney between the HyCoSy-SonoVue and laparoscopy (hysteroscopy)(P>0. 05) ,the diagnostic rate of H yCoSy-SonoVue was higher than that of HSG. Conclusions The HyCoSy-SonoVue method is safety and it would be an effective diagnosis in the evaluation of fallopian tube pathology for infertile women.
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Objective To assess the value of real-time myocardial contrast enhancement imaging (real-time MCE) on acute myocardial infarction.Methods Eight open-chest canine models of myocardial infarction were established by ligating left anterior descent branch of coronary artery (LAD) on level after first diagonal branch. The real-time MCE, using intravenous instillation of a new kind of Perfluorocarbon contrast agent， were performed before the occlusion, 1 hour and 3 hours after the occlusion. The myocardial contrast agents perfusion and wall motion was observed on the middle of papillary muscles scan plane.Results The real-time MCE showed not only the black aridity of contrast agents but also the wall motion abnormality 1 hour and 3 hours after the occlusion. In comparison with pathology, the defects of contrast perfusion were larger than the stained infarction zones. In addition, the flash contrast imaging revealed the reperfusion defect of adjacent zones.Conclusions With the ability of showing the myocardial microcirculation and wall motion function simultaneously, the real-time MCE makes MCE exam significantly easier to perform. Finally, flash contrast imaging will be the cornerstone upon which perfusion quantification will be built.