Practice and experience of training model based on automated breast ultrasound system / 中华医学教育探索杂志

The new ultrasound device, automated breast ultrasound (ABUS), has the advantages of repeatable reading of standardized whole breast images, and can separate ultrasound scanning and diagnosis. ABUS is more suitable for breast ultrasound training. This study compared the breast ultrasound imaging training model with ABUS diagnosis practice as the core and the traditional breast ultrasound imaging training model with handhold ultrasound operation and diagnosis as the core, and found that the new training model with ABUS diagnosis practice as the core had a short training period. The diagnostic level of doctors have improved rapidly, and the new training model could efficiently train more technically qualified ultrasound doctors for breast disease.

Swertiamarin ameliorates carbon tetrachloride-induced hepatic apoptosis via blocking the PI3K/Akt pathway in rats

Swertiamarin (STM) is an iridoid compound that is present in the Gentianaceae swertia genus. Here we investigated antiapoptotic effects of STM on carbon tetrachloride (CCl₄)-induced liver injury and its possible mechanisms. Adult male Sprague Dawley rats were randomly divided into a control group, an STM 200 mg/kg group, a CCl₄ group, a CCl₄+STM 100 mg/kg group, and a CCl₄+STM 200 mg/kg group. Rats in experimental groups were subcutaneously injected with 40% CCl₄ twice weekly for 8 weeks. STM (100 and 200 mg/kg per day) was orally given to experimental rats by gavage for 8 consecutive weeks. Hepatocyte apoptosis was determined by TUNEL assay and the expression levels of Bcl-2, Bax, and cleaved caspase-3 proteins were evaluated by western blot analysis. The expression of TGF-β1, collagen I, collagen III, CTGF and fibronectin mRNA were estimated by qRT-PCR. The results showed that STM significantly reduced the number of TUNEL-positive cells compared with the CCl₄ group. The levels of Bax and cleaved caspase-3 proteins, and TGF-β1, collagen I, collagen III, CTGF, and fibronectin mRNA were significantly reduced by STM compared with the CCl₄ group. In addition, STM markedly abrogated the repression of Bcl-2 by CCl₄. STM also attenuated the activation of the PI3K/Akt pathway in the liver. These results suggested that STM ameliorated CCl₄-induced hepatocyte apoptosis in rats.

Screening the Effective Hemostasis Fraction of Balanophora Involucrata / 中国药师

Objective: To screen the effective hemostasis fraction of Balanophora involucrata. Methods: Balanophora involucrata was extracted by 95% ethanol using reflux extraction, and the residue was extracted by water. The filtrate was combined and concen-trated, and then extracted by petroleum ether, ethylacetate and n-butylalcohol in turn to respectively obtain petroleum ether phase, eth-ylacetate phase, n-butylalcohol phase and H2O phase. The effective hemostasis fraction was determined by measuring the time of blood coagulation and hemorrhage combined with plasma recalcification time. Results: Compared with the blank group, ethylacetate extract from Balanophora involucrata could significantly shorten the time of blood coagulation and hemorrhage, and the plasma recalcification time (P<0. 01). n-Butylalcohol group at high dose could shorten the time of hemorrhage and the plasma recalcification time (P<0.05),while had no effect on the time of blood coagulation(P>0.05). Petroleum ether extract and H2O phase couldn't shorten the time of blood coagulation and hemorrhage, and the plasma recalcification time(P>0. 05). Conclusion: The effective hemostasis frac-tion of Balanophora involucrata mainly concentrates in ethylacetate extract.

The research of contrast on acceptance of automated breast volume scanner,digital screening mammography and handheld ultrasound / 中华超声影像学杂志

Objective To compare patients'satisfaction and comfort associated with automated breast volume scanner(ABVS),handheld ultrasound(HHUS)and mammography(MMG).Methods Five hundred and twenty-eight women who performed ABVS examination and previously had undergone MMG and HHUS were enrolled.BMI,bra size,with or without lesion,lesion size,pain score of MMG,ABVS and HHUS were documented and analyzed.Results The pain score of MMG was significantly higher than that of ABVS[4.0(2.0,6.0)vs 2.0(1.0,4.0)](P <0.05).92.4% of the cases were preferred for the ABVS examination,which was higher than that for the MMG(45.5%),and was similar to HHUS(94.7%).Bra size,BMI,with or without lesion and lesion size could affect the pain degree of ABVS.Conclusions Routine use of ABVS will be well tolerated by patients than MMG.

The mechanism of total saponins from Medicago polymorpha on glycometabolism in type 2 diabetic rats / 重庆医学

Objective To explore the effect of total saponins from Medicago polymorpha (TSMP) on glucose metabolism in type 2 diabetes mellitus (T2DM) rats and its possible mechanism.Methods T2DM rats were established by feeding with fat diets and intraperitoneally injecting with STZ 30 mg/kg.The rats were divided into control group,model group,metformin group (0.2 g/kg),TSMP high dose group (1.4 g/kg) and TSMP low dose group (0.7 g/kg),which were administrated for four weeks.At the end of administration,blood samples were collected to determine insulin resistance index (IRI),levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbAlc),hepatic glycogen,interleukin (IL)-1 β,tumor necrosis factor (TNF)-α,free fatty acids (FFA) and Leptin,and activities of pyruvate kinase (PK),hexokinase (HK),glucose-6-phosphatase (G-6-Pase),fructose-1,6-bisphosphatase and glucokinase (GK).Western blot was used to detect the expression levels of G-6-Pase and phosphoenolpyruvate carboxykinase (PEPCK) proteins.Results Compared withthe model group,high dose (1.4 g/kg) TSMP decreased IRI,levels of FBG,HbA1 c,IL-1β,TNF-α,FFA and Leptin,and activities of G-6-Pase and fructose-1,6-bisphosphatase in T2DM rats (P＜ 0.05),while increased level of hepatic glycogen,and activities of PK,HK and GK (P＜0.05).Moreover,high dose (1.4 g/kg) TSMP down-regulated expression levels of G-6-Pase and PEPCK protein in liver tissues.Conclusion Chronic administration of TSMP can improved glucose homeostasis in T2DM rats,which might be related to promoting utilization of glucose,and alleviating inflammatory and insulin resistance.

The mechanism of total saponins from Medicago polymorpha on glycometabolism in type 2 diabetic rats / 重庆医学

Objective To explore the effect of total saponins from Medicago polymorpha (TSMP) on glucose metabolism in type 2 diabetes mellitus (T2DM) rats and its possible mechanism.Methods T2DM rats were established by feeding with fat diets and intraperitoneally injecting with STZ 30 mg/kg.The rats were divided into control group,model group,metformin group (0.2 g/kg),TSMP high dose group (1.4 g/kg) and TSMP low dose group (0.7 g/kg),which were administrated for four weeks.At the end of administration,blood samples were collected to determine insulin resistance index (IRI),levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbAlc),hepatic glycogen,interleukin (IL)-1 β,tumor necrosis factor (TNF)-α,free fatty acids (FFA) and Leptin,and activities of pyruvate kinase (PK),hexokinase (HK),glucose-6-phosphatase (G-6-Pase),fructose-1,6-bisphosphatase and glucokinase (GK).Western blot was used to detect the expression levels of G-6-Pase and phosphoenolpyruvate carboxykinase (PEPCK) proteins.Results Compared withthe model group,high dose (1.4 g/kg) TSMP decreased IRI,levels of FBG,HbA1 c,IL-1β,TNF-α,FFA and Leptin,and activities of G-6-Pase and fructose-1,6-bisphosphatase in T2DM rats (P＜ 0.05),while increased level of hepatic glycogen,and activities of PK,HK and GK (P＜0.05).Moreover,high dose (1.4 g/kg) TSMP down-regulated expression levels of G-6-Pase and PEPCK protein in liver tissues.Conclusion Chronic administration of TSMP can improved glucose homeostasis in T2DM rats,which might be related to promoting utilization of glucose,and alleviating inflammatory and insulin resistance.

Analysis of Drug Treatment Strategy for One Case of ARDS after Fracture Operation / 中国药师

Objective: To explore the entry points and monitoring points of individualized treatment for fracture surgery patients with ARDS.Methods: Clinical pharmacists comprehensively assessed the patient's conditions and looked up lots of literatures.Some suggestions on the anti-infection treatment efforts, glucocorticoid use dispute and rational use of ambroxol were offered.The efficacy and adverse reactions of drugs in the treatment process were monitored using some subjective and objective indicators.Results: The consensus about the pros and cons, dosages, as well as the possible dosage decrease of glucocorticoid therapy, the dosages of antimicrobial agents, and the dosages and treatment course of ambroxol was achieved between clinical pharmacists and doctors.As a result, the maximum benefits were obtained for the patient.Conclusion: Clinical pharmacists can explore the treatment and monitoring for specific diseases and find out intervention entry points of clinicians and patients to play a certain role in clinics, and accumulate treatment experience gradually.

Effect of Cyslosorus acuminatus Flavonone Glycoside on Kidney Epithelial-mesenchymal Transition in Rats with Diabetic Kidney Disease / 中国药房

OBJECTIVE:To investigate the effect of Cyslosorus acuminatus flavonone glycoside (CAF) on kidney epitheli-al-mesenchymal transition(EMT)in rats with diabetic kidney disease(DKD). METHODS:Rats were randomly divided into nor-mal group(normal saline),model group(normal saline),positive group [rosiglitazone,0.4 mg/(kg·d)],CAF high-dose and low-dose groups [12.5,25 mg/(kg·d)],10 in each group. Except for normal group,other groups were intraperitoneally injected strepto-zotocin(60 mg/kg)+high fat diet to induce DKD,and intragastrically administrated related medicines in 13-16 weeks. After the ex-perimental period,fasting blood glucose level and serum creatinine(Scr),blood urea nitrogen(BUN)contents of rats were detect-ed,collagen deposition and basement membrane thickening in kidney tissue were observed. Immunohistochemistry was used to de-tect α-smooth muscle actin(α-SMA),fibronectin,epithelial cadherin(E-cadherin)expressions in kidney tissue,and Western blot was used to determine the glycogen synthase kinase 3β(GSK-3β),phosphorylated GSK-3β(p-GSK-3β),β-catenin expressions in kidney tissue. RESULTS:Compared with normal group,fasting blood glucose level,Scr and BUN contents in model group were significantly increased (P<0.01);kidney tissue showed obvious collagen deposition and basement membrane thickening;theα-SMA,fibronectin,β-catenin expression levels and GSK-3β phosphorylation degree in kidney tissue were significantly increased (P<0.01),while E-cadherin expression levels was significantly decreased(P<0.01). Compared with model group,fasting blood glucose level,Scr and BUN contents in each administration group were significantly reduced(P<0.05 or P<0.01);collagen depo-sition and basement membrane thickening in kidney tissue were significantly improved;the α-SMA,fibronectin,and β-catenin ex-pression levels and GSK-3β phosphorylation degree in kidney tissue were significantly decreased (P<0.05 or P<0.01),while E-cadherin expression levels in positive group and CAF high-dose group were significantly increased(P<0.01). CONCLUSIONS:CAF can inhibit the kidney EMT of rats with DKD,the molecular mechanism may be associated with downregulating β-catenin ex-pression and inhibiting GSK-3βphosphorylation inactivation.

Progress in genetic research on psoriatic arthritis / 中华医学遗传学杂志

Psoriatic arthritis is a form of inflammatory arthritis found among patients with psoriasis, which can lead to pain, swelling or stiffness in one or more joints and even movement disorders. Epidemiological studies have shown a higher heritability for psoriatic arthritis compared with psoriasis vulgaris. With the evolvement of DNA sequencing, many genes have been associated with psoriasis vulgaris and psoriatic arthritis, which included MHC, TNF, LCE, IL23R, IL12B, TRAF3IP2 and TNFAIP3, though some, such as MHC, IL-13 and PTPN22, have been specifically associated with psoriatic arthritis. These studies have laid a foundation for risk prediction, diagnosis and drug development for psoriatic arthritis.

Effects of Prophylactic Antibiotics on Infections after Coronary Stent Implantation / 医药导报

Objective To analyze whether routine prophyrlactic antibiotic administration is necessary for the patients undergoing coronary stent implantation. Methods The clinical data of 156 patients from January 2010 to December 2010 (prophylactic antibiotic therapy),and 466 patients from January 2014 to December 2014(no-prophylactic antibiotic therapy), who underwent coronary stent implantation, were retrospectively analyzed. The prophylactic antibiotics and the infection rates in two groups were compared. Results The rate of infections related to coronary stent implantation in no-prophylactic antibiotic therapy group and prophylactic antibiotic therapy group, such as surgical site infection (0.2% vs 1.3%,P>0.05) and catheter-related infection(0.6% vs 1.9%,P>0.05), was not significant different(P>0.05). Similarly, the unrelated to coronary stent implantation was not significant different, too ( P > 0. 05). Conclusion Routine prophylactic antibiotic administration is unnecessary for the patients undergoing coronary stent implantation.

Effects of Telmisartan and Valsartan on Insulin Resistance in Obese Hypertensive Patients / 医药导报

Objective To observe the effects of telmisartan and valsartan on insulin resistance in obese hypertensive patients. Methods Sixty-eight patients with essential hypertension and body mass index ( BMI) ≥25 kg · ( m2 ) -1 were randomly divided into the telmisartan group (33 cases) and valsartan group (35 cases). Blood pressure, fasting serum glucose, fasting insulin (Fins) and insulin resistance (HOMA-IR) were measured before and after 16 weeks treatment. Results Compared with basal levels, SBP and DBP were significantly decreased in both group ( P 0. 05);( 3. 0 ± 0. 7) vs. (3. 0 ± 0. 7) ( P > 0. 05), respectively]. Conclusion In obese hypertensive patients, telmisartan and valsartan exert similar antihypertensive effect, but telmisartan may have a benefit in insulin resistance in comparison to valsartan.

Establishment of Fingerprint and Mutual Mode of Aqueous Extracts of Eucommia ulmoides Oliv.from Different Regions by HPLC / 医药导报

Objective To establish fingerprint and mutual mode of aqueous extracts of Eucommia ulmoides Oliv.from different regions by high performance liquid chromatography ( HPLC). Methods The column of SinoChrom ODS￣BP (250 mm×4.6 mm, 5 μm) was used.The mobile phase consisted of acetonitrile￣0.1% phosphoric acid with gradient elution.The flow rate was 1.0 mL.min-1 , the detective wavelength was 230 nm, and the column temperature was 25 ℃ . Results The fingerprint consisted of 14 common peaks.The overall similarity for ten batches of Eucommia ulmoides Oliv.from different regions was 0.592-0.986.The standard fingerprint of Eucommia ulmoides Oliv.was established by HPLC. Conclusion This fingerprint method is simple and repeatable, and it provides a scientific basis for the quality control of Eucommia ulmoides Oliv.

Effect of Compound Nitroglycerin Gel on Skin Ulcer Wound in Rats / 医药导报

Objective To study the protective effect of compound nitroglycerin gel on rats with skin ulcer wound and its action mechanism. Methods Skin ulcer modle of 54 rats was established.Then the rats were randomly divided into three groups (n=18 each), including model control group, Jin wan hong group, and compound nitroglycerin gel group. Wound healing process and healing time were recorded.At the day 7 and 14 after the model was established, the number of fibroblasts and new blood capillaries of granulation tissue from center of the wound were measured,and RT-PCR was used to detect mRNA expression levels of VEGF, Ang1 andHIF-1α. Results As compared with model control group [(24.17±5.91) days], healing time of skin in the compound nitroglycerin gel group was significantly shorter [(14.67±3.76) days, P<0.01].The numbers of fibroblasts (61.20±7.56) and new blood capillaries (9.35±1.43) were increased, and mRNA expression levels of VEGF (1.692±0.196), HIF-1α (1.527±0.174) and Ang1 (1.548±0.203) were remarkably up-regulated on 7th day (P<0.05 or P<0.01).While on 14th day, the numbers of fibroblasts (28.00±5.96) and new blood capillaries (4.20±1.30) were decreased and the mRNA expression levels of VEGF (1.156±0.123), HIF-1α(1.021±0.105) and Ang1 (1.034±0.134) were significantly down-regulated (P<0.05 or P<0.01) . Conclusion Compound nitroglycerin gel can treat skin ulcer wound via regulating the numbers of fibroblasts, new blood capillaries and VEGF/Ang1/HIF-1α signal transduction pathway.

Echocardiographic diagnosis of congenital mitral valve malformation / 中华超声影像学杂志

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Study of sunitinib-liposome-loaded microbubbles for growth Inhibition and apoptosis induction of renal carcinoma cell strain GRC-1 / 中华超声影像学杂志

Objective To investigate the effect of growth inhibition and apoptosis induction of sunitinib-liposome-loaded microbubbles on renal carcinoma cell strain.Methods GRC-1 cell strain was cultured in vitro,and was divided into 6 groups:blank control group,pure microbubbles group,pure lipsomes group,sunitinib group,sunitinib-liposome-loaded microbubbles without ultrasound treat group,sunitinib liposome-loaded microbubbles with ultrasound treat group.Growth inhibition in different groups was observed at different time with MTT assay,apoptosis induction with Sigma-FlTC technology and transmission electron microscope.Results The growth inhibition and apoptosis promotion of GRC-1 cell were significantly increased in sunitinib-liposome-loaded microbubbles with ultrasound treat group compared to the other groups.Conclusions Microbubble guided sunitinih delivery can increase the effect of the growth inhibition and apoptosis induction of GRC-1 cells,which may provide an more effective approach for cancer treatment.

Establishment and evaluation of rabbit unstable atherosclerotic plaque model induced by cold stress / 中华老年医学杂志

Objective To establish and evaluate unstable atherosclerotic plaque model in abdominal aorta induced by cold stress. Methods Sixty male New Zealand white rabbits were randomly divided into three groups:cold stress group fed with high fat diet and followed by balloon induced arterial wall injury of abdominal aorta at week 2 and exposed to cold (4℃) for 1 h per day except for the first postoperative week,balloon-injury group treated by high fat diet plus balloon-injury, control group fed a normal chow without any treatment. Pathological changes of atherosclerotic plaques among these groups were evaluated at 20 weeks. Meanwhile, serum concentrations of blood lipid,oxidized low density protein(ox-LDL),hypersensitive C-reaction protein (hs-CRP)and interleukin (IL)-8 were determined. Results There was no difference in blood lipid level between cold-stress and balloon-injury groups.Serum concentrations of ox-LDL[(56.1 +14.3)mg/L vs.(42.9± 13.8)mg/L],hs-CRP[(149.1+78.3)mg/L vs. (94.5±57.3)mg/L],IL-8 [(97.6±17.9)μg/L vs.(57.5±18.3)μg/L]and macrophage infiltration[(30.9±5.6)％ vs,(18.7±4.8) ％] were significantly higher in cold stress group than in balloon-injury group (t =2.78,6.91,14.94,6.88,all P＜0.05). Higher angiogenesis rate of atherosclerotic plaque in cold-stress group (23/31,74.1％) was observed in comparison with group balloon-injury(5/25,20,0％)(x2=16.26,P＜0.05). Conclusions Establishment of rabbit unstable atherosclerotic plaque model induced by cold stress in synergy with high fat diet and balloon-injury is feasible, which is superior to conventional method through high fat diet plus balloon-injury surgery.

Case study of pharmaceutical direct supply at Wuhan Pu Ai Hospital / 中华医院管理杂志

Wuhan Pu Ai Hospital implemented the pharmaceutical direct supply mode since October 2006 as an experiment.The pilot proved the mode as successful in reducing drug costs proportion,promoting rational use of drugs,and raising business volume of the hospital.Authors also recommend to further efforts in drug supply price supervision mechanism,government subsidy mechanism,direct supply catalogue and drug supply mode among others.Other recommendations include innovation in directly supply mode,hospital internal reform,packaged performance appraisal and incentive mechanism for medical workers,and building a ceiling mechanism for total medical expense control.

Comparison of ultrasonography and X-ray in the assessment of peripheral joints invovement in psoriatic arthritis / 中华超声影像学杂志

Objective To compare and investigate the role of ultrasonography and X-ray examination in the assesment of peripheral joints in psoriatic arthritis (PsA).Methods One hundred and twenty-five groups joints of twenty-five patients with PsA underwent ultrasonography and X-ray examination,including knee joints,wrist joints,ankle joints,metacarpophalangeal joints and interphalangeal finger joints,metatarsophalangeal joints and interphalangeal toe joints.The results of the two examinations were analysed and compared.Results The numbers of patients with abnormal joints in knee joints,wrist joints,ankle joints,metacarpophalangeal/interphalangeal finger joints,and metatarsophalangeal/interphalangeal toe joints were 9,9,9,10,and 11,respectively.Ultrasonography found more abnormal joints than X-ray ( P ＜0.01 ).The cardinal ultrasonographic manifestations of PsA were synovitis (29),tendonitiS (16),and bone erosion (7).The cardinal X-ray manifestations of PsA were bone destruction (11 ),periarticular osteoporosis (5),periosteal reaction (3) and periarticular soft tissue swelling (4).Ultrasonography found more synovium and tendon abnormalities than X-ray (P ＜ 0.01 ),and X-ray found more bone abnormalities than ultrasonography ( P ＜0.01).Conclusions Ultrasonography has the ability of demonstrating early changes of peripheral joints in PsA.The combination of ultrasonography and X-ray can make the diagnosis of PsA more correct and comprehensive.

The clinical value of contrast-enhanced ultrasound in superficial lymphadenopathy qualitative diagnosis / 中华超声影像学杂志

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.