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OBJECTIVE： To establish the method for simultaneous determination of saikosaponin a and saikosaponin d in Bupleurum chinense water extract， and to optimize its water extraction technology for electromagnetic cracking. METHODS： HPLC method was used. The determination was performed on SB-C18 column with mobile phase consisted of acetonitrile-water （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 40 ℃. The detection wavelength was set at 210 nm， and the sample size was 10 μL. Based on single factor experiment， using extraction time， particle size， solide-liquid ratio as factors， total extraction rate of saikosaponin a to saikosaponin d as indexes， the extraction technology was optimized by using Box-Behnken response surface methdology， and compared with the results of ultrasound method and decoction method. RESULTS： The linear range of saikosaponin a and saikosaponin d were 50.70-202.80 μg/mL （r＝0.999 9） and 50.50-202.00 μg/mL （r＝0.999 9）， respectively. The quantitation limits were 0.16 and 0.13 μg/mL， respectively. The detection limits were 0.05 and 0.04 μg/mL，respectively. RSDs of precision， stability and reproducibility tests were all lower than 2％. The average recoveries were 98.23-102.47％ （RSD＝1.80％， n＝6） and 98.84％-102.06％ （RSD＝1.60％， n＝6）. The optimal extraction technology was as follows： the extraction time of 2.50 min； the particle size of 80 mesh， solid-liquid ratio of 1 ∶ 28 （g/mL）. Results of 3 times of validation tests showed that the optimal technology included the average total extraction rates of saikosaponin a and saikosaponin d were 8.42 mg/g， which was higher than that of ultrasonic method （8.34 mg/g） and decoction method （8.06 mg/g）， and the extration time was shorter. CONCLUSIONS： Established method is simple and accurate， and can be used for simultaneous determination of saikosaponin a and saikosaponin d in B. chinense water extract. The optimized water extraction technology for electromagnetic cracking is stable and feasible.
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Objective To compare the accuracy of ultrasound,pulse indicator continuous cardiac output monitoring (PiCCO) and traditional methods in predicting fluid responsiveness in septic patients.Methods Forty-six septic patients of both sexes,aged 18-72 yr,requiring mechanical ventilation treatment in the intensive care unit,were enrolled in the study.Venous blood samples were collected for determination of plasma B-type natriuretic peptide (BNP) concentrations by chemiluminescence assay,and central venous pressure (CVP) was recorded.Stroke volume variation (SVVTTE),distensibility index of inferior vena cava (dIVC) and velocity time integral changes of aortic blood flow (△VTI) were measured by ultrasound method.SVVPiCCO and global end-diastolic volume index (GEDVI) were measured by PiCCO method.The patients were divided into negative fluid responsiveness group and positive fluid responsiveness group according to the fluid responsiveness after volume expansion.The receiver operating characteristic curves of the parameters mentioned above in predicting fluid responsiveness were drawn.A consistency check for dIVC,△VTI and SVVPiCCO thresholds was conducted by using Kappa statistics.The agreement between SVVTTEand SVVPiCCO was analyzed by the Bland-Altman analysis.Results There were 24 patients in positive fluid responsiveness group and 22 patients in negative fluid responsiveness group.Compared with negative fluid responsiveness group,the plasma BNP concentration,CVP and GEDVI were significantly decreased,and SVVPiCCO,SVVTTE,dIVC and △VTI were increased before volume expansion in positive fluid responsiveness group (P＜0.05).The area under the curve (95％ confidence interval),sensitivity and specificity of the plasma BNP concentration were 0.894 (0.807-0.981),81.8％ and 79.2％,respectively,of CVP 0.859 (0.752-0.965),81.8％ and 79.2％,respectively,of GEDVI 0.772 (0.628-0.915),72.7％ and 75.0％,respectively,of SVVPiCCO 0.965 (0.922-1.008),95.8％ and 81.8％,respectively,of SVVTTE 0.940 (0.874--1.006),91.7％ and 86.4％,respectively,of dIVC 0.964 (0.920-1.008),83.3％ and 95.5％,respectively,and of △VTI 0.958 (0.909-1.008),87.5％ and 90.9％,respectively.The Kappa value for dIVC threshold and SVVPiCCO threshold was 0.826,and for △VTI threshold and SVVPiCCO threshold was 0.743 (P＜0.01).The mean deviation of SVVTTE and SVVPiCCO was 0.209,95％ confidence interval (-2.967-3.385)％,and the limit of agreement (-2.46-2.62)％ (P＜ 0.05).Conclusion Ultrasound and PiCCO methods can accurately predict fluid responsiveness,have a good agreement and are superior to the traditional method in septic patients.
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Objective To explore the value of predicting fluid responsiveness using velocity time index variation (△VTI) and stroke volume variation (△SV) before and after passive leg raising (PLR)monitored by bedside temporary test equipment (TTE).Methods A cohort of 42 patients supported with mechanical ventilation in our hospital admitted from October 2014 to October 2015 were prospectively selected.The hemodynamic variables including heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),VTI,SV and other parameters were monitored before and after after undergoing PLR.Fluid resuscitation volume expansion test was carried out after stroke volume index (SVI) monitored by pulse indicator continuous cardiac output monitoring (PICCO).Patients were divided into fluid responsiveness positive group and fluid responsiveness negative group according to presence or absence of SVI ≥ 15％ after fluid resuscitation volume expansion.Results Of 42 patients,22 belonged to fluid responsiveness positive group,20 got into fluid responsiveness negative group.There were no significant differences in basic clinical data between two groups.Before and after PLR,there were no distinct changes in HR and CVP (P ＞ 0.05),while MAP,VTI and SV increased significantly (P ＜ 0.05) after PLR in fluid responsiveness positive group.Contrarily,there were no noticeable changes in MAP and SV after PLR (P ＞ 0.05),but HR,CVP and VTI increased significantly (P ＜ 0.05) in fluid responsiveness negative group.The degrees of △VTI and △SV in fluid responsiveness positive group were much higher than those in fluid responsiveness negative group (P ＜0.05).According to SVI ≥ 15％ monitored by PICCO after fluid resuscitation volume expansion test as a standard,the area under the ROC (AUC) of △VTI between prePLR and post-PLR was 0.75 (95％ CI:O.593-0.907,P ＜ 0.01),the sensitivity and specificity were 63.6％ and 95％ respectively using △VTI 15.6％ as threshold value.The AUC of △SV was 0.844 (95％CI:O.716-0.972,P ＜0.01),the sensitivity and specificity were 81.8％ and 85.0％ respectively using △SV 10.5％ as threshold value.Conclusion △VTI and △SV monitored by TTE before and after PLR could be employed for predicting fluid responsiveness of critical patients under the status of spontaneous respiration.Their value for prediction of critical patients could be further improved by combined employment of these two indexes of variation.
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Objective To explore the value of BI-RADS scoring system based on the sonographic features in the breast nodules.Methods In order to build a Logistic regression model,regression was made to analyse 401 patients ' sonographic features of breast nodules.A scoring system was developed based on the results of regression's filter and the weight of each factor,used to score and classify the other 243 patients.It's diagnostic value was evaluated through comparing all types of theoretic risk ranges of BI-RADS.Results Age,morphology,orientation,margin,echo pattern and microcalcifications in a mass were selected in the final step of the logistic regression analysis.By means of scoring system,the scores corresponding to BI-RADS 3,4a,4b,4c,5 classes are 6,7-8,9-15,16-22 and ≥23 respectively.Case study comprehensive score of BI-RADS 3-5 classification' s positive predictive values were 0,4.17％,21.43％,84.85％,1 00％,and the area under the ROC curve scoring system was 0.947.Conclusions The scoring system can objectively score and classify breast nodules,and therefore provide an effective reference for clinical evaluation of benign and malignant breast.
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ObjectiveTo evaluate the application of chest-abdomen longitudinal diameter ratio,total lung area and lung longitudinal diameter in different gestational ages by two-dimensional ultrasonography.MethodsFive hundred and ninty-two fetus of normal singleton pregnancy between 18 and 40 weeks were ultrasonic scanned by standard 4-chamber view and fetus torso coronal section.The heart area,thoracic area,bilateral lungs pointed to the corresponding diaphragmatic dome gallery on the top of the vertical distance,diaphragmatic dome iterated top to the bottom of the fetal bladder distance were measured respectively.Related regression analysis was done on fitting total lung area and longitudinal diameter with pregnant increasing.ResultsA normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.The best-fit regression equations of total lung area was:Y =0.83 X +13.894,R2 =0.914;Lung longitudinal diameter was:Y =0.669 X + 3.124,R2 =0.892.Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation was in constant range:0.44 - 0.59.Conclusions Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation is in constant range.The normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.These parameters may be useful for the prenatal assessment of lung development.
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Objective To study the ultrasonographic and acoustic contrast features of breast fibroadenoma and breast cancer and explore the value of contrast enhanced ultrasonography in the differential diagnosis of benign and malignant breast tumors. Method A retrospective analysis of 18 cases breast fibroadenoma and 12 cases breast cancer in the performance of contrast-enhanced ultrasound was done. Results After contrast agent injection, tumor dimension increased in 4 cases with breast fibroadenoma and 7 cases with breast cancer. The ultrasonographic and acoustic contrast features of breast fibroadenoma showed no significant changes. They showed stenosis, perpendicular and circumambulates vascular shape. The breast cancers significantly increased the number of tumor blood vessels with the thicker,tortuous blood vessels into the tumor. Conclusions The contrast enhanced ultrasonography assessed more accurate size of tumors. The image displayed grown sizes, more vascularity and bending vascular shape in the breast cancer. It was more accurate than gray-scale ultrasound on diagnosing breast cancer.