Establishment of layered training system of ultrasound medicine based on physician and sonographer collaboration / 中华医学教育探索杂志

In order to meet the social demand for ultrasound talents, a layered training system of ultrasound medical talents suitable for China's national conditions has been explored. The department of ultrasound of West China Hospital of Sichuan University has formulated and implemented a "three-layers" ultrasound education and training system in combination with its own reality. The first layer mainly refers mastering the basic ultrasound examination ability mainly through relevant ultrasound theoretical knowledge and basic operation skills training. The second layer is based on the first level to further master the ability of ultrasound diagnosis and differential diagnosis of common and frequently occurring diseases in various systems, and to be capable of engaging in basic ultrasound teaching and scientific research. The third layer means mastering the ability of ultrasound diagnosis, evaluation and interventional diagnosis and treatment of difficult and specialized diseases, grasping the latest development direction of the sub-specialty, and having the ability to engage in ultrasound teaching and clinical research. The results show that the "three-layers" ultrasound education and training system conforms to China's national conditions and is worthy of reference and promotion.

Treatment of calcaneal fracture with calcaneal reduction forceps and external fixation / 中国医师进修杂志

Objective:To study the clinical effect of the minimally invasive treatment of calcaneal fractures by closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation.Methods:Clinical data of 16 patients with unilateral calcaneal fractures admitted to Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2017, including 14 males and 2 females, with a unilateral calcaneal fracture were analyzed retrospectively. The Bohler angle, Gissane angle, and calcaneal width, height and length were measured before and after the operation. The ankle function was evaluated according to the AOFAS score at 6 and 12 months after the operation.Results:The Bohler angle, Gissane angle, width, height and length 3 d and 6 months after operation were significantly better than before operation: (28.82 ± 1.72)° and (25.84 ± 1.96)° vs. (16.71 ± 2.74)°, (120.92 ± 3.85)° and (119.65 ± 3.84)° vs. (103.63 ± 4.62)°, (35.23 ± 1.94) and (36.51 ± 2.01) mm vs. (39.52 ± 1.26) mm, (48.52 ± 2.16) and (48.86 ± 1.98) mm vs. (46.94 ± 2.48) mm, (71.23 ± 2.49) and (70.94 ± 2.36) mm vs. (67.53 ± 2.53) mm, there were statistical differences ( P<0.05); there were no statistical difference in those indexes before 6 months after operation and 3 d after operation ( P>0.05). The average AOFAS score 12 months after operation was significantly higher than 6 months after operation (80.6 scores vs. 60.1 scores), there was statistical difference ( P<0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case. The average AOFAS score was 60.1 at 6 months after the operation and 80.6 at 12 months after the operation, which was significantly higher than the average AOFAS score at 6 months after the operation ( P < 0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case, respectively. Conclusions:The application of closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation is effective for the treatment of displaced calcaneal fractures, with a simple procedure, minimal trauma, fewer skin and soft tissue complications, and satisfactory clinical results.

Analysis of Glycosyls Profile of Aroma Glycosides in Meili Grape by High Performance Liquid Chromatography-RefractiveIndex Detector with Amino Column / 分析化学

A high performance liquid chromatography method based on amino column to uncover the glycosyls of aroma glycosides in Meili grape was established.Meili grapes were sampled from Yangling, Shaanxi province, China.Aroma glycosides in grape skins were extracted by extraction buffer (0.1 mol/L Na2HPO4/NaH2PO4, pH 7.0, 13% ethanol (V/V)), then enzymatically hydrolysed by AR2000 enzyme preparation in citrate-phosphate buffer (pH 5.0), and the glycosyls liberated were isolated by amino column, and determined by high performance liquid chromatography-refractive index detector (HPLC-RID).The HPLC-RID experimental conditions were developed as follows: amino column temperature 35℃, RID temperature 35℃, injection volume 20 μL, mobile phase acetonitrile/ethyl acetate/water=60∶25∶15 (V/V), flow rate 1 mL/min.The results showed that the reasonable linearity was achieved for rhamnose, xylose, arabinose, apiose and glucose (R2>0.996), with the detection limit (LOD) of 93-123 mg/L and quantitation limit (LOQ) of 309-409 mg/L.The relative standard deviation (RSD, n=10) of the peaks of each monosaccharide (5 g/L) was 2.3%-6.4%, and the recoveries ranged from 73.8% to 125.7%.The molar percentages of the aroma glycosides in Meili grape were 4.1%-6.1% for 6-O-α-L-rhamnopyranosyl-β-D-glucopyranoside, 2.3%-8.8% for 6-O-β-D-xylopyranosyl-β-D-glucopyranoside, 0.1%-3.9% for 6-O-α-L-arabinofuranosyl-β-D-glucopyranoside, 5.5%-9.8% for 6-O-α-L-apiofuranosyl-β-D-glucopyranoside, and 76.3%-86.8% for 6-O-β-D-glucopyranosyl-β-D-glucopyranoside.The contents of each aroma glycoside and the total glycosides in Meili grape didn′t show obvious relationship with berry maturity index during grape maturity.

Prevalence rates of healthcare-associated infection in a tumor hospital in 3 years / 中国感染控制杂志

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a tumor hospital,and provide evidence for prevention and control of HAI.Methods According to requirement of cross sectional survey of nationwide HAI monitoring network,prevalence rates of HAI in hospitalized patients at a tumor hospital in 2013-2015 were surveyed,surveyed results were statistically analyzed.Results A total of 3 515 hospitalized patients were investigated from 2013 to 2015,24(0.68%)had HAI.The prevalence rates of HAI from 2013 to 2015 were 0.79%,0.54%,and 0.76%respectively,difference was not statistically significant(x2=0.65,P>0.05).The main infection site was lower respiratory tract,accounting for 45.83%.The main pathogens causing HAI were gram-negative bacilli,accounting for 47.37%,followed by fungi(26.32%).Conclusion The prevalence rate of HAI in tumor patients is low,targeted monitoring should be carried out according to the current situation,the prevention and control of lower respiratory tract infection should be focused on,fungal infection should be paid attention.

Repairing articular cartilage defects by transplantation of periosteum combined with bone marrow mesenchymal stem cells and chondrocytesin vivo / 中国组织工程研究

BACKGROUND:The main strategies for cartilage repair include abrasion and lavaging, driling, microfracture technology. But most of these technologies are considered certain limitations that can only aleviate pain and have short-term effects. Cartilage tissue engineering technology has great significance and broad application prospects for cartilage regeneration and repair. OBJECTIVE:To investigate the effect of periosteum combined bone marrow mesenchymal stem cels and chondrocytes on the repair of articular cartilage defects in the intercondylar fossa of the rabbit knee joints. METHODS:Bone marrow mesenchymal stem cels and chondrocytes were isolated and purified from rabbits. Twenty-eight New Zealand white rabbits were enroled to create articular defects in the intercondylar fossa with peiosteal coverage in both knee joints, and then these rabbits were randomly divided into two groups: experimental and control groups. The defects in the left side were treated with transplantation of periosteum combined with bone marrow mesenchymal stem cels and chondrocytes or autologous periosteum in the experimental and control groups, respectively, while the defects in the right side received no treatment as blank controls. These rabbits were kiled at 8 and 12 weeks after surgery in each group and newborn tissue samples at defect site were taken for gross observation, histological observation and Wakitani scoring. RESULTS AND CONCLUSION:At 12 weeks after surgery, in the experimental group, the repaired tissues were substantialy smooth with a very similar color to the surrounding cartilage tissues, a large number of chondrocytes and cartilage lacunae were visible to form the cartilage matrix, type II colagen immunohistochemical staining was positive, and the tissue was stained darker with toluidine blue; in the control group, the repair tissues were stil white, the newborn tissues presented with local depression, less smooth surface, and hard texture, there was only a very smal amount of chondrocytes, toluidine blue staining was shalow, type II colagen immunohistochemical staining was negative, and no cartilage matrix formed; in the blank control group, the cartilage defects colapsed with irregular surface, the repaired tissues were fibrous tissues and stained lighter with toluidine blue. These findings indicate that autologous periosteum combined with bone marrow mesenchymal stem cels and chondrocytes can effectively repair articular cartilage defects.

Contrast-enhanced ultrasound and 3D reconstruction for assessment of the deep inferior epigastric perforator / 中华超声影像学杂志

Objective To assess the deep inferior epigastric perforator (DIEP) vessels in patients with breast reconstruction flaps by contrast-enhanced ultrasound (CEUS) and three-dimensional ultrasound (3DUS) reconstruction techniques.Methods Conventional ultrasound,CEUS and 3DUS were used to evaluate DIEP vessels of breast reconstruction flaps in 43 patients before surgical procedures.The identification,localization and spatial relationship of DIEP vessels were analyzed with conventional ultrasound,CEUS and 3DUS methods.The findings of CEUS and 3DUS were compared to conventional ultrasound and surgical outcome.Results Compared to CDFI,40 cases (93％) were observed more clearly with CEUS,and were showed more accurately than conventional ultrasound.41 cases (95％) could be displayed wonderfully in 3D ultrasound.Perforators which were detected by ultrasound were confirmed in the surgery and the transferred flaps survived completely.Conclusions Perforators can be displayed more clearly and located more accurately by CEUS and 3DUS.CEUS and 3DUS could play a very important role in the preoperative navigation of the DIEP than conventional ultrasound.

A pilot study to evaluate the invasiveness of mandible ameloblastoma on ultrasonography / 中华超声影像学杂志

Objective To evaluate and demonstrate ultrasonographic characteristics of mandibular ameloblastoma with active proliferation. Methods Nineteen subjects with ameloblastomas in the mandibles were examined with ultrasonography. In addition to sizes,internal echoes,the research was focused on blood flow of the tumors and destruction of mandibles. Ultrasonographic appearances of the tumors were compared with histopathological findings. Sensitivity and specificity of Doppler flow signals and destruction of mandibles for prediction of active tumor proliferations were calculated. Results Fifteen cases (79%)showed no or minimal flow signals on color Doppler flow imaging(CDFI), whereas the remaining 4 lesions demonstrated abundant flow signals,in which 3 cases were confirmed histopathologically with active tumor proliferations. The sensitivity and specificity of the Doppler flow signals for prediction of active tumor proliferations were 100% and 94%, respectively. Fourteen cases (74%) showed the mandibular cortices were thin but continuous,among the remaining 5 lesions showed local cortices destruction,3 of them were confirmed histopathologically with active proliferations. The sensitivity and specificity of the destruction of cortical bone for prediction of active tumor proliferations were 100% and 88 %, respectively. Conclusions Ultrasonography can be used as a new effective supplementary diagnostic method for mandibular ameloblastomas. CDFI of tumor vascularity and destruction of cortical bone could be used to predict active tumor proliferations and invasiveness.

Experimental study of contrast enhanced transrectal ultrasound for monitoring radiofrequency ablation of prostate / 中华超声影像学杂志

Objective To determine the feasibility and safety of radiofrequeney(RF)ablation of entire prostate guided and monitored by contrast-enhanced transrectal ultrasound(CE-TRUS)in canine model.Methods Contrast ultrasound-guided RF ablation of entire prostate was preformed transrectally using Cool-tiptm electrodes in 7 normal canines under general anesthesia.The urethra/bladder and rectum were protected by infusion of cold distilled water through a Foley catheter and injection of cold distilled water into the prostate-rectum space,respectively.CE-TRUS findings were compared with TTC-stained pathologic results.Results All the 7 canines tolerated the ablation procedures.CE-TRUS clearly demonstrated hypoechoic thermal lesions as avascular/nonperfusion areas.The average number acquired for entire prostate ablation was 4.3(3 to 6).The average ablation volume achieved on pathology was 96.55%.There was no statistically significant difference when compared average ablative volumes between CE-TRUS and TTC-stained pathology[(9.16±5.20)cm3 vs(8.62±3.13)cm3,P=0.583].The coefficient correlation was 0.94(P=0.002).No thermal related injuries were found in anv of the bladder and rectum.The thermal related inj uries of the urethra were less than 1/4 quadrant.Conclusions It is feasible to ablate the entire prostate using RF thermal energy under CE-TRUS guidance.CE-TRUS plays a key role for achieving entire prostate ablation.The urethra and rectum can be protected by cooling of these structures during the procedure.

Usefulness of contrast enhanced ultrasound in the diagnosis of breast lesions / 中华超声影像学杂志

Objective To evaluate the usefulness of contrast enhanced ultrasound in the diagnosis of breast lesions. Methods Contrast enhanced ultrasound was performed after administration of SonoVue in 104 patients scheduled for surgical tumor removal. The enhancement morphology was classified as non, peripheral,homogeneous,regional,or heterogeneous enhancement based on distribution of enhancing areas. All breast lesions enhancement morphology were analyzed, and the diagnostic value of contrast enhanced ultrasound was calculated. Results The prevalence of non enhancement was significantly higher in benign lesions than in malignant ones(P = 0.013),and the prevalence of peripheral enhancement was significantly higher in malignant lesions than in benign ones (P = 6.02 × 10-7). Conclusions Contrast enhanced ultrasound is useful in diagnosis of breast lesions.

Infection of Central Venous Catheterization in Tumor Patients with Chemotherapy:Analysis and Nursing Intervention / 中华医院感染学杂志

OBJECTIVE To evaluate the infection of central venous catheterization in tumor patients with chemotherapy and analyze its risk factors and the role of nursing intervention. METHODS The prospective overall monitoring method was used,including catheterization,maintenance,observation and monitoring. RESULTS Of 446 cases with chemotherapy,the infection rate was 2.24% (10 cases). The infection mainly correlated with age,catheterization time,chemotherapy duration,venous nutrition,complication and hormone. CONCLUSIONS The infection of central venous catheterization is inevitable due to multiple risk factors. The measures to prevent and reduce hospital infection are holding the key steps of central venous catheterization,executing the management system of sterilization,keeping tract smooth,cutting down time of central venous catheterization and strengthening nursing education about central venous catheterization.

Contrast-enhanced ultrasound for differential diagnosis of hyperechoic liver lesions / 中华超声影像学杂志

Objective To assess the value of contrast-enhanced ultrasound(US)in differential diagnosis of hyperechoic hepatic lesions when compared to conventional US.Methods Eighty-four hyperechoic liver lesions in 66 patients were examined using both conventional and contrast-enhanced US techniques.Results Receiver operating characteristic analysis revealed a significant improvement in the discrimination of malignant versus benign hyperechoic hepatic lesions (area under the receiver operating characteristic curve,0.867±0.045 at conventional US,0.997±0.003 with contrast-enhanced US(P＜0.0001).For correct diagnoses types of hyperechoic liver lesions,contrast-enhanced US improved from 64.3% to 92.9%,comic)ared with conventional US (P＜0.001).Conclusions Contrast-enhanced US showed a significant improvement in characterization and differentiation of hyperechoic hepatic lesions when compared to conventional US.

THE IMMUNOLOGIC PROTECTION OF SELENIUM ON GASTRIC MUCOSAL LESIONS OF MICE INFECTED BY HELICOBACTER PYLORI / 营养学报

Objective: To study the immunologic protection of selenium on gastric mucosal lesions of BALB/C mice infected by Helicobacter pylori (HP). Method:The model was built by ig HP in BALB/C mice and then effects of selenium on gastric mucosal lesions and the CD4、CD8 cells were observed.HP was examined by both of bacterial culture and rapid usease test (RUT). Results:1.0 ?g/g bw selenium could effectively prevent gastric mucosal damages induced by HP. HP could decreased the ratio of CD4 to CD8,but selenium could enhance the activity of CD4 cell and increase the ratio. Conclusion: Se can effectively prevent the gastric mucosal damages of mice infected by HP. One of the mechanisms is that Se can enhance the CD4 activity and increase CD4 /CD8.

Expression and relationship among CD44V6, p16 and PCNA in gastric mucosal lesions with Helicobacter pylori infection / 中华检验医学杂志

Objective To study the expression and relationship among CD44V6,p16 and PCNA in gastric mucosal lesions with HP infection. Methods Expression of CD44V6,p16 and PCNA were investigated in 114 gastric mucosal lesions by use of immunohistochemistry.HP was examined by both Warthin -Starry method and RUT. Ruselts Comparing HP positive group (P