Bolus材质对乳腺癌胸壁电子束放疗剂量分布的影响

目的:评估组织等效物Bolus材质对乳腺癌术后胸壁电子束放疗剂量分布的影响。方法:构建乳腺癌改良根治术后胸壁放疗模型,基于国际原子能机构(IAEA)官网中6 MeV电子束相空间文件(PSF)和Geant4蒙特卡罗应用软件包,计算Bolus材质中水、聚苯乙烯、聚乳酸、甘油和硅胶5种不同材质电子束放疗胸部剂量分布,对比胸壁和肺组织中剂量分布差异。结果:Bolus材质对电子束在胸壁的最大剂量深度(d_(max))影响较小,10 mm厚的Bolus所致d_(max)最大差异约2 mm;对剂量分布产生影响较大,尤其在胸壁后缘和浅表肺组织中,胸壁后缘剂量由大到小对应Bolus材质依次为聚苯乙烯、水、聚乳酸、硅胶和甘油,对于5 mm和10 mm厚的Bolus材质,剂量差异分别约为8%和15%;浅表肺组织中剂量由大到小对应Bolus材质依次是水、聚苯乙烯、聚乳酸、硅胶和甘油,对于5 mm和10 mm厚的Bolus材质,剂量差异最大分别可达约50%和70%。结论:Bolus材质对胸壁电子束放疗剂量分布所产生影响较大,合理选择Bolus材质有助于保证靶区剂量,减少肺组织中剂量沉积。

"Pretend"Bolus在乳腺癌根治术后调强放疗应用中的剂量学研究

目的：研究填充物在乳腺癌根治术后调强放疗计划中的剂量并进行比较，并探讨乳腺癌根治术后调强放疗的理想方案。方法：选取15例乳腺癌根治术后病人进行计划设计，应用Pinnacle9．2计划系统，采用5-6个照射野制定两组计划，分别为加填充物（Bolus）和不加填充物计划，使用相同的剂量一体积约束条件，处方剂量均为200cGy／25day，比较这两个计划PTV的适形度和剂量均匀性，双全肺及患侧肺的V5，V20，V30等剂量学指标。结果：使用BOLUS的IMRT计划能获得较满意的剂量分布，两种方法相比，除了靶区剂量，其余危及器官的剂量受量差异均无统计学意义。肺受量改变不明确，P〉0．05。结论：加了BOLUS做调强计划，大大提高了计划的适形度和均匀性，对某些患者可以减少肺v20，v30等剂量。结论：建议临床对于对乳腺癌根治术后的患者，做IMRT计划时加入0．5cm的填充物，可以提高表面剂量和靶区适形度。

Test-Bolus部位选择对MSCT双期脑血管成像质量的影响

目的对比不同部位Test-Bolus测试对MSCT脑动静脉双期成像图像质量的影响。方法75例随机分配到脑动脉环窦汇(A)组、颈内动静脉(B)组、颈总动静脉(C)组(每组25例),以相同参数行Test-Bolus测试及MSCT双期脑血管成像,用Kruskal-Wallis H检验比较3组测试成功病例CTA、CTV图像质量差异。结果A,B,C3组Test-Bolus测试成功显示动静脉强化峰值率分别为76%,92%,96%;3组测试动静脉峰值时间差有差别(P<0.005);3组测试动脉峰值时间没有统计学差异(P=0.744)。3组CTA图像脑动脉各级分支清晰显示,静脉干扰轻微,两者评分及脑动静脉最大强化CT差值均无显著差异(P=0.192;P=0.347;P=0.327)。3组CTV图像深浅静脉、静脉窦显示清晰,其评分没有差别(P=0.839);脑动脉仍强化明显,动脉干扰评分及动静脉最大强化CT差值没有差别(P=0.347;P=0.327)。结论颅内、颈内、颈总动静脉行Test-Bolus测试成功后,确定MSCT双期脑血管成像延时扫描时间对CTA及CTV图像质量影响无显著差异,颈内动静脉可作为MSCT脑动静脉双期成像推荐测试部位。

小剂量Test Bolus技术在脑动脉瘤诊断中的价值

脑动脉瘤被称为颅内的＂不定时炸弹＂,瘤体因高血压、动脉粥样硬化等多种因素随时可能发生破裂,导致患者大量脑出血后致死致残率极高,而严重威胁人类生命和健康,是最危险的脑血管病之一,任何年龄阶段均可发生脑动脉瘤,其中以40～60岁多见,且女性多于男性;而脑动脉瘤最常见的CT表现是自发性蛛网膜下腔出血。本文收集我院2012-12—2013-12临床及CT资料完整的17例颅内动脉瘤患者,

Bolus下空腔对放疗浅表剂量和最大剂量点深度的影响

探讨浅表肿瘤放疗时Bolus下空腔对浅表剂量和最大剂量点深度的影响。在Eclipse计划系统里创建30 cm×30 cm×30 cm的体模及体模表面创建10 mm厚的Bolus,设置Bolus和体模材料均为水。在Bolus和体模之间设置0 mm、2 mm、5 mm、10 mm、20 mm、30 mm厚度的Air空腔,将源皮距设置为100 cm,射野面积大小分别取5 cm×5 cm、10 cm×10 cm、15 cm×15 cm、20 cm×20 cm、25 cm×25 cm。剂量大小为100 cGy,获取不同空腔厚度不同射野大小下,体模浅表1 mm深度的剂量(D s)和体模内最大剂量点的深度值(d_(max)),同时用德国PTW公司水箱在加速器上做同样条件的实验,用EBT 3胶片测量浅表剂量D s,电离室获取d_(max)。将计划系统得到的结果和实验测量的结果进行差异对比,结果表明:无Bolus时,计划系统D s为0,而实验测量D s有剂量,计划系统和测量结果均显示射野面积大小为5 cm×5 cm时,D s随空腔厚度增加减小最快。当射野面积大小在15 cm×15 cm及以上时,D s随空腔厚度变化较为平稳。计划系统和实验测量结果均显示无Bolus时d_(max)最大,计划系统里随着空腔厚度增加d_(max)变化较为平稳;实验结果为射野面积为10 cm×10 cm及以下时,d_(max)随空腔厚度增加变化显著,而射野面积在15 cm×15 cm及以上时d_(max)随空腔厚度变化较为平稳,且计划系统和实验测量的结果都为射野面积越小,d_(max)越大。除在无Bolus时计划系统与实验测量D s差异很大,其他不同射野面积大小、不同空腔厚度的D s差异均接近于0;计划系统与实验测量d_(max)总体差异较大,在不同空腔厚度下,小射野面积差异比大射野面积差异大,且在空腔厚度为0 mm时,所有射野面积的d_(max)差异最接近0。计划系统会低估浅表剂量计算精度,为减小误差,浅表肿瘤需加Bolus,且Bolus下空腔厚度为0 mm最佳。

Test Bolus法与Bolus Tracking法在头颈CTA中的对比研究

目的通过Test Bolus法与Bolus Tracking法在头颈CTA扫描技术的图像质量对比,探讨头颈CTA扫描的最佳扫描技术。方法选取头颈CTA检查Test Bolus法和Bolus Tracking法的患者各30例,将扫描数据进行图像后处理,主观评价采用五分法,客观评价分别在主动脉弓、颈总动脉和大脑中动脉M1段血管内测量CT值,分析两种扫描方法的主观评价和客观评价差异性比较。结果主观评价图像质量Test Bolus法优于Bolus Tracking法,差异具有统计学意义(P﹤0.05)。客观评价血管内CT值Test Bolus法均高于Bolus Tracking法,主动脉弓血管内CT值差异无统计学意义(P﹥0.05);颈总动脉和大脑中动脉M1段管内CT值差异具有统计学意义(P﹤0.05)。结论在头颈CTA扫描技术中,Test Bolus法扫描可准确计算CTA的扫描启动时间,可以获取最佳扫描时机。

Clinical and Dosimetric Implications of Air Gaps between Bolus and Skin Surface during Radiation Therapy

Purpose: The main objective of the study was to evaluate the effect of air gaps of 0 - 5.0 cm between bolus and skin for 1.0 cm Superflab bolus on surface dose (DSurf) and depth of maximum dose (dmax) in solid water and Rando? phantoms. Methods: In this work, the effects of bolus to surface distance on DSurf and variation in dmax were analyzed in a solid water phantom and in an anthropomorphic Rando? phantom for different field sizes, using Gafchromic? EBT films and farmer chamber. Results: For field sizes of 5 × 5 cm2 the DSurf is significantly affected by increasing air gaps greater than 5 mm. For field sizes larger than 10 × 10 cm2, DSurf is nearly the same for air gaps of 0 - 5.0 cm. For small fields and 6 MV photon beam, dmax increases with increasing air gap, while for 10 MV beam and smaller field sizes (i.e. 5 × 5 and 10 × 10 cm2) the dmax first decreases and then increases with the air gaps. For both 3DCRT and IMRT plans on Rando?, DSurf reduction is more prominent with increasing air gaps. Conclusion: For field sizes larger than 10 × 10 cm2 DSurf is largely unaffected by air gaps. However, smaller air gap results in shallower dmax for both 6 MV and 10 MV photon beams at all fields sizes. Special consideration should be taken to reduce air gaps between bolus and skin for field sizes smaller than 10 × 10 cm2 or when surface contour variations are greater or when the bolus covers small area and at the border of the field.

Peristaltic transport of rheological fluid:model for movement of food bolus through esophagus

Fluid mechanical peristaltic transport through esophagus is studied in the paper. A mathematical model has been developed to study the peristaltic transport of a rheological fluid for arbitrary wave shapes and tube lengths. The Ostwald-de Waele power law of a viscous fluid is considered here to depict the non-Newtonian behaviour of the fluid. The model is formulated and analyzed specifically to explore some important information concerning the movement of food bolus through esophagus. The analysis is carried out by using the lubrication theory. The study is particularly suitable for the cases where the Reynolds number is small. The esophagus is treated as a circular tube through which the transport of food bolus takes place by periodic contraction of the esophageal wall. Variation of different variables concerned with the transport phenomena such as pressure, flow velocities, particle trajectory, and reflux is investigated for a single wave as well as a train of periodic peristaltic waves. The locally variable pressure is seen to be highly sensitive to the flow index ＂n＂. The study clearly shows that continuous fluid transport for Newtonian/rheological fluids by wave train propagation is more effective than widely spaced single wave propagation in the case of peristaltic movement of food bolus in the esophagus.

湿纱布与bolus在腱鞘巨细胞瘤放疗中的剂量学差异

目的:探讨利用湿纱布与bolus在腱鞘巨细胞瘤放疗中的剂量学差异。方法:回顾性选取8例采用湿纱布作为组织等效补偿膜的腱鞘巨细胞瘤患者,以原始CT扫描序列作为第一组数据,勾画实际body(不包括纱布),然后,添加虚拟bolus,获得第二套数据。分别在Varian Eclipse 13.6制作两组计划(Plangauze和Planbolus),比较两组数据的剂量学差异。最后,采用两组模体,分别实测两种组织补偿物对射线的衰减程度,比较Plangauze和Planbolus的差异。结果:Plangauze组与Planbolus组的均匀性指数、适形度指数、Dmax、Dmean、总机器跳数以及低剂量区域体积(V10、V20)和高剂量区域体积(V80、V90)的比较均无统计学差异(P>0.05),两组计划靶区剂量均能满足临床要求,且两组模体中,Plangauze和Planbolus实测剂量值差异较小。结论:使用湿纱布作为组织补偿物在腱鞘巨细胞瘤放疗中能达到虚拟bolus的剂量分布。考虑腱鞘巨细胞瘤的特殊性,使用湿纱布能够更好地包覆靶区,减小组织补偿下空腔,结果更加准确,可推荐作为该肿瘤的补偿物。

Intravenous Contrast Material Administration at High-pitch Dual-source CT Coronary Angiography: Bolus-tracking Technique with Shortened Time of Respiratory Instruction Versus Test Bolus Technique

Objective To investigate the feasibility of acquiring the similar homogeneous enhancement using bolus-tracking techniques with shortened respiratory time in prospectively electrocardiogram-gated high-pitch spiral acquisition mode (Flash mode) coronary computed tomography angiography (CCTA) compared with test bolus technique. Methods One hundred and eighty-four consecutive patients with mean heart rate ≤65 beats per minute undergoing CCTA were prospectively included in this study. The patients were randomly divided into two groups. Patients in the group A (n=92) instructed to shorten respiratory time received CCTA using bolus-tracking technique with high-pitch spiral acquisition mode (Flash mode), while those in the group B (n=92) underwent CCTA with test bolus technique. The attenuation in the ascending aorta, image noise, contrast-to-noise ratio and radiation doses of the two groups were assessed. Results There were no significant differences in the mean attenuation values in the ascending aorta (483.18±59.07 HU vs. 498.7±83.51 HU, P=0.183), image noise (21.4±4.5 HU vs. 20.9±4.3 HU, P=0.414), contrast-to-noise ratio (12.1±4.2 vs. 13.8±5.1, P=0.31) between the groups A and B. There were no significant differences in the radiation dose of dynamic monitoring scans (0.056±0.026 mSv vs. 0.062±0.018 mSv, P=0.068) and radiation dose of angiography (0.94±0.07 mSv vs. 0.96±0.15 mSv,P=0.926) between the two groups, while 15 mL less contrast material volume was administered in the group A than the group B. Conclusion Bolus-tracking technique with shortened time of respiratory in Flash mode of dual-source CT yields the similar homogeneous enhancement with less contrast material in comparison to the test bolus technique.

乳腺癌根治术后定制化组织补偿物与常规bolus剂量学对比及急性皮肤反应影响

目的探讨定制化组织补偿物与常规blous用于乳腺癌根治术后胸壁放疗的优势,并验证其临床特性。方法基于定位CT图像获取20例乳腺癌改良根治术后放疗患者的胸壁数据,制作定制化组织补偿物,分别验证定制化组织补偿物和常规bolus与胸壁的贴合性,通过Eclipse计划系统比较计划和实际使用两种组织补偿物的剂量学参数及其对急性皮肤反应的影响。结果定制化组织补偿物无论是在胸壁贴合性方面还是实际计划剂量分布方面均优于常规bolus;且定制化组织补偿物在对急性皮肤反应方面优于常规bolus。结论定制化组织补偿物在实际操作中方便可行,且价格适中,值得临床应用。

Test-Bolus改良法在头颈部CTA检查中的应用价值

目的:对比Test-Bolus改良法与经验值法在头颈部CTA检查中的应用效果,探讨TestBolus改良法的应用价值。方法:将140例行头颈部CTA检查的患者按随机数字表法分为Test-Bolus经验值法组(A组)和Test-Bolus改良法组(B组),每组70例,分别运用常规经验值法和改良法进行头颈部CTA扫描,测量两组带骨薄层增强图像不同层面(主动脉弓层面、双侧颈动脉窦层面、双侧大脑中动脉M1段层面)动脉血管内的CT值,并对两组减影VR图像进行主观质量评分。结果:A、B两组不同层面动脉血管内CT值差异均无统计学意义(P值均>0.05)。VR图像评分为优、良的例数总和所占百分比分别为:A组77.1%(54/70),B组95.7%(67/70),B组明显高于A组,差异有统计学意义(Z=-9.567,P=0.000)。A组减影VR图像质量主观评分为(3.11±0.28)分,B组为(3.44±0.32)分,B组评分明显高于A组,差异有统计学意义(P<0.05)。结论:头颈部CTA检查中采用Test-Bolus改良法计算增强延迟时间更合理,图像质量更好。

ZHIBAO SANBIAN WAN (至宝三鞭丸)——(Treasured Bolus of Triple Animal Penes)

Chief ComponentsPenis and testes of the ursine seal(Penis etTestes Callorhini)Penis of the deer(Penis Cervi)Penis and testes of the dog(Penis et TestesCanis)

Care-bolus技术不同监测层面在显示子宫内膜下强化带中的应用

目的 探讨Care-bolus技术不同监测层面在显示子宫内膜下强化带中的应用。材料与方法 前瞻性纳入69位受试者,将受试者随机分为A、B两组,使用Care-bolus技术,行盆腔动态对比增强磁共振成像(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)扫描。A组受试者监测腹主动脉,B组受试者监测髂内动脉。扫描完成后再根据子宫有无病灶将A、B两组分为A;、A;和B;、B;四组。评估各组数据内膜下强化带(sub endometrial enhancement,SEE)显示情况并计算显示率,测量SEE和邻近正常肌层信号值。采用卡方检验定性评估各组SEE显示率,采用独立样本t检验定量比较各组SEE与肌层的强化差异。结果 B组显示率整体比A组高,但差异无统计学意义(P>0.05),其余各组之间显示率差异均无统计学意义。SEE信号值均比肌层高,且A组整体比B组强化差异更明显,差异有统计学意义(F=1.37,P<0.05);同时有病灶组A;比B;的强化差异更大,差异有统计学意义(F=2.31,P<0.05),其余各组间差异无统计学意义。结论 DCE-MRI扫描时使用Care-bolus技术能很好地显示内膜下强化带;且监测腹主动脉比髂内动脉更优。

Impact of bolus volume on small intestinal intra-luminal impedance in healthy subjects

AIM: To assess the impact of bolus volume on the characteristics of small intestinal (SI) impedance signals.METHODS: Concurrent SI manometry-impedance measurements were performed on 12 healthy volunteers to assess the pattern of proximal jejunal fluid bolus movement over a 14 cm-segment.Each subject was given 34 boluses of normal saline (volume from 1 to 30 mL) via the feeding tube placed immediately above the proximal margin of the studied segment.A bolus-induced impedance event occurred if there was > 12% impedance drop from baseline,over ≥ 3 consecutive segments within 10 s of bolus injection.A minor or major imped-ance event was defined as a duration of impedance drop < 60 s or ≥ 60 s,respectively.RESULTS: The minimum volume required for a detectable SI impedance event was 2 mL.A direct linear relationship between the SI bolus volume and the occurrence of impedance events was noted until SI bolus volume reached 10 mL,a volume which always produced an impedance flow event.There was a moderate correlation between the bolus volume and the duration of impedance drop (r = 0.63,P < 0.0001) and the number of propagated channels (r = 0.50,P < 0.0001).High volume boluses were associated with more major impedance events (≥ 10 mL boluses = 63%,3 mL boluses = 17%,and < 3 mL boluses = 0%,P = 0.02).CONCLUSION: Bolus volume had an impact on the type and length of propagation of SI impedance events and a threshold of 2 mL is required to produce an event.

Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction

AIM: To look at the relationship between eosinophilic oesophagitis(EO) and food bolus impaction in adults. METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction(FBO) between 2012 and 2014. In this cohort, 96 were adults(64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy. The food bolus was either advanced into the stomach using the push technique or retrieved using a standard retrieval net. Biopsies were obtained in 51 patients from the proximal and distal parts of the oesophagus at initial gastroscopy. All biopsy specimens were assessed and reviewed by dedicated gastrointestinal pathologists at the Department of Pathology, University Hospital Geelong. The diagnosis of EO was defined and established by the presence of the following histological features:(1) peak eosinophil counts > 20/hpf;(2) eosinophil microabscess;(3) superficial layering of eosinophils;(4) extracellular eosinophil granules;(5) basal cell hyperplasia;(6) dilated intercellular spaces; and(7) subepithelial or lamina propria fibrosis. The histology results of the biopsy specimens were accessed from the pathology database of the hospital and recorded for analysis. RESULTS: Our cohort had a median age of 60. Seventeen/51(33%) patients had evidence of EO on biopsy findings. The majority of patients with EO were male(71%). Classical endoscopic features of oesophageal rings, furrows or white plaques and exudates werefound in 59% of patients with EO. Previous episodes of FBO were present in 12/17 patients and 41% had a history of eczema, hay fever or asthma. Reflux oesophagitis and benign strictures were found in 20/34 patients who did not have biopsies. CONCLUSION: EO is present in approximately one third of patients who are admitted with FBO. Biopsies should be performed routinely at index endoscopy in order to pursue this treatable cause of long term morbidity.

Comparative Study on the Surface Dose of Some Bolus Materials

In order to investigate the possibility of using different materials as bolus in radiotherapy, five samples denoted by S2 - S6 were prepared and analyzed by comparison with one available commercial bolus denoted by S1. Sample S1 was a thermoplastic material from Qfix;S2 was a moldable silicon rubber (RTV-530 from Prochima);S3 and S4 were obtained by adding micrometric particles of Al and Cu respectively (at the same mass concentration of 5.5%);S5 was another moldable silicon rubber (GSP400 from Prochima) and S6 was a mixture of GSP400 and micrometric particles of Cu (at the mass concentration of 5.5%). The measurements of normalized transmitted dose as a function of sample thickness were performed for all samples (S1 - S6) at two values of electron beam energy (6 and 9 MeV) produced by a linear accelerator VARIAN 2100SC. The results showed that the maximum of the normalized transmitted dose of manufactured samples (S2 - S6) is registered at smaller sample thicknesses than for the analyzed commercial bolus (sample S1). The smallest sample thickness corresponding to normalized maximum point dose is obtained for sample S2 (RTV-530). Measurements performed for electron beam energy of 6 and 9 MeV have proven the possibility of using the manufactured samples as bolus in radiotherapy.

Semi-Solid and Solid Bolus Swallows in High-Resolution Oesophageal Manometry for the Detection of Motility Disorders

Background/Aims: High-resolution oesophageal manometry utilises water swallows to evaluate oesophageal function. However, small volumes of water are not representative of normal eating and as a result often produce normal manometry studies in patients with dysphagia. This study sets out to establish optimal diagnostic thresholds for semi-solid solid swallows and evaluate their ability to uncover motility abnormalities in patients with motility disorders. Method: Manometry was performed using ten 5-mL single water swallows followed by two semi-solid and two solid swallows in the upright position. Normative values for the adjunctive tests were obtained from patient controls while patients with major motility disorders were used to establish the optimal diagnostic thresholds. Diagnostic thresholds identified were prospectively tested in patients with normal water swallows but oesophagus related symptoms and in those with minor and major motility disorders. Results: Normal values for semi-solid and solid were determined in patient controls (n = 100). Development of diagnostic thresholds included 120 patients with major motility disorders. Optimal diagnostic thresholds identified for oesophagogastric junction dysfunction in semi-solid and solid swallows (IRP > 15.5 mmHg). Hypercontractilty and spasm used existing thresholds (>8000 mmHg-s-cm and < 4.5 s, respectively) but modified frequency of ≥50% of adjunctive swallows. Diagnostic thresholds were applied to symptomatic patients with normal water swallows (n = 70) identifying 12/70 (17%) to have abnormal adjunctive swallows. One of 30 patients (3%) with ineffective motility had abnormal adjunctive swallow and 12 patients with oesophageal spasm, oesophagogastric junction obstruction, and hypercontractility had abnormal adjunctive swallows that moved them up the motility disorder hierarchy. Conclusions: Semi-solid and solid challenge increase diagnostic yield of motility disorders.

Continuous versus bolus nasogastric tube feeding in premature neonates: Randomized controlled trial

Background: Whether premature infants should be fed by bolus or continuous gavage feeding, is still a matter of debate. A recent Cochrane analysis revealed no difference. Study design and methods: We carried out a randomized controlled trial in premature infants on continuous versus bolus nasogastric tube feeding, to search for differences with respect to number of incidents, growth, and time to reach full oral feeding. In total, 110 premature neonates (gestational age 27 - 34 weeks) were randomly assigned to receive either continuous or bolus nasogastric tube feeding. Basic characteristics were comparable in both groups. Results: No significant difference in weight gain could be detected between the two groups, mean weight gain amounting 151.6 (108.9 - 194.3) and 152.4 (102.2 - 202.6) grams per week in the continuous and bolus group, respectively. No significant differences were found between both groups in the time needed to achieve full oral feeding (8 oral feedings per day), full oral feeding being achieved at day 31 (range 19 - 43) and day 29 (range 18 - 40) of life in the continuous and bolus group, respectively. We also found no significant differences in the number of 'incident-days' (three or more incidents a day): 3.5 (0 - 9) versus 2.7 (0 - 6.5) days in the continuous and bolus group, respectively. Conclusion: No significant differences were found in weight gain, time to achieve full oral feeding and number of incident-days between preterm infants enterally fed by nasogastric tube, according to either the bolus or continuous method.

All-round Tonic Bolus of Ten Drugs

Chief ComponentsPilose asiabell root(Radix CodonopsisPilosulae)Bighead atractylodes rhizome(Rhizoma Atractylodis Macrocephalae)Poria(Poria)Liquorice(Radix Glycyrrhizae)Chinese angelica root(Radix AngelicaeSinensis)