The structures of DICOM image and BMP image are introduced through the analyses of them and DICOM standard.The method of translating DICOM image into BMP one is also presented.

This paper briefly introduced the development course, present situation and characteris-tics of United States Medical Licensing Clinical skills examination. Based on the elaboration of four key elements, namely organization and management, subjects setting, method and form, and evaluation method-ology, we analyzed the advantages and disadvantages, to provide experiences and references for improving and perfecting our country's Medical Licensing Clinical skills examination.

In this paper,the constitute elements of Sino-US licensed doctors' practical skill examination evaluation index system are expounded.Through comparison,the differences on the formulation basis,classification principle,test content,and ability requirements are inferred;On the basis of referring to the advanced experience and practice of the United States,and by combining the requirements of the most basic requirements of global medical education,suggestions for improving the Chinese licensed doctors' practical skill examination evaluation index system are proposed in terms of integrating the test syllabus classification,adjusting the distribution of clinical practice ability examination content,increasing the proportion of medical humanities content test,as well as establishing a scientific examination evaluation index weight table.

Objective To explore the value of 31P magnetic resonance spectroscopy(31P MRS)for differential diagnosis of bone malignancy and inflammation.Methods Radiography.MRI and 31P MRs were performed on 20 bone malignancy patients,22 bone and soft-tissue inflarnmation patients and 32 healthy voluntecrs.The spectra were analyzed by measuring the areas under the peaks of various metabolites,and by calculating the pH from the Pi shift relative to PCr.The data were analyzed by one-way analysis of vailance (ANOVA).Results Analysis of the 31P MRS data suggested differences among the bone malignancy,the inflammation and the healthy group.The mean of PME/β-ATP ratio(1.24±0.37)in malignancy group increased significantly(P＜0.01).The mean of PDE/β-ATP(2.21.±0.37),Pi/β-ATP(1.46±0.43)in inflammation group was higher than that of the other two groups(P＜0.05),but the ratio of PME/β-ATP (0.19±0.10)wag not increasing.The LEP/T31P(0.10±0.02),PCr/T31P(0.45±0.03)and ATP/T31P (0.45±0.03)ratios in control group were significantly difierent from the two others(P＜0.01).The mean of intracellular pH in malignancy group was 7.45±0.16,higher than that in control group(7.05±0.06),and in inflaruination group(7.20±0.13)(P＜0.01).Conclusions The significant increase of PME and intraeellular pH is of great value in diagnosis of bone malignancy.Combined conventional radiography and MRI.31PMRs would be a simple,no-.invasive and effective diagnostic method.

The medical contingent of Chinese PLA to libera operated the China Ebola treatment center(ETC) with 100 beds,and employed 80 Liberian health workers according to the task requirements and the normal operation demand.Under consideration of current health education situation and epidemic prevention requirements,combined with experiences in the fight against SARS,the training content includes the Ebola prevention and control knowledge,isolation of patients and safe burial,malaria prevention and control knowledge,hospital disinfection technology,psychological intervention.Training methods diversified,with theoretical teaching,site visit,on-site demonstration and training and video guide.With the pass of the simulation training evaluation model in all staff,the expected goals of pre-service training have been achieved.

Objective To investigate the quality of life(QOL)of patients with stroke and its related factors.Methods The QOL of eighty-two stroke survivors was assessed in terms of SF-36 scores,motor impairment (Fugl-Meyer),disability[Barthel index(BI)]and depression(HAMD)more than one year after their first episode.Their social demographic characteristics such as age,gender,education and income were recorded,as were the characteristics of their disease and any complications.Multiple regression analysis was used to analyse the related factors.Results The average age of the 82 subjects was 61.89 + 9.81 years(range,33-81).56 of them were male (68.2％).Scores on all items of the SF-36 for these subjects were lower than those of a normal population.Correlation analysis showed income,cost for medical care,regular exercise,movement function,ability in the activities of daily living,depression,hypertension and shoulder pain were significantly correlated with most of the SF-36 domain scores.Motor function,income and cost for medical care explained 34％ of the variance in SF-36 scores.Motor function was the single most important factor.Conclusion The major factors affecting the QOL of stroke patients are motor function,level of income and cost for medical care.Paying more attention to rehabilitation treatment,taking regular exercise and more income could help improve the QOL of stroke survivors.

Objective To discuss the clinical efficacy of balloon occlusion technique in treating pernicious placenta previa.Methods Between January 2015 and March 2016,a total of 16 matcrnal patients with pernicious placenta previa,who were admitted to the Interventional Department of Qujing Municipal First People's Hospital,received balloon occlusion management to assist obstetrician in dealing with placenta previa.Central type of placenta previa with highly suspected placenta implantation were diagnosed in 15 patients by color ultrasound or MRI.Balloon catheters were placed in bilateral internal iliac arteries before cesarean section was carried out,and immediately after the fetus was taken out the balloons were inflated to temporary occlude the targeted arteries.Based on the hemostatic status the balloon catheters were timely retrieved.One patient received emergency temporary balloon occlusion of abdominal aorta,and laparotomy revealed that the placenta had penetrated to the subserosa of uterine anterior wall,and total hysterectomy had to be carried out.Results Successful balloon occlusion was achieved in all 16 patients.The mean blocking time of the artery was 15 minutes and the amount of blood loss was 300-1200 ml.Conclusion In treating pernicious placenta previa,balloon occlusion treatment before cesarean section is safe and reliable,it can significantly reduce the amount of blood loss during surgery,make quick and effective hemostasis,provide a clear surgical field for the performance of cesarean section,and,more important,save the maternal life.This effective technique has fully showed the necessity of multidisciplinary collaboration,including obstetrics,interventional radiology,etc.

Objective To discuss the clinical application of ultrasound-guided temporary balloon occlusion in performing cesarean section for patients with pernicious placenta previa.Methods At Qujing Municipal First People's Hospital,the Interventional Department and Ultrasonography Department assisted the Obstetrics Department to accomplished cesarean section for 13 patients with pernicious placenta previa.The diagnosis of central placenta previa was confirmed by both color ultrasound and MRI in all the 13 patients.Before cesarean section,the balloons were placed in bilateral common iliac arteries or in abdominal aorta,and the balloons were inflated at the same time when the fetus was delivered so as to temporarily obstruct the target vessels.Based on the hemostatic condition,the balloon was timely withdrawn.Results Among the 13 patients,temporary abdominal aorta occlusion was employed in one and temporary bilateral common iliac artery occlusion in 12.Ultrasound-guided occlusion was successfully accomplished in 12 patients,and the average blocking time was ＜15 min.The amount of intraoperative blood loss was 800-1500 ml.Conclusion Ultrasound-guided temporary balloon occlusion before cesarean section is safe with reliable effect in treating pernicious placenta previa,it can remarkably reduce the amount of intraoperative blood loos,and it has no X-ray radiation damage,therefore,this technique is worthy of clinical application.