Objective To evaluate the quality of examination papers of otolaryngology among students of grade 2007 in the first clinical college of Chongqing Medical University.Methods Totally 202 copies of examination papers of otolaryngology from grade 2007 students in our college were taken as research references.SASS 15.0 software was used to statistically analyze total score of every student and score of each question.Mean score,standard deviation,difficulty coefficient and discrimination coefficient of each question were counted and normality test was conducted.Results Scores were in negative skewness distribution,with mean score of 80.9,standard deviation of 10.9,the lowest score of 56.5,the highest score of 98.0,difficulty coefficient of 0.781,and discrimination coefficient of 0.308.Conclusions Examination papers are well designed and discriminated and can objectively reflect students' command of the course.However,distribution of sores is unreasonable and examination paper is relatively easy to complete,indicating the weakness in the teaching process.

Objective To analyze ultrasonographic imaging feature of primary fallopian tube carcinoma (PFTC) and the reasons for misdiagnosis.Methods Clinical data and ultrasonographic imaging feature of 41 patients with pathologically confirmed PFTC were retrospectively analyzed from August 2008 to November 2016 in General Hospital of Chinese People's Liberation Army.Results Ultrasonographic characteristics of 41 PFTC cases:(1) Type Ⅰ (6 cases),the cystic adnexal mass with single or multiple papillary projections and circuity tubular structures,color Doppler flow imaging showed abundant blood flow signal inside the nipples.(2) Type Ⅱ (2 cases),the sausage shaped complex adnexal mass showed clear boundary,the cystic area that lined along the fallopian tube was around or at the side of the solid part,color Doppler flow imaging showed rich or abundant blood flow signal inside the solid part.(3) Type Ⅲ (13 cases),the sausage shaped hypoechoic adnexal mass showed clear boundary,color Doppler flow imaging showed rich or abundant blood flow signal inside the mass.(4) Type Ⅳ (14 cases),the single or multiple adnexal masses showed irregular surface,with predominant solid components,color Doppler showed rich or abundant blood flow signal inside the tumor;the normal ovarian structure was not detected in unilateral or bilateral adnexa area;and one or more signs of metastasis were found,such as the peritoneal thickening of vesicouterine pouch,uterine rectum pouch and omental,metastasis to other distant organs,and so on.(5) Type Ⅳ (6 cases),only hydrosalpinx or no abnormal ultrasonographic changes in the adnexal area.Nineteen (46.3％,19/41) cases were correctly diagnosed by preoperative ultrasonography,while 22 (53.7％,22/41)cases were missed or misdiagnosed.Conclusions Ultrasonography imaging of PFTC has certain characteristics,but it tends to be missed or misdiagnosis when the lesion is small.Ultrasound can show the location,size,internal echo,blood flow and distant metastasis of lesion,which can be taken as the first choice of imaging methods for preoperative diagnosis and postoperative follow-up of PFTC.

Objective To explore the ultrasonographic imaging characteristics of placenta increta and clinical data, and analyze the reasons for failure to make an accurate diagnosis. Methods By means of a retrospective analysis of 27 patients with placenta increta confirmed by operation and pathologic examination from January 2014 to May 2017 in the General Hospital of the People's Liberation Army (also Hospital 301 for short), the reasons for missed diagnosis and misdiagnosis are comprehensively summarized. Results The ultrasound examination in all the 27 cases (5 cases of first pregnancy, 17 cases of scar, 5 cases of maternal) illustrated the poorly-defined boundary between placenta and uterus mesometrium, the loss of retroplacental space, multiple lacunae echo areas, and the incomplete high-echo area of the serous membrane of placenta and bladder (involving the bladder); despite 3 normal placenta, the rest 24 were all diagnosed as placenta previa before operation, of which 20 belonged to central placenta previa and the other 4 belonged to marginal placenta previa. Twenty liveborn infants were delivered in the study, 13 of them went through abdominal hysterectomy after cesarean section surgery, 8 of them only received cesarean section surgery; 2 of them went through vaginal hysterectomy, 1 received cesarean section surgery after interventional embolization, 1 Uterine rupture in utero before got to the hospital, with the rest 2 received interventional embolization clamp scraping as a consequence of deadly induced labor or stillbirth. Postoperative placenta increta types demonstrated adhensive implantation, penetrating implantation, and implantation into muscular but not membrane layer in 3, 2, and 22 cases respectively. In terms of implanting position, only 3 patients (3/17) with cicatricial uterus did't undergo the implantation into the scar area mainly in the left wall, left anterior wall and posterior wall, as for patients with non-scar uterus, posterior wall implantation was the main mode presented in 6 cases (6/10). Fifteen of all the involved 27 cases were identified while 12 cases failed to be distinguished. The deep reasons of misdiagnosis were placental location (placenta adheres to the posterior wall), fetal head shelter, or small placental placement, gestational age, larger range of placenta implantation, emergency ultrasound only pay attention to the emergency situation and ignore the exist at the same time, experience of inspectors with placenta increta and so on. Conclusions Although there are some limitations in prenatal ultrasound diagnosis of placenta, it is still an important method for the diagnosis and prenatal dynamic monitoring of the condition before the placenta implantation.