Fourteen cases of craniocerebral shotgun injury were repoted, including 10 males and 4 females. Eleven patients were treated non—operatively and 3 operatively. Two of the 3 patients died after operation. The clinical manifestation, wound judgment and management are discussed detailly in the paper. The complications of the injury such as intracranial hematoma, brain abcess, epilepsy and morality were significantly lower than those of other missile craniocerebral injury. Although the matal pills remained in the patient brains for a long time, the final outcome of shotgun injured patients is good.

As a weapon of mass destruction ,the biological weapon , composed of biological warfare agents and their re-lease devices,is characterized by strong pathogenicity , large pollution areas, various routes of infection, low cost, user-friendliness and a large number of impact factors .Although the United Nations has banned the use of biological weapons , there are still some countries and regions that continue biological weapon researches .In addition, illegal use of biological warfare agents in the field of terrorism and non-military arena poses a serious threat to public safety .Early detection of bio-logical warfare agent use and determination of its type are crucial to biological weapon defense and epidemic control .There-fore, to enhance researches on rapid detection and early warning of biological warfare agents is of great significance .This paper reviews the main technologies currently applied to the field of biological warfare agent detection and their progress .

Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61％) were injured from falling objects.Fifty-eight patients (84％) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32％) sustained associated injuries.Twenty-nine patients (42％) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.

Background Patients often suffer from a few complications of neurological and psychiatric problems after traumatic brain injury including damage of cognition, mental disorders and behavior problems. Damage of cognition is a common sequela in traumatic brain injury. Numerous researchers were focus on the cognition changes of patients with mild brain injury. But their conclusions are debatable. Executive function is one of the important components of cognition. In this study,we tried to find out the executive functional alterations of the patients with mild brain injury.Methods 159 patients with brain injury caused by transportation events and 68 normal controls were assessed executive function. The executive function tests included the block design in WAIS, the Stroop test, the verbal fluency and the modified version of Wisconsin card sorting test (M-WCST). These tests were applied to compare the scores of traumatic brain injury patients with various severities including mild, moderate, and severe and with different CT/MRI results.Results Patients with mild head injury got significantly lower scores on all tests than normal controls ( P＜0.01 ). But there was no significant difference between mild and moderate brain injury group. Except Stroop test and WCST categories, patients with mild brain injury got significantly lower scores on all other tests than those with severe brain injury ( P ＜0.05). In the brain injury cases with damage signs on CT/MRI, there was no significant difference on scores of all tests except block design tests among brain injury patients with various severities. Among the brain injury cases without any damage signs on CT/MRI, there was no significant difference on scores of all tests among brain injury patients with various severities. The correlation analysis showed that scores of block design and verbal fluency test were negatively related to the severity of brain injury( P＜0.05). The age and the education level of the patients had negative and positive correlation, respectively, to executive function.Conclusions The executive function of patients with mild brain injury was impaired when the medication was terminated. We should pay more attention to patients with mild brain injury by performing various tests for assessment of disability.

Objective　To analyze the rate of depression among Chinese Parkinson’s disease patients by Meta-analysis. Methods　CNKI，VIP，Wanfang，PubMed，Web of Science and Embase databases were searched systematically. The studies focus on depression of Parkinson’s disease patients in China from the year of establishment to 2019 were collected. Two researchers independently screened literature，extracted data and applied the standard of Agency for Healthcare Research and Quality to evaluate the quality of literatures. According to the results of heterogeneity test，the data were analyzed by Stata 12.0 software using random effect model. Results　A total of 7842 PD patients，4394 males and 3088 females，were included in 37 studies. The combined value of depression detection rate was 43.0% ［95%CI （0.370，0.490）］. Subgroup analysis showed that the incidence of depression in the study with sample size<150 was 47.7% ［95%CI （0.413，0.542）］，and the incidence of depression in the study with sample size≥ 150 was 34.3% ［95%CI （0.254，0.432）］，respectively. The prevalence rates of depression with assessment tools were different，Hamilton Depression Rating for Depression 43.0%［95%CI（0.359，0.501）］，Center for Epidemiologic Studies Depression Scale 38.1% ［95% CI （0.301，0.461）］，Self-Rating Depression Scale 41.0% ［95%CI （0.163，0.657）］，Beck Depression Inventory 46.0% ［95%CI （0.353，0.567）］. The incidence of depression in female PD patients was 43.0% ［95%CI（0.340，0.519）］，43.2% ［95%CI （0.330，0.533）］ in male. The incidence of depression was 43.2% ［（95%CI （0.330，0.533）］，among patients disease duration ≤ 5 years，44.4% ［（95%CI （0.362，0.501）］ in patients with PD whose disease duration more than 5 years. The incidence of depression was 40.2%［95%CI（0.226，0.538）］in PD patients whose onset age ≥60 years，45.3% ［95%CI（0.335，0.570）］in PD patients whose onset age <60 years. The incidence of depression was 45.4%［95%CI（0.441，0.497）］in patients with UPDRSIII score > 25，39.1%［95%CI（0.261，0.521）］ in those with score ≤ 25.42.1%［95%CI（0.303，0.538）］PD patients with mild depression，22.7%［95%CI（0.160，0.293）］with moderate depression and 7.4%［95%CI（0.049，0.100）］ with severe depression. Conclusion　The incidence of depression is high in PD patients. The emotion of PD patients in every stage need evaluate，diagnose and cure earlier.

OBJECTIVES: Clarifying the expression of breast cancer receptor is the key to clinical treatment for breast cancer. This study aims to explore the correlation between X-ray and clinical characteristics of 4 molecular subtypes and their receptor types of breast cancer. METHODS: A total of 439 breast cancer patients who confirmed by pathology and performed X-ray examination were enrolled. The X-ray and clinical characteristics of 4 molecular subtypes and the expression of their receptors were analyzed. RESULTS: Luminal A type showed the highest proportion of spiculate masses, and the lowest calcification score, showing significant difference with other 3 subtypes (all CONCLUSIONS Four molecular subtypes of breast cancer and their receptor expressions are correlated with X-ray and clinical characteristics, which can provide a basis for clinical diagnosis and treatment.
Biomarkers, Tumor ; Breast Neoplasms/genetics* ; Female ; Humans ; Receptor, ErbB-2/genetics* ; Receptors, Estrogen ; Receptors, Progesterone ; X-Rays

To explore the effect of digital breast tomosynthesis (DBT) on the classification of breast imaging-reporting and data system (BI-RADS) and its significance.
 Methods: A total of 832 patients with breast diseases, who came from Second Clinical College of Fujian Medical University from May 2013 to November 2013, were collected. The patients were examined by double position radiography (including craniocaudol and mediolateral oblique) and COMBO mode [including DBT and full-field digital mammography (FFDM)]. Meanwhile, the results of FFDM and DBT were classified. The number of glands, the characteristics of mass and other indirect signs were compared by COMBO and FFDM modes. Paired Wilcoxon rank sum text was adopted to investigate the differences between COMBO mode and FFDM mode in the 832 patients, and receiver operator characteristic curve (ROC) was applied to analyze the 79 patients with the pathological results.
 Results: The patients with large amount of glands (including Class c and Class d) accounted for 87.6% in the 832 patients, while the patients with small amounts of glands (including Class a and Class b) accounted for 11.7%. In estimating the content of glands, more details about the distribution of glands were found in the COMBO mode compared with those in the FFDM mode. According to the results of paired Wilcoxon rank sum test, there was significant statistical difference in BI-RADS classcification in breast masses between the COMBO mode and the FFDM mode (P<0.05), though the overall classification of the COMBO mode is higher than that of the FFDM mode. The pathology was served as a standard to estimate the diagnostic efficiency. The area under ROC curve was 0.805 in the FFDM mode, while that in the COMBO mode was 0.941. The optimal sensibility in the COMBO mode was 82.9%, which was higher than that in the FFDM mode. However, the specificity was 93.2% in both COMBO mode and the FFDM mode.
 Conclusion: DBT has a high clinical significance in BI-RADS classification for breast X-ray examination.
Breast Neoplasms ; diagnostic imaging ; Comparative Effectiveness Research ; Female ; Humans ; Mammography ; methods ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: To analyze the relationship between the ischemic ST-T changes in electrocardiogram (ECG) and the coronary artery diseases based on the perspective of diagnostics.
 METHODS: A total of 341 patients, who underwent coronary angiography in Department of Cardiology of Xiangya Hospital, Central South University from June 2013 to April 2014, were enrolled for this study. The internationally recognized diagnostic criteria for ischemic ST-T changes in ECG and the Judkins diagnostic criteria for coronary angiography were applied, respectively. The sensitivity and specificity of ECG were analyzed.
 RESULTS: There were more ischemic ST-T changes in women than that in men (P<0.01). Ischemic changes in coronary angiography were not significantly different between male and female patients (P>0.05). For ischemic diagnostic tests by ECG ST-T, the total sensitivity and specificity was 83.6% and 54.4%, respectively. The sensitivity and specificity was 82.3% and 68.0% or 85.0% and 28.2% in the male or female group, respectively. 
 CONCLUSION Ischemic ST-T changes in ECG possess important value in the diagnosis of the coronary artery diseases. The sensitivity of ECG in the diagnosis of myocardial ischemia in women was higher than that in men, whereas the specificity of ECG in the diagnosis of myocardial ischemia in men was higher than that in women.
Coronary Angiography ; Coronary Artery Disease ; diagnosis ; Electrocardiography ; Female ; Humans ; Male ; Myocardial Ischemia ; diagnosis ; Sensitivity and Specificity