Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.

Objective To investigate the adjunctive therapeutic effects and safety of intravenous immunoglobin (IVIG) for treating pneumonia following kidney transplantation.Methods Sixteen cases of pulmonary infection after kidney transplantation were divided into two groups.Twenty-eight cases were subjected to IVIG therapy (0.2 g·kg-1 ·day-1) for 7-10 days besides the standard specific anti-bacterial,anti-fungal,and anti-virus treatment and regular immunosuppressive regimen with dose adjustment (IVIG group),and the control group was only treated with standard specific anti-pathogen therapy.The incidence and mortality ofsevere pulmonary infection,levels of serum IgG,T lymphocyte subsets,and creatinine in the two groups were observed.Results The effective power of IVIG group and control group was 100 ％ and 93.75 ％ (P＜0.05).The incidence of severe pneumonia in IVIG and control groups was 0 and 12.5％,respectively (P＜0.05),with the mortality being 0 and 6.25％,respectively (P＜ 0.05).The levels of serum IgG were significantly increased in IVIG group as compared with that before treatment and in control group.There were no significant adverse reactions associated with IVIG infusion.Conclusion As an adjunctive therapy,IVIG treatment for pulmonary infection can reduce the incidence of severe pulmonary infection and mortality after kidney transplantation,further increase the survival rate of patients after kidney transplantation.

Objective To investigate whether correlation exists between quantitative perfusion parameters obtained from dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI) and different prognostic factors or immunohistochemical subtypes of breast cancers. Methods A retrospective analysis of DCE?MRI was performed in 87 breast cancer patients with 91 pathology confirmed breast lesions. All the patients underwent the immunohistochemistry after the operation, 80 breast cancer patients with 84 breast lesions were divided into different subtypes based on the immunohistochemical profiles. All the patients underwent plain MRI and DCE?MRI. The volume transfer constant (Ktrans), rate constant (kep) and volume of EES per unit volume of tissue (Ve) value were calculated. Results of the immunohistochemistry and observation results of the the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor?2 (HER?2) were recorded. Subtypes were also categorized. The degree of the expression of Ki?67 was observed simultaneously. Among the 87 breast cancer patients (with 91 breast lesions), 68 were ER?positive,18 were ER?negative, 60 were PR?positive, 26 were PR?negative;30 were HER?2 positive and 58 were HER?2 negative. Eighty breast cancer patients (with 84 breast lesions) were divided into different subtypes:19 were Luminal A, 49 were Luminal B, 7 were HER?2 positive subtype and 9 were triple negative breast cancer (TNBC). The quantitative perfusion parameters with diffierent expression of the receptors were analyzed through Mann?Whitney U test, the correlation between the degree of the expression of Ki?67 and quantitative perfusion parameters was obtained with Spearman test. Furthermore, the distributions of the perfusion parameters between groups according to immunohistochemical subtype were compared using the Kruskal?Wallis test. Results Ktrans and kep value were higher in tumors with ER?negative and PR?negative than with ER?positive and PR?positive and difference was statistically different ( P<0.05). There was no statistically significance in the quantitative perfusion parameters between HER?2 positive and HER?2 negative (P>0.05). The degree of the expression of Ki?67 was 5%to 90%the mean value was 33%, the median and interquartile range of Ktrans, kep and Ve value was 1.33/min (0.88/min), 2.63/min (2.34/min) and 0.51 (0.22) respectively. There was no significant correlations between the degree of the expression of Ki?67 and Ktrans and kep value (r value was 0.24 and 0.22 respectively, P value was 0.03 and 0.04 respectively), and the degree of the expression of Ki?67 was not associated with Ve (r=0.00, P=0.97). Ktrans value was lower in Luminal A and Luminal B than that in HER?2 positive subtype and TNBC, kep value was lower in Luminal A and Luminal B than that in TNBC, and Ve value in Luminal A, Luminal B and HER?2 positive subtype were higher than that in TNBC, kep value was lower in Luminal B than that in HER?2 positive subtype, statistically significance was seen among them (P<0.05).Triple?negative breast cancer showed the highest kep value (3.99/min) and the lowest Ve value (0.41) than the other subtypes. Conclusion The different subtypes of breast cancer may be predicted to some extent with quantitative perfusion parameters, and there is no correlation between quantitative perfusion parameters and the prognostic factors.

OBJECTIVE To establish a model for chlorpyrifos(CPF)whole-body dynamic inhalation exposure in SD rats and investigate the injury effects after acute exposure by CPF. METHODS By optimizing the aerosol parameters ,the animal acute dynamic inhalation exposure of CPF was established. Absorption sampling-gas phase detecting technology was used to monitor the concentration of CPF in the whole-body dynamic-inhalation exposure cabin by exploring the relationship between the concentration , particle size of CPF aerosol and the CPF inhalation time in the exposure cabin via a particle size detector. Using Bliss method,specific pathogen free SD male rats were allocated to the environment of CPF exposure at different lethal concentrations and time points. The symptoms and deaths of these SD male rats in different groups were recorded within the following 10 d. Based on the median lethal concentra?tion time(LCt50),the values of plasma cholinesterase(ChE)were checked at different time points after being exposed at different doses. RESULTS The mean concentrations of CPF aerosol at nine time points was 160.6 mg · m-3,the relative standard deviation value was 6.9%;the geometrical mean of aerosol particle size was 1.1 μm,and the geometric standard deviation was 1.8. The results met the technical requirements of Organization for Economic Cooperation and Development regarding acute inhalation exposure. Under these equipment conditions,the LCt50 of CPF acute inhalation of SD male rats was 1654.2 mg · m-3 · h,suggesting that plasma ChE inhibitory rate was higher with the increase in the exposing dose,and that there was a significant difference as compared with the controls(P<0.05). CONCLU?SION The model for whole-body dynamic-inhalation exposure of CPF is applicable to rats,which can serve as an experimental platform and technical support to inhalation vulnerability and the research on prevention and cure of organophosphate industrial products and nerve agents.

OBJECTIVE:To provide reference for informationized construction of outpatient narcotic drug management in the hospital. METHODS:The narcotic drugs management system,which consisted of the hospital information system and the intelli-gent management machine of narcotic drugs were introduced in working procedure and informationized management,and its effects were evaluated. RESULTS:After informationized construction,the recycling of empty ampoules and used patches was included in compulsory management procedure;informationized management would be achieved completely from safety management,prescrib-ing and dispensing property management,prescription management,batch number management,outcoming and incoming manage-ment,five specialmanagement,etc. Compared with traditional dispensing mode,the dispensing time of each prescription was shortened under informationized dispensing mode,decreasing from(174±32.3)s to(128±30.7)s(P<0.05). Pharmacists could communicate with physicians online by the system;drug application,incoming,use,inventory reconciliation,special book for reg-istration and special book of account were all completed by electronic recording and electronic registering;the system could auto-matically complete the report form of prescription information for evaluation. CONCLUSIONS:It is feasible of the informationized mode of outpatient narcotic drug management in our hospital.

Objective To research the operation method for hypospadias by one-stage urethroplasty.Methods According to the length of urethra defect,18 cases were operated by using one-stage urethroplasty with perineal and preputial island flaps.Results 16 cases were successful in all patients(88.9%),except one case of urethrostenosis and urethral fistula respective.The case of urethrostenosis recovered by dilation of urethra after 5 months and the patient of urethral fistula was successfully repaired by operation after 8 months.All patients were followed up for 6～26 months with satisfactory penis and micturition.Conclusion The technique of one-stage urethroplasty by using perineal and preputial island flaps is the one of best choices for hypospadias.

Objective To explore psychological resilience, anxiety, depression, coping styles and social supports status among parents of preterm infants of ophthalmic clinic, and analyze their relationship. Methods A total of 217 parents of preterm infants at ophthalmic clinic of hospital were selected by convenience sampling method and investigated by self- designed general information questionnaire, Connor-Davidson Resilience Scale, Self-rating Anxiety Scale, Self-rating Depression Scale, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Results The total score of psychological resilience was (67.48 ± 14.20) points. The average score of positive coping styles dimension was (1.98±0.50) points, and negative coping style dimension score was (1.19±0.55) points. The social support score was moderate with a total score of (42.75 ± 6.17) points, the anxiety and depression got a total score of (36.77 ± 8.17) points and (39.67 ± 9.02) points respectively. Psychological resilience was negatively correlated with anxiety and depression (r=-0.363--0.242, P<0.01), and was positively correlated with coping styles and the social support (r=0.141-0.312, P<0.05 or 0.01). Multi-factor linear regression analysis showed that depression and social support were the influence factors of psychological resilience(t=-4.376, 2.516, P<0.01 or 0.05). Conclusions The parents of preterm infants are at the poor psychological states. Coping styles and depression are the important factors which affect psychological resilience among parents of preterm infants. Nurses should assess the psychological status of the parents, provide targeted interventions to relieve stress, guide the parents use social support effectively, and improve their psychological state.

Objective To investigate the signal intensity ratio and signal-to-noise ratio of breast lesions in 3.0 T MR diffusion weighted imaging with different b values.Methods Ninety seven patients with 106 solid breast lesions (44 malignant,62 benign) confirmed by pathology were retrospectively analyzed.The patients were examined by 3.0 T MR DWI with different b values (b =0,400,800,1 000 s/mm2) before surgery.The signal-to-noise ratio (SNR) and signal intensity ratio (SIR) of benign and malignant lesions were observed and measured under different b values.One-way ANOVA and t test were used to analyze quantitative data.ROC curve was used to analyze the diagnostic efficiency of SIR under different b values.Results Under different b values,class A image was found in 92 cases,class B images was found in 5 cases.While b value were 0,400,800,1 000 s/mm2,SIR of benign lesions were 2.33 ± 1.36,2.25 ± 1.13,2.06 ± 0.84,2.02 ± 0.79 respectively,SIR of malignant lesions were 2.02 ± 0.79,2.27 ± 0.85,2.61±0.78,2.82 ± 1.01 respectively.While b value was 0 or 400 s/mm2,there was no significant differences for SIR between benign and malignant lesions (t value were 1.58,1.26 respectively; P value were 0.12,0.90 respectively),but there were statistically significances between benign and malignant lesions under b value 800 s/mm2 or 1 000 s/mm2 (t value were 3.41,4.29 respectively ;P ＜0.01).There was no differences in SIR for benign and malignant lesions under different b values respectively (F value is 1.21,2.22 respectively; P ＞0.05).While b value were 0,400,800,1 000 s/mm2,the diagnostic sensitivity and specificity of SIR for breast benign and malignant lesions were 56.8％ (25/44),56.8％ (25/44),75.0％ (33/44),77.3％ (34/44) and 51.6％ (32/62),54.8％ (34/62),66.1％ (41/62),66.1％ (41/62) respectively.While b value were 0,400,800,1 000 s/mm2,SNR were 170 ±93,145 ±72,84 ±41,70 ± 39 respectively.Different b values,there was statistically significant difference between groups (F =55.89,P ＜ 0.01) ; and there were significant differences between every two b values (P ＜ 0.05).Conclusion The higher b values (800 s/mm2 and 1 000 s/mm2) are superior to lower b values in the differential diagnosis of benign and malignant breast lesions using 3.0 T MR scanner.

Objective To explore the clinical head nurses'effective competence through interviewing nursing supervisors by in depth interview method and to provide reference for constructing training content for clinical head nurses in Macau and Guangzhou.Methods In depth interview was carried out among 8 nursing supervisors from 2 hospitals in Macau and 9 nursing supervisors from 2 tertiary hospitals in Guangzhou.Content analysis was utilized through organizing records and then forming written documentations.Results The themes were drawn after the interview,which were good moral character accomplishment,good communication skill,prospective and creative thinking,favorable executive ability.Forwardlooking and innovative were significantly different in Macau and Guangzhou.Conclusions The effective clinical head nurses' competence is multi-faceted,the results can provide reference for selection,evaluation and training for head nurses.

Objective To evaluate the anxiety and depression problems in children parents with leukemia, as well as the problems' influence to the psychosocial characteristics of leukemia children.Methods Twenty long-term survivors of childhood leukemia (group A), thirty children newly diagnosed as leukemia (group B) and fifty age-matched healthy controls (group C) completed the questionnaires allowing assessment of symptoms associated with anxiety, depression and self-concept. At the same time, the anxiety and depression in the parents of children with leukemia were also measured using SAS and SDS. Results The anxiety and depression scores of the parents in study group (48.56±9.23, 51.86±9.53) were much higher than that in normal population (37.23±12.59, 41.88±10.57) (P = 0.000, 0.000, respectively), the positive rate of anxiety and depression symptoms among group B was significantly higher than that among group A (60.0 % vs 25.0 %, 46.7 % vs 20.0 %; P <0.05, respectively). There was a significant positive relation between the depression and anxiety scores in the parents of children with leukemia(r =0.947, P =0.0000). Group A scored significantly higher on subscales of somatization/panic (6.11 ±4.36), generalized anxiety (5.72±4.56),social phobia (7.67±4.19) and the total scale (25.8±13.98) than group C (the score was 3.68±3.39, 2.54±2.99,4.24±2.88 and 15.9±10.52, respectively) (P<0.05, respectively), group B scored significantly higher on subscales of social phobia (6.03 ±2.16) than group C (4.24±2.88) (P =0.016). There was a significantly positive relation between the depression score in children with leukemia and the anxiety (r = 0.309, P = 0.029) & depression(r = 0.342, P = 0.015) scores in their parents. Group A scored significantly higher on the total score of self-concept(60.8±6.25) as well as the subscales of happiness(7.95±1.32) than group G (64.48±7.89 vs 8.64±1.19) (P =0.039, 0.026, respectively); and group B scored significantly higher on subscales of behavior (12.47±1.25), intelligence(10.80±2.12), physical appearance and attributes (8.40±2.66), anxiety (9.93±1.29) and the total scale (59.83±5.87) than group C (14.00±2.17, 12.60±2.96, 9.64±2.30, 11.38+2.18, 64.48±7.89) (P <0.05, respectively). There was a significantly positive relation between the score of gregarization subscale in leukemic children and the anxiety score in their parents (r = 0.337, P = 0.017). Conclusion The findings of our studies have suggested that the parents of children with leukemia are at risk for psychological difficulties, and which have a great influence on the psychological health of their children.