Objective To investigate the characteristic and the value of renal solid lesions' boundary at contrast-enhanced ultrasonography(CEUS). Methods The study included 225 patients (124 males, 101 females) with renal 239 solid lesions [133 renal cell carcinoma(RCC) and 106 benign lesions]. The enhanced mode of lesion boundary at CEUS was observed. The histopathologic pseudocapsule of RCCs was analysed.Results Enhanced modes of all lesions' boundary at CEUS were classified as: type Ⅰ , iso-enhanced boundry in whole phase, 82.85 % (198 of 239) ;type Ⅱ , a perilesional annular highly-enhanced signal at early phase,4.18% (10 of 239);type Ⅲ ,perilesional annular highly-enhanced signal in whole phase,9.62% (23 of 239) ;type Ⅳ, perilesional annular highly-enhanced signal in midium and late phase, 1.25 % (3 of 239) ;type Ⅴ ,iso-enhanced boundry in the mdium and late phase with no enhancment at early phase, 2. 09% (5 of 239). The distribution of types Ⅰ , Ⅱ , Ⅲ between groups were significant different( P=0.000, 0.046,0. 000), the type Ⅳ and Ⅴ was not ( P = 0.256,0.068). The distribution of perilesional annular highlyenhanced signal between benign and RCC groups was statistically different (x2=29. 681, P=0.000).Regared it as a diagnostic criteria of RCC,the sensitivity was 26.32% (35/133) ,the specificity was 99.06%(105/106) ,the positive predictive value was 97.22% (35/36),the negative predictive value was 51.72%(105/203) ,and the accuracy was 58.58% (140/239). The perilesional annular highly-enhanced signal was not correlated with the pseudocapsule in pathology ( P = 1. 000). Conclusions The boundary enhancement mode of renal solid lesions at CEUS was divided into five types. The perilesional annular highly-enhanced signal was important in diagnosis of RCC,which was not correlated with the pseudocapsule in pathology.

Objective:To explore the traits of gray matter volume in general anxiety disorder (GAD)and ob-sessive compulsive disorder (OCD)by using magnetic resonance imaging (MRI)technique.Methods:Twenty-eight GAD,25 OCD and 39 normal controls were recruited.All patients were met the Diagnostic and Statistical Mannal of Mental Disorders,Fourth Edition,Text Revision (DSM-IV-TR)or the International Statistical Classifica-tion of Disease and Related Health Problems Tenth Revision (ICD-10)diagnostic criteria for GAD or OCD.All subjects underwent structural MRI scan.The severity of anxiety and OCD symptoms were rated in all patients with the Hamilton Anxiety Rating Scale (HAMA)and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).The gray matter volume (GMV)was compared between all groups by using the voxel-based morphometry (VBM)a- nalysis.The correlation analysis between GMV and total scores of HAMA and Y-BOCS was performed in GAD and OCD.Results:The GMV was increased in regions including left anterior cingulate cortex in GAD (P =0.016,small volume correction),while only decreased GMV was observed in OCD in bilateral orbitofrontal cortex (OFC)(P <0.001,uncorrected).GAD had larger GMV than OCD in several regions including bilateral OFC (P <0.001,un-corrected).The higher total score of HAMA was associated with increased GMV of right temporal cortex in GAD, and with the GMV of OFC in OCD (P <0.001,uncorrected).Conclusion:No sharing of GMV abnormalities in GAD and OCD was observed in the current study.The traits of brain structure and the potential neural substrate of anxiety symptom in GAD and OCD may be significantly different.

Objective To explore the related risk factors of cerebral hemorrhage complicated with stress ulcer (SU). Methods The clinical data of 1 185 patients with cerebral hemorrhage admitted to Department of Emergency Medicine of Nanjing General Hospital from March 2006 to March 2014 were retrospectively analyzed. Patients were divided into two groups according to whether patients complicated with SU or not. Data was collected within 8 hours after admission in two groups including gender,age,amount of bleeding,the bleeding site (basal ganglia,thalamus, brainstem,brain lobe,ventricle,subarachnoid,and cerebellum),disturbance of consciousness,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,systolic blood pressure(SBP),history of hypertension,and history of cerebral hemorrhage. The statistically significant risk factors found using univariate analysis was selected and was analyzed to find independent risk factors with multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve)was plotted to analyze the independent risk factors and evaluate their power of test. Results 1 185 patients with cerebral hemorrhage were enrolled in the study,293 cases occurred SU,accounting for 24.7%,and 892 cases without SU,which accounted for 75.3%. As shown by univariate analysis,risk factors for cerebral hemorrhage complicated with SU included age,amount of bleeding,the bleeding site,disturbance of consciousness,APACHEⅡscore,SBP. As to the site of bleeding,brain,thalamus,brainstem hemorrhage complicated with SU were higher proportion,45.3%(43/95),39.1%(63/161),36.9%(48/130),which were significantly higher than those of the lobes of the brain 〔26.2% (33/126)〕,cerebellum 〔18.8% (15/80)〕,basal ganglia〔16.1%(78/485)〕,arachnoid the inferior vena cava 〔12.0% (13/108)〕. Multivariate logistic regression analysis showed that amount of bleeding 〔odds ratio (OR)=3.305,P=0.001,95%confidence interval (95%CI)2.213-48.634〕,the bleeding site (OR=1.762,P=0.008,95%CI 0.123-2.743),SBP (OR=1.223,P=0.034,95%CI 0.245-2.812) were independent risk factors of cerebral hemorrhage complicated with SU. The area under the ROC curve (AUC)of amount of bleeding and SBP were 0.846 and 0.597,suggesting that amount of bleeding has moderate diagnostic value and SBP has low diagnostic value. Conclusions Cerebral hemorrhage patients with large amount of bleeding,the bleeding site in the ventricle,thalamus or brainstem,high SBP are of great risk. We should lower blood pressure and give preventive treatment for SU as soon as possible.

Objective: To screen out suspected risk factors associated with neurosis, such as personality dis-order, life events, parental rearing behavior, and to explore degree of their associations. Methods: A case-control study was carried out among 100 cases with neurosis and 200 controls without mental disorder, matched by gender and age (+3 years) . The Life Events Scale (LES), Parental Rearing Style Questionnaire (EMBU), Personali-ty Diagnostic Questionnaire (PDQ-4) were self-reported by the subjects. Results: Single factor analysis showed that there were statistical differences (P <0.05) between case and control groups in negative life event (22.5 vs. 2.5), paternal rejection [(40.4±14.1) vs.(35.4±7.9)], paternal overprotection [(29.1±7.5)vs.(28.2±5.6)], maternal rejection rearing behavior [(40.4±13.7)vs.(36.8±8.5)], and overall personality disorder [(29.8±14.1)vs.(17.1±13.0)] . Using non-conditional logistic regression analysis, the potential protective factor was positive events (OR=0.92, 95% CI:0.87-0.98), and the potential risk factors included negative live events (OR=1.06, 95% CI:1.04～1.08) and overall personality disorder (OR=4.84, 95% CI: 2.24～10.49) . Conclusion: Positive life event may be a protective factor for neurosis, while negative life e-vent and personality disorder may be risk factors.

Objective:To evaluate the test-retest reliability and validity of Chinese version of World Health Organization Composite International Diagnostic Interview version 3.0(CIDI-3.0)by community-based study.Methods:Among 202 subjects from Dalian city,with the clinician-administered Structured Clinical Interview for DSM-IV(SCID),102 patents were diagnostic as mood disorder,anxiety disorder,schizophrenia or psychotic disorder and so on.All of the patients and the other 100 subjects without mental disorders as the control group were interviewed blindly by CIDI-3.0 to test the validity of CIDI-3.0.Ten patients among them were interviewed twice independently in a 7-day interval to evaluate the reliability of CIDI-3.0.Results:(1)For the screen section,the sensitivity values of different mental disorders ranged from 60.4% to 93.1%,while the specificity values from 33.6% to 92.7%.The positive predictive values were from 60.1% to 95.1%,and the negative predictive values were from 68.1% to 93.7%.(2)For different mental disorders,the specificity values ranged from 97.1% to 98.9%,while the sensitivity values were from 33.3% to 70.3%.Positive predict values were from 66.7% to 95.7%,and negative predictive values were from 87.7% to 95.4%.(3)The consistency was 0.78 in any mental disorder.(4)For test-retest reliability,kappa values ranged from 0.737 to 1.0.Conclusion:By clinical reappraisal,the Chinese version of CIDI-3.0 has satisfied validity and reliability.The screen section has high sensitivity,while the diagnostic sections have high specificities.That indicates that CIDI-3.0 is acceptable as a validated instrument for community survey on mental disorders.

Objectives: To implement cost effective evaluation on the interventions to personality dysfunction in adolescents, so as to provide scientific evidences for extending the interventions. Methods: Cost identification, measurement of the cost, and valuing the cost were implemented to calculate the cost of the interventions. Effects of the interventions were measured based on three indicators: (1) differences of the decreasing scores of Personality Diagnostic Questionnaire-4 (PDQ-4) between intervention group and control group from grade one to three, (2) differences of the decrease number of students with personality dysfunction between intervention group and control group from grade one to three, and (3) differences of the incidence of personality dysfunction between intervention group and control group. Cost-effectiveness ratios (CERs) were calculated for the economic evaluation of the interventions. Results: The total cost of the interventions was 67, 860 Yuan. After intervention, among all of the students in intervention group, the cost of reducing one score of PDQ-4 was 9. 25 Yuan. The cost of reducing one person with personality dysfunction was 6169 Yuan. And the cost of avoiding one person developed personality dysfunction was 2714 Yuan. The cost effectiveness were not balanced among Cluster A, Cluster B and Cluster C personality dysfunction. Similar tendency was found among 10 types of personality dysfunction. Conclusion: The "Intervention Measure on Personality Dysfunction" in adolescents is easy to implement and has relative low costs. Further interventions of the specific cluster or type of personality dysfunction can be carried out based on the findings from this study.

Objectives: To explore the effect of personality dysfunction on freshmen's mental status. Methods:Cohort study design was applied in the study. Exposure factors were personality dysfunction and intervention. The mental health status of 2516 freshmen was evaluated by Symptom Checklist 90 (SCL-90), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Relative risk (RR) and attributive risk (AR) were calculated to test the relationship between exposure factors and mental health status. Results: Cohort study showed that RRs of all types of personality dysfunction history in senior high schools developing mental symptoms in the freshman year were between 1. 980 to 10. 167. Interventions to personality dysfunction during high schools had protective effect to the development of mental symptoms. Conclusion: Personality dysfunction isa risk factor of mental symptoms of freshmen. Early intervention could decrease the risk of the mental symptoms.

Objective To evaluate the effect of slow-release microcapsules of HCF( hepatocyte growth factor) on angiogenesis in infracted myocardium.Method Myocardial infarction was induced in 30 New Zealand rabbits by ligating the middle of left descending coronary artery. Group Ⅰ ( n = 10) was served as a control group, group Ⅱ ( n =10) as a blank microcapsule group, group Ⅲ ( n = 10) as experimental group with each microcapsule contains 1 μgHGF as HCF group. In group Ⅱ andⅢ, 5 blank microcapsules or FGF slow-release microcapsules were implanted into myocardium under epicedium between the left descending coronary artery and left circumflex branch. The heart function of each rabbit was evaluated with echocar-diography and cheterization, angiogenesis was evaluated by immunohistochemical technique 6 weeks later.Result As compared with group Ⅰ and Ⅱ , rabbits treated with HGF had higher microvessel counts ( P < 0. 01), and LVFS and EF were significantly increased [ (101. 28±19. 50,105. 28 ±18. 28,161. 28 ±15. 85, P <0.01 ]. Conclusion Subepicardial implantation of HGF slow release microcapsule in the infracted rabbit model can enhance effective angiogenesis and improve left ventricular function.

Objective After acute craniocerebral trauma , to a certain extent , arterial blood lactate and lactate clearance rate reflect the illness severity .We aimed to investigate the prognosis value of arterial blood lactate and lactate clearance rate in patients with craniocerebral trauma . Methods 94 cases with craniocerebral trauma treated in the Department of Emergency of Nanjing General Hospital of Nanjing Military Regionfrom February 2015 to November 2015 were retrospecively analysed .GCS ( Glasgow Coma Scale ) score, arterial blood lactate , blood pressureand heart rate were measured once patients admitted to hospital and 6 hours later ,arterial blood lactate was measured again to calculated the arterial blood lac-tate clearance rate .Based on the GCS score , we divided the patients into mild group (13-15), medium group (9-12) and severe group (3-8).We also divided the patients into death group and survival group according toprognosis .We compared arterial blood lactate and lactate clearance rate betweeeneach group respectively . Results There were significant differences in arterial blood lactate (F=19.99,P<0.01) and 6h lactate clearance rate(F=6.21,P<0.01)be-tween lighter group , medium group and severe group .The initial arterial blood lactate of death group was significantly higher than sur-vival group[(4.20 ±1.36)mmol/L vs (1.58 ±0.93)mmol/L], the difference was statistically significant (t=-9.78,P<0.01). The 6 h lactate clearance rate of death group was significantly lower than survival group [(31.73 ±12.84)%vs (46.25 ±12.01)%], the difference was statistically significant (t=4.55,P<0.01). Conclusion Arterial blood lactate and 6 h lactate clearance rate can evaluate the severity and prognosisof illnessin patients with craniocerebral traumaand have important application value in clinical work .

Objective Acute coronary syndrome ( ACS) is frequently accompanied by chronic comorbidities , which may se-riously affect its prognosis .This study aims to investigate the value of the Charlson Comorbidity Index ( CCI) in predicting the outcome of ACS by assessing the impact of individual and post-weighted-assignment comorbid conditions of the disease . Methods We retro-spectively analyzed the clinical data on 1 096 cases of ACS treated in Jinling Hospital from January 2010 to March 2014 .We reviewed their general information , clinical presentations , complications , and previous treatments , calculated CCI , and used in-hospital mortali-ty as the index for judging the prognosis . Results Of the 1 096 patients, 73%were males (aged 64.2 ±12.9 years), 27% were females (aged 72.1 ±12.6 years), and 46.8% had comorbidities. Of the diseases included in the CCI system , previous myocardial infarction was the most frequent comorbidity (18.0%), followed by diabetes mellitus ( 14.7%), moderately to severe renal disease (7.1%), cerebrovascular disease (6.0%), and chronic lung dis-ease (6.0%).Single factor analysis revealed statistically significant differences between different CCI groups in such clinical indicators as history of coronary artery disease , history of hypertension , time between symptom onset and admission , hemodynamics , drugs adminis-tered (aspirin, P2Y12 blockers, ACEI/ARB or statins), and reperfusion therapy (P<0.05).Logistic regression analysis showed the strongest predictors of in-hospital mortality were heart failure (OR 1.88, 95%CI:1.57-2.25), metastatic tumor (OR 2.25, 95%CI:1.60-3.19), renal disease (OR 1.84, 95% CI:1.60-2.11), and diabetes mellitus (OR 1.35, 95% CI:1.19-1.19). Receiver operating characteristic curve analysis manifested that either CCI with age or CCI with age and gender was superior to CCI a -lone in predicting in-hospital mortality of ACS patients (AUC 0.761 [95%CI 0.748-0.773] and 0.756 [95%CI:0.743-0.768] vs 0.670 [95%CI:0.656-0.685]). Conclusion Heart failure, diabetes mellitus, renal disease, and metastatic tumors contrib-ute to the in-hospital mortality of ACS patients .CCI together with age and gender may help to assess the prognosis of the disease .