Objective To explore the behavior and initial sandtray characters of the children with oppositional defiant disorders (ODD) in order to provide psychological and behavioral intervention as early as possible.Methods The differences of the Conners parent symptom questionnaire (PSQ) and initial sandtrays between 24 children with ODD and 24 normal children were compared.Results PSQ indicated that children with ODD had higher scores of conduct proble((1.31 ± 0.53),(0.36 ± 0.31)),learning problem ((2.01 ± 0.66),(0.57 ±0.5)),hyperactivity-impulsion ((1.60 ± 0.77),(0.35 ± 0.41)),anxiety ((0.60 ± 0.50),(0.27 ± 0.25)) and hyperactivity index((1.12 ± 0.31),(0.78 ± 0.28)) than normal children.On the use of toys,the experimental group was significantly higher in armament and transports and lower in plants and stones(P＜0.05).On the theme of sandtrays,the ODD group was significantly higher in disorder,neglect,injury,threat and lower in integration and energy (P ＜ 0.05).Conclusion The results show that the children with ODD have more anxiety experience than normal children and this may be associated with oppositional conduct.Children with ODD use more aggressive toys and wounded themes,revealing their attack and conflict.Psychological intervention can be provided according to the characters of behavior scale and initial sandtray.

Objective To investigate the effect of neurofeedback training for tics symptoms and electroencephalogram (EEG) spectrum change in children with tic disorder.Methods 19 patients with transient tic disorder (TTD),20 with chronic motor or vocal tic disorder (CTD) and 15 with Tourette' s disorder (TS) received 40 sessions of neurofeedback training.The clinical effect was evaluated with Yale Global Tic Severity Scale,and brain activity improvement with EEG theta/beta,theta / sensorimotor rhythm (SMR) power ratio.Results The patients with three types of tic disorder all showed a reduction of tics symptoms (TTD:10.32 ± 0.82 vs.5.91 ± 5.74;CTD:12.35 ±1.50 vs.4.00 ±2.22; TS:25.33 ±2.80 vs.13.73 ±4.22; P＜0.01).Additionally,the patients showed theta decreasing and SMR enhancing after the sessions.The ratio of theta/beta (TTD:2.52 ±0.38 vs.2.33 ±0.32;CTD:2.43 ±0.39 vs.2.21 ±0.30; TS:2.64 ±0.35 vs.2.39 ±0.26) and theta/SMR was significantly lower than before treatment (P ＜ 0.01).Conclusion Neurofeedback training is an effective and valuable treatment in tic disorder especially in the patients with transient tic disorder and mild chronic motor or vocal tic disorder.

Objective To discuss the clinical value of ultrasonic elastography for thyroid nodules,and compared with pathology.Methods 77 patients with 105 thyroid lesions were analyzed.Tissue stiffness on elastography was scored from one(greatest elastics train)to five (no strain).Results On elastography:scores 1 and 2 were found in 75％ benign lesions.Scores 3 to 5 were found in 97.4％ malignant lesions.There were statistically difference in the scores of elastography between the benign and malignant lesions (P ＜0.01).Conclusions The ultrasonic elastography had positive significance in differentiating benign and malignant thyroid nodules.If the score of elastography is more than or equal to 3,the thyroid nodule is highprobablely malignant.

Objective To investigate the cognitive impairment and time-on-task characteristics of combined type(C type) and predominantly inattentive type (Ⅰ type) of children with attention deficit hyperactivity disorder(ADHD).Methods 24 cases with C type ADHD,20 cases with Ⅰ type ADHD and 24 normal children were completed 2 Block period of continuous performance test task,with conducting a comparative analysis of the behavior results of three groups and block1 and block2.Results 1.three groups comparison:hit numbers of C type (64.37 ±5.29) and Ⅰ type (63.55 ±5.28) were lower than that of the normal control group(67.04 ±2.03) ; reaction time of Ⅰ type (540.33 ± 90.33) ms was longer than that of the normal control group (470.56 ± 95.39)ms; intra-individual variability(ⅡⅤ) of C type (174.24 ± 56.3)ms and Ⅰ type (201.12 ± 50.79)ms were higher than that of the normal control group(144.72 ± 37.17) ms.Commission errors of other figures after 1 of C type was higher than that of Ⅰ type; reaction time of commission errors of Ⅰ type[(701.34 ±311.54) ms] was longer than that of C type((512.57 ± 279.22)ms),and all the differences were statistically significant (P ＜ 0.05).2.Timeon-task comparison:hit numbers,omission errors and ⅡⅤ had the significantly main effect of the type of subjects (P ＜ 0.05) ; hit numbers,omission errors,reaction time and ⅡⅤ had the significantly main effect of time-on-task (P＜0.01) ; Block2 the reaction time of C type and Ⅰ type((501.82 ± 112.47)ms,559.33 ± 90.73)ms) were significantly longer than that of Block1 ((473.19 ± 106.43) ms,(523.45 ± 99.86) ms) (P ＜ 0.05),while no significant difference (P＞0.05) in the normal control group.Conclusions C type ADHD has attention deficit and impulsivity and response inhibition defects.Ⅰ type ADHD has attention deficit and information processing capacity backward.Reaction rate of ADHD is more vulnerable to the impact of time-on-task.Two subtypes of ADHD children has different modes of cognitive impairment.

AIM:To evaluate the application and effect of bandage contact lens in pterygium excision combined with conjunctival transplantation (CAT).METHODS:In a prospective, randomized, controlled clinical study, 110 patients (110 eyes) diagnosed with primary pterygium were collected in PLA NO.474 Hospital from January 2015 to January 2016.The 110 patients enrolled in the study in turn, and divided into two groups by the odd and even number.The odd number divided into bandage contact lens group (CAT + bandage contact lens, n=55), while the even number divided into control group (CAT, n=55).Visual analog scale (VAS) and corneal irritation were evaluated on 1, 3 and 7d after operation.Cornea fluorescent staining testing was carried out on 3d after operation.Following-up all the patients with 1a at least observed the recurrence of pterygium.RESULTS:The score of VAS in bandage contact lens group less than that in control group on 1d (4.13±2.06 vs 5.80±1.93, t=4.391, P<0.001) and 3d (2.09±1.36 vs 3.65±1.65, t=5.422, P<0.001) after operation, while there was no significant difference between two groups on 7d (t=1.295, P=0.198) after operation.The corneal irritation in bandage contact lens group less than that in control group on 1d and 3d after operation (P<0.05), while there was no significant difference between two groups on 7d after operation (P=0.052).Cornea fluorescent staining testing area in bandage contact lens group was less than that in control group on 7d after operation (0.33±0.37mm2 vs 2.73±2.21mm2, t=7.921, P<0.01).There was no significant difference in recurrence rate between two groups after 1a operation (P=1.000).CONCLUSION:Bandage contact lens could significantly release pain and corneal irritation, promote the healing of the corneal epitheliums in the defected area, and increase the postoperative comfort level in patients after operation.

ObjectiveTo study the relationship between 18F-FDG uptake and tumor cell density,glucose transporter expression,cellular proliferation and angiogenesis before and after radiotherapy in C6 glioma rats.MethodsThirty C6 glioma-bearing male SD rats were randomly divided into three groups:A,B and C ( 10 rats in each group).Two weeks later,18F-FDG PET/CT was performed in group A.In groups B and C,18 F-FDG PET/CT was performed at 48 h and 1 week after radiotherapy,respectively.The ratio of SUVmax of tumor to muscle (T/M) was calculated.HE staining,immunohistochemical staining and Western blot were used to measure tumor cell density,Ki67 labeling index ( LI),microvessel density ( MVD),Glut-1 and VEGF expression quantitatively.The one-way analysis of variance and bivariate correlation analysis were used to compare the changes of each indicator and evaluate the correlation between T/M and biological indicators,respectively.Results Significant differences of T/M,tumor cell density,Ki67 LI,MVD,Glut-1 and VEGF among groups A,B and C were observed ( F =6.77,60.66,104.56,95.49,9.13,24.48,respectively,all P ＜0.05).Least significant difference (LSD) test showed that there was no significant difference between group A and B in T/M,tumor cell density and Ki67 LI ( 10.86 ± 3.31,730.50 ± 78.93,20.02 ± 2.14 vs 9.23 ± 4.56,672.70 ± 92.98,18.56 ± 2.26).However,the indicators of group C (5.16 ± 2.52,355.60 ± 72.62,7.81 ± 1.76 ) were significantly decreased compared with those of groups A and B (all P ＜0.05 ).MVD and Glut-1 expression of group B increased slightly compared with those of group A ( 19.50 ± 1.96,0.20 ± 0.09 vs 17.90 ± 2.02,0.15 ± 0.04),but the difference was not statistically significant.Nevertheless,the two indicators were significantly decreased in group C ( 8.40 +1.84 and 0.07 ±0.06,P ＜0.05).VEGF expression in group B (0.42 ±0.13) was significantly higher than that in groups A and C (0.17 ±0.04 and 0.16 ± 0.09) ( both P ＜ 0.05 ).The changes of T/M were positively correlated with the changes of tumor cell density between groups A and B ( r =O.81,P ＜ 0.05 ).Changes of T/M were positively correlated with the changes of tumor cell density,Ki67 LI,MVD and Glut-1 between groups A and C (r =O.83,0.71,0.68,0.62,all P ＜ 0.05 ).ConclusionsThe changes of 18 F-FDG uptake in C6 glioma rats were only correlated to the changes of tumor cell density at 48 h after radiotherapy.However,the changes of 18F-FDG uptake closely correlate to the changes of a variety of biological indicators at 1 week post radiotherapy.

Objective To investigate the correlation between ~(18)F-fluorodeoxyglucose (FDG) uptake and hypoxia inducible factor1α (HIF-1α) level,microvessel density (MVD) in human gliomas.Methods ~(18)F-FDG PET scan was performed preoperatively in 41 patients with gliomas (including 23 highgrade and 18 low-grade tumors).The ratios of maximum standardized uptake value(SUV_(max))between tumor (T)and contralateral white matter (WM) were calculated (T/WM).Immunohistochemical stain methods were used to evaluate the level of HIF-1α and measure the MVD in tumors.Correlation analysis between SUV_(max) of T/WM and HIF-1α level,MVD wag performed.The t-test,one-way ANOVA test,Spearman rank correlation and Wilcoxon signed-rank test were calculated using SPSS 11.5 software.Results (1)The SUV_(max) of T/WM,HIF-1α level and MVD in high-grade and low-grade tumors groups were 3.39±1.43,95.7% and 44.13±16.1 vs 1.46±0.55.55.6% and 18.83±7.07,respectively.The difierences of SUV_(max) of T/WM,HIF-1α level and MVD between two groups were statistically significant (t=-5.921,z=-3.938,t=-6.745,all P＜0.05).(2)Among 41 gliomas,the strong positive expression of HIF-1α was observed in 8,mederate in 9,weak in 15 and negative expression was found in 9,SUV_(max) of T/WM and MVD increased with increasing HIF-1α level.The differences of SUV_(max) of T/WM and MVD among 4 different groups were statistically significant (F=7.41,P＜0.05).(3) The MVD of all gliomas was ranged from 9.76 to 94.52,which correlated with SUV_(max) of T/WM(r=0.759,P＜0.05).Conclusions The SUV_(max) of T/WM correlates with HIF-1α level and MVD in gliomas.Therefore,~(18)F-FDG PET provides preoperatively a noninvasive assessment of hypoxia or angiogenesis in human glionma.

?AIM: To discuss the effect of laser exposure on visual acuity and macula.?METHODS: Retrospective and consecutive case series. A retrospective analysis of 11 patients (11 eyes) with laser retinal injury was carried out from January 2014 to June 2015 in Ophthalmology Department of No. 474 Hospital of Chinese PLA. All individuals underwent visual acuity, best corrected visual acuity ( BCVA ) , and spectral-domain optical coherence tomography ( SD-OCT) for macular at first visit, and fundus fluorescein angiography ( FFA ) , visual field, and multifocal electroretinogram ( mf ERG ) were perform if necessary. Symptomatic therapies, supportive therapies and pars plana vitrectomy ( PPV ) were performed depended on the patient’s condition. The patients were followed-up at 1, 3 and 6mo after the first visit, and patients were undertaken visual acuity, BCVA, macular SD-OCT and so on.?RESULTS: Eight patients ( 73%) were under 18 years old and all patients were young males, who were injured by laser pointers when playing. Three patients ( 27%) over 18 years old were injured accidentally at work. Ten (91%) patients’ BCVA were ≤0. 3, while one ( 9%) patient’s BCVA was higher ≥0. 3. Full-thickness macular holes ( the diameter 224-519 μm ) were detected in 10 patients (91%), while sub-foveal RPE changes and IS/OS injury in 1 patient ( 9%) . Macular hole with traction or cystoid edema in 6 eyes (55%) were received PPV, while the other 5 eyes ( 4 eyes with stable macular hole and 1 eyes with RPE injury ) received conservative treatment. Macular hole closed successfully in 1 eye ( 17%) after PPV, while macular hole in the other 5 eyes ( 83%) were stable after PPV of which the cystoid edema faded. The 4 patients with macular hole and 1 patient with RPE injury were stable during follow-up period. However, the BCVA in all patients had no significant improvement at end.?CONCLUSION: Exposure to laser devices could lead to severe macula injury that could reduce central vision, which is permanent.

Objective To investigate the behavioral problems,intellectual ability and executive functioning characteristics as well as their correlations in children with borderline intellectual functioning (BIF) and attention deficit hyperactivity disorder (ADHD).Methods 60 children with BIF,60 children with ADHD and 60 typical developing children (TDC) participated this study.Parental report measures of behavioral problems were administrated using the Conners' Parent Symptom Questionnaire (PSQ) and Achenbach Children Behavior Checklist Scale (CBCL).All the participants performed the Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and a neuropsychological test named integrated visual and auditory continuous performance test (IVA-CPT).Comparison of cognitive profiles and correlation between psychological features were carried out to test the differences and commons among the groups.Results (1) Behavioral problems:the children with BIF had higher scores(3.68±2.85) in withdrawal factor than the children with ADHD (2.82±2.24) and TDC (1.03± 1.59).The children with ADHD had higher scores in conduct,impulsivity,aggressive and delinquent behavior than the children with BIF and TDC.The children with BIF/ADHD had higher scores in learning,anxiety,depression,somatic complaint and hyperactivity than the TDC.(2) Executive functioning:the children with BIF had more visual omission error (12.17± 10.48) than the children with ADHD (6.95±7.20) and TDC (2.33±2.48).The children with BIF and ADHD had lower auditory accuracy and higher visual reaction time,visual/auditory response variability,visual/auditory misrepresentation and auditory omission numbers than the TDC.These was no group difference in auditory reaction time.(3) Correlation analysis:intellectual ability was correlated with behavior problems and neurophysiological index such as conduct,learning,impulsivity,anxiety,depression factors,visual/auditory accuracy,visual reaction time and visual/auditory response variability.Conclusion BIF and ADHD are associated with poor executive functioning and increased behavior problems.The cognitive deficit may be a marker of vulnerability of poor academic and social outcomes in children with BIF and/or ADHD.