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 intelligence structure and attention properties,and to explore the relationship between them in children with attention deficit hyperactivity disorder of the predominantly inattention type (ADHD-Ⅰ),predominantly hyperactive-impulsive type (ADHD-HI) and combined type (ADHD-C).Methods Children with ADHD-Ⅰ (n=24),ADHD-HI(n=12) and ADHD-C (n=54) aged between 7-10 years were tested with Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and integrated visual and auditory continuous performance test (IVA-CPT).Comparisons of cognitive profiles of C-WISC scores between subtypes of ADHD were performed.Additionally,the relationship between attention/response control quotients and cognitive profiles was investigated.Results (1) Intelligence structure:verbal intelligence (VIQ) of ADHD-HI (110.08± 10.64) was higher than that of ADHD-C (101.13± 13.20) and ADHD-Ⅰ (94.71± 11.11).Full scale intelligence quotient (FIQ) of ADHD-HI (104.33±9.63) was higher than that of ADHD-Ⅰ (94.38± 10.48).Factor A of ADHD-HI (45.75±7.14) and ADHD-C (41.41±8.57) were higher than that of ADHD-Ⅰ (36.67±6.72).Factor C of ADHD-HI (33.42±5.42) was higher than that of ADHD-C (29.24±5.26) and ADHD-Ⅰ (29.13±5.39).(2) Attention properties:Full scale attention quotient of ADHD-C (90.26± 11.67) was lower than that of ADHD-Ⅰ (98.17 ± 18.03) and ADHD-HI (99.25± 15.58).Auditory attention quotient of ADHD-C (89.94± 14.16) was lower than that of ADHD-Ⅰ (99.00± 18.66).(3) Relationship between intelligence and attention:the Pearson correlations of the auditory attention quotient and auditory control quotient with the PIQ were 0.24 and 0.29 respectively.The correlations of the visual attention quotient with the PIQ and FIQ were 0.21 and 0.25 respectively.The correlations of the full scale attention quotient with PIQ and FIQ were 0.27 and 0.24 respectively.Each of these correlations reached the level of significance at the 5％ level.Conclusion Cognitive profile and attention properties analysis reveal that children with different subtypes of ADHD have distinct weakness in intelligence structure.The understanding of relationship between intelligence structure and attention properties in children with subtypes of ADHD is useful for ADHD diagnosis and treatment.

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 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.

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 behavioral problems and intelligence in children with attention deficit hyperactivity disorder (ADHD) with different degree of sensory integrative dysfunction (SID).Methods Ninety-eight children with ADHD and fifty typical developing children (TD) whose intelligence were assessed with Chinese revised wechsler intelligence scale for children(C-WISC) in this study.Parental report measures of sensory integrative dysfunction and behavioral problems were administrated using the sensory integrative rating scale of children,conners' parent symptom questionnaire (PSQ) and achenbach children behavior checklist scale (CBCL) respectively.Relationship between behavioral problems,cognitive profiles and SID were examined in in children with ADHD with different degree of SID (33 without SID,33 mild SID and 32 severe SID).Results (1) Behavioral problems:the children with ADHD with severe SID (SS) had higher scores in Conduct problem,Learinng problem,Impulsivity-hyperactivity,Hyperactivity index of the PSQ and Depression,Somatic complaint of the CBCL than the children with ADHD without SID (NS),the children with ADHD with mild SID (MS),and TD.SS group had higher scores in Withdrawn behavior,Hyperactivity index,Aggressive and Delinquent behavior in CBCL than the TD and NS groups(P＜0.05).(2) Intelligence:the SS group(98.53±l0.80) had lower Verbal Intelligence Quotient (VIQ) than the TD group(107.40± 12.03) and lower Performance Intelligence Quotient (PIQ) (94.59± 10.56) than the other groups(TD:108.96± 10.20; NS:101.88±8.15 ; MS:100.73 ± 9.52).Additionally,the SS group had lower full scale intelligence quotient (FIQ) (96.22± 10.12) than the NS(102.70±7.52) and TD group (109.18±9.95)(P＜0.05).(3) The scores of SID were negatively correlated with behavior problems (PSQ and CBCL) and positively correlated with PIQ and FIQ.Conclusion SID have negative impact on behavioral problems and cognitive function in children with ADHD.The relationship between sensory integration and cognitive function may provide a new way for the clinical intervention of children with ADHD.

Objective To compare the event-related potential(ERP) difference waveforms between attention deficit hyperactivity disorder (ADHD) children and normal children in the conflict task,and to investigate the neural mechanism of conflict monitoring of ADHD. Methods ERPs elicited by performing the spatial SimonStroop task were recorded in 32 children with ADHD and 32 normal children. The differences of ERP and behavior dren with ADHD(0.80±0. 11 ,0.87 ±0.08) were less than normal children (0.88 ±0.07,0.93 ±0. 04)in Sireaction time of ADHD group( (773.03 ±99.34)ms) in the Siin were longer than the control group( (737.21 ±81.40)ms) ,the differences had statistic significance (P＜0. 05). 2. ERP results:the amplitude of N2 of the children with ADHD in the four conditions were smaller than the control group, the difference in Siin had statistic sigof prefrontal and anterior cingulate cortex of ADHD were weaker than the control group. Conclusions The results suggest that, due to the inadequate allocation of attention resources of the children with ADHD, they have conflict monitoring function defects compare with normal children. The function defects of conflict information processing related brain areas may be the main neural mechanism. The result of the behavior and ERP can become the reference indicator for the early diagnosis and treatment of ADHD.

Objective:To investigate the characteristics of event-related potentials(ERPs)P300 in the development of attention cognitive function of school-age children.Methods:A total of 180 school-age children were divided into 3 groups according to their ages (7-8 years old group with 48 cases, 9-10 years old group with 44 cases and 11-12 years old group with 48 cases). All of the participants completed an Oddball task, and their behavioral data, P3a and P3b components of ERPs were analyzed by SPSS 21.0.Results:(1)The differences of hit numbers(49(47.25, 50), 50(49, 50), 50(50, 50) ), correct reaction time((533.37±56.94) ms, (486.91±61.12) ms, (411.55±51.97) ms), and Omission errors (2(1, 4), 2(1, 3), 1(0, 2) ) among the three groups were statistically significant( F/χ 2=20.635, 54.477, 13.169, all P<0.01). (2)There was a main effect of age( F=3.884, P=0.023) and an interaction effect between age and condition( F=3.314, P=0.038) on the amplitude of P3a, while the main effect of condition was not significant( F=0.111, P=0.740). The amplitude of P3a component in 11-12 years old group ((11.02±6.00)μV) was significantly larger than that of 7-8 years old group ((7.36±4.48)μV) and 9-10 years old group ((7.76±5.17)μV, both P<0.05). However, there was no significant interaction effect between age and condition on P3a latency, P3b amplitude and latency ( P>0.05). Conclusion:P3a may be a sensitive indicator of cognitive function in school-age children, and the age of 11-12 years old is a sensitive period for the development of children's attention orientation and selection ability, which may be related to the development of brain network.

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.