The study is designed to investigate the progress in cardiac auscultation proficiency of residents after training program.Thirty eight residents were selected to test their ability of cardiac auscultation.There were 13 cardiac events(or murmurs)in 15 patients,and the auscultation proficiency was expressed as the percentage of recognizing cardiac events accurately.The results showed that the highest auscultation proficiency was whole systolic and diastolic murmurs(up to 79 percent and 61 percent respectively)before training.The percentage of recognizing continuous murmurs,click,mitral stenosis and regurgitation,aortic stenosis increased significantly after training program(P＜0.05).

Objective To discuss the correlationship between the diagnosis of surgical pathology and the signs of malignancy which is both displayed by breast conventional mammography and amplificatory mammography with partial compression.Methods 65 cases with breast cancer were examined by both breast conventional mammography and amplificatory mammography with partial compression.The results of the two methods were analyzed.Results In all 65 cases of breast cancer,the comparison between breast conventional mammography and amplificatory mammography with partial compression could provide 16/60 cases in the X-ray signs of malignancy,which were in accordance with pathological examination results,19/41cases in the occurrence of calcification,13/37 cases in ductal calcification,0/4 cases in mixed type calcification,18/46 and 14/59 cases in the occurrence of lobulation and spicule signs.Conclusion Amplificatory mammography with partial compression can provide better insight in breast cancer than conventional mammography,especially in the region of dense shadow,small calcification and dense breast lesions,amplificatory mammography with partial compression can provide higher accuracy in diagnosis,especially for early breast cancer.

Objective Toexploretheclinicalvalueofcombiningapplicationofthreedimensionalpseudocontinuousarterialspin labeling (3D-pCASL)andsusceptibilityweightedimaging (SWI)inpredictingtheoutcomsofcerebralischemia.Methods Thirty-two patientswithmoderatetoseverestenosisofunilateralmiddlecerebralartery(MCA)and16healthyvolunteers(asacontrolgroup) underwenttheexaminationsoftheroutineMRI,MRA,3D-pCASL (PLD:1525ms,2525ms)andSWI.Thepatientsweredividedinto twogroups:lowperfusiongroupandequal/highperfusiongroupaccordingtotherCBFof3D-pCASLwithPLD:2525ms.OnSWI, theparametersofdeepmedullaryvein(DMV)includedratioofquantity,totallengthinbilateralunitareaandsubjectivescoreofischemic side.ThedifferencesofthevaluesofDMV parametersamongthegroupswerecompared,andthecorrelationsbetweenrCBFand DMVparameterswereanalyzed.Thereexaminationswereperformed6monthslaterandtheincidenceofinfarctionwascomparedbetween thelowperfusiongroupandtheequal/highperfusiongroup.ThecorrelationbetweenvaluechangeofrCBFandDMV,andthetransformation tendencyfromtheischemiclesiontocerebralinfarctionwerealsoanalyzed.Results Inthelowperfusiongroup,allDMVparameters werehigherthanthoseinthecontrolgroupandtheequal/highperfusiongroup,andthedifferencesbetweengroupswerestatistically significant(P＜0.05),buttherewerenosignificantdifferencesbetweenthevaluesofthecontrolgroupandtheequal/highperfusion group (P＞0.05).Thereexaminationresultsof6monthslatershowedthat4caseswithcerebralinfarctionwereallfromthelowperfusion group.Theincidenceofthecerebralinfarctioninthelowperfusion groupwas25%andwassignificantlyhigherthanthat(0%)in theequal/highperfusiongroup (P＜0.05).Theincidencewas positivelycorrelatedwiththeratioofquantity,totallengthinbilateral unitareaandsubjectivescoreofischemicsideofDMV (r＝0.512,0.43,0.449,P＜0.05),whilenegativelycorrelatedwithrCBF (r＝－0.501,P＜0.05).Conclusion TherearesomechangesofrCBFandDMVincerebralischemicarea,andthereisacorrelationbetween rCBFandDMV.3D-pCASLandSWIcanshowcerebralbloodflowperfusionandDMVinischemicarea,andplayanimportantrolein studyingtheoutcomesofcerebralischemiclesions.

Objective:To investigate the risk factors of dysplasia in patients with ulcerative colitis (UC) in China.Methods:From March 1st, 2012 to December 30th, 2013, a total of 154 UC patients were prospectively enrolled from the following 11 hospitals, Xijing Hospital of Digestive Diseases, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Peking Union Medical College Hospital, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Nanfang Hospital affiliated to Southern Medical University, China-Japan Friendship Hospital, The Second Hospital of Hebei Medical University, West China Hospital affiliated to Sichuan University, The Seventh Medical Center of PLA General Hospital, Zhongshan Hospital affiliated to Xiamen University, and the First Affiliated Hospital of Anhui Medical University. The patients were followed up till December 1st, 2017. All the UC patients underwent colon endoscopy and histopathological evaluation. T test and Chi-square test were used for statistical analysis. Cox proportional risk model was used for identifying the risk factors of dysplasia in UC patients. Results:Finally, 133 UC patients were enrolled, the age was (50.0±11.9) years, the diagnosis age was (35.5±11.6) years, the course of disease was (14.5±6.7) years, and the number of endoscopic examinations was (3.4±1.6) times. A total of 21 patients were detected with dysplasia. No patients were detected with colorectal cancer. The results of univariate analysis revealed that the diagnosis age (hazard ratio ( HR)=1.05, 95% confidence interval ( CI) 1.01 to 1.10, P=0.009) and extensive colitis ( HR=2.92, 95% CI 0.97 to 8.79, P=0.057) were factors with statistically significant difference. The results of multivariate analysis revealed that the old age at diagnosis ( HR=1.06, 95% CI 1.02 to 1.11, P=0.003) and extensive colitis ( HR=3.68, 95% CI 1.21 to 11.19, P=0.022) were independent risk factors of dysplasia in UC patients. The cumulative incidence of dysplasia of UC patients with extensive colitis was higher than that of patients with left-sided colitis (24.3%, 17/70 vs. 6.3%, 4/63), and the difference was statistically significant ( χ2=8.023, P=0.005). Conclusions:Extensive colitis and older age at diagnosis are two independent risk factors of dysplasia in UC patients of our country. The cancer monitoring should be strengthened in UC patients with long course of disease and extensive colitis.