Objective To evaluate the image quality of dynamic three-dimensional contrast enhanced ultrasonography(3D-CEUS) in liver tumors.Methods Twenty-five patients were examed with 2D-CEUS and dynamic 3D-CEUS.Contrast-enhanced computed tomography or magnetic resonance imaging(CECT/MRI) were performed early or late.Two readers reviewed the images of both modalities and graded the images according to diagnostic criteria as follows:tumor blood fusion in arterial phase(unclear-score 0,moderate-score 1,clear-score 2),tumor boundry and relationship with periphery tissues (unclear score 0,moderate-score 1,clear-score 2).The concordance between the two modalities for showing liver tumors was evaluated by Kappa test.Results Twenty-three of 25 danymic 3D-CEUS were displayed successfully versus total objects in CECT/ MRI.Among them,for showing blood fusion,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 18 lesions scored 2,7 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.65.For showing tumor boundry and relationship with peripherytissues,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 21 lesions scored 2,4 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.52.Conclusions Danymic 3D-CEUS was shown to be useful for displaying tumor blood fusion,boundry and relationship with periphery tissues in single liver tuomor,the concordance between dynamic CEUS and CECT/MRI for single liver tuomor was fair.For huge liver tumor and multi-tumors,3D-CEUS can not give overall information.

Objective To explore optimized procedures and science decision-making methods for the triage in sanitary train and improve efficiency. Methods The work condition of triage was evaluated with queuing theory and mathematical models. Results The work of triage needs to be further optimized. The M/M/n model of queuing theory can improve efficiency, and then waiting-time that from triage site to specifically sickbed can be shorten consumedly. Conclusion The application and assistance decision on queuing theory in the triage can optimize organization plan and enhance work efficiency.

Objective To investigate the mental health status and related personality type of psychological clinic adoleScent in general hospital and provide data for psychology treatment and intervention.Methods 219 adolescence consulters in 2006 were tested by symptom checklist(SCL-90) and eysenck personality questionnaire(EPQ).The caseswere separatedthree age groups,A group(16～20 years old),B group(21～25 years old),C group(26～30 years old)and disposed by SPSS 13.0.Results All factor scores of SCL-90 in psychological clinic adolescents were higher than those of youth norm in China(P＜0.01).The scores of female consulters were significant higher than those of male in depression(P＜0.05).The incident rate of mild mental obstacle(factor score＞2)in 3 age groups were significant different.The incidence rate of B and C groups were higher A group(P＜0.01).The factor scores were positive associated with P in EPQ and negative associated with L in EPQ.The obsession score of SCL-90 was negative associated with E in EPQ.Conclusions The mental health status of psychological clinic adolescents was not as good as norm adolescents.In psychological consulting and psychological health service,measures in different age and different personality could help build up healthy personality and effectively promote the development of mental health.

Objective To explore the ultrasonographic characteristics in craniocerebral gunshot injured areas and the value of ultrasound technology for judging the activity of wound tissues. Methods After establishment of the model of penetrated craniocerebral gunshot wound, the ultrasonographic characteristics of the tissues in the injured areas were observed by conventional ultrasound and contrastenhanced ultrasonography(CEUS) ,and compared with the pathological changes of the wound area. Results ①A straight-looking, irregular-edged, easily distinguishable pipe-shaped high-level echo can be seen by conventional ultrasound in craniocerebral gunshot injured areas. ②The pipe-shaped strong echo usually shows non-enhancement by the CEUS,or shows homogeneous hypo-enhancement in some areas. ③Tissues around the pipe-shaped echo usually appears that the homogeneous hypo-enhancing area and non-enhancing area exist together. ④Around the above-mentioned the hypo-enhancing area and non-enhancing area, a hyper-enhancing area can be seen, and appears to be a typical ring-shaped high-level echo in short-axis section of the pipe-shaped echo. ConclusionsConventional ultrasound can easily shows the distribution of craniocerebral gunshot injured areas characterized by pipe-shaped high-level echo, and CEUS can precisely demonstrate necrotic tissues in the gunshot injured areas,distinguish them from the degenerative tissues and normal tissues. The application of ultrasound technology will greatly improve the therapeutic and treatmental level of the craniocerebral gunshot wound.

Objective To explore the value of the determination of the devitalized tissue area of bullet wounds in the pig extremities by contrast-enhanced ultrasound(CEUS).Methods A model of bullet wounds to the pig limb soft tissue was constructed with a model 53 smoothbore.The sonographic features of the soft tissue of and around the primary traumatic channel of the pig extremities were observed by routine ultrasound and CEUS and compared with the pathological findings.Results The primary traumatic channel of bullet wounds to the pig extremities produced clearer tubular echoes under routine ultrasonic imaging.The echoes from inside the traumatic channel changed with time.Part of tissue close to the periphery of the traumatic channel presented with a filling defect area except the primary traumatic channel after ultrasonic contrast of the traumatogenic area.The pathological examination revealed devitalized necrotic tissues in the filling defect area while the heterogeneous low potentiation of the tissue around and the most peripheral circular high potentiation of the traumatic channel indicated a degenerative tissue change and a small angiectatic change after CEUS.Conclusions Routine ultrasound may determine the run of the primary traumatic channel in the traumatogenic area of bullet wounds to the pig extremities while CEUS may accurately distinguish the devitalized tissue in the traumtogenic area.The combination of both is bound to raise greatly the level of the treatment and cure of bullet wounds.

Objective To investigate the value of emergency bedside focused assessment with sonography for trauma (FAST) in combination with regional organ focused ultrasonography in patients with closed abdominal trauma.Methods Two hundred and thirty-seven patients with closed abdominal trauma underwent bedside ultrasonography in the Emergency Department at General Hospital of Chengdu Military Command.In patients with unstable hemodynamics or severe craniocerebral injury,ultrasonography was ended immediately after FAST screening.In patients with stable vital signs,the focused regional organ injury after FAST screening was determined based on the mechanism of trauma,action location and direction of external force,abdominal symptoms,and signs.The results of operation and CT scanning were considered as golden criteria and used to compare with those of ultrasonography.Results (1) The diagnostic sensitivity of FAST to abdominal organ rupture and ascites due to abdominal organ rupture calling for emergency operation was 79.3％ and 100％,respectively.The total specificity of FAST was 98.2％,positive predictive value 93.9％,and negative predictive value 86.7％.(2) The diagnostic accordance rate of single visceral injury examined by regional organ focused ultrasonography was 91.2％ and that of multiple visceral injury was 63.6％.The missed diagnoses were predominantly contusion and microlaceration.Conclusions FAST can quickly screen out the patients with unstable hemodynamics due to abdominal organ rupture calling for emergency management.Regional organ focused ultrasonography can increase the rate of correct diagnosis of visceral injury and decrease the rate of missed diagnosis.

The correlation between the anatomic site of spinal cord injury and real-time conditions of bladder and urethral function was assessed in order to provide a reasonable basis for the clinical treatment of neurogenic bladder. A total of 134 patients with spinal cord injuries (105 males, 29 females; averaged 34.1 years old) were involved in this retrospective analysis, including urodynamic evaluation, clinical examination and imaging for anatomical position, and Bors-Comarr classification. The associations between the levels of injury and urodynamic findings were analyzed. The results showed that mean follow-up duration was 16.7 months (range 8-27 months). Complete spinal cord injuries occurred in 21 cases, and incomplete spinal cord injuries in 113 cases. Of the 43 patients with upper motor neuron (UMN) injuries, hyperreflexia and (or) detrusor sphincter dyssynergia were demonstrated in 30 (69.8%), 31 (72.1%) suffered low bladder compliance (less than 12.5 mL/cmH(2)O), 28 (65.1%) had high detrusor leak point pressures (greater than 40 cmH(2)O), and 34 (79.1%) had residual urine. Of the 91 patients with lower motor neuron (LMN) injuries, areflexia occurred in 78 (85.7%), high compliance in 75 (82.4%), low leak point pressures in 80 (87.9%), and residual urine in 87 (95.6%), respectively. The associations between the anatomical site of spinal cord injury and urodynamic findings were ill defined. In patients with spinal cord injury, this study revealed a significant association between the level of injury and the type of voiding dysfunction. The anatomical site of spinal cord injury can not be predicted in real-time condition of bladder and urethral function. Management of neurogenic bladder in patients with spinal cord injury must be based on urodynamic findings rather than inferences from the neurologic evaluation.

Objective To explore the value of echo-tracking technique in the detecting the ipsilateral external iliac artery elasticity after gunshot wound in pig limbs.Methods Two-dimensional ultrasound imagings and elasticity parameters of external iliac artery of fifteen pig limbs were obtained respectively,and the results were compared with pre-injury groups.The animals were sacrificed after ultrasonography.Pathological examinations of adjacent external iliac artery of injured pig limbs were analyzed.Results Two-dimensional ultrasound imagings of external iliac arteries had no significant changes post-injury.The changes of elasticity parameters were significiant differences in the injured group comparing with the pre-injured group (P ＜0.05),including the increased stiffness parameter(β),pressure-strain elasticity modulus (Ep)and the decreased arterial compliance(AC).Pathological result showed that the internal elastic lamina of artery detected were flat,endothelial cells came off discontinuously and structure of them were undefined.Conclusions Echo-tracking technique can find the elastic changes of adjacent artery indirect injured by gunshot wound sensitively and which can suggest the occurrence of vascular indirect injury.

Poly ( duenedumethylammonuum chlorude ) ( PDDA ) functuonaluzed sulver nanopartucles ( AgNPs ) prepared wuth PDDA as the protectuve and reductuve agents was combuned wuth graphene oxude ( GO ) to prepare PDDA functuonaluzed cubuc sulver nanopartucles ( C-AgNPs)/GO composute, whuch was then modufued on a glassy carbon electrode ( GCE) to form C-AgNPs-PDDA/GO/GCE. The surface morphologues of dufferent modufued electrodes were characteruzed by scannung electron mucroscope ( SEM ) , and theur correspondung cycluc voltammetruc ( CV) behavuors were unvestugated, unducatung that the composute of C-AgNPs-PDDA/GO exhubuted excellent electrocatalytuc oxudatuon actuvuty to DA and NO-2 . By usung dufferentual pulse voltammetry, the responses of C-AgNPs-PDDA/GO/GCE were lunear un the ranges of 0 . 030-0 . 300 μmol/L and 0 . 300-300 μmol/L wuth detectuon lumut of 9. 8 nmol/L (S/N=3) for DA, and 30. 0-2300 μmol/L wuth detectuon lumut of 12. 6 μmol/L (S/N=3) for NO-2, respectuvely. The modufued electrode dusplayed good selectuvuty, reproducubuluty and stabuluty, and could be used for the sumultaneous determunatuon of DA and NO-2 un human serum samples wuth recoverues of 97. 4%-104. 2% and 98. 0%-102. 8%, respectuvely. Compared wuth spectrophotometruc method, the determunatuon results were satusfactory, showung that the modufued electrode possessed a potentual applucatuon value.

Objective To investigate the feasibility and clinical significance of fecal DNA tests for colon tumor diagnosis and screening,we inspected the mutations of APC,p53 and K-ras genes in the tissue and feces of patients with colorectal tumor.Methods We collected 46 patients with colorectal cancer(CRC),60 patients with colorectal adenomas( CRA) and 30 cases of normal person in Huizhou First People Hospital in Guangdong Province from Nov.2011 to Aug.2012.Then all the tumor tissues and feces of these people were detected the mu-tation rate about the APC,p53 and K-ras genes using polymerase chain reaction single strand conformation poly-morphism analysis method(PCR-SSCP).Results The mutation rates of APC,p53,K-ras genes of feces in CRC group,CRA group and normal group were 58.7%(27/46),65.2%(30/46)and 60.9%(28/46),20.0%(12/60),25.0%(15/60)and 23.3%(14/60),3.33%(1/30),0%(0/30)and 0%(0/30),respectively.How-ever the mutation rate in tissues were 63.0%(29/46),69.6%(32/46)and 63.0%(29/46),25.0%(15/60), 26.7%(16/60)and 26.7%(16/60),0%(0/30),0%(0/30) and 0%(0/30).Corresponding mutations could be found in feces and tumor tissues.Consistency checking for mutations rate in feces and tumor tissues of CRC group and CRA group showed that the Kappa value were 0.818(P<0.001),0.901(P<0.001),0.862(P<0.001)and 0.857(P<0.001),0.870(P<0.001),0.822(P<0.001).It means an excellent consistency.Con-clusion Fecal DNA testing is expected to become an effective noninvasive colon tumor early diagnosis and screening method.