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 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 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 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 specific ultrasonic manifestation features of intracranial foreign bodies after firearm injury,and to evaluate the value of ultrasonography in detecting intracranial foreign bodies.Methods ① The specific ultrasonic manifestation features of intracranial foreign bodies were summarized by making ultrasonic scanning over known foreign bodies of different types inserted before hand in around the injury tracts.②With the summary,ultrasonic scanning was made to the foreign bodies with unknown size and types,the result was confirmed with the fetched-out foreign bodies,and the coincidence of ultrasonography in scanning the intracranial foreign bodies after firearm injury was evaluated.Results Ultrasonography could distinguish intracranial foreign bodies from brain parenchyma,intraeranial foreign bodies of different types had different ultrasonic manifestation features.The size and the materials of the foreign bodies had certain affection on the result of ultrasonic scanning.The accuracy of qualitative judgement in scanning the intracranial foreign bodies was 71.52％,and the accuracy in scanning the foreign bodies with diameter ＞ 0.5 cm was higher than that with the diameter ＜ 0.5 cm.The coincidence in qualitative judgement of the foreign bodies of different materials ranged as follows:bullet (97 ％ )＞ steel ball (81.13％),bone pieces (78％) and glasses (72％) ＞gauze (54.67％) and wood pieces (54.67％).Conclusions The intracranial foreign bodies of different materials have specific ultrasonic manifestation features and ultrasonography can scan out their locations.The coincidence of qualitative judgement in scanning the bodies with diameter over 0.5 cm is high.Ultrasonography may be of important significance in guiding the fetch-out of intracranial foreign bodies on the spot and in raising the rescuing level of firearm injury.

Objective To evaluate the impact of sarpogrelate on the in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) in peripheral arterial diseases (PAD).Methods PAD patients who had PTA for the first time were divided into two groups receiving respectively clopidogrel and aspirin (clopidogrel group) or sarpogrelate and aspirin (sarpogrelate group).Vascular ultrasonography was performed at 6 months after PTA in all patients to evaluate the degree of ISR.Results 62 patients finished the follow-up visits as required.The in-stent restenosis in the sarpogrelate group and clopidogrel group was 7.0％ vs.18.1％ (P =0.036),the peak systolic velocity ratio was 1.34 vs.2.08 (P =0.010) and the cases of ISR was 1 vs.10 (P =0.005) respectively.No patients reported serious adverse events.Conclusions Sarpogrelate combined with aspirin is safe and effective.Compare with clopidogrel and aspirin,sarpogrelate and aspirin can significantly reduce the rate of ISR after PTA and the intimal proliferation in the stent.

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.

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.

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.

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.