Biliary atresia is a severe chronic liver disease in infancy that manifests as destructive inflammatory obstructive cholangiopathy.Recent evidence supports that early Kasai procedure by 30 days of life achieves the greatest likelihood of slowing or preventing the need for liver transplant in biliary atresia patients.Unfortunately,the average age at the time of Kasai procedure is around 60 days of life both in China and abroad.The primary reason for this is that there are many difficulties and challenges in early diagnosis.For example,age stratification should be considered when using GGT levels as a screening tool for biliary atresia in infant less than 30 days.What's more,imaging modality such as US shows lower accuracy in very early stage due to milder pathological change in biliary tract,which post challenges on precision medicine and improving prognosis.This article reviewed different early diagnostic methods of screening for biliary atresia,so as to provide a reference for the early diagnosis of biliary atresia,and help discuss the potential development prospect and research direction in the future.

Objective To develope and evaluate the outcomes of combining"Curriculum Ideological and Political Education"with interactive teaching in ultrasonic practice class.Methods Fifty-one sophomores in the medical en-gineering cross experimental class of Beihang University who participated in the ultrasonic course in 2022 were se-lected as research objects.They were divided into two groups:one group adopted the classic teaching mode,the an-other group adopted the"Curriculum Ideological and Political Education"interactive teaching mode.After the train-ing,a questionnaire survey and a written examination of basic knowledge were conducted.The test scores of the two groups and the feedback from questionnaires for teaching effect were compared.Results There was no significant difference in the theoretical exam achievement rate between the two groups of students.The students'learning initia-tive and understanding of doctors'profession after the application of this new training method were significantly im-proved as compared with the classic lecture group,with a statistical difference.Student feedback showed that more ideological and political elements needed to be integrated into the ultrasound medicine classroom.Conclusions It is a good teaching method to integrate the interactive teaching of"Curriculum Ideological and Political Education"with learning of ultrasonic specialized courses.

Objective:To investigate the clinical and radiological outcomes of ultrasound guided injection of platelet-rich plasma (PRP) in the treatment of intratendinous rotator cuff tear.Methods:A retrospective study was conducted to analyze the clinical data of 43 patients (46 shoulders) who had been treated for intratendinous partial-thickness rotator cuff tear by ultrasound guided injection of PRP consecutively from July 2021 to March 2022 at Department of Sports Medicine, Peking University Third Hospital. There were 23 males and 20 females, with an age of (47.8±13.5) years and a course of disease of 6 (4, 18) months, involving 22 left shoulders and 24 right shoulders. The visual analog scale (VAS) pain score, the University of California at Los Angeles (UCLA) rating scale, and the shoulder index of the American Shoulder and Elbow Surgeons (ASES) were determined before injection and at the last follow-up. The changes in tear size were also evaluated by magnetic resonance imaging (MRI) before PRP injection and 3 to 5 months after PRP injection.Results:The 43 patients were followed up for 15 (12, 17) months after treatment. Of this cohort, 7 shoulders (15.2%, 7/46) were recovered to complete normal and very satisfied with the injection effects while 19 shoulders(41.3%, 19/46) satisfied with the effects after injection, yielding an overall satisfaction rate of 56.5% (26/46). At the last follow-up, the VAS score [3.0 (2.0, 4.0) points], ASES score [80.0 (65.0, 88.8) points], and UCLA score [29.0 (20.0, 32.0) points] were significantly improved compared with those before injection [5.5 (4.0, 8.0) points, 55.0 (39.2, 65.0) points, and 16.0 (12.0, 20.3) points] ( P < 0.05). MRI evaluation showed the tear volume was significantly reduced after PRP injection [46.1 (20.9, 77.5) mm 3 before injection versus 28.2 (12.5, 63.6) mm 3 after injection] ( P<0.05), and a >50% tear volume diminution was observed in 13 shoulders (34.2%,13/38). There were no complications during or after injection. Conclusion:As the ultrasound guided injection of PRP into intratendinous lesions is effective and safe for patients with intratendinous partial-thickness rotator cuff tear, it can be an alternative treatment for the patients or professional athletes who are unwilling to undergo surgery.

Objective:To study the value of "database of introspection and feedback for difficult cases" in process management of residents in the department of ultrasound.Methods:Twenty-five residents trained in the department of ultrasound from September 2018 to August 2019 were enrolled to the study group, and 27 residents trained from September 2017 to August 2018 were placed to the control group. The study group recorded the difficult or misdiagnosed cases as well as their introspection and feedback, and the teachers organized group case teaching every week to make up the deficiency of their students according to the feedback database. The database was also one of the references of the teaching committee for the modifying of teaching rounds. SPSS 17.0 was used for t test. Results:The annual clinical thinking tests showed that the average scores of grade 1 and 2 of the study group were significantly higher than those of the control group with the same seniority [(88.0±2.0) vs. (85.2±2.1), (86.9±2.3) vs. (84.3±2.6)]. The questionnaires showed that the residents' initiative and pertinence in learning and the teachers' understanding of the learning situation of their students were increased.Conclusions:"Database of introspection and feedback for difficult cases" is an effective method in the process management, and could improve the training quality of residents in the department of ultrasound.

Objective:Based on the research results of the national continuing medical education project "musculoskeletal ultrasound and new technology quality class" held by the Department of Ultrasound Diagnosis of Peking University Third Hospital, to explore and analyze the effect of basic and applied teaching method based on musculoskeletal ultrasound.Methods:Totally 109 participants attending the classes held on April 14-18, 2019 and on September 9-13, 2019 were selected as study objects, and the training effects of quality private classes were evaluated by questionnaires, operational tests and theoretical tests. SPSS 21.0 was used for t test. Results:The results showed that more than 80% of students were satisfied with the teaching content, teaching plan and teaching materials. Through the class training, the greatest gains of the students were that the operation ability [67 cases (30.7%)] and the theoretical level [53 cases (24.3%)] had been significantly improved. All 109 students passed the operation test. There were no statistical differences in the average scores of theoretical tests among the students with different professional titles, academic qualifications and whether they were from primary hospitals (75-80 points, P>0.05) . Conclusion:The musculoskeletal ultrasound quality private class can improve the students' operating ability and theoretical level in the musculoskeletal system. The class model can guarantee the teaching quality and provide a new direction for continuing medical education.

Humans ; Arthroscopy ; Injections, Intra-Articular ; Hip Joint/surgery* ; Pain ; Ultrasonography, Interventional ; Treatment Outcome

Objective:To investigate the clinical value of ultrasound shear wave dispersion (SWD) imaging in assessing the hepatic inflammation activity in patients with chronic hepatitis B.Methods:Fifty-two patients with chronic hepatitis B who underwent liver biopsy in Peking University Third Hospital and Beijing Ditan Hospital Affiliated to Capital Medical University from December 2020 to December 2021 were prospectively enrolled.Liver stiffness (LS) and shear wave dispersion slope (SWDS) were measured by SWD imaging in all participants. Baseline data and laboratory indexes of liver function were collected.Liver inflammation grading(G0-G4) and fibrosis staging (S0-S4) were determined by pathological examination. The relationship between SWDS and various indicators was analyzed by univariate and multivariate linear regression analysis. The participants were grouped according to the pathological grading of hepatic inflammatory activity. The differences of various indexes among three groups were compared, and the correlations between SWDS, LS and laboratory indicators and hepatic inflammatory activity were analyzed. The ROC curve was used to evaluate the diagnostic performances of ultrasound and laboratory indicators for hepatic inflammation activity, and the diagnostic accuracy of different indicators was compared by Delong test.Results:Inflammation and fibrosis were both independent affecting factors of SWDS (all P<0.05); there were significant differences in alanine transaminase(ALT), aspartate aminotransferase(AST), LS and SWDS among groups with different inflammatory activities (all P<0.05). The SWDS and LS of the G3 and G2 groups were statistically higher than those of the G1 group (all P<0.001). ALT was only significantly different between G1 group and G2 group ( P<0.05), and AST was only significantly different between G1 group and G3 group ( P<0.05); The SWDS and LS showed strongly positive correlation ( rs=0.728, P<0.001) and moderately positive correlation ( rs=0.679, P<0.001) with hepatic inflammatory activity, respectively; while the correlations between ALT, AST and hepatic inflammatory activity were weaker( rs=0.376, P<0.05; rs=0.485, P<0.001). The area under the ROC curve, sensitivity and specificity of SWDS for diagnosing hepatic inflammation ≥G2 grade were 0.965, 0.933 and 0.865, respectively. Conclusions:SWDS has certain value in evaluating the hepatic inflammatory activity of ≥G2 grade in patients with chronic hepatitis B.

Objective:To explore the relationship between personality traits and procrastination in young people and the mediating role of self-control.Methods:A total of 344 college students (191 males and 153 females) were assessed with the Mini-IPIP Scale (Mini-IPIP), Dual-Mode of Self-Control Scale (DMSC-S, including control system and impulse system) and General Procrastination Scale (GPS).Results:The GPS scores were negatively correlated with scores of agreeableness subscale and conscientiousness subscale (r=-0.13, -0.53, Ps＜0.05), and positively correlated with scores of neuroticism subscales (r=0.27, P＜0.01).The structural equation modeling supported the impulse system fully mediated the relationship between neuroticism and procrastination (η2=0.15, 95％CI=0.02-0.25), and those two systems partly mediated the relationship between conscientiousness and procrastination (η2=0.20, 0.20;95％CI=-0.38——0.05, -0.70——0.24).Conclusion:The relationship between youth personality and procrastination may be mediated by a dual system of self-control.Additionally, the degree to how self-control affects the relationship between big five personality trait and procrastination is different under the different types of personality.

To explore the clinical application value of high‐frequency contrast‐enhanced ultrasound in guiding peripheral lung consolidation biopsy . Methods Clinical data of 33 patients with peripheral pulmonary w ho underwent high‐frequency contrast‐enhanced ultrasound biopsy were retrospectively analyzed . According to the pathological results as the gold standard ,the puncture path , needle tip display ,puncture complications and the diagnostic rate of pathological results were described . Results Among the 33 patients ,32 patients had pathological findings ,including 18 malignant lesions ,14 benign lesions ,and 1 non‐effective tissue . ①T he difference between lesion enhancement and peripheral lung tissue enhancement time within 2 .5 s were in 20 patients ( 12 benign ,8 malignant) ,12 patients ( 2 benign ,10 malignant) showed difference greater than 2 .5 s . T here were 19 cases with uniform enhancement ,including 9 benign cases ( 28 .1% ) ,10 malignancy cases ( 31 .3% ) ; 13 cases with uneven enhancement ,including 5 cases with benign ( 15 .6% ) ,8 cases with malignancy ( 25 .0% ) . T he rate of relatively uneven enhancement of malignant lesions was higher ,but the difference was not statistically significant ( P ＝0 .618 ) . ② High‐frequency contrast‐enhanced images were scored at 2 points or more in 28 cases ( 87 .5% ) ,and the high‐frequency contrast‐enhanced ultrasound images were satisfactory . ③Interventional puncture path score was 2 points or more in 29 cases ( 90 .6% ) . ④Puncture needle tip display were scored at 1 point or more in 28 cases ( 87 .5% ) . ⑤A total of 87 needles were punctured ,and 32 cases obtained pathological diagnosis of puncture ( 97 .0% ,32/33) . Conclusions Due to its high spatial resolution ,high‐frequency ultrasound can avoid adjacent tissues and blood vessels by showing the position of the needle tip in real time without the need of puncture frame and multi‐angle needle insertion during operation ,and accurately locate the target with good safety .

Combining with the feature of ultrasound medicine and obeying the basic principle of feedback, we introduced the sandwich feedback method into standardized training of residents. By telling residents where improvement was needed, residents could clearly know their goal in the process of training. The training pass rate in the sandwich feedback method group and the traditional teaching method group were compared and the results showed that the pass rate in the sandwich feedback method group was higher than that in the traditional teaching method group, indicating that the introduction of sandwich feedback method can help residents comprehend their abilities in time and find out their shortcomings and advantages, so as to improve continuously. In addition, it would effectively supervise and urge teachers to continuously improve their teaching awareness and level.