This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The “whirlpool sign” of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus. The degrees of rotation of the SMV winding around SMA were also detected by sonography. Surgery was performed in patients with sonography diagnosed malrotation.A total of 39 patients were sonographically diagnosed as malrotation which was subsequently confirmed by surgery. The sensitivity and positive predictive value of the sonographic diagnosis were both 100% (39/39). The sensitivity, specificity and accuracy of “whirlpool sign” for the detection of midgut volvulus were 95.2% (20/21), 88.9% (16/18), and 92.3% (36/39), respectively. Greater degrees of rotation (equal or greater than 720°) showed higher risk (odds ratio, 5.0; P < .01) for intestinal necrosis occurrence.Sonography is more accurate in diagnosing suspected malrotation than upper gastrointestinal contrast study. Specific sonographic “whirlpool sign” related to volvulus may be used as a potential indicator for intestinal necrosis. In addition, sonography can exclude malrotation and may help the diagnosis of other diseases, such as annular pancreas and duodenal atresia.

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Traffic congestion in inland waterways caused by insufficient throughput capacity of locks has become a compelling problem in developed inland shipping countries. In order to avoid excessive time wasted in waiting for lock service, it is suggested that some types of cargoes should be unloaded at the quays and transported by road/train to their destinations, which is called water–land transshipment. By this means, the ships are divided into two groups that either pass the lock or are transshipped at the quays, engendering the lock and water–land transshipment co‐scheduling (LWTC) problem. This paper focuses on the LWTC, where the roll‐on roll‐off ships, passenger ships, and general cargo ships that can be transshipped and other ships that can only pass the lock are considered in a lock‐quay co‐scheduling system. The LWTC problem is decomposed into an outer‐layer main 0‐1 optimization problem and two inner‐layer subproblems: lock scheduling and berth allocation. A multiobjective optimization model is proposed for the LWTC problem based on its two‐layer structure. To solve the LWTC problem, a hybrid heuristic method is proposed, where a modified binary nondominated sorting genetic algorithm II is proposed to solve the main problem, and the two subproblems are solved by specific heuristics. The proposed model and hybrid method are tested on instances extracted from historical data of traffic at Three Gorges Dam, the results of which demonstrate the feasibility of the model and the superiority of the proposed hybrid heuristic method over other comparisons.

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