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Objective:To explore the method of ultrasonography for detecting the fetal umbilical vein diameter, blood flow volume and normalized volume blood flow and establish normal reference ranges with umbilical vein diameter, blood flow volume and normalized blood flow and Z-scores for umbilical vein diameter and blood volume flow.Methods:This was a prospective study on 907 normal fetuses in the Second Xiangya Hospital, Central South University and Women and Children Healthcare Hospital of Zhuzhou from March 2019 to December 2020. The umbilical vein diameter (Duv), umbilical vein blood flow volume (Quv) and normalized volume blood flow (nQ = Quv/estimated fetal weight) of the free loop of umbilical vein (FUV) and fetal intra-abdominal umbilical vein (IUV) were collected. And the mean values and 90% confidence intervals of Duv, Quv and nQ in two segments of umbilical veins at different gestational ages were calculated. Regression analysis of Duv, Quv and nQ were performed with gestational age (GA), and the parameters of umbilical vein in different segments were compared. Finally, with gestational age (GA) as the independent variable, Z-scores of the Duv and Quv were built.Results:The mean values and 90% confidence intervals of Duv, Quv, and nQ in 858 (94.6%) normal fetal umbilical veins were successfully obtained. The Duv, Quv of the FUV and IUV increased as pregnancy progressed. The Quadratic curve of Duv and Linear curve of Quv were of the highest fitnesses, respectively( r=0.951, 0.941, 0.986, 0.982; all P<0.001). While nQ increased with GA followed by a decreased trend, and the Quadratic curve was the highest fitting curve of nQ( r=0.610, 0.611; all P<0.001). Duv-FUV was greater than Duv-IUV( P<0.001), nQ-FUV was bigger than Quv-IUV( P=0.001), and he difference was not statistically significant between Quv-FUV and Quv-IUV( P=0.133). Z-scores models of Duv and Quv were successfully established, and all Z-scores were Gaussian distribution. Conclusions:The normal ranges and Z-scores of umbilical vein parameters are useful to improve the evaluation of placental circulation and provide a strong basis for the monitoring of fetus-related diseases and the evaluation of pregnancy prognosis. The choice of FUV or IUV umbilical vein to evaluate placental circulation may depend on the actual situation in clinical application.
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Background@#and Purpose Brainstem gliomas (BSGs) in adults are rare brain tumors with dismal outcomes. The aim of this study was to determine the clinical and genetic features in a series of BSGs and their association with the prognosis. @*Methods@#Fifty patients who underwent a stereotactic biopsy between January 2016 and April 2018 at a single institution were collected. Data on clinicopathological characteristics were analyzed and factors associated with patient survival were identified using a Cox regression model. @*Results@#The median age at diagnosis was 55.5 years, and 62% of the patients were male. Glioblastoma (44%) accounted for the largest proportion of BSGs, and oligodendroglioma (2 of 50) was rarely encountered. The IDH mutation (6 of 44) occurred infrequently in astrocytomas, and IDH-mutant tumors harbored both ATRX loss and MGMT promoter methylation at a relatively low level. Wild-type IDH astrocytomas were identified as having high rates of 1p/19q codeletion (5 of 38) and loss of heterozygosity 1p (8 of 38) or 19q (8 of 38) only. In diffuse midline glioma H3K27M mutant, MGMT promoter methylation occurred in three of four cases. Patients were offered radiotherapy and/or concurrent/adjuvant temozolomide chemotherapy, and their median survival time was 13 months. Multivariate analysis revealed that a low tumor grade, absence of tumor enhancement, duration of symptoms ≥3 months, Karnofsky performance status ≥70, and ATRX loss conferred a survival advantage. @*Conclusions@#Adult BSGs showed different molecular genetic characteristics, but also resembled supratentorial gliomas in their clinical features associated with oncological outcomes.
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Background@#and Purpose Brainstem gliomas (BSGs) in adults are rare brain tumors with dismal outcomes. The aim of this study was to determine the clinical and genetic features in a series of BSGs and their association with the prognosis. @*Methods@#Fifty patients who underwent a stereotactic biopsy between January 2016 and April 2018 at a single institution were collected. Data on clinicopathological characteristics were analyzed and factors associated with patient survival were identified using a Cox regression model. @*Results@#The median age at diagnosis was 55.5 years, and 62% of the patients were male. Glioblastoma (44%) accounted for the largest proportion of BSGs, and oligodendroglioma (2 of 50) was rarely encountered. The IDH mutation (6 of 44) occurred infrequently in astrocytomas, and IDH-mutant tumors harbored both ATRX loss and MGMT promoter methylation at a relatively low level. Wild-type IDH astrocytomas were identified as having high rates of 1p/19q codeletion (5 of 38) and loss of heterozygosity 1p (8 of 38) or 19q (8 of 38) only. In diffuse midline glioma H3K27M mutant, MGMT promoter methylation occurred in three of four cases. Patients were offered radiotherapy and/or concurrent/adjuvant temozolomide chemotherapy, and their median survival time was 13 months. Multivariate analysis revealed that a low tumor grade, absence of tumor enhancement, duration of symptoms ≥3 months, Karnofsky performance status ≥70, and ATRX loss conferred a survival advantage. @*Conclusions@#Adult BSGs showed different molecular genetic characteristics, but also resembled supratentorial gliomas in their clinical features associated with oncological outcomes.
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Objective:To explore the relationship of lymphocyte function-associated antigen 3 (LFA-3, CD58) expression in glioma with clinical features and its role in clinical prognosis. Methods:Clinical data and mRNA microarray data of 514 patients with glioma were obtained from The Cancer Genome Atlas and were used to study the expression of LFA-3 (CD58). Cox regression was used to analyze the relationship between CD58 expression and survival of patients with glioma. Multivariate analysis of variance was used to further analyze the relationship of CD58 with age, sex, and pathological grade of glioma. Results:The results of the stratified χ2 test of CD58 expression and tumor grading were shown, considering tumor type, gender and age of diagnosis (all P<0.05). CD58 expression was sig-nificantly correlated with overall survival (OS) and disease-free survival (DFS) of patients with glioma. Patients with high CD58 expres-sion presented short OS and DFS (P<0.0001). Conclusion:CD58 possibly promotes tumorigenesis in gliomas and thus can serve as a potential tumor diagnostic marker and individual therapeutic target.
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Objective To analyze computed tomography imaging features of primary adrenal schwannoma.Methods The clinical and radiological data of six cases of adrenal schwannoma confirmed by histopathology were analyzed in this study.Results All six cases of adrenal schwannoma were well-circumscribed,round-like or oval-like,solid and cystic tumors,in which two cases were with calcification,and three cases with septations.On the enhanced CT images,all six tumors displayed progressive enhancement.Conclusion Adrenal schwannoma usually presents a well-defined heterogeneous mass with cystic degeneration,sepations,calcification and characteristic progressive contrast enhancement.
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Purpose To analyze the clinicopathologic features, immunophenotypes, image features and diagnosis of hemangioblastoma.Methods The clinical and pathological features were studied with HE and immunohistochemical staining in 40 cases of hemangioblastoma.The image features were studied with CT and MRI.Results The clinical symptoms of these cases were dizziness,headache,vomitting, optic disc edema and ataxia. The CT and MRI showed a sharply demarcated tumor with cystic areas and a solid mural nodule. After enhancement scanning, the mural nodule was usually enhanced and the wall of the cystic area was not. Histopathologically, this tumor was characterized by two main components: capillary and stromal cells. Immunohistochemically, the endotheliocyte was positive for CD34 and FⅧRAg, but most of the stromal cells were positive for S-100 and part of the cells were also positive for NSE. The endotheliocyte and the stromal cell were all positive for vimentin, but negative for GFAP, EMA and p53. The expression of Ki-67 was very low.Conclusions Hemangioblastoma is characterized by stromal cells and numerous capillary, but the origin of the stromal cell is not clear. Its image features have some characteristics. It needs to be distinguished from pilocytic astrocytoma, angiomatous meningioma and renal carcinoma.
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[Objective]To explore the value of different surgical methods in the treatment of the displaced femoral neck fracture in the elderly.[Method]A follow up study was done on 95 cases older than 65 years who were treated with internal fixation,femoral head arthroplasty and total hip joint replacement from 2003 to 2008.The differenee upon operation time,blood loss,duration of hospitalization,joint function evaluation one and two years after operation,complications and reoperation rate were compared.[Result]The internal fixation group had the shortest operation time and hospitalization and the least blood loss but the highest immobilization time,highest co-mplication rate and reoperation rate as we1l as the worst joint function.While the total hip joint repl acement group had the least immobilization time,the lowest compliction rate and reoperation rate,best joint function but required better health condition.The femoral head arthroplasty group had the least operation injury but had relative higher reoperation rate and worse joint function compared to the total hip joint replacement group.[Conclusion]Prosthetic replacement is reliable to treat femoral neck fractures in the elderly.