The application value of a special surface fence in percutaneous transhepatic cholangial drainage under the guidance of C-arm CT / 实用放射学杂志

Objective To explore the application value of a special fence in percutaneous transhepatic cholangial drainage(PTCD)under the guidance of C-arm CT.Methods A total of 43 patients who underwent PTCD were randomly divided into observation group and control group.The intervention operation in the observation group was guided by C-arm CT and located by special fence;in the control group,the intervention operation was only performed under digital subtraction angiography(DSA)fluoroscopy.Respectively,the differences in operation time,number of puncture needles and number of complications between the two groups were compared.Results The operation time,puncture times and complications in the observation group were(39.33±12.96)min,(1.67±0.80)times and 3 cases respectively;in the control group were(86.77±22.70)min,(3.41±1.26)times and 13 cases respectively;There were significant differences between the two groups(P<0.05).Conclusion The application of special fence in PTCD under the guidance of C-arm CT can short the operation time,reduce the number of punctures and reduce complications,which has important clinical application value.

Effect of depression on response to ursodeoxycholic acid and the occurrence of liver cirrhosis in patients with primary biliary cholangitis / 临床肝胆病杂志

ObjectiveDepression is common in patients with primary biliary cholangitis （PBC）， but the role of depression in disease progression remains unclear. This study aims to investigate the association between depression and treatment response and the impact of depression on liver cirrhosis in PBC patients. MethodsA retrospective analysis was performed for the clinical data of 141 patients with PBC who attended the outpatient service of autoimmune liver diseases in General Hospital of Tianjin Medical University from January 2018 to December 2020 and received standard ursodeoxycholic acid （UDCA） monotherapy for 1 year， and 170 healthy controls， matched for age and sex， who underwent physical examination in Physical Examination Center were enrolled as healthy control group. Patient Health Questionnaire-9 （PHQ-9） was used to evaluate depressive state in the patients with PBC and the healthy controls. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The binary logistic regression model and the decision tree model were used to analyze the influencing factors for liver cirrhosis in patients with PBC， as well as the influence of depression and the HLA-DRB1 gene on liver cirrhosis. The receiver operating characteristic （ROC） curve， the area under the ROC curve （AUC）， and goodness of fit were used to evaluate model performance. All 13 variables were used to establish a classification and regression tree （CART） model， i.e.， age， sex， PHQ-9 score， the DRB1*03∶01 gene， and the serum levels of alanine aminotransferase， aspartate aminotransferase， alkaline phosphatase （ALP）， gamma-glutamyl transpeptidase （GGT）， total bilirubin， immunoglobulin G， immunoglobulin M （IgM）， C3， and C4. The indications including AUC， sensitivity， and specificity were used to evaluate the performance of CART model in the model cohort. ResultsCompared with the normal control group， the PBC group had a significantly higher proportion of the patients with depression （53.9% vs 15.3%， χ2=57.836， P<0.001）. Compared with the PBC patients without depression， the PBC patients with depression had a significantly poorer response to UDCA treatment （χ2=7.549， P=0.006） and significant increases in the serum levels of ALP （Z=-2.157， P=0.031）， GGT （Z=-2.180， P=0.029）， and IgM （Z=-2.000， P=0.046）. Compared with the PBC patients without depression， the PBC patients carrying the HLA-DRB1*03∶01 allele had a significant increase in the risk of liver cirrhosis （P<0.001）. The binary logistic regression model analysis showed that PHQ-9 score （OR=1.148， 95%CI： 1.050 — 1.255， P=0.002）， the HLA-DRB1*03∶01 gene （OR=5.150， 95%CI： 1.362 — 19.478， P=0.016）， age （OR=1.057， 95%CI： 1.009 — 1.106， P=0.018）， and serum ALP level （OR=1.009， 95%CI： 1.001 — 1.017， P=0.020） were independent risk factors for liver cirrhosis in patients with PBC. The decision tree analysis showed that PHQ-9 score ≥3.5 was also a risk factor for liver cirrhosis in PBC patients. ConclusionDepression is associated with poor treatment response in patients with PBC， and it is an independent risk factor for liver cirrhosis in patients with PBC. This study highlights the important clinical significance of the identification and early management of depressive state in patients with PBC.

Modified Latarjet splitting subscapularis muscle under arthroscopy: an anatomical study based on axillary nerve, glenoid, and subscapularis muscle / 中国修复重建外科杂志

OBJECTIVE@#To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting.@*METHODS@#A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively.@*RESULTS@#In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane.@*CONCLUSION@#In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.

Penehyclidine hydrochloride regulates angiopoietin 2/vascular endothelial cadherin (Ang2/VE-cadherin) pathway to alleviate LPS induced lung injury in rats / 细胞与分子免疫学杂志

Objective To explore the effect and mechanism of penehyclidine hydrochloride (PHCD) on vascular endothelial injury in septic rats. Methods Fifty male SD rats were randomly divided into control group, lipopolysaccharide (LPS) induced sepsis group (model group), low dose PHCD (0.3 mg/kg) group, medium dose PHCD (1.0 mg/kg) group and high dose PHCD (3.0 mg/kg) groups, ten mice for each group. Normal saline was injected into the tail vein of the control group, and 10 mg/kg lipopolysaccharide (LPS) was injected into the tail vein of the rats in other groups to prepare the sepsis rat models. After the models were successfully established, low, medium and high doses (0.3, 1.0, 3.0 mg/kg) of PHCD solution were injected into the tail vein of the rats of corresponding groups. Wet/dry mass ratio (W/D) of lung tissue of rats in each group was measured, and ELISA was used to assay interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6 content and rat plasma angiopoietin 2 (Ang2) content in bronchoalveolar lavage fluid (BALF). HE staining was used to observe the pathological changes of lung tissues. Immunohistochemical staining was used to observe the expression of Ang2 in the right lung tissues. Western blot analysis was performed to detect Ang2 and vascular endothelial cadherin (VE-cadherin) protein in lung tissues. Results Compared with the control group, the W/D ratio of the lung tissues of rats in the model group and the contents of IL-1β, IL-6 and TNF-α in BALF were significantly increased; the lung tissues showed obvious pathological damage, with up-regulation of Ang2 expression and down-regulation of VE-Cadherin expression. Compared with the model group, the W/D ratio of the lung tissues of rats in three PHCD treatment groups and the contents of IL-1β, IL-6 and TNF-α in BALF were significantly reduced; the pathological damage of lung tissue was significantly reduced, with down-regulation of Ang2 expression and up-regulation of VE-cadherin expression. Conclusion PHCD can reduce LPS-induced lung inflammation in rats with sepsis by regulating the Ang2/VE-Cadherin pathway, thereby improving vascular endothelial injury.

A nomogram model integrating LI-RADS features based on MRI for predicting microvascular invasion in hepatocellular carcinoma following Milan criteria / 中华放射学杂志

Objective:To establish and verify a nomogram model based on MRI liver imaging reporting and data system (LI-RADS) features for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) following the Milan criteria.Methods:A retrospective analysis was conducted on data from 118 HCC patients (121 lesions) confirmed by pathology from June 2016 to June 2022 at the Third Affiliated Hospital of Soochow University. Forty-seven HCCs were diagnosed as MVI-positive and 74 HCCs as MVI-negative. The data was randomly divided into the training set (83 patients with 84 HCCs, including 31 MVI-positive and 53 MVI-negative HCCs) and the test set (35 patients with 37 HCCs, including 16 MVI-positive and 21 MVI-negative HCCs) using cross-validation method. HCC imaging features were evaluated based on LI-RADS (version 2018). In the training set, the χ 2 test was used to compare the differences in LI-RADS features between the MVI-positive group and the MVI-negative group. The logistic regression analysis was conducted to identify independent risk factors for predicting MVI-positive and to construct the nomogram model. The receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to evaluate the performance and clinical benefits of the nomogram model in predicting MVI tumors. Results:There were statistically significant differences between the MVI-positive group and the MVI-negative group in terms of tumor size, tumor margin, mosaic architecture, and corona enhancement ( P<0.05). Multivariate logistic analysis results showed that HCC maximum diameter>3 cm (OR=1.427, 95%CI 1.314-12.227, P=0.009), nonsmooth tumor margin (OR=3.167, 95%CI 1.227-461.232, P=0.041), mosaic architecture (OR=1.769, 95%CI 1.812-61.434, P=0.022), and corona enhancement (OR=4.015, 95%CI 3.327-836.384, P=0.011) were independent risk factors for predicting MVI-positive tumors. Based on the independent predictors, the constructed nomogram model demonstrated an area under the ROC curve of 0.863 (95%CI 0.768-0.947) and 0.887 (95%CI 0.804-0.987) in the training and test sets for predicting MVI tumors, respectively. DCA showed that the curve of the nomogram model was consistently above the treat-all and treat-none strategies across all reasonable threshold probabilities in the training set, indicating that patients could obtain clinical benefits from the model. Conclusions:The preoperative nomogram model based on MRI LI-RADS features can effectively predict MVI in HCC following the Milan criteria, which could benefit the patients.

Comparison of magnetically controlled capsule gastroscopy and conventional gastroscopy for gastric and duodenal examination of children / 中华消化内镜杂志

Objective:To investigate the clinical application value and safety of magnetically controlled capsule gastroscopy (MCCG) in gastric and duodenal examination of children in comparison with conventional gastroscopy.Methods:Data of 160 outpatients or inpatients with abdominal pain accompanied by Helicobacter pylori infection aged 8-16 who underwent either MCCG or conventional gastroscopy in Shanghai Children's Hospital from March 2020 to March 2022 were retrospectively analyzed. Children were divided into the MCCG group ( n=80) and the conventional gastroscopy group ( n=80) according to different examination methods. The detection and examination time of lesions in upper gastrointestinal tract, tolerance and safety between the two groups were analyzed. Results:MCCG was successfully performed in 79 children and conventional gastroscopy was successfully performed in 78 children, respectively. The positive detection rates were 1.3% (1/79) and 1.3% (1/78) in the esophagus ( χ2=0.000, P>0.999), 87.3% (69/79) and 91.0% (71/78) in the stomach ( χ2=0.552, P=0.327) , 15.2% (12/79) and 19.2% (15/78) in duodenum ( χ2=0.450, P=0.533) with no significant difference between the two groups. There was no significant difference in the examination time [72.0 (41.0, 109.5) min VS 6.0 (4.3, 7.0) min, U=24, P<0.001] in the MCCG group and the conventional gastroscopy group. No adverse event occurred in either group. Conclusion:There is no significant difference in the detection rate of gastric and duodenal lesions between the MCCG group and the conventional gastroscopy group. MCCG is safe and stable, and can be used as an diagnostic tool for gastric and duodenal diseases in children.

The value of bronchoalveolar lavage fluid genechip analysis for the identification of pathogens in children with refractory pneumonia / 中华实用儿科临床杂志

Objective:To investigate the value of bronchoalveolar lavage fluid (BALF) genechip analysis for the identification of pathogens in children with refractory pneumonia.Methods:A retrospective study of 500 children clinically diagnosed with refractory pneumonia in the Department of Respiratory and Critical Care Medicine, Kunming Children′s Hospital, Kunming Medical University between January 2020 to January 2022 was made.During hospitalization, bronchoscopic examination and bronchoalveolar lavage were performed.BALF was collected and analyzed using genechip technology to detect potential pathogens.At the same time, bacterial culture tests of sputum and BALF samples from the patients were performed. χ2 test was used to compare the positive rates of pathogens detected by different detection methods. Results:Of the 500 children patients, 482 cases (96.4%) were positive of BALF genechip analysis for pathogen identification.There were 71 cases (14.7%) infected with a single pathogen, and 411 cases (85.3%) with 2 or more pathogens.The top 3 bacteria were Streptococcus pneumoniae [117 cases (8.3%)], Haemophilus influenzae [63 cases (4.5%)], and Bordetella pertussis [32 cases (2.3%)]. The patients were mostly infected with respiratory syncytial virus [269 cases (19.1%)], followed by parainfluenza virus [217 cases (15.4%)], and adenovirus [132 cases (9.3%)]. Among the 500 patients, 116 cases (23.2%) were positive of BALF genechip analysis for bacteria identification, 47 cases (9.4%) had a positive BALF culture, 43 cases (8.6%) had a positive sputum culture.The bacterial detection rate of BALF genechip analysis was statistically significantly higher than that of BALF culture and sputum culture tests ( χ2=34.90, 39.85; all P<0.001). Conclusions:Most patients with refractory pneumonia have mixed infections.The genechip technology can rapidly and efficiently identify the pathogens, thus providing clinical guidance for anti-infection treatment.

Mechanism, prevention and treatment of acute lung injury caused by 2019-nCoV infection / 国际儿科学杂志

The main target organ of 2019 novel coronavirus(2019-nCoV)was the lung and acute respiratory distress syndrome, a life-threatening condition, could happen in severe cases.The main receptor of 2019-nCoV is angiotensin-converting enzyme 2(ACE2). Other receptors reported included CD147, tyrosine protein kinase receptor UFO, Neuropilin-1, Kidney injury molecule-1, et al.When 2019-nCoV is bound with ACE2, the expression of ACE2 would be down-regulated, which causes an increased angiotensin level and consequent lung injury through downstream signals.In addition, 2019-nCoV infection can induce inflammatory cytokine storm, cause coagulation dysfunction, trigger lung epithelial cell apoptosis, et al, which collaboratively contribute to lung injury.The clinical symptoms of 2019-nCoV infection in children are mild, which is thought due to the advantages of children in innate immune response and the low level of adaptive immune response.The fundamental means to prevent and treat lung injury was inhibiting the proliferation and replication of the 2019-nCoV virus, but so far, there are no specific antiviral drugs found yet.Approaches like recombinant human soluble ACE2 protein, neutralizing antibody against protein S, inhibiting angiotensinⅡ, contradicting inflammation factors, or stem cell infusion may be helpful to prevent and alleviate lung injury.

Effect of hepatic fibrosis on proton density fat fraction based on histogram analysis in evaluating hepatic steatosis: an experimental study / 中华放射学杂志

Objective:To explore the value of proton density fat fraction(PDFF) based on histogram analysis for quantification hepatic steatosis and fibrosis in rabbit model and the interference of hepatic fibrosis to the evaluation of hepatic steatosis with PDFF.Methods:From March to November 2020, 135 New Zealand white rabbits were randomly divided into control group ( n=30) and experimental group ( n=105) using a random number table. The volume ratio of CCl 4 and olive oil was 1∶1 to prepare 50% CCl 4 oil solution, and experimental rabbits were subcutaneously injected with the oil solution. An equal dose of normal saline was subcutaneously injected for control group rabbits. At the end of the 4 th, 8 th, and 12 th week, 35 in the experimental group and 10 rabbits in the control group were randomly selected to conduct the mDixon-Quant scanning, and histogram analysis of PDFF was analyzed including volume, mean, median, standard deviation, 25 th, 50 th, 75 th, 90 th quantile, skewness, kurtosis, entropy and inhomogeneity. After the examination, the rabbits were sacrificed and the liver percentage of steatosis (PSH) and fibrosis (POF) were recorded by semi-quantitative analysis. Spearman correlation analysis was used to correlate PDFF with PSH and POF. Multiple linear regression analysis was used to determine independent PDFF histogram parameters for evaluating PSH and POF. A receiver operator characteristic (ROC) curve was used to assess the diagnostic accuracy of PDFF for discriminating mild from moderate-severe hepatic steatosis and mild from moderate-severe hepatic fibrosis with median of PSH or POF for dichotomy, and DeLong test was used to compare the area under the curve (AUC). With the correction of hepatic fibrosis, correlation coefficient and AUC were compared of PDFF for discrimination mild from moderate-severe hepatic steatosis. Results:The PDFF mean, median, standard deviation, 75 th, 90 th showed correlation with PSH ( r=0.558, 0.522, 0.319, 0.723, 0.646, -0.589, all P<0.05). The entropy and 75 th were independent parameters for evaluating PSH (β=2.347, -5.960, P=0.018, 0.001). The PDFF 75 th was the optimal parameter for discriminating mild from moderate-severe hepatic steatosis with AUC=0.915 ( P=0.001). The PDFF volume, mean, median, standard deviation, 75 th, 90 th, entropy showed correlation with POF ( r=0.355, 0.393, 0.376, 0.298, 0.485, 0.426, -0.681, all P<0.05). The entropy, standard deviation and volume (β=-11.041, 1.356, 0.190, P=0.001, 0.026, 0.016) were independent parameters for evaluation of hepatic fibrosis, and the entropy was the optimal parameter for hepatic fibrosis (AUC=0.771, P=0.001). The correlation between PSH and PDFF 75 th was less pronounced when fibrosis was present ( r=0.512, P=0.001) than when fibrosis was absent ( r=0.751, P=0.002). The PDFF 75 th showed a significant difference in discriminating mild hepatic steatosis from moderate-severe hepatic steatosis after correction of POF (AUC=0.895, 0.950, Z=2.970, P=0.025). Conclusions:PDFF based on histogram analysis provided a noninvasive, accurate estimation of quantification for hepatic steatosis and fibrosis. Hepatic fibrosis reduced the correlation between hepatic steatosis and PDFF and the presence of hepatic fibrosis can confound the quantification of hepatic steatosis with PDFF.

Progress in pathogenic mechanisms of neurotropic viruses crossing blood-brain barrier and invading central nervous system / 中华微生物学和免疫学杂志

Blood-brain barrier is a natural barrier between blood and brain tissue that can protect the brain from invasion by infectious pathogens in blood and maintain the homeostasis of the brain environment. However, neurotropic viruses can escape or disrupt blood-brain barrier and then invade the brain, causing serious complications in the central nervous system such as encephalitis and meningitis, which seriously threaten human life. This paper mainly summarized the research progress in the pathogenic mechanisms of common neurotropic viruses crossing blood-brain barrier and invading the central nervous system.

Clinical value of narrow-band imaging endoscopy in children with esophageal polyps / 中华消化内镜杂志

To investigate the diagnostic value of narrow-band imaging (NBI) endoscopy for esophageal polyps in children. Microscopic morphology of various polyps in 35 children with esophageal polyps in Children's Hospital of Shanghai from January 2016 to June 2020 were observed under both traditional white light endoscopy and NBI endoscopy. The sensitivity and specificity of traditional white light endoscopy and NBI endoscopy were compared with the pathological results as the gold standard. A total of 70 esophageal polypoid lesions were found in 35 children, including 27 single polyps. Pathological results indicated that the majority of polyps were non-neoplastic polyps (52.9%, 37/70).The sensitivity of NBI endoscopy in the diagnosis of esophageal neoplastic polyps was significantly higher than that of white light endoscopy [93.9% (31/33) VS 90.9% (30/33), P < 0.001], and the specificity was also higher [89.2% (33/37) VS 78.4% (29/37), P=0.864]. By observing the microscopic structure of esophageal polyps, NBI endoscopy contributes to the clinical prediction of the pathological properties of polyps. Its sensitivity is superior to the white light endoscopy.

Dual role of exosomes in viral infection: immune activation and immune escape / 中华微生物学和免疫学杂志

Exosomes are extracellular vesicles containing a variety of cell membrane molecules and related protein. They have been found to act as important intercellular messengers carrying functional RNAs, proteins and lipids that can induce phenotypic changes in recipient cells and promote cell activation or inhibition effect. In recent years, some studies have shown that exosomes can not only play an immune activation role to trigger antiviral immune response after viral infection, but also help to spread virus among cells, thus contributing to viral immune escape. Exosomes can either spread or limit an infection depending on the type of pathogen and the features of source cells, and can be studied as potential targets for development of antiviral drugs and vaccines. This review summarized the role of exosomes in viral infections with an emphasis on their potential contribution to pathogenesis.

Analysis of early chest high resolution CT images of novel coronavirus pneumonia / 中华放射学杂志

Objective@#To investigate the first chest HRCT imaging manifestations infected with novel coronavirus pneumonia (NCP).@*Method@#A retrospective analysis of the first chest HRCT images of 106 patients with NCP clinically diagnosed in our hospital from January 3 to 25, 2020. Lesion distribution, morphology and surrounding involvement were analyzed.@*Result@#Lesions were found in the first lung HRCT of 106 patients, with unilateral lung distribution in 11 cases (10.4%), bilateral lung distribution in 95 cases (89.6%), and peripheral distribution of lung in 65 cases (61.3%). 41 cases (38.7%) were distributed at the same time; 8 cases (7.5%) were 1 lesion, 5 cases (4.7%) were 2 lesions, 93 cases (87.8%) were multiple lesions, and 12 cases were nodular lesions (11.3%). 94 cases of ground-glass lesions (88.7%), 7 cases of cord-like lesions (6.6%), 15 cases (14.2%) of coexisting lesions of two or more forms; 10 cases (9.4%) involving one lung lobe There were 96 cases (90.6%) involving two or more lung lobes; 24 cases (22.6%) with enlarged mediastinal lymph nodes (19 cases over 60 years old, accounting for 79.2%); 3 cases with pleural effusion (2.8 %), 1 case had pericardial effusion (0.9%), and 2 cases had pleural involvement / thickening (1.9%). Patients over 60 years of age mostly present with multiple lesions, multiple morphology, peripheral and central distribution of lungs, involving multiple lung lobes, and enlarged mediastinal lymph nodes.@*Conclusions@#Lung lesions of NCP patients can be detected for the first time by chest HRCT, which is the preferred imaging method. Thoracic HRCT scans play an important role in the early diagnosis of new coronavirus (NCP). .

Imaging observation of the acromiaohumeral distance after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect / 中华创伤骨科杂志

Objective:To observe the changes in acromiaohumeral distance(AHD) in patients undergoing the modified arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect.Methods:A retrospective study was performed of the 52 patients who had undergone the modified arthroscopic double-button Latarjet procedure from October 2014 to October 2016 at Department of Sports Medicine, The First Affiliated Hospital to Shenzhen University for recurrent anterior shoulder dislocation complicated with glenoid bone defect. They were 33 males and 19 females, having 30 left and 22 right shoulders affected. Their ages ranged from 19 to 45 years(mean, 29.6 years). Their glenoid bone defects ranged from 17% to 30%(mean, 23.4%). CT scans were performed on the surgery side to observe the healing and reshaping of the bone grafts and to measure the AHDs of healthy shoulder, immediately, 6, 18 and 36 months after operation. Their American Shoulder and Elbow Surgeons(ASES), Rowe and Walch-Duplay scores were recorded before operation and at the final follow-up for comparison.Results:The follow-up time for this series ranged from 37 to 44 months (mean, 40.6 months). The AHDs at immediate postoperation(9.6 mm ± 0.7 mm), 6 months postoperation(8.6 mm ± 0.9 mm), 18 months postoperation (8.0 cm ± 0.8 cm) and 36 months postoperation(7.9 cm ± 0.8 cm) were significantly wider than the healthy side value (7.8 mm ± 0.8 mm)( P<0.05). The ASES, Rowe and Walch-Duplay scores at the final follow-up (93.9±3.2, 94.5±2.7 and 95.7±3.6) were significantly improved than the preoperative values (67.3±9.1, 40.1±4.2 and 63.5±9.0) ( P<0.05). The final follow-ups observed no symptoms or signs of chronic shoulder pain, rotator cuff injury or acromion impingement. Conclusion:As the AHD becomes wider rather than narrower after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect, no subsequent rotator cuff injury may happen due to the uplift of the humeral head after the modified arthroscopic double-button Latarjet procedure.

Analysis of the initial chest high resolution CT manifestations of COVID-19 / 中华放射学杂志

Objective:To investigate the initial chest high resolution CT (HRCT) manifestations of the patients with COVID-19.Methods:A retrospective analysis of the first chest HRCT images of 106 patients with COVID-19 was performed who were confirmed in our hospital from January 3 to 25, 2020. Lesion distribution, morphology and surrounding involvement were analyzed.Results:The lesions were found on all initial HRCT images of 106 patients, with unilateral lung distribution in 11 cases (10.4%) and bilateral lung distribution in other 95 cases(89.6%), peripheral distribution of lung in 65 cases (61.3%) and peripheral and central distribution in other 41 cases (38.7%). HRCT showed 8 cases (7.5%) with 1 lesion, 5 cases (4.7%) with 2 lesions, and other 93 cases (87.8%) with multiple lesions. HRCT also showed the nodular lesions in 12 cases(11.3%), ground-glass opacities in 94 cases (88.7%), fibrous stripes in 7 cases (6.6%), and mixed lesions in 15 cases (14.2%). Only one lung lobe was involved in 10 cases (9.4%) , while more than two lobes were involved in other 96 cases (90.6%) . In addition, 24 cases (22.6%) with enlarged mediastinal lymph nodes (over 60 years old in 19 cases, accounting for 79.2%), 3 cases with pleural effusion (2.8 %), 1 case with pericardial effusion (0.9%), and 2 cases with pleural involvement/thickening (1.9%) were found. Patients over 60 years old mostly presented with multiple lesions, various appearances, peripheral and central distributions of lungs, involving multiple lobes, and enlarged mediastinal lymph nodes.Conclusions:Lung COVID-19 lesions can be shown by the initial chest HRCT, which is the preferred imaging method. Thoracic HRCT scans play an important role in the early diagnosis of COVID-19.

Shoulder gouty arthritis with tophus: a case report and literature review / 中华骨科杂志

Gout is a common metabolic disease. Gouty arthritis is associated with the deposition of urate crystals in the synovial fluid or para-articular soft tissues, which often affects the hands, feet, wrists, ankle and knees joints. However, the shoulder joint is unusual involved. In the present study, a 49-year-old male patient complained of right shoulder pain for 9 months and aggravating with limited range of motion for 2 weeks. Physical examination showed that the external rotation was 10° and hand back was S 5 of the right shoulder. The MRI showed shoulder joint effusion and intra-articular loose bodies. The patient was admitted to the hospital with the diagnosis of "loose bodies of the right shoulder with synovial chondromatosis possibly". Arthroscopic examination revealed that a lots of urate crystals were deposited on synovium, cartilage and rotator cuff. Loose bodies removal and joint debridement were performed. Histopathologic examination of the specimen demonstrated synovitis hyperplasia with urate crystals deposition. Shoulder gouty arthritis characterized by pain and limited movement. The imaging of tophi depends on the calcium-containing deposits. Tophus with calcium deposits can be found on X-ray and CT. MRI can not only evaluate the tophus but also the evaluate the other intra-articular pathologies. Due to no typical manifestations and specific images of shoulder gouty arthritis, pathological diagnosis is the "gold standard". Shoulder arthroscopy provide a minimal invasive technique in diagnosing and treating of the shoulder disease. Undoubtedly, it could be a reliable diagnosis and treatment method for shoulder gouty arthritis.

Expression and clinical significance of Cripto-1 and mTOR in cervical cancer / 中国医师杂志

Objective:To study the expression and clinical significance of teratocarcinoma-derived growth factor 1 (Cripto-1) and mammalian target of rapamycin (mTOR)in cervical cancer (CC)cancer tissues.Methods:From January 2012 to May 2017, 152 patients with CC in the 2nd Affiliated Hospital of Chengdu Medical College were selected as CC group, and 40 patients with uterine fibroids as control group. The quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of Cripto-1 and mTOR in 152 cases of CC tissues and 40 cases of normal cervical tissues. The expression difference between the two and their relationship with pathological features and prognosis were statistically analyzed.Results:The relative expression of Cripto-1 and mTOR in CC tissues was significantly higher than that in normal cervical tissues ( P<0.05). There was a significant positive correlation between Cripto-1 and mTOR expression in CC tissues ( r=0.634, P<0.05). The expression of Cripto-1 and mTOR protein in CC tissues were associated with International Federation of Gynecology and Obstetrics (FIGO) stage and tumor grade ( P<0.05), but not with age, pathological type, depth of invasion and lymph node metastasis ( P>0.05). The 3-year overall survival (OS) rate of patients with high Cripto-1 expression was not significantly different from that of patients with low Cripto-1 expression ( P>0.05), while the 3-year OS of high mTOR expression group was significantly lower than that of low mTOR expression group (χ 2=5.808, P=0.016). Conclusions:The expression of Cripto-1 and mTOR is increased in CC tissues.Both of them are related to FIGO stage and tumor grade, which may become a new molecular marker for diagnosis, treatment and evaluation of CC.

ThevalueofthefusiontechnologyofbronchialarteryCTAwith 3Dreconstructionoftracheaininterventionaltreatmentsforhemoptysis / 实用放射学杂志

Objective TodiscussthevalueofthefusiontechnologyofbronchialarteryCTA with3Dreconstructionoftracheain interventionaltreatmentsforhemoptysis.Methods AretrospectiveanalysiswasconductedinthefusionimagesofthebronchialarteryCTA with 3DreconstructionoftracheaandDSAin58patientswithhemoptysis,therelatedparametersofthebronchialartery(BA)wereobserved (the typeofBA,thebronchialopening,thebronchialoriginandthepositionrelationshipbetweenthebronchus),andthestatisticalanalysiswas performed.Results Inthe58hemoptysispatients,CTArevealed156BAs,including73leftBAs,76rightBAsand7heterotopic BAs.Therewere67BAsresponsibleforhemoptysis,ofwhich64BAswerefromnormaloriginand3BAswerefromheterotopicorigin.Four typesofBAswerefoundandthemostwereR1L1,accountingfor44.8%.BAsaboveandbelowthetrachealcarinaaccountedfor61.5% and 38.5%,respectively.Themeandiameterwas(3.56±1.21)mmforBAsresponsibleforhemoptysisand (1.67±0.32)mmforBAs irresponsibleforhemoptysis.Conclusion ThefusiontechniqueofbronchialarteryCTAandtracheal3Dreconstructionoftracheacan welldetecttheoriginofthesuspectedhemoptysisresponsibilityBA,theposition,andtherelationshipbetweentheshapeandthebifurcation ofthebronchusI.tcanbeusedasthefirstchoiceofroutineexaminationforhemoptysisinterventionaltherapy.

Correlation analysis of colon polyps'size,dysplasia and intestinal metaplasia / 安徽医科大学学报

The patients undergoing gastroscope and enteroscopy examination were respectively divided into gastric intestinal metaplasia group (n = 397) and non gastric intestinal metaplasia group (n = 360),and the differences in size,number,location and dysplasia of colonic polyps between the two groups were compared. In GIM group,the polyps incidence after classification of polyp size and colonic dysplasia was significantly higher than that in non GIM group (P < 0. 05),while the number and location of colonic polyps were no significant difference between two groups. By the logistic regression analysis,more than 50 years old of age,male,HP infection,the diameter of polyps are larger than 2. 0 cm,or dysplasia showed high possibility to appear gastric intestinal metaplasia (OR > 1,P< 0. 05),the diameter of colonic polyps are 1. 0 ～ 2. 0 cm which showed high possibility to non intestinal metaplasia (OR < 1,P < 0. 05),and there was no significant difference between the two groups in the incidence of GIM in colonic polyps less than 0. 5 cm or 0. 5 ～ 1. 0 cm in diameter. Not only age,gender and HP infection were related to the occurrence of IM,but the risk of GIM increased in patients with colonic polyps' diameter more than 2. 0 cm and dysplasia. Those who found colonic polyps > 2. 0 cm in diameter and polyps with dysplasia were suggested to undergo gastroscopy in order to find GIM early and follow up to improve the detection rate of early gastric cancer.

Progress of research on Cerenkov luminescence imaging in intraoperative navigation / 中华核医学与分子影像杂志

Surgical removal of tumor and metastatic lymph nodes are important for the prognosis of patients.Optical intraoperative navigation can achieve real-time tumor location and border recognition,providing an effective way to guide tumor removal and achieve intraoperative navigation precisely.Cerenkov luminescence imaging(CLI)as a nuclide optical imaging method,which combines the advantages of optical imaging and radionuclides,has opened up a new way of navigation in optical surgery.This article reviews the progress of CLI in intraoperative navigation.