A deep transfer learning method using plain radiographs for the differential diagnosis of osteonecrosis of the femoral head with other hip diseases / 中华骨科杂志

Objective:To develop a deep transfer learning method for the differential diagnosis of osteonecrosis of the femoral head (ONFH) with other common hip diseases using anteroposterior hip radiographs.Methods:Patients suffering from ONFH, DDH, and other hip diseases including primary hip osteoarthritis, non-infectious inflammatory hip disease, and femoral neck fracture treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to December 2020 were enrolled in the study. A clinical data set containing anteroposterior hip radiographs of the eligible patients was created. Data augmentation by rotating and flipping images was performed to enlarge the data set, then the data set was divided equally into a training data set and a testing data set. The ResNet-152, a deep neural network model, was used in the study, but the original Batch Normalization was replaced with Transferable Normalization to construct a novel deep transfer learning model. The model was trained to distinguish ONFH and DDH from other common hip diseases using anteroposterior hip radiographs on the training data set and its classification performance was evaluated on the testing data set.Results:The clinical data set was comprised of anteroposterior hip radiographs of 1024 hips, including 542 with ONFH, 296 with DDH, and 186 with other common hip diseases (56 hips with primary osteoarthritis, 85 hips with non-infectious inflammatory osteoarthritis, 45 hips with femoral neck fracture). After data augmentation, the size of the data set multiplied to 6144. The model was trained 100 050 times in each task. Accuracy was used as the representative parameter to evaluate the performance of the model. In the binary classification task to identify ONFH, the best accuracy was 95.80%. As for the multi-classification task for classification of ONFH and DDH from other hip diseases, the best accuracy was 91.40%. The plateau of the model was observed in each task after 50 000 times of training. The mean accuracy in plateaus was 95.35% (95% CI: 95.33%, 95.37%), and 90.85% (95% CI: 90.82%, 90.87%), respectively. Conclusion:The present study proves the encouraging performance of a deep transfer learning method for the first-visit classification of ONFH, DDH, and other hip diseases using the convenient and economical anteroposterior hip radiographs.

Osteoclast-mediated pain and collapse mechanisms in the femoral head necrosis with bone marrow edema / 西安交通大学学报(医学版)

【Objective】 To explore pain and collapse mechanisms in fosteonecrosis of the femoral head (ONFH) with bone marrow edema (BME). 【Methods】 ONFH patients at ARCO Ⅲ stage who underwent total hip arthroplasty in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were enrolled; the femoral head samples, clinical and imaging data were collected. These patients were divided into BME group and non-BME group according to the MR data in one week preoperative. Hematoxylin-eosin and Sirius red staining were performed to observe the morphological changes in bone tissue of femoral head specimens. Western blotting and qPCR were used to semi-quantitatively analyze the expression levels of CTSK, RANKL, and Netrin-1 proteins and mRNA in different regions of the bone tissue. 【Results】 Clinical and imaging data showed that ONFH patients with BME had significantly higher scores of VAS than ONFH patients without BME. Hematoxylin-eosin staining showed that bone structure disorder and a large number of empty bone lacunae were found in the necrotic areas in both groups, but there exited significant granulation tissue in the BME group, and spindle-shaped fibroblastic cells and inflammatory cells aggregated in the repaired region. Sirius red staining revealed the necrotic and sclerotic areas were accumulated with many collagenous fiber in the BME group. The results of Western blotting and qPCR showed that Netrin-1 expressions in the necrotic, sclerotic and health areas in the BME group were higher than those in the non-BME group (P<0.05), while osteoclast related proteins and mRNA expressions of the necrotic and sclerotic areas in the BME group was higher than those in the non-BME group (P<0.05). 【Conclusion】 All these findings indicated that hip pain was positively correlated with femoral head necrosis with BME, hyperactive osteoclasts participated in the femoral head collapse with BME, and the upregulated expression of Netrin-1 mediated the pain mechanism.

A Survey of the Current Status of Surgical Treatment of Hemophilic Osteoarthropathy in China Mainland 17 Grade A General Hospitals / 罕见病研究

  Objective  To understand the current status of surgical treatment for hemophilia osteoarthropathy (HO) in China.  Methods  Using an online questionnaire, select domestic hospitals that partici-pated in the compilation of the 'Guideline for perioperative management of hemophilia patients undergoing orthopaedic surgery in China ', in addition to members of the National Joint Surgery Group, and the Orthopedic Branch of the Chinese Medical Association for targeted investigation and analysis.  Results  A total of 17 domestic hospitals were included, all of which were general hospitals. Hospitals that started HO surgery treatment before 2000 accounted for 35.29%. A total of 3057 surgical cases of HO were reported by those hospitals. The most commonly performed surgical procedures were hip and knee joint replacement. The most commonly used coagulation factor replacement regimen was recombinant coagulation factor preparation. Ten hospitals reported finding patients with transfusion-related infectious diseases. Bleeding and hematoma formation were the most frequently reported surgical complications. Excessive length of hospital stay and high economic costs were the most frequently reported problems.  Conclusions  Surgical treatment for HO in 17 hospitals is mainly carried out in some large comprehensive medical centers in the eastern region. Compared with the patient base, the popularity and number of surgeries are still relatively insufficient. It is necessary to further standardize the treatment system by standardizing factor replacement and strengthening rehabilitation to improve surgical treatment outcomes.

Downregulation of CDC42 inhibits the proliferation and stemness of human trophoblast stem cell via EZRIN/YAP inactivation.

Placental dysplasia increases the risk of recurrent spontaneous abortion (RSA). However, the underlying mechanism regulating placental development remains unclear. In this study, we showed that the expression of CDC42 was decreased in the villous tissue of RSA samples compared to healthy controls. Further examination demonstrated that CDC42 deficiency led to the differentiation of human trophoblast stem cells (hTSCs) and inhibited their proliferation. Genetic manipulation of YAP and EZRIN in hTSCs revealed that CDC42 regulates the stemness and proliferation of hTSCs; this is dependent on EZRIN, which translocates YAP into the nucleus. Moreover, the expression pattern of EZRIN, YAP, and Ki67 was also abnormal in the villous tissue of RSA samples, consistent with in vitro experiments. In summary, these findings suggest that the CDC42/EZRIN/YAP pathway plays an important role in placental development.

Bioinformatics and Computer Simulation Approaches to the Discovery and Analysis of Bioactive Peptides.

The traditional process of separating and purifying bioactive peptides is laborious and time-consuming. Using a traditional process to identify is difficult, and there is a lack of fast and accurate activity evaluation methods. How to extract bioactive peptides quickly and efficiently is still the focus of bioactive peptides research. In order to improve the present situation of the research, bioinformatics techniques and peptidome methods are widely used in this field. At the same time, bioactive peptides have their own specific pharmacokinetic characteristics, so computer simulation methods have incomparable advantages in studying the pharmacokinetics and pharmacokineticpharmacodynamic correlation models of bioactive peptides. The purpose of this review is to summarize the combined applications of bioinformatics and computer simulation methods in the study of bioactive peptides, concentrating on the role of bioinformatics in simulating the selection of enzymatic hydrolysis and precursor proteins, activity prediction, molecular docking, physicochemical properties, and molecular dynamics. Our review shows that new bioactive peptide molecular sequences with high activity can be obtained by computer-aided design. The significance of the pharmacokinetic-pharmacodynamic correlation model in the study of bioactive peptides is emphasized. Finally, some problems and future development potential of bioactive peptides binding new technologies are being prospected.

Characteristics of newly reported HIV infection in Ningbo， Zhejiang Province from 2017 to 2020 / 上海预防医学

ObjectiveTo analyze the local human immunodeficiency virus （HIV） infection characteristics and influencing factors of newly reported HIV infected cases and acquired immunodeficiency syndrome patients （AIDS） in Ningbo City from 2017 to 2020， and to provide scientific basis for local effective AIDS prevention and control measures. MethodsFrom January 1， 2017 to December 31， 2020， the newly reported HIV/AIDS patients in Ningbo were recruited and face-to-face questionnaire was used to collect relevant information such as demography， behavior， infection route and infection location of research subjects. The data were processed and analyzed by EpiData 3.1 and SPSS 23.0 software. ResultsA total of 449 newly reported HIV/AIDS patients were recruited and 399 cases completed the survey. The survey subjects were mainly male （346， 86.7%）， unmarried （188， 47.1%），with local household registration （246， 61.6%）， with junior high school and lower education level （195， 48.9%）， and 25 to 44 years old （206， 51.6%）. The local HIV/AIDS infection rate was 68.4% （273/399）， among which the local HIV/AIDS infection rate of homosexual transmission was 74.9% （146/195）. Multivariate analysis showed that heterosexual transmission of HIV infection （OR=0.349，95%CI：0.201‒0.606）， using dating software to find local sexual partners （OR=2.133，95%CI：0.201‒0.606）， and received no AIDS education services before HIV confirmation （OR=1.914，95%CI：1.196‒3.063） were the influencing factors of local HIV/AIDS infection （P<0.05）. ConclusionThe newly reported HIV/AIDS in Ningbo mainly infects HIV locally， and the coverage of HIV/AIDS education is insufficient before HIV confirmation. A high proportion of local HIV/AIDS infections is found in people who find local sexual partners through dating software and who infected through homosexual transmission before HIV confirmation. It is necessary to strengthen local HIV/AIDS education and Internet intervention among MSM who seek sexual partners through dating software.

Questionnaire survey of patients undergoing breast augmentation in China / 中华医学美学美容杂志

Objective:To understand the psychology of patients undergoing breast augmentation, and to provide reference for preoperative communication between clinicians and patients.Methods:From September 2016 to September 2017, the Guangdong Second Provincial General Hospital formulated a 37-question questionnaire based on BREAST-Q and Chinese national conditions, and investigated patients who planned to undergo breast augmentation in 34 hospitals.Results:A total of 2066 valid questionnaires were collected. Fifty-four percent of women were dissatisfied with their nude appearance, which was more dissatisfied compared with their appearance when dressed. Surgical safety (20.1%), surgical effect (16.8%), surgical method and incision selection (16.5%), breast implant material (14.5%) and doctor′s skill (11.6%) were the five most important factors for considering breast augmentation. Only 26.6% of the respondents were supported by their family members or partners when they made the decision to have breast augmentation. Most women had limited knowledge of breast augmentation, with only 24.9 percent of respondents having a thorough understanding of the procedure.Conclusions:Women undergoing breast augmentation have an urgent need to improve their appearance, and their decision-making process is affected by many factors, among which surgical safety is the most worrying factor for patients. This group of people have limited knowledge about surgery, and the popularization of breast augmentation by plastic surgeons remains to be strengthened.

Studies on the minimally invasive percutaneous suture technique of eight times for repairing closed injury extensor tendon zone I of finger / 中华骨科杂志

Objective:To discuss the clinical curative effect of the minimally invasive percutaneous suture technique of eight times for repairing closed injury extensor tendon zone I of finger.Methods:From February 2017 to January 2020, 12 patients (male 8, female 4) with mallet finger deformity were retrospectively studied, with an average age of 35 years (range, 18-50 years). And all the affected fingers were acute closed rupture of extensor tendon in zone I of single finger, 5 cases of the left finger and 7 cases of the right finger. There were 1 case of the thumb finger, 2 cases of the index finger, 3 cases of the middle finger, 4 cases of the ring finger and 2 cases of the little finger. 12 patients with fresh sputum mallet fingers were with 3-0 thread monofilament suture on extensor tendon zone I of finger in the minimally invasive percutaneous suture technique of eight times, and the distal end of the tendon was fixed to the base of the distal phalanx through the bone hole. Removal of the Kirschner wire 6-8 weeks, the brace was used to fix the affected finger in the dorsal extension. The flexion and extension of the affected finger was gradually strengthened. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up. The active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger were measured, and the total action movement (TAM) of the finger were recorded. Finger function was evaluated according to TAM of the American Association of Hand Surgeons.Results:All operations were successfully completed, the operation time of the patients ranged from 18 to 25 min, with an average of 20.1±0.2 min. There was only a small amount of bleeding in the surgery. All 12 cases were followed up and the follow-up periods ranged from 6 to 14 months, with an average of 10.2±1.1 months. Mallet finger deformities were all corrected postoperatively; there were no knot exposure, skin necrosis and other complications. According to the Crawford standard, 9 cases were excellent, 2 cases were good, and 1 case was fair. The excellent and good rate was 91.7% (11/12). The mean active flexion of distal interphalangeal joints on the wounded finger and healthy finger were 82.11°±2.02° and 84.09°±2.01°, the mean active extension of distal interphalangeal joints on the wounded finger and healthy finger were -2.04°±3.01° and 0.02°±1.02°, there were significant differences between them ( t=2.447, 3.246; P=0.019, 0.004). The degrees of active joint activity of wounded finger were: 91.02°±4.01° of the metacar-pophalangeal joint, 94.04°±2.11° of the proximal interphalangeal joint, 83.01°±2.02° of the distal interphalangeal joint, and 265.05°±13.04° of total active activity; the degrees of active joint activity of healthy finger were: 93.01°±3.21° of the metacar-pophalangeal joint, 94.03°±3.07° of the proximal interphalangeal joint, 85.02°±2.01° of the distal interphalangeal joint, and 269.02°±12.10° of total active activity. The TAMs of the healthy side were 269.02°±12.10°, and the TAMs of the affected side were 265.05°±13.04°, there was no significant difference between them ( P>0.05). According to TAM system assessment criteria: excellent in 9 patients, good in 3 patients, and the excellent and good rate was 100% (12/12). Conclusion:The minimally invasive percutaneous suture technique of eight times can well repair closed injury extensor tendon zone I of finger, can have satisfactory treatment outcome in mallet finger with a simple procedure and good outcome. It is a simple, safe, effective method with minimal invasion.

From people to Panthera: Natural SARS-CoV-2 infection in tigers and lions at the Bronx Zoo

We describe the first cases of natural SARS-CoV-2 infection detected in animals in the United States. In March 2020, four tigers and three lions at the Bronx Zoo developed mild respiratory signs. SARS-CoV-2 RNA was detected by rRT-PCR in respiratory secretions and/or feces from all seven affected animals; viral RNA and/or antibodies were detected in their keepers. SARS-CoV-2 was isolated from respiratory secretions or feces from three affected animals; in situ hybridization co-localized viral RNA with cellular damage. Whole genome sequence and haplotype network analyses showed tigers and lions were infected with two different SARS-CoV-2 strains, suggesting independent viral introductions. The source of SARS-CoV-2 infection in the lions is unknown. Epidemiological data and genetic similarities between keeper and tiger viruses indicate human to animal transmission.

Exhaled breath is a significant source of SARS-CoV-2 emission

Despite notable efforts in airborne SARS-CoV-2 detection, no clear evidence has emerged to show how SARS-CoV-2 is emitted into the environments. Here, 35 COVID-19 subjects were recruited; exhaled breath condensate (EBC), air samples and surface swabs were collected and analyzed for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR). EBC samples had the highest positive rate (16.7%, n = 30), followed by surface swabs(5.4%, n = 242), and air samples (3.8%, n = 26). COVID-19 patients were shown to exhale SARSCoV-2 into the air at an estimated rate of 103-105 RNA copies/min; while toilet and floor surfaces represented two important SARS-CoV-2 reservoirs. Our results imply that airborne transmission of SARS-CoV-2 plays a major role in COVID-19 spread, especially during the early stages of the disease. One Sentence SummaryCOVID-19 patient exhales millions of SARS-CoV-2 particles per hour

Isolation and characterization of SARS-CoV-2 from the first US COVID-19 patient

The etiologic agent of the outbreak of pneumonia in Wuhan China was identified as severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) in January, 2020. The first US patient was diagnosed by the State of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens, and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into two virus repositories, making it broadly available to the public health and research communities. We hope that open access to this important reagent will expedite development of medical countermeasures. Article SummaryScientists have isolated virus from the first US COVID-19 patient. The isolation and reagents described here will serve as the US reference strain used in research, drug discovery and vaccine testing.

Reconstruction of digestive tract with Roux-en-Y anastomosis in 4K laparoscopic distal radical gastrectomy / 中华消化外科杂志

The laparoscopic vision platform developed from the prototype of candlelight reflector device to HD, 3D and 4K ultra HD, which revolutionized surgery from open surgery to minimally invasive surgery. With the continuous application in gastric cancer surgery, the importance of laparoscopy in radical gastrectomy is gradually recognized. Radical gastrectomy mainly includes lymph node dissection and digestive tract reconstruction. The reconstruction of digestive tract after radical gastrectomy for distal gastric cancer has been a hot topic of discussion and research, which is directly related to the incidence of postoperative complications, nutritional status and quality of life. This paper mainly discusses the Roux-en-Y digestive tract reconstruction of radical gastrectomy for distal gastric cancer with 4K laparoscopic.

Reconstruction of digestive tract with Roux-en-Y anastomosis in 4K laparoscopic distal radical gastrectomy / 中华消化外科杂志

The laparoscopic vision platform developed from the prototype of candlelight reflector device to HD, 3D and 4K ultra HD, which revolutionized surgery from open surgery to minimally invasive surgery. With the continuous application in gastric cancer surgery, the importance of laparoscopy in radical gastrectomy is gradually recognized. Radical gastrectomy mainly includes lymph node dissection and digestive tract reconstruction. The reconstruction of digestive tract after radical gastrectomy for distal gastric cancer has been a hot topic of discussion and research, which is directly related to the incidence of postoperative complications, nutritional status and quality of life. This paper mainly discusses the Roux-en-Y digestive tract reconstruction of radical gastrectomy for distal gastric cancer with 4K laparoscopic.

Effect of oblique lateral lumbar intervertebral fusion on inflammatory factors in patients with degenerative spinal canal stenosis / 国际外科学杂志

Objective:To investigate the effect of oblique lateral lumbar intervertebral fusion (OLIF) on inflammatory factors in patients with degenerative spinal canal stenosis (DLSS).Methods:Retrospective analysis of clinical data of 64 DLSS patients in the department of orthopedics, Jizhong Energy Fengfeng Group Hospital from June 2016 to June 2018 was performed. There were 35 males and 34 females, aged (60.70±6.27) years, and the age range was 20 to 80 years. According to the different surgical methods, they were divided into posterior decompression and internal fixation fusion (PLIF) group ( n=32) and OLIF group ( n=32). The coperation time, intraoperative bleeding volume, postoperative bed rest time, hospitalization time , the back and leg pain visual analogue score (VAS) , Japanese Orthopaedic Association(JOA) score of lumbar vertebrae and serum inflammatory factors [tumor necrosis factor-alpha(TNF-α), interleukin-1alpha(IL-1α), C-reactive protein(CRP)] were observed at preoperative, 3 months and last follow-up. Follow-up using outpatient examination and telephone interview was performed and survial up to March 2019. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was performed using independent sample t test or analysis of variance of repeated measurement data. Internal comparisons were performed using paired t tests. Count data were expressed as percentage (%), and χ2 test was used. Results:There was no significant difference in operation time between OLIF group and PLIF group ( P>0.05). In OLIF group, the amount of blood loss (119.72±30.41) mL, bedridden time (2.16±0.35) d and postoperative hospital stay (5.18±2.06) d were significantly lower than that of PLIF group[(318.26±94.62) mL, (3.17±0.54) d, (7.35±1.24) d], the differences between the two groups were statistically significant( P<0.05). All patients were followed for 8 months. The 3 months after operation and last follow-up, the VAS scores of back pain in OLIF group [(1.93±0.54) scores, (1.74±0.63) scores]were significantly lower than that in PLIF group [(4.05±0.62) scores, (3.87±0.74) scores]. The VAS scores of leg pain in OLIF group [(1.56±0.71) scores, (1.37±0.52) scores] were significantly lower than that of PLIF group [(3.74±0.79) scores, (2.53±0.59) scores]. The JOA scores of lumbar vertebrae in PLIF group [(22.57 ±1.83) scores, (24.38±1.65) scores] were significantly higher than that of PLIF group [(20.35±1.78) scores, (22.14±1.35) scores], the differences between the two groups were statistically significant( P<0.05). At 3 months after operation, the levels of serum TNF-α(16.95±3.92) ng/L, IL-1α(9.17±3.78) ng/L and CRP (1.97±0.24) mg/L in OLIF group were significantly lower than those in PLIF group [(20.46 ±4.27) ng/L, (11.51±4.25) ng/L, (2.36±0.32) mg/L]. Last follow-up, the level of serum TNF-α(13.47±3.54) ng/L, IL-1α(6.52±2.09) ng/L and CRP (1.42±0.16) mg/L in the OLIF group were significantly lower than those in the PLIF group [(18.08±3.84) ng/L, (8.73±5.43) ng/L, (2.04±0.25) mg/L], the differences between the two groups were statistically significant ( P<0.05). Conclusion:Compared with PLIF, OLIF can reduce the amount of intraoperative bleeding, shorten the recovery time, reduce the expression of inflammatory factors and improve the prognosis of patients with DLSS.

Targeting castration-resistant prostate cancer with a novel ROR

Prostate cancer (PCa) patients who progress to metastatic castration-resistant PCa (mCRPC) mostly have poor outcomes due to the lack of effective therapies. Our recent study established the orphan nuclear receptor ROR

Clinical and CT features of anaplastic thyroid carcinoma / 中华内分泌外科杂志

Objective:To investiqate the clinical and CT features of anaplastic thyroid carcinoma.Methods:The clinical and CT data of 23 anaplastic thyroid carcinoma patients were retrospectively analyzed, mainly including gender, age, chief complaint, and CT signs such as tumor size, distribution status, morphology, calcification, necrosis, peripheral invasion, lymph node metastasis and lung metastasis.Results:Among 23 cases of ATC, the ratio of male to female was 7∶16. 21 cases (91.3%) had hoarseness or cervical mass, 8 cases (34.8%) had rapid enlargement of tumor size, 6 cases (26.1%) with lesion in unilateral lobe, 8 cases (34.8%) in unilateral lobe + isthmus, 9 cases (39.1%) in bilateral lobe + isthmus, diameter of tumors was (6.1 ± 1.7) cm, 20 cases (87.0%) had irregular shape of tumors. 16 cases (69.6%) with rough calcification, 17 cases (73.9%) with extensive necrosis, 15 cases (65.2%) with tracheoesophageal groove extension, 18 cases (78.3%) with cervical lymph node metastasis, 8 cases (34.8%) with lung metastasis, 16 cases (69.6%) with trachea invasion, 7 cases (30.4%) with common carotid artery invasion, and 10 cases (43.5%) with internal jugular vein invasion.Conclusions:The clinical features include elderly women patients, big tumors size, rapid enlargement of tumor size, CT signs include irregular shape, coarse calcification, extensive necrosis, tracheoesophageal groove extension, cervical lymph node metastasis, lung metastasis and invasion of trachea, common carotid artery and internal jugular vein. These features have great value in the diagnosis of ATC and evaluation of peripheral structure invasion, cervical lymph node metastasis and distant metastasis.

Value of CT enhancement degree in diagnosing cervical lymph node metastasis of papillary thyroid carcinoma / 中华内分泌外科杂志

Objective:To investigate the value of CT enhancement degree in diagnosing cervical lymph node metastasis of papillary thyroid carcinoma (PTC) .Methods:CT data of 535 neck lymph nodes with pathological diagnosis in 251 cases were retrospectively analyzed. The ratio and difference between the density of CT enhancement and plain scan were calculated. Mann-Whitney test was used to analyze the distribution of ratio and difference in lymph node metastasis group and non-metastasis group. The optimal thresholds of ratio and difference in the two groups were obtained by receiver operating characteristic (ROC) curve analysis.Results:535 cervical lymph nodes including 271 in metastatic group and 264 in non-metastatic group. The ratios of two groups were 2.30 (2.04, 2.76) and 1.66 (1.51, 1.81) ( Z=-16.94, P<0.05) respectively, and the differences were 58 (49, 76) Hu and 31 (22, 36) Hu ( Z=-18.045, P<0.05) respectively. When the ROC area under curve of ratio and difference between the two groups were 0.923 and 0.951 respectively, the optimal thresholds were 1.93 and 39.5Hu respectively. The sensitivity and specificity of diagnosing lymph node metastasis were 84.9% and 87.1%、91.5% and 86.0%respectively.The sensitivity and specificity of combination of the two diagnosing lymph node metastasis were 82.3% and 91.7%. Conclusions:The ratio of enhancement and plain scan density ≥1.93 and the difference ≥39.5Hu have a high diagnostic efficiency for cervical lymph node metastasis of PTC. The specificity of the two is similar, but the latter has higher sensitivity. The combination of the two can significantly improve the specificity, thereby reducing unnecessary surgical trauma.

Clinical effect of linear mastoplasty in treatment of mastoptosis / 中华医学美学美容杂志

Objective To evaluate the effect of Lejours' procedure in the treatment of breast prolapse.Methods From July 2014 to July 2018,the Second People's Hospital of Guangdong Prov ince accepted 36 female patients with breast prolapse and correction failure,aged 25 42 years,with an average age of 32.1 years.According to the preoperative design,the pedicel epidermis,the redundant skin,the prosthesis and capsule were removed,and the mammary flap was fixed on the fascia of pectoralis major muscle,and the nipple and areola were fixed and sutured layer by layer.Results In 36 cases,the shape of breast was improved,the scar of incision was smaller,and the color of scar became lighter with time.There were no serious complications such as nipple and areola necrosis.The breast was straight and round after operation.After 6-24 months follow-up,one patient had delayed wound healing and received repeated dressing changes for 7 days.Conclusions The design of the op eration is simple,with little scar,few complications and good long term effect.The shape of the breast after repair is round and straight,which can be used as one of the feasible operation methods for the repair of breast ptosis.

Replication of 3D laparoscopic membrane anatomic radical gastrectomy for gastric cancer / 中华胃肠外科杂志

According to the current evidence-based medicine researches, the eastern and western countries have reached a consensus that D2 operation is a standardized procedure for advanced gastric cancer.However, the postoperative five-year survival rate is still not satisfactory. Professor Gong Jianping of Tongji Hospital, Tongji Medical Gollege of Huazhong University of Science and Technology proposed a theory of membrane anatomy (the third element of surgical anatomy) and the concept of cancer leakage—an epoch-making concept in surgical anatomy. The Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University was honored to be selected as one of the first domestic replication units of 3D laparoscopic radical gastrectomy under membrane anatomy. Professor Gong Jianping has visited our hospital several times for surgical demonstration, explanation of membrane anatomy theory and replication training. Through the understanding of membrane anatomy theory, we found that 3D laparoscopic radical gastrectomy guided by membrane anatomy can achieve good results, e.g less bleeding, complete resection, complete lymph node dissection and avoidance of side damage, meanwhile the operation is simple and safe. At the same time, it can avoid the shedding of cancer cells, so as to reduce the iatrogenic leakage of cancer and improve the efficacy of radical gastrectomy. In addition, the standardized procedure of laparoscopic radical gastrectomy makes it scientific, reproducible and easy to be popularized.