Argon-helium cryoablation treatment of undifferentiated pleomorphic sarcoma of the thyroid: A case report and literature review.

Undifferentiated pleomorphic sarcoma is an extremely rare malignant thyroid tumor. Thyroid sarcoma differs from common malignant thyroid tumors, such as thyroid follicular cell carcinoma. It is usually highly malignant, progresses rapidly, and is prone to remote metastasis. Currently, there is no standard protocol for the treatment of thyroid sarcomas, and most treatment effects are unsatisfactory. Argon-helium cryoablation is an important method of local treatment that is widely used in patients with unresectable advanced tumors. However, owing to the low incidence of thyroid sarcomas, there are no relevant literature reports on the treatment of thyroid sarcomas using cryoablation in China. This study reports the case of a patient with undifferentiated pleomorphic sarcoma of the thyroid gland who was treated with argon-helium cryoablation, and the immediate outcome was good. Based on a review of relevant literature, we discussed the effectiveness and safety of argon-helium cryoablation treatment to provide clinical guidance and references for the treatment of patients with thyroid sarcoma.

Surgical management and outcome of Extra-adrenal myelolipomas at unusual locations: A report of 11 cases in a single center.

Purpose: Extra-adrenal myelolipomas (EAMs) are rare benign tumors composed of both mature adipose and hematopoietic tissues with unclear etiology. There have been only sporadic case reports about the clinical characteristics and management of EAMs. Here we present our experience and practice in the clinical diagnosis and treatment of 11 consecutive patients with EAMs. Method: We retrospectively reviewed 11 consecutive patients, who received surgeries in our department and were confirmed as having EAMs by postoperative histopathology from April 2016 to December 2021. Clinical information and follow-up data of all patients were collected and analyzed afterwards. Results: Of the 11 EAM patients (7 male and 4 female) with a mean age of 47.6 years, 3 were asymptomatic and 8 were symptomatic with a mean symptom duration of 6.07 months. EAMs were found in the thoracic spine in 4 cases, paravertebral mediastinal regions in 3 cases, ilium in 2 cases, humerus in 1 case, and rib in 1 case. All patients were initially misdiagnosed as other tumors by radiologists. All 11 patients received gross total excision or curettage with a mean intraoperative blood loss of 781.82 ± 1143.3 ml and a mean operation duration of 180.91 ± 98.41 min. Patients' Frankel scores and Karnofsky Performance Status score were improved or at least preserved postoperatively. No significant complications occurred postoperatively. All the 11 patients survived, and no local recurrence or distant metastasis occurred during the mean follow-up period of 42.0 months. Conclusion: The surgical outcome and prognosis of EAMs are excellent and surgery can serve as the method of radical treatment.

Primary lung adenocarcinoma complicated with lung hamartoma: A case report and literature review. / åŽŸå‘æ€§è‚ºè ºç™Œåˆå¹¶è‚ºé”™æž„ç˜¤1ä¾‹å¹¶æ–‡çŒ®å¤ä¹ .

The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B (KIF20B) gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.

[Imaging study on safety of deep needling at Dachangshu (BL 25)].

OBJECTIVE: Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25). METHODS: The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured. RESULTS: The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01). CONCLUSION: At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.

Optimal surgical timing and approach for tibial plateau fracture.

BACKGROUND: Tibial plateau fracture is a common fracture encountered in the clinic. OBJECTIVE: This study determined the optimal timing and surgical approach for patients with tibial plateau fracture. METHODS: Fifty-two patients with complex tibial plateau fractures were treated in our hospital (the People's Hospital of Zhongjiang County) between 2013 and 2015. These patients were recruited as participants in this study; all patients were randomly allocated into two groups of 26 patients each. Patients in Group 1 underwent single-incision, single-plate knee surgeries via an antero-lateral approach, and patients in Group 2 underwent anterior median incisions of the knee for double-plate surgeries. The effects of the approaches were compared and analyzed. RESULTS: The best time to perform surgery was 6-8 days post-injury. The anterior median incision, double-plate method approach was better than the antero-lateral, single-incision, single-plate method. For the former method, the healing among middle-aged and young patients was better than that of elderly patients, and that healing of men was slightly better than that of female patients. However, the degree of healing among patients was > 80% at 5 months postoperatively. The purpose of surgical management has been fully achieved. CONCLUSION: The optimal timing of surgery for patients with complex tibial plateau fractures is 6-8 days post-injury. The surgical approach needs to be determined based on the actual condition of the patient. However, the treatment effect of an anterior median incision, double-plate method is better, and the recovery rate may approach 80% at 5 months postoperatively.

Cardiac imageology changes in patients with mild obstructive sleep apnea without cardiovascular disease.

PURPOSE: This study aims to assess changes in cardiac imageology of patients with mild obstructive sleep apnea (OSA) without cardiovascular disease. METHODS: All enrolled participants underwent polysomnography (PSG). Some participants underwent transthoracic echocardiography, speckle tracking echocardiography, and cardiac-enhanced magnetic resonance imaging (MRI) if they were willing. They were divided into three groups according to PSG results: non-OSA, mild OSA, and moderate-to-severe OSA. Imageology parameters were compared, and the relationship between OSA severity and imageology indices was analyzed by correlation analysis and multiple linear regression. RESULTS: Of the 352 enrolled participants, 274 participants with OSA had an apnea-hypopnea index (AHI) of ≥ 5 (86 mild OSA and 188 moderate-to-severe OSA cases), and 78 participants with non-OSA had an AHI of < 5. Transthoracic echocardiography showed that E/A and E'/A' values were lower in the mild OSA group than in the non-OSA group (1.12 ± 0.37 vs 1.27 ± 0.45 and 0.83 ± 0.33 vs 0.99 ± 0.42, respectively, p < 0.05). The aorta and ascending aorta widths were smaller in the mild OSA group than in the moderate-and-severe OSA groups (27.36 ± 2.87 mm vs 28.87 ± 2.95 mm and 30.27 ± 3.79 mm vs 31.63 ± 3.74 mm, respectively, p < 0.05). A regression analysis showed that cardiac function changes in patients with OSA may be related to age, obesity, and OSA severity. CONCLUSION: Patients with mild OSA without cardiovascular disease displayed changes in cardiac structure and function on transthoracic echocardiography.

Prognostic analysis of oral cancer based on deep learning / 口腔疾病防治

@#TNM（tumor node metastasis）classification is a common way to evaluate the prognosis of patients with oral cancer; however, many years of application have proven this method to be confined merely in clinical and pathological data and it cannot be adapted to the development of modern medicine. Deep learning (DL) has been widely used in various aspects of human life, has advantages for conducting efficient and intelligent searches and can explore and analyze substantial medical information well. Additionally, the application of DL to medical practice is quickly increasing. In the field of oral cancer prognosis, DL can efficiently process and analyze the pathological, radiographic and molecular data of oral cancer patients represented by lymphocytes, gray level cooccurrence matrix (GLCM) and gene maps and make accurate prognostic judgments accordingly. By assisting physicians in optimizing treatment plans, DL can effectively improve patients’ survival. Although DL lacks sufficient data and practical clinical application in prognostic studies, it has shown good clinical application prospects.

Imaging study on safety of deep needling at Dachangshu (BL 25) / 中国针灸

OBJECTIVE@#Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25).@*METHODS@#The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured.@*RESULTS@#The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01).@*CONCLUSION@#At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.

Primary lung adenocarcinoma complicated with lung hamartoma: A case report and literature review / 中南大学学报(医学版)

The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B (KIF20B) gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.

Imageology of internal carotid artery siphon in non-arteritic anterior ischaemic optic neuropathy.

AIM: To evaluate whether narrowing of internal carotid artery siphon (ICAS) may increase the risk of developing non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: Totally 30 consecutive patients who had unilateral NAION and 30 gender-matched control subjects were recruited in the present study. The diameter of ICAS of all the participants were measured using head-and-neck computed tomographic angiography (CTA). Color doppler flow imaging (CDI) was used to measure the haemodynamics parameters of ICAS and short posterior ciliary arteries (SPCAs) in all subjects. Comparison of parameters between the NAION patients and controls as well as between the two sides within the patients were performed. The correlation between the diameter of ICAS and NAION was analyzed. RESULTS: A comparison of parameters between the affected side of the NAION patients and the controls, including the diameter of ICAS, the resistance index (RI) of ICAS, the blood flow velocities of SPCAs and RI of SPCAs, showed significantly difference (P<0.01), while there was no significant difference in terms of the mean blood flow velocity (Vm) of ICAS; Similar results were found while comparing all the measurements of the affected and unaffected side of patients (P for RI of SPCAs <0.05). No marked difference was detected in nearly all parameters except for RI of ICAS and SPCAs between the unaffected side of the NAION patients and the controls (P<0.05). The diameter of ICAS were significantly positive correlated with both peak systolic velocity (PSV) of SPCAs and end diastolic velocity (EDV) of SPCAs in patients with NAION (r=0.514, P<0.01 and r=0.418, P<0.05, respectively). CONCLUSION: Narrowing of ICAS may increase the risk of developing NAION.

Non-invasive diagnosis of liver fibrosis: A review of current imaging modalities.

Hundreds of millions of patients are suffering from cirrhosis and other chronic liver diseases worldwide, and this public health problem continues to grow. It has been proven that liver fibrosis is reversible after the elimination of the etiology, especially in the early stage. Thus, early diagnosis of liver fibrosis is of vital importance for clinical treatment. Liver biopsy remains the gold standard for both diagnosis and staging of fibrosis, but is suboptimal, due in large parts to its invasive nature and sundry associated complications. To overcome this, a number of non-invasive diagnosis based on serum biomarkers or imaging modalities have been developed. While diagnosis based on serum biomarkers is cheaper and more acceptable to patients, almost none developed to date are liver-specific, and may engender a false positive error. The imaging modalities have evolved rapidly and are taking on more and more important roles in the diagnosis of liver fibrosis.

Primary isolated intracranial Rosai-Dorfman disease: Report of a rare case and review of the literature.

BACKGROUND: Intracranial involvement is an uncommon manifestation of Rosai-Dorfman disease (RDD) and had been rarely reported. In this study, we explore clinical characteristics, imageology manifestations and pathological features of primary intracranial RDD so as to improve the understanding for this disease. METHODS: One case (16-years-old boy) with primary intracranial RDD was analyzed and studied retrospectively by MRI features, histopathological observation and immunohistochemical staining, and the related literatures were reviewed. RESULTS: The case was single lesion and involved the dura of the left middle cranial fossa base, which was iso-hypo signal intensity on T1WI and hypointense on T2WI and FLAIR image. The lesion was a homogeneous contrast enhancement mass with dural tail sign and had peritumoral brain edema. Pathological analysis showed the lesion consisted of variable numbers of mature lymphocytes, plasma cells and neutrophils. The characteristic histiocytes were emperipolesis and positively expressed for S-100 and CD-68 and negatively expressed for CD-1a by immunohistochemical analysis. Based on clinical presentations and histological findings after surgical excision, a final diagnosis of primary intracranial RDD was made. CONCLUSION: Primary intracranial RDD, especially located in the cranial base, is exceptionally rare, which hard to be distinguished with meningoma by imageology and clinical manifestations, but could be diagnosed by pathological and immunohistochemical examinations. Surgery is of the most importance treatment and prognosis is optimistic for this disease.

Research progress of methods allowing quantitative analysis of aortic valve calcification / 中国胸心血管外科临床杂志

@#With the development of social economy and medicine, degenerative heart valve disease has become the major part in heart valve disease. Calcific aortic valve disease (CAVD) is one of the most representative manifestations of degenerative valvular disease. Aortic valve calcification (AVC) has been found to be a strong predictor of major cardiovascular events, which makes it necessary to identify an effective way to evaluate the degree of AVC. Numerous methods of quantitative assessment of AVC have been reported. Here, we discuss these methods from the aspects of pathology and imageology.

The clinical characteristics of posterior reversible encephalopathy syndrome in patients with chronic renal failure.

Few studies have investigated posterior reversible encephalopathy syndrome (PRES) in patients with chronic renal failure (CRF). The present study analyzed the clinical manifestations, laboratory examinations and imaging features of PRES in patients with CRF. A total of 42 patients with CRF with or without PRES were recruited in the current retrospective case-control study. Patient data taken prior to the onset of PRES in patients with CRF and PRES (n=21) were collected and analyzed. At the same time, data from patients with CRF but without PRES (n=21) were also analyzed. Brain magnetic resonance imaging (MRI) scans were collected from patients in the PRES group. The mean blood pressure of patients in the PRES group was significantly higher than that of the control group (systolic blood pressure: 172±15 mmHg vs. 135±14 mmHg, P<0.01; diastolic blood pressure: 95±16 mmHg vs. 64±13 mmHg, P<0.01). Furthermore, compared with the control group, mean serum albumin (Alb) and hemoglobin (Hb) concentrations in the PRES group were significantly lower (Alb: 29.1±5.3 g/l vs. 34.6±6.1 g/l, P=0.001; Hb: 74±16 g/l vs. 89±28 g/l, P=0.037). By contrast, mean LDH concentration was significantly higher in the PRES group (LDH: 336±141 U/l vs. 235±89 U/l, P=0.004). In the PRES group, 24 h urine volume was significantly lower in the PRES group than in the control group (24 h urine volume: 651±520 ml vs. 982±518 ml, P=0.046). No significant differences in levels of serum potassium (4.5±0.6 mmol/l vs. 4.4±0.5 mmol/l, P=0.377), sodium (138.3±4.9 mmol/l vs. 139.0±6.8 mmol/l, P=0.325), calcium (2.0±0.24 mmol/l vs. 1.9±0.24 mmol/l, P=0.673), alanine aminotransferase; (24±14 U/l vs. 18±8 U/l, P=0.975); aspartate aminotransferase (29±11 U/l vs. 24±9 U/l, P=0.619) and uric acid (448±148 µmol/l vs. 378±116 µmol/l, P=0.599) were found between the two groups. PRES is a relatively common nervous system complication arising in patients with CRF. Certain biochemical markers, including Hb and Alb, may be associated with PRES. Diagnosing PRES is difficult as computed tomography (CT) brain scans may be normal and MRI scans, which are more sensitive than CT scans at diagnosing PRES, are not always performed in patients with CRF. Thus, brain MRI scans should be taken first in such patients when PRES is suspected.

Review of primary extra-adrenal myelolipoma of the thorax.

Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery.

Study on relationship between imageology and pathology of 624 patients with T1 stage lung cancer / 中华胸心血管外科杂志

Objective To study the relativity between imageology and pathology during lung cancer,and estimate whether the lung cancer is preinvasive lesions,which can support evidences for the operation methods.Methods Clinical data of 624 patients who were diagnosed as lung adenocarcinoma and had solitary pulmonary nodule(diameter≤3 cm) were collected,all of them were scanned by thin layer CT scan(1 mm).The correlation between imageology and pathology data were analyzed.Results In 125 cases of GGO,the ratio of invasive lesions were 0 (0/72),6.1％ (3/49) and 100％ (4/4) in stage T1a,T1b and T1c respectively.In 285 cases of mGGO,if solid component was less than 0.5 cm,the ratio of invasive lesions were 1.7％ (1/58),6.9％ (2/29) and 50.0％ (2/4) in stage T~,T1b and Tic;but the ratio of invasive lesions were 81.3％ (13/16),94.1％ (96/102) and 97.4％ (74/76) respectively when the solid component was more than 0.5 cm.In 214 cases with solid nodules,the ratio of invasive lesions were 87.1％ (27/31),98.8％ (84/85) and 99.0％ (97/98) in stage T1 a,T1b and T1c.Conclusion The ratio of invasive lesions and solid component increased gradually along with the growing of tumor diameter in stage T1 lung cancer.CT imaging was highly correlated with the pathology diagnosis of preinvasive lesions and invasive lesions,which can be used as the guidance for operation methods.

Study on relationship between imageology and pathology of 624 patients with T1 stage lung cancer / 中华胸心血管外科杂志

Objective To study the relativity between imageology and pathology during lung cancer,and estimate whether the lung cancer is preinvasive lesions,which can support evidences for the operation methods.Methods Clinical data of 624 patients who were diagnosed as lung adenocarcinoma and had solitary pulmonary nodule(diameter≤3 cm) were collected,all of them were scanned by thin layer CT scan(1 mm).The correlation between imageology and pathology data were analyzed.Results In 125 cases of GGO,the ratio of invasive lesions were 0 (0/72),6.1％ (3/49) and 100％ (4/4) in stage T1a,T1b and T1c respectively.In 285 cases of mGGO,if solid component was less than 0.5 cm,the ratio of invasive lesions were 1.7％ (1/58),6.9％ (2/29) and 50.0％ (2/4) in stage T~,T1b and Tic;but the ratio of invasive lesions were 81.3％ (13/16),94.1％ (96/102) and 97.4％ (74/76) respectively when the solid component was more than 0.5 cm.In 214 cases with solid nodules,the ratio of invasive lesions were 87.1％ (27/31),98.8％ (84/85) and 99.0％ (97/98) in stage T1 a,T1b and T1c.Conclusion The ratio of invasive lesions and solid component increased gradually along with the growing of tumor diameter in stage T1 lung cancer.CT imaging was highly correlated with the pathology diagnosis of preinvasive lesions and invasive lesions,which can be used as the guidance for operation methods.

Application of next generation sequencing technology for genetic diagnosis of a case with globoid cell leukodystrophy / 临床儿科杂志

Objective To explore the clinical, radiological features and gene mutation of GALC gene in one child with globoid cell leukodystrophy (Krabbe disease). Methods The clinical and radiological data of a patient diagnosed with Krabbe disease through next-generation sequencing were retrospectively analyzed. Sanger sequencing was used to confirm the results. Results The patient was late infantile form with main manifestations of progressive psychomotor regression and convulsion. Brain MRI showed symmetric long T1 and long T2 signal changes in the white matter next to lateral ventricle angle, posterior limb of internal capsule, and the ministry of corpus callosum. The patient was found to have compound heterozygous mutations of c.1832T>C in exon 15 and c.979T>G in exon 9, which resulted in amino acid changes of p.L611S and p.F327V, respectively. Sanger sequencing results showed that the two heterozygous mutations were correspondingly inherited from his mother and father. Conclusions Next-generation sequencing technology is a useful tool for the detection of GALC gene mutation, which is valuable for definite diagnosis and differential diagnosis of Krabbe disease in clinical practice.

[Present situation of laryngotracheal stenosis' diagnosis technology].

Laryngotracheal stenosis is a complex and dangerous disease,which caused by trauma or endotracheal intubation.Accurately and clearly to show the length and area of the airway stenosis,which is of great significance for the correct qualitative and quantitative diagnosis of the disease and the development of the treatment.The relevant inspection has its advantages and disadvantages.How to use inspection accurate and reasonable,there is no unified standard.Therefore,this paper will evaluate the role and significance of different relevant inspection(pulmonary function tests,ultrasound,bronchoscopy,CT,MRI) in the diagnosis of laryngotracheal stenosis,providing reference for laryngeal and tracheal stenosis diagnosis and treatment.

The application of comparative imageology in oral and maxillofacial medical imaging diagnostics teaching / 中华医学教育探索杂志

The development of medical imaging diagnosis technology has brought forward higher requirements for the teaching of oral and maxillofacial medical imaging diagnostics, In this study, we intro-duce the methods and concepts of comparative imaging to guide students to analyze and compare oral and maxillofacial diseases from different perspectives, and to promote the students' understanding of the disease image and mastery of disease diagnosis, improve the students' ability to choose the appropriate imaging method in the future clinical work. Comparative imaging is one of the important teaching methods in the diagnosis of oral and maxillofacial medical imaging, and it is also the direction of its future development.