Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared to women with cervical intraepithelial neoplasia(CIN),women with VIN or VAIN were older.The rate of high-risk HPV DNA in women with vulvar or vaginal lesions was 84%(84/100).VAIN occurred mainly in the upper vagina(90%,69/75).VIN or VAIN often accompanied or followed CIN or cervical cancer(79%,31/39),and VIN or VAIN 2,3 often accompanied or followed CIN 2,3 or cervical cancer(70%,16/23).Conclusion:Our data suggest that women with high-risk HPV infection are at risk of developing VIN or VAIN 2,3.The vulva and vagina should be carefully inspected by colposcopic examination at the time of colposcopy for any abnormal findings.

Background The optic quality of Toric intraocular lens (IOL)-implanted eye is affected by the residual astigmatism and individual difference of corneal spherical aberration and different magnification from steep and flat axis refraction.Whether correcting Toric IOL spherical aberration can effectively improve the image quality of individual patient is a question to be studied.Objective This study attempted to collect eye parameters of cataract patients to reconstruct the customized vision model by using Zemax optical software,and to evaluate the image performance with different Toric IOL spherical aberration.Methods A prospective study was performed.Forty-five eyes of 45 cataract patients were included in Second Hospital of Hebei Medical University from August 2012 to October 2013.Several relevant parameters were measured by Pentacam,including anterior and posterior surface height of cornea,corneal thickness,curvature radius of flat and steep meridians of anterior surface astigmatism,refractive diopter and curvature radius of posterior surface.The astigmatism of anterior and posterior corneal surface was described by Matlab 4.5 software.Corneal astigmatism model were set as aspheric state,and the effective position of Toric IOL was calculated using Holladay Ⅰ formula.Customized individual model eyes were constructed by Zemax software.The contrast sensitivity function (CSF) of different spherical Toric IOLs at different spatial frequencies were calculated and compared between 300 Td light environment with 3 mm pupil diameter (photopia light) and 0.3-1.0 Td light environment with 5 mm pupil diameter (mesopia light).This study was approved by Second Hospital of Hebei Medical University ethics committee,all the patients signed the informed consent.Results The mean astigmatism power was (1.51 ± 0.36) D and (1.49 ± 0.37) D,and the mean astigmatism meridian was (101.5 ± 59.8) ° and (101.9±58.5) ° in the model eyes and cataract eyes,respectively,without significant differences between them (t=0.886,0.652;both at P＞0.05).Bland-Altman test showed a good agreement in astigmatism power and astigmatism meridian between model eyes and cataract eyes.The LogCSF values at 1.5,3.0,6.0,12.0 and 18.0 c/d spatial frequencies were significantly higher in the aspherical Toric IOL model eyes than those in the spherical Toric IOL model eyes,and the LogCSF values at various spatial frequencies were significantly higher in the Toric IOLs with spherical aberrations of-0.13 μm and-0.26 μm than those in the zero spherical aberrations in both photopia light and mesopia light (all at P＜0.05).Conclusions A precise corneal astigmatism model based on cornea high data of cataract eyes was successfully constructed through special formulas with Zemax software.Aspherical Toric IOL can compensate for spherical aberration of cornea and enhance the optic quality in individual model eye.

Background Pentacam anterior segment analysis system (Pentacam) is more accurate in the quantitative evaluation of ocular anterior segment in primary angle-closure glaucoma (PACG) eyes than slit lamp microscope and ultrasound biomicroscope (UBM).However,its accuracy in the earlier stage of PACG before and after YAG laser peripheral iridotomy (LPI) is not fully elucidated.Objective This study was to assess the effect of YAG LPI in PACG patients with Pentacam.Methods A prospective self-controlled study was performed.Thirtyfive fellow eyes (pre-clinical stage of PACG) of acute PACG and 35 fellow eyes of chronic PACG were included in the Second Hospital of Hebei Medical University from July,2012 to December,2013.YAG LPI was performed on the eyes,and the parameters of ocular anterior segment including central anterior chamber depth (ACD),anterior chamber volume (ACV) and peripheral anterior chamber angle (ACA) were measured and compared by Pentacam before and 1 day,7 days,28 days after operation.This study was approved by the Ethic Committee of the Second Hospital of Hebei Medical University and informed consent was obtained from all subjects.Results In pre-clinical stage of PACG eyes,the postoperative ACD and ACV values were increased in comparison with preoperation,showing significant differences among various time points (ACD:F =6.783,P =0.004;ACV:F =19.090,P =0.000),and no significant difference was found in ACA among different time points (F =0.153,P =0.928).In the fellow eyes of chronic PACG,the postoperative ACD and ACV values were larger than those of preoperation,with significant differences among various time points (ACD:F =21.576,P =0.000;ACV:F =47.506,P =0.000),and no significant difference was found in ACA among different time points (F=0.581,P=0.629).The change values of ACD and ACV were (0.064±0.022) mm and (27.840±4.963) mm3 in the eyes of pre-clinical stage of PACG,and those in the fellow eyes of chronic PACG were (0.047-± 0.020) mm and (21.000 ± 3.278) mm3,showing significant differences between the two groups (ACD:t=2.783,P=0.008;ACV:t=5.749,P=0.000).Conclusions Pentacam allows easy,fast,automatic and non-contact quantification and three-dimension image of the anterior chamber parameters before and after YAG LPI in pre-clinical stage of PACG eyes and fellow eyes of chronic PACG.The ACD deepens and ACV increases after LPI in glaucomous eyes,especially in the pre-clinical stage of PACG eyes.

Objective To analyze the patterns and distribution of lymph node metastasis in patients with adenocarcinoma of the esophagogastric junction ( AEG). Methods The pathological data of 393 patients with AEG from 2006 to 2009 were analyzed. The patterns and distribution of lymph node metastasis were analyzed in patients with different Siewert subtypes, depths of tumor invasion, and maximum diameters of the tumor, and the high?risk lymphatic drainage areas were investigated. Between?group comparison was performed by χ2 test. Results The metastatic rate and ratio of abdominal lymph nodes in AEG were 69?? 2%and 31?? 31%, respectively. The incidence rates of lymph node metastasis in the cardia, lesser curvature, left gastric artery, splenic artery, splenic hilum, mesenteric root, and abdominal aorta were the highest. The metastatic rate and ratio of mediastinal lymph nodes were 16?? 4% and 8?? 3%, respectively. The incidence rates of lymph node metastasis in the lower paraesophageal, esophageal hiatus, and superior diaphragmatic areas were the highest. Compared with Siewert type II and type III AEG, Siewert type I AEG had a significantly higher mediastinal lymph node metastatic rate (P= 0?? 003) and a significantly lower abdominal lymph node metastatic ratio (P= 0?? 002).The metastatic ratios of lymph nodes in multiple abdominal regions were higher in patients with stage T3+T4 AEG and a maximum tumor diameter of ≥6 cm than in the control group, while the metastatic ratios of mediastinal lymph nodes in groups with different maximum tumor diameters were similar. The metastatic ratios of lymph nodes in the greater curvature, hepatoduodenal ligament, and inferior diaphragmatic areas were lower than 10% in all groups. Conclusions In radiotherapy for AEG, the abdominal high?risk lymphatic drainage areas involve the cardia, lesser curvature, left gastric artery, splenic artery, splenic hilum, mesenteric root, and abdominal aorta, while the mediastinal high?risk lymphatic drainage areas involve the lower paraesophageal, esophageal hiatus, and superior diaphragmatic areas. In addition, the personalized target volume design should be based on the patterns of lymph node metastasis with different Siewert subtypes and clinical pathological characteristics.

OBJECTIVETo explore the expression of hypoxia inducible factor-1α(HIF-1α) in esophageal squamous cell carcinoma and its correlation with clinicopathological features.

METHODSOriginal literatures in foreign languages regarding correlation between HIF-1α and esophageal squamous cell carcinoma were identified from Cochrane Library, PubMed, EMbase database, and Chinese original literatures were from CBM, CNKI. All analyses were performed by Stata 11.0 software. Histological grade, degree of differentiation, T stage, lymph node metastasis, tumor stage, lymphatic invasion and vascular invasion were analyzed using pooled odds ratio (OR) with 95% confidence interval (CI).

RESULTSA total of 14 studies including 1 121 patients were enrolled in this meta analysis. Comparing with normal tissue, the expression of HIF-1α in esophageal squamous cell carcinoma was significantly enhanced (OR = 0.088, 95% CI: 0.061-0.129, P = 0.000); HIF-1α was significantly associated with T stage and lymph node metastasis (OR = 0.421, 95% CI: 0.222-0.798, P = 0.008; OR = 0.387, 95% CI: 0.207-0.725, P = 0.003). High expression of HIF-1α was correlated with an increased depth of tumor invasion, more lymph node metastasis and advanced tumor stage, whereas there was no relation to the degree of differentiation, histological grade, tumor stage, lymphatic invasion and vascular invasion.

CONCLUSIONSHigh expression of HIF-1α protein correlates with an increased risk of esophageal squamous cell carcinoma. HIF-1α may be an indicator for T stage, lymph node metastasis and tumor stage, but further studies are needed.

Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Confidence Intervals ; Esophageal Neoplasms ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Lymphatic Metastasis ; Odds Ratio

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.