We report a case of 46-year-old xanthoderm woman who was diagnosed as malignant peripheral nerve sheath tumors of right maxillary sinus, and have a literature review. Histology confirmed a diagnosis of malignant peripheral nerve sheath tumor. The woman had the right total maxillectomy and postoperative adjuvant radiotherapy. There is no local recurrence or metastasis of one year following up. Literature review revealed MPNST in the nasal cavity and para-nasal sinuses were not common with poor prognosis. The main cause of death is local recurrence and metastasis. Surgical resection showed more advantage than adjuvant radiotherapy and chemotherapy.
Female ; Humans ; Maxillary Sinus ; Middle Aged ; Neoplasm Recurrence, Local ; Nerve Sheath Neoplasms ; pathology ; therapy ; Neurilemmoma ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Radiotherapy, Adjuvant

Objective To evaluate left ventricular(LV)global and regional systolic function by three-dimensional speckle tracking imaging (3D-STI)in patients with systemic lupus erythematosus (SLE). Methods Twenty-two patients with SLE were selected randomly as SLE group and twenty-two healthy people were included as control group.3D-STI was performed in all participants to get global and regional strain parameters,including global longitudinal peak systolic strain(GLS),global circular peak systolic strain (GCS ),global radial peak systolic strain (GRS ),global area peak systolic strain (GAS ),segmental longitudinal peak systolic strain (SLS),segmental circumferential peak systolic strain (SCS),segmental radial peak systolic strain (SRS),and segmental area peak systolic strain (SAS).The sensitivity and specificity of GCS and GAS reflecting LV systolic function in patients with SLE were analyzed under the receiver operating characteristic (ROC)curve.Results ①The global strain:compared with the control group,GCS and GAS decreased significantly in SLE group (P <0.01),there was no significant change in GLS and GRS(P >0.05).②The regional strain:compared with the control group,the SCS in segments of basal anteroseptal,basal inferoseptal,mid anterior,mid inferosptal,mid anterolateral,apical inferior,apical lateral decreased significantly in SLE group.The SAS of basal anterior,basal inferoseptal,mid inferosptal, mid anterolateral,apical anterioe,apical lateral decreased significantly in SLE group (P <0.01).The SCS in segments of apex and the SAS of mid anterior,apical septal,apex decreased in SLE group (P <0.05).③The ROC curve:the sensitivity and specificity of GCS on detecting the LV systolic dysfunction were 59.1%and 87.5%,and those of GAS were 77.3% and 83.3%,respectively.Conclusions 3D-STI is a convenient and accurate way to early detect LV global and regional systolic dysfunction in SLE patients.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia.Methods Forty patients with uremia and forty healthy volunteers were enrolled.The quantitative parameters,including vorticity,sum total energy loss (sEL),average energy loss(aEL),and the alteration circulation were measured in the VFM imaging mode.Difference was evaluated between two groups at apical,mid and basal segments at different periods.E/e'was derived via dual-Doppler imaging technology.And correlationship was analyzed between vorticity,sEL,aEL,circulation and E/e',separately.Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole,there were difference in vorticity,sEL,aEL between two groups (P ＜0.05).Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94 ± 8.40) m2/s vs (8.36 ± 7.84) m2/s,(5.34 ± 5.24) m2/s vs (13.37 ± 10.42) m2/s,P ＜0.05].②In control group,vorticity,sEL and aEL were different in different segments of same phase or at different phases of same segment,and also did in the uremia group(P ＜0.01).③In uremia group,vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r =0.34,P =0.046)and atrial systole(r =0.38,P =0.02).And sEL had a good correlation with E/e'at basal segment of rapid filling phase,isovolumetric relaxation time and at mid segment of rapid filling phase(r1 =0.44,P1 =0.008;r2 =0.48,P2 =0.003;r3 =0.50,P3 =0.002),and in time phase mentioned above,there were also the correlationship between aEL and E/e'(r1 =0.39,P1 =0.017;r2 =0.49,P2 =0.002;r3 =0.48,P3 =0.003).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns.Methods One hundred and sixty-nine patients with hypertension and 50 healthy volunteers were enrolled.Hypertensive patients were divided into four groups with different ventricular configurations according to ASE guide line in 2005:normal geometry group,concentric remodeling group,concentric hypertrophy group and eccentric hypertrophy group.The quantitative parameters,including average energy loss(aEL) and circulation were measured.Difference was evaluated among five groups at apical,mid and basal segments and at different periods.The correlationship was analyzed between aEL,circulation and E/e',respectively.Results ① Compared to control group,aEL was higher in four hypertension groups at three segments of atrial systole(P ＜0.05).aEL in eccentric hypertrophy group was higher than those in control group,normal geometry group or concentric remodeling group at apical and mid segments of atrial systole,and higher than those in other hypertensive groups at basal segment (P ＜ 0.05).In four hypertension groups,circulations in rapid filling phase of anterior mitral valve were lower than that in control group,but circulations in slow filling phase of posterior mitral valve were higher than that in control group(P ＜0.05).The circulation in slow filling phase of posterior mitral valve in concentric remodeling group was higher than that in normal geometry group,and that in eccentric hypertrophy group was higher than those in normal geometry group and concentric remodeling group(P ＜0.05).②When intra-group comparison,aEL were different in different segments of same phase or at different phases of same segment(P ＜0.05).③aEL had a good correlation with E/e'at basal segment of atrial systole in four hypertension groups(r =0.66,P ＜0.01).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of hypertensive patients with different left ventricular geometric patterns,it may be a good supplement for assessing cardiac diastolic function and reflect the extent of damage.

Objective:To evaluate the effect of anthracyclines on myocardial work in patients with breast cancer by left ventricular pressure strain loop (PSL).Methods:From April 2019 to June 2020, 30 breast cancer patients treated with AC-T regimen(Adriamycin/epirubicin+ cyclophosphamide+ docetaxel) in the Second Affiliated Hospital of Harbin Medical University were selected as case group, and 30 healthy volunteer were selected as control group. Transthoracic echocardiography was performed in the case group at 3 time points: before chemotherapy (T0 phase), after the third cycle of chemotherapy (T1 phase), and after the sixth cycle of chemotherapy (T2 phase) respectively. Conventional ultrasonic parameters were collected. Left ventricular PSL was used to evaluate the left ventricular myocardial work index, including global work index (GWI), global constructive work (GCW), global work waste (GWW) and global work efficiency (GWE). The same examination was performed in the control group, and the results between T0 phase and control group, among different phases were compared.Results:①There were no statistically significant differences of general information, conventional ultrasound parameters, left ventricular strain and myocardial work parameters between T0 phase and control group (all P>0.05). ②There were no statistically significant differences of LVEF, GLS, GWI, GCW, GWE and GWW between T1 phase and T0 phase (all P>0.05). ③There were no statistically significant differences in LVEF between T2 phase and T0 phase ( P>0.05). The absolute values of GLS, GWI, GCW and GWE decreased, but GWW increased, the difference was statistically significant (all P<0.05). ④There were no significant differences in LVEF between T2 phase and T1 phase ( P>0.05), but the absolute values of GLS, GWI, GCW and GWE decreased, while GWW increased (all P<0.05). Conclusions:Left ventricular PSL can effectively evaluate the myocardial work of anthracycline chemotherapy in breast cancer patients, which is superior to LVEF and provide a new evaluation method for asymptomatic patients.

Objective:To investigate the occurrence of human papillomavirus (HPV) single and multiple infections in different cervical lesions, and to analyze the distribution of HPV types in patients with single infection and the change of viral load before and after treatment.Methods:A total of 4 783 HPV-DNA-positive cases who were detected by cervical exfoliated cells HPV-DNA testing from May 2017 to March 2019 in Shanxi Provincial People's Hospital were retrospectively analyzed, of which 3 728 cases met the criteria and were included in this study. Fluorescence quantitative polymerase chain reaction (PCR) was used to determine HPV genotype and viral load, and liquid-based thin-layer cytology (TCT) test and colposcopic histopathological diagnosis were performed. According to the histopathological results, the patients were divided into chronic cervicitis+cervical intraepithelial neoplasia (CIN) Ⅰ group, CIN Ⅱ+CIN Ⅲ group and cervical cancer group.Results:A total of 3 364 cases had HPV single infection, of which chronic cervicitis+CIN Ⅰ accounted for 78.27% (2 633/3 364), CIN Ⅱ+CIN Ⅲ accounted for 18.73% (630/3 364), and cervical cancer accounted for 3.00% (101/3 364); 364 cases had HPV multiple infections, of which chronic cervicitis+CIN Ⅰ accounted for 51.65% (188/364), CIN Ⅱ+CIN Ⅲ accounted for 42.58% (155/364), and cervical cancer accounted for 5.77% (21/364). The difference in the proportion of cervical lesions with different pathological grades in HPV single infection and multiple infections was statistically significant ( χ2 = 127.21, P < 0.01). The top four HPV single infection genotypes in chronic cervicitis+CINⅠ group and CINⅡ+CINⅢ group were type 16, 52, 58 and 53, and their proportions were 17.05% (449/2 633), 12.91% (340/2 633), 9.08% (239/2 633) and 8.89% (234/2 633) in chronic cervicitis+CINⅠ group, and 32.22% (203/630), 10.32% (65/630), 8.41% (53/630) and 5.87% (37/630) in CINⅡ+CINⅢ group. In the cervical cancer group, the top two HPV single infection genotypes were type 16 and 18, and their proportions were 81.19% (82/101) and 6.93% (7/101). The viral load of 120 patients with HPV infection was 4.89±1.14 before treatment and 2.86±1.63 after treatment, and the difference was statistically significant ( t = 13.260, P < 0.01). Conclusions:HPV multiple infections are more likely to aggravate the degree of cervical lesions than single infection. Common HPV infection subtypes in different cervical lesions include type 16, 52, 58, 53 and 18.

Objective To explore the safety of fat reduction treated by non invasive focused ultrasound.Methods A randomized double-blind and negative control clinical trial was carried out on the excess fat of 40 subjects' abdomen by a JCS-01 non-invasive focused ultrasound device.Subjects received treatments with the device on day 1 and day 7.Observations on the area treated and inquiries on feelings were conducted during treatments.Before the first treatment and 14 days after the treatment,laboratory examinations were performed,including liver function,blood lipid tests,etc.Results 40 subjects participated in the trial and 36 subjects (18 each in both treatment and control groups) accomplished 2 times of treatments,all followed-up and laboratory examinations.During the process of treatments,4 subjects in the experimental group complained about feelings of tepidity or pricking.One subject on blood test of triglyceride showed slightly higher than her early normal result,which fell to the normal level at reexamination.Conclusions Subjects treated by non-invasive focused ultrasound at the area of no more than 500 cm2 every time and at an interval of 6 days manifest little changes on the blood test results,with slightly local reactions but no complaints during follow-up.

Objective To investigate the association between the polymorphism of C-reactive protein (CRP) gene and plasma level of hs-CRP in patients with ischemic stroke.Methods 548 patients with acute ischemic stroke were considered to be the case group and 993 age-matched healthy controls were randomly selected from community-based population.Three tagging SNPs of the CRP gene (rs876537,rs3093059,and rs3091244) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The plasma hs CRP levels were measured by routine method and multiple logistic regression was applied to evaluate genetic effect on plasma hs-CRP level.Results (1) The hs-CRP concentration and elevation (≥3.0 mg/L) proportion were significantly higher in case group than in control group [(3.534 ± 3.484) mg/L vs.(1.957 ± 2.344) mg/L,43.1％ vs.16.6％,t=10.74 and 23.45,both P＜0.05].(2) Compared with controls,the case group had higher conventional vascular risks,including higher blood pressure [SBP:(145.33 ± 22.11) vs.(134.92±19.48) mmHg,t=14.30,P＜0.05; DBP:(88.14±12.72) vs.(81.42± 12.44) mmHg,t=12.44,P＜0.05],higher low-density lipoprotein cholesterol [(2.714±0.904)vs.(2.286 ± 0.704) mmol/L,t =9.72,P＜ 0.05],and lower concentration of high-density lipoproteincholesterol [(1.213±0.317) vs.(1.438±0.262) /L,t=-12.89,P＜0.05].(3) Both rs876537 and rs3093059 polymorphism of CRP gene showed statistical associations with elevation of plasma hs-CRP level in case group.After adjusted for covariates including age,sex,hypertension,type 2 diabetes and other factors,additive model and dominant model of rs3093059 showed that the adjusted ORs (95 ％ CI) were 1.548 (1.103-2.171),1.562 (1.070-2.281) respectively (both P＜ 0.05).And ORs (95％ CI) of additive model and dominant model of rs876537 were 1.368 (1.067-1.753),1.719 (I.190-2.482) respectively after adjusted for covariates (both P ＜ 0.05).Conclusions Plasma hs-CRP concentration is significantly higher in ischemic stroke patients than in healthy population.The polymorphism of rs876537 and rs3093059 of CRP gene has association with elevation of plasma hs-CRP level in ischemic stroke patients.

Objective To investigate the association of C-reactive protein (CRP) gene polymorphisms and plasma hs-CRP level,and effect on the genetic susceptibility of ischemic stroke (IS).Methods A case-control study was conducted and 548 patients with acute ischemic stroke and 993 agematched controls from community-based population were included in this study.Epidemiological questionnaires were managed to collect for demographic information.Blood pressure was measured and blood glucose,triacylglycerol,cholesterol,and high sensitivity C-reaction protein (hs-CRP) were detected.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for genotyping of CRP gene in all participants.Results The levels of plasma hs-CRP and the proportion of elevated plasma hs-CRP (≥3.0 mg/L) in the ischemic stroke patients (3.534 ± 3.484) mg/L (43.1％) were significantly higher than those of controls (1.957 ±2.344) mg/L (16.6％),t =9.475,P ＜ 0.01,x2 =128.326,P ＜ 0.01.The results of association analysis indicated that rs3093059 and rs3091244 of CPR gene presented statistical associations with ischemic stroke.After correction for confounding factors,ORs (95％ CI) of additive model and dominant model of rs3093059 were 0.697 (0.528-0.921),0.671 (0.487-0.923) respectively.ORs 95％ CI) of dominant model of rs3091244 was 0.728 (0.536-0.988).Further analysis indicated the polymorphism of rs876537,rs3093059,rs3091244 of CPR genotyping were significantly associated with plasma hs-CRP elevation (≥ 3.0 mg/L) both in ischemic stroke patients and in controls (P ＜0.05).Conclusion The CRP genetic polymorphisms were negatively associated with ischemic stroke,and positively corrleted with plasma hs-CRP elevation.However,plasma hs-CPP was positively correlated with ischemic stroke.These results suggested that the plasma hs-CRP levels might be accompanied by ischemic stroke.

Objective To evaluate the left ventricular flow field characteristics in patients with obstructive and non-obstructive hypertrophic cardiomyopathy (HCM) using vector flow mapping (VFM),then assess the left ventricular hemodynamics.Methods 40 patients with HCM were randomly selected as case group,among which 20 patients with left ventricular outflow tract(LVOT) obstruction (group Ⅰ) and 20 patients without LVOT obstruction(group Ⅱ),40 healthy adult volunteers served as control group.The conventional parameters:left ventricular ejection fraction(LVEF),interventricular septal thickness and radial and pressure gradient of left ventricular outflow tract and VFM parameters:left ventricular peak systolic velocity (Vs),systolic flow (Fs),total negative systolic flow (SQ-) and vortex parameters were measured and compared.The correlation between LVOT pressure gradient and VFM parameters were assessed.Results There was no significant difference of LVEF in three groups.Compared with control group,interventricular septal thickness in group Ⅰ and group Ⅱ was much higher(P ＜0.05).Radius in group Ⅰ was much lower than that of group Ⅱ and pressure gradient of LVOT in group Ⅰ was significantly higher compared with group Ⅱ (P ＜0.05).Comparison of VFM parameters:①Compared with control group,SQ-of basal segments in case groups were lower (P ＜0.05),while SQ-of mid and apical segments were higher(P ＜ 0.05),Vs and Fs of all segments increased (P ＜0.05),and number of vortex,vortex diameter and vorticity of obstruction and non-obstruction groups were higher(P ＜0.05).②Compared with group Ⅱ,SQ-of basal segments decreased and SQ-of mid and apical segments increased in group Ⅰ,Vs and Fs of all segments were higher.The number of vortex,vortex diameter were higher in group Ⅰ (P ＜ 0.05).③ Correlation analysis:Fs in apex,the number of vortex relatively correlated with press gradient of LVOT(r =0.60,0.65,respectively).Conclusions VFM can effectively evaluate the flow field characteristics of left ventricle in patients with obstructive and non-obstructive HCM,and Fs in apex,number of vortex were correlated with the degree of obstruction,then further assess the left ventricular hemodynamics quantitively.