Objective To further understand the clinical manifestations and improve clinical diagnosis of patients with leptomeningeal metastasizing high-grade glioma.Methods Sixteen patients with leptomeningeal metastasizing high-grade glioma (WHO classification:grade Ⅲ-Ⅳ) in Department of Radiotherapy,the First Hospital of Jilin University from July 2010 to September 2015 were respectively analyzed.The pathological types included anaplastic gliomas (1),anaplastic oligodenastrocytoma (1),glioblastoma (12),small-cell glioblastoma (1),gliosarcoma (1).We reviewed the relative clinical manifestations of the patients,and further compared them with 163 patients with systemic malignant solid tumors at corresponding period.Results The median time from initial diagnosis to the diagnosis of leptomeningeal metastasis was 13.0 months (range 2-19 months).Plain and enhanced magnetic resonance imaging was obtained in all patients.The main radiographic characteristics included ependymal enhancement (11),leptomeningeal enhancement (3),nodules of implantation metastasis in spinal canal (1),cranial nerve enhancement (2),and ventricular dilatation (1).Eight patients received cerebrospinal fluid examination.The diagnosis of leptomeningeal metastasis in 15/16 patients was determined by radiographic findings.Comparing with leptomeningeal metastasis from systemic malignant tumors at the corresponding period,the incidence of headache in patients with high-grade glioma was significantly lower (6/16 vs 81.6％ (133/163);x2 =16.3,P ＜ 0.01);and the incidence of cranial nerve paralysis was also significantly lower (4/16 vs 56.4％ (92/163);x2 =5.79,P =0.016 1).The incidence of nerve root symptoms was lower than that of systemic malignant tumors,though without statistically significant difference (2/16 vs 26.4％ (43/163);x2 =1.49,P=0.222).Nine patients respectively received chemotherapy,intrathecal chemotherapy or intrathecal chemotherapy combined with whole brain radiotherapy.The median survival tine was 4.5 months (range 0.7-13.3 months).Conclusions The imaging examination played an important role in the diagnosis of high-grade leptomeningeal metastasizing glioma.Comparing with the systemic malignant solid tumors,the leptomeningeal metastasizing high-grade glioma had its unique clinical characteristics.

Objective To investigate the ultrasonic imaging features of thyroid follicular adenoma for conducting the correct diagnosis and differentiation diagnosis.Methods The clinical and imaging data in 64 cases of pathologically proven thyroid follicular adenoma were analyzed on the maximal diameter of tumor,nodularity number,high and low echogenicity,peripheral halo,echo hom-ogeneity,calcifications,and so on.The misdiagnosis causes were investigated.Results The mass was mainly solid or cystic-solid mixed echo.The ultrasonic imaging features of thyroid follicular adenoma were non-peripheral halo or thin wall halo,hyperecho or isoecho,internal macrocalcifications and peripheral calcifications,homogeneous echo structure.Conclusion The ultrasonographic examination can provide the better diagnosis and differentiation diagnosis on thyroid follicular carcinoma.

The toroidal ion trap is an ideal candidate for miniaturized ion trap because it has much higher ion trapping capacity than a standard quadrupole ion trap of equal trapping dimensions. A novel toroidal ion trap mass analyzer with triangular electrode which contained a filament end cap, a detector endcap, an inner ring and an outer ring was reported. After designing and optimizing the electrodes by theoretical simulations, we found that the asymmetric triangle electrodes could reduce the affection from toroidal shape and improve the ion ejection rate and the mass resolution of the ion trap. The best design of the toroidal ion trap with a mass resolution of 1486 at m/z 609 was obtained.

Objective To explore the status of pain catastrophizing in patients with postherpetic neuralgia (PHN) and its influencing factors, and to analyze the correlation between pain catastrophizing and alexithymia. Methods A total of 243 PHN patients were recruited as study subjects and surveyed using a general information questionnaire, the Pain Catastrophizing Scale (PCS), and the 20-item Toronto Alexithymia Scale (TAS-20). Multiple linear regression analysis was conducted to explore the influencing factors of pain catastrophizing, and Pearson correlation analysis was used to explore the correlation between pain catastrophizing and alexithymia. Results The mean PCS score of the 243 PHN patients was (30.04±11.33), with the highest mean score for items in the helplessness dimension and the lowest for items in the magnification dimension. Multiple linear regression analysis showed that age, monthly family income per capita, disease duration, and pain intensity were independent influencing factors of pain catastrophizing in PHN patients (P < 0.05), collectively explaining 49.5% of the variance. Pearson correlation analysis showed a significant positive correlation between pain catastrophizing and alexithymia in PHN patients (P < 0.01). Conclusion PHN patients exhibit high levels of pain catastrophizing, which is influenced by age, disease duration, pain intensity, and monthly family income per capita. Furthermore, there is a significant positive correlation between pain catastrophizing and alexithymia.

Objective To assess the influence and early diagnosis treatment of bronchiectasis using severity score in patients with chronic obstructive pulmonary disease (COPD) combined with bronchiectasis. Methods Sixty patients with bronchiectasis in stable stage were selected from July 2016 to August 2017. The patients were divided into simple bronchiectasis group (32 cases) and bronchiectasis combined with COPD group (28 cases). The general clinical features, chest high-resolution CT (HRCT), pulmonary function, fractional exhaled nitric oxide (FENO) and bronchiectasis severity score between 2 groups were compared. The changes of the indexes 6 months after treatment with inhaled salmeterol fluticasone (50 μg/250 μg) in bronchiectasis combined with COPD group were observed. Results The bronchiectasis severity score and FENO in bronchiectasis combined with COPD group were significantly higher than those in simple bronchiectasis group: (4.82 ± 0.91) scores vs. (2.88 ± 0.83) scores and (39.04 ± 9.57) nmol/L vs. (28.66 ± 6.12) nmol/L, and there were statistical differences (P＜0.01). The forced expired volume in one second as a percentage of expected value (FEV1% Pred) and forced vital capacity as a percentage of expected value (FVC%Pred) in bronchiectasis combined with COPD group were significantly lower than those in simple bronchiectasis group: (61.36 ± 5.23)% vs. (71.28 ± 6.67)% and (61.57 ± 7.60)% vs. (72.84 ± 7.19)% , and there were statistical differences (P＜0.01). In bronchiectasis combined with COPD group, there were statistical differences in the bronchiectasis severity score, FEV1% Pred, FVC% Pred and FENO 6 months after treatment with inhaled salmeterol fluticasone and before treatment (P＜0.05). There was a negative correlation between FEV1% Pred and bronchiectasis severity score before and after treatment (r＝-0.802 and-0.618, P＜0.05); and there was a positive correlation between the FENO and bronchiectasis severity score (r ＝ 0.728 and 0.586, P＜0.05). Conclusions The pathogenetic condition of bronchiectasis combined with COPD is severe compared with simple bronchiectasis. Inhaled salmeterol fluticasone is effective in patients with bronchiectasis combined with COPD.

Objective To analyze the diagnostic value of ultrasonographic calcification on benign and malignant thyroid nodules. Methods The clinical data of 133 thyroid nodules diagnosed in our hospital from January 2015 to June 2017 by ultrasound examination and surgical or biopsy were retrospectively analyzed. Compared the correlation between the characteristics of calcified foci of thyroid nodules and benign and malignant nodules. Results In 133 patients, 176 thyroid nodules were found by ultrasound, including 71 (40. 34％) nodules with calcification and 105 (59. 66％) nodules without calcification. A total of 112 benign nodules(63. 64％) and 64 malignant nodules(36. 36％) were found by pathological diagnosis. The incidence of malignant nodules in calcified thyroid nodules (77. 46％) was significantly higher than that in no-calcified thyroid nodules (7. 62％), and the difference was statistically significant (P＜0. 05). Among 38 nodules with calcified calcification, the incidence of malignant nodules was 94. 74％ (36/38); the incidence of malignant nodules in 23 nodules with calcified calcification was 47. 83％ (11/23) There was a statistically significant difference between the two groups(P＜0. 05). The incidence of calcification in malignant thyroid nodules was 87. 50％(56/64) significantly higher than that in benign thyroid nodules(13. 39％, 15/112) (P＜0. 05). Conclusion The characteristics of calcification under ultrasonography are of great value in the diagnosis of benign and malignant thyroid nodules. In particular, microcalcification calcification can be used as one of the specific indicators of screening for malignant thyroid nodules. It is worthy of clinical promotion.

Objective:According lung adenocarcinoma(LUAD)ferroptosis and non-coding RNA in patients with a long-chain(lncRNA)correlation,binding immunophenotyping constructing new risk rating model to assess the prognosis of LUAD patients.Methods:Based on bioinformatics technology,download the transcriptome data and clinical data of LUAD samples from the TCGA database,obtain genes related to ferroptosis from the FreeDb database,and used"caret"package to screen 504 cases of LUAD samples and randomly divided into training set and validation set according to the ratios of 50%and 50%.Pearson correlation analysis and univariate-factor Cox regression were used to screen ferroptosis-related lncRNA related to the prognosis of LUAD,and the"Conen-susClusterPlus"package of R software was used.Immune correlation analysis with CIBERSORT software,LASSO regression analysis to establish ferroptosis-related lncRNA model,receiver operating characteristic(ROC)curve and area under the curve(AUC)to test the performance of the prognostic model,and verified by validation set.Results:Univariate factor Cox and LASSO regression analysis constructed nine risk scoring models composed of lncRNA related to ferroptosis.Both univariate and multivariate Cox regression analy-sis showed that this prognostic model can be used as an independent prognostic factor(P<0.001).The model had good prediction performance in training set,internal validation set and external validation set.Conclusion:The risk score model of LUAD patients constructed in this study can be used as a new independent prognostic evaluation method,or it may have further application value.

Objective Compared with chest CT,endoscopic ultrasonography (EUS) can more accurately determine the upper and lower margins of esophageal cancer,and marking the upper and lower margins of the esophageal cancer with titanium clip contributes to the delineation of target area of esophageal cancer during radiotherapy.To compare the effects of esophageal X-ray,chest computed tomography (CT)scan and EUS-assisted placement of marker clip in the determination of the length of gross target volume (GTV),aiming to provide reference for the determination of GTV during esophageal cancer radiotherapy.Methods Thirty patients who were initially diagnosed with thoracic esophageal cancer by histological and cytological examinations and scheduled to receive radiotherapy were recruited in this investigation.All patients received esophageal X-ray,CT scan,and EUS-assisted placement of marker clip.The length of GTV was quantitatively measured and statistically compared among three different methods.Results The length of GTV was (6.1 ± 1.4) cm,(6.8± 1.9) cm and (6.3± 1.9) cm determined by esophageal X-ray,CT scan and EUS-assisted placement of marker clip,respectively.Compared with CT scan,the length of GTV determined by EUS-assisted placement of marker clip did not significantly differ (P=0.11).The length of GTV determined by esophageal X-ray was significantly shorter than that by CT scan (P =0.03).Among all patients,the length of GTV determined by EUS-assisted placement of marker clip was longer compared with that by chest CT scan in 22.2％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was the same as that by chest CT scan in 11.1％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was shorter compared with that by chest CT scan in 66.7％ of patients.Conclusions EUS-assisted placement of marker clip differs from esophageal X-ray and CT scan in determining the length of GTV,which acts as one of the effective methods in the determination of the length of GTV during esophageal cancer radiotherapy.

Objective To externally validate the accuracy of combined use of neutrophil-lymphocyte ratio (NLR),V20,and Dmean in predicting the incidence of grade Ⅲ or higher radiation-induced lung injury (RILI) in lung cancer patients.Methods A total of 166 lung cancer patients,who participated in the model establishment were selected into the internal validation group,and 85 lung cancer patients who received intensity-modulated radiotherapy in our department between June 2016 and June 2018 were assigned into the external validation group.The incidence rate of grade 3 or higher RILI was statistically compared between the internal and external validation groups.Multivariate logistic analysis was performed for NLR,V20 and Dmean The discrimination degree of the predictive model was evaluated by using ROC curve in combination with NLR,V20 and Dmean The calibration degree of the predictive model was assessed by Hosmer-Lemeshow test.Results The incidence rate of grade 3 or higher RILI in the internal and external validation groups was 23.8％ and 22.9％.Multivariate logistic analysis demonstrated that NLR,V20 and Dmean significantly differed in the internal validation group (P=0.032,0.006 and 0.005).However,only V20 significantly differed in the external validation group (P=0.038).The discrimination and calibration degree of RILI was almost consistent between the internal and external validation groups (both P＞0.05).The area under the curve (AUC) predicted by NLR,V20,Dmean and the combination of three indexes were 0.611,0.646,0.682 and 0.775 in the internal validation group,and 0.544,0.702,0.658 and 0.754 in the external validation group,respectively.The calibration degree in the internal validation group was P=2.797and 0.834,P=2.452 and 0.653 in the external validation group.Conclusion Combined application of NLR,V20 and Dmean can accurately predict the incidence of grade Ⅲ or higher RILI in lung can cancer patients,which has been validated by external dataset.

Objective To explore the value of non-contrast CT findings of acute ischemic stroke(AIS)for predicting early prognosis after mechanical thrombectomy.Methods Data of 161 AIS patients from clinical center 1 who underwent mechanical thrombectomy were retrospectively analyzed.The patients were divided into training set(n=113)and internal test set(n=48)at the ratio of 7∶3,while 79 AIS patients who underwent mechanical thrombectomy from clinical center 2 were retrospectively enrolled as external test set.According to the National Institutes of Health stroke scale(NIHSS)scores 7 days after thrombectomy,patients'prognosis were classified as good(＜15 points)or poor(≥15 points).Pre-treatment non-contrast CT images of patients were reviewed,and CT findings were comparatively analyzed.Independent predictors of patients'early prognosis after mechanical thrombectomy were obtained with sequential univariate and multivariate logistic regressions,and a predicting model was established and visualized as a nomogram.The receiver operating characteristic curve was drawn,and the distinction was assessed with the area under the curve(AUC),then calibration was assessed with Hosmer-Lemeshow goodness of fit test,and the net benefit was evaluated with decision curve analysis(DCA).Results Alberta stroke program early CT score(ASPECTS),hyperdense middle cerebral artery sign(HMCAS)and basal ganglia calcification were all independent predictors of early prognosis of AIS after mechanical thrombectomy(all P＜0.05).The predictive model was established combining the above 3 variables and then visualized as a nomogram to predict prognosis of AIS after mechanical thrombectomy,with AUC of 0.776 in internal test set(χ2=6.052,P=0.417)and 0.800 in external test set(χ2=2.269,P=0.811).DCA showed that the nomogram might provide clinical net benefit within certain threshold probability ranges.Conclusion ASPECTS,HMCAS and basal ganglia calcification were all independent predictors of early prognosis of AIS after mechanical thrombectomy.The nomogram originated from predicting model combining the three could be used to somewhat accurately predict poor early prognosis after mechanical thrombectomy.