Evoked potentials which can monitor spinal cord function in operation continuously and timely has been widely used in spinal orthopedics. However, intraoperative evoked potentials are affected by the technique in a variety of factors, how to improve the accuracy of intraoperative monitoring is still a problem to explore. In this paper, intraoperative nerve monitoring application and intraoperative potential reasons for the changes in the spine surgery orthopedic surgery were reviewed.

Purpose To investigate the relationship between Epstein-Barr virus (EBV) and lymphoepithelioma-like carcinoma (LELC) of the parotid gland and detect the gene expression products of EBV harbouring in LELC cells. Methods Thirty-two parotid LELCs were collected from the Departments of Pathology, Sun Yat-sen University of Medical Sciences, Guangzhou, China during the period of January 1986 and December 1995. All the 32 formalin-fixed paraffin-embedded blocks had been consecutively re-sectioned again. Immunohistochemical and in situ nucleic acid hybridization methods for detection of EBV gene encoded products were performed. Results (1) 32 LELCs were found out of 125 parotid gland carcinomas, the frequency was 25.6% (32/125). (2) All of the 32 specimens contained a variable number of EBNA-1 and EBERs positive neoplastic cells. (3) Twenty-seven out of 32 specimens (27/32, 84.4%) had a portion of carcinoma cells expressing LMP-1. (4) No ZEBRA positive cell could be found. (5) EA-D, VCA and MA positivity rates for these 32 parotid LELCs reached to 71.9%(23/32), 68.8%(22/32), and 12.5%(4/32), respectively. Conclusions (1) The parotid gland LELC is frequently to be seen in Guangzhou locale of China, where is a high-incidence area of nasopharyngeal carcinoma (NPC). The parotid gland LELC and NPC are co-prevalent in Guangzhou locale. (2) This disease is also consistently associated with EBV infection. (3) The EBV infection of the parotid gland LELCs is essentially the type of latency Ⅱ, expressing EBNA-1, EBERs and LMP-1. (4) The latent infected EBV harbouring in LELC cells could in part be switched over to lytic cycle, producing EA-D, VCA or/and MA.

OBJECTIVETo study the diagnosis and the differential diagnosis of nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL).

METHODS245 cases of Hodgkin's lymphoma (HL) diagnosed between 1980 and 2000 from 3 hospitals in Guangzhou were reviewed. Four cases of NLPHL were confirmed according to the WHO classification of lymphoid neoplasms. Among the other 3 cases of NLPHL, 2 collected from other clinical centers and 1 from Fudan University Cancer Hospital. Immunohistochemistry (IHC) were performed on paraffin sections through SP technique using a panel of markers to define the large neoplastic cells (CD45, CD20, CD15, CD30 and vimentin) as well as the non-neoplastic background cells (CD3, CD20, CD45RO, CD57, CD68 and TIA-1).

RESULTSSeven patients with NLPHL were 4 males and 3 females, age 29 to 70 years, average 43.8 years. All patients had lymphadenopathy. Histologically, in NLPHL, instead of the structure of normal lymph nodes, the tumor tissue became nodular in architecture. Characteristic lymphocytic and histiocytic (L&H) cells with scant cytoplasm and large multilobulated nuclei distributed among a predominant population of small lymphoid cells. The large cells exhibited a CD45+, CD20+, but CD15-, CD30- and vimentin-phenotype. The background cellularity was relatively rich in B cells and the majority of T-cells infiltrated were CD57(+) cells. TIA-1+ cells were few.

CONCLUSIONSNLPHL can be diagnosed according to the morphologic and immunophenotypic features rather than by morphology alone. It is important to distinguish this tumor from its morphologic mimics, such as lymphocyte-rich classical Hodgkin's lymphoma (LRCHL) and T-cell rich B-cell lymphoma (TCRBCL). The immunophenotype of neoplastic cells and background cells are the helpful criteria for the differential diagnosis.

B-Lymphocytes ; Diagnosis, Differential ; Hodgkin Disease ; Humans ; Immunophenotyping ; Lymphoma, B-Cell

Objective:To explore the value of dual-layer detector spectral CT quantitative parameters in evaluating the treatment response of neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).Methods:The study was a cross-sectional study. From May 2021 to March 2023, a total of 52 patients with LARC who received complete nCRT and were pathologically confirmed rectal adenocarcinoma at the Guangdong Province Hospital of Traditional Chinese Medicine were retrospectively enrolled. Each patient underwent spectral CT examination before and after nCRT, including plain scan, arterial phase (AP), and venous phase (VP) scans. According to the tumor regression grade, the patients were divided into the good response ( n=20) and the poor response group ( n=32). Measurements of the primary tumor′s spectral CT parameters, including effective atomic number (Z eff) at plain scan, iodine concentration (IC), CT values of 40 keV and 100 keV virtual monochromatic image (VMI) at dual-enhanced phases, were taken before and after nCRT. Additionally, the normalized iodine concentration (NIC), spectral curve slope (λHU), and the change rate of the above parameters before and after nCRT were calculated. The independent sample t-test or Mann-Whitney U test was used to compare the differences between the two groups. The receiver operating characteristic (ROC) curve was used to assess the efficacy of various metrics in evaluating the tumor treatment response of nCRT. A binary logistic regression analysis of combined parameter results was performed for the parameters with the areas under curve (AUC)>0.75, and the AUC of the combined parameter was evaluated. Results:There were significant differences in NIC AP and λHU VP before nCRT, NIC VP and λHU VP after nCRT, and the change rates of Z eff, NIC AP, NIC VP and λHU AP between the good response group and the poor response group ( P<0.05). The remaining parameters showed no statistically significant difference ( P>0.05). The ROC curve results showed that the AUCs of the above 8 parameters for evaluating tumor treatment response of nCRT were 0.702, 0.655, 0.695, 0.769, 0.738, 0.807, 0.791, and 0.677, respectively. The AUC of the combined model of the three parameters with AUC>0.75 (λHU VP after nCRT, the change rate of NIC AP and NIC VP) was 0.869, with 80.0% sensitivity and 84.4% specificity. Conclusion:The quantitative parameters derived from spectral CT may provide new markers for evaluating the response to nCRT treatment in patients with LARC. The multi-parameter combined model can improve diagnostic efficacy.