Objective To study the value of the new method of abdominal wall low frequency vibration (AWLFV) by prenatal ultrasound in diagnosis and differential diagnosis of placenta membranacea (PM).Methods Thirty-six cases of abnormal placenta were enrolled into the study.AWLFV was used in all 36 cases.The vibration was conducted with a frequency of 3 to 5 times per second and a duration less than 3 seconds at a time.And then the placenta was immediately observed to record the placenta echogenicity changes,and in the same place the thickness of the placenta was measured.The echo characteristics of PM and other abnormal placenta was compared.Results Thirty-six cases were finally diagnosed as complete PM in 2 cases,partial PM in 16 cases,placental sinus in 15 cases,and placental chorionic hemangioma in 3 cases.The echo characteristics of complete and partial PM were obviously different before and after AWLFV on ultrasonic image.The homogeneous echotexture of PM before AWLFV was changed immediately to the inhomogeneous echotexture after AWLFV.The spiral shape of the placenta was displayed.And in other plasentaI anomalies this feature was not observed before and after vibration.Conclusion The AWLFV is an effective method in diagnosis and differentiation of PM.

Objective To investigate the safe zone and the soft tissue damage of two-incision minimally in-vasive total hip replacement,and to retrospectively analyze the clinical result.Method 20 adult cadavers(40 hips) were used for anatomic research.The Course of the later femoral cutaneous nerve was recorded.The angle between the intermission of the piriformis muscle and gluteus medius muscle with horizontal plane was also recorded.Analogue operation was taken on 3 fresh cadavers to assess the injury extent of soft tissues around incisions.27 cases under-went two-incision minimally invasive total hip replacement.Results LFCN was found potentially at risk as far as 6～71 mm medial to anterior superior iliac spine(ASIS)along the inguinal ligament,as much as 21～112 mm distal on the lateral border sartorius muscle from the ASIS.With the operative leg fully adducted,flexed over the nonopera～tire leg and the patella placed horizontal,the angle between the intermission of the piriformis muscle and gluteus medius muscle with horizontal plane is(60±5)°(range 55°-68°).Imitating modified two-incision THA on 3 freshhips revealed muscle contused on gluteus medius-piriformis muscle and gluteus minimus muscle.The average length of the anterior incision was 5.0 cm(4.6～6.5 cm)and of the posterior incision 3.7 em(3.0～4.2 cm).All of the patients were ambulant the day after surgery.Blood transfusion was carried out in 4 cases including one case of femo-ral neck fracture.The patients were followed up for 18 months(13～25 months).No other complications occurred.The mean Harris score was 94.5(92～96).Conclusion Front incision from the point inferior ASIS 3 cm and 1cmlater from ASIS vertically 6 cm should be chosen and the real incision should be 60°with horizontal plane.GIuteus medius,piriformis muscle and ghteus minimus muscle will be contused in two-incision minimally invasive surgeryto-tal hip replacement.Two-incision total hip replacement has the advantage of being muscle sparing and minimally in-vasive with less blood loss and rapid recovery.However,this technique is time consuming,technically demanding,and requires fluoroscopy.

Adult ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; surgery ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Female ; Humans ; Keratin-7 ; metabolism ; Keratin-8 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Liver Neoplasms ; secondary ; Mixed Tumor, Malignant ; metabolism ; pathology ; surgery ; Nephrectomy ; Neprilysin ; metabolism ; Synaptophysin ; metabolism ; Vimentin ; metabolism

Objective To explore the efficacy of standardized ultrasound in screening fetal severe abnormalities during 11-13+6 weeks.Methods Prenatal ultrasonographic findings of 3 515 fetuses during 11-13+6 weeks gestation were analyzed retrospectively.The value of ultrasound in the diagnosis of severe fetal abnormalities during 11-13+6 weeks were evaluated.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value during 11-13+6 weeks of standardized ultrasound in diagnosis of fetal severe abnormalities was 80.00％ (60/75),99.42％ (3 420/3 440),99.00％ (3 480/3 515),75.00％ (60/80) and 99.56％ (3 420/3 435),respectively.A total of 21 kinds of severe abnormalities were found in 5 different organ systems.Conclusion The standardized ultrasound during 11-13+6 weeks can screen fetal abnormalities including severe structural deformities and fetal chromosomal abnormalities.

Objective:To investigate the diagnostic value of erythrocyte sedimentation rate/C-reactive protein (ECR), fibrinogen and D-dimer in periprosthetic infection after artificial knee replacement.Methods:A total of 205 patients, including 62 males and 143 females, aged 66.9±9.5 years (range 26-84 years), who underwent revision of artificial knee joint at Department of Joint Surgery, The First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2021 were retrospectively collected.122 cases of periprosthetic joint infection (PJI), including 43 cases of acute infection; 79 cases of chronic infection (13 cases of chronic infection combined with rheumatoid arthritis were analyzed separately); there were 83 cases without PJI, including 73 cases of aseptic loosening, 8 cases of prosthesis dislocation and 2 cases of joint stiffness. Erythrocyte sedimentation rate, C-reactive protein, white blood cell count, fibrinogen and D-dimer levels were examined before surgery, and the sensitivity and specificity of the indicators were calculated using the receiver operating characteristic (ROC) curve. The diagnostic value of different inflammatory markers was compared according to the area under curve (AUC).Results:The levels of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and D-dimer in acute PJI group were 2.47±2.91, 50 (38, 62) mm/1 h, 31.6 (13.9, 79.3) mg/L, 4.25±0.94 g/L, 763 (453, 1 157) ng/ml, respectively. The chronic PJI group was 3.06±2.95, 50 (34, 64) mm/1 h, 20.4(12.7, 43.3) mg/L, 4.19±0.91 g/L, 586 (317, 1 122) ng/ml, and the non-PJI group was 6.20±4.64, 22 (15, 34) mm/1 h, 4.6 (2.7, 7.74) mg/L, 3.10±0.59 g/L and 363 (181, 591)ng/ml were statistically significant ( P<0.05). The AUC of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and D-dimer in the acute PJI group were 0.82, 0.85, 0.90, 0.88, and 0.76, respectively.The optimal critical values were 2.89, 37.00 mm/1 h, 13.6 mg/L, 3.86 g/L, and 443.0 ng/ml, respectively, with sensitivity of 76.7%, 79.1%, 76.7%, 69.8%, and 82.4%, and specificity of 79.5%, 78.3%, 94.0%, 94.0%, 90.4%, and 63.8%, respectively. The AUC of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, D-dimer, and white blood cell count in the chronic PJI group were 0.77, 0.82, 0.87, 0.85, 0.67, and 0.63, respectively. The optimal critical values are 2.91, 33.00 mm/1 h, 10.9 mg/L, 4.01 g/L, 558.5 ng/ml, and 5.575×10 9 /L, respectively, with sensitivity of 68.2%, 78.8%, 81.8%, 63.6%, 57.9%, and 75.8%, and specificity of 79.5%, 73.5%, 88.0%, 95.2%, 72.5%, and 49.4%, respectively. Conclusion:Fibrinogen has a higher diagnostic value for knee joint PJI, followed by ECR, and D-dimer has the lowest diagnostic value for knee joint PJI.

Objective:To investigate the clinicopathological characteristics of non-Hodgkin lymphoma (NHL) in Shandong province.Methods:The clinicopathological data of 2 886 NHL cases in Shandong Cancer Hospital from January 2002 to December 2017 were retrospectively analyzed, the clinicopathological characteristics of patients were summarized and compared with other regions in China and abroad.Results:The median age of all NHL cases was 52 years old (4-90 years old), and the ratio of male to female was 1.57∶1. The subtypes distribution analysis revealed that B-cell NHL (B-NHL) accounted for 66.7% (1 925 cases) of all cases and T-cell NHL (T-NHL) accounted for 27.3% (788 cases) of all cases. The common subtypes were diffuse large B-cell lymphoma (36.0%, 1 039/2 886), NK/T-cell lymphoma (8.8%, 254/2 886), follicular lymphoma (8.2%, 237/2 886) and peripheral T-cell lymphoma (7.4%, 214/2 886). Of all the cases, the nodal lymphomas accounted for 45.8% (1 322 cases) and the extra nodal lymphomas accounted for 54.2% (1 564 cases); there were 389 patients (13.5%) with stage Ⅰ, 678 patients (23.5%) with stage Ⅱ, 975 patients (33.8%) with stage Ⅲ, and 722 patients (25.0%) with stage Ⅳ. The distribution of NHL subtypes in Shandong province was consistent with the domestic multicenter study. However, T-NHL subtype ratio was significantly higher than the foreign studies.Conclusions:The overall incidence of NHL in Shandong province of China is dominated by middle-aged people, and the proportion of B-NHL is higher than that of T-NHL. The distribution of NHL subtypes in Shandong province of China are different from those in the European and American countries, but are roughly consistent with the domestic multicenter study.