Objective To study the imaging diagnosis of tumors and tumor-like lesion of fibrous histiocyte origin in the femora.Methods Imaging features of femoral fibrous histiocyte neoplasm and tumor-like lesion were restrospectively analyzed in 17 cases ,including 16 cases proved by surgery and pathology, and one case was follow-up studied in five years.All cases were examined by plain X-ray flim, CT scan in 5 cases. Results There were fibrous dysplasia of bone in 8 cases,non-ossifying fibroma in 5cases ,fibrosarcoma of bone and benign fibrous histiocyte tumor of bone in 1 case respectively ,malignant fibrous histiocyte tumor of bone in 2 cases. They were diagnosed correctly before operation in 13 cases (13/17,76.5%) and misdiagnosed in 4 cases.Conclusion The most of femoral fibrogenic tumor and tumor-like lesion can be dingnosed correctly before operation ,because of they are of specific imaging features, while femoral fibrous histocyte original tumors are not of specific imaging findings, it must combine with clinical and pathologic data in diagnosis.

Objective To study the imaging value in diagnosis of congenital cholangiectasis.Methods The clinical and imaging (CT and ultrasonics) data of 6 patients with congenital cholangiectasis were restrospectively analyzed with literature review.Results According to Todani's classifications of cholangiectasis,there were type I in one case,CT showed cystic hypodense shadow with thin and smooth wall;type IV in 4 cases,CT showed cystic or fusiform extension of intra-and extra-hepatic bile ducts;type V in one case,CT showed cystic extension of intra-hepatic bile ducts,and the central spot enhancement could be seen on contrast-enhanced CT scan.6 cases underwent ultrasonic examinations,ultrasound showed extension of intra-and extra-hepatic bile ducts in 6 cases,choledochal cyst in one.4 cases suspected with congenital cholangiectasis,and misdiagnosed in one.In company with cholecystitis and cholelithiasis in one,biliary carcinoma in one and cirrhosis in one.Conclusion CT and US are of important value in diagnosis of congenital cholangiectasis.

Objective To explore the imaging features of primary bone tumors and tumor-like lesions of the skull,so that to improve the diagnostic accuracy of the disease.Methods 47cases with bone tumors and tumor-like lesions of the skull confirmed by pathology or typical imaging manifestations were retrospectively analysed.Results Of 47 cases,there were benign tumors in 22 cases,malignant tumors in 6 cases and tumor-like lesions in 19 cases.Benign tumors included osteoma of 11cases,epidermoid tumor and cyst of 4 cases,osteochondroma and neurofibromatosis of 2 cases respectively,carvernous angioma ,osteoid osteoma,and benign fibrohistiocytoma of 1case respectively.Malignant tumors included multiple myeloma and angiosarcoma of 2 cases respectively,Ewing’s tumor and osteosarcoma each and all in 1 case .Tumor-like lesions included fibrodysplasis of bone in 8 cases, Langerhans’ cell histiocytosis in 7 cases ,brown tumor and deformed osteitis each and all in 2 cases.Conclusion Primary bone tumor and tumor-like lesions of the skull are of a great variety,each one has its own imaging characteristics,the diagnosis of them should be combined with clinic and pathologic data.

Objective To summarize CT features , benign and malignant differential main points of the tumors of germ cell origin in the mediastinum.Methods 32 cases with pathologically confirmed the tumors of germ cell origin in the mediastinum were retrospectively analysed.Results Of 32 cases,26 were benign tumors,including cyst mass in 10,solid mass in 9 and cyst-solid mass in 7.6 cases were malignant tumors, including seminoma in 1 ,endodermal sinus tumor or yolk sac tumor in 1,embryo cell casinoma in 1 and malignant teratoma in 3 .Typical benign teratoid tumors appeared as water to soft tissue density masses,with defined margin,fat or calcification inside the tumors,around tissues were compresed by tumors,the malignant tumors appeared as lobular or irregular masses and around organ invaded.Conclusion CT is a reliable method for the diagnosis of the tumors of germ cell origin in the mediastinum accurately.Malignant tumors of germ cell origin in the mediastinum are difficult differentiation from other mediastinal malignant tumors.

Objective : To compare the wear of Ceramage and IPS e.max Press offering foundation for nonmetallic materials selection in clinical. Methods : 20 class I cavities were prepared in the approximal flattened sides of the extracted human maxillary first molars. The cavities were divided into 2 groups randomly, and then restored with Ceramage or IPS e.max Press. Inlays were prepared according to the manufactures’ instructions with indirect methods and cemented with Varolink N. The non-wear extracted maxillary third molars were used as antagonistic enamel cusps after standardized prepared. After the self-made wear-testing device concluded 200,000 cycles under a load of 20 N, the wear depth of specimens and antagonistic enamel cusps was assessed by Kavo PREP assistant. Results : The wear in Ceramage group was (298.30 ± 40.02) μm, while the wear of normal enamel was (206.60 ± 49.17) μm. The wear in IPS e.max Press group was (212.90 ± 61.21) μm, while the wear of normal enamel was (217.00 ± 25.10) μm. The wear of IPS e.max Press inlays was higher than Ceramage inlays (P < 0.05). Ceramage inlays showed higher wear than normal enamel (P < 0.05), while IPS e.max Press inlays was not statistically different from the normal enamel (P > 0.05). Conclusions Ceramage has more wear than IPS e.max Press. Ceramage shows higher wear compared with normal enamel, while IPS e.max Press has lower antagonistic war compared with normal enamel.

Objective To explore risk factors of poor early prognosis in the treatment of COVID-19 by nematevir and ritonavir tablets Paxlovid and establish the prediction model to provide reference for improving the effect of such patients. Methods 92 inpatients of COVID-19 treated with Paxlovid in three military tertiary hospital in southern Fujian from January 2023 to March 2023 were retrospectively analyzed. The clinical indicators of 92 inpatients were collected for univariate and multivariate analysis by single factor and multiple factors and the independent risk factors of poor early prognosis in Paxlovid were screened out. Logistic model equation was transformed to construct the combined predictors, and ROC curve was used to determine the area under the curve (AUC) and the optimal critical value of the combined predictors. Results Among 92 patients, 31 (33.70%) developed poor early prognosis, including 11 deaths (35.48%), 17 critical cases (54.84%) and 3 severe cases (9.68%). Multi-factor Logistic regression analysis showed that the disease days, lymphocyte count, aspartate aminotransferase(AST), C reactive protein(CRP) and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. A formula for calculating the combined predictors (Y) was established as Y_{combinedpredictors}=7.875X_{disease days}+126.188X_{lymphocyte count}+1.438X_AST+X_CRP+220.500X_{ventilator-assisted ventilation} based on the above independent risk factors, and the ROC curve was drawn. With the maximum area under the ROC curve of the combined predictors being 0.939, the prediction value was best, and the optimal critical value of the ROC curve corresponding to the maximum Youden index (0.756) was 447.920.Theoretical accuracy of the model was 89.10%. Conclusion The disease days, lymphocyte count, AST, CRP and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. Combined predictors could be calculated by the above risk factors before medication. The efficiency should be improved by taking more active treatment, including combining with other anti-COVID-19 drugs when the prediction result exceeds 447.920.