Objective To investigate the application of MSCT three-dimensional digital navigated biopsy in subcarinal lesions.Methods 82 patients were enrolled.Study subjects were randomly divided into control group and research group.Three-dimensional positioning and three-dimensional navigation needle biopsy were used in research groups, while CT cross-sectional image positioning with conventional puncture needle was used in control group.Puncture accuracy, one-time success rate of puncture, complications, diagnosis accuracy and operation time were compared between the two groups.Results Puncture success rate, definite diagnosis rate were 87.80%(36/41) and 97.56%(40/41) for the research group,and 60.97%(24/41) and 80.49% (33/41) for the control group, respectively,which on the research group were higher than that on the control group(χ2=8.945, 6.116;P<0.05).Complication rate and operating time were 14.63% (6/41) and (11.64±2.76) min for the research group, and 41.45% (17/41) and (22.22±6.31) min for the control group, respectively, which were lower on the research group than that on the control group (χ2=7.31,t=-11.70,P<0.05).Conclusion MSCT three-dimensional digital navigated biopsy technique could promote the efficiency of subcarinal space puncture biopsy significantly,which is a novel, convenient, precise and safe method.

Objective To determine the distribution profile of apocrine sweat glands in axillary region of patients with axillary osmidrosis,and to compare their distribution at different sites.Methods Fifteen patients with axillary osmidrosis were enrolled in this study from September to December 2010.All the patients underwent surgical removal of apocrine sweat glands under direct vision.Full-thickness skin tissue measuring 2 mm in width was excised down to the axillary superficial fascia at the incisional surgical sites from five patients.Five points,which were at the center of axillary region (point 1),1 cm away from the center of axillary region (point 2),1 cm inside the edge of axillary hair-bearing area (point 3),the edge of axillary hair-bearing area (point 4),and 1 cm outside the edge of axillary hair-bearing area (point 5),were marked,and dark red,rough granular subcutaneous tissue was obtained at these points in 10 patients with axillary osmidrosis.Results The secretory portion of apocrine sweat glands was mainly distributed in the reticular dennis and superficial subcutaneous adipose tissue,but no apocrine sweat glands were obs erred in the epidermis,dermal papilla or axillary superficial fascia.The distribution profile of apocrine sweat glands was consistent with that of axillary hairs.There were numerous apocrine sweat glands in the center of axillary region,but only a small number at the edge of axillary hair-bearing area,and no apocrine sweat gland was observed at 1 cm outside the edge.The percentage of apocrine sweat gland area at point 1-5 was 74.1％,46.6％,25.3％,2.1％,and 0 respectively,with significant differences between point 1 and 2 (t--29.78,P＜ 0.01),point 2 and 3 (t--9.76,P＜ 0.01),point 3 and 4 (t =20.83,P＜ 0.01),but not between point 4 and 5 (t =1.96,P ＞ 0.05).Conclusions During the surgical treatment of axillary osmidrosis,the removal of apocrine sweat glands should be extended to the reticular dennis and superficial subcutaneous adipose tissue in depth and the edge of axillary hair-bearing area in width,and there is no need to blindly increase the extent of removal.

Multiple evanescent white dot syndrome (MEWDS) is an acute retinal disease characterized by multifocal white spots in the fundus often seen in the unilateral eye. The lesions mainly involve the retinal pigment epithelium and the outer retinal structure. Typical ocular manifestations of MEWDS include grayish-white outer retinal spots with a clear borderline identified on the fundus, findings of hyper-autofluorescence in the early stage consistent with the spots identified on the fundus, and the optical coherence tomography manifestation of multifocal disruption of the ellipsoid zone. With the rapid development of multimodal imaging technology, some scholars found that these manifestations are not exclusive to MEWDS as some types of chorioretinopathy can also show MEWDS-like changes. The etiology of these diseases may be inflammation, infection, immunity, or tumor-related, misdiagnosed by masquerading as MEWDS. Here we summarized the clinical manifestations and imaging features of MEWDS and reviewed the fundus lesions changes that can be misdiagnosed as MEWDS.

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.