BACKGROUND:With the prevalence of total hip arthroplasty,the demand for revision has been increased due to the prosthesis life and various complications.OBJECTIVE:To retrospectively analyze the reasons and clinical effectiveness of revision,clinical application of revision prosthesis,and related revision techniques.METHODS:Clinical data of 85 patients undergoing total hip revision were analyzed retrospectively.Among which,there were 23 cases of biological T.O.P acetabular cup (allograft bone graft) plus polyethylene liner,51 cases of titanium mesh cup plus bone cement fixation,and 11 cases of common acetabular cup;common hip stem in 63 cases (including 47 cases of bone cement fixation);lengthened hip stem in 34 cases (16 cases of modular prosthesis and 18 cases of bone cement fixation).Subsequently,the hip function was assessed by Harris hip scores.RESULTS AND CONCLUSION:All cases were followed up,and the mean follow-up was 30.2 months.(1) The average Harris hip scores changed from preoperative 30.07 to postoperative 90.32.The wound healed well,no dislocation or infection,and the hip function was improved significantly.(2) To conclude,aseptic loosening of the prosthesis is the main cause of reversion occurred,followed by prosthesis dislocation.Acetabular wall bone defect and decrease in bone mass are the main problems in revision.Adequate preoperative preparation for possible and unexpected events,and reasonable selection of prosthesis according to the bone defects will be helpful.Noticeably,early arthroplasty reversion will obtain good clinical efficacy.

Objective To discuss the X-ray characteristics of triple negative breast cancer(TNBC)for improving the diagnostic level.Methods 105 cases of TNBC which confirmed by pathology and immunohistochemistry were analyzed their X-ray performance and clinical pathology.Results (1)The main pathologic types of TNBC was infiltrating ductal carcinoma(64 cases,61.0%),secondly was medullary carcinoma(24 cases,22.9%).(2)The X-ray manifestations of this group were mainly the mass shape(78.1 %).Nearly half of them had clear edge(46.3%).And 24.4% were tumor with calcification.(3)The calcification in TNBC was rare and the distribu-tion mainly for regional or cluster,while the morphology was mainly for malignant and suspicious for malignancy.(4)The X-ray per-formance characteristics of infiltrating ductal carcinoma and medullary carcinoma in TNBC had differences in tumor morphology and edge(P <0.05).Conclusion (1)The X-ray manifestations were always the circular similarity of tumor with clear edge in TNBC.(2) The proportion of medullary carcinoma is larger in TNBC,and the X-ray manifestations is more likely show as benign lesions.(3) The calcification probability is lower in TNBC,and the calcification form is mainly as suspicious for malignancy and malignant.

Objective:To evaluate the relationships among contrast-enhanced ultrasound (CEUS) features, molecular type, and biomarker expression of breast cancer.Methods:A retrospectively analysis of breast cancer patients confirmed by pathology were performed using Breast Imaging Report And Data System (BI-RADS) ultrasound category lesions in the Second Affiliated Hospital Zhejiang University School of Medicine from May 2020 to April 2021. All patients underwent conventional ultrasound and CEUS before biopsy and/or surgery. The relationships among BI-RADS category, quantitative and qualitative CEUS features and biomarker expression of breast cancer were evaluated.Results:All 149 patients with 149 breast lesions were included. The numbers of BI-RADS category 4A, 4B, 4C, and 5 were 8, 60, 49, and 32, respectively. Among them, the numbers of Luminal A like, Luminal B like (human epidermal growth factor receptor-2 (HER-2) positive), Luminal B like (HER-2 negative), HER-2 overexpression and triple negative type were 81, 29, 17, 15, and 7. No significant correlations were found among BI-RADS category, molecular types, and biomarker estrogen receptor (ER), progesterone receptor (PR), HER-2, and antigen Ki-67 (Ki-67) expression (all P>0.05). There were no correlations between quantitative or qualitative CEUS features and molecular types of breast cancer (all P>0.05). There were no correlations between qualitative CEUS variables and ER, PR, HER-2, and Ki-67 expression (all P>0.05). Ascending slope (AS) were negatively correlated with ER and PR expression( r=-0.40, P=0.01; r=-0.35, P=0.03). Descending slope (DS) were positively correlated with ER and PR expression( r=0.42, P=0.01; r=0.36, P=0.03). Arrive time (AT) were positively correlated with HER-2 expression( r=0.37, P=0.02). Conclusions:AS and DS are correlated with ER and PR expression.Arrive time (AT) is correlated with HER-2 expression. The quantitative variables of CEUS are helpful for evaluation of biomarker expression in breast cancer.