Objective To analyze the CT findings of benign lymphoepithelial lesion (BLEL) of major salivary glands.Methods The CT findings of 11 cases with BLEL which were clinically and pathologically confirmed were analyzed.The relevant literatures were reviewed.All the patients received plain CT.Among them,5 patients had contrast CT as well.The location,number,shape,margin,density,and enhancement characteristics of the lesions were observed.Results Of 11 BLEL,8 lesions were located in the parotid gland,three in the submandibular gland.There were 7 cases with bilateral multiple lesions,and 4 cases with unilateral solitary lesion.BLEL of major salivary gland could be classified into three types according to the CT findings,including multinodular type,solitary mass type,and diffusely infiltrating type.Multinodular type was the most common type.The typical CT findings of the lesion included diffusely enlargement of bilateral parotids and (or) submandibular glands,heterogeneous increase of density of the parenchyma with multiple soft tissue density nodules,and multiple cystiform hypodense.On contrast-enhanced CT,the lesions mostly manifested as heterogeneous enhancement.The solid part of the nodules showed moderate or marked enhancement.However,the cystiform hypodense showed no enhancement.Conclusion Although the CT findings of BLEL of major salivary glands are variable,they still share some common characteristics,which are useful in the clinical diagnosis.

Objective To analyze the imaging appearances of solitary fibrous tumors (SFT) of the lower limb.Methods The imaging manifestations of SFT of the lower limb proved with pathology in 2 patients were reported and the relevant literatures were reviewed.All patients underwent MR examination,and 1 received skeletal radiography.Results Both tumors were mainly located within the biceps muscle of thigh.MR demonstrated that the tumor appeared as a solitary round or oval well circumscribed mass,with inhomogeneous low to intermediate intensity signal on T1WI and heterogeneous low to high intensity signal on T2WI.Inhomogeneous enhancement was demonstrated on T1WI.Marked enhancement of solid components in the tumor was identified.No bone destruction was found on plain film.Conclusion There are some characteristics on the imaging of SFT of the lower extremity.MRI is the optimal imaging method for the diagnosis of this disease.

Objective:To investigate the expression of CXCL12-CXCR4 and VEGF-C in pancreatic cancer and relation to clinical pathology.Methods:The tissue samples including PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were obtained from 30 patients with PAC.The expressions of CXCL12,CXCR4and VEGF-C proteins in these tissues were assayed by immunohistochemical staining.The expressions of CXCL12,CXCR4 and VEGF-C mRNA in PAC were also investigated by fluorescence quantitative real-time PCR.Results:In all the samples,the positive rates of CXCL12 protein in PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were respectively 13.3%(4/30),46.7%(14/30),56.7%(17/30) and 50.0%(15/30).The positive rates of CXCR4 protein in PAC,the cancerous peripheral tissues,the normal pancreatic tissues and peripheral lympho nodes were respectively 80.0%(24/30),70.0%(21/30),26.7%(8/30) and 73.3%(22/30).The expression levels of CXCR4 mRNA in PAC tissues,the cancerous peripheral tissues and peripheral lympho nodes were higher than that in the normal pancreatic tissues(P

To study the anticoagulant effect of Xiang-Qi-Tang (XQT),the mice model of endotoxemia was established to detect the expression of coagulation factors and their regulatory proteins in serum and aorta.The results showed that XQT could decrease the expression of TF and increase the expression of tPA in the aorta of mice with endotoxemia,and also decrease the expression of sEPCR in the serum.We further found that XQT caused the decrease of sEPCR through the regulation of PKC δ and ADAM17 to contribute the anticoagulation in mice.This study may provide a new strategy for treating endotoxin-induced disease and provide evidences for further researching the pharmacological action of XQT.

Objective To evaluate the CT and pathological features of head and neck pilomatricoma.Methods We retrospectively analyzed the CT findings of 13 patients with head and neck pilomatricoma which were pathologically confirmed.Of them 7 patients received plain CT,2 patients received contrast-enhancement,and 4 patients received plain CT plus contrast-enhancement.Results All the patients presented with solitary tumors,9 of them occurred in the parotid gland region,one in the left occipital,one in the right forehead,one in the right parietal,and another one in the left eyelid.The maximal diameter of the tumors ranged from 0.6 to 2.3 cm with a mean of 1.5 cm.All lesions were well-circumscribed,with partial attachment to the overlying skin.Most of lesions were isodense relative to adjacent skeletal muscle on nonenhanced CT scans,sand-like or nodular calcifications within the masses were showed in 8 cases,and no cystic degeneration was found.On contrast-enhanced imaging,mild to moderate homogenous enhancement was showed in 3 cases,heterogeneous moderate enhancement with patchy nonenhancing necrosis area in one case,marked enhancement in one case,and complete calcification with no enhancement in one case.Conclusion Head and neck pilomatricoma presents with certain characteristics on CT,which are useful in the clinical diagnosis and differential diagnosis.

Objective To investigate the clinical efficacy of deep inferior epigastric perforator (DIEP) flap in the repair of soft tissue defects of the calf.Methods From January,2015 to January,2017,the DIEP flap was used to repair the soft tissue defect of calf in 11 patients,which were 7 males and 4 females,aged 23-62 years,with an average age of 42 years.Among them,there were 5 cases of anterior tibial soft tissue defect and 6 cases of posterior tibial soft tissue defect.The size of soft tissue defects ranged from 9.0 cm×5.0 cm to 32.0 cm×12.0 cm.The wounds were heavily polluted and debridement exploration combined VSD surgery in emergency.After 7 to 14 days,free deep inferior epigastric perforator flap was used to repaire.The flap was cut in the range of 10.0 cm×6.0 cm-34.0 cm×13.0 cm.Nine cases of abdominal donor sutured direct,and a small part of 2 cases to take thigh thick skin graft repair.Results All the flaps survived.In only 1 patient,the distal part of the flap was necrotic and healed after appropriate treatment.Eleven patients were followed-up for 3-18 months (average of 10 months).The shape of the flap was similar to that of the affected area.The texture was soft and not bloated.Conclusion The DIEP flap can provide reliable blood supply,large cutting area and flexible design.It can be used to repair soft tissue defect of calf and obtain satisfactory clinical results.

Objective:To explore the interaction effect of diabetes and obesity on recurrence or anal fistula in patients with perianal abscess after simple incision and drainage.Methods:The clinical data of 163 patients with perianal abscess who underwent simple incision and drainage from Jun. 2021 to Jun. 2023 were analyzed retrospectively. The incidence of recurrence or anal fistula in 6 months after surgery was calculated. Multivariate Logistic regression model was used to analyze the influencing factors of postoperative recurrence or anal fistula. The multiplicative and additive models were used to analyze the interaction effect of diabetes and obesity on the risk of postoperative recurrence or anal fistula.Results:In 6 months after simple incision and drainage, the incidence of recurrence or anal fistula was 28.22% (46/163). Univariate analysis results showed that gender, obesity, and diabetes were related to recurrence of perianal abscess or incidence of anal fistula ( P<0.05). Multivariate Logistic regression analysis results showed that obesity ( OR=2.447, 95% CI: 1.320-4.538) and diabetes ( OR=2.162, 95% CI: 1.187-3.938) were independent risk factors for postoperative recurrence or anal fistula ( P<0.05). Interaction effect analysis found that after adjusting for confounding factors, diabetes and obesity had additive interaction effect on the risk of postoperative recurrence or anal fistula. The relative excess risk due to interaction (RERI), attribution percentage (AP), and interaction effect index (S) were 1.829 (95% CI: 0.605-3.007), 0.405 (95% CI: 0.143-0.597), and 2.098 (95% CI: 1.201-3.172), respectively. There was no multiplicative interaction effect between the two ( P>0.05) . Conclusions:Diabetes and obesity are independent risk factors for recurrence or anal fistula in patients with perianal abscess after simple incision and drainage. The two may have synergistic effect on the risk of postoperative recurrence or anal fistula.

Objective:To explore the influencing factors of postoperative recurrence in patients with complex anal fistula, and to construct a nomogram model to predict the risk of postoperative recurrence and verify it.Methods:Clinical data of 310 patients with complex anal fistula who underwent fistulectomy in the hospital from Aug. 2019 to Mar. 2023 were retrospectively selected and divided into modeling group (93 cases) and validation group (217 cases) in a 3∶7 ratio according to system randomization method. Hospital electronic medical record system was used to collect patient baseline data and calculate the recurrence rate of patients 6 months after surgery. According to the data of the modeling group, multivariate Logistic regression was used to analyze the influencing factors of postoperative recurrence in patients with complex anal fistula. Based on the influencing factors, a nomogram model was established to predict the risk of postoperative recurrence, and external verification was performed based on the data of the validation group.Results:The recurrence rate at 6 months after operation was 20.43% (19/93) in the modeling group and 17.51% (38/217) in the validation group. There was no significant difference in recurrence rate between the two groups ( χ2=0.370, P=0.543) . The proportion of male, smoking history, diabetes mellitus, high anal fistula and unclear position of internal orifice in the recurrence group was higher than that in the non-recurrence group, and the body mass index and course of disease were higher than those in the non-recurrence group ( P<0.05) . Based on the above seven influencing factors, a nomogram model of the risk of recurrence of complex anal fistula after surgery was established. C index of the modeling group and the validation group was 0.984 and 0.798 respectively, the calibration curve was close to the ideal curve, and the Receiver operating characteristic AUC of the nomogram prediction model was>0.70, indicating that model consistency, prediction efficiency and differentiation were good. Conclusion:The nomogram prediction model based on gender, body mass index, smoking history, diabetes mellitus, course of disease, high anal fistula and internal orifice position can effectively predict the risk of postoperative recurrence in patients with complex anal fistula.

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective: To investigate the prevalence, gender and age distribution characteristics of tonsilloliths and its CT diagnosis, in order to improve the knowledge of clinicians. Methods: The images of 2 710 patients who underwent head and neck CT scans from November 2015 to November 2016 were retrospectively reviewed, the prevalence, gender and age distribution of tonsilloliths and CT manifestation were analyzed. SPSS 18.0 was used for statistical analysis. Results: Tonsilloliths were found in 383 (14.1%) of the 2 710 patients, including 217 men and 166 women. The prevalence was 15.1% in men and 13.1% in women, and no gender difference was seen. The age of patients with tonsilloliths ranged from 6-88 years, and the mean age was (51.1±16.8) years. The prevalence of tonsilloliths in patients 40 years and younger was significantly lower than in those who were over 40 years (χ²=15.201, P<0.001), and the prevalence of tonsilloliths was positively correlated with age(r=0.812, P=0.008). One hundred and twenty eight cases of tonsilloliths were located on the right side, and 157 were located on tleft side. Tonsilloliths were detected bilaterally in 98 patients. There was no significant difference between left and right sides(χ²=1.919, P=0.166). Most of tonsilloliths showed a single small tonsillolith, 60.6% of tonsilloliths showed only one tonsillolith, whereas 39.4% showed two or more. The size of tonsilloliths ranged from 1.0 to 10.0 mm, the mean maximum diameter was (2.3±1.2) mm, and 86.7% of tonsilloliths with a maximum diameter of no more than 3.0 mm. Tonsilloliths showed dot, round or oval hyperdense in tonsillar crypt or parenchyma. CT attenuation of majority tonsilloliths was over 120 Hu. Conclusion Tonsilloliths are more common than previously suggested, its CT diagnosis is not difficult, and the knowledge of clinician and radiologist needs to be improved.