OBJECTIVETo study the cause of X-ray misdiagnosis of the avascular femur head necrosis, so as to reduce the misdiagnosis rate and raise the early diagnosis level.

METHODSThe clinical and X-ray data of 99 patients(123 hips) with avascular femur head necrosis diagnosed by MRI were analyzed retrospectively. Among the patients, 56 patients were male and 43 patients were female,ranging in age from 21 to 84 years old,with an average of 53 years old. The patients had symptoms such as hip pain,functional restriction in flexion, adduction, abduction and internal rotation,and some patients had limping. The duration of the disease ranged from 1 week to 2 years.

RESULTSAmong 99 patients(123 hips),46 patients(52 hips) was misdiagnosed by the X-ray, the misdiagnosis rate was 42.27%, 100.00% in 0 stage, 100.00% in I stage, 83.67% in II stage, 18.18% in II stage, 0.00% in IV stage, 0.00% in V stage; the X-ray stage was negatively correlated with the rate of misdiagnosis. The careless film-reading and invigorating large enterprises while relaxing control over small ones was the main reason of misdiagnosis,then the lack of clinical histories and low-quality of X-ray projection.

CONCLUSIONThe relevant clinical history and comprehensive careful film-reading is the key to reduce the rate of misdiagnosis.

Adult ; Aged ; Aged, 80 and over ; Diagnostic Errors ; Female ; Femur Head Necrosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Radiography ; X-Rays

ObjectiveTo observe the clinical efficacy and safety of Bushen Ruyan Formulation （补肾乳岩方， BRF） in treating premenopausal breast cancer patients of disharmony of the chong （冲） and ren （任） meridian type under endocrine intensive therapy. MethodsA total of 88 premenopausal breast cancer patients who received endocrine intensive therapy and were diagnosed with disharmony of the chong and ren meridian by traditional Chinese medicine （TCM） were included and randomly divided into a control group and a treatment group， with 44 cases in each group. The control group received ovarian function suppression （OFS） combined with endocrine therapy， while the treatment group was given oral BRF additionally. Both groups were treated for three months. The clinical efficacy was evaluated by comparing the pre- and post-treatment results of the Functional Assessment of Cancer Therapy-Breast （FACT-B）， modified Kupperman score， T cell subsets （CD3⁺， CD4⁺， CD8⁺， CD4⁺/CD8⁺）， sex hormone levels， including estradiol （E₂）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， progesterone （P）， testosterone （T）， and prolactin （PRL）， tumor markers， such as carcinoembryonic antigen （CEA）， carbohydrate antigen 125 （CA125）， and carbohydrate antigen 153 （CA153）， TCM syndrome score， and TCM syndrome efficacy. Blood routine tests， liver function and kidney function were monitored to assess safety. ResultsThe FACT-B scores of each domains and the total scores of the treatment group increased， while the social/family status score of the control group decreased. The treatment group had significantly higher scores in all domains and total score compared to the control group （P＜0.05 or P＜0.01）. The modified Kupperman score and TCM syndrome score of the treatment group decreased， and were lower than those of the control group （P＜0.01）. The levels of CD3⁺ and CD4⁺ in the treatment group increased， and were higher than those of the control group （P＜0.05）. Serum testosterone levels in the treatment group were lower than those in the control group （P＜0.05）. The total effective rate of TCM syndrome efficacy in the treatment group was 67.44%， significantly higher than the 23.26% in the control group （P＜0.05）. No significant abnormalities were observed in the blood routine tests or liver/kidney function indicators in either group before or after treatment. ConclusionBRF can effectively improve quality of life， alleviate symptoms， increase serum CD3⁺ and CD4⁺ levels， and enhance clinical efficacy in premenopausal breast cancer patients undergoing endocrine intensive endocrine therapy. It is also safe with no significant adverse effects.

Ambystoma mexicanum/immunology* ; Amputation ; Animals ; Biomarkers/metabolism* ; Blastomeres/immunology* ; Cell Lineage/immunology* ; Connective Tissue Cells/immunology* ; Epithelial Cells/immunology* ; Forelimb ; Gene Expression ; High-Throughput Nucleotide Sequencing ; Humans ; Immunity ; Peroxiredoxins/immunology* ; Regeneration/immunology* ; Regenerative Medicine/methods* ; Single-Cell Analysis/methods*