Objective To explore the CT and MRI features of chordoma and analysis misdiagnosis.Methods The CT and MRI imaging data were analyzed retrospectively in 1 8 patients with chordoma.The imaging findings of the preoperative misdiagnosed lesions were analyzed and summarized.Results 1 2 cases were diagnosed correctly preoperatively,6 cases were misdiagnosed.Chordoma was located in the skull base in 9 cases,in the sacrum in 8 cases,and in cervical vertebrae in 1 case.CT and MRI showed oval or round shape lesions in 12,and irregular shape in 6.14 cases of them displayed clear boundary,4 cases displayed unclear boundary.CT showed soluble osseous bone destruction and uneven isodensity or slightly low density mass.Spot or lamellar shaped calcifications or residual substances of bone were found around or inside of the lesions in 9 cases.MRI showed equal or low signal intensity on T1 WI and high signal intensely on T2 WI.After the CT and MRI contrast enhancement,mass showed mild-to-moderate heterogeneity enhancement. Conclusion Chordoma has certain characteristics on CT and MRI imaging.The combination use of CT and MRI scans has an important value in localization quantitative and qualitative diagnosis of chordoma.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

Objective: To explore the influence of body mass index (BMI) on postoperative complications and survival in patients with esophageal squamous cell carcinoma (ESCC) using propensity score matched (PSM) methods. Methods: We retrospectively analyzed clinical data of 533 patients with ESCC who were admitted for thoracic surgery in Shandong Provincial Hospital, between January 2011 and December 2012. After conducting PSM methods to balance the covariates, the incidence of postoperative complications and sur-vival rate were compared between the two groups. The effects of BMI on postoperative complications and survival were analyzed with multivariate Logistic regression and Cox proportional hazard analyses, respectively. Survival analysis was performed using Kaplan-Mei-er curves and Log-rank test. Results: After adjusting the PSM and confounding variables, the two groups were well matched (146 pa-tients each) without significant differences in baseline characteristics. The incidence of wound infection and respiratory system compli-cations in the H-BMI group (BMI≥25 kg/m2) were significantly higher than those in the N-BMI group (18.5-25 kg/m2) (P<0.05). H-BMI was an independent risk factor for wound infection and respiratory system complications. In the present study, no significant differ-ence was observed in the 3-year overall survival between H-BMI and N-BMI patients (54.1% vs. 47.8%, P=0.212). Patients with H-BMI had significantly better 5-year overall survival than those with N-BMI (39% vs. 25%, P=0.016). The subgroup analysis showed that pa-tients with H-BMI had a better overall survival than those with N-BMI in stages Ⅰ-Ⅱ (47.3% vs. 29.0%, P=0.032). However, this difference was not significant when patients were stratified into stages Ⅲ and Ⅳ (24.5% vs. 16.7%, P=0.393). Conclusions: H-BMI appears not to decrease the overall survival of patients with ESCC. Therefore, ESCC in patients with H-BMI can receive surgical treatment safely, but proper intraoperative management and close postoperative monitoring should be performed.

Objective To evaluate the effectiveness of peer support interventions on exclusive breastfeeding among primiparous women. Methods Randomized controlled trials (RCTs) that reportedthe effectiveness of peer support interventions on exclusive breastfeeding among primiparous women were retrieved in several electronic databases. Data were analyzed using RevMan 5.3 software after quality assessment and data extraction. Results A total of 9 RCTs which included 1435 patients were incorporated in this meta-analysis. The meta-analysis revealed that peer support interventions could increase the rate of exclusive breastfeeding(OR=2.84, 95％CI2.22-3.64, P<0.01), increase duration of exclusive breastfeeding(WMD=43.66, 95％CI28.04-59.27, P<0.01). Subgroup analysis showed that peer support increased the rate of exclusive breastfeeding atone month(OR=1.84,95％CI1.24-2.73, P<0.01), three months(OR=2.28, 95％CI1.67-3.12, P<0.01)and six months(OR=3.42,95％CI2.46-4.76, P<0.01) of postpartum. Conclusions Peer support interventions could increase exclusive breastfeeding rate and duration of exclusive breastfeeding. It is worth being popularized.