Objective To investigate the role of dynamic contrast-enhanced MRI (DCE-MRI) in the estimation of tumor angiogenesis and pathologic grading of extrahepatic cholangiocarcinoma.Methods Routine preoperative MRI and DCE-MRI scanning were performed on 57 patients with extrahepatic cholangiocarcinoma.The early signal enhancement ratio (eSER) and delayed signal enhancement ratio (dSER) of DCE-MRI were calculated.Microvessel density (MVD) and vascular endothelial growth factor (VEGF) expressions were detected in the extrahepatic cholangiocarcinoma tissue samples using immunohistochemical methods.The relations between the eSER or dSER and MVD,VEGF and the pathological grading of extrahepatic cholangiocarcinoma were analyzed.Results There was a positive correlation between the eSER or dSER and MVD of extrahepatic cholangiocarcinoma (r =0.62,P ＜ 0.05 ; r =0.45,P ＜ 0.05).The eSER of extrahepatic cholangiocarcinoma with a positive VEGF expression was higher than those with a negative VEGF expression (t =3.53,P ＜ 0.05).There was no significant difference in dSER between the positive VEGF expression group and the negative VEGF expression group (t =1.35,P ＞0.05).There was no significant difference in the eSER or dSER among the different differentiated extrahepatic cholangiocarcinoma (F =2.65,P ＞ 0.05 ; F =2.23,P ＞ 0.05).Conclusions The eSER and dSER reflected tumor angiogenesis of extrahepatic cholangiocarcinoma,and DCE-MRI contributed to the evaluation of biological features of extrahepatic cholangiocarcinoma in vivo.

Objective: To choose the corresponding teaching methods according to different teaching stage in the teaching of pathology for five-year clinical students, and to analyze the difference of teaching effects between staged-teaching and traditional teaching. Methods: Students were randomly divided into two groups, with 112 in the experimental group and 118 in the control group. Considering that the teaching content in the experimental group contained the general introduction and different sections and students might experience stages such as "knowledge memorizing", "pathology-clinical connection" and "knowledge application", so presentation, assimilation and discussion class (PAD class), blending teaching and flipped classroom were adopted respectively. Examination scores and questionnaire survey were used to evaluate the difference between two teaching ways. SPSS 19.0 was used for data analysis, and t-test and chi-square test were used for inter-group comparison. Results: The pathological average score of students in the experimental group was (78.56±7.172), which was higher than (72.53±8.539) in the control group, with statistically significant difference (t=5.809, P=0.000). According to the questionnaire survey, the teaching effects using different teaching methods in different stages in the experimental group was superior than that in the control group, with statistically significant difference (P<0.01). Conclusion Using different teaching methods in different stages is beneficial to guide students for truly comprehending the knowledge, applicating appropriate learning methods, and gradually forming their self-learning ability.

Objective To investigate the relationship between the expression levels of thyroid transcription factor-1(TTF-1)and Galectin-3 in differentiated thyroid carcinoma(DTC)tissues and clinical manifestations and prognosis of patients.Methods A total of 76 DTC patients admitted to the hospital from January 1,2017 to May 30,2020 were selected as the study objects.Cancer tissue specimens obtained during surgery were in-cluded in the DTC group(n=76),and corresponding paracancer tissue specimens were included in the para-cancer group(n=76).The expressions of TTF-1 and Galectin-3 in DTC group and paracancer group were de-tected by immunohistochemistry,and the relationship between the expression levels of TTF-1 and Galectin-3 and the clinicopathological characteristics of DTC patients was analyzed.Multivariate Cox regression analysis was used to investigate the prognostic factors of DTC patients.Results The positive expression rates of TTF-1 and Galectin-3 in DTC group were higher than those in paracancer group,and the difference was statistically significant(P＜0.05).The TTF-1 positive expression rate and Galectin-3 positive expression rate in DTC pa-tients with TNM stage Ⅲ to Ⅳ,low differentiation,tissue type of papillary thyroid carcinoma and lymph node metastasis were higher than those in DTC patients with TNM stage Ⅰ to Ⅱ,medium/high differentiation,tis-sue type of thyroid follicular carcinoma and no lymph node metastasis.The difference was statistically signifi-cant(P＜0.05).The 3-year overall survival rate of TTF-1 negative and Galectin-3 negative DTC patients was higher than that of TTF-1 positive and Galectin-3 positive DTC patients,and the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis showed that lymph node metastasis,positive TTF-1 and positive Galectin-3 were prognostic factors in DTC patients(P＜0.05).Conclusion TTF-1 and Galectin-3 are related to TNM stage,differentiation degree,tissue type,lymph node metastasis and 3-year sur-vival rate of DTC patients,and have important reference value for the diagnosis and prognosis evaluation of DTC patients.

Coronary angiography (CAG) as a typical imaging modality for the diagnosis of coronary diseases hasbeen widely employed in clinical practices. For CAG-based computer-aided diagnosis systems, accurate vessel segmentation plays a fundamental role. However, patients with bradycardia usually have a pacemaker which frequently interferes the vessel segmentation. In this case, the segmentation of vessels will be hard. To mitigate interferences of pacemakers and then extract main vessels more effectively in CAG images, we propose an approach. At first, a pseudo CAG (pCAG) image is generated through a part of a CAG sequence, in which the pacemaker exists. Then, a local feature descriptor is employed to register the relative location of pacemaker between the pCAG image and the target CAG image. Finally, combining the registration result and segmentation results of main vessels and pacemaker, interferences of pacemaker are removed and the segmentation of main vessels is improved. The proposed method is evaluated based on 11 CAG images with pacemakers acquired in clinical practices. An optimization ratio of the Dice coefficient is 12.04%, which demonstrates that our method can remove overlapping pacemakers and achieve the improvement of main vessel segmentation in CAG images.Our method can further become a helpful component in a CAG-based computer-aided diagnosis system, improving its diagnosis accuracy and efficiency.
Humans ; Coronary Angiography/methods* ; Diagnosis, Computer-Assisted ; Pacemaker, Artificial ; Image Processing, Computer-Assisted/methods* ; Algorithms

A 15-year-old female was referred to the hospital with intermittent fever, where multiple systemic abnormalities were found, such as splenomegaly, secondary hypersplenism, retinitis pigmentosa, and ectodermal dysplasia. Medical history revealed that she had suffered recurrent respiratory infections, blurred vision at night, and dysplasia of teeth and nail beds since childhood. Then she was suspected to be experiencing ROSAH syndrome, a rare disease newly recognized in recent years, which was finally confirmed by gene sequencing results. During a course of treatment with tumor necrosis factor inhibitors, recurrent fever with elevated inflammatory markers reappeared, and the child developed headaches. To guide the comprehensive treatment and improve the patient's quality of life, the multidisciplinary team in Peking Union Medical College Hospital discussed together and directed the following treatment.