Objective: To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio), and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF). Methods: A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected, and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis. Results: Among the 355 patients, 156 children (43.9%) required a transannular patch, and 199 patients (56.1%) did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45±0.12 vs. 0.54±0.15, (-1.75±0.98) scores vs.(-0.86±1.39) scores], and the differences were statistically significant (t=5.29, 6.32, all P<0.01). Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of -2 for the children received transannular patch, the area under the curve (AUC) was 0.702 (95%CI: 0.64-0.76), sensitivity was 69%, and specificity was 83%; in the case of the GA ratio of 0.58 for the children received transannular patch, the AUC was 0.712 (95%CI: 0.66-0.77), sensitivity was 70%, and specificity was 87%. Conclusions The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice.

【Objective】 To investigate the expressions of H3.3G34W, p63 and SATB2 in giant cell tumor of bone (GCTB) and the effect and value of their combined application in the diagnosis of GCTB. 【Methods】 We collected the samples and medical records of 54 cases of GCTB and 83 cases of non-giant cell tumor of bone (14 cases of aneurysmal bone cyst, 16 cases of chondroblastoma and 53 cases of non-ossifying fibroma) diagnosed between 2020 and 2022 in the Department of Pathology of Honghui Hospital Affiliated to Xi’an Jiaotong University. The expressions of H3.3G34W, p63 and SATB2 were detected by EliVision immunohistochemical method. χ² test was used to determine whether there are significant differences in the positive rates of H3.3G34W, p63 and SATB2 among all the groups. The combined diagnostic model including H3.3G34W, p63 and SATB2 was established by Logistic regression analysis, and the diagnostic value of the model was evaluated by ROC curve analysis. 【Results】 The positive rates of H3.3G34W, p63 and SATB2 in GCTB group were 81.5%, 90.7% and 92.6%, respectively; the positive rates in NGCTB group were 2.4%, 28.9% and 62.7%. Compared with NGCTB group, the age of GCTB group was significantly older [(41.222±14.849) vs. (16.566±9.439) , P<0.001] , and the prevalence was higher in women than in men (51.9% vs. 48.1%, P<0.001). In addition, compared with the NGCTB group, the positive rates of H3.3G34W (81.5% vs. 2.4%, P<0.001), p63 (90.7% vs. 28.9%, P<0.001) and SATB2 (92.6% vs. 62.7%, P<0.001) were significantly higher in the GCTB group. Univariate regression analysis built a univariate prediction model and ROC curve analysis showed that age (AUC=92.9%, P<0.001), sex (AUC=64.5%, P=0.004), H3.3G34W positive rate (AUC=89.5%, P<0.001), p63 positive rate (AUC=80.9%, P<0.001) and SATB2 positive rate (AUC=65.0%, P=0.003) were independent predictors of diagnosis of giant cell tumor of bone. Multivariate regression analysis (Logistic) constructed a hybrid prediction model. ROC curve analysis suggested that the hybrid model showed better prediction value than the single factor model (AUC=98.4%, P<0.001). 【Conclusion】 H3.3G34W, p63 and SATB2 are effective molecular markers for the diagnosis of GCTB, and their combined application can improve the prediction efficiency of the diagnosis of GCTB.

Objective: To investigate the value of jugulo-omohyoid lymph nodes (JOHLN) in predicting occult lateral cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC). Methods: The clinicopathological data of 136 out of 2 100 PTC patients, who had a high risk of lateral neck lymph node metastasis and treated by us from January 2010 to December 2015, were retrospectively analyzed. Super selective neck dissection (SSND, level Ⅲ and Ⅳ)was performed and JOHLNs were sent for frozen section in all the 136 cases. The clinicopathological data was analyzed and the significance of JOHLN in predicting lateral cervical LNM was calculated using the SPSS software package. Results: Of the 136 patients, total thyroidectomy was performed in 76 cases (55.9%) and unilateral lobectomy plus isthmus was performed in the other 60 cases (44.1%). SSND was performed in 72 patients (52.9%), level Ⅱ-Ⅳ dissection in 15 (11.0%), and level Ⅱ-Ⅴ dissection in 49 (36.0%). According to the pathological results, 38 patients were pN0(27.9%), 18 (13.2%) were pN1a and 80 (58.8%) were pN1b. The lymph node metastasis(LNM) rates at level Ⅱ-Ⅵ were 19.9%, 43.4%, 42.6%, 2.9%, and 59.6%, respectively. The sensitivity, specificity and accuracy of JOHLN in predicting lateral neck metastasis were 58.8%, 62.9%, and 76.7%, respectively. The rates for predicting level Ⅱ metastasis were 81.5%, 43.2%, and 59.4%, respectively. None of the patients died in the follow-up. Only 1 recurrence was found in level Ⅱ and regional control was achieved after level Ⅱ and Ⅴ dissection. Conclusions JOHLN has a high accuracy for predicting lateral cervical lymph node metastasis and high sensitivity for level Ⅱ metastasis. For patients with high risk of lateral cervival metastasis, super-selective neck dissection including level Ⅲ and Ⅳ can confirm the stage and reduce the risk of reoperation. Dissection for level Ⅱ, Ⅲ, and Ⅳ is recommended.