Objective To investigate the relationship between the cystic fluid characteristics of symptomatic sacral canal cyst and the interventional therapeutic prognosis.Methods A total of 114 patients with symptomatic sacral canal cyst were enrolled in this study.Clinically,all patients complained of discomfort at lumbosacral area.Among the 114 patients,86 were primary sacral canal cyst and 28 were recurrent sacral canal cyst.Under DSA guidance,percutaneous puncturing of the cyst was performed,2-5 ml cerebrospinal fluid (CSF) was aspirated and sent for laboratory tests.Then a small amount of nonionic contrast agent was injected into the cyst to determine whether the cyst was communicated with the subarachnoid space or not.Finally,double-needle method was used to aspirate the cyst fluid.Results Radiography showed that communication between the cyst and subarachnoid space was detected in 66 patients (group A),while no communication between the cyst and subarachnoid space was observed in 48 patients (group B).In patients with primary symptomatic sacral canal cyst,the differences in the sugar and chloride levels of CSF between group A and group B were statistically significant.In patients with recurrent symptomatic sacral canal cyst,the differences in the sugar,protein and chloride levels of CSF between group A and group B were also statistically significant.Statistically significant correlation existed between the single or multiple CSF changes and the interventional therapeutic prognosis.Conclusion Sacral canal cysts can be classified into two types:cyst-subarachnoid space communicating type and cyst-subarachnoid space non-communicating type.The characteristics of CSF in patients with primary symptomatic sacral canal cyst are different from those in patients with recurrent symptomatic sacral canal cyst.Multiple CSF changes,the increased sugar level and decreased chloride level in CSF are well correlated with the interventional therapeutic prognosis.

Objective To explore the effect of laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy on the treatment of patients with high-risk prostate cancer.Methods A total of 50 patients with local advanced high-risk prostate cancer were treated with laparoscopic radical treatment for prostate cancer.According to application of postoperative adjuvant endocrine therapy (AHT),the patients were divided into the observation group and control group.General surgery condition and 2-year survival rate were compared between two groups.Results All the 50 patients finished operation successfully.The 2-year total biochemical recurrence rate was 76% in observation group,and the control group was 52.00%.The patients received AHT therapy in the observation group were able to tolerate treatment during follow-up.Conclusion Laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy can significantly improve 2-year non-biochemical recurrence rate and control the disease progression.

Objective To explore the effect of laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy on the treatment of patients with high-risk prostate cancer.Methods A total of 50 patients with local advanced high-risk prostate cancer were treated with laparoscopic radical treatment for prostate cancer.According to application of postoperative adjuvant endocrine therapy (AHT),the patients were divided into the observation group and control group.General surgery condition and 2-year survival rate were compared between two groups.Results All the 50 patients finished operation successfully.The 2-year total biochemical recurrence rate was 76% in observation group,and the control group was 52.00%.The patients received AHT therapy in the observation group were able to tolerate treatment during follow-up.Conclusion Laparoscopic radical prostatectomy for prostate cancer combined with endocrine adjuvant therapy can significantly improve 2-year non-biochemical recurrence rate and control the disease progression.

Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.

Along with the aging of population in China,more and more people suffer from osteoporosis.As a consequence,osteoporotic vertebral compression fracture has become one of the major clinical issues.More and more patients like to take percutaneous vertebroplasty (PVP) as the preferred treatment,thus,the number of patients who develop recurrent vertebral fracture after PVP is also increased.In recent years,more and more attention has been paid to the recurrent fractures after PVP for vertebral compression fractures by clinicians.In order to reduce the incidence of recurrent vertebral fracture after PVP,it is necessary to make the further and deep studies on the risk factors that cause recurrent vertebral fractures.This paper aims to make a comprehensive review about the risk factors that may cause recurrent vertebral fractures after PVP for osteoporotic vertebral compression fracture.

Background::The potential impact of pre-existing coronary artery stenosis (CAS) on acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with PE.Methods::In this multicenter, prospective case-control study, 88 cases and 163 controls matched for age, sex, and study center were enrolled. Cases were patients with PE with elevated hs-cTnI. Controls were patients with PE with normal hs-cTnI. Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression was used to evaluate the association between CAS and hs-cTnI elevation.Results::The percentage of CAS was higher in the case group compared to the control group (44.3% [39/88] vs. 30.1% [49/163]; P = 0.024). In multivariable conditional logistic regression model 1, CAS (adjusted odds ratio [OR], 2.680; 95% confidence interval [CI], 1.243–5.779), heart rate >75 beats/min (OR, 2.306; 95% CI, 1.056–5.036) and N-terminal pro-B type natriuretic peptide (NT-proBNP) >420 pg/mL (OR, 12.169; 95% CI, 4.792–30.900) were independently associated with elevated hs-cTnI. In model 2, right CAS (OR, 3.615; 95% CI, 1.467–8.909) and NT-proBNP >420 pg/mL (OR, 13.890; 95% CI, 5.288–36.484) were independently associated with elevated hs-cTnI. Conclusions::CAS was independently associated with myocardial injury in patients with PE. Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.