Objective To explore the correlation between epidermal growth factor receptor (EGFR) gene mutations and computed tomography (CT) characteristics in lung adenocarcinoma.Methods Chest CT scan results of 200 postoperative lung adenocarcinoma patients were retrospectively studied,the EGFR gene mutations detection results were statistically analyzed,and the correlation between EGFR gene mutations status and CT characteristics was investigated.Results Single factor analysis results showed that non smoking,female patients,air bronchogram sign and small tumor diameter were significantly associated with EGFR gene mutations (P＜0.05),and the incidence of GGO in the EGFR gene mutation group was higher than that in the wild group,but no statistical significance was found (P＞0.05),while other clinical and CT signs,such as age,lobulation,spicule,calcification,cavity and pleural indentation were not associated with EGFR gene mutations (P＞0.05).Logistics regression analysis results showed that non smoking and air bronchogram sign were significantly associated with EGFR gene mutations (P＜0.05),but gender and tumor size were not associated with EGFR gene mutations(P＞0.05).Conclusions Non smoking and air bronchogram sign may be used as predictive factors for EGFR gene mutations in lung adenocarcinoma.

Objective To explore a new method in treating acute closed rupture of the Achilles tendon. Methods 22 cases of closed rupture of the Achilles tendon, which had been wounded within one week, were treated with short incision and tenocutaneous relaxing suture from 1994 to August 2001. Results The duration of follow up ranged from eight months to five years. According to Arner Lindholm criteria of therapeutic evaluation, excellent results were obtained in 19 (86.4% ), good in 3 (13.6% ), with the excellent and good rate being 100% . Conclusion Short incision and tenocutaneous relaxing suture is an effective treatment for acute closed rupture of the Achilles tendon because of its less suture tension and more blood supply protection. [

Objective To explore a therapeutic method for repairing the avulsion injury of total hand skin. Methods Bilateral chest navel flaps with nerves were used to repair the avulsion injury of total hand skin. Two nerves of the right lateral flap were anastomosed with the first and third common palmar digital nerves respectively; two nerves of the left lateral flap were anastomosed with the dorsum manus of ulnar nerve and cutaneous branch of radial nerve respectively. Results Postoperative follow up of 12 to 15 months showed that two cases were successful. The injured hands regained thalposis and thigmesthesia; the ulnar hand had sensitive thigmesthesia when touching a table; and the grasping function of the hand recovered partially. Conclusion Bilateral chest navel flaps with nerves are recommendable to all kinds of hospitals for repairing the avulsion injury of total hand skin.

Objective:To examine the features of multislice spiral computed tomography (MSCT) in micropapillary-predominant lung adenocarcinomas to improve the understanding of this type of lung cancer. Methods:The MSCT features of 18 cases with micro-papillary-predominant lung adenocarcinoma (micropapillary component>50%) confirmed by histopathology were analyzed retrospec-tively. Results:Among the 18 cases of lung cancer, 1 was diffuse, 3 were central, and 14 were peripheral lung cancer (PLC). The size of the adenocarcinomas in the 14 PLC cases ranged from 1.3 cm to 8.5 cm, with an average of 3.56 cm, including the size of 8 cases greater than or equal to 3 cm. Among the 18 cases, 13 were lobulated, 9 showed spicule signs, 7 showed pleural indentation signs, 5 had pleural adhesions, 1 had bronchial truncation (i.e., cut-off sign), and 4 were surrounded by obstructive inflammation. In addition, calcifi-cation was observed in one case, uneven density in two large lesions, air bronchus sign in four, and solid and ground-glass mixed densi-ty in two. Among the total number of cases, a variety of the measurable enhanced CT values (ΔCT) of lesions were found in 16, ranging from 13 HU to 80 HU, with an average of 47.5 HU, of which 15 were cases ofΔCT≥15 HU and 15 were cases ofΔCT≥20 HU. Pleu-ral thickening was observed in two cases with pleural effusion, and pleural metastasis in one case was confirmed by histopathology. One case with pleural effusion suffering pleural metastasis was confirmed. Ground-glass density nodules in both lungs were observed in one case, with a few bilateral pleural and pericardial effusions. Eight cases had mediastinal or hilar enlarged lymph nodes with uneven density enhancement, and lymph node metastasis was pathologically confirmed in six cases. Lymph node metastasis was found in four cases, but no apparent enlargement of lymph nodes in MSCT was observed. Conclusion:Micropapillary-predominant lung adenocarci-nomas were common in non-smoking elderly female patients, whose lung cancer cases were mostly PLC. The typical features of PLC include lobulation, spicule, and pleural indentation signs. Solid density ranked first in the PLC cases, with evident enhancement and high rate of lymph node metastasis.

Objective:To study the predictive value of combining alpha-feto protein (AFP) with contrast-enhanced MRI imaging features in predicting incidence of microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 206 patients with hepatocellular carcinoma treated at Tianjin Medical University Cancer Institute and Hospital from January 2017 to April 2019 were retrospectively analyzed. There were 179 males and 27 females, with an average age of 58.7 years. The roles of preoperative MRI imaging features and clinical data on predicting the incidence of MVI in patients with hepatocellular carcinoma were evaluated by univariate and multivariate logistic regression analyses. Multivariable regression analysis was then used to plot a nomogram.Results:There were 86 patients (41.7%) with MVI positivity and 120 patients (58.3%) with MVI negativity. Multivariate logistic regression analysis showed that AFP >400 μg/L ( OR=3.318, 95% CI: 1.243-8.855, P=0.017), two-trait predictor of venous invasion (TTPVI) ( OR=13.111, 95% CI: 6.797-28.119, P<0.001), diffusion weighted imaging/T 2 weighted imaging (DWI/T 2WI) mismatch ( OR=17.233, 95% CI: 4.731-44.490, P<0.001), and rim enhancement( OR=5.665, 95% CI: 2.579-18.152, P=0.013) predicted increased risks of MVI in patients with hepatocellular carcinoma. The constructed nomogram directly predicted the risk of MVI in these patients. Conclusions:AFP>400 μg/L, TTPVI, DWI/T 2WI mismatch and rim enhancement were independent risk factors in predicting MVI in patients with hepatocellular carcinoma. This predictive model of MVI which was based on multivariate logistic regression analysis was helpful to clinicians in making individualized treatment plans for patients with hepatocellular carcinoma.

Objective To compare the efficacy and safety of mirtazapine and buspirone on panic disorder.Methods 86 cases with panic disorder were divided into two groups: the mirtazapine(30～60 mg/d) group and the buspirone(15～30 mg/d) group.Hamilton Anxiety Scale(HAMA) was adopted to evaluate the efficacy.Safety was evaluated with Treatment Emergent Symptom Scale(TESS),laboratorial and physical examination.Results The effective rate of mirtazapine group and buspirone group was 90.7% and 83.7% respectively 8 weeks after treatment(χ2=1.17,P>0.05).The scores of HAMA of the mirtazapine group decreased more than that of the buspirone group 1 or 2 weeks after treatment(tt=2.94,P<0.01 and t=2.49,P<0.05 respectively).At the end of wk,But there was not significant difference between two groups 4 or 8 weeks after treatment(P>0.05).Some mild side-effects were observed in both groups.Conclusion Mirtazapine shows a similar effect to buspirone and takes effect earlier on panic disorder.

Traditional Chinese medicine (TCM) intervention should be concisely and precisely reported in randomized controlled trials (RCTs). Based on State Food and Drug Administration's categories, we recommend reporting the interventions as follows: (1) Single Chinese herbal medicine-based/formula-based/extraction-based intervention includes 1) Name, dosage format and registration; 2) The composition and quality of intervention; 3) Pharmaceutical processing and quality control; 4) Stability of final product and quality control; 5) Function and safety description; 6) Dosage and treatment course; 7) Control group. (2) Active compound-based TCM drug intervention includes 1) Name of active compound(s); 2) Original source of active compound(s); 3) The brief process obtaining active compound(s); 4) Percentage of active compound(s) in final product; 5) Added materials and its quality and quantity control. Besides, the detailed information of intervention can be published as an online supplement in web site.

Evaluating outcome is the primary means by which different medical modalities can be compared with regard to effectiveness. In traditional Chinese medicine (TCM), this focus has prompted practitioners to search for outcome measures that can objectively verify the effectiveness of TCM interventions, especially in the context of randomized controlled trials (RCTs). Commonly used indexes for outcome assessment in RCTs of TCM can be categorized into two types: TCM-specific outcomes such as tongue and pulse characteristics, and Western medicine (WM)-specific outcomes such as blood test and X-ray examination results. Some studies include both types of indicators. During the trial design, it is necessary to consider the rationales of selecting outcome assessments, the purpose and study approach, balance between objective and subjective indexes, standardization of outcome assessment, and standardized outcome indexes. We recommend to report the outcome assessment in RCTs of TCM in the following format: 1) identifying the primary and secondary outcomes based on the purpose and hypothesis of the trial; 2) defining the primary and secondary outcomes clearly; 3) presenting the rationale of selection; 4) presenting the method with aims to standardize the assessment process; 5) presenting the method to improve the reliability of assessment; and 6) stating the termination criteria in the trial.

Objective To explore the normal range of the volume of frontal lobe in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain. Methods This is a clinical multi-center study. Two hundred Chinese healthy volunteers (age range= 18 to 70) recruited from 16 hospitals were divided into 5 groups, i. e. , age range from 18 to 30, age range from 31 to 40, age range from 41 to 50, age range from 51 to 60, and age range from 61 to 70. Each group contained 20 males and 20 females. All of the volunteers were scanned by MR using T1 weighted threedimensional magnetization prepared rapid acquisition gradient echo sequence. We used the manual method to trace the region of interest and measured the left and right frontal lobe volumes separately. All the data were analyzed with SPSS (version 13.0). The sex differences in the frontal lobe volumes were analyzed by independent-samples t test, and the side differences were analyzed by paired-samples t test. Correlation and regression analysis was used between the age and the frontal lobe volumes. Results In 200 healthy Chinese Han volunteers, the total frontal lobe volumes was (563 ± 73) cm3. For male, the volumes of the left and the right frontal lobe were (288±42) cm3 and (292 ±41 ) cm3 ,respectively. The volumes of the left and right frontal lobe in 100 women were (273 ±30) cm3 and (274 ± 30) cm3 respectively. The differences of sex (t = 3. 334, P < 0. 05 ) and side ( t = - 3.09, P < 0. 05 ) in the total frontal lobe volumes reach significant. There was no significant differences in women ( t = - 1. 304, P > 0. 05 ). There were negative correlations between the frontal lobe volumes and age in men and women ( r = - 0. 586, - 0. 498, P <0. 01 ). Conclusions The total frontal lobe volume of men was larger than that of women. The volume of the right frontal lobe was larger than the left frontal lobe in men, and the asymmetries didn't exist in women.The total frontal lobe volumes were both shrinking with age in men and women, which was more rapid in men than in women.