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:This study is to improves the understanding of adenoid cystic carcinoma (ACC) of the tracheobronchial tree by observing the multi-slice cornputed tomography (MSCT) features. Methods:The MSCT features of 19 cases with primary tra-cheobronchial ACC confirmed by histopathology were retrospectively analyzed. Results:Among the 19 cases, lesions were located in the trachea in seven cases, in the segmental and above segmental bronchi in 10 cases, in the peripheral lung in two cases. Intra-and ex-traluminal growth were observed in 15 cases (79%), whereas broad-based intraluminal lesions were exhibited in two cases (11%). Among the seven cases of tracheal ACC, the CT scans for five cases showed a notable tendency toward submucosal extension. Two cas-es manifested as a diffuse or circumferential wall thickening of the trachea, and the other three cases presented homogeneous mass fill-ing of the trachea with wall thickening. The 10 cases with bronchial ACC were manifested as intra-and extraluminal growth. Eight cas-es presented homogeneous polypoid growth toward the adjacent lumen, and seven cases presented extraluminal parts that were larger than the intraluminal parts. Among 13 contrast-enhanced examinations, three cases were without enhancement, five cases were slightly enhanced, four cases were moderately enhanced, and one case was highly enhanced. Conclusion:MSCT performances of ACC of the tracheo-bronchial tree possessed certain characteristics, such as broad-based mass, intra- and extraluminal growth, and diffuse wall thickening. CT can diagnose tumor malignancy, but the definitive diagnosis for ACC should depend on pathology.

Objective To summarize the features of multislice spiral computed tomography (MSCT) examination of gastrointestinal stromal tumors (GISTs),and investigate the relationship between predictors and risk of MSCT examination for GISTs.Methods The clinical data of 110 patients with GISTs who were admitted to the Tianjin Medical University Cancer Institute and Hospital from July 2011 to February 2014 were retrospectively analyzed.All the patients received 64-slices spiral CT (64S-SCT) or 16-slices spiral CT (16S-SCT) scan,and the data were transported to the PACS work station for multiplanar reconstruction.All the tumor samples were collected during operation and diagnosed by morphological manifestation and immunohistochemistry of tumors.Very low,low,and medium risk of GISTs were regarded as lower risk grade,and high risk of GISTs as high risk grade.The univariate analysis and multivariate analysis about features of imaging and risk were done by chi-square test and multivariate logistic regression model.Results Tumors located at the stomach in 81 cases,small intestines in 26 cases and colorectum in 3 cases.Diameter of tumors was 0.8-25.0 cm.Smaller tumors were in round or oval shape with well demarcated boundary,and larger tumors were irregular with unclear boundary.Endo-luminal growth of lessions was detected in 25 cases,duplex growth in 35 cases and extra-luminal growth in 50 cases.Enhanced CT scan showed that most of tumors in 105 patients demostrated moderate and high enhancement,heterogeneous enhancement in 74 cases,low density sacvariable necrosis area without enhancement in 60 cases and superficial,cracked-like and deep ulcer without calcification,metastasis and ascites in 23 cases.According to the features of GISTs by MSCT examination,location of tumor,diameter,shape,boundary,growth,enhancement,cystic necrosis,ulcer and metastasis were risk factors affecting risk classification of tumors by univariate analysis (x2=7.442,49.966,31.513,46.038,13.836,16.626,23.489,8.280,6.811,P ＜0.05).Diameter of tumor more than 10 cm and ulcer were independent risk factors affecting risk classification of tumors by multivariate analysis (OR =9.927,0.070 ; 95％ confidence intewal:1.888-52.180,0.012-0.398,P ＜ 0.05).Conclusion There is a characterization in the location,diameter,shape,boundary of tumor,growth,enhancement,cystic necrosis,ulcer and metastasis,and diameter of tumor more than 10cm and ulcer are independent risk factors affecting the risk classification of GISTs.

Objective To discuss the efficiency of fibrin glue amikacin complex in controlling infection by observing the changes of leukocyte and neutrophilic granulocyte classifying counts after fibrin glue amikacin complex treated deep wound. Methods Clinical case-control study was used in the study. All patients were divided randomly into test group (100 patients) and control group (100 pa-tients), matched by wound location, wound size, time from injury to operation, combined injury and gen-eral antibiotics use to compare leukocyte and neutrophilic granulocyte classifying counts between both groups and observe possible toxic and side-effect in test group. Results Firstly, the test group and control group had the comparability in aspects of gender distribution, average age and injury mechanism (P >0.05). Secondly, there was statistical difference in classifying counts of leukocyte and neutrophilic granulocyte in the test group at different time points (P <0.05). The classifying counts of leukocyte and neutrophilic granalocyte peaked at 24 hours after operation, then decreased with treatment time and reached the lowest at 24 days after surgery or at day 1 before discharge. Thirdly, there existed statistical significance upon leukocyte counts in the test group and control group except for at day 1 after operation (P > 0.05), with lower counts in test group than control group. In aspect of neutrophil classifying counts, there was statistical significance (P < 0.05) at other time points in beth groups except for time points at days 1,2 and 12 (P >0.05). The test group had lower neutrophil classifying counts compared with con-trol group at different time points. Conclusion The fibrin glue amikacin complex has good clinical effort and high security, with no toxic or side effort in treatment of deep wound infection, and is worth clinical applicaiton.

Objective:To investigate the accuracy of a threshold-based segmentation method based on cone beam breast CT(CBBCT) images in breast density measurement,and its value for breast-type classification and breast cancer screening.Methods:A retrospec-tive analysis of 195 patients who had undergone CBBCT examination at Tianjin Medical University Cancer Institute and Hospital be-tween May 2012 and August 2014 was performed.A total of 64 breasts were analyzed.On the basis of the classification criteria for breast density in BI-RADS,they were classified into four types and the majority report was reported.Breast density was measured by the threshold-based segmentation method based on CBBCT images and corrected manually to obtain the corrected breast density.A month later,the procedure was repeated.Intra-class correlation coefficients(ICCs)were used to compare the intra-observer and inter-observer consistencies of threshold-based segmentation and manually corrected breast density measurement results for non-dense and dense breasts.Results:For threshold-based segmentation measurements the intra-observer and inter-observer ICC values were 0.0.9624(95% CI:0.9388~0.9770)and 0.9666(95% CI:0.9500~0.9785).For manually corrected measurements,the intra-observer and inter-observer ICC values were 0.9750 (95% CI: 0.9592~0.9847) and 0.9775 (95% CI: 0.9661~0.9855). The ICC between the threshold-based segmentation method and manual correction was 0.9962 (95% CI: 0.9983~0.9977). The ICC values of threshold-based and manually corrected measurement in non-dense and dense breasts were 0.9497(95% CI:0.7072-0.9914)and 0.9983(95% CI:0.9971-0.9990),respectively.Conclusions:The threshold-based segmentation method based on CBBCT is a reliable and accurate com-puter-aided method of measuring breast density.It is expected to be applied in large-scale screening of breast cancer and to provide more information for predicting the risk of breast cancer.

Objective To investigate the feasibility and clinical effect of transaxillary dual-plane breast augmentation under endoscope combined with autologous fat transplantation.Methods From January 2015 to December 2015,88 patients who accepted augmentation mammoplasty were divided into control group (from January to June) and observation group (from July to December).Patients in control group only accepted transaxillary dual-plane breast augmentation and transaxillary dual-plane breast augmentation combined with autologous fat transplantation was used for patients in observation group.Patients' basic information,surgery-related indicators,recovery situations,complications and patients' satisfactory data were collected.34 patients in control group and 38 patients in observation group were followed up.Results For surgery-related indicators and recovery situations,statistically significant difference was not found in the blood lost,duration of drainage tube and postoperative stay (P＞0.05),but was found in operation time (P＜0.05).And there was no significant difference in terms of surgical effects between two groups (P＞0.05).There were no complications such as hematoma,infection,capsular contracture in two groups.25 patients in observation group were performed B ultrasonic examination 6 months after operation.Multiple cysts were found at the cleavage in only 1 patient and were cured by suction.And the rest B ultrasonic results were negative for pathologic findings such as calcifications,cysts and masses.Conclusions Autologous fat transplantation is useful in minimizing the unaesthetic appearance of the cleavage and the bad feeling of the inframammary fold and thus a proper solution for the patient's breasts with thin soft tissue.

Objective To evaluate the clinical effect of nanofat on superficial rhytides of face and neck and dark lower eyelids.Methods From September 2014 to January 2017,a total of 86 cases were collected in our hospital for voluntary nanofat transplantation on superficial rhytides and dark lower eyelids.This was a retrospective study,which included 18 cases of eye wrinkles,14 cases of forehead wrinkles,neck wrinkles in 14 cases,and 22 cases of dark lower eyelids.First of all,we harvested mircofat through liposuction,and then transformed mircofat to nanofat.At last,nanofat was grafted into intradermal layer of the skin with sharp needles.We took the standard photographs of the patients.After six months follow-up,doctors and patients evaluated the short term and long-term postoperative effect.Results No serious complications occurred in all patients.Postoperative evaluation of facial and neck superficial wrinkles showed that the satisfactory rate of doctors and patients after one month,was 85.9％and 84.3％,and after 6 months 87.5％ and 84.3％,respectively.Postoperative evaluation of dark lower eyelids showed that the satisfactory rate of doctors and patients after one month was 45.5％ and 36.4％,and after 6 months 81.8％ and 86.4％,respectively.Conclusions Nanofat can rectify the superficial rhytides of face and neck and dark lower eyelids in some patients.However,for some patients the effect is not satisfied.

Objective To analyze the characteristic of Yunnan unexpected sudden death (YUSD) cases by pathological diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),in order to offer clue for ARVC etiologic research of YUSD.Methods The pathological diagnosis results of 9 cases of sudden death of ARVC in Yunnan,as well as epidemiological investigation data,were used to comprehensively analyze the pathological features of the pathological diagnosis of ARVC in Yunnan.Results The 9 cases including 8 females and 1 male,aged 16-47 years.The sudden death time was from June to August,mainly distributed in 8 families from the disease seriously ridden 7 villages.Three of them had a genetic history of family YUSD,2 cases had a history of mental stimulation,1 case had eaten Trogia venenata;and acute symptoms and signs were palpitation,chest tightness,shortness of breath,and loss of consciousness.Pathological observations were the typical ARVC change,mainly right ventricular lesions,with different degrees of cardiac enlargement and extensive adipose tissue infiltration in the ventricular wall.Among them,6 cases of fat infiltration almost reached the full thickness of the heart wall.In addition to the pathological changes of ARVC,8 cases were accompanied by one or several pathological changes in myocarditis,cardiac dysplasia,nephropathy,pulmonary edema,pneumonia and pancreatitis.Of the 9 cases,5 cases were diagnosed with ARVC,2 cases with ARVC and pulmonary edema,1 case with ARVC and acute hemorrhagic necrotizing pancreatitis,and 1 case with ARVC and Trogia venenata poisoning.The clinical examination abnormalities of the family members of the cases mainly showed arrhythmogenic electrocardiography changes and abnormal myocardial enzymes.Conclusions The nine cases have showed typical epidemiology characteristics of YUSD,and cardiachistological changes are consistent with the ARVC pathological diagnostic criteria.A part of YUSD cases may be caused by ARVC,and the inference will be proved by cadaveric pathologic examination and related pathogenic gene detection.

Objective: To investigate the prognostic value of chest computed tomography (CT) characteristics in crizotinib-treated pa-tients with advanced non-small cell lung cancer (NSCLC). Methods: Forty-seven patients with advanced ALK-rearranged NSCLC who re-ceived crizotinib treatment from January 2014 to March 2017 were enrolled in this retrospective study. Pre-treatment CT characteris-tics were evaluated. Patients were followed up after crizotinib treatment, and the best overall response and progression-free survival (PFS) were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). Results: The median PFS of all patients was 10 months. There was no association between CT characteristics and response. In univariate analysis, large tumor size (P=0.009), central type (P=0.002), consolidation of surrounding lung tissue (P=0.002), pleural effusion (P=0.001), and lymphangitic carcino-matosis (P=0.019) suggested a poor prognosis. Multivariate Cox regression analysis showed that location (hazard ratio, 3.219; 95% con-fidence interval: 1.517-6.833; P=0.002) was an independent prognostic predictor. Conclusions: Pre-treatment CT characteristics are useful in predicting the PFS of crizotinib-treated patients with advanced NSCLC harboring ALK rearrangement.