Objective To evaluate the predictive value of a nomogram model developed by integrating clinical and ultrasound multiparameters for HER-2-positive breast cancer.Methods This study retrospectively enrolled 343 patients with pathologically confirmed breast cancer from three medical centers and randomly divided them into training and validation cohorts.Univariate analysis,LASSO regression,and multivariate logistic regres-sion were conducted on the training set to identify independent prognostic factors and construct a nomogram model.Bootstrap resampling with 1000 iterations was performed to evaluate the model's robustness.Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit test.Receiver operating characteristic(ROC)curves were generated to evaluate model discrimination,and the area under the curve(AUC)along with other performance metrics were calculated.Decision curve analysis was employed to assess the clinical utility of the model,and the validation cohort was used for external validation.Results Univariate,LASSO,and multivariate regression analyses demonstrated that age,TTP(time to peak),and the presence of a filling defect sign were independent predictors of HER-2-positive breast cancer(all P<0.05).Based on these independent predictors,a nomogram model was constructed.Bootstrap validation with 1,000 resamples indicated that the model's predictive performance was stable.The Hosmer-Lemeshow test confirmed satisfactory model calibration,while the calibration curve illustrated accurate prediction probabilities.The area under the curve(AUC)for the training set was 0.863(95%CI:0.806～0.920),and for the validation set,it was 0.846(95%CI:0.764～0.929),indicating strong discriminative and generalization capabilities.Additionally,the clinical decision curve analysis demonstrated favor-able clinical utility.Conclusion A nomogram model integrating clinical and multimodal ultrasound parameters demonstrates potential utility in predicting HER-2-positive breast cancer.

Objective To evaluate the predictive value of a nomogram model developed by integrating clinical and ultrasound multiparameters for HER-2-positive breast cancer.Methods This study retrospectively enrolled 343 patients with pathologically confirmed breast cancer from three medical centers and randomly divided them into training and validation cohorts.Univariate analysis,LASSO regression,and multivariate logistic regres-sion were conducted on the training set to identify independent prognostic factors and construct a nomogram model.Bootstrap resampling with 1000 iterations was performed to evaluate the model's robustness.Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit test.Receiver operating characteristic(ROC)curves were generated to evaluate model discrimination,and the area under the curve(AUC)along with other performance metrics were calculated.Decision curve analysis was employed to assess the clinical utility of the model,and the validation cohort was used for external validation.Results Univariate,LASSO,and multivariate regression analyses demonstrated that age,TTP(time to peak),and the presence of a filling defect sign were independent predictors of HER-2-positive breast cancer(all P<0.05).Based on these independent predictors,a nomogram model was constructed.Bootstrap validation with 1,000 resamples indicated that the model's predictive performance was stable.The Hosmer-Lemeshow test confirmed satisfactory model calibration,while the calibration curve illustrated accurate prediction probabilities.The area under the curve(AUC)for the training set was 0.863(95%CI:0.806～0.920),and for the validation set,it was 0.846(95%CI:0.764～0.929),indicating strong discriminative and generalization capabilities.Additionally,the clinical decision curve analysis demonstrated favor-able clinical utility.Conclusion A nomogram model integrating clinical and multimodal ultrasound parameters demonstrates potential utility in predicting HER-2-positive breast cancer.

Polyetheretherketone (PEEK) as a new type of thermoplastic engineering plastic, has good biological activity, elastic modulus close to human cortical bone and radiation permeability, and has been widely used in medical field. This study aims to explore the safety and clinical efficacy of using 3D printing personalized PEEK materials to repaire scapular bone defects after bone tumor resection. A total of 6 patients who underwent the implantation of 3D printed PEEK scapular prosthesis from January 2020 to December 2021 in Yunnan Cancer Hospital were retrospectively analyzed. There were 3 males and 3 females, with age ranged from 14 to 52 years. There were 1 case of synovial sarcoma, 1 of Ewing's sarcoma, and 4 of chondrosarcoma. PEEK prosthesis was designed and fabricated based on CT data before surgery. Tumor resection and prosthesis replacement were performed under the premise of ensuring safe surgical boundaries, including 2 cases of total scapular prosthesis replacement and 4 cases of partial scapular prosthesis replacement. The operation time was 90-170 min, and the intraoperative blood loss was 100-400 ml. All 6 patients received satisfactory follow-up, with a tumor progression free survival time of 16-28 months. No tumor recurrence or metastasis was observed, and all patients survived tumor free. At last follow-up, the Constant-Murley shoulder joint score was a minimum of 62 points and a maximum of 68 points. The Japanese Orthopaedic Association's shoulder joint score was 63 points minimum and 78 points maximum. Computer-aided design 3D printing PEEK material prosthesis has certain advantages in the treatment of scapular tumor limb salvage. It has light weight, well adapted, relatively simple installation, good histocompatibility, and can obtain a better appearance and function of the shoulder joint after operation. It can become one of the options for limb salvage treatment of scapular tumor.

Objective: To explore the mechanism and influencing factors of mirror-image artifact of color blood flow (MACBF) due to longitudinal strong echo big interface (LSEBI). Methods: Fifty suspicious patients with MACBF beside the main pulmonary artery and/or the left pulmonary artery undergoing echocardiography examination from November 2018 to April 2019 in Shengjing Hospital of China Medical University were chosen as the subjects. Image characteristics of the MACBF were observed, and mechanism and influence factors of the MACBF were explored with Doppler imaging principle. Results: Of all the subjects with MACBF, 36 subjects occurred only on the left side of the main pulmonary artery, 14 subjects occurred on both the left side of the main pulmonary artery and the left pulmonary artery. The LSEBI was found between the real color blood flow (RCBF) and the MACBF, there was a mirror relationship between the RCBF and the MACBF. The LSEBI on the left of the main pulmonary artery and the left pulmonary artery were the interface of the left lung and pleural. The signal strength of MACBF enhanced as the distance between the blood flow and the LSEBI got closer or the gain of the color blood flow got bigger. Conclusions MACBF may caused by LSEBI beside vessel. The formation of MACBF and its signal strength are influenced by the distance between blood flow and LSEBI and the gain of the color blood flow.

To observe the efficacy and safety of apatinib in the treatment of advanced bone and soft tissue sarcoma, and to analyze the possible related factors affecting the progression-free survival (PFS) of patients. Methods: Twenty-one patients with ad-vanced bone and soft tissue sarcoma admitted to the Department of Orthopaedics, Yunnan Cancer Hospital from June 2017 to Sep-tember 2018, were treated with apatinib tablets. The main efficacy index was progression free survival (PFS), and the secondary effica-cy index was overall survival (OS). Clinical efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) 1.1, and overall response rate (ORR), disease control rate (DCR), and safety were olserved according to the National Cancer Institute (NCI) 4.0 standard. Results: All of the 21 patients were followed up. At the last follow-up time point, March 31st, 2019, there were no CR, 2 patients (9.5%) with PR, 7 patients with SD (33.3%), and 12 patients with PD (57.1%). The ORR was 9.5%, the DCR was 42.8%, the medi-an PFS was 8 months, and the median OS was 14 months. The patient's gender, age, ECOG score, tissue source, surgery, or chemother-apy had no statistically significant effect on PFS (P>0.05). Only the history of radiotherapy before taking apatinib was a factor for pa-tients with PFS. The effect was statistically significant (P<0.05), and patients with a history of radiotherapy had a lower PFS than pa-tients without a history of radiotherapy. The adverse reactions of gradeⅢand above had hand-foot syndrome (14.3%), pneumotho-rax (14.3%) and anemia (4.8%). Conclusions: Apatinib has a certain effect for advanced bone and soft tissue sarcoma. The adverse re-actions are generally predictable, controllable and reversible. Apatinib can be a choice for patients with advanced bone and soft tissue sarcoma with good treatment adherence and no other treatment options.

ObjectiveTo evaluate temporary balloon occlusion of the abdominal aorta in high-order position sacral tumor surgical operation as a useful adjuvant technique.MethodsReviewed 79 cases of patients from 2005 to 2015 treated in our department and the diagnosis of high-order position sacral tumor. Temporary balloon occlusion of abdominal aorta was used in 50 patients(male 29,female 21)during the sacral tumors surgical operations. The other 29 patients(male 18,female 11)with sacral tumors who received the non-temporary balloon occlusion therapy were used as control group. The statistical differences of the whole surgery time,the blood loss during the surgery,the happening of the postoperative deep vein thrombosis,the time of the postoperative extubation were analyzed. ResultsThe differences were statistically significant(P<0.001)in the whole surgery time of balloon occlusion group(146.36±29.38)min vs non-balloon occlusion group(206.03±125.93)min,the blood loss of balloon occlusion group(1610.70±491.14)ml vs non-balloon occlusion group(2658.62±562.213)mL, and the time of the postoperative extubation of balloon occlusion group(6.60±2.76)d vs non-balloon occlusion group(12.52±2.86)d. However,there was not significant difference of the happening of the postoperative deep vein thrombosis between balloon occlusion group and non- balloon occlusion group. ConclusionTemporary balloon occlusion of abdominal aorta is effective and reliable. It significantly reduced the time of operations,the loss of blood,mean days in hospital,effusion of post-operation and recurrence rate. It makes the operation of sacral tumors much more safer than before and is a technique worthy of popularizing.

Endocardial fibroelastosis(EFE) is a rare heart disease with a thickening of the endocardium by layers of collagenous and elastic fibres.Patients with EFE have diastolic and systolic heart failure.With the improvement of medicine,some progress has been achieved in EFE research.This article gave a comprehensive review to deepen the understanding of EFE.

Objective To explore the value of two-dimensional ultrasound speckle-tracking imaging (STI) in assessing the left ventricular torsion (LVtor) in patients with apical hypertrophic cardiomyopathy (AHCM). Methods Thirty-four patients with AHCM and 21 healthy volunteers underwent two-dimensional echocardiography. High frame rate two-dimensional images of left ventricular short-axis views at the levels of mitral annulus and apex were obtained. Peak rotation (Prot) and the time to Prot, peak rotation velocity on basal and apical plane in left ventricular short-axis views, the peak twist (Ptw) and time to peak twist, half time of untwisting (HTU) were measured using two-dimensional strain software while twisting rate (Untw R) was calculated. All the above indices were compared between patients and healthy volunteers. Correlation was analyzed between HTU and E, A, E/A ratio. Results Compare with healthy volunteers, Prot and time to Prot and peak rotation velocity on apical plane in AHCM significantly increased, so did Ptw and peak rotation velocity of left ventricular (all P<0.05). HTU delayed with the Untw R and peak untwisting velocity decreased in the AHCM group (all P<0.05). There was negative correlation between HTU and E/A ratio in patients with AHCM. Conclusion When the left ventricular systolic function maintained normal in patients with AHCM, the peak rotation on apical plane and the LVtor increased with Untw R decreased. STI can sensitively evaluate the function alteration of myocardium in patients with AHCM.

Objective To evaluate the value of real-time three-dimensional echocardiography（RT3DE）to predict the long-term response to cardiac resynchronization therapy（CRT）.Methods Twenty-six patients with heart failure were scheduled for CRT.RT3DE was performed before and one year after the pacemaker implantation,and left ventricular（LV）dyssynchrony was defined as the maximum difference（Tmsv 16-Dif）and standard deviation（Tmsv 16-SD）when the minimum systolic volume of 16 segments was reached.Patients were divided into re-sponders and non-responders according to a reduction ≥15 % in LV end-systolic volume（LVESV）after CRT.Results Seventeen patients（65.4 %）were classified as responders.Compared with non-responders,the responders demonstrated a significant increase in LV ejection fraction,and reduction in Tmsv 16-SD.Tmsv 16-SD was a determinant factor for Δ LVESV ≥15%.Tmsv 16-SD 〉3.5% could be employed to evaluate the short-term response to CRT with 80 % sensitivity and 77 % specificity.Conclusions CRT can increase the LV systolic function and synchrony.RT3DE is highly predictive for long-term response to CRT

OBJECTIVETo investigate the effect of vasoactive intestinal peptide (VIP) on angiogenesis after focal cerebral ischemia.

METHODSFocal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 120 min in adult SD rats with intracerebroventricular VIP administration at the beginning of reperfusion. Immunohistochemistry was performed to assay BrdU immunoreactive endothelial cells, expressions of VEGF, flt-1 and flk-1 in the ischemic zone, and the protein expressions of vascular endothelial growth factor (VEGF) in the brain was measured using Western blotting.

RESULTSImmunohistochemical staining revealed significantly increased BrdU immunoreactive endothelial cells on the margins of the ischemic lesion in rats treated with VIP as compared with that in the control rats (P<0.05). VIP significantly increased the number of VEGF immunoreactive cells and flt-1- and flk-1-positive endothelial cells in comparison with the control group (P<0.01). Western blotting showed that VIP treatment resulted in significantly increased VEGF protein level in the ipsilateral hemisphere (P<0.05).

CONCLUSIONSVIP enhances angiogenesis in the ischemic brain by increasing the expressions of VEGF in the brain tissue and its receptors flt-1 and flk-1 in the endothelial cells.

Animals ; Brain ; drug effects ; metabolism ; Brain Ischemia ; immunology ; metabolism ; pathology ; physiopathology ; Endothelial Cells ; drug effects ; metabolism ; Gene Expression Regulation ; drug effects ; Male ; Neovascularization, Physiologic ; drug effects ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism ; Vasoactive Intestinal Peptide ; pharmacology