Objective:To investigate the value of nomogram model based on CT features in differentiating ectopic pancreas (EP) from gastrointestinal stromal tumors (GIST) with a long diameter less than 3 cm.Methods:This study was a case-control study. The clinical and imaging data of 43 patients with EP and 90 patients with GIST confirmed by pathology in the Affiliated Hospital of Guizhou Medical University from August 2013 to March 2024 were retrospectively analyzed. Preoperative CT images were analyzed to obtain qualitative features (number of lesions, location, morphology, growth pattern, borders, cystic degeneration, calcification, ulceration, catheter sign, central umbilication) and quantitative features (lesion long diameter, short diameter, long/short diameter, lesion and normal pancreas arterial-phase and venous-phase CT values, and enhancement ratio). Statistical analyses, including independent sample t-tests, Mann-Whitney U tests, χ2 tests, and Fisher exact tests, were performed to compare CT characteristics between the two groups. Binary logistic regression analysis was used to obtain independent predictors to identify the two groups, to establish a joint model, and to draw a nomogram. The discriminative performance of the independent predictors and the combined model was assessed using receiver operating characteristic (ROC) curves, while calibration curves were used to evaluate model fit. Results:The differences in age, location, morphology, border, catheter sign, central umbilication, short diameter, long/short diameter, arteriovenous phase enhancement CT value and arteriovenous phase enhancement ratio were statistically significant between the EP group and the GIST group (all P<0.05). The logistic analysis showed that the differences in age ( OR=0.920, 95% CI 0.885-0.956, P<0.001), border ( OR=5.994, 95% CI 2.111-17.022, P=0.001), long/short diameter ( OR=7.820, 95% CI 1.841-33.224, P=0.005), and venous phase enhancement ratio ( OR=8.847, 95% CI 1.103-70.972, P=0.040) were the independent predictors for distinguishing EP from GIST, and the area under the ROC curve (AUC) were 0.782 (95% CI 0.698-0.866), 0.684 (95% CI 0.600-0.767), 0.705 (95% CI 0.607-0.803), and 0.693 (95% CI 0.605-0.781), respectively. Combined age, border, long diameter/short diameter and venous phase enhancement ratio were plotted in a nomogram with an AUC of 0.881 (95% CI 0.817-0.945), sensitivity and specificity of 74.4% and 93.3%, respectively. The calibration curve demonstrated a strong agreement between predicted and actual probabilities (Hosmer-Lemeschow test, P=0.267). Conclusions:CT imaging reveals significant differences between EP and small GISTs (<3 cm). EP is more likely when patients are younger and lesions exhibit indistinct borders, a higher long-to-short diameter ratio, and greater venous-phase enhancement. The nomogram derived from CT features provides a valuable tool for differentiating EP from GIST.

Objective:To investigate the value of nomogram model based on CT features in differentiating ectopic pancreas (EP) from gastrointestinal stromal tumors (GIST) with a long diameter less than 3 cm.Methods:This study was a case-control study. The clinical and imaging data of 43 patients with EP and 90 patients with GIST confirmed by pathology in the Affiliated Hospital of Guizhou Medical University from August 2013 to March 2024 were retrospectively analyzed. Preoperative CT images were analyzed to obtain qualitative features (number of lesions, location, morphology, growth pattern, borders, cystic degeneration, calcification, ulceration, catheter sign, central umbilication) and quantitative features (lesion long diameter, short diameter, long/short diameter, lesion and normal pancreas arterial-phase and venous-phase CT values, and enhancement ratio). Statistical analyses, including independent sample t-tests, Mann-Whitney U tests, χ2 tests, and Fisher exact tests, were performed to compare CT characteristics between the two groups. Binary logistic regression analysis was used to obtain independent predictors to identify the two groups, to establish a joint model, and to draw a nomogram. The discriminative performance of the independent predictors and the combined model was assessed using receiver operating characteristic (ROC) curves, while calibration curves were used to evaluate model fit. Results:The differences in age, location, morphology, border, catheter sign, central umbilication, short diameter, long/short diameter, arteriovenous phase enhancement CT value and arteriovenous phase enhancement ratio were statistically significant between the EP group and the GIST group (all P<0.05). The logistic analysis showed that the differences in age ( OR=0.920, 95% CI 0.885-0.956, P<0.001), border ( OR=5.994, 95% CI 2.111-17.022, P=0.001), long/short diameter ( OR=7.820, 95% CI 1.841-33.224, P=0.005), and venous phase enhancement ratio ( OR=8.847, 95% CI 1.103-70.972, P=0.040) were the independent predictors for distinguishing EP from GIST, and the area under the ROC curve (AUC) were 0.782 (95% CI 0.698-0.866), 0.684 (95% CI 0.600-0.767), 0.705 (95% CI 0.607-0.803), and 0.693 (95% CI 0.605-0.781), respectively. Combined age, border, long diameter/short diameter and venous phase enhancement ratio were plotted in a nomogram with an AUC of 0.881 (95% CI 0.817-0.945), sensitivity and specificity of 74.4% and 93.3%, respectively. The calibration curve demonstrated a strong agreement between predicted and actual probabilities (Hosmer-Lemeschow test, P=0.267). Conclusions:CT imaging reveals significant differences between EP and small GISTs (<3 cm). EP is more likely when patients are younger and lesions exhibit indistinct borders, a higher long-to-short diameter ratio, and greater venous-phase enhancement. The nomogram derived from CT features provides a valuable tool for differentiating EP from GIST.

Mice ; Animals ; Humans ; Disease Models, Animal

Objective:To investigate the feasibility of mandibular angle osteotomy combined with high-density polyethylene (MEDPOR) prosthesis implantation for one-time lower facial contouring of the protuberance and related surgical precautions.Methods:A total of 18 patients who were treated in the oral and maxillofacial surgery of Yangzhou First People＇s Hospital from June 2010 to August 2016 were selected to complete the mandibular angle osteotomy combined with MEDPOR prosthesis implantation in the lower part of the prosthetic plane. The patients were followed up regularly and the effect of surgery was observed.Results:All 18 patients were operated successfully with an average time of 2 hours. The effect of operation was satisfactory. Except for one patient whose hematoma caused local bruise to subside completely in 2 weeks, all the others were discharged smoothly in one week after operation. After 2 months to 3 years of follow-up, the effect was satisfactory.Conclusions:Mandibular angle osteotomy combined with MEDPOR prosthesis is safe and effective.

OBJECTIVE:To provide reference for further improving the rationality of perioperative prophylactic use of antibiotics in laparoscopy surgery. METHODS:Electronic medical records and medical orders of 5 288 inpatients underwent laparoscopy surgery were collected from our hospital during Jan. 1st-Dec. 31st,2016 by using related information system software. The perioperative prophylactic use of antibiotics was investigated retrospectively. Rationality of medical orders was evaluated. RESULTS:Among 5 288 patients underwent laparoscopy surgery,1 890 patients used antibiotics for infection prevention during perioperative period. The rate of prophylactic use of antibiotics was 35.7%. The rate of prophylactic use of antibiotics in stomach,duodenum and small intestine operation was the highest(69.4%);the rate of prophylactic use of antibiotics in hepatobiliary and pancreatic surgery also reached 68.0%;prophylactic use of antibiotics was not found in the surgery of abdominal external hemia. The majority of 1 890 patients who had used antibiotics prophylactically during perioperative period used antibiotics alone(83.4%). Top 3 drugs in the list of use frequency were cefuroxime sodium(63.9%),metronidazole(13.5%)and cefotaxime sodium(11.85). There were irrational medical orders in 151 cases(8.0%)of perioperative prophylactic use of antibiotics;among prescriptions of irrational drug use,the majority was unsuitable drug selection(50.3%),followed by unsuitable drug selection among nonstandard medical orders. CONCLUSIONS:The overall situation of perioperative prophylactic use of antibiotics is basically satisfactory in laparoscopic surgery of our hospital. The rate of prophylactic use of antibiotics is relatively high in type Ⅰ incision surgery,and irrational drug use is found in some medical orders of prophylactic drug use. It is necessary to formulate regulations for prophylactic use of antibiotics in accordance with the actual situation of the hospital,strengthen medical order evaluation for perioperative prophylactic use of antibiotics in laparoscopy surgery,relevant rational drug use education.

OBJECTIVETo analyze clinical features and mutations of EFEMP1 gene in a Chinese pedigree with familial dominant drusen.

METHODSClinical features of the pedigree were studied with fundus photography, fundus fluorescein angiography and optical coherence tomography. Molecular genetic analysis was performed on the patients and unaffected individuals from the family. All coding exons of the EFEMP1 gene were amplified by polymerase chain reaction (PCR) and sequenced. The results were compared with wild-type sequences from NCBI. The proband who had suffered from choroidal neovascularization and preretinal hemorrhage received an intravitreal injection of an anti-vascular endothelial growth factor (VEGF) preparation.

RESULTSA heterozygous mutation C>T (R345W) was identified in exon 10 of the EFEMP1 gene in two affected individuals from the family. The same mutation was not detected in unaffected family members and 100 healthy individuals. Postoperative follow-up of the patient receiving intravitreal injection of anti-VEGF drug showed that visual acuity was improved and fundus appeared to be stable.

CONCLUSIONThe R345W mutation in EFEMP1 is responsible for the dominant drusen in this family. Intravitreal injection of anti-VEGF drug is a promising treatment for the improvement in vision.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Exons ; Extracellular Matrix Proteins ; genetics ; Female ; Genes, Dominant ; Humans ; Male ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Retinal Drusen ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

Objective To observe the surgical results of prominent malar-complex and to explore the more effective methods by improving the shape of face through operation.Methods Total 80 patients of prominent malar-complex were treated by strengthening reduction plasty of mala and zygoma through intra-oral approach accompanied with minor pre-auricular incision and the midfacial SMAS lift in order to improve the shape of prominent malar-complex and to prevent malar-cheek parenchyma sag.Results The face skeleton and midfacial chalasis of all patients were significantly improved with satisfaction.All the patients obtained good results during the follow-up period of over six months.Of them there was one case of maxillary sinusitis that had been cured by further symptomatic treatment.Conclusions Strengthening reduction plasty of mala and zygoma accompanied with the midfacialSMAS lift can properly and safely improve the facial shape of patients with prominent malar-complex.

Objective:To study the relationship between CXCL12/CXCR4 expression and the neural invasion of salivary adenoid cystic carcinoma(SACC).Methods:Totally 41 SACC specimens,30 tongue cancer specimens,20 pleomorphic adenoma specimens and 20 normal nerve specimens were included in the present study.The specimens were made into sections of 4?m and EnVision method was used to detect the expression of the chemokine receptor CXCR4 in SACC sections and the expression of the chemokine CXCL12 in the peripheral nerve tissue sections.Results:The chemokine receptor was highly expressed in ACC cells.The positive rate of CXCR4 was 63.41% in the SACC sections,which was significantly higher than those in the tongue cancer group(36.67%)and the pleomorphic adenoma parotid group(35%)(P