Objective To explore the value of multimodal MRI combined with digital breast 3D tomography(DBT)in evaluating lymphatic vascular infiltration(LVI)in patients with invasive breast cancer-non special type(IBC-NST)mass type.Methods A total of 102 patients with IBC-NST mass type were divided into LVI group and non LVI group based on whether LVI occurred.The influencing factors of LVI were analyzed by using multivariate logistic regression.Clinical value of multimodal MRI combined with DBT in evaluating LVI in patients with IBC-NST mass type were analyzed by receiver operating characteristic(ROC)curve.Results Multivariate logistic analysis showed that apparent diffusion coefficient(ADC)value,maximum tumor diameter and peritumoral edema were independent risk factors for LVI in IBC-NST mass type(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of ADC value,maximum tumor diameter and peritumoral edema alone and in combination for LVI in patients with IBC-NST mass type were 0.749,0.655,0.638 and 0.791,respectively.Conclusion ADC value and its combined application model have high efficacy in evaluating LVI in patients with IBC-NST mass type.

Purpose To investigate the clinicopathological features,differential diagnosis and prognosis of atypical fibroxanthoma(AFX).Methods Pathological features of 15 cases of AFX and 3 cases of pleomorphic dermal sarcoma(PDS)misdiagnosed as AFX were retrospectively analyzed by hematoxylin and eosin staining and immunohistochemical EnVision staining technology.Clinical information was collected and analyzed,and the relevant literatures were re-viewed.Results The age of the 15 patients with AFX ranged from 18 to 78 years,with an average age of 57 years.4 cases occurred in the head and neck,and 11 cases occurred in the trunk and limbs.3 patients with PDS misdiagnosed as AFX were aged from 56 to 60 years,with an average age of 58 years.The tumors were located in the trunk and limbs.Microscopically,15 cases of AFX and 3 cases of PDS misdiagnosed as AFX were composed of proliferative pleo-morphic and atypical spindle cells interspersed with a varying number of multinucleated cells.15 cases of AFX tumors were superficial and located in the dermis.In 3 cases of PDS misdiagnosed as AFX,1 case was located in subcutane-ous adipose tissue,1 case had superficial subcutaneous extension,and the third case had positive basal margin.Immu-nohistochemically,the immunophenotypes of the two groups were consistent.CD10 was expressed in all cases,CD68 was positive in most cases,SMA was expressed in a few cases,desmin was focal expressed in a very few cases,and S-100,SOX10,CD34,HMB-45,Melan A,STAT6 and CK(AE1/AE3)were not expressed in all cases.Ki67 prolifera-tion index ranged from 2％to 30％.15 patients with AFX were followed up from 12 to 108 months.One patient had tumor recurrence 1 year and 3 years after operation due to positive basal margin.Most of the other patients underwent extended resection after diagnosis and were in good condition without tumor recurrence and metastasis.3 cases of PDS misdiagnosed as AFX were followed up for 31 to 78 months.One patient had lung metastasis after 2 years,one patient recurred 4 times after operation,and the other patient died after 4 times of recurrence.Conclusion AFX is a rare dis-ease with similar pathological characteristics and immunophenotype to PDS.AFX can be diagnosed only when the tumor is small and completely confined to the dermis.When the maximum diameter of the tumor is more than 3 cm,or the presence of any form of subcutaneous extension requires a high level of vigilance for PDS.Careful differentiation and correct classification of AFX and PDS are very important for the treatment and prognosis of the disease.

A 75-year-old male patient with non-small cell lung cancer in the lower lobe of the left lung underwent left lobectomy, followed by 4 cycles of adjuvant chemotherapy with paclitaxel and platinum, 4 cycles of chemotherapy with docetaxel and cisplatin, and immunotherapy with sintilimab, 13 cycles of immunotherapy with sintilimab monotherapy, and 5 cycles of endostatin and sintilimab, spanning a total of 5 years. Due to disease progression, he received the monotherapy with anlotinib, 42 days later, the patient developed intestinal perforation, and laparoscopic ileal perforation repair surgery was performed. During the operation, a perforation with a diameter of about 1 cm was observed in the ileum, indicating the outflow of digestive fluid and a large amount of purulent fluid accumulation in the pelvic cavity; no signs of gastrointestinal tumor metastasis were observed. After surgery, the patient developed abdominal infection and peritonitis, and was given symptomatic and supportive treatments such as anti-infection for 7 days. However, the patient developed severe complications such as lung infection, heart failure, sepsis, and respiratory failure, and died.

Purpose To investigate the clinicopathological features,differential diagnosis and prognosis of atypical fibroxanthoma(AFX).Methods Pathological features of 15 cases of AFX and 3 cases of pleomorphic dermal sarcoma(PDS)misdiagnosed as AFX were retrospectively analyzed by hematoxylin and eosin staining and immunohistochemical EnVision staining technology.Clinical information was collected and analyzed,and the relevant literatures were re-viewed.Results The age of the 15 patients with AFX ranged from 18 to 78 years,with an average age of 57 years.4 cases occurred in the head and neck,and 11 cases occurred in the trunk and limbs.3 patients with PDS misdiagnosed as AFX were aged from 56 to 60 years,with an average age of 58 years.The tumors were located in the trunk and limbs.Microscopically,15 cases of AFX and 3 cases of PDS misdiagnosed as AFX were composed of proliferative pleo-morphic and atypical spindle cells interspersed with a varying number of multinucleated cells.15 cases of AFX tumors were superficial and located in the dermis.In 3 cases of PDS misdiagnosed as AFX,1 case was located in subcutane-ous adipose tissue,1 case had superficial subcutaneous extension,and the third case had positive basal margin.Immu-nohistochemically,the immunophenotypes of the two groups were consistent.CD10 was expressed in all cases,CD68 was positive in most cases,SMA was expressed in a few cases,desmin was focal expressed in a very few cases,and S-100,SOX10,CD34,HMB-45,Melan A,STAT6 and CK(AE1/AE3)were not expressed in all cases.Ki67 prolifera-tion index ranged from 2％to 30％.15 patients with AFX were followed up from 12 to 108 months.One patient had tumor recurrence 1 year and 3 years after operation due to positive basal margin.Most of the other patients underwent extended resection after diagnosis and were in good condition without tumor recurrence and metastasis.3 cases of PDS misdiagnosed as AFX were followed up for 31 to 78 months.One patient had lung metastasis after 2 years,one patient recurred 4 times after operation,and the other patient died after 4 times of recurrence.Conclusion AFX is a rare dis-ease with similar pathological characteristics and immunophenotype to PDS.AFX can be diagnosed only when the tumor is small and completely confined to the dermis.When the maximum diameter of the tumor is more than 3 cm,or the presence of any form of subcutaneous extension requires a high level of vigilance for PDS.Careful differentiation and correct classification of AFX and PDS are very important for the treatment and prognosis of the disease.

Objective To explore the value of multimodal MRI combined with digital breast 3D tomography(DBT)in evaluating lymphatic vascular infiltration(LVI)in patients with invasive breast cancer-non special type(IBC-NST)mass type.Methods A total of 102 patients with IBC-NST mass type were divided into LVI group and non LVI group based on whether LVI occurred.The influencing factors of LVI were analyzed by using multivariate logistic regression.Clinical value of multimodal MRI combined with DBT in evaluating LVI in patients with IBC-NST mass type were analyzed by receiver operating characteristic(ROC)curve.Results Multivariate logistic analysis showed that apparent diffusion coefficient(ADC)value,maximum tumor diameter and peritumoral edema were independent risk factors for LVI in IBC-NST mass type(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of ADC value,maximum tumor diameter and peritumoral edema alone and in combination for LVI in patients with IBC-NST mass type were 0.749,0.655,0.638 and 0.791,respectively.Conclusion ADC value and its combined application model have high efficacy in evaluating LVI in patients with IBC-NST mass type.

A 75-year-old male patient with non-small cell lung cancer in the lower lobe of the left lung underwent left lobectomy, followed by 4 cycles of adjuvant chemotherapy with paclitaxel and platinum, 4 cycles of chemotherapy with docetaxel and cisplatin, and immunotherapy with sintilimab, 13 cycles of immunotherapy with sintilimab monotherapy, and 5 cycles of endostatin and sintilimab, spanning a total of 5 years. Due to disease progression, he received the monotherapy with anlotinib, 42 days later, the patient developed intestinal perforation, and laparoscopic ileal perforation repair surgery was performed. During the operation, a perforation with a diameter of about 1 cm was observed in the ileum, indicating the outflow of digestive fluid and a large amount of purulent fluid accumulation in the pelvic cavity; no signs of gastrointestinal tumor metastasis were observed. After surgery, the patient developed abdominal infection and peritonitis, and was given symptomatic and supportive treatments such as anti-infection for 7 days. However, the patient developed severe complications such as lung infection, heart failure, sepsis, and respiratory failure, and died.

OBJECTIVE: To analyze the clinical characteristics of patients with emergency in-hospital cardiac arrest (IHCA) in Kashgar, Xinjiang Uygur Autonomous Region and the factors affecting the success rate of cardiopulmonary resuscitation. METHODS: Retrospectively selected patients who had cardiac arrest and cardiopulmonary resuscitation in the emergency department of the People's Hospital of 6 counties and cities in Kashgar area from January 2019 to January 2022. The clinical data of all patients were collected, including gender, age, major underlying diseases, the beginning and duration of resuscitation, the number of electric defibrillation acute physiology and chronic health evaluation II (APACHE II). According to whether the resuscitation was successful, all patients were divided into successful resuscitation group and failed resuscitation group. The clinical characteristics of the two groups were compared. Then, the influencing factors of the success rate of cardiopulmonary resuscitation in IHCA patients were analyzed by binary Logistic regression. RESULTS: A total of 1 376 patients were enrolled, including 1 117 cases of failed resuscitation and 259 cases of successful resuscitation. The success rate of resuscitation was 18.82%. Compared with the resuscitation failure group, the patients in the successful resuscitation group were younger (age: 49.10±20.99 vs. 58.44±18.32), the resuscitation start time was earlier [resuscitation start time ≤ 5 minutes: 76.45% (198/259) vs. 66.61% (744/1 117)], the proportion of cardiovascular and cerebrovascular diseases was lower [cardiovascular disease: 49.42% (128/259) vs. 58.19% (650/1 117), cerebrovascular disease: 17.37% (45/259) vs. 21.58% (241/1 117)], the number of electric defibrillation was lower [times: 0 (0, 2) vs. 1 (0, 1)], the proportion of endotracheal intubation was more [80.31% (208/259) vs. 55.60% (621/1 117)], APACHE II score was lower (13.75±8.03 vs. 17.90±4.63), and the difference was statistically significant (all P < 0.01). Binary Logistic regression analysis showed that age, start time of resuscitation, ventilation mode and APACHE II score were protective factors affecting the success rate of cardiopulmonary resuscitation in patients with emergency IHCA [age: odds ratio (OR) = 0.982, 95% confidence interval (95%CI) was 0.973-0.991, P < 0.001; resuscitation start time ≤ 5 minutes: OR = 0.629, 95%CI was 0.409-0.966, P = 0.034; tracheal intubation assisted ventilation: OR = 0.243, 95%CI was 0.149-0.397, P < 0.001; low APACHE II score: OR = 0.871, 95%CI was 0.836-0.907, P < 0.001], while underlying diseases (cardiovascular diseases) are a risk factor affecting the success rate of cardiopulmonary resuscitation (OR = 1.190, 95%CI was 1.015-1.395, P = 0.036). CONCLUSIONS Age, resuscitation start time, ventilation mode, APACHE II score and major underlying diseases (cardiovascular diseases) have a greater impact on the success rate of resuscitation in IHCA patients. The above factors are conducive to improving or formulating more effective rescue strategies for IHCA patients, so as to achieve the purpose of improving the success rate of clinical treatment.
Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Cardiopulmonary Resuscitation ; Heart Arrest/therapy* ; Electric Countershock ; Hospitals

OBJECTIVE To improve th e quality standard for Gerbera piloselloides. METHODS The properties of G. piloselloides were observed and microscopic identification was conducted for powder. The moisture ，total ash ，acid-insoluble ash and ethanol-soluble extract were detected according to the method stated in 2020 edition of Chinese Pharmacopoeia （part Ⅳ）. The contents of nodakenin，luteolin-7-O-β-D-lutinoside，luteoloside，apigenin-7-O-β-D-lutinoside，apigenin-7-O-β-D-glucopyranoside and marmesin were determined by high performance liquid chromatography method. RESULTS G. piloselloides were shrunken ，densely covered with thick white cotton wool ，with many fibrous roots ；the surface was taupe or gray-brown ；its texture was brittle and easy to break ；the cross section was yellow-white ，and there was an obvious small wooden heart in the center. Its powder was tan ， and non-glandular hairs ，stone cells ，calcium oxalate cubes ，ducts，fibers could be seen unde r microscope. The measured values of moisture，total ash ，acid-insoluble ash and alcohol-soluble extract ， for 15 batches of samples were 8.63％-11.34％，10.39％-14.93％， 3.29％-6.37％ and 9.03％-15.02％，respectively；average values were 10.01％，12.26％，4.61％，12.36％. The linear ranges of nodakenin，luteolin-7-O-β-D-rutinoside，luteoloside，apigenin- 7-O-β-D-lutinoside，apigenin-7-O-β-D-glucopyranoside and marmesin we re 3.87-154.88，1.64-65.41，1.60-64.00，1.92-76.96， 1.27-50.93，0.40-15.89 μg/mL，respectively（r≥0.999 1）. RSDs of precision ，stability（24 h）and repeatability tests were all less than 3％. The average recoveries were 101.88％，100.89％，102.64％，95.75％，96.71％ and 103.48％，respectively；RSDs were 0.55％，0.43％，0.34％，0.49％，0.47％ and 0.37％，respectively（n＝6）；the contents of above 6 components were 0.152 7-0.852 2， 0.084 5-0.669 7，0.136 7-0.961 0，0.126 0-1.193 2，0.128 8-1.102 2，0.046 9-0.678 0 mg/g. CONCLUSIONS The established method can be used for the quality control of G. piloselloides . It is preliminarily proposed that the moisture in G. piloselloides is not more than 12.0％；the total ash is not more than 15.0％，the acid-insoluble ash is not more than 6.0％，the alcohol-soluble extract is not less than 9.0％；the contents of luteoloside and apigenin- 7-O-β-D-glucopyranoside are not less than 0.016％.

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.