Objective To explore the value of MRI functional imaging in the differential diagnosis between inflammatory pseudo-tumors and malignant tumors in the parotid gland.Methods A total of 20 cases with malignant tumors of the parotid gland and 15 cases with inflammatory pseudotumors of the parotid gland were retrospectively analyzed,and all patients were underwent enhanced MRI examinations of the maxillofacial region.All patients had complete MRI examination data and were confirmed by surgical pathology or clinical follow-up results.The morphological manifestations and the characteristics of MRI functional imaging of the parotid gland tumors that was time-signal intensity curve(TIC)type,apparent diffusion coefficient(ADC)were observed,and all imaging mani-festations data of the two groups were statistically analyzed via the x2 test,respectively.Results There were no statistical differ-ences in the morphological manifestations and functional imaging characteristics(TIC type and average ADC value)between the two groups(P＞0.05),while there was statistical difference in maximum ADC value between the two groups(P=0.017).Conclusion There is an overlap in the imaging characteristics of inflammatory pseudotumors and malignant tumors in the parotid gland.The wide distribution range and higher maximum value of ADC in multiple measurements of parotid gland inflammatory pseudotumors have certain significance for the differential diagnosis,thus guiding the clinical formulation of treatment plans.

Objective:To analyze the CT and MRI manifestations of hepatic angiomyolipoma (HAML) to improve the diagnostic accuracy of HAML.Methods:A retrospective analysis was conducted on the clinical data of 46 cases of HAML confirmed by tumor surgery or biopsy in Yueqing People's Hospital of Zhejiang and Rui'an People's Hospital of Zhejiang from November 2015 to June 2024. Among them, there were 20 males and 26 females, with an average age of (40±18) years. The CT and MRI manifestations of the patients were recorded, and the tumor location, size, shape, boundary, CT density, T 1-weighted imaging, T 2-weighted imaging, diffusion-weighted imaging (DWI), fat suppression sequence, and inverse phase signal were observed. Results:29 cases underwent plain CT scan combined with enhanced scan. Among them, 4 cases (13.8%) had a round shape, 22 cases (47.8%) had a nearly round shape, and 3 cases (10.3%) had an irregular shape. 26 cases (89.7%) had clear boundaries, and 3 cases (10.3%) had unclear boundaries. 5 cases (17.2%) had uniform density, and 24 cases (82.8%) had non-uniform density. The CT value of the tumor was (32±6.8) Hu. 25 cases (86.2%) contained fat tissue within the tumor. Among them, 13 cases (44.8%) were mixed type. After enhancement, the fat tissue and necrotic cystic changes did not enhance, and the soft tissue components showed varying degrees of enhancement in the arterial phase. Among them, 6 cases continued to enhance in the portal venous phase and delayed phase, showing " fast in and slow out" , and 7 cases showed decreased enhancement in the portal venous phase and delayed phase, showing " fast in and fast out" . 17 cases underwent plain MRI scan combined with enhanced scan. Among them, 12 cases were mixed type. On T 2-weighted imaging with fat suppression, it was a mixed high signal, on T 1-weighted imaging, it was an isointense/low signal or mixed low signal, and on DWI, it was a high signal, with partial signal reduction on the inverse phase. 9 cases of tumor septation showed isointense signals on T 1-weighted imaging, 7 cases showed isointense signals on T 2-weighted imaging, and 2 cases showed high signals on T 2-weighted imaging. After enhancement, the mass showed heterogeneous enhancement, with 7 cases showing " fast in and fast out" and 5 cases showing " fast in and slow out" . Conclusion:Plain CT scan shows that HAML is round or nearly round, with non-uniform low density or uniform isodensity. Plain MRI scan shows isointense or slightly high signal on T 2-weighted imaging, low signal on T 1-weighted imaging, and high signal on T 2-weighted imaging with fat suppression. After enhancement, there is significant or mild to moderate enhancement in the arterial phase, with " fast in and fast out" or " fast in and slow out" as the characteristics.

Objective To investigate the application value of 320-slice wide-detector multi-phase left at-rial appendage computed tomography angiography(LAA-CTA)with pulmonary artery(PA)monitoring in the preoperative evaluation of left atrial appendage closure.Methods A retrospective analysis was conducted on the clinical data of 110 patients who underwent LAA-CTA before left atrial appendage closure.Among them,47 patients underwent single-phase enhanced scanning with superior vena cava(SVC)monitoring(con-trol group),and 63 patients underwent multi-phase enhanced scanning with pulmonary artery monitoring(study group).The differences in imaging effects of the left atrial appendage under different monitoring points and phase imaging methods were compared,as well as the accuracy of comparing with the diagnostic results of transesophageal ultrasound(TEE),and the differences in the presentation of thrombus,perithrombus,and hypoperfusion areas in the left atrial appendage.Results The study group could comprehensively display the multi-phase CT value changes of different components(thrombus,peri-thrombotic viscosity,normal blood)within the left atrial appendage cavity,and its evaluation of lesion size and progression was superior to that of the control group.Using TEE as the gold standard,the study group demonstrated better diagnostic ac-curacy for different components and normal regions within the left atrial appendage cavity compared to the control group(P<0.001).Additionally,the study group improved the detection rate of peri-thrombotic vis-cosity,clearly delineated thrombus boundaries,and enhanced diagnostic accuracy(P<0.001).Conclusion Multi-phase LAA-CTA with pulmonary artery monitoring can effectively evaluate the morphological dimensions,thrombus,and peri-thrombotic CT manifestations of the left atrial appendage.It is simple to operate,with an accuracy rate close to the gold standard,providing reliable imaging evidence for preoperative evaluation of left atrial appendage closure.

Objective To explore the value of MRI functional imaging in the differential diagnosis between inflammatory pseudo-tumors and malignant tumors in the parotid gland.Methods A total of 20 cases with malignant tumors of the parotid gland and 15 cases with inflammatory pseudotumors of the parotid gland were retrospectively analyzed,and all patients were underwent enhanced MRI examinations of the maxillofacial region.All patients had complete MRI examination data and were confirmed by surgical pathology or clinical follow-up results.The morphological manifestations and the characteristics of MRI functional imaging of the parotid gland tumors that was time-signal intensity curve(TIC)type,apparent diffusion coefficient(ADC)were observed,and all imaging mani-festations data of the two groups were statistically analyzed via the x2 test,respectively.Results There were no statistical differ-ences in the morphological manifestations and functional imaging characteristics(TIC type and average ADC value)between the two groups(P＞0.05),while there was statistical difference in maximum ADC value between the two groups(P=0.017).Conclusion There is an overlap in the imaging characteristics of inflammatory pseudotumors and malignant tumors in the parotid gland.The wide distribution range and higher maximum value of ADC in multiple measurements of parotid gland inflammatory pseudotumors have certain significance for the differential diagnosis,thus guiding the clinical formulation of treatment plans.

Objective:To analyze the CT and MRI manifestations of hepatic angiomyolipoma (HAML) to improve the diagnostic accuracy of HAML.Methods:A retrospective analysis was conducted on the clinical data of 46 cases of HAML confirmed by tumor surgery or biopsy in Yueqing People's Hospital of Zhejiang and Rui'an People's Hospital of Zhejiang from November 2015 to June 2024. Among them, there were 20 males and 26 females, with an average age of (40±18) years. The CT and MRI manifestations of the patients were recorded, and the tumor location, size, shape, boundary, CT density, T 1-weighted imaging, T 2-weighted imaging, diffusion-weighted imaging (DWI), fat suppression sequence, and inverse phase signal were observed. Results:29 cases underwent plain CT scan combined with enhanced scan. Among them, 4 cases (13.8%) had a round shape, 22 cases (47.8%) had a nearly round shape, and 3 cases (10.3%) had an irregular shape. 26 cases (89.7%) had clear boundaries, and 3 cases (10.3%) had unclear boundaries. 5 cases (17.2%) had uniform density, and 24 cases (82.8%) had non-uniform density. The CT value of the tumor was (32±6.8) Hu. 25 cases (86.2%) contained fat tissue within the tumor. Among them, 13 cases (44.8%) were mixed type. After enhancement, the fat tissue and necrotic cystic changes did not enhance, and the soft tissue components showed varying degrees of enhancement in the arterial phase. Among them, 6 cases continued to enhance in the portal venous phase and delayed phase, showing " fast in and slow out" , and 7 cases showed decreased enhancement in the portal venous phase and delayed phase, showing " fast in and fast out" . 17 cases underwent plain MRI scan combined with enhanced scan. Among them, 12 cases were mixed type. On T 2-weighted imaging with fat suppression, it was a mixed high signal, on T 1-weighted imaging, it was an isointense/low signal or mixed low signal, and on DWI, it was a high signal, with partial signal reduction on the inverse phase. 9 cases of tumor septation showed isointense signals on T 1-weighted imaging, 7 cases showed isointense signals on T 2-weighted imaging, and 2 cases showed high signals on T 2-weighted imaging. After enhancement, the mass showed heterogeneous enhancement, with 7 cases showing " fast in and fast out" and 5 cases showing " fast in and slow out" . Conclusion:Plain CT scan shows that HAML is round or nearly round, with non-uniform low density or uniform isodensity. Plain MRI scan shows isointense or slightly high signal on T 2-weighted imaging, low signal on T 1-weighted imaging, and high signal on T 2-weighted imaging with fat suppression. After enhancement, there is significant or mild to moderate enhancement in the arterial phase, with " fast in and fast out" or " fast in and slow out" as the characteristics.

Signal transducer and activator of transcription (STAT) is a family of cytoplasmic transcription factors including seven proteins of STAT-1, -2, -3, -4, -5A, -5B and -6. The genes encoding the STAT family are located on are located on chromosome 2 (STAT1 and STAT4), chromosome 12 (STAT2 and STAT6) and chromosome 17 (STAT3, STAT5A and STAT5B). Among these seven proteins, STAT3 and STAT5 have the strongest correlation with tumor progression, and ionizing radiation can affect STAT3 level. Continuous activation of STAT3 can regulate a variety of functions, including cell proliferation, cell cycle progression, apoptosis, angiogenesis and immune escape. STAT3 is highly complex in its biological function and activator action. Therefore, it is of great significance to further study the biological function and signaling pathway of STAT3.

Objective To investigate the efficacy and feasibility of ultrasound-guided percutaneous catheter drainage for cervical abscess.Methods The clinical data of 18 patients with cervical abscess treated by percutaneous puncture and catheterization under ultrasound guidance were analyzed retrospectively.Results All of the 18 patients were successfully treated on one round.None of the 18 patients was nerve injury,main vessels injury or dead during the operation.Conclusions Ultrasound-guided percutaneous catheter drainage of neck abscess is safe and effective,and has high clinical application value.

Objective To investigate the effect of pre-implanted anti-adhesion patch under laparoscopic approach in a Miles' operation on the incidence of parastomal hernia in elderly patients.Methods A total of 68 patients with low rectal cancer admitted into our general surgery department were enrolled in the study from January 2012 to January 2015.All patients received laparoscopic assisted Miles operation.According to whether or not the pre-implanted anti adhesion patch was used during the operation,the 68 cases were divided into pre-implanted patch group(n=38)and the non-implanted patch group(n=30).The operation states,postoperative complications,complications during follow-up and 3-year survival rate were compared between the two groups.Results The operation duration was longer in the pre-implanted patch group than in the non-implanted patch group[(235.7± 33.6)min vs.(94.3±28.9)min,t =5.36,P=0.000].The incidence of complications was lower in the pre implanted patch group than in the non-implanted patch group at 3 years after operation[10.5％ (4/38)vs.90.0％(27/30),x2 =42.69,P =0.000].The local recurrence rate,distant metastasis rate and 3-year overall survival rate had no significant difference between the two groups[23.7 ％ (9/38)vs.23.3％ (7/30),31.6％ (12/38) vs.33.3％ (10/30) and 71.1％ (27/38) vs.70.0％ (21/30)respectively,x2=0.06,0.02 and 0.01,P=0.800,0.878 and 0.925].Conclusions Pre-implanted anti-adhesion patch under laparoscopic approach can significantly reduce the incidence of parastomal hernia in elderly patients after a Miles' operation,which is worthy of promotion.

Objective To evaluate the efficacy and safety of intensity modulated radiation therapy (IMRT) for whole-brain radiotherapy with simultaneous integrated boost for brain metastases.Methods From January 2015 to January 2017,120 patients with brain metastases undergoing hospital radiotherapy at the First People's Hospital and the Second People's Hospital of Yulin City of Guangxi Zhuang Autonomous Region were randomly divided into three dimensional conformal radiation therapy (3DCRT) group (n =60) and IMRT group (n =60) by envelope method.The curative effects of the two groups and the changes of patient's mental states before and after radiotherapy were compared.Results The median survival times of patients in 3DCRT group was 11.5 months,and the 6 months and 1 year survival times rates were 83.3％ and 35.0％ respectively.The median survival times of patients in IMRT group was 12.9 months,and the 6 months and 1 year survival rates were 86.7％ and 38.3％ respectively.There was no significant difference in prognosis between the two groups (x2 =0.143,P =0.705).There were 8 cases with complete remission,38 cases with partial remission,11 cases with stable disease,3 cases with progressive disease in 3DCRT group,and there were 9,40,9,2 cases in IMRT group respectively.There was no statistically significant difference in short-term efficacy between the two groups (Z =-0.641,P =0.520).Univariate analysis results showed that recursive partitioning analysis (RPA) classification (x2=53.484,P ＜0.001),extracranial lesions control (x2=13.392,P ＜ 0.001),whether the midline offset (x2 =4.427,P =0.035) were prognostic factors.Multivariate analysis results showed that RPA classification (HR =2.631,95 ％ CI:1.884-3.673,P ＜ 0.001),extracranial lesions control (HR =1.697,95％ CI:1.034-2.786,P =0.037),whether the midline offset (HR =1.787,95％ CI:1.118-2.856,P =0.015) were the independent prognostic factors for the overall survival.According to the results of activities of mini-mental state examination,the scores of 3DCRT group before and after radiotherapy were 27.12 ± 2.42 and 26.08 ± 2.42 respectively,with a significant difference (t =2.723,P =0.009);and the scores of IMRT group before and after radiotherapy were 26.57 ± 3.09 and 27.20 ± 2.46 respectively,with no significant difference (t =-1.610,P =0.1 13).Conclusion IMRT for whole-brain radiotherapy with simultaneous integrated boost is an effective treatment for multiple brain metastases,which can relieve symptoms,prolong survival time and improve quality of life.

Objective:To evaluate the efficacy and safety of thalidomide on preventing and treating radiation-induced oral mucositis (RIOM) in nasopharyngeal carcinoma (NPC). Methods:A total of 60 patients with NPC were randomly divided into treatment group and control group. The treatment group took thalidomide and gargled with mixture of saline+gentamycin+dexamethasone when ra-diotherapy started, and the control group gargled only with mixture of saline+gentamycin+dexamethasone. The time of occurrence and degree of RIOM in both groups were registered at the same time. Results:The incidence of RIOM in treatment group was lower than that in control group (P<0.05). For the incidence of 3 or 4 grade RIOM, the treatment group was also lower than the control group. No statistical difference in terms of objective response rate was found between the two groups (P>0.05). There was no statisti-cally significant difference between the treatment group and the control group in the oral average dose, V30, V35, V40, V45, V50, and V54 (P>0.05). There was no statistically significant difference between the treatment group and the control group in the use of nutri-tion agents, hormones and antibiotics (P>0.05). There was no statistical difference between the groups in the drowsiness, peripheral nerve toxicity, hematologic toxicity and gastrointestinal reaction (P>0.05). Conclusion:Thalidomide can reduce the incidence and se-verity of RIOM for radiotherapy of patients with NPC, which deserves clinic application.