Objective To analyze the impact of digital conversion of screen-film chest radiographs on image quality in patients with pneumoconiosis. Methods Ten high-kilovoltage screen-film chest radiographs from pneumoconiosis patients were digitally converted using three devices, including a digital single-lens reflex camera, a smartphone, and a medical film scanner. The image quality and optical density values before and after image adjustment were compared across different image formats. Results Before adjustment, among the 30 JPEG images, 24 had diagnostic defect areas and 26 had unqualified optical density values. In RAW format, optical density values were not qualified in 18 out of 30 images. In DICOM format, optical density values were not qualified in nine of ten images. After adjustment, optical density values were not qualified in 13 JPEG images, 12 RAW images, and one DICOM image. Comparisons of chest radiograph quality grade distributions before and after adjustment showed significant differences for all three image formats (all P<0.05). Conclusion After being digitally converted by taking images in RAW format with digital photographic equipment and undergoing post-processing adjustment, the quality of screen-film chest radiographs for pneumoconiosis can meet the diagnostic requirements.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

Objective To study the clinical and pathologic factors for prognosis of children and adolescents with thyroid carcinoma.Methods Clinicopathological data of 110 children and adolescents with thyroid carcinoma at the Affiliated Tumor Hospital of Zhengzhou University from January 1984 to March 2008 were collected and reviewed in this study.Univariate analysis was performed by using Log－rank test to determine predictors of survival,and multiva-riable analysis was performed by a Cox regression model.Results The overall 5－ year and 10 －year survival rates were 95.5%,88.2%,respectively.Gender and histopathologic typing were not related to prognosis.The 5 －year and 10－year survival rates in group ≤12 years old were 91.7% and 81.3%,and those in group ＞12 years old were 98. 4% and 93.5%,respectively.The 5－year and 10－year survival rates in stage T1 and T2 were 100.0%,in stage T3 were 100.0% and 66.7%,respectively,and those in stage T4 were 58.3% and 0.The 5－year and 10－year sur-vival rates in N0 group and N1a group were 100.0%,and those in N1b group were 93.4% and 82.9%,respectively. For patients without the distant metastasis group,the 5－year and and 10－year survival rates were all 96.9%,which were significantly higher than those in the distant metastasis group(84.6%,23.1%).The 5－year and 10－year sur-vival rates in groupⅠwere all 97.8%,those in groupⅡwere 84.6% and 23.1%,respectively,and those in groupⅣwere all 75. 0%.The 5－year and 10－year survival rates in the solitary lesions group were 98.7%,in the multiple le-sions group were 88.2% and 64.7%,respectively.For differentiated thyroid carcinoma,the 5－year and 10－year sur-vival rates in low,and medium risk groups were all 100.0%and those in high risk group were 83.3% and 50.0%,re-spectively.There was a significant relationship between survival and age group,T stage,N stage,M stage,TNM stage, the number of lesions,and risk stratification(all P＜0.05).The Cox regression analysis showed that T stage and M stage were the independent prognostic factors.Conclusions The primary tumor and distant metastatic are important factors affecting the prognosis of children and adolescents.Earlier diagnosis for primary tumor and aggressive manage-ments for metastatic lesions are critical to the survival rate of children and adolescents with thyroid carcinoma.

Objective To evaluate the roles of cytomorphology and immunohistochemistry in distinguishing between basaloid squamous cell carcinoma ( BSC) and small cell carcinoma ( SCC) of lung. Methods The direct smears and/or liquid-based cytology preparation ( ThinPrep) of bronchial brushing/washing and fine-needle aspiration ( FNA ) specimens from 17 cases of biopsy-proven BSC of lung were retrospectively reviewed and compared with those from 17 cases of SCC.The cytomorphologic parameters analyzed included proportion of cohesive cell clusters, cell palisades/rosettes, adenoid cystic features, crushing artifact, nuclear maximum diameter, nuclear molding, scantiness of cytoplasm,“salt-and-pepper”nuclei, distinct nucleoli, spindly configuration, individual cell keratinization, necrosis, hyaline material, apoptosis and mitotic activity.Immunocytochemical/immunohistochemical study of 25 cases was performed. Ten FNA samples of basaloid squamous cell carcinoma were also analyzed for epidermal growth factor receptor mutations in exons 18, 19, 20 and 21 using amplification refractory mutation system.Results Most of the 17 BSC cases ( 15/17 ) showed a predominance of tightly cohesive tumor cell clusters.The proportion of isolated tumor cells was high in SCC ( more than 60% in 14 cases ) .The nuclear maximum diameter of BSC was slightly larger than that of SCC (9 to 11μm in BSC versus 7 to 9μm in SCC).“Salt-in-pepper” nuclei, nuclear molding and crushing artifact were detected in all SCC cases (15/17, 17/17 and 14/17, respectively).These features were only occasionally found in BSC group.Nucleoli were present in BSC and rarely ( 2/17 ) in SCC. Only 9 of 17 BSC cases showed individual cell keratinization. The differences in the above-mentioned cytomorphologic features were statistically significance (P<0.05).The results of immunohistochemistry performed on the cell block sections and immunocytochemistry performed on the ThinPrep slides were identical to that performed on the corresponding biopsy specimens.The tumor cells in BSC were consistently positive for CK5, p40 and p63.TTF1, chromogranin A, synaptophysin and CD56 were positive in most of SCC.One of SCC cases showed focal PAX5 expression.No EGFR mutations were detected in the 10 BSC cases studied.Conclusions Selected cytomorphologic features, including presence of cohesive cell clusters, larger nuclear size, distinct nucleoli, lack of crushing artifact, absence of nuclear molding and presence of individual cell keratinization, are helpful in diagnosing BSC on cytology specimens. Immunohistochemistry using a panel of TTF1, CK5, p40/p63 and chromogranin A/synaptophysin/CD56 provides further clues in differential diagnosis between BSC and SCC.EGFR mutation study is often negative in lung BSC.