Renal glomus tumor is rare, and this report describes two cases of it. Two patients, aged 37 and 60 years old, were admitted to the hospital due to renal masses discovered during physical examinations. Both cases underwent preoperative ultrasound and CT examinations, which revealed a left kidney tumor and a fully endogenous renal tumor in the left kidney, respectively. Subsequently, they received appropriate surgical interventions, with one case undergoing radical nephrectomy and the other undergoing laparoscopic partial nephrectomy. Postoperative pathology revealed a glomus tumor and a glomus tumor of undetermined malignant potential, respectively. No recurrence or metastasis was observed in either case. At the 121-month and 14-month follow-up, respectively, there was no evidence of recurrence or metastasis.

Plain combined with three-phase contrast-enhanced CT is the most commonly used imaging technique for the diagnosis of renal masses, and it also plays an important role in predicting the malignancy and aggressiveness of renal tumors. The pathological findings of renal tumors are important in determining treatment options as well as prognosis. This article reviews current research and summarizes common CT variables for renal tumors, including tumor diameter, growth rate, enhancement characteristics, tumor margins, the proportion of cystic components, and variables related to the R. E.N.A.L. score. This paper aims to analyze the role of these variables in predicting the pathological malignancy and aggressiveness of the renal tumor.

Objective:To analyze the diagnostic value of sex hormone combined with carcinoembryonic antigen on lymph node metastasis in breast cancer patients.Methods:52 cases of breast cancer patients who underwent surgical resection were collected and divided into non-metastasis group and metastases group after axillary lymph node ultrasonography. The blood samples was collected from patients and the levels of serum estradiol, testosterone, progesterone and carcinoembryonic antigen were detected; The diagnostic value of the above indexes in patients with lymph node metastasis was analyzed; Logistic risk regression model was used to analyze the independent risk factors for lymph node metastasis after surgical resection.Results:There were significant differences between the non-metastatic group and the metastatic group in the largest tumor diameter and menopause (all P<0.05), but there were no significant differences among other general data (all P>0.05). The serum estradiol level in the non-metastatic group was (153.97±35.55) pg/ml, the progesterone level was (0.33±0.05) ng/ml, and the carcinoembryonic antigen level was (11.44±3.77) ng/ml, while the estradiol level in the metastatic group was (207.19±52.11) pg/ml ( t=4.13, P<0.001), progesterone level (0.38±0.04) ng/ml ( t=4.01, P<0.001), carcinoembryonic antigen level (15.41±3.46) ng/ml ( t=3.94, P<0.001). The above three indicators were significantly increased in patients in the transfer group. The area under the curve of estradiol was 0.83, the area under the curve of progesterone was 0.80, the area under the curve of carcinoembryonic antigen was 0.77, the area under the curve of the combination of the three was 0.85, and the area under the curve of the combination of the three was the largest. Logistic risk regression model showed that estradiol, progesterone, and carcinoembryonic antigen levels were independent risk factors affecting lymph node metastasis in breast cancer patients (all P<0.05) . Conclusion:The sex hormone estradiol, progesterone combined with carcinoembryonic antigen has a high diagnostic value for lymph node metastasis in patients with breast cancer, and can independently predict the occurrence of lymph node metastasis in breast cancer patients.

Objective:To compare the dosimetric difference between 3D-printed multi-channel applicator and conventional vaginal single-channel applicator for brachytherapy, aiming to provide guidance for patients receiving brachytherapy after cervical cancer surgery.Methods:From January 2019 to November 2020, 25 cervical cancer patients complicated with VAIN Ⅲ receiving 192Ir high-dose-rate brachytherapy after cervical cancer surgery were selected. Each patient was located by CT scanning with 3D-printed multi-channel applicator and conventional vaginal single-channel applicator, and corresponding plan and evaluation were carried out. The dose volume histogram (DVH) was obtained by inverse dose optimization algorithm. The dosimetric differences of high-risk clinical target volume (HRCTV), bladder and rectum during brachytherapy were compared with those of source applicators. The optimal treatment plan was selected. Results:D 90%, D 100%, V 100% and V 150% of the plans designed by 3D-printed individual multi-channel applicator had no significant differences compared with those designed by conventional single-channel applicator (all P>0.05). The bladder and rectal D 2cm 3 designed by 3D-printed multi-channel applicator were significantly lower than those using conventional single-channel applicator, and the differences were statistically significant (both P<0.05). Conclusion:The multi-channel individual applicator target made by 3D-printing technology has good conformal property, properly protects the bladder and rectum and possesses treatment advantages over conventional single-channel applicator.

OBJECTIVES: Pelvic lymph node metastasis (PLNM) is an important factor that affects the stage and prognosis of prostate cancer. Invasive extended pelvic lymph node dissection (ePLND) is the most effective method for clinically diagnosing PLNM. Accurate preoperative prediction of PLNM can reduce unnecessary ePLND. This study aims to investigate the clinical value of radiomics nomogram in predicting PLNM of prostate cancer based on T₂-weighted imaging (T₂WI). METHODS: Magnetic resonance (MR) data of 71 patients with prostate cancer who underwent ePLND from January 2017 to June 2021 in Peking University First Hospital were collected retrospectively. All patients were assigned into a training set (January 2017 to December 2020, n=56, containing 186 lymph nodes) and a test set (January 2021 to June 2021, n=15, containing 45 lymph nodes) according to the examination time of multiparametric magnetic resonance imaging (mpMRI). Two radiologists matched the dissected lymph nodes on MRI images, and manually annotated the region of interest (ROI). Based on the outlined ROI, 3 metastatic lymph node prediction models were established: Model 1 (only image features of T₂WI), Model 2 (radiomics features based on random forest), and Model 3 (combination of the image and radiomics features). A nomogram was also established. The clinicopathologic characteristics of the patients were obtained from the medical records, including age, the Gleason score, the level of prostate-specific antigen (PSA), and clinical and pathological T stage. The preoperative radiological features of the pelvic lymph nodes (LNs) include size of LNs (the short and long diameters) and volume of LNs. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the 3 models and decision curve analysis (DCA) was used to evaluate the clinical benefits of the models. RESULTS: No significant differences were found between the training set and test set regarding age, Gleason scores, PSA level, and clinical and pathological T stage (all P>0.05). The differences in volume, short diameter and long diameter between metastatic and non-metastatic LNs were statistically significant in both training set and test set (all P<0.05). In multivariate regression analysis, the short diameter and marginal status of LNs were included in Model 1. Eighteen omics features were selected to construct Model 2. The signal distribution of LNs and Rad score were the significant risk factors for predicting metastasis of pelvic LNs in Model 3. The C-index of nomogram based on Model 3 reached 0.964, and the calibration curve showed that the model had high calibration degree. In the test set, the area under the curves of Model 1, 2, and 3 were 0.78, 0.93, and 0.96 respectively, Model 2 and Model 3 showed significantly higher diagnostic efficiency than Model 1 (Model 1 vs Model 2, P=0.019; Model 1 vs Model 3, P=0.020). There was no significant difference in the area under the curve between Model 2 and Model 3 (P=0.649). The DCA results of the 3 models showed that all models obtained higher net benefits than the PLNM-all or PLNM-none protocol in different ranges of threshold probabilities and Model 3 had the highest clinical benefit. CONCLUSIONS The radiomics nomogram based on T₂WI shows a good predictive efficacy for preoperative PLNM in patients with prostate cancer, which could be served as an imaging biomarker to optimize decision-making and adjust adjuvant treatments.
Humans ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Prostate-Specific Antigen ; Prostatic Neoplasms/pathology* ; Retrospective Studies

Objective : To investigate the influence and molecular mechanism of hypoxia-inducing factor-1 α( HIF- 1 α) gene silencing combined with methyl selenenic acid (MSA) on cervical cancer cell proliferation，apoptosis and cell migration． Methods : HeLa cells were transfected with HIF-1 interference RNA and negative control RNA．Af- ter transfection for 48 h，cells were stimulated with MSA for 24 h，and cell proliferation was determined by CCK-8 assay and colony formation．Apoptosis was determined by flow cytometry combined with Annexin V-FITC / PI．The expression levels of HIF-1α , Bcl-2 ，and E-cadherin were detected by Western blot assay． Cell migration ability was determined by Transwell assay. RNA-seq analysis was used to investigate the differentially expressed genes and differential signaling pathways. Results : Compared with the control group，interfering with HIF-1α combined with MSA significantly inhibited cell proliferation (P ＜0．01) ．Flow cytometry results showed that the combined drug group significantly induced apoptosis．Transwell results showed that interfering with HIF-1α combined with MSA inhibited HeLa cell migration．Compared with the control group，interfering with HIF-1α combined with MSA down- regulated the expression of Bcl-2 and up-regulated the expression of E-cadherin. RNA-sequencing combined with signal pathway enrichment results showed that the expression of apoptotic signal pathway and downstream genes was inhibited． Conclusion HIF-1α gene silencing combined with MSA can synergically inhibit the proliferation and induce apoptosis of cervical cancer cells，and its regulatory mechanism may be related to the expression of Bcl-2 family proteins and the inhibition of p53 signaling pathway.

Objective:To analyze clinical and imaging features of Sturge-Weber syndrome in children.Methods:Clinical data were collected from 27 children with Sturge-Weber syndrome in Xuzhou Children′s Hospital, Xuzhou Medical University from July 2013 to December 2019, and analyzed retrospectively.Results:Among the 27 children, 17 were males and 10 were females. Their age at the clinic visit ranged from 2 days to 10 years and 7 months, and averaged 2.54 years. All the 27 patients presented with facial port-wine stains of varied color from light red to purple red, which were all distributed across the facial midline, including 21 with predominantly unilateral port-wine stains and 6 with bilateral symmetrical port-wine stains. There were 17 patients with ocular choroidal vascular malformations, including 14 with congenital glaucoma, 5 with high intraocular pressure, and 1 with optic nerve atrophy accompanied by transient blindness. Neurological impairment occurred in 12 patients, and all manifested as epilepsy. All the 27 children underwent imaging examination, and abnormalities were found in 20. Among the 10 patients with abnormal computed tomography images, local calcification was observed in 8, and local thickening of the skull on the side affected by skin lesions in 8; 13 of 14 patients with abnormal magnetic resonance imaging scan results had signs of brain atrophy, 9 showed enhanced gyrus-like blood vessel formation by enhanced magnetic resonance imaging, and 5 showed decreased branches of the anterior and middle cerebral artery on the affected facial side by magnetic resonance angiography.Conclusions:Children with Sturge-Weber syndrome are clinically characterized by predominantly unilateral port wine stains on the face, some of whom are accompanied by epilepsy, glaucoma or mental retardation, and imaging examinations mainly show local calcification, brain atrophy, local thickening of the skull plate, enhanced gyrus-like blood vessel formation, etc. Early definite diagnosis and comprehensive systemic treatment are needed to reduce disability and mortality rates in patients with Sturge-Weber syndrome, and long-term follow-up should be considered.

OBJECTIVE： To investigate estrogen-like effect of tetrahydroxy stilbene glucoside （TSG） and its effects on the expression of estrogen receptor （ER） in uterus of sexually immature mice. METHODS： Totally 60 sexually immature Kunming mice were randomly divided into normal group， positive control group （estradiol valerate， 0.18 mg/kg）， TSG low-dose and high-dose groups （50， 150 mg/kg）， TSG low-dose and high-dose groups+estradiol valerate groups （same dose as medication alone group）. Normal group was given constant volume of water intragastrically， and administration groups were given relevant medicine 0.2    mL/10 g， once morning and night， for consecutive 5 d. The uterus index and body weight increase of mice in each group were determined and calculated the next day after the last administration. The contents of serum estrogen （E2， LH， FSH） were determined by ELISA. HE staining was used to observe the morphology characteristics of uterus， and uterine tube diameter and endometrial thickness were detected. The expression of ER（ER-α and ER-β） in uterus was detected by immunohistochemical staining. RESULTS： The myometrium of the mice in normal group was parallel and compact， the epithelium of the uterus was columnar， and the expression of ER-α and ER-β was low. The uterine tube diameter， endometrium and epithelium of mice in each administration group increased， thickened or proliferated in varying degrees， and the expression of ER-α and ER-β changed. Compared with normal group， uterus indexes （positive control group， TSG high-dose group， TSG+estradiol valerate groups）， the increase of body weight （positive control group， TSG high-dose groups， TSG low-dose+estradiol valerate group）， uterine tube diameter and endometrial thickness （positive control group， TSG low-dose group， TSG+estradiol valerate groups）， the expression of ER-α （positive control group， TSG+estradiol valerate groups） and the expression of ER-β （postive control group， TSG high-dose+estradiol valerate group）were increased significantly， while serum contents of LH （positive control group， TSG high-dose group） and FSH （TSG low-dose+estradiol valerate group） were decreased significantly （P＜0.05 or P＜0.01）. The uterus index， uterine tube diameter， endometrial thickness and the expression in ER-α and ER-β of TSG+estradiol valerate groups， the increase of body weight and serum content of E2 in TSG low-dose+estradiol valerate group were significantly higher than same TSG dose alone groups （P＜0.05 or P＜0.01）. The uterus index， uterine tube diameter， endometrial thickness and the expression of ER-α and ER-β in TSG groups， uterine tube diameter and the expression of ER-β in TSG+estradiol valerate groups， body weight increase of mice in TSG low-dose group were significantly lower than positive control group， while serum content of LH in TSG+estradiol valerate groups were significantly higher than positive control group （P＜0.05 or P＜0.01）. CONCLUSIONS： TSG can increase uterus indexes and body weight of sexually immature mice to certain extent， regulate estrogen level， increase the diameter of uterine tube and endometrial thickness and up-regulate the expression of ER in the uterus， showing certain estrogen-like effect， which is weaker than that of estradiol valerate. Combined use of them may antagonize the effect of estradiol valerate.

Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.