Objective To investigate the computed tomography (CT) features of solitary nodular invasive mucinous lung adenocarcinoma (IMA) in stage IA and establish its prediction model. Methods We included 53 lesions of 53 patients with stage-IA IMA and 141 control lesions of 141 patients with invasive non-mucinous lung adenocarcinoma (NIMA) that were confirmed by surgical pathology in our hospital from January 2017 to December 2019. Univariable analysis was used to compare the demographics and CT signs of the two groups. Multivariable logistic regression analysis was performed to determine the main factors influencing solitary nodular IMA. A risk score prediction model was constructed based on the regression coefficients of the main influencing factors. A receiver operating characteristic (ROC) curve was used to assess the performance of the model. Results The univariable analysis showed significant differences between the two groups in age, largest nodule diameter, tumor-lung interface, lobulation, spiculation, air-bronchogram or vacuole sign, vessel abnormalities (P < 0.05). The spiculation sign was different between the two groups, which was longer and softer in the IMA group while shorter and harder in the NIMA group. There was no significant difference in sex, nodule shape, or pleural retraction (P > 0.05), but irregular shapes were slightly more frequent in the IMA group. The multivariable logistic regression analysis showed that obscure tumor-lung interface (odds ratio (OR = 20.930, P < 0.05), air-bronchogram or vacuole sign (OR = 7.126, P < 0.05), spiculation sign (OR = 4.207, P < 0.05), and vessel abnormalities (OR = 0.147, P < 0.05) were the main influencing factors. The prediction model based on those factors’ regression coefficients had an area under the ROC curve of 0.829 (P < 0.05). Conclusion Compared with those with NIMA, patients with solitary nodular IMA in stage IA were older and more likely to have the CT features of obscure tumor-lung interface, air-bronchogram or vacuole sign, and longer and softer spiculation. Based on the regression coefficients of tumor-lung interface, air-bronchogram or vacuole sign, spiculation, and vessel abnormalities, the risk score prediction model showed good predictive performance for solitary nodular IMA.

Nevus-like basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by the occurrence of multiple maxillofacial keratocysts, basal cell carcinoma, child medulloblastoma, and various skeletal and soft tissue dysplasia. In 2020, a patient with NBCCS dominated by facial basal cell carcinoma was admitted to Xiangya Hospital of Central South University. The patient was an elderly woman. Ten years ago, the systemic mass appeared, especially on the face, but it was not treated. Later, these masses gradually increased in volume and number, and showed invasive properties. The nasal mass was broken and suppurated, seriously affecting the patient's life quality. The patient came to the hospital to improve the symptoms. Staphylococcus aureus and Providencia rettgeri were cultured in the patient's nasal secretions. Nasal sinus enhanced MRI showed that the subcutaneous soft tissue of the right cheek and the anterolateral mucosa of the left nasal cavity were invaded, indicating multiple malignant skin lesions. After admission, local anesthesia was performed and some masses were removed. Pathological examination of the mass showed basal cell carcinoma. After general anesthesia, multiple masses were resected. The postoperative pathological examination showed that multiple basal cell carcinoma invaded the deep dermis near subcutaneous fat layer. Combined with the results of clinical and immunohistochemical examination, the patient was diagnosed as NBCCS. There were no clear tumor thrombus in the vessel and no nerve invasion. No recurrence or new tumor was found after 1 year follow-up. The incidence rate of NBCCS is low and clinical symptoms are different. The patient's life quality is poor and the patient needs long-term individualized treatment.
Aged ; Basal Cell Nevus Syndrome/surgery* ; Carcinoma, Basal Cell/surgery* ; Child ; Female ; Hamartoma Syndrome, Multiple ; Humans ; Magnetic Resonance Imaging

OBJECTIVES: Rhinoplasty is one of the most common cosmetic surgeries in China. Septal extension grafts (SEG) have been widely used in rhinoplasty, but there are few reports on SEG derived from ear cartilage. This study aims to explore the effectiveness and stability of auricular cartilage nasal SEG transplantation in Chinese rhinoplasty. METHODS: A retrospective analysis of 35 rhinoplasty patients admitted from September 2019 to March 2022 has been conducted. Among them, 29 patients underwent rhinoplasty for the first time and 6 patients underwent rhinoplasty with the age of 18-32 (average 22.4) years old. The postoperative follow-up was 3-28 (average 18.5) months. The improvement of the nose shape was observed. The changes of the nose tip angle, nasolabial angle, and nasofrontal angle were compared between before and after the operation, and the complications were recorded. RESULTS: All patients who underwent rhinoplasty with a septal extension grafts constructed from the concha cavity and concha cartilage showed significant improvement in nasal contour. The preoperative nasal tip angle, nasolabial angle, and nasofrontal angle were significantly improved compared with 3 months after operation (all P<0.001), and there was no significant difference between 3 months and 14 months after operation (all P>0.05). The appearance of nasal cavity was satisfactory in 32 patients after operation. Columella deviation occurred in 2 patients and 1 patient complained of downward rotation of the nasal tip, which was satisfied after readjustment of the graft. CONCLUSIONS The simplified SEG derived from auricular cartilage can provide stable support for the nasal tip, the nasal shape is natural after operation, and minimal trauma of unilateral auricle cartilage transplantation remains.
Humans ; Young Adult ; Adult ; Rhinoplasty ; Ear Cartilage/transplantation* ; Retrospective Studies ; Nasal Septum/transplantation* ; Plastic Surgery Procedures

Objective:To compare the value of NoSAS score, STOP-BANG questionnaire (SBQ) and Epworth Sleepiness Scale (ESS) in assessing the risk of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with respiratory disease (RD).Methods:The clinical data, NoSAS, SBQ and ESS scores of 190 patients who underwent overnight polysomnography (PSG) were collected. According to the receiver operating characteristic (ROC) curve, with different apnea-hypopnea index (AHI) as the judgment cutoff, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio (DOR) and accuracy of the three scales were compared.Results:With AHI ≥5 times/h as the cutoff, the area under the ROC curve (AUC) of NoSAS and SBQ were 0.833 and 0.729, respectively, indicating that both have predictive value for mild OSAHS. Among them, NoSAS had a larger DOR value (16.150), indicating that NoSAS had the higher accuracy in assessing the risk of mild OSAHS. When AHI>15 times/h was used as the cutoff, the AUC value of NoSAS was 0.704, indicating that it has predictive value for moderate OSAHS. When AHI>30 times/h was used as the cutoff, the AUC value (0.706) and DOR value (6.527) of SBQ were high, indicating that it has predictive value and good accuracy for severe OSAHS. The SBQ is more sensitive than NoSAS and ESS when evaluating patients at high risk for OSAHS ( SBQ≥3). Conclusions:When evaluating the risk of mild and moderate OSAHS in RD patients, NoSAS is better than SBQ and ESS, and when evaluating severe OSAHS, SBQ is better than NoSAS and ESS. In clinical work, appropriate predictive tools should be selected according to the actual situation to assess the risk of OSAHS, so as to formulate and implement early intervention plans based on the assessment results.

Infantile hemangioma is the most common benign tumors in infancy with predictable disease evolution and duration. At present, the basic understanding of the development, proliferation and regression of infantile hemangioma is not sufficient, an ideal lively human infantile hemangioma model which could provide a standard platform for observation of cellular, molecular basis of infantile hemangioma development and drug mechanism is urgently needed. Up to now, a model that completely mimics the biological behavior of infantile hemangiomas has not been successfully established, but the existing research progress has laid a solid foundation for the pathogenesis of hemangioma and clinical targeted therapy. In this paper, the research progress of cell line and animal model of infantile hemangioma and its clinical value in recent years were summarized, as well as the favorable factors that may be used in the construction of infant hemangioma model in the future, providing the latest reference for the selection of animal model of infantile hemangioma.

Infantile hemangioma is the most common benign tumors in infancy with predictable disease evolution and duration. At present, the basic understanding of the development, proliferation and regression of infantile hemangioma is not sufficient, an ideal lively human infantile hemangioma model which could provide a standard platform for observation of cellular, molecular basis of infantile hemangioma development and drug mechanism is urgently needed. Up to now, a model that completely mimics the biological behavior of infantile hemangiomas has not been successfully established, but the existing research progress has laid a solid foundation for the pathogenesis of hemangioma and clinical targeted therapy. In this paper, the research progress of cell line and animal model of infantile hemangioma and its clinical value in recent years were summarized, as well as the favorable factors that may be used in the construction of infant hemangioma model in the future, providing the latest reference for the selection of animal model of infantile hemangioma.

To explore the role of progesterone in the pathogenesis and development of hemangioma in nude mice.
 Methods: The hemangioma model was established. Progesterone was injected intramuscularly at different doses (0.2, 0.4, and 0.8 mg/d) for one week. Camellia oil (0.4 mL/d) was injected intramuscularly as control. The size of hemangioma was observed dynamically. The subcutaneous implants were harvested on the 14th and 28th days. The expression of vascular endothelial growth factor in the tumor tissues were evaluated using immunohistochemistry and microvessel density (MVD) was counted under the microscope.
 Results: On the 14th day, the expression of vascular endothelial growth factor (P<0.01 and P<0.05, respectively) was higher, the volume of tumors (All P<0.01) and MVD (All P<0.01) were greater in the high-dose progesterone group than those in the control and low-dose progesterone group. On the 28th day, there was no significant difference in the volume of tumors among 4 groups (P>0.05). The expression of vascular endothelial growth factor (P<0.01) was lower, and MVD (All P<0.05) were less in the middle-dose and high-dose progesterone group than those in the control and low-dose progesterone group.
 Conclusion: Progesterone promotes angiogenesis via upregulation of vascular endothelial growth factor expression, promotion of hemangiomas proliferation, suggesting that excessive progesterone supplementation may be one of the initial factors for early hemangioma formation.
Animals ; Cell Line, Tumor ; Hemangioma ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neovascularization, Pathologic ; Progesterone ; Vascular Endothelial Growth Factor A

In May 2019, the International Diabetic Foot Working Group (IWGDF) updated and issued guidelines for the prevention and management of diabetic foot disease. This guide puts forward some suggestions for the diagnosis, treatment and effective prevention of diabetic foot: the prevention of diabetic foot should start with high-risk foot, early screening and treatment of diabetic foot infection, foot ulcer and peripheral vascular disease and early comprehensive treatment. Effective prevention and early treatment can reduce the incidence of cardiovascular and cerebrovascular events in patients with diabetes, reduce the amputation rate and mortality, and improve the prognosis and quality of life of patients.

This article summarizes the pharmacological treatment of infantile hemangioma in soft tissue.We aim to review the literature and summarize the mechanisms,methods,efficiency and adverse reactions of beta blockers,glucocorticoids,bleomycin and imiquimott,and to analyze the rational options.Beta blockers,as oral and external use,have high efficiency and few side effects,and can be used as a first -line medication for infantile hemangiomas.Imiquimod external use and topical glucocorticoid and bleomycin injection have good efficacy and potential adverse reactions.They can be used as an alternative treatment for infantile hemangioma.

Objective To analyze the difference and correlation of the evaluation of the medical students' communication ability between the examiners,standardized patients (SP) and medical students themselves in objective structured clinical examination (OSCE),and to provide scientific basis for the appropriate evaluation method of medical students' communication ability.Methods OSCE was used to evaluate the communication ability of 90 medical students in Daping Hospital,Chongqing,and the three parties were evaluated by the examiners,SP and medical students themselves.Excel and SPSS 17.0 statistical analysis software were used,through Friendman M.test,t test and correlation analysis to analyze the differences and correlation of the three parties evaluations.Results The different evaluation between the three parties on the communication ability of medical students was as follows.Examiner's evaluation was the lowest (8.39 ± 1.18),SP's evaluation was the highest (9.62 ± 0.73),Medical students themselves' evaluation was higher (9.28± 1.09);The examiner's evaluation of Medical students' empathy,verbal communication ability,nonverbal communication ability and etiquette was lower (P=0.00).The correlation analysis of the three parties' evaluation showed that there was a significant correlation between the three parties on the connnunication ability,empathy and nonverbal communication ability (P＜0.05).The evaluation of SP and medical students themselves on medical students' language communication ability and etiquette was significantly correlated (P＜0.05).Conclusions Using examiner or SP or medical students themselves only to evaluate the communication ability of medical students is not accurate,The Examiner and SP as the main trial test personnel should collaborate to evaluate medical students' communication ability.The examiner can evaluate three projects such as what is medical ethics and law,empathy,nonverbal communication ability,while the SP can evaluate the two projects:what is language communication ability and etiquette.The collaborative evaluation of the two sides can be more accurate to reflect the doctor-patient communication ability of medical students.