Objective:To assess the clinical and imaging features of SMARCB1-deficient sinonasal carcinoma.Methods:Form January 2016 to November 2021, the clinical data and pretreatment imaging findings of 16 cases with pathologically proven SMARCB1-de?cient sinonasal carcinomas were analyzed retrospectively in Beijing Tongren Hospital, Capital Medical University. Immunohistochemistry for SMARCB1 showed loss of the protein in the tumor nuclie. Clinical and imaging features, including tumor location, TNM stage, size, density of CT, bone change, MRI signal intensity, enhancement pattern, type of time-intensity curve (TIC) of dynamic contrast enhanced MRI (DCE-MRI), apparent diffusion coefficient (ADC) value and diffusion weighted imaging (DWI) were evaluated. For 14 cases, correlation of the ADC value and Ki-67 index was subsequently evaluated with Pearson correlation analysis.Results:For the 16 cases SMARCB1-deficient sinonasal carcinomas, clinical stage of T4 was 12 cases and T3 was 4 cases. The location included ethmoid sinus ( n=4), nasal cavity only ( n=1), both nasal cavity and ethmoid ( n=8), ethmoid and maxillary sinus ( n=1), ethmoid and frontal sinus ( n=1), ethmoid and sphenoid sinus ( n=1). The tumor size was (4.5±1.2) cm. Iso-attenuated of CT images was showed in 13 cases and heterogeneous with necrosis was showed in 3 cases. Focal bone erosion was found in 13 cases and extensive bone destruction was found in 3 cases. Compared with adjacent muscles, T 1WI of all 16 cases showed isointense, with focal hypointense in 3 cases. On T 2WI, the tumor was graded as isointense in 9 cases, hyperintense in 7 cases, with lower inner septal in 6 cases. Enhancement was graded as mild in 11 cases, moderate in 5 cases.MRI Enhancement images showed mild enhancement in 11 cases, moderate enhancement in 5 cases, heterogeneous enhancement in 6 cases, and homogeneous enhancement in 10 cases. For DCE-MRI of 14 cases, there were 10 cases of Ⅲ type and 4 cases of Ⅱ type of the TIC. The ADC value of 14 cases was (1.02±0.27)×10 -3 mm 2/s. The Ki-67 index was 48%±21%. No correlation was observed between Ki-67 index and ADC value ( r=-0.38, P=0.183). Conclusions:SMARCB1-deficient carcinomas are mostly centered in the nasal and ethmoid region of anatomic distribution. Tendency to be infiltrative the adjacent bone structure with invasive bone reaction, mild to moderate heterogeneous enhancement, T 2WI with lower inner septal, and Ⅲ types of TIC are certain suggestive imaging features of the entity.

OBJECTIVE: To investigate the effectiveness of dorsal perforator flap of cross-finger proper digital artery in the treatment of finger soft tissue defect caused by high-pressure injection injury. METHODS: Between July 2011 and June 2020, 14 cases of finger soft tissue defect caused by high-pressure injection injury were repaired with dorsal perforator flap of cross-finger proper digital artery. All patients were male, with a mean age of 36 years (range, 22-56 years). The defects were located on the index finger in 8 cases, middle finger in 4 cases, and ring finger in 2 cases. The causes of injury include 8 cases of emulsion paint injection, 4 cases of oil paint injection, and 2 cases of cement injection. The time from injury to debridement was 2-8 hours, with a mean time of 4.5 hours. The soft tissue defects sized from 4.0 cm×1.2 cm to 6.0 cm×2.0 cm. The flaps sized from 4.5 cm×1.5 cm to 6.5 cm×2.5 cm. The donor site of the flap was repaired with skin graft. The pedicle was cut off at 3 weeks after operation, and followed by functional exercise. RESULTS: All flaps and skin grafts at donor sites survived, and the wounds healed by first intention. Twelve patients were followed-up 16-38 months (mean, 22.6 months). The texture and appearance of all flaps were satisfactory. The color and texture of the flaps were similar to those of the surrounding tissues. The two-point discrimination of the flap was 10-12 mm, with a mean of 11.5 mm. There were different degrees of cold intolerance at the end of the affected fingers. At last follow-up, the finger function was evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association, 3 cases were excellent, 8 cases were good, and 1 case was poor. CONCLUSION The dorsal perforator flap of cross-finger proper digital artery can effectively repair finger soft tissue defect caused by high-pressure injection injury. The operation was simple, and the appearance and function of the finger recover well.
Humans ; Male ; Adult ; Female ; Perforator Flap ; Upper Extremity ; Fingers/surgery* ; Ulnar Artery ; Skin Transplantation

Candida albicans is one of the most common species of Candida, which is an important cause of invasive candidiasis in clinic. Due to the frequently use of classical antifungal agents, there are amounts of drug resistant C. albicans being isolated, causing the significantly decreasing of the efficacy of some antifungal agents in clinical treatment. Besides, the use of some compounds in clinic has been limited because of their toxicities. In such a context, drug combination therapy shows great potential on antifungal because of the synergy of different drugs or therapeutic methods that could bring, which could improve the weaknesses of single drug.

Objective To study the antifungal activity of N2 derivatives. Methods The anti-fungal activity of N2 compounds was investigated by micro-liquid dilution. Then the activity of N2 compounds on hyphal and biofilm formation was investigated. Results N2 compounds had significant antifungal activity against Candida albicans. It also expressed actively inhibitory effect on hyphal and biofilm formation. The mechanism of its fungicidal function was to damage the structure of candida albicans’ cell membrane and cell wall. Conclusion The results showed that N2 had obvious antifungal activity against Candida albicans., which provided a new idea for the development of antifungal drugs and the solution of antifungal drugs resistance.

Objective:To assess the clinical and imaging features of NUT gene-related sinonasal carcinomas (NUT midline carcinome).Methods:The clinical data and pretreatment imaging findings of 5 cases with pathologically proven NUT sinonasal carcinomas were analyzed retrospectively in Beijing Tongren Hospital, Capital Medical University from January 2016 to December 2020. Of 5 cases, the tumors affected 4 females and 1 male with an age range of 15 to 48 years (median 19 years). Clinical data of all cases were available before surgery with both CT and MR examination. Tumor location, CT density, boney change, calcification, tumor size, T 1WI, T 2WI and diffusion weighted imaging (DWI) signal intensity, appearance diffusion coefficient (ADC), type of time intensity curve (TIC) of dynamic contrast-enhanced (DCE)-MRI were evaluated. Results:All five cases belonged to T4 stage of the clinic TNM system. The locations were nasal cavity ethmoid, sphenoid and maxillary sinus ( n=1), nasal and maxillary sinus ( n=1), nasal cavity and ethmoid sinus ( n=3). Iso-attenuated in 3 cases, heterogeneous with local necrosis in 2 cases, and heterogeneous with calcification in 3 cases on CT imaging. Bone erosion was found in 4 cases, and bone erosion with destruction in 1 case. The tumor sizes ranged from 4.2 to 4.9 cm (median 4.5 cm) on MR axial imaging. On T 1WI, 5 cases showed isointense compared with adjacent temporal muscles, with focal hypointense in 2 cases. On T 2WI, the tumor was graded as isointense in 3 cases, and hyperintense in 2 cases. Heterogeneous enhancement in all cases with mild in 3 cases, and moderate in 2 cases on postcontrast MR imaging. On DCE-MRI of 5 cases, there were 3 cases of type Ⅲ (washout-shaped curves), and 2 cases of type Ⅱ of the TIC (plateau-shaped curves). The range of ADC values was from 0.63×10 -3 to 1.17×10 -3 mm 2/s, and median ADC value was 0.84×10 -3 mm 2/s, of 5 cases with varying degrees of high signal on DWI. The Ki-67 index ranged from 30% to 80% of the tumor. An immunohistochemical study showed that the tumor cells of 5 cases were all positive for both NUT and INI-1 genes. One case was performed with biopsy and followed by chemotherapy, four cases were performed with surgery, combined with the following chemotherapy, and one also was implemented with radiation therapy. The follow-up time was 7-16 months. Five cases were all alive during the follow-up. Conclusions:The NUT midline sinonasal tract carcinoma is a rare, gene-related solid malignant tumor. The tumor is more commonly seen in young patients, mostly centered in the nasal and ethmoid region with invasive growth, more calcification on CT, and heterogeneous enhancement on MRI. These findings are some characteristics of the tumor.

This is a report of a complex defects in the right upper extremity treated in the Department of Hand and Microsurgery, 521 Hospital of Norinco Group, in October 2016. The patient received multi-transfers of flaps for one-stage reconstruction, including a double-paddled ALTPF and a compound flap of the great toe and the second toe. Vascular compromises occurred in flaps on the 2nd day after surgery. All the flaps were rescued and survived completely after surgical exploration. Followed-up at 3 year after surgery showed that the appearance and function of the affected limb recovered well. The flexion and extension of elbow and wrist were normal. The pinch function of the reconstructed thumb and index finger recovered well.

Objective To compare the clinical effect of three methods of treatment for the in-stent restenosis(ISR)after percutaneous coronary intervention(PCI),drug coated balloon(DCB)compared with common balloon and drug eluting stent(DES).Methods From August 2014 to January 2018,95 cases of ISR in the Second Affiliated Hospital of Southeast University were diagnosed by coronary angiography.They were treated with common balloon,DCB or second generation DES.The patients were assigned to the DCB group 25 cases or the second-generation DES group(23 cases)and balloon group(47 cases)according to the therapeutic strategies they accepted.Major adverse cardiac events(MACE)of patients were followed by telephone or hospital visit at 6-12 months.MACE was defined as a composite of cardiac death,nonfatal myocardial infarction(MI),and target vessel revascularization(TVR).Results In summary,95 patients with DES-ISR were enrolled,including 47 patients in the balloon group,23 patients in the DCB group and 25 patients in the second-generation DES group.Coronary angiography was performed 6-12 months after operation.The minimum lumen diameter(MLD)of the DCB group was significantly larger than those of the balloon and DES groups[(1.86 ±0.27)mm vs.(2.16 ±0.43)mm,t =3.57,P =0.00;(1.94 ±0.31)mm vs.(2.16 ± 0.43)mm,t=2.05,P=0.05].The restenosis rate of the DCB group was significantly lower than those of the balloon group and DES group[15 cases(31.91％)vs.2 cases(8.69％),χ2 =4.53,P=0.02;8 cases(32.00％)vs.2 cases(8.69％),χ2 =2.66,P=0.05].The rate of late lumen loss(LLL)in the DCB group was significantly lower than those of balloon group and DES group [(0.67 ±0.28)mm vs.(0.21 ±0.18)mm,t =7.17,P =0.00;(0.43 ± 0.28)mm vs.(0.21 ±0.18)mm,t=3.21,P=0.00].MACE was significantly lower than balloon group and DES group[16 cases(34.04％)vs.1 cases(4.76％),χ2 =7.02,P=0.01;8 cases(32.00％)vs.1 cases(4.76％),χ2 =4.06,P=0.02].Conclusion Drug balloon dilatation in stent restenosis is more effective and safer than common balloon dilatation and re-implantation of drug eluting stents.

Objective To develop a digital signal processing method for magnetic positioning of electronic capsules according to the theory of multiple alternating magnetic field source electromagnetic positioning, so as to reduce the volume and power consumption of electronic capsules. Method Based on STM32 MCU, software algorithms such as fast digital filtering, peak detection and frequency detection were designed to replace the corresponding analog hardware circuits such as analog filtering, peak detection and comparison circuits. Results The experimental results showed that the average relative error of the peak detection and frequency detection of the digital signal processing system were 1.51％ and 0.28％ , respectively. The linear relationships of theoretical amplification factor and actual amplification factor of the programmable amplifier were basically consistent, and the average ratio difference was 4.51 dB. Conclusions The proposed digital signal processing system can replace some analog hardware circuits, providing a basis for reducing the size and power consumption of electronic capsules.

Objective: To explore the relationship among levels of N terminal pro brain natriuretic peptide (NT-proBNP), lipoprotein (a) [Lp (a)] and in-stent restenosis (ISR) in patients after stent implantation. Methods: A total of 625 pa-tients, who received drug-eluting stent implantation in our department and underwent coronary angiography one year after surgery, were continuously collected. According to presence of ISR or not, patients were divided into no restenosis group (n=532) and ISR group (n=93). Plasma levels of NT-proBNP and Lp (a) were measured and compared between two groups. Single-factor and multi-factor Logistic regression analysis were used to analyze the relationship among levels of NTproBNP, Lp (a) and coronary ISR. Results: Compared with no restenosis group, there were significant rise in plasma levels of NT-proBNP [(749. 43±154. 82) ng/L vs. (856. 12±132. 45) ng/L]and Lp (a) [(299. 23±29. 07) mg/L vs. (321. 12±31. 05) mg/L]in ISR group, P=0. 001 both; multi-factor Logistic analysis indicated that plasma levels of NTproBNP (OR=2. 162, 95％CI 2. 002～2. 333) and Lp (a) (OR=2. 903, 95％CI 2. 648～3. 184) were independent risk factors for ISR, P＜0. 05 both. Conclusion: N terminal pro brain natriuretic peptide and lipoprotein (a) are independent risk factors for in-stent restenosis in patients undergoing stent implantation.

Objective To understand the distribution and antimicrobial resistance of pathogens causing wound in-fection in army officers and soldiers following military training injury,and provide reference for antimicrobial use in clinical anti-infection treatment.Methods Wound secretion from injured army patients who were admitted to a mili-tary hospital between January 2014 and June 2015 was performed bacterial culture and antimicrobial susceptibility testing.Results 647 pathogenic bacteria strains were isolated from 1 029 wound secretion specimens ,isolation rate was 62.88%,the top 6 isolated bacteria were Staphylococcus aureus (S .aureus ,29.99%,n =194),Escherichia coli (E.coli,19.32%,n=125),Pseudomonas aeruginosa (19.17%,n=124),Enterococcus spp .(13.60%,n=88), Klebsiella pneumoniae (K .pneumoniae ,7.73%,n =50),and Acinetobacter baumannii (A.baumannii,5.87%, n=38).S .aureus and Enterococcus spp .had high susceptibility to vancomycin,linezolid ,and daptomycin (resist-ance rates ≤3.41 %),44.33% of S .aureus were methicillin-resistant,2.27% of Enterococcus spp .were vancomy-cin-resistant .E.coli and K .pneumoniae had high susceptibility rates to piperacillin/ tazobactam (resistance rates were 1 .60% and 0 respectively),except A.baumannii,resistance rates of gram-negative bacteria to carbapenems were all low (resistance rates ≤4.00%).Conclusion Military clinicians should select appropriate antimicrobial agents according to antimicrobial susceptibility testing results,reduce the disability rate due to infection in trauma patients,and provide clinical support for the treatment of the wounded.