Objective To explore the imaging features, clinical outcome, and prognosis of indeterminate pulmonary nodules (IPN) in patients with high-grade soft tissue sarcoma. Methods A retrospective study of 82 patients with high-grade soft tissue sarcoma who have IPNs. The clinical characteristics, imaging features of IPN, and survival of patients were analyzed with statistical software. Results The IPN size of 82 patients was 6.453±0.864 mm. IPN diameter, shape, density, and nodule discovery interval may be CT imaging features related to malignancy tendency. Age (HR=1.047, 95%CI: 1.007-1.088) and interval between each nodule discovery (HR=3.194, 95%CI: 1.052-9.694) are independent factors that affect the survival of patients with malignant IPN. Conclusion The imaging features of chest CT may provide important guidance for determining the nature and survival prognosis of benign and malignant nodules.

To predict the distribution and habitat of Dermacentor nuttallii in Xinjiang and to under-stand its life cycle history.In this study,Maximum Entropy Modeling(MaxEnt)was used to pre-dict the geographical distribution and adaptation area of Dermacentor nuttallii in Xinjiang,and jackknife test and response curve of environmental variables were used to evaluate the environmen-tal factors affecting the distribution of Dermacentor nuttallii.Dermacentor samples were collected randomly based on predicted sites.The species of Dermacentor was identified by the combination of morphological characteristics and molecular biology.The New Zealand white rabbit was the only blood donor,and the life cycle and biological characteristics of the tick were observed and recorded by the method of earmuffs feeding under natural light in the laboratory.The jackknife test and SPSS analysis results showed that the main environmental variables affecting the distribution of suitable areas of Dermacentor nuttallii were average temperature(Bio1),average daily tempera-ture range(Bio2),seasonal temperature change(Bio4),driest month precipitation(Bio14),precip-itation variation coefficient(Bio15).The response curves of major environmental variables showed that Dermacentor nuttallii had the highest presence probability when Bio1 was 15.58 ℃,Bio2 was 6.19 ℃,Bio4 had a coefficient of variation of 1 500,Bio14 had a coefficient of variation of 20 mm,Bio15 had a coefficient of variation of 23.799 and Bio19 was 69 mm.The prediction results showed that the suitable areas of Dermacentor nuttallii in Xinjiang were Tianshan Mountain range in Junggar Basin,Turpan basin in Altai Mountain valley and some areas south of Tianshan Mountain range,accounting for 50.99％of the total area of Xinjiang.Dermacentor were collected from the predicted area according to MaxEnt model and identified as Dermacentor nuttallii by morphologi-cal and molecular biological methods.The full blood stage was 5.31 d,the degeneration stage was 8.19 d,and the degeneration rate reached 95.5％.If the full blood stage was 8.65 d and the degener-ation stage was 12.86 d,the degeneration rate reached 98％.The full blood stage of adult ticks was 6.75 d,the early egg stage of full blood females was 5.86 d,and the spawning stage of full blood fe-males was 12.5 d.The eggs hatched into young ticks after 25.92 d,and the hatching rate reached 90％.Dermacentor nuttallii took 62-107 d to complete a life history,with an average of 86.06 d.The constructed MaxEnt model has high prediction accuracy and accuracy.According to the varia-ble analysis of the main environmental factors,precipitation and temperature are the main environ-mental factors affecting Dermacentor nuttallii.The study of the whole life cycle of Dermacentor nuttallii in Xinjiang provides the basis for establishing the method of artificial breeding of pure species of Dermacentor nuttallii in Xinjiang.

Ankle joint cartilage injuries could lead to severe pain and limited joint activity,and early diagnosis of ankle joint cartilage injury is particularly important.3D-MR sequences has good diagnostic efficiency for ankle joint cartilage injuries.The research progresses of 3D-MRI in diagnosing ankle cartilage injuries were reviewed in this article.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Objective:To explore the incidence, clinical characteristics, imaging features, clinical outcome and prognosis of indeterminate pulmonary nodules (IPN) in patients with osteosarcoma.Methods:A total of 69 patients of osteosarcoma with IPN in lung treated in the Bone tumor Center of Eastern Theater General Hospital from January 2011 to January 2021 were collected retrospectively, there were 47 males and 22 females, with a median age of 19 years old (range 7-60 years old). The clinical characteristics including disease-free interval, the chemotherapy response, with recurrence/non-pulmonary, IPN presence before / during / after chemotherapy and imaging features of IPN including number of IPN, location of IPN, density of IPN, boundary clarity of IPN and outcome. The patients were divided into the metastasis pulmonary nodules group and the benign nodules group according to the final outcome of IPN. Further, χ 2 test was performed for comparison of the clinical and imaging characteristics between the two groups. The survival of patients was counted and the correlation between single factor and survival was compared by Kaplan-Meier test, and multivariate survival analyses were performed using Cox proportional hazards regression models. Results:Sixty-nine cases occurred IPN in 211 patients with osteosarcoma, with an incidence of 32.7%. Of the 69 patients, 45 patients (65.2%) with IPN were diagnosed as metastases, and 24 patients (34.8%) with IPN were diagnosed as benign nodules. Follow-up length ranged from 1 to 124 months, with the median follow up time 43 months. To the end of follow-up, 41 patients (59.4%) remained alive and 28 patients (40.6%) had died. The median survival time was 41.0 (20.0, 65.0) months and the median survival time after diagnosis of IPN was 25.0 (10.0, 43.0) months. There were significant differences in lung nodule density ( P<0.001), boundary ( P=0.002), history of recurrence/extra-pulmonary metastasis ( P=0.023) and chemotherapeutic effect ( P<0.001) between the metastasis pulmonary nodules group and the benign nodules group. Multivariate survival analysis showed that chemotherapeutic effect was an independent factor affecting the overall survival of patients [ HR=0.048, 95% CI (0.01, 0.26)]. Boundary definition [ HR=0.12, 95% CI (0.02, 0.93)] and chemotherapeutic effect [ HR=0.06, 95% CI (0.01, 0.29)] were independent factors influencing survival after diagnosis of IPN. Conclusion:Osteosarcoma patients with IPN have a poor prognosis. The poor effect of chemotherapy is an independent risk factor for the overall survival time of those patients and the survival time after diagnosis of IPN. The boundary definition of IPN is an independent risk factor for the survival time after diagnosis of IPN.

Objective:To analyze the iodine content distribution of drinking water in Jingdezhen City, and master the status of prevention and control of iodine deficiency disorders (IDD), so as to provide a basis for adopting targeted control measures and scientific adjustment of control and prevention strategies.Methods:According to the "National Iodine Deficiency Disorders Surveillance Program" and the "National Water Iodine Content Survey Program for Drinking Water", the surveillance of IDD in Jingdezhen City was carried out from 2017 to 2020. Household edible salt samples from pregnant women and students aged 8 to 10 were collected to detect salt iodine content, and urine samples were collected to detect urinary iodine. Thyroid volume of students was measured by B-ultrasonography, and the rate of goiter was calculated. In 2017, the iodine content of drinking water in Jingdezhen City was investigated, and the results were analyzed.Results:From 2017 to 2020, a total of 1 800 students were examined for thyroid gland, and 11 students were found to have goiter, with an goiter rate of 0.61%. A total of 3 201 edible salt samples and 3 201 urine samples were collected from students, the median of salt iodine was 24.96-26.40 mg/kg, the consumption rate of qualified iodized salt was 98.50%-99.50%, and the median of urinary iodine was 172.56-218.35 μg/L. A total of 1 600 edible salt samples and 1 600 urine samples were collected from pregnant women, the median of salt iodine was 24.40-25.38 mg/kg, the consumption rate of qualified iodized salt was 97.25%-98.00%, and the median of urinary iodine was 161.55-205.60 μg/L. In 2017, a total of 667 water samples were collected from 52 villages and towns in 4 counties and districts. The median of water iodine of the 4 counties and districts was 0.6-3.2 μg/L, and that of the 52 villages and towns was 0.3-12.3 μg/L.Conclusions:The iodine nutrition level of students and pregnant women in Jingdezhen City is generally at an appropriate level, but the iodine content of drinking water is low. It is suggested to strengthen the health education and health promotion of IDD among key population, guide the residents to supplement iodine scientifically, and continuously eliminate the harm of IDD.

Clinical data of 19 patients with congenital pyruvate kinase deficiency were analyzed. Insufficient pyruvate kinase confirmed the diagnosis. Laboratory parameters of hemolysis were summarized. In cases of neonatal hyperbilirubinemia and unexplained hemolytic anemia, pyruvate kinase activity and next generation sequencing test may help the early diagnosis.

Objective To investigate the outcome and affecting factors of patients with osteosarcoma after recurrence.Methods Retrospective analysis was used to analyze the achieved data and prognosis-related factors of 72 patients with extremity osteosarcoma after recurrence from June 2000 to September 2012 through multicenter joint treatment.37 males and 35 females were included.The overall age was 7 to 61 years old (average age22.2 years old).Classification based on the tumor recurrent parts:42 cases (58.3％) on femur,18 cases (25％) on tibia,7 cases (9.7％) on humerus and 5 cases (6.9％) on fibula.Classification based on metastases:14 cases of simple recurrence (19.4％),58 cases (80.6％) of recurrence with metastasis:29 cases (40.3％) of recurrence occurred first,9 cases (12.5％) of metastasis occurred firstly,20 cases (27.8％) of simultaneous recurrence with metastasis;12/14 patients (16.7％) of simple recurrence had long-term survival,but 2 died (2.8％).Six of 58 patients (8.3％) of recurrence with metastasis had long-term survival but 52 died (72.2％).Results The overall 10-year postrelapse survival rate of the 72 patients was 25％.Kaplan-Meier univariate analysis revealed that postrelapse survival was significantly influenced by the continued treatment after recurrence and the number of postoperative chemotherapy,but it was not significantlyinfluenced by age,gender and the number of preoperative chemotherapy.Multivariate analysis revealed that the continued treatment after recurrence and the number of postoperative chemotherapy were independent prognostic factors (P=0.002,P=0.007).At the same time,according to the survival curve grouped by different indicators,the number of chemotherapy after recurrence has no significant effect on TFS.However,the continued treatment after recurrence has obvious statistical significance on improving TFS and OS of patients (P=0.026,P=0.002).Conclusion Resection and standard postoperative chemotherapy had significant effects on the postrelapse survival in patients with osteosarcoma.There are good prospects for further multimodal therapy and multicenter cooperation for osteosarcoma after recurrence.

Objective: To evaluate the impact of the targeted next-generation sequencing (NGS) assay for difficult congenital anemias. Methods: Blood Disease Hospital Anemia Panel 2014 (BDHAP-2014) including 217 known genes of congenital anemias was developed. NGS and parental verification were performed for patients who were suspected diagnosed with congenital anaemia from August 2014 to July 2017. Results: A total of 46 patients were enrolled in this study, the clinical suspection were 11 cases Fanconi anemia (FA), 8 cases congenital dyserythropoietic anemia (CDA), 6 cases congenital sideroblast anemia (CSA), 12 cases congenital hemolytic anemia (CHA), 1 case dyskeratosis congenital (DC), 4 cases iron-refractory iron deficiency anemia and 4 cases unexplained cytopenia (Uc), respectively. 28 (60.9%) of 46 patients became confirmed cases after targeted NGS, corresponding to 44 mutations of which 33 were new. 26(56.5%) patients with results of the assay matching to clinical suspection, including FA (5/11, 45.5%), CSA (6/6, 100.0%), CDA (3/8, 37.5%) and CHA (12/12, 100.0%). 2 (4.3%) cases not matching to clinical suspection, including dyskeratosis congenital (DC) was made in 1(2.2%) patients with suspected FA and familial hemophagocytic lymphohistiocytosis (FHL) was made in 1(2.2%) patients with suspected unexplained cytopenia (Uc). In 12 CHA patients, the hemolytic type was further clarified by the NGS. The remaining 18 cases were not clearly diagnosed. Conclusion Targeted NGS assay is of major impact on congenital anemias. The assay should be used routinely in congenital anemias.

Objective: To reveal the genetic characteristics of erythrocyte membrane protein in hereditary spherocytosis (HS) in China. Methods: Next-generation sequencing technology was used to detect mutations in genes of erythrocyte membrane proteins in 51 clinically diagnosed HS patients. The relationship between gene mutations and clinical phenotypes was analyzed. Results: Mutations in erythrocyte membrane protein genes were detected in 37 patients, including 17 with ANK1 mutations (17/37, 45.9%), 14 with SPTB mutations (14/37, 37.8%), and 5 with SLC4A1 mutations (5/37, 13.5%). One patient carried both heterozygous ANK1 mutation and SPTB mutation (1/37, 2.7%). SPTA1 and EPB42 mutation was not fou nd in any patient. Nonsense mutations (36.8%) and missense mutations (31.6%) were most common. Of the 38 mutations detected, 34 were novel mutations and have not been reported elsewhere (89.5%). Sixteen HS patients underwent parental genetic validation, 6 patients (37.5%) inherited gene mutation from parents and 10 (62.5%) were de novo. The peripheral blood cell parameters of HS patients were not related to the mutant genes and gene mutation types. However, it seems that HS patients with mild clinical status are prone to carry SPTB mutations while more patients with severe clinical status have ANK1 mutations. Conclusions ANK1 and SPTB are the most common mutant genes in Chinese HS patients, mainly with missense mutations and nonsense mutations. There was no significant correlation between the mutation of HS related genes and the severity of HS.