1.Overseas imported cystic echinococcosis misdiagnosed as pulmonary and hepatic cysts: a case report
Zhenyu HUANG ; Yuan LI ; Shitong GAO ; Lisha ZHANG ; Jing LI ; Lixiang MI
Chinese Journal of Schistosomiasis Control 2024;36(4):435-438
		                        		
		                        			
		                        			 Cystic echinococcosis, a zoonotic disease that poses a significant threat to human health and animal husbandry development, is prevalent across the world and predominantly occurs in agricultural and pastoral regions. However, cystic echinococcosis cases are rare in non-endemic areas, which is likely to cause misdiagnosis or missing diagnosis, resulting in delay in treatment. This report presents an overseas imported cystic echinococcosis case misdiagnosed as pulmonary and hepatic cysts, so as to provide insights into diagnosis and treatment of cystic echinococcosis in non-endemic areas. 
		                        		
		                        		
		                        		
		                        	
2.An analysis of breast cancer patients with ultrasound BI-RADS 3 lesions after minimally invasive excision in clinicopathological features and influencing factors of residual tumor
Liang LI ; Zequn FENG ; Lianfang ZHANG ; Ruiqing WANG ; Xiaoxia ZHANG ; Liyuan LIU ; Lixiang YU ; Zhigang YU ; Zhongcheng GAO
Chinese Journal of Surgery 2024;62(2):135-140
		                        		
		                        			
		                        			Objectives:To examine the clinicopathological characteristics and the influencing factors of the residual tumor of patients with Breast Image Report and Data System (BI-RADS) grade 3 lesions diagnosed with malignancy after minimally invasive excision.Methods:In this retrospective case-control study, clinicopathological data of 69 cases, which had been evaluated as BI-RADS 3 lesions by ultrasound (4 151 cases) diagnosed with breast cancer by minimally invasive excision pathology, were analyzed between May 2012 and June 2016 at the Department of Breast Surgery of the Second Hospital of Shandong University and Linyi People′s Hospital. All patients were female, aged (43.4±8.2) years (range: 22 to 70 years). Based on residual tumor after minimally invasive excision, patients were classified into two subgroups: tumor residual group ( n=39) and non-tumor residual group ( n=30). The clinicopathological features between the two groups were compared. The differences in clinicopathological characteristics were compared in different groups using the χ 2 test and the t test. Potential variables identified in the univariate analysis and other relevant variables will be analyzed multivarially using Logistic regression models. The Kaplan-Meier method was applied for survival analysis and survival curves. Results:The breast cancer detection rate of ultrasound BI-RADS 3 lesions was 1.66% (69/4 151), and their maximum diameter of the masses was (1.27±0.45) cm (range: 0.5 to 2.3 cm). Among them, the maximum diameter were ≤1 cm in 28 cases and >1 cm in 41 cases. Histopathological results showed carcinoma in situ in 24 cases and invasive carcinoma in 41 cases, positive expression of the estrogen receptor in 47 cases, positive expression of the progesterone receptor in 43 cases, Ki-67 proliferation index elevated in 26 cases. Axillary metastasis positive rate was 10.1% (7/69). Residual tumor after minimally invasive surgery was found in 39 cases (56.5%). Univariate analysis showed that the tumour residual group showed a significantly increased rate of positive expression of the estrogen receptor (91.9%(34/37) vs. 61.9%(13/21), χ2=7.838, P=0.012). In multivariate analysis, the only variable found to significantly affect the residual tumor was the positive expression of the estrogen receptor ( OR=16.852, 95% CI: 1.819 to 156.130, P=0.013). The 5-year disease-free survival rate of breast cancer patients with breast ultrasound BI-RADS 3 lesions was 97.1% and the overall survival rate was 98.6%. Conclusions:BI-RADS 3 lesions diagnosed by ultrasound undergoing ultrasound-guided minimally invasive excision have a certain risk of detected malignancy, approximately 1.66%. Patients with positive expression of the estrogen receptor are more likely to develop residual tumor. A secondary operation should be considered to ensure that no tumor residues remain in the cavity.
		                        		
		                        		
		                        		
		                        	
3.An analysis of breast cancer patients with ultrasound BI-RADS 3 lesions after minimally invasive excision in clinicopathological features and influencing factors of residual tumor
Liang LI ; Zequn FENG ; Lianfang ZHANG ; Ruiqing WANG ; Xiaoxia ZHANG ; Liyuan LIU ; Lixiang YU ; Zhigang YU ; Zhongcheng GAO
Chinese Journal of Surgery 2024;62(2):135-140
		                        		
		                        			
		                        			Objectives:To examine the clinicopathological characteristics and the influencing factors of the residual tumor of patients with Breast Image Report and Data System (BI-RADS) grade 3 lesions diagnosed with malignancy after minimally invasive excision.Methods:In this retrospective case-control study, clinicopathological data of 69 cases, which had been evaluated as BI-RADS 3 lesions by ultrasound (4 151 cases) diagnosed with breast cancer by minimally invasive excision pathology, were analyzed between May 2012 and June 2016 at the Department of Breast Surgery of the Second Hospital of Shandong University and Linyi People′s Hospital. All patients were female, aged (43.4±8.2) years (range: 22 to 70 years). Based on residual tumor after minimally invasive excision, patients were classified into two subgroups: tumor residual group ( n=39) and non-tumor residual group ( n=30). The clinicopathological features between the two groups were compared. The differences in clinicopathological characteristics were compared in different groups using the χ 2 test and the t test. Potential variables identified in the univariate analysis and other relevant variables will be analyzed multivarially using Logistic regression models. The Kaplan-Meier method was applied for survival analysis and survival curves. Results:The breast cancer detection rate of ultrasound BI-RADS 3 lesions was 1.66% (69/4 151), and their maximum diameter of the masses was (1.27±0.45) cm (range: 0.5 to 2.3 cm). Among them, the maximum diameter were ≤1 cm in 28 cases and >1 cm in 41 cases. Histopathological results showed carcinoma in situ in 24 cases and invasive carcinoma in 41 cases, positive expression of the estrogen receptor in 47 cases, positive expression of the progesterone receptor in 43 cases, Ki-67 proliferation index elevated in 26 cases. Axillary metastasis positive rate was 10.1% (7/69). Residual tumor after minimally invasive surgery was found in 39 cases (56.5%). Univariate analysis showed that the tumour residual group showed a significantly increased rate of positive expression of the estrogen receptor (91.9%(34/37) vs. 61.9%(13/21), χ2=7.838, P=0.012). In multivariate analysis, the only variable found to significantly affect the residual tumor was the positive expression of the estrogen receptor ( OR=16.852, 95% CI: 1.819 to 156.130, P=0.013). The 5-year disease-free survival rate of breast cancer patients with breast ultrasound BI-RADS 3 lesions was 97.1% and the overall survival rate was 98.6%. Conclusions:BI-RADS 3 lesions diagnosed by ultrasound undergoing ultrasound-guided minimally invasive excision have a certain risk of detected malignancy, approximately 1.66%. Patients with positive expression of the estrogen receptor are more likely to develop residual tumor. A secondary operation should be considered to ensure that no tumor residues remain in the cavity.
		                        		
		                        		
		                        		
		                        	
4.Changes of Th17/Treg proportion and the expressions of related cytokines in peripheral blood of patients with Hashimoto's thyroiditis
Yingtong TIAN ; Ru GAO ; Zhuoying FENG ; Ming LI ; Lixiang LIU ; Mengqi SHI ; Yutong JI ; Yang DU
Chinese Journal of Endemiology 2022;41(4):265-269
		                        		
		                        			
		                        			Objective:To observe the ratio of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood of patients with Hashimoto's thyroiditis (HT) and the expression changes of related cytokines in serum, and to explore their role in the occurrence and development of HT.Methods:Using the case-control study method, 35 HT patients examined in the General Hospital of Heilongjiang Beidahuang Group from February to November 2019 were selected as HT group, and 39 healthy people in the same period were selected as control group. Early morning fasting venous blood samples of the two groups were collected to test the levels of thyroid stimulating hormone (TSH), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The expressions of serum interleukin (IL)-6, IL-17 and transforming growth factor β (TGF-β) were tested by enzyme-linked immunosorbent assay (ELISA); the number of Th17, Treg in peripheral blood were determined by flow cytometry. Results:The levels of TPOAb, TgAb and TSH in HT group [130.60 (43.37, 714.40), 368.10 (136.90, 1 103.00) U/ml, 9.05 (6.62, 15.23) μU/ml] were significantly higher than those in control group [2.66 (1.52, 4.69), 12.63 (11.43, 14.60) U/ml, 1.87 (1.36, 2.23) μU/ml, U = 6.87, 6.62, 4.85, P < 0.001], and the FT 4 level [0.76 (0.63, 1.04) ng/dl] was lower than that in control group [1.14 (1.02, 1.26) ng/dl, U = 7.39, P < 0.001]. The expressions of IL-6, IL-17 and TGF-β in HT group were higher than those in control group ( t = 2.41, 9.04, 2.44, P < 0.05). The number of Th17 and the ratio of Th17/Treg in HT group were higher than those in control group ( t = 4.20, 3.50, P < 0.05), and the number of Treg was lower than that in control group ( t = 4.45, P = 0.001). Conclusion:In HT patients, Th17 are increased, Treg decreased, Th17/Treg ratio increased, and the expressions of IL-6, IL-17 and TGF-β are increased.
		                        		
		                        		
		                        		
		                        	
5.Serum biomarkers of differential metabolism in high iodine diet intervention population
Yang DU ; Lijun FAN ; Yanhui GAO ; Lixiang LIU ; Dianjun SUN
Chinese Journal of Endemiology 2021;40(10):775-780
		                        		
		                        			
		                        			Objective:To explore the serum different metabolites in population of dietary intervention with high iodine.Methods:Thirty-eight healthy volunteers were recruited in Harbin Medical University, all women, aged > 20 years. Dietary intervention was carried out by eating iodine-rich food (kelp) for 11 consecutive days. The effect of intervention was evaluated through urinary iodine test. Peripheral blood was collected, the metabolic alterations associated with high iodine intake before and after intervention were investigated using ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF MSMS). Multivariate statistical analysis was used to screen potential biomarkers. And disturbed metabolic pathway analysis was performed.Results:The medians urinary iodine before and after intervention were 129.48 and 795.94 μg/L, respectively. A total of 20 serum biomarkers were screened and their chemical structures were identified. Glycerol phospholipid metabolic pathway, tryptophan metabolic pathway and pentose and glucuronate interconversions pathway were closely related with high iodine intake (impact value > 0.1).Conclusions:After the intervention of high iodine diet, there are obvious differential metabolites in peripheral blood, which may be used as biomarkers for evaluation of population iodine nutrition. High iodine intake has an impact on metabolic pathway of glycerol phospholipid in human body.
		                        		
		                        		
		                        		
		                        	
6. T1ρ technique in quantitatively evaluation on ankle osteochondral lesions of talus
Chinese Journal of Medical Imaging Technology 2020;36(3):444-447
		                        		
		                        			
		                        			 Objective: To explore the feasibility of T1ρ technique in evaluating ankle osteochondral lesions of talus (OLT). Methods: Totally 40 patients with ankle OLT underwent both conventional MRI and T1ρ imaging, also arthroscopy examination within 1 week. Conventional MRI,arthroscopy and T1ρ imaging were observed, and ankle OLT were classified into - type (type - injury group, respectively) according to the improved Hepple classification standards. Then normal cartilage areas of 20 cases were randomly selected as the normal control group. T1ρ values of cartilage in each group were measured and analyzed. The consistency of OLT typing Results: using conventional MRI and arthroscopy was compared. Results: T1ρ images could clearly show ankle talus cartilage, and the colorific orders were different according to the degree of injuries. T1ρ values of cartilage increased with the aggravation of cartilage damage. There was no statistically difference (P=0.12) in T1ρ values of damaged cartilage of type  injury group ([43.07±2.05]ms) and type Ⅱ injury group ([45.24±2.19]ms), whereas statistically differences of T1ρ values of damaged cartilage were found among other groups (P<0.05). The consistency of OLT typing Results: using conventional MRI and arthroscopy was good (Kappa=0.80, P<0.01). Conclusion: T1ρ technique can clearly display the talus cartilage of the ankle joint and quantitatively evaluate the degree of talus cartilage damage, especially for patients with early talus cartilage damage. 
		                        		
		                        		
		                        		
		                        	
7. Morphologic variations of the fibular malleolar groove and fibrocartilaginous ridge injury on MRI with and without re-current peroneal tendon dislocation
En DENG ; Lixiang GAO ; Qinwei GUO
Chinese Journal of Orthopaedics 2019;39(9):562-566
		                        		
		                        			 Objective:
		                        			To compare the morphological variation of the fibular malleolar groove and fibrocartilaginous ridge injury in those with and without peroneal tendon dislocation using MRI.
		                        		
		                        			Methods:
		                        			Data of 45 patients (40 males, 5 females; average age 23.4±7.7 years, 11-44 years) with recurrent peroneal tendon dislocation treated from April 2010 to July 2017 and 45 patients (33 males, 12 females; average age 41.6±11.8 years, 17-67 years) without dislocation treated from June 2015 to Septem-ber 2017 were retrospectively analyzed. The morphological variation of the fibular malleolar groove and fibrocartilaginous ridge in-jury were compared between the two groups according to Rosenberg’s classification (convex, the posterior cortex of the fibula bulg-es outward; concave, the posterior fibular surface has a shallow-to-deep depression; flat, neither concavity nor convexity is found).
		                        		
		                        			Results:
		                        			In group of patients with recurrent peroneal tendon dislocation: concave, 10 patients (22.2%, 10/45); flat, 27 patients (60.0%, 27/45); convex, 8 patients (17.8%, 8/45); fibrocartilaginous ridge injury, 44 patients (97.8%, 44/45). In group of patients without peroneal tendon dislocation: concave, 16 patients (35.6%, 16/45); flat, 18 patients (40.0%, 18/45); convex,11 patients (24.4%, 11/45); fibrocartilaginous ridge injury, 13 patients (28.9%, 13/45).
		                        		
		                        			Conclusion
		                        			According the results, significant differ-ence has not been found in morphologic variations of the fibular malleolar groove between patients with and without recurrent pero-neal tendon dislocation. Fibrocartilaginous ridge injury is common in MRI of patients with recurrent peroneal tendon dislocation. 
		                        		
		                        		
		                        		
		                        	
8.Clinicopathological characteristics and risk factors of female breast hyperplasia in different age groups
Fei WANG ; Shuohao SHEN ; Liyuan LIU ; Qi WANG ; Hongchuan JIANG ; Lisong TENG ; Zhimin FAN ; Cuizhi GENG ; Feng JIN ; Lili TANG ; Jianguo ZHANG ; Xiang WANG ; Shu WANG ; Xuening DUAN ; Lixiang YU ; Fei ZHOU ; Yujuan XIANG ; Shuya HUANG ; Chao ZHENG ; Qinye FU ; Dezong GAO ; Liang LI ; Zhongbing MA ; Qiang ZHANG ; Zhigang YU
Chinese Journal of General Surgery 2019;34(3):235-239
		                        		
		                        			
		                        			Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (< 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3% vs.42.7%,P < 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9% vs.61.7%,P <0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4% vs.4.2%,P < 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.
		                        		
		                        		
		                        		
		                        	
9.MRI findings of joint infection and adhesion after anterior cruciate ligament reconstruction
Chinese Journal of Medical Imaging Technology 2018;34(6):915-918
		                        		
		                        			
		                        			Objective To analyze the joint lesions of synovial thickening after anterior cruciate ligament (ACL) reconstruction,and to explore the differences of MRI findings between joint infection and adhesion.Methods Clinical and MRI data of 25 patients with synovial thickening (11 with infections and 14 with adhesion) confirmed by arthroscopy were retrospectively analyzed.The time interval from first ACL reconstruction to the arthroscopy after ACL was 0.3-2.5 (mean[1.1±0.6]) months and 6.0-19.0 (mean[11.0±4.9]) months,respectively.Results The lesions caused synovial thickening on MRI included joint infection and joint adhesion.MRI findings of joint infection included synovial thickening,moderate to massive joint effusion,different degrees of soft tissue swelling,bone marrow edema of distal femur and proximal tibia,ACL graft continuous fiber (high signals in 5 patients) and bone tunnel pseudo widened in 5 patients,while of joint adhesion included synovial thickening,striped short T2 signals in part of the thickened synovium on suprapatellar bursa,medial and lateral recess,the infrapatellar fat pad and the intercondylar fossa,without or only a small amount of joint effusion,ACL graft continuous,as well as high signals and rough edge in 3 patients,while bone tunnel was not significantly widened.Statistical differences of joint effusion,soft tissue swelling,edema of bone marrow and bone tunnel pseudo widened were found between joint infection and joint adhesion (all P<0.05).Conclusion MRI findings of joint infection mainly included synovial thickening,joint effusion and high signal of joint cavity,while of joint adhesion were synovial thickening,equal or slightly high signal of joint cavity.Joint infections mainly occurred in the early stage after operation,while joint adhesions mainly occurred in the middle and late stage after operation.
		                        		
		                        		
		                        		
		                        	
10.Comparison of T1ρ,MR and arthroscopy in the diagnosis of knee joint cartilage
Journal of Practical Radiology 2018;34(2):256-259
		                        		
		                        			
		                        			Objective To explore the value of T1ρin the diagnosis of knee osteoarthritis(OA),and to compare the diagnostic ability of T1ρ, MR and arthroscopy for early patellar cartilage injury.Methods 28 patients underwent T1ρMR imaging.We processed the images and measured T1ρvalues of the normal and damage cartilage.All cases were recorded results of MR and arthroscopy.Results T1ρ sequence could show cartilage clearly,and performed different colour levels,T1ρvalues of normal cartilage were less than 50 ms,and increased with aggravation of cartilage injury.The differences ofⅠ-ⅡandⅢ-Ⅳhad statistically significant.9 cases in grade 0 under MR and arthroscopy performed high values in T1ρ,which similar to gradeⅠ-Ⅱinjury,the diagnosis sensitivity of T1ρfor early cartilage injury was higher than MR and arthroscopy.In addition,arthroscopy and MR had high consistency in the diagnosis of cartilage.Conclusion T1ρcan effectively predict early cartilage injury and knee OA non-invasively,and can detect early cartilageinjury before MR and arthroscopy.
		                        		
		                        		
		                        		
		                        	
            
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