Primary angiosarcoma of the breast: Diagnosis with computer-assisted MRI-guided radio-guided occult lesion localization (ROLL) technique

Primary angiosarcoma of the breast is a rare type of breast cancer that represents approximately 0.04% of all primary breast tumors. We report herein a case of primary breast angiosarcoma that was only visible on magnetic resonance imaging (MRI) examination. The patient presented with a palpable right breast lump that was not visible either on ultrasonography and mammography. MRI showed a lesion of the right breast that presented washout kinetics. MRI-guided biopsy allowed histopathological examination of the tumor that was further confirmed as primary angiosarcoma. Subsequently, MRI guided ROLL (radio-guided occult lesion localization) technique was used for localizing the lesion prior to surgery.     

宫颈环形电切术治疗宫颈癌前病变的临床效果

目的：探讨宫颈环形电切术（LEEP）应用于宫颈癌前病变（CIN）的临床效果。方法：CIN 患者221例,采用 LEEP 手术进行治疗,比较术前 CIN 级别与术后病理诊断符合率,评价术前、术后1年和3年高危型人类乳头瘤病毒（HR-HPV）感染率,术后并发症。结果：221例 CIN 患者术前检查和术后病例确诊 CINⅠ级的符合率达83．4％,CINⅡ级和 CINⅢ级的符合率达90．4％;病理结果示一次性切除病变组织189例（85．5％）,补切周边手术32例（14．5％）;1年和3年随访时 HR-HPV 感染率较手术前明显降低;3年 HR-HPV 感染者最低,差异有统计学意义（P ＜0．05）;7例出现并发症,发生率为3％;术后1年随访时未复发110例（49．8％）,随访3年未复发51例（23．1％）。结论：LEEP 手术是治疗 CIN 安全有效的方法。     

基于规则化位移场的弹性减影成像研究

目的：提出一种新的基于规则化位移场的弹性减影成像方法,探讨其在消融损伤成像监控中应用的可行性。方法分别进行有限元仿真和离体实验研究,对压缩量不同情况下的位移场进行规整化和减影处理,处理后的位移场在深度方向进行微分获得弹性减影图像。结果仿真和离体实验数据显示,在消融治疗中,基于规则化位移场的弹性减影成像在压缩量变化的情况下,可获得效果较好的弹性图像,比传统弹性成像更好地反映了损伤区域的情况。结论基于规则化位移场的弹性减影成像方法实现压缩量不同情况下的弹性减影成像,优于传统弹性成像方法,可以用于消融治疗的损伤监控。     

3D打印技术制备个体化终板匹配颈椎间融合器的初步尝试

目的：探讨3D打印制备个体化颈椎间融合器的可行性并验证其终板匹配性。 方法：选取经福尔马林浸泡的成人新鲜尸体标本10具,男女各5具。截取标本的颈1-颈7节段,行CT平扫并将平扫图像导入Mimics软件,制作个体化颈5/6椎间融合器模型。通过3D打印机打印出椎间融合器。对每具标本施行颈5/6椎间隙减压植骨术。术后再次行CT检查,通过打印椎间融合器与上下终板之间的间隙来评价终板匹配性,每个椎间融合器测量36个点,间距＜1mm,匹配性优;1mm≤间距＜2mm,匹配性良;间距≥2mm,匹配性差。 结果：大体观察发现椎间融合器与椎间隙嵌合度较好,融合器植入后稳定性较好,无融合器过大不能置入发生,无融合器松动脱落。6例标本（60%）所有测量点匹配性均为优;3例标本（30%）中14个点（3.89%）匹配性良,其中1例6个点、另2例各4个点匹配性良;1例标本（10%）中共3个点（0.83%）匹配性差;共计343个点（95.28%）匹配性优。 结论：Mimics软件可很好呈现颈椎椎体和椎间隙解剖结构,并可据此进行颈椎Cage的个体化设计;利用3D打印可实现颈椎Cage产品快速成型,且打印产品与宿主终板匹配满意。     

项七针治疗椎动脉型颈椎病和对椎-基底动脉血流动力学的影响

目的 观察项七针治疗椎动脉型颈椎病的疗效和对椎-基底动脉血流动力学的影响。方法 将病人随机分为项七针组38例和颈夹脊组34例，进行症状评分和经颅彩色多普勒检查椎-基底动脉血流速指标。结果 经治疗2个疗程后，项七针组总有效率为89．47％，颈夹脊组为76．47％，两组差异有统计学意义（P〈0．05）；项七针组治疗后椎-基底动脉平均血流速度（MV）、椎-基底动脉搏动指数（PI）、阻力指数（RI）的改变与颈夹脊组比较均有统计学意义（P〈0．05）。项七针组疗效和改善脑供血方面均优于颈夹脊组。结论 运用针灸治疗椎动脉型颈椎病，可收到一定的临床疗效，且在改善病人症状积分及椎-基底动脉血流速度等方面亦显示出较好好的治疗作用。     

Outcomes Among Diabetic Patients Undergoing Percutaneous Coronary Intervention With Contemporary Drug-Eluting Stents: Analysis From the BIONICS Randomized Trial

Objectives

The authors sought to investigate the impact of diabetes mellitus (DM) on outcomes following contemporary drug-eluting stent (DES) implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial.

无骨折脱位型颈脊髓损伤患者颈髓的弥散张量成像

目的探讨应用磁共振弥散张量成像(DTI)定量分析无骨折脱位型颈脊髓损伤患者的可行性。方法对15例无骨折脱位型颈脊髓损伤患者(患者组)和20例健康志愿者(对照组)行常规MRI和DTI扫描,分别测量各向异性分数(FA)和表观弥散系数(ADC)。结果患者组FA为(0.475±0.109),ADC为(1.438±0.252)×10-3mm2/s。对照组FA为(0.604±0.096),ADC值为(1.371±0.280)×10-3mm2/s。与对照组相比,患者组FA降低(P0.05),ADC无显著性差异(P=0.267)。纤维束示踪成像(FT)显示,患者组颈髓白质纤维束不同程度受压凹陷、扭曲、减少、稀疏甚至断裂。结论 DTI能够敏感地发现无骨折脱位型颈脊髓损伤,FT能直观显示颈髓白质纤维束的细微损伤,为颈髓损伤程度的临床评估提供客观依据。     

Hypermethylation of TFPI2 correlates with cervical cancer incidence in the Uygur and Han populations of Xinjiang,China

Tissue factor pathway inhibitor 2 (TFPI2) is a Kunitz-type serine proteinase inhibitor, which plays an important role in the etiology of human malignancies. DNA methylation is a common epigenetic modification of the genome that is involved in regulating many cellular processes. In addition to human papilloma virus (HPV) infection, DNA methylation may play a role in the carcinogenesis of cervical cancer. Methylation of 22 CpG sites in the promoter region of the TFPI2 gene was detected by MassARRAY spectrometry and a gene mass spectrogram was drawn using MALDI-TOF MS. HPV16 was detected by PCR. We show that aberrant methylation of TFPI2 is present in a higher proportion of invasive cervical carcinoma (ICC) clinical samples as compared to normal cervical samples in Uygur and Han. Across the four pathologic lesions of the progression of cervical cancer, ICC showed the highest level of aberrant methylation, and with a stronger correlation between CpG site and lesion grade in Uygur than in Han. Moreover, a difference in TFPI2 methylation between Uygur patients positive and negative for HPV16 infection was observed at CpG_6 (P = 0.028) and CpG_15 (P = 0.007). Altogether, these results indicate that DNA methylation of TFPI2 may play an important role in the carcinogenesis of cervical cancer and that the differential methylation of TFPI2 may at least partially explain the disparity in cervical cancer incidence between Uygur and Han women.     

Unusual fungal bodies in conventional cervical smears: Report of nine cases

Candida spp have often been reported in cervical cytology, other fungal organisms are very rare in modern literature. We report nine cases of conventional cervical smears showing Penicillium, Aspergillus, and Cladosporium spp in healthy imunocompetent females. Penicillium spp seen in four out of nine smears, Cladosporium spp alone in three out of nine smears, and Cladosporium spp along with Aspergillus spp in two out of nine smears. A detail of these nine cases is presented with discussion on importance of these structures when observed in conventional cervical smears. Awareness of such contaminants is important to differentiate from true infection for relevant therapeutic implications. A systematic step‐wise approach to such structures is also suggested. Diagn. Cytopathol. 2015;43:234–237. © 2014 Wiley Periodicals, Inc.     

Juvenile ossifying fibroma diagnosed on fine needle aspiration cytology: A diagnostic challenge

Preoperative diagnosis of jaw lesions is not always possible on the basis of clinico‐radiological findings alone and needs to be confirmed before attempting any surgical intervention. Fibro‐osseous lesions of the jaw comprise a spectrum of diseases which include cement‐osseous dysplasia, fibrous dysplasia, and ossifying fibroma. The cytomorphological distinction between these individual entities is difficult. We present a case of maxillary fibro‐osseous lesion in an adolescent girl diagnosed and categorized as juvenile ossifying fibroma preoperatively on cytology and confirmed on histopathology. Although aspirates are usually paucicellular in fibro‐osseous lesions, certain cytological features if present in cellular cytosmears can offer further categorization and a definitive diagnosis may be possible in light of clinico‐radiological correlation. Diagn. Cytopathol. 2015;43:75–79. © 2014 Wiley Periodicals, Inc.