Undifferentiated pleomorphic sarcoma is an extremely rare malignant thyroid tumor. Thyroid sarcoma differs from common malignant thyroid tumors, such as thyroid follicular cell carcinoma. It is usually highly malignant, progresses rapidly, and is prone to remote metastasis. Currently, there is no standard protocol for the treatment of thyroid sarcomas, and most treatment effects are unsatisfactory. Argon-helium cryoablation is an important method of local treatment that is widely used in patients with unresectable advanced tumors. However, owing to the low incidence of thyroid sarcomas, there are no relevant literature reports on the treatment of thyroid sarcomas using cryoablation in China. This study reports the case of a patient with undifferentiated pleomorphic sarcoma of the thyroid gland who was treated with argon-helium cryoablation, and the immediate outcome was good. Based on a review of relevant literature, we discussed the effectiveness and safety of argon-helium cryoablation treatment to provide clinical guidance and references for the treatment of patients with thyroid sarcoma.

UNASSIGNED: Extra-adrenal myelolipomas (EAMs) are rare benign tumors composed of both mature adipose and hematopoietic tissues with unclear etiology. There have been only sporadic case reports about the clinical characteristics and management of EAMs. Here we present our experience and practice in the clinical diagnosis and treatment of 11 consecutive patients with EAMs.
UNASSIGNED: We retrospectively reviewed 11 consecutive patients, who received surgeries in our department and were confirmed as having EAMs by postoperative histopathology from April 2016 to December 2021. Clinical information and follow-up data of all patients were collected and analyzed afterwards.
UNASSIGNED: Of the 11 EAM patients (7 male and 4 female) with a mean age of 47.6 years, 3 were asymptomatic and 8 were symptomatic with a mean symptom duration of 6.07 months. EAMs were found in the thoracic spine in 4 cases, paravertebral mediastinal regions in 3 cases, ilium in 2 cases, humerus in 1 case, and rib in 1 case. All patients were initially misdiagnosed as other tumors by radiologists. All 11 patients received gross total excision or curettage with a mean intraoperative blood loss of 781.82 ± 1143.3 ml and a mean operation duration of 180.91 ± 98.41 min. Patients\' Frankel scores and Karnofsky Performance Status score were improved or at least preserved postoperatively. No significant complications occurred postoperatively. All the 11 patients survived, and no local recurrence or distant metastasis occurred during the mean follow-up period of 42.0 months.
UNASSIGNED: The surgical outcome and prognosis of EAMs are excellent and surgery can serve as the method of radical treatment.

The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B (KIF20B) gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.
遵义医科大学附属医院于2020年9月收治的原发性肺腺癌合并肺错构瘤患者1例，男，62岁，以吞咽困难就诊。2015年3月发现肺结节于门诊规律随访，2020年9月胸部CT显示左肺下叶结节增大、有分叶，左肺上叶有磨玻璃结节影，行胸腔镜下楔形手术，术后病理确诊为左肺上叶原发性肺腺癌、左肺下叶肺错构瘤。全外显子组测序发现驱动蛋白20(kinesin family member 20B，KIF20B)基因在肺腺癌中无表达，在肺错构瘤中有表达。肺腺癌合并肺错构瘤的临床表现不典型，可位于同侧及对侧肺叶，两者影像学表现多样，不能完全区分，手术后的病理学检查是金标准，需警惕肺错构瘤恶变的可能。.

OBJECTIVE: Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25).
METHODS: The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured.
RESULTS: The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01).
CONCLUSIONS: At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.
目的：基于磁共振成像技术探讨大肠俞直刺危险深度和深刺法的安全性，为规范大肠俞深刺法提供数据支持。方法：应用磁共振仪采集148例健康成年受试者第4腰椎棘突下的水平断面图像，分析解剖结构，测量大肠俞直刺时的危险深度。结果：大肠俞直刺危险深度：男性左右两侧分别为（11.2±1.3）cm、（11.0±1.2）cm，女性左右两侧分别为（9.8±1.3）cm、（9.7±1.3）cm。大肠俞直刺危险深度与体质量指数（BMI）呈正相关，在体型相近情况下，男性受试者大肠俞直刺危险深度大于女性受试者（P<0.01）。结论：目前临床所用的大肠俞深刺法是安全的。临床上应用大肠俞深刺法时，可根据体型及性别确定进针深度。.

BACKGROUND: Tibial plateau fracture is a common fracture encountered in the clinic.
OBJECTIVE: This study determined the optimal timing and surgical approach for patients with tibial plateau fracture.
METHODS: Fifty-two patients with complex tibial plateau fractures were treated in our hospital (the People\'s Hospital of Zhongjiang County) between 2013 and 2015. These patients were recruited as participants in this study; all patients were randomly allocated into two groups of 26 patients each. Patients in Group 1 underwent single-incision, single-plate knee surgeries via an antero-lateral approach, and patients in Group 2 underwent anterior median incisions of the knee for double-plate surgeries. The effects of the approaches were compared and analyzed.
RESULTS: The best time to perform surgery was 6-8 days post-injury. The anterior median incision, double-plate method approach was better than the antero-lateral, single-incision, single-plate method. For the former method, the healing among middle-aged and young patients was better than that of elderly patients, and that healing of men was slightly better than that of female patients. However, the degree of healing among patients was > 80% at 5 months postoperatively. The purpose of surgical management has been fully achieved.
CONCLUSIONS: The optimal timing of surgery for patients with complex tibial plateau fractures is 6-8 days post-injury. The surgical approach needs to be determined based on the actual condition of the patient. However, the treatment effect of an anterior median incision, double-plate method is better, and the recovery rate may approach 80% at 5 months postoperatively.

OBJECTIVE: This study aims to assess changes in cardiac imageology of patients with mild obstructive sleep apnea (OSA) without cardiovascular disease.
METHODS: All enrolled participants underwent polysomnography (PSG). Some participants underwent transthoracic echocardiography, speckle tracking echocardiography, and cardiac-enhanced magnetic resonance imaging (MRI) if they were willing. They were divided into three groups according to PSG results: non-OSA, mild OSA, and moderate-to-severe OSA. Imageology parameters were compared, and the relationship between OSA severity and imageology indices was analyzed by correlation analysis and multiple linear regression.
RESULTS: Of the 352 enrolled participants, 274 participants with OSA had an apnea-hypopnea index (AHI) of ≥ 5 (86 mild OSA and 188 moderate-to-severe OSA cases), and 78 participants with non-OSA had an AHI of < 5. Transthoracic echocardiography showed that E/A and E\'/A\' values were lower in the mild OSA group than in the non-OSA group (1.12 ± 0.37 vs 1.27 ± 0.45 and 0.83 ± 0.33 vs 0.99 ± 0.42, respectively, p < 0.05). The aorta and ascending aorta widths were smaller in the mild OSA group than in the moderate-and-severe OSA groups (27.36 ± 2.87 mm vs 28.87 ± 2.95 mm and 30.27 ± 3.79 mm vs 31.63 ± 3.74 mm, respectively, p < 0.05). A regression analysis showed that cardiac function changes in patients with OSA may be related to age, obesity, and OSA severity.
CONCLUSIONS: Patients with mild OSA without cardiovascular disease displayed changes in cardiac structure and function on transthoracic echocardiography.

OBJECTIVE: To evaluate whether narrowing of internal carotid artery siphon (ICAS) may increase the risk of developing non-arteritic anterior ischaemic optic neuropathy (NAION).
METHODS: Totally 30 consecutive patients who had unilateral NAION and 30 gender-matched control subjects were recruited in the present study. The diameter of ICAS of all the participants were measured using head-and-neck computed tomographic angiography (CTA). Color doppler flow imaging (CDI) was used to measure the haemodynamics parameters of ICAS and short posterior ciliary arteries (SPCAs) in all subjects. Comparison of parameters between the NAION patients and controls as well as between the two sides within the patients were performed. The correlation between the diameter of ICAS and NAION was analyzed.
RESULTS: A comparison of parameters between the affected side of the NAION patients and the controls, including the diameter of ICAS, the resistance index (RI) of ICAS, the blood flow velocities of SPCAs and RI of SPCAs, showed significantly difference (P<0.01), while there was no significant difference in terms of the mean blood flow velocity (Vm) of ICAS; Similar results were found while comparing all the measurements of the affected and unaffected side of patients (P for RI of SPCAs <0.05). No marked difference was detected in nearly all parameters except for RI of ICAS and SPCAs between the unaffected side of the NAION patients and the controls (P<0.05). The diameter of ICAS were significantly positive correlated with both peak systolic velocity (PSV) of SPCAs and end diastolic velocity (EDV) of SPCAs in patients with NAION (r=0.514, P<0.01 and r=0.418, P<0.05, respectively).
CONCLUSIONS: Narrowing of ICAS may increase the risk of developing NAION.

Laryngotracheal stenosis is a complex and dangerous disease,which caused by trauma or endotracheal intubation.Accurately and clearly to show the length and area of the airway stenosis,which is of great significance for the correct qualitative and quantitative diagnosis of the disease and the development of the treatment.The relevant inspection has its advantages and disadvantages.How to use inspection accurate and reasonable,there is no unified standard.Therefore,this paper will evaluate the role and significance of different relevant inspection(pulmonary function tests,ultrasound,bronchoscopy,CT,MRI) in the diagnosis of laryngotracheal stenosis,providing reference for laryngeal and tracheal stenosis diagnosis and treatment.

Few studies have investigated posterior reversible encephalopathy syndrome (PRES) in patients with chronic renal failure (CRF). The present study analyzed the clinical manifestations, laboratory examinations and imaging features of PRES in patients with CRF. A total of 42 patients with CRF with or without PRES were recruited in the current retrospective case-control study. Patient data taken prior to the onset of PRES in patients with CRF and PRES (n=21) were collected and analyzed. At the same time, data from patients with CRF but without PRES (n=21) were also analyzed. Brain magnetic resonance imaging (MRI) scans were collected from patients in the PRES group. The mean blood pressure of patients in the PRES group was significantly higher than that of the control group (systolic blood pressure: 172±15 mmHg vs. 135±14 mmHg, P<0.01; diastolic blood pressure: 95±16 mmHg vs. 64±13 mmHg, P<0.01). Furthermore, compared with the control group, mean serum albumin (Alb) and hemoglobin (Hb) concentrations in the PRES group were significantly lower (Alb: 29.1±5.3 g/l vs. 34.6±6.1 g/l, P=0.001; Hb: 74±16 g/l vs. 89±28 g/l, P=0.037). By contrast, mean LDH concentration was significantly higher in the PRES group (LDH: 336±141 U/l vs. 235±89 U/l, P=0.004). In the PRES group, 24 h urine volume was significantly lower in the PRES group than in the control group (24 h urine volume: 651±520 ml vs. 982±518 ml, P=0.046). No significant differences in levels of serum potassium (4.5±0.6 mmol/l vs. 4.4±0.5 mmol/l, P=0.377), sodium (138.3±4.9 mmol/l vs. 139.0±6.8 mmol/l, P=0.325), calcium (2.0±0.24 mmol/l vs. 1.9±0.24 mmol/l, P=0.673), alanine aminotransferase; (24±14 U/l vs. 18±8 U/l, P=0.975); aspartate aminotransferase (29±11 U/l vs. 24±9 U/l, P=0.619) and uric acid (448±148 µmol/l vs. 378±116 µmol/l, P=0.599) were found between the two groups. PRES is a relatively common nervous system complication arising in patients with CRF. Certain biochemical markers, including Hb and Alb, may be associated with PRES. Diagnosing PRES is difficult as computed tomography (CT) brain scans may be normal and MRI scans, which are more sensitive than CT scans at diagnosing PRES, are not always performed in patients with CRF. Thus, brain MRI scans should be taken first in such patients when PRES is suspected.

Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery.