简介：AbstractBackground:Andersson lesions (ALs) are not uncommon in ankylosing spondylitis (AS). Plain radiography (PR) is widely used for the diagnosis of ALs. However, in our practice, there were some ALs in AS patients that could not be detected on plain radiographs. This study aimed to propose the concept of occult ALs and evaluate the prevalence and radiographic characteristics of the occult ALs in AS patients.Methods:A total of 496 consecutive AS patients were admitted in the Affiliated Drum Tower Hospital, Medical School of Nanjing University between April 2003 and November 2019 and they were retrospectively reviewed. The AS patients with ALs who met the following criteria were included for the investigation of occult ALs: (1) with pre-operative plain radiographs of the whole-spine and (2) availability of pre-operative computed tomography (CT) and/or magnetic resonance imaging (MRI) of the whole-spine. The occult ALs were defined as the ALs which were undetectable on plain radiographs but could be detected by CT and/or MRI. The extensive ALs involved the whole discovertebral junction or manifested as destructive lesions throughout the vertebral body. Independent-samples t test was used to compare the age between the patients with only occult ALs and those with only detectable ALs. Chi-square or Fisher exact test was applied to compare the types, distribution, and radiographic characteristics between detectable and occult ALs as appropriate.Results:Ninety-two AS patients with a mean age of 44.4 ± 10.1 years were included for the investigation of occult ALs. Twenty-three patients had occult ALs and the incidence was 25% (23/92). Fifteen extensive ALs were occult, and the proportion of extensive ALs was significantly higher in detectable ALs (97% vs. 44%, χ2 = 43.66, P < 0.001). As assessed by PR, the proportions of osteolytic destruction with reactive sclerosis (0 vs. 100%, χ2 = 111.00, P < 0.001), angular kyphosis of the affected discovertebral units or vertebral body (0 vs. 22%, χ2 = 8.86, P = 0.003), formation of an osseous bridge at the intervertebral space adjacent to ALs caused by the ossification of the anterior longitudinal ligament (38% vs. 86%, χ2 = 25.91, P < 0.001), and an abnormal height of the affected intervertebral space were all significantly lower in occult ALs (9% vs. 84%, χ2 = 60.41, P < 0.001).Conclusions:Occult ALs presented with more subtle radiographic changes. Occult ALs should not be neglected, especially in the case of extensive occult ALs, because the stability of the spine might be severely impaired by these lesions.

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简介：美元符号这个符号用于表示美元和比索（拉丁美洲一些国家和菲律宾的货币单位）。美元符号的竖线可能来自于比索（pesos）的缩写＂P＂。字母＂S＂压在＂P＂上．变成一个大写＂S＂。

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简介：横向:1.一部很受欢迎的美国电影,又名:查理的天使2.2007年NHK大河剧,改编自日本著名小说家井上靖的同名历史小说,讲述了日本雄踞一方的甲州霸主武田信玄及其军师山本勘助的故事3.一种在水中使用的炸弹4.成语,比喻叙述从头到尾,源源本本,没有遗漏:也形容查点数目5.韩国女艺人,因主演《我的野蛮女友》而走红6.一个中亚国家7.日本女演员,与竹野内丰主演了日剧《WITH

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简介：Objective:Toexploretheeffectofmorphologicalchangesinthedevelopmentofcondylomaacuminatum(CA)MaterialsandMethods:LesionsinfivepatientswithCAwereobserved.Results:Uponelectronmicroscopy,themostcharacteristicfeatureofthelesionsimportantfordiagnosis,wasthepresenceofdistinctperinuclearvacuolizations,orso-calledkoilocytes,amongsomeepithelialcells.Thesecellspossessedhyperchromaticnuclei,swollenmitochondria,dilatedendoplasmicreticulumanddissolvedglycogen.Therewereinterchromatingranulesandperichromatingranulesinsomenuclei.Moreoversomevirusparticleswerealsoseeninthenucleiofsomeinfectedcells.Conclusions:Theultrastructuralfindingsmaybeusedtohistopathologicallyexplainthepathogenesisandmechanismofthisdisease,anditishelpfulfordiagnosisofCA.

简介：AbstractBackground:Thermal ablation of thyroid nodules is new modality for the management of the benign and malign lesions. This minimally invasive treatment is performed as an outpatient, local anesthetic, single professional procedure that can treat neoplastic lesions without removing normal thyroid tissue and thus avoiding hypothyroidism.Method:A comprehensive review of the most relevant literature regarding the thermal ablation of benign and malign nodules was performed in order to currently define its role on the management of the nodular thyroid disease. The data was divided into benign and malign literature.Results:The benign nodules can be effectively treated by radiofrequency ablation (RFA) but some limitation exists regarding the nodule’s size but not nodules characteristics. The RFA of primary malign tumors of the thyroid recently demonstrated positive and safe long-term follow-up and encouraged additional investigation and possibly a definitive role in the management of these low risk nodules.Conclusion:RFA is a safe, cost-effective minimally invasive procedure that avoids thyroid tissue removal while destroying neoplastic one thus, preventing hypothyroidism.

简介：Duodenalpolypsorlesionsareuncommonlyfoundonupperendoscopy.Duodenallesionscanbecategorizedassubepithelialormucosally-based,andthetypeoflesionoftendictatesthework-upandpossibletherapeuticoptions.Subepitheliallesionsthatcanariseintheduodenumincludelipomas,gastrointestinalstromaltumors,andcarcinoids.Endoscopicultrasonographywithfineneedleaspirationisusefulinthecharacterizationanddiagnosisofsubepitheliallesions.Duodenalgastrointestinalstromaltumorsandlargeormultifocalcarcinoidsarebestmanagedbysurgicalresection.Brunner＇sglandtumors,solitaryPeutz-Jegherspolyps,andnon-ampullaryandampullaryadenomasaremucosally-basedduodenallesions,whichcanrequireremovalandaretypicallyamenabletoendoscopicresection.Severalanatomiccharacteristicsoftheduodenummakeendoscopicresectionofduodenallesionschallenging.However,advancedendoscopictechniquesexistthatenabletheresectionoflargemucosally-basedduodenallesions.Endoscopicpapillectomyisnotwithoutrisk,butthisprocedurecaneffectivelyresectampullaryadenomasandallowspatientstoavoidsurgery,whichtypicallyinvolvespancreaticoduodenectomy.Endoscopicmucosalresectionanditsvariations（suchascap-assisted,cap-band-assisted,andunderwatertechniques）enablethesafeandeffectiveresectionofmostduodenaladenomas.Endoscopicsubmucosaldissectionispossiblebutverydifficulttosafelyperformintheduodenum.

简介：AbstractPediatric skull base lesions are complex and challenging disorders. Safe and comprehensive management of this diverse group of disorders requires the expertise of an experienced multidisciplinary skull base team. Adult endoscopic skull base surgery has evolved due to technologic and surgical advancements, multidisciplinary team approaches, and continued innovation. Similar principles continue to advance the care delivered to the pediatric population. The approach and management of these lesions varies considerably based on tumor anatomy, pathology, and surgical goals. An understanding of the nuances of skull base reconstruction unique to the pediatric population is critical for successful outcomes.

简介：　　MenandwomengoouttogetheragreatdealinAmerica,especiallyinthecities.Theyskitogether,worktogether,dinetogether,eitheratrestaurantsorineachother'sapartments.Thisdoesnotmeanthattheyarenecessarilyinterestedinhavingsextogether,thoughitmayappearso,and,ofcourse,withsomemenandwomenitisso.……

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简介：AbstractBackground:Applying ultrasonic imaging system during surgery requires the poring of saline, performing the measurement, and acquiring data from its display—which requires time and is highly "performer dependent," i.e., the measure is of a subjective nature. A new ultrasonic device was recently developed that overcomes most of these drawbacks and was successfully applied during tumor-in-brain neurosurgeries. The purpose of this study was to compare the two types of US devices and demonstrate their properties.Methods:The study was performed in the following stages: (i) an ex vivo experiment, where slices of the muscle and brain of a young porcine were laid one on top the other. Thicknesses and border depths were measured and compared, using the two types of US instruments. (ii) During human clinical neurosurgeries, tumor depth was compared by measuring it with both devices. (iii) Following the success of stages (i) and (ii), using solely the new US device, the tumor thickness was monitored while its resection. Correlation, Pearson’s coefficient, average, mean, and standard deviation were applied for statistical tests.Results:A high correlation was obtained for the distances of tissue borders and for their respective thicknesses. Applying these ultrasonic devices during neurosurgeries, tumor depths were monitored with high similarity (87%), which was also obtained by Pearson’s correlation coefficient (0.44). The new US device, thanks to its small footprint, its remote measurement, and the capability of monitoring intraoperatively and in real-time, provides the approach to tumor’s border before its complete resection.Conclusions:The new US device provides better accuracy than an ultrasonic imaging system; its data is objective; it enables to control the residual tumor thickness during its resection, and it is especially useful in restricted areas. These features were found of great help during a tumor-in-brain surgery and especially in the final stages of tumor’s resection.