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Breast cancer is the most common malignant tumor in women and its early detection is decisive. Breast imaging plays an important role in early detection of breast cancer as well as monitoring and evaluation during treatment, but manual detection of medical images is usually time-consuming and labor-intensive. Recently, deep learning algorithms have made significant progress in early breast cancer diagnosis. By combing the relevant literature in recent years, a systematic review of the application of deep learning techniques in breast cancer diagnosis with different imaging modalities is conducted, aiming to provide a reference for in-depth research on deep learning-based breast cancer diagnosis. Firstly, four breast cancer imaging modalities, namely mammography, ultrasonography, magnetic resonance imaging and positron emission tomography, are outlined and briefly compared, and the public datasets corresponding to multiple imaging modalities are listed. Focusing on the different tasks (lesion detection, segmentation and classification) of deep learning architectures based on the above four different imaging modalities, a systematic review of the algorithms is conducted, and the performance of each algorithm, improvement ideas, and their advantages and disadvantages are compared and analyzed. Finally, the problems of the existing techniques are analyzed and the future development direction is prospected with respect to the limitations of the current work.

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脑出血的发病率低于脑梗死，但致死率和致残率高，在我国，约46％的脑出血患者在发病1年内死亡或遗留严重残疾，因此规范脑出血的诊疗就显得尤为重要。2018年，美国心脏学会（American Heart Association，AHA）/美国卒中学会（American Stroke Association，ASA）根据其发布的自发性脑出血管理指南中证据级别较高的Ⅰ类或Ⅲ类推荐意见，制定了脑出血患者的临床管理指标，将指南转化为临床可实践的量化指标。从2021年7月开始，我国国家神经系统疾病医疗质量控制中心联合中国卒中学会医疗质量管理与促进分会，采用改良德尔菲法，最终制定了包括11项指标的脑出血医疗质量控制指标体系。本文对这11项指标进行具体解读，以期指导医疗机构在最佳时间内安全、有效地为患者提供医疗救护，提高脑出血患者的医疗救护质量，从而改善患者的临床转归。 Abstract: The incidence of intracerebral hemorrhage (ICH) is less than ischemic stroke, but its mortality and disability rate are high. In China, nearly 46% of patients with ICH died or left serious disability within one year. Therefore, it is particularly important to standardize the diagnosis and treatment of ICH. In 2018, the American Heart Association (AHA) /American Stroke Association (ASA) developed clinical management indicators for patients with ICH based on the higher level of evidence level Ⅰ or Ⅲ recommendations in the guidelines for the management of spontaneous ICH, translating the guidelines into clinically practical quantitative indicators. From July 2021, the National Center for Healthcare Quality Management in Neurological Diseases and the Management and Improvement of Chinese Medical Care Quality on Stroke, Chinese Stroke Association adopted the improved Delphi method and finally formulated an index system for medical quality control of ICH, including 11 indicators. This paper makes detailed interpretation of these 11 indicators in order to guide medical institutions to provide medical assistance for patients in the best time safely and effectively, improve the quality of medical assistance for patients with ICH, and improve the clinical outcome of patients.

Abstract Purpose Urachal cancer is similar to gastrointestinal adenocarcinoma in histology, and gastroscopy/colonoscopy is often administered during perioperative evaluation. However, gastroscopy and colonoscopy have corresponding disadvantages. This study discusses whether gastroscopy/colonoscopy is truly necessary for patients with urachal cancer. Patients and methods A total of 166 bladder adenocarcinoma cases diagnosed at Sun Yat-sen University Cancer Center were retrospectively reviewed and divided into two groups (urachal cancer and nonurachal cancer), and perioperative evaluations were retrieved. Results There were 78 patients with urachal cancer, the median age was 48 years, and 59 were male. Perioperative gastroscopy/colonoscopy revealed 5 intestinal polyps and 1 adenoma during these evaluations, and no primary gastrointestinal cancer was found. Meanwhile, preoperative imaging evaluation did not detect significant gastrointestinal lesions. For 88 patients with nonurachal cancer, including primary bladder adenocarcinoma and metastatic tumors from gastrointestinal cancer, the median age was 56 years, and 64 were male. Preoperative imaging evaluation demonstrated 36 cases of gastrointestinal lesions, and 32 were confirmed by gastroscopy/colonoscopy; the other 4 were negative. Another 4 cases of colon cancer were detected by regular colonoscopy for suspected primary bladder adenocarcinoma. In all, 35 cases of colon cancer and 1 case of gastric cancer were identified by endoscopic examination. The diagnostic consistency of imaging and gastrointestinal endoscopy was favorable (P

The incidence of intracerebral hemorrhage (ICH) is less than ischemic stroke, but its mortality and disability rate are high. In China, nearly 46% of patients with ICH died or left serious disability within one year. Therefore, it is particularly important to standardize the diagnosis and treatment of ICH. In 2018, the American Heart Association (AHA) /American Stroke Association (ASA) developed clinical management indicators for patients with ICH based on the higher level of evidence level Ⅰ or Ⅲ recommendations in the guidelines for the management of spontaneous ICH, translating the guidelines into clinically practical quantitative indicators. From July 2021, the National Center for Healthcare Quality Management in Neurological Diseases and the Management and Improvement of Chinese Medical Care Quality on Stroke, Chinese Stroke Association adopted the improved Delphi method and finally formulated an index system for medical quality control of ICH, including 11 indicators. This paper makes detailed interpretation of these 11 indicators in order to guide medical institutions to provide medical assistance for patients in the best time safely and effectively, improve the quality of medical assistance for patients with ICH, and improve the clinical outcome of patients. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of individualized treatment strategy based on imaging evaluation in patients with rheumatoid arthritis (RA). Methods: Eighty patients with RA of the wrist treated in the Second Affiliated Hospital of Nanjing Medical University, China from January 2018 to December 2022 were assigned to control and study groups. Conventional methods were used for treating control subjects, based on RA laboratory index results, while the study group received individualized treatment based on RA laboratory index results and results of imaging evaluation. Before and after treatment, serum levels of rheumatoid factor (RF) and C-reactive protein (CRP) were assayed using immunoturbidimetry. Erythrocyte sedimentation rate (ESR) was determined by Wei method. Imaging examination - ultrasound or magnetic resonance imaging (MRI) - was carried out in study group before and after treatment. Disease activity score 28 (DAS28) and score on the visual analogue scale (VAS) were evaluated before and after treatment, and the curative effect in the two groups was compared based on curative effect evaluation. Results: In both groups, post-treatment values of RF, CRP and ESR were lower than the corresponding pre-treatment levels, but were significantly smaller in study group (p < 0.05). The DAS28 and VAS scores of the two groups after treatment were significantly lower (p < 0.05) than the pret-reatment levels, but the DAS28 and VAS scores were significantly lower in study group (p < 0.05). Treatment efficacy in study group (95.0 %) was significantly higher than in control patients (77.5 %, p = 0.0476). The results of imaging indicators showed significantly reduced post-treatment synovial thickness and joint effusion in study group patients when compared with control patients (p < 0.01). Conclusion: Individualized treatment strategy for RA patients based on imaging results enhances curative effectiveness, reduces disease activity, relieves pain, and improves the quality of life of patients. [ABSTRACT FROM AUTHOR]

Purpose: Urachal cancer is similar to gastrointestinal adenocarcinoma in histology, and gastroscopy/colonoscopy is often administered during perioperative evaluation. However, gastroscopy and colonoscopy have corresponding disadvantages. This study discusses whether gastroscopy/colonoscopy is truly necessary for patients with urachal cancer. Patients and methods: A total of 166 bladder adenocarcinoma cases diagnosed at Sun Yat-sen University Cancer Center were retrospectively reviewed and divided into two groups (urachal cancer and nonurachal cancer), and perioperative evaluations were retrieved. Results: There were 78 patients with urachal cancer, the median age was 48 years, and 59 were male. Perioperative gastroscopy/colonoscopy revealed 5 intestinal polyps and 1 adenoma during these evaluations, and no primary gastrointestinal cancer was found. Meanwhile, preoperative imaging evaluation did not detect significant gastrointestinal lesions. For 88 patients with nonurachal cancer, including primary bladder adenocarcinoma and metastatic tumors from gastrointestinal cancer, the median age was 56 years, and 64 were male. Preoperative imaging evaluation demonstrated 36 cases of gastrointestinal lesions, and 32 were confirmed by gastroscopy/colonoscopy; the other 4 were negative. Another 4 cases of colon cancer were detected by regular colonoscopy for suspected primary bladder adenocarcinoma. In all, 35 cases of colon cancer and 1 case of gastric cancer were identified by endoscopic examination. The diagnostic consistency of imaging and gastrointestinal endoscopy was favorable (P < 0.001), and the negative predictive value and diagnostic efficiency of imaging were 96.9% and 94.6%, respectively. Conclusions: The vast majority of gastrointestinal cancer cases can be identified by assessment of the patient's clinical symptoms, meticulous physical examination, and imaging evaluation. We recommend that gastroscopy/colonoscopy only be applied to patients with urachal cancer when the above examinations are positive. [ABSTRACT FROM AUTHOR]

Objective: This study explored the clinical features and immune responses of children with primary ciliary dyskinesia (PCD) during pneumonia episodes. Methods: The 61 children with PCD who were admitted to hospital because of pneumonia were retrospectively enrolled into this study between April 2017 and August 2022. A total of 61 children with pneumonia but without chronic diseases were enrolled as the control group. The clinical characteristics, levels of inflammatory indicators, pathogens, and imaging features of the lungs were compared between the two groups. Results: The PCD group had higher levels of lymphocytes (42.80% versus 36.00%, p = 0.029) and eosinophils (2.40% versus 1.25%, p = 0.020), but lower neutrophil counts (3.99 versus 5.75 × 109/L, p = 0.011), percentages of neutrophils (46.39% versus 54.24%, p = 0.014), CRP (0.40 versus 4.20 mg/L, p < 0.001) and fibrinogen (257.50 versus 338.00 mg/dL, p = 0.010) levels. Children with PCD and children without chronic diseases were both most commonly infected with Mycoplasma pneumoniae (24.6% versus 51.9%). Children with PCD had significantly more common imaging features, including mucous plugging (p = 0.042), emphysema (p = 0.007), bronchiectasis (p < 0.001), mosaic attenuation (p = 0.012), interstitial inflammation (p = 0.015), and sinusitis (p < 0.001). Conclusion: PCD is linked to immune system impairment, which significantly contributes to our understanding of the pathophysiology of this entity. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical features, diagnosis and treatment of osteomyelitis of the jaw caused by an actinomycotic infection and to provide a reference for clinical diagnosis and treatment. Methods A case of osteomyelitis in the bilateral maxilla and the left zygomatic bone and arch caused by a mixed bacterial infection dominated by Actinomycetes was reviewed and analyzed in combination with the literature. Results The patient had left upper posterior tooth pain with repeated left facial swelling for 7 months. The patient's left face was swollen before surgery, the left maxillary alveolar bone was necrotic, and the upper palate showed fistula discharge. A maxillofacial magnetic resonance imaging scan excluded tumors and other space-occupying lesions. According to CBCT images, the initial diagnoses were left infraorbital space infection and osteomyelitis of the bilateral maxillary, the left zygomatic bone, the left zygomatic arch and the lateral orbital wall. Necrosis of the left maxilla and the zygomatic bone was excised, the focus was cleared and the focal tooth was extracted under general anesthesia. Histopathological results confirmed osteomyelitis and actinomycotic infection. Anti-inflammatory therapy with penicillin sodium was given before surgery, and piperacillin sodium and tazobactam sodium, dexamethasone sodium phosphate, tranexamic acid and mecobalamine were given after surgery. The patients' 6-month follow-up results showed that the maxillofacial shape was basically symmetrical; no ulceration, pus or abnormal secretion was found in the skin or intraoral mucosa; and the surgical area showed good recovery. A review of the relevant literature showed that Actinomyces is an opportunistic pathogen, and factors such as trauma and dental infection have been implicated in the pathogenesis of osteomyelitis. In addition to surgery, antibiotics are used to treat the disease and multidisciplinary symptomatic treatment combined with supportive treatment is required to achieve a better prognostic effect. Conclusion Actinomycotic osteomyelitis occurring in the maxilla and the zygomatic bone is an extremely rare disease that can be diagnosed by clinical manifestations, bacteriological examination and biopsy. Appropriate and effective penicillin drugs should be given at the initial stage of treatment, more sensitive antibiotics should be selected according to the results of the drug sensitivity test, and the lesions should be surgically removed when the patient's condition improves. Active symptomatic and supportive treatment should be performed during the treatment period.

ObjectiveThe occurrence of Brucella-induced abdominal aortic aneurysms is an exceedingly rare phenomenon, yet it stands as one of the most severe complications within this context. The combined utilization of serological testing and imaging diagnostics has been validated as an effective approach for the identification of Brucella-induced abdominal aortic aneurysms. Presently, the predominant therapeutic strategies encompass antibiotic treatment and surgical intervention. Nonetheless, ongoing controversies persist concerning the establishment of diagnostic criteria, the optimal timing and selection of antibiotic regimens, and the nuanced decision between open surgical procedures and endovascular interventions. Through a meticulous analysis of cases originating from our institution as well as a comprehensive review of previously documented instances, we aim to engage in a detailed discourse on the salient diagnostic and therapeutic facets surrounding Brucella-induced abdominal aortic aneurysms.MethodsWe conducted a retrospective summary of three cases involving Brucella-induced abdominal aortic aneurysms treated within our institution. Furthermore, we performed a comprehensive PubMed search, without imposing restrictions on language or publication year, to identify pertinent literature pertaining to Brucella-induced abdominal aortic aneurysms. The selection criteria primarily focused on case reports delineating occurrences of abdominal aortic aneurysms attributed to Brucella infection.ResultsWe present three distinct cases of Brucella-induced abdominal aortic aneurysms managed at our institution, providing comprehensive insights into the employed diagnostic and therapeutic approaches. Additionally, over the past five decades, a total of 24 cases in 23 publications of Brucella-induced abdominal aortic aneurysms have been reported on PubMed. The earliest report dates back to 1976.ConclusionOur analysis suggests that Brucella-induced abdominal aortic aneurysm is characterized by a remarkably low incidence but is associated with a substantial risk of life-threatening complications. The integration of serological and imaging assessments assumes pivotal importance in facilitating prompt diagnosis of this condition. The prompt initiation of targeted antibiotic therapy is recommended, and the selection of appropriate surgical strategies should be guided by considerations including aneurysm dimensions and morphological attributes. The timely identification and intervention carry utmost significance in retarding disease advancement and ameliorating unfavorable clinical outcomes.

Enhui Guo,1,2,&ast; Chengqian Li,2,3,&ast; Yanjiao Hu,4 Kongyuan Zhao,1,2 Qingmei Zheng,1,&ast; Liming Wang1,&ast; 1Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 2Qingdao Medical College, Qingdao University, Qingdao, People’s Republic of China; 3Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 4Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingmei Zheng; Liming Wang, Department of Gynecology, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Huangdao District, Qingdao, Shandong, 266000, People’s Republic of China, Tel +86-18661806725 ; +86-18661807912, Email zhengqingmei0532@126.com; wlmqingyi@163.comAbstract: Leiomyoma with bizarre nuclei (LBN), also known as symplastic leiomyoma, is a histological subtype of benign leiomyoma with bizarre cells and nuclear atypia. Differentiating LBN from other benign leiomyoma subtypes, uterine smooth muscle tumors of uncertain malignant potential (STUMP), or leiomyosarcoma (LMS) can be diagnostically challenging owing to overlapping features in clinical presentation and pathologic morphological analysis. The difficulty of distinguishing LBN from other lesions, especially from LMS, and the potential of LBN for subsequent malignant transformation make LBN an important topic of research. Herein, we review the definition, diagnosis, treatment, and prognosis of LBN. Histopathological examination is essential for distinguishing LBN from other diseases. Pathology sampling and morphological examination remain the key to diagnosis. The newly established ancillary immunohistochemical (IHC) and molecular genetic analysis can be useful tools for differential diagnosis. Furthermore, serum biomarkers and imaging examination may also be useful diagnostic tools. Attention should be paid to the differentiation between LBN and LMS because morphological diagnosis may still be challenging in some cases. Some IHC markers of LBN have been identified, which may be helpful for differential diagnosis. Furthermore, the use of IHC panels as diagnostic markers may be advocated. Molecular genetic studies suggest that some genes can aid with the differential diagnosis between LBN and LMS. However, increasing evidence support the idea that LBN and LMS are molecularly related, indicating that LBN may represent a potentially malignant stage of precancerous progression. At present, conservative treatment is recommended for primary LBN, especially for patients desiring to retain fertility, but close follow-up with imaging examinations is required.Keywords: diagnosis, histopathology, molecular genetics, imaging examination, treatment, prognosis

At present, metabolic-associated fatty liver disease （MAFLD） has become the most common liver disease worldwide. MAFLD can not only progress into liver cirrhosis and hepatocellular carcinoma, but also be closely related to the incidence and development of metabolic diseases including obesity, type 2 diabetes mellitus, and cardiovascular diseases. Currently, no highly-effective drugs have been approved for clinical treatment of MAFLD. In recent years, the potential role of brown adipose tissue （BAT） in MAFLD has attracted increasing attention. However, the association between BAT and MAFLD and the mechanism of BAT in the treatment of MAFLD remain to be elucidated. In this article,recent research progress upon the role of BAT in the progression and treatment of MAFLD was reviewed, and advances in relevant imaging examination were analyzed, aiming to further unravel the association between BAT and MAFLD and explore the feasibility of BAT as a new therapeutic target for MAFLD.

Objective To discuss and summarize the preventive measures and treatment methods for aspiration/ingestion during dental procedures. Methods One case of aspiration during an implant operation was reported, and the literature on aspiration/ingestion during oral procedures was reviewed. Results An implant screwdriver accidentally slipped into the mouth of the patient during implant surgery. The patient experienced no obvious discomfort except a few coughs. The surgeon and assistant paused the procedure immediately to search for the screwdriver, but it was not found. The patient declared that there was no special abnormality, such as breathing disorder or chest distress, so we considered that the foreign body was ingestion. After the implant surgery was completed, no foreign body was found in the stomach via gastroscopy. Chest X-ray and CT showed a dense metal shadow in the lower lobe of the left lung. Under local anesthesia, bronchoscopy and biopsy forceps were used by respiratory physicians to clip out the foreign body. After removal of the foreign body, the patient had no obvious discomfort but a slight cough. Cephalexin and metronidazole were given for three days to prevent infection. Three days later, the patient had no complaints of respiratory discomfort. After reviewing the literature, we found that the operation should be paused immediately after aspiration/ingestion occurs during dental procedures and that the dental chair should be laid down to prevent the foreign body from descending deeper, which may increase the difficulty of removal and cause gastrointestinal and respiratory tract injury. The position of the foreign body should be determined by imaging examination, and the corresponding means to remove the foreign body should be performed. Conclusion Patients may have no obvious symptoms after aspiration/ingestion during dental procedures, and the foreign body can be removed after imaging examination.

Abstract Background Mesenchymal-epithelial transition exon14 (METex14) skipping is one of the therapeutic driver oncogene mutations in non-small cell lung cancer (NSCLC), and can be treated with tepotinib and capmatinib. There is only one report on computed tomography (CT) findings of METex14 skipping-positive NSCLC, which shows that the primary tumor tends to have a large mass in the upper lobe, and extrathoracic metastases are common. This study examined the CT findings of METex14 skipping-positive NSCLC, focusing on the features of the margins and internal structures. Methods We consecutively included patients with METex14 skipping-positive NSCLC who were diagnosed between January 2018 and December 2020 at four independent institutions. We retrospectively reviewed the patient demographics and CT findings for tumor margins (invasion into surrounding tissue, lobulation, pleural indentation, spicula, and ground-glass opacity) and internal structures (air bronchograms, cavitation and internal low-density area). Results Fifteen patients with METex14 skipping-positive NSCLC were identified. Almost half of the patients were men (7/15; 46.7%), and their median age was 75.0 years. More than half were either current or former smokers (9/15; 60.0%). A vast majority of histological subtypes were adenocarcinoma (10/15; 66.7%), followed by pleomorphic carcinoma (3/15; 20.0%) and squamous cell carcinoma (2/15; 13.3%). With regard to CT findings, most primary tumors presented as masses larger than 30 mm (12/15; 80.0%) and were located in the upper lobes (12/15; 80.0%). Invasion into surrounding tissue and presence of internal low-density areas were observed in 60.0% (9/15) and 66.7% (10/15) of the primary tumors, respectively. Additionally, their frequencies increased to 72.7% (8/11) and 90.9% (10/11) in stage III/IV cases, respectively. In lymph node metastasis, internal low-density areas were observed in 8/10 cases (80.0%). Although these two CT features were rarely observed in distant metastases at diagnosis, they became apparent with progression of the metastatic tumor size. Conclusions METex14 skipping-positive NSCLC tumors tend to invade surrounding tissue and possess internal low-density areas. These CT findings might be characteristic of METex14 skipping-positive NSCLC.

Pelvic organ prolapse is rarely associated with severe bilateral ureteral hydronephrosis and renal dysfunction. The etiopathogenetic mechanism has not been fully elucidated. Contemporary imaging methods of the urinary tract play a decisive role in assessing the morphological function of the kidneys. In cases of moderate and severe pelvic organ prolapse, surgery appears to be the main choice of treatment. Our case concerns a postmenopausal patient with three vaginal deliveries in her obstetric history and with a history of bilateral hydronephrosis and impaired renal function who was referred to the outpatient clinic for a gynecological examination due to complete uterine prolapse. Bilateral hydroureteronephrosis due to prolapse was assessed as the main cause of renal dysfunction. A surgical intervention was decided to the pelvic floor and a vaginal hysterectomy was performed with simultaneous correction of the cystocele and rectocele. The postoperative course was uneventful. Three months later, reexamination of the urinary tract showed complete remediation of kidney morphology and function. The present case report emphasizes the significant degree of bilateral hydroureteronephrosis and deterioration of renal function rarely seen in patients with complete uterine prolapse. At the same time, it is pointed out that the exclusion of renal dysfunction related to complete uterine prolapse should be the main concern of the modern gynecologist even for complex cases with coexisting etiological factors for renal disease, in order to avoid permanent renal parenchymal damage and ensure the best health and quality of life of these patients. [ABSTRACT FROM AUTHOR]

Infantile malignant osteopetrosis （IMO） is mainly manifested with the increased bone density, smaller bone marrow cavity and severe extramedullary hematopoiesis. At present, hematopoietic cell transplantation represents the only curative treatment for IMO. In this article, we reported a 3-month-old male infant with IMO. He was admitted due to abnormal hemograms for 10 d at 9 d after incarcerated right oblique inguinal hernia surgery. Clinical manifestations mainly included inspiratory dyspnea, hepatosplenomegaly and decreased levels of hemoglobin and platelets. Thoracic and pelvic X-ray examination and CT scan of head and neck revealed increased bone density. High-resolution clinical exome sequencing detected homozygous mutation of c. 1480delC （p.Q494Sfs*34） in the T-cell immune regulator 1（TCIRG1） gene, which has not been reported yet. Sequencing data showed that this mutation was inherited from his parents （heterozygous status in his parents, his parents were cousins）.

Objective: This study explored the clinical features and immune responses of children with primary ciliary dyskinesia (PCD) during pneumonia episodes. Methods: The 61 children with PCD who were admitted to hospital because of pneumonia were retrospectively enrolled into this study between April 2017 and August 2022. A total of 61 children with pneumonia but without chronic diseases were enrolled as the control group. The clinical characteristics, levels of inflammatory indicators, pathogens, and imaging features of the lungs were compared between the two groups. Results: The PCD group had higher levels of lymphocytes (42.80% versus 36.00%, p = 0.029) and eosinophils (2.40% versus 1.25%, p = 0.020), but lower neutrophil counts (3.99 versus 5.75 × 109/L, p = 0.011), percentages of neutrophils (46.39% versus 54.24%, p = 0.014), CRP (0.40 versus 4.20 mg/L, p < 0.001) and fibrinogen (257.50 versus 338.00 mg/dL, p = 0.010) levels. Children with PCD and children without chronic diseases were both most commonly infected with Mycoplasma pneumoniae (24.6% versus 51.9%). Children with PCD had significantly more common imaging features, including mucous plugging (p = 0.042), emphysema (p = 0.007), bronchiectasis (p < 0.001), mosaic attenuation (p = 0.012), interstitial inflammation (p = 0.015), and sinusitis (p < 0.001). Conclusion: PCD is linked to immune system impairment, which significantly contributes to our understanding of the pathophysiology of this entity.

Pelvic organ prolapse is rarely associated with severe bilateral ureteral hydronephrosis and renal dysfunction. The etiopathogenetic mechanism has not been fully elucidated. Contemporary imaging methods of the urinary tract play a decisive role in assessing the morphological function of the kidneys. In cases of moderate and severe pelvic organ prolapse, surgery appears to be the main choice of treatment. Our case concerns a post-menopausal patient with three vaginal deliveries in her obstetric history and with a history of bilateral hydronephrosis and impaired renal function who was referred to the outpatient clinic for a gynecological examination due to complete uterine prolapse. Bilateral hydroureteronephrosis due to prolapse was assessed as the main cause of renal dysfunction. A surgical intervention was decided to the pelvic floor and a vaginal hysterectomy was performed with simultaneous correction of the cystocele and rectocele. The postoperative course was uneventful. Three months later, re-examination of the urinary tract showed complete remediation of kidney morphology and function. The present case report emphasizes the significant degree of bilateral hydroureteronephrosis and deterioration of renal function rarely seen in patients with complete uterine prolapse. At the same time, it is pointed out that the exclusion of renal dysfunction related to complete uterine prolapse should be the main concern of the modern gynecologist even for complex cases with coexisting etiological factors for renal disease, in order to avoid permanent renal parenchymal damage and ensure the best health and quality of life of these patients. [ABSTRACT FROM AUTHOR]

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of malignant pulmonary tumor. The incidence rate of LCNEC was reported to be 0.3%–3% in lung cancers. Although LCNEC is classified as non-small cell lung cancer (NSCLC), it is more aggressive and malignant than other NSCLC, and its biological behavior is similar to that of small cell lung cancer (SCLC). Most of the LCNEC patients are elderly smoking male and the clinical manifestations are not specific. The imaging manifestations of the tumors are often located in the periphery and the upper lobes, and the enlargement of mediastinal or hilar lymph nodes is common. The diagnosis is mainly based on pathology by the histological features and immunohistochemistry (IHC). Specific neuroendocrine markers such as chromogranin A (CgA), synaptophysin (Syn) and CD56 are usually diffusely positive in LCNEC, and found that insulinoma-associated protein (INSM1) and high rate of Ki-67 are helpful for diagnosis. More differential diagnoses also increase the difficulty of correctly diagnosing LCNEC. The rise of LCNEC molecular typing in recent years may be helpful for diagnosis and subsequent treatment. This review focuses on the epidemiological features, imaging studies, pathology, diagnosis, treatment, and prognosis of LCNEC.

Objective: Axillary lymph node management is an important part of breast cancer surgery and the accuracy of preoperative imaging evaluation can provide adequate information to guide operation. Different molecular subtypes of breast cancer have distinct imaging characteristics. This article was aimed to evaluate the predictive ability of imaging methods in accessing the status of axillary lymph node in different molecular subtypes. Methods: A total of 2,340 patients diagnosed with primary invasive breast cancer after breast surgery from 2013 to 2018 in Jiangsu Breast Disease Center, the First Affiliated Hospital with Nanjing Medical University were included in the study. We collected lymph node assessment results from mammography, ultrasounds, and MRIs, performed receiver operating characteristic (ROC) analysis, and calculated the sensitivity and specificity of each test. The C-statistic among different imaging models were compared in different molecular subtypes to access the predictive abilities of these imaging models in evaluating the lymph node metastasis. Results: In Her-2 + patients, the C-statistic of ultrasound was better than that of MRI (0.6883 vs. 0.5935, p=0.0003). The combination of ultrasound and MRI did not raise the predictability compared to ultrasound alone (p=0.492). In ER/PR+HER2-patients, the Cstatistic of ultrasound was similar with that of MRI (0.7489 vs. 0.7650, p=0.5619). Ultrasound+MRI raised the prediction accuracy compared to ultrasound alone (p=0.0001). In ER/PR-HER2-patients, the C-statistics of ultrasound was similar with MRI (0.7432 vs. 0.7194, p=0.5579). Combining ultrasound and MRI showed no improvement in the prediction accuracy compared to ultrasound alone (p=0.0532). Conclusion: From a clinical perspective, for Her-2+ patients, ultrasound was the most recommended examination to assess the status of axillary lymph node metastasis. For ER/PR+HER2- patients, we suggested that the lymph node should be evaluated by ultrasound plus MRI. For ER/PR-Her2- patients, ultrasound or MRI were both optional examinations in lymph node assessment. Furthermore, more new technologies should be explored, especially for Her2+ patients, to further raise the prediction accuracy of lymph node assessment. [ABSTRACT FROM AUTHOR]

Background: Mesenchymal-epithelial transition exon14 (METex14) skipping is one of the therapeutic driver oncogene mutations in non-small cell lung cancer (NSCLC), and can be treated with tepotinib and capmatinib. There is only one report on computed tomography (CT) findings of METex14 skipping-positive NSCLC, which shows that the primary tumor tends to have a large mass in the upper lobe, and extrathoracic metastases are common. This study examined the CT findings of METex14 skipping-positive NSCLC, focusing on the features of the margins and internal structures.Methods: We consecutively included patients with METex14 skipping-positive NSCLC who were diagnosed between January 2018 and December 2020 at four independent institutions. We retrospectively reviewed the patient demographics and CT findings for tumor margins (invasion into surrounding tissue, lobulation, pleural indentation, spicula, and ground-glass opacity) and internal structures (air bronchograms, cavitation and internal low-density area).Results: Fifteen patients with METex14 skipping-positive NSCLC were identified. Almost half of the patients were men (7/15; 46.7%), and their median age was 75.0 years. More than half were either current or former smokers (9/15; 60.0%). A vast majority of histological subtypes were adenocarcinoma (10/15; 66.7%), followed by pleomorphic carcinoma (3/15; 20.0%) and squamous cell carcinoma (2/15; 13.3%). With regard to CT findings, most primary tumors presented as masses larger than 30 mm (12/15; 80.0%) and were located in the upper lobes (12/15; 80.0%). Invasion into surrounding tissue and presence of internal low-density areas were observed in 60.0% (9/15) and 66.7% (10/15) of the primary tumors, respectively. Additionally, their frequencies increased to 72.7% (8/11) and 90.9% (10/11) in stage III/IV cases, respectively. In lymph node metastasis, internal low-density areas were observed in 8/10 cases (80.0%). Although these two CT features were rarely observed in distant metastases at diagnosis, they became apparent with progression of the metastatic tumor size.Conclusions: METex14 skipping-positive NSCLC tumors tend to invade surrounding tissue and possess internal low-density areas. These CT findings might be characteristic of METex14 skipping-positive NSCLC. [ABSTRACT FROM AUTHOR]

Chromophobe renal cell carcinoma (CHRCC) is a rare subtype of renal cancer, accompanied by subcapsular renal hematoma (SRH) without a history of traumatic or hemorrhagic disease, which is clinically rare. The reason for CHRCC with SRH may be caused by tumor rupture or vascular rupture. In the early stage, it is often asymptomatic and can be easily overlooked and misdiagnosed, leading to delayed treatment and serious consequences. A 39-year-old female patient was admitted to the emergency department due to sudden dull pain and discomfort in the lower back. Subsequent ultrasound, CT, and MRI imaging examinations revealed the presence of chromophobe renal cell carcinoma with a volume of 4.5 × 3.5 × 3 cm in the middle and lower pole of the right kidney. In addition, a subcapsular hematoma with an area of approximately 6 × 11 cm was also found. The patient underwent laparoscopic radical nephrectomy. Due to its atypical syptmoms and signs, it is often overlooked or misdiagnosed. CHRCC has unique histological features, which distinguish it from other subtypes of renal cell carcinoma. Imaging studies such as CT scan and MRI are helpful in diagnosing and identifying associated complications. In this case, the presence of the perirenal hematoma is a notable finding, which may be caused by tumor-induced vascular disruption. This report underscores the importance of recognizing and managing complications associated with CHRCC. Early diagnosis and appropriate surgical treatment are crucial for favorable outcomes in these cases. • Cases of CHRCC accompanied by acute hemorrhage are uncommon, it is extremely easy to be misdiagnosed. • At the outset, the symptoms can be atypical and easily misdiagnosed, leading to serious consequences. • CHRCC is a type of kidney cancer that is rare and exhibits distinct radiographic and histopathological features. • It was surgically managed to excise the tumor and control the hematoma, resulting in a successful outcome. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the effectiveness of the case management mode on the application of smear-positive pulmonary tuberculosis patients. Methodology: This was a randomized control trial. A total of 70 newly diagnosed smear-positive pulmonary tuberculosis patients were recruited and been randomly divided into experimental group and control group, with 35 participants in each group. In the experimental group, patients received the tuberculosis case management mode based on the conventional management mode. In the control group, patients received the routine management mode. We compared the knowledge, attitude, and practice score; sputum-negative conversion rate, effective imaging rate of the two groups at the time of initial admission, discharge, and one month after discharge. Results: The results showed that there was no significant difference in baseline data between the two groups (p > 0.05); at the time of discharge and one month after discharge, the knowledge, belief, behavior, sputum-negative conversion rate, and imaging examination effective rate of the experimental group were higher than those of the control group (p < 0.05). Conclusions: The case management mode can improve the knowledge, attitude, and practice level; sputum-negative conversion rate; and imaging efficiency of newly treated smear-positive pulmonary tuberculosis patients. [ABSTRACT FROM AUTHOR]

Abstract Background In this study, we aimed to investigate the preoperative serum carcinoembryonic antigen (CEA) in the diagnosis of positive lymph node metastasis (LNM), and to evaluated the relationship between CEA and survival in patients with locally advanced gastric cancer (LAGC). Methods The significance of the preoperative serum CEA level for the diagnose of LAGC and prediction of LNM was determined using the receiver operating characteristic (ROC) curve. The areas under the ROC of CEA were compared with those of other tumor markers or imaging examination including CT and MRI. Logistic regression was utilized to identify the risk factors predicting positive LNM. Independent prognosis factors were evaluated using univariate and multivariate COX regression analyses. Results The ROC curves showed that the AUCs of CEA, CA199, and CA125 for diagnosing LAGC were 0.727, 0.594, and 0.566. When used to predict LNM, the AUC of CEA, CA199 and CA125 were 0.696, 0.531, and 0.588. Logistic regression analysis demonstrated that preoperative serum CEA were significantly associated with positive LNM. On combining imaging examination with CEA, the sensitivity and specificity were 85.3 and 79.4%, respectively, with the AUC equal to 0.853. The combination of CEA and imaging examination preformed the highest levels of AUC and sensitivity for diagnosing LNM, which is significantly higher than using either of them alone. Although patients with abnormal CEA have a poor prognosis, two models of multivariate analysis showed that CEA was not the independent prognosis factor for survival. Conclusions CEA can be used to diagnose gastric cancer and determine whether it has LNM. Moreover, combined with CEA could improve the diagnostic sensitivity of imaging examination for lymph node involvement.

Neurofibromatosis type 1 is a rare genetic disorder, which is a benign nerve tumor resulting from aberrant growth of the cells of nerve sheath. NF1 patients were associated with multisystem involvement, characterized by neurofibroma, of which 50% were associated with plexus neurofibroma. Characteristically benign plexiform neurofibromas can cause pain, disfigurement, compression and functional changes. Although plexiform neurofibroma is common in the head and neck, the orbital plexiform neurofibroma is rare and easily confused with other orbital tumors. There is no consensus with regard to the treatment strategy of plexiform neurofibromas, current treatment has remained largely surgical, but comes with a high recurrence rate after partial removal. We describe a case of a 4-year-old patient with orbital plexiform neurofibroma who has a 3-year history of ptosis in the right eye. At the begining, we misdiagnosed it as hemangioma. After surgical resection, it was confirmed as plexiform neurofibroma by histopathological examination. One year after surgery, the tumor recurred, so surgical resection was performed again, and the ptosis was corrected. After that, the patients were followed up and examined annually, and no recurrence was found so far. This case shows that an infant or a child present with unilateral eye swelling and ptosis of the upper eyelid should be evaluated for orbital neurofibroma.

Heart rate is a relatively simple and non-invasive method that is used as an important physiological indicator in many studies and has a close relationship with heart structure and function, cardiovascular disease and sudden cardiac death. In general, appropriately low heart rate during resting means effective heart function and cardiovascular fitness; heart rate at recovery is an important indicator of health and disease condition. We found a beagle dog (Dog_1) with a high heart rate in the previous preliminary experiment. Therefore, purpose of this study was to compare the heart rate response of the Dog_1 with the control group during 12 weeks of interval exercise, to evaluate the structural and functional abnormalities of the heart and to verify the applicability of exercise program. Heart rate was checked during 12 weeks of interval exercise, and after the exercise was over, imaging examination and hematological and serum biochemistry were performed. As a result, Dog_1 (165.6 ± 1.5) showed significantly higher heart rate in low intensity session of interval exercise than control group (133.3 ± 0.5, p < 0.01). In addition, Dog_1 (181.2 ± 1.4) showed significantly higher heart rate than control group (155.1 ± 0.9) in high intensity session (p < 0.01). The heart rate (30 sec, 60 sec) during recovery state was higher in Dog_1 (30 sec: 156.8 ± 4.0, 60 sec: 166.8 ± 5.8) than in the control group (30 sec: 111.2 ± 2.5, 60 sec: 104.0 ± 5.1, p < 0.01). The results of the imaging examination of Dog_1 with high heart rate confirmed that the heart had no functional and structural abnormalities. All beagles with the interval exercise program did not show maladjustment, and in the hematological and serum biochemistry results, all the parameter were within the reference range. If the interval exercise program of this study is used in the future, it is expected to be used as an important basic data to achieve the purpose of health, welfare, and physical fitness improvement of dogs.

Abstract Background The majority of ruptured intracranial aneurysms are combined with subarachnoid hemorrhage, but patients with only intracerebral hematoma without any subarachnoid hemorrhage are extremely rare. Case presentation The patient was hospitalized due to sudden dizziness combined with slurred speech. The patient showed considerable decreased physical activity without any nuchal rigidity. Head CT showed hematoma in the left temporal lobe, and the shape of hematoma was extremely irregular. MRI indicated the absence of any vascular malformations. The patient was diagnosed with middle cerebral artery bifurcation aneurysm in the left by head CTA. Intracranial aneurysm clip and removal of hematoma in the left temporal lobe were performed under general anesthesia. The patient did not show any significant neurological dysfunction after the surgery and was followed up for 4 months after discharge with GOS score of 5 points. Conclusions Intracranial hematoma with irregular morphology around the lateral fissure of the brain should be considered critical in order to avoid misdiagnosis and any possibility of missed diagnosis of vascular lesions, so as to ensure an exact therapeutic strategy with good prognosis for the patients.

Background: In this study, we aimed to investigate the preoperative serum carcinoembryonic antigen (CEA) in the diagnosis of positive lymph node metastasis (LNM), and to evaluated the relationship between CEA and survival in patients with locally advanced gastric cancer (LAGC).Methods: The significance of the preoperative serum CEA level for the diagnose of LAGC and prediction of LNM was determined using the receiver operating characteristic (ROC) curve. The areas under the ROC of CEA were compared with those of other tumor markers or imaging examination including CT and MRI. Logistic regression was utilized to identify the risk factors predicting positive LNM. Independent prognosis factors were evaluated using univariate and multivariate COX regression analyses.Results: The ROC curves showed that the AUCs of CEA, CA199, and CA125 for diagnosing LAGC were 0.727, 0.594, and 0.566. When used to predict LNM, the AUC of CEA, CA199 and CA125 were 0.696, 0.531, and 0.588. Logistic regression analysis demonstrated that preoperative serum CEA were significantly associated with positive LNM. On combining imaging examination with CEA, the sensitivity and specificity were 85.3 and 79.4%, respectively, with the AUC equal to 0.853. The combination of CEA and imaging examination preformed the highest levels of AUC and sensitivity for diagnosing LNM, which is significantly higher than using either of them alone. Although patients with abnormal CEA have a poor prognosis, two models of multivariate analysis showed that CEA was not the independent prognosis factor for survival.Conclusions: CEA can be used to diagnose gastric cancer and determine whether it has LNM. Moreover, combined with CEA could improve the diagnostic sensitivity of imaging examination for lymph node involvement. [ABSTRACT FROM AUTHOR]

Ankle sprains are more common in sports injuries. They are sports injuries that are second only to knee injuries in sports. Especially in various intense sports, the incidence rate is 80% of joint injuries. In the field of modern medicine, ankle sprains belong to the category of soft tissue injuries. TCM believes that ankle joint injuries belong to the category of tendon injuries, and the syndrome is "qi stagnation and blood stasis". Suddenly, after suffering a flashback, both Qi and blood were injured, and the blood stagnated outside the veins, which gradually became the evidence of blood stasis and qi stagnation. In the practice of traditional Chinese medicine in the treatment of ankle sprains, due to the weight-bearing characteristics of the ankle joint, patients usually perform walking activities without fully recovering. The condition does not heal and develops into an old ankle sprain. Traditional Chinese medicine has accumulated rich experience in the treatment of ankle joints, and foreign countries often apply exercise therapy to joint muscle rehabilitation. The purpose of this article is to study the treatment of ankle injury in sports training with microscope. In terms of methods, patients were treated with calcaneal bone traction and temporary external fixation of the ankle joint through emergency treatment. It is proposed that the detection of proprioceptors causes tissues containing mechanoreceptors to be damaged, which can lead to a decrease in proprioceptive sensation and the formation of joint proprioceptive loss. Microscopic imaging examination was performed on the patients, and the condition and degree of ankle tear, the type of injury and the internal surrounding tissues were clearly and clearly understood. Through observation, formulate the corresponding treatment plan. Inferior tibiofibular fixation screw treatment is performed on the patient, and there may be some preoperative preparation and postoperative preparation. In the experimental aspect, data were obtained from a case in a hospital. And screen to get the data needed for this article. [ABSTRACT FROM AUTHOR]

Choroidal melanoma(CM)has the largest number in uveal malignant tumors and is the common intraocular malignant tumor among adults. Its morbidity takes the second place in intraocular malignant tumors in China, following retinoblastoma. This study reviewed pathological feature, pathogenesis, imaging examination and progress on therapeutic research of choroidal melanoma in recent years.

Objective: The occurrence of Brucella-induced abdominal aortic aneurysms is an exceedingly rare phenomenon, yet it stands as one of the most severe complications within this context. The combined utilization of serological testing and imaging diagnostics has been validated as an effective approach for the identification of Brucella-induced abdominal aortic aneurysms. Presently, the predominant therapeutic strategies encompass antibiotic treatment and surgical intervention. Nonetheless, ongoing controversies persist concerning the establishment of diagnostic criteria, the optimal timing and selection of antibiotic regimens, and the nuanced decision between open surgical procedures and endovascular interventions. Through a meticulous analysis of cases originating from our institution as well as a comprehensive review of previously documented instances, we aim to engage in a detailed discourse on the salient diagnostic and therapeutic facets surrounding Brucella-induced abdominal aortic aneurysms., Methods: We conducted a retrospective summary of three cases involving Brucella-induced abdominal aortic aneurysms treated within our institution. Furthermore, we performed a comprehensive PubMed search, without imposing restrictions on language or publication year, to identify pertinent literature pertaining to Brucella-induced abdominal aortic aneurysms. The selection criteria primarily focused on case reports delineating occurrences of abdominal aortic aneurysms attributed to Brucella infection., Results: We present three distinct cases of Brucella-induced abdominal aortic aneurysms managed at our institution, providing comprehensive insights into the employed diagnostic and therapeutic approaches. Additionally, over the past five decades, a total of 24 cases in 23 publications of Brucella-induced abdominal aortic aneurysms have been reported on PubMed. The earliest report dates back to 1976., Conclusion: Our analysis suggests that Brucella-induced abdominal aortic aneurysm is characterized by a remarkably low incidence but is associated with a substantial risk of life-threatening complications. The integration of serological and imaging assessments assumes pivotal importance in facilitating prompt diagnosis of this condition. The prompt initiation of targeted antibiotic therapy is recommended, and the selection of appropriate surgical strategies should be guided by considerations including aneurysm dimensions and morphological attributes. The timely identification and intervention carry utmost significance in retarding disease advancement and ameliorating unfavorable clinical outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ma, Yang, Liu, Sun, Li and Guo.)

Age-related macular degeneration(AMD)is the main cause of blindness in the people older than 50 years old. In recent years, following the improvement of imaging techniques in ophthalmology, the pathogenesis of the disease, the level of diagnosis and efficacy evaluation ability greatly improved. In this paper, we reviewed and discussed the recent advancement on imaging research of age-relate d macular degeneration.

Background: The multidisciplinary team (MDT) has been carried out in many large hospitals now. However, given the costs of time and money and with little strong evidence of MDT effectiveness being reported, critiques of MDTs persist., Aim: To evaluate the effects of MDTs on patients with synchronous colorectal liver metastases and share our opinion on management of synchronous colorectal liver metastases., Methods: In this study we collected clinical data of patients with synchronous colorectal liver metastases from February 2014 to February 2017 in the Chinese People's Liberation Army General Hospital and subsequently divided them into an MDT+ group and an MDT- group. In total, 93 patients in MDT+ group and 169 patients in MDT- group were included totally., Results: Statistical increases in the rate of chest computed tomography examination ( P = 0.001), abdomen magnetic resonance imaging examination ( P = 0.000), and preoperative image staging ( P = 0.0000) were observed in patients in MDT+ group. Additionally, the proportion of patients receiving chemotherapy ( P = 0.019) and curative resection ( P = 0.042) was also higher in MDT+ group. Multivariable analysis showed that the population of patients assessed by MDT meetings had higher 1-year [hazard ratio (HR) = 0.608, 95% confidence interval (CI): 0.398-0.931, P = 0.022] and 5-year (HR = 0.694, 95%CI: 0.515-0.937, P = 0.017) overall survival., Conclusion: These results proved that MDT management did bring patients with synchronous colorectal liver metastases more opportunities for comprehensive examination and treatment, resulting in better outcomes., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of malignant pulmonary tumor. The incidence rate of LCNEC was reported to be 0.3%-3% in lung cancers. Although LCNEC is classified as non-small cell lung cancer (NSCLC), it is more aggressive and malignant than other NSCLC, and its biological behavior is similar to that of small cell lung cancer (SCLC). Most of the LCNEC patients are elderly smoking male and the clinical manifestations are not specific. The imaging manifestations of the tumors are often located in the periphery and the upper lobes, and the enlargement of mediastinal or hilar lymph nodes is common. The diagnosis is mainly based on pathology by the histological features and immunohistochemistry (IHC). Specific neuroendocrine markers such as chromogranin A (CgA), synaptophysin (Syn) and CD56 are usually diffusely positive in LCNEC, and found that insulinoma-associated protein (INSM1) and high rate of Ki-67 are helpful for diagnosis. More differential diagnoses also increase the difficulty of correctly diagnosing LCNEC. The rise of LCNEC molecular typing in recent years may be helpful for diagnosis and subsequent treatment. This review focuses on the epidemiological features, imaging studies, pathology, diagnosis, treatment, and prognosis of LCNEC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yang, Fan and Lu.)

Objective: Axillary lymph node management is an important part of breast cancer surgery and the accuracy of preoperative imaging evaluation can provide adequate information to guide operation. Different molecular subtypes of breast cancer have distinct imaging characteristics. This article was aimed to evaluate the predictive ability of imaging methods in accessing the status of axillary lymph node in different molecular subtypes., Methods: A total of 2,340 patients diagnosed with primary invasive breast cancer after breast surgery from 2013 to 2018 in Jiangsu Breast Disease Center, the First Affiliated Hospital with Nanjing Medical University were included in the study. We collected lymph node assessment results from mammography, ultrasounds, and MRIs, performed receiver operating characteristic (ROC) analysis, and calculated the sensitivity and specificity of each test. The C-statistic among different imaging models were compared in different molecular subtypes to access the predictive abilities of these imaging models in evaluating the lymph node metastasis., Results: In Her-2 + patients, the C-statistic of ultrasound was better than that of MRI (0.6883 vs. 0.5935, p=0.0003). The combination of ultrasound and MRI did not raise the predictability compared to ultrasound alone (p=0.492). In ER/PR+HER2- patients, the C-statistic of ultrasound was similar with that of MRI (0.7489 vs. 0.7650, p=0.5619). Ultrasound+MRI raised the prediction accuracy compared to ultrasound alone (p=0.0001). In ER/PR-HER2- patients, the C-statistics of ultrasound was similar with MRI (0.7432 vs. 0.7194, p=0.5579). Combining ultrasound and MRI showed no improvement in the prediction accuracy compared to ultrasound alone (p=0.0532)., Conclusion: From a clinical perspective, for Her-2+ patients, ultrasound was the most recommended examination to assess the status of axillary lymph node metastasis. For ER/PR+HER2- patients, we suggested that the lymph node should be evaluated by ultrasound plus MRI. For ER/PR-Her2- patients, ultrasound or MRI were both optional examinations in lymph node assessment. Furthermore, more new technologies should be explored, especially for Her2+ patients, to further raise the prediction accuracy of lymph node assessment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zheng, Huang, Peng, Xia, Cui, Han, Wang and Xie.)

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Authors. A diagnostic discordance in the original pathology reports has been noticed and requires further evaluation, therefore the paper will be retracted., (Copyright © 2022. Published by Elsevier Ltd.)