Computed tomography, magnetic resonance imaging, and Fdeoxyglucose positron emission computed tomography/computed tomography findings of alveolar soft part sarcoma with calcification in the thigh: A case report

BACKGROUND Alveolar soft part sarcoma(ASPS)is an extremely rare malignant sarcoma,accounting for less than 1%of all soft-tissue sarcomas.However,limited information is available on multimodal imaging[computed tomography(CT),magnetic resonance imaging(MRI),and positron emission computed tomography/computed tomography(PET/CT)]of ASPS.CASE SUMMARY This study reports a case of a 35-year-old female patient with ASPS of the left thigh with lung metastasis.The patient presented with a 1-year history of a palpable mass in the lower extremity,which exhibited rapid growth for 3 wk.CT,MRI,and F-deoxyglucose PET/CT examinations were performed.CT showed a slightly hypodense or isodense mass with patchy calcifications.On MRI examination,the mass manifested hyperintensity on T1-weighted,T2-weighted,and diffusion-weighted images with some signal voids.PET/CT images demonstrated an intensely hypermetabolic mass in the left thigh and hypermetabolic nodules in lungs.CONCLUSION ASPS should be considered as a possible diagnosis when a slow-growing mass is detected in the soft tissue of the extremities,with hyperintensity and numerous signal voids on T1-weighted,T2-weighted,and diffusion-weighted images and intense F-deoxyglucose uptake on PET/CT.ASPS can have calcifications on CT.

Clinical significance of S100A7 protein in predicting recurrence of breast cancer in patients undergoing breast-conserving surgery with radiotherapy

Objective To investigate the relationship between the expression of S100A7 protein and prediction of recurrence and prognosis of breast cancer in patients undergoing breast-conserving surgery combined with radiotherapy.Methods 349 samples of carcinoma tissue wax blocks were selected from January 2011 to January 2014 in Qingdao Central Hospital.All the patients had undergone breast-conserving surgery.We analyzed S100A7 expression in tumor tissue by immunohistochemical staining.Using univariate and multivariate analyses,we evaluated the relationship between S100A7 and clinical results,to explore independent risk factors for local regional recurrence(LRR).Results The positive expression of S100A7 in the recurrence group(66.7%)was significantly higher than in the non-recurrence group(38.4%),P=0.025.A log-rank test showed that high S100A7 expression was significantly correlated with 5-year regional recurrence free survival rate(RFS)(94.9%vs 89.5%,P=0.0408),distant metastasis free survival rate(DFS)(95.4%vs 83.5%,P<0.001),and overall survival rate(OS)(99.0%vs 92.5%,P=0.0011).Histological grade,vessel carcinoma embolus,lymph node metastasis,S100A7 expression,and tumor size were factors that influenced RFS.Multivariate analysis of the Cox proportional hazard model showed that high S100A7 expression was an independent risk factor that affected breast cancer RFS(HR=6.864,95%CI:1.575-29.915,P=0.01).Thus,we concluded that high S100A7 expression is associated with increased risk of LRR and distant metastasis of breast cancer after breast-conserving surgery and postoperative radiotherapy.S100A7 can be used as a molecular marker to screen for patients with high recurrence risk after breast-conserving surgery.

Contralateral needling at unblocked collaterals for hemiplegia following acute ischemic stroke

Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups： 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven- tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize （LU5） in the upper limb and Jianliao （TEl4） in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and FugI-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee- dling was higher than that of conventional acupuncture （46.67% vs. 31.11%, P 〈 0.05）. The neuro- logical deficit score of contralateral needling was significantly decreased compared with conven- tional acupuncture （P 〈 0.01）. The Modified Barthel Index and FugI-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture （both P 〈 0.01）. The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.

Sorafenib in Liver Function Impaired Advanced Hepatocellular Carcinoma

Objective To explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma(HCC).Methods In this three-center open-label study from November 2011 to May 2013,we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups,one group with 95 patient to receive sorafenib(400 mg a time,twice a day) and the other group with 94 patients to receive best supportive care.The primary end points were progression-free survival and overall survival.Results The median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively(Hazard ratio in the sorafenib group,0.55;95% confidence interval,0.40-0.75;P=0.002).The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively(Hazard ratio in the sorafenib group,0.48;95% confidence interval,0.35-0.68;P<0.001).The main adverse effect of sorafenib was rash and acne of the skin(in 51.7% patients).The incidences of severe rash,diarrhea,and dry skin were 5.6%,5.6%,and 2.2% in the sorafenib group.One patient reached partial response in the sorafenib group.Conclusions Sorafenib is safe in patients with liver function impaired advanced HCC.It is effective in terms of progression-free survival and overall survival compared with best supportive care.Liver functions are the important predictive factors.

Chronic colchicine poisoning with neuromyopathy,gastric ulcers and myelosuppression in a gout patient:A case report

Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.