Adenomatoid tumor of the uterus: analysis of misdiagnosed cases and a literature review.

Adenomatoid tumors are rare, specific, benign tumors of the reproductive tract that originate from mesenchymal tissue. A patient was diagnosed with uterine fibroids 1 year previously when a mass of approximately 30 mm was found in the left adnexal region during a physical examination. At 1 year of follow-up, ultrasound showed that the mass in the left adnexal area had greatly increased to 61 × 45 × 50 mm. Contrast-enhanced pelvic magnetic resonance imaging (MRI) was performed before surgery and suggested a borderline tumor. Histopathology suggested signet ring cell carcinoma, and an immunohistochemical examination suggested a uterine adenomatoid tumor. Our suspicion of a borderline tumor was based mainly on the following features: the mass had increased in size within 1 year, the cancer antigen 125 concentration had increased, and several lymph nodes in the pelvic and groin regions showed positive signals on MRI enhancement. Uterine adenomatoid tumors are challenging to diagnose, especially adenomatosis with signet ring cells. However, the accuracy of diagnosing this disease can be greatly improved by combining ultrasound and MRI. This article describes the most comprehensive and reliable imaging features of ultrasound and MRI, which play an important role in diagnosing uterine adenomatoid tumors and provide useful information for clinicians.

Achilles tendon thickening does not affect elasticity and functional outcome after surgical repair of Achilles rupture: A retrospective study.

PURPOSE: Previous studies have confirmed that Achilles tendon occurs Achilles thickening after repair surgery of the rupture. Although this mechanism has been elucidated in the laboratory, there are few reports on its impact on clinical function. We designed a retrospective study to investigate the Achilles thickening after Achilles tendon rupture repair and its correlation between the elasticity and postoperative function. METHODS: In this retrospective analysis, patients who underwent surgical treatment for acute Achilles tendon rupture from April 2016 to April 2020 were included. All the patients were regularly followed up at 3 months, 1 year, and 2 years after surgery. American Orthopaedic Foot Ankle Surgeon (AOFAS) scale and Leppilahti score were used to evaluate functional outcomes. Achilles elasticity was measured by ultrasound shear wave of elasticity. Achilles thickening was calculated as maximal transverse and longitudinal diameter in cross-sectional plane of magnetic resonance scan. Sample t-tests was used for different follow-up periods. Correlation between Achilles thickening and other factors were analyzed using Pearson's method. p < 0.05 indicates a statistically significant difference. RESULTS: AOFAS scale and Leppilahti score at 1 year were significantly higher than at 3 months postoperatively (both p < 0.001). These functional scales were also improved at 2-year follow-up significantly (both p < 0.001). The dorsiflexion difference showed gradually recovery in each follow-up period (t = -17.907, p < 0.001). The elasticity of the Achilles appeared to continuously decreases during the postoperative follow-up period in all position sets (p < 0.001). In thickening evaluation, the cross-sectional area of the thickest plane of Achilles was significantly higher at 1 year postoperatively (310.5 ± 25.2) mm2 than that at 3 months postoperatively ((278.0 ± 26.2) mm2, t = -8.219, p < 0.001) and became thinner in 2-year magnetic resonance scan ((256.1 ± 15.1) mm2, t = 16.769, p < 0.001). The correlations between Achilles thickening, elasticity, and functional outcome did not show statistical significance (p > 0.05) in every follow-up period. CONCLUSION: Achilles tendon thickens after surgery in the 1st year, but begins to gradually return to thinning about 2 years after surgery. There was no significant correlation between the increase and decrease of thickening and the patients' clinical function scores, Achilles elasticity, and bilateral ankle dorsiflexion difference.

[Adsorption Characteristics and Long-term Effectiveness Evaluation of Iron-nitrogen Co-doped Biochar for Secondary Water-Soluble Organic Matter].

In order to economically and efficiently remove dissolved organic matter (DOM) in the secondary water of wastewater treatment plants, this study adopted iron-nitrogen co-doped biochar material (Fe-N-C) as a new adsorbent and systematically analyzed the effect of this new carbon material on the secondary water DOM, as well as the adsorption performance, kinetic process, selectivity, and mechanism of action. In addition, the long-term performance and reusability of the adsorption material were thoroughly investigated through a fixed-bed adsorption device. The results show that Fe-N-C had outstanding adsorption performance for secondary water DOM. When the dosage was only 1.0 g·L-1, the removal rates of TOC, UV254, and UV280 were as high as 40.18%, 76.92%, and 78.26%, respectively, which are far higher. Regarding the adsorption effect of pure biochar and conventional activated carbon, the adsorption process conformed to the pseudo-second-order kinetics and Freundlich adsorption isotherm model, indicating that the adsorption process is a multilayer chemical adsorption involving valence electrons and the exchange of electrons. The three-dimensional fluorescence spectroscopy, molecular weight distribution, and resin analysis results, such as classification and characterization, showed that Fe-N-C had selective adsorption for different components in the secondary water DOM. The fixed bed adsorption column with Fe-N-C as the core had the maximum removal rate of secondary water TOC, UV254, and UV280 as high as 94.09%, 95.65%, and 97.18%, respectively, and had good stability. It was close to adsorption saturation when the processing capacity reached 620 times the bed volume. However, after the regeneration heat treatment, the adsorption performance was remarkably restored. These results are expected to provide reference for the further development of high-efficiency adsorption water treatment technology.

Reliability, validity and responsiveness of the Mandarin (Simplified) Chinese version of the EORTC QLQ-OH45 among cancer patients.

PURPOSE: The goal of our study was to evaluate the reliability, validity, responsiveness and acceptability of the Mandarin (simplified) Chinese version of the EORTC QLQ-OH45. METHODS: From October 2017 to February 2018, 393 cancer patients were enrolled from three different hospitals in China. A forward and backward translation was made to develop the Mandarin (simplified) Chinese version of EORTC QLQ-OH15. The QLQ-C30 and QLQ-OH15 questionnaires (which we have assembled and named QLQ-OH45 in this paper) were self-administered. Results were statistically analysed using SPSS 21.0. The reliability and validity tests of the questionnaires were assessed by Cronbach's α coefficient, Pearson correlation test and Mann-Whitney U tests. Responsiveness to change was measured in an independent sample of patients with head and neck cancer undergoing surgery or radiotherapy or chemotherapy. RESULTS: An acceptable internal consistency reliability for most multiple-item scales was demonstrated, as Cronbach's α coefficients were greater than 0.7 for most multiple-item scales, excepting for cognitive functioning (0.36) and oral health-related QoL functioning (0.55). All domain's test-retest reliability coefficients (r) was higher than 0.8. Multi-trait scaling analysis showed good convergent and discriminant validity. A difference in the quality of life (QoL) between older (≥65 years) and younger (<65 years) groups of patients was showed by the known-group comparisons. Low correlations were found between the scales of the QLQ-OH15 and QLQ-C30 in all areas. CONCLUSION: The Mandarin (simplified) Chinese version of QLQ-OH45 demonstrates satisfactory psychometric properties and can be used to measure the oral health-related QoL (OHRQoL) for Chinese cancer patients.

Diagnosis and evaluation of gastric cancer by positron emission tomography.

Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using (18)F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area.