Background Ki‐67 expression has been shown to be an important risk factor associated with prognosis in patients with soft tissue sarcomas (STSs). Its assessment requires fine‐needle biopsy and its accuracy can be influenced by tumor heterogeneity. Purpose To develop and test an MRI‐based radiomics nomogram for identifying the Ki‐67 status of STSs. Study type Retrospective. Population A total of 149 patients at two independent institutions (training cohort [high Ki‐67/low ki‐67]: 102 [52/50], external validation cohort [high Ki‐67/low ki‐67]: 47 [28/19]) with STSs. Field Strength/Sequence Fat‐saturated T2‐weighted imaging (FS‐T2WI) with a fat‐suppressed fast spin/turbo spin echo sequence at 1.5 T or 3 T. Assessment After radiomics feature extraction, logistic regression (LR), random forest (RF), support vector machine (SVM), and k‐nearest neighbor (KNN) were used to construct radiomics models to distinguish between high and low Ki‐67 status. Clinical‐MRI characteristics included age, gender, location, size, margin, and MRI morphological features (size, margin, signal intensity, and peritumoral hyperintensity) were assessed. Univariate and multivariate logistic regression analysis were applied for screening significant risk factors. Radiomics nomogram was constructed by radiomics signature and risk factors. Statistical Tests Model performances (discrimination, calibration, and clinical usefulness) were validated in the validation cohort. The nomogram was assessed using the Harrell index of concordance (C‐index), calibration curve analysis. The clinical utility of the model was assessed by decision curve analysis (DCA). Results LR, RF, SVM, and KNN models represented AUCs of 0.789, 0.755, 0.726, and 0.701 in the validation cohort (P > 0.05). The nomogram had a C‐index of 0.895 (95% CI: 0.837–0.953) in the training cohort and 0.852 (95% CI: 0.796–0.957) in the validation cohort and it demonstrated good calibration and clinical utility (P = 0.972 for the training cohort and P = 0.727 for the validation cohort). Data Conclusion This MRI‐based radiomics nomogram developed showed good performance in identifying Ki‐67 expression status in STSs. Level of Evidence 3. Technical Efficacy Stage 2.

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Auriculocondylar syndrome (ARCND) is a genetic and rare craniofacial condition caused by abnormal development of the first and second pharyngeal arches during the embryonic stage and is characterized by peculiar auricular malformations (question mark ears), mandibular condyle hypoplasia, micrognathia and other less-frequent features. GNAI3, PLCB4 and EDN1 have been identified as pathogenic genes in this syndrome so far, all of which are implicated in the EDN1-EDNRA signal pathway. Therefore, ARCND is genetically classified as ARCND1, ARCND2 and ARCND3 based on the mutations in GNAI3, PLCB4 and EDN1, respectively. ARCND is inherited in an autosomal dominant or recessive mode with significant intra- and interfamilial phenotypic variation and incomplete penetrance, rendering its diagnosis difficult and therapies individualized. To raise clinicians’ awareness of the rare syndrome, we focused on the currently known pathogenesis, pathogenic genes, clinical manifestations and surgical therapies in this review.

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Background For patients with congenital defective type of earlobe cleft, repair techniques similar to those used for earlobe lacerations are not suitable due to the presence of certain tissue defects. However, traditional earlobe reconstruction techniques imply the need to form complex flaps using adjacent normal tissues, which may lead to many complications that seem to be too complicated for them. Objectives In this study, we developed a technique to repair the earlobe using residual lobular tissue based on the characteristics of congenitally defective earlobe clefts. Methods We designed a triangular random flap out of the remnant lobular tissue, rotated and embedded into the edge of the remnant earlobe to repair the earlobe. Results In the past 3 years, this technique was applied to 15 patients with congenital defect type earlobe clefts. With this technique, the new earlobe achieved the desired aesthetic results, such as smooth edges and fullness of form, without complicated and unnecessary incisions. It also solves the aesthetic problem of residual lobular tissue on the face. Conclusions Based on the characteristics of the congenitally defective type of earlobe cleft, we innovatively proposed the utilization of residual lobular tissues for earlobe repair, and the feasibility and multiple advantages of this technique have been demonstrated in practice.