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Objective: To observe the efficacy of percutaneous microwave ablation on low-risk papillary thyroid microcarcinoma (PTMC) and impact on patient's life quality. Methods: Totally 75 pathologically confirmed patients with single low risk PTMC (T1N0M0) were treated with ultrasound-guided percutaneous microwave ablation and followed up at 1, 3, 6, 12 and 24 months respectively after operation. The therapeutic effect and complications were observed, and score the physical component summary (PCS), mental component summary (MCS) and 36-item short form health survey (SF-36) scores were counted. Results: The operation was successfully completed in all 75 patients. Four patients experienced temporary hoarseness during the ablation process and recovered within 2 h, while 15 patients complained of radiation-induced ear root pain, neck pain and other symptoms which immediately relieved after ablation. Twenty-four months after operation, the effective rate of treatment was 100% (75/75), the lesion disappearance rate was 93.33% (70/75), while no local recurrence occurred. The maximum diameter and volume of lesions increased 1 and 3 months after operation but decreased 6, 12 and 24 months after operation (all P0.05). PCS scores at different time points before and after operation showed no statistical significant difference (all P>0.05). MCS scores and SF-36 scores of all time points after operation were higher than those before operation (all P<0.05). Conclusion: Percutaneous ablation is safe and effective for treating low risk PTMC, which can improve the patient's life quality.
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Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .
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We report a case of a 46 year old female patient with nasal hemangiopericytoma. She complained of left nasal congestion, pus snot for 10 years, sometimes with left nasal bleeding. Physical examination: in the left nasal tract saw red soft neoplasm, roughness surface, easy bleeding when touched. Sinus CT shows: bilateral maxillary sinus, ethmoid sinus, sphenoid sinus and the left posterior nasal cavity lesions, considering inflammation with the formation of polyps, tumor not excluded. The left nasal cavity neoplasm biopsy shows: hemangioma of left nasal cavity. After admission in general anesthesia, we do transnasal endoscopic sinus openning operation and the left nasal cavity neoplasm resection. Postoperative pathological examination shows: the left nasal cavity hemangiopericytoma. Immunohistochemical showed: Vimentin(+), Smooth muscle actin(+), Desmin(-), endothelial cells CD31(-) and CD34(-). No postoperative radiotherapy or chemotherapy, no tumor recurrence. After one year of follow-up, the contact was lost.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Endoscopy , Epistaxis , Ethmoid Sinus , Pathology , Hemangiopericytoma , Diagnosis , Pathology , Inflammation , Pathology , Nasal Cavity , Pathology , Nasal Polyps , Pathology , Neoplasm Recurrence, Local , Nose Neoplasms , Diagnosis , Pathology , Sphenoid Sinus , PathologyABSTRACT
Objective To assess the feasibility of semi-quantitative scoring system for contrast-enhanced ultrasound (CEUS)quantitative analysis's color images in the differential diagnosis of breast nodules.Methods Totally 244 BI-RADS 4 breast solid lesions received CEUS before core needle biopsy or surgical resection were included.A semi-quantitative scoring system for color images of CEUS quantitative analysis were built.The scores were given as follows:1 )Color type and its distribution (0 to 4);2)Color scope (0 to 1 );3)Color margin (0 to 1 );4)Color shape (0 to1 ).The total score for each lesion would be from 0 to 7.And the differenital value between benign and malignant lesions were assessed.Results The total semi-quantitative scores of 102 malignant tumors (5.1 ±1 .7)was significant higher than that of benign lesions (3.34±0.7)(P < 0.05 ).In 102 malignant lesions,the total scores of 81 lesions (79.41 %)were more than 4 points,and in 142 benign lesions,the total scores of 89 lesions (62.67%)were less than 4 points.Depending on the Wilcox rank sum test (Mann-Whitney)analysis,the distribution of total scores between benign and malignant lesions was significant different (P <0.000 1).Total score 4 was selected as the best cutoff,the area under ROC curve was 0.749,on which the sensitivity,specificity and accuracy were 79.4%,62.7% and 69.67%,respectively.Conclusions The semi-quantitative scoring system of CEUS quantitative analysis color images showed good sensitivity but not satisfied specificity and accuracy in differential diagnosis between malignant and benign breast lesions.
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Objective To investigate the role of health-promoting volunteers in the promotion of community health activities. Methods Fifty health volunteers were trained and went to take part in health-promoting activities together with community medical workers.Results After health-promoting activities,the rate of archive-establishment for hypertensive and diabetic patients,the rate of standardized management over the patients with archives,the rate of disease control were all significantly higher than that before the health promotion(all P<0.05).Conclusion The health-promoting volunteers are surely effective for the improvement of health knowledge and the formation of healthy behaviors.
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Clinical manifestation bipolar coagulation treatment for nosebleed. The patient was affected by nasal obstruction, fever and headache three weeks after operation. Clinical and laboratory examination nasal septum's bilateralism knuckle, soft quality, puncture with purulent secretion. Diagnose: abscess of nasal septum.