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Objective To investigate the safety and efficacy of microwave ablation guided with laparoscopy and transvaginal ultrasound in the treatment of adenomyosis.Methods Seventy patients with 89 lesions of adenomyosis were treated with laparoscopy and transvaginal ultrasound guided microwave ablation.Intraoperative and postoperative complications were observed.The differences in dysmenorrhea score,menstrual flow and dysmenorrhea time before and after treatment were compared.Ultrasound examinations were performed 1,3 and 6 months after treatment to measure the volumes of uterus and adenomyosis lesions.Results Outflow liquid from vagina 1-3 days after treatment was found in 1 patient,and mild vaginal bleeding was found in 3 patients.No serious complication occurred in the other 66 patients.Compared with preoperation,the dysmenorrhea score,menstrual flow and dysmenorrhea time decreased in all patients after treatment (all P＜0.01).The volumes of uterus and adenomyosis lesions 1,3 and 6 months after treatment were significantly less than those before treatment (all P＜0.01).Conclusion Laparoscopy and transvaginal ultrasound guided microwave ablation is a safe and efficient therapy for adenomyosis.
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Purpose To explore the short-term clinical efficacy and application value of transvaginal sonography-guided laparoscopic percutaneous microwave coagulation therapy in the treatment of uterine adenomyoma.Materials and Methods Forty patients with uterine adenomyoma who visited the Central Hospital of Wuhan from October 2015 to October 2016 were selected in this study.These patients were invalid in traditional treatment for severe dysmenorrheal,but still unwilling to excise uterus.Microwave needles were placed into uterine adenomyoma to conduct percutaneous microwave coagulation therapy under the whole-process monitoring and guidance of laparoscope and transvaginal ultrasonography.Results All of 64 nidi in the 40 patients were ablated successfully,and none had damage to peripheral vital organs or vessels.Intraoperative hemorrhagic volume was extremely small.Postoperative menstrual blood volume and dysmenorrheal severity were improved notably,but none had obvious recurrence until now.The uterine volumes at postoperative one,three and six months as well as one year were (135.0±73.2) cm3,(108.2 ± 62.9) cm3,(91.4 ± 58.4) cm3,and (84.8 ± 50.0) cm3,respectively,all were evidently smaller than the (207.2± 97.4) cm3 before operation (P＜0.01).The n idus sizes at postoperative one,three and six months as well as one year were (42.3±34.2) cm3,(30.6±27.4) cm3,(24.7±23.0) cm3 and (23.0± 19.4) cm3,respectively,all were evidently smaller than the (67.9±48.2) cm3 before operation (P＜0.01).There were also significant differences in laboratory examinations of CA125 and CA199 before and after operation (P＜0.01).Conclusion Percutaneous microwave coagulation therapy as a non-invasive technique that can both maintain patients' uteruses and resolve their pain,is more safe and real-time under the monitoring of laparoscope,thus being promising as a new routine for the treatment of uterine adenomyoma.
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Objective To explore the role of remote ischemic preconditioning(RIPC)in prevention of contrast -induced nephropathy(CIN)in elderly patients undergoing coronary artery angiography(CAA).Methods 106 elderly patients were enrolled in this randomized control trial.According to random number table,the patients were randomized into control group (n =53)and RIPC group(n =53).All of the patients received 1 000mL of 0.9% sodium chloride injection before CAA.The RIPC group patients underwent RIPC in their right arms with sphygmomanometer cuff infla-tion for 5 minutes prior to the CAA,three cycles were repeated.Serum creatinine was detected before and 48 hours after CAA.Results CIN was reported in 10 cases in the control group and 3 cases in the RIPC group(χ2 =4.30, P =0.04).The levels of serum creatinine were increased[(96.38 ±9.50)μmol/L vs (88.87 ±10.24)μmol/L] after CAA in the control group(t =2.28,P =0.03),and there was no difference in the RIPC group(t =1.17,P =0.24).Conclusion RIPC has a protective effect on CIN in elderly patients in our study.Since this method is harm-less and cost effective,further studies is required to popularize PIPC to our clinical practice for prevention of CIN.
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<p><b>OBJECTIVE</b>To investigate the optimal treatment and prognostic factors of esthesioneuroblastoma (ENB).</p><p><b>METHOD</b>Forty-nine cases of ENB, received therapies in Chinese people liberation army general hospital from October 2004 to June 2013, were reviewed retrospectively. The therapeutical strategies and prognostic factors were analyzed using the Kaplan-Meier method. Efficacy of different therapeutical strategies was compared.</p><p><b>RESULT</b>The 5-year overall survival (OS) in the group was 63.8%. The 5-year OS of Kadish stage A, B, C were 90.0%, 77.1%, 32.6%, respectively, with significant difference (χ(2) = 7.379, P = 0.03). The 5-year OS of the patients treated by surgery and radiotherapy, chemoradiotherapy, surgery with chemoradiotherapy were 68.6%, 0, 92.3%, respectively, with significant difference (χ(2) = 8.140, P = 0.02). The 5-year OS of the patients with transnasal endoscopic resection (or combined with transcranial resection) and lateral rhinotomy ( or combined with transcranial resection) were 63.7%, 50.0%, respectively, which had no significant difference (χ(2) = 3.818, P = 0.05).</p><p><b>CONCLUSIONS</b>ENB has a relatively good prognosis in head and neck malignancies, the prognosis is associated with clinical stages and treatment approaches. Transnasal endoscopic surgery based multimodality is the preferable choice.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Combined Modality Therapy , Esthesioneuroblastoma, Olfactory , Diagnosis , Therapeutics , Nasal Cavity , Nose Neoplasms , Diagnosis , Therapeutics , Prognosis , Retrospective StudiesABSTRACT
Objective To evaluate the diagnostic value of ultrasonography on thyroid microcarcinoma ,and to find out its sono-graphic characteristics .Methods Ultrasound performance of 206 thyroid microcarcinoma nodules in 150 patients confirmed by sur-gery and pathology were retrospectively analyzed ,nodules internal echo ,boundary ,the shape ,the blood flow and internal calcifica-tion and calcification size ,distribution and type were observed and compared with 82 benign nodules(diameter ≤1 cm) .Results In terms of solid low echo ,minicalcification ,aspect ratio≥1 ,rich blood flow and neck lymph node enlargement ,thyroid microcarcinoma were significantly higher than that of thyroid benign nodules (P<0 .05) .Ultrasonographic performance of thyroid microcarcinoma often presented as solid low echo ,irregular form ,aspect ratio ≥1 ,internal mostly small calcification ,edge blur and the surrounding small burrs .Color doppler blood flow showed that ,blood supply was rich in patients with strong nodules ,distribution was irregular , smaller nodules blood flow was not rich .Conclusion The two-dimensional and color doppler flow imaging(cdfi) might be has a im-portand value on thyroid microcarcinoma diagnosis .
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Objective To investigate the significance of sonographic patterns of thyroid calcification in diagnosis of thyroid nodule.Methods 235 patients with 355 thyroid nodules were retrospectively analyzed.Nodule calcification size,distribution and pattern were observed.Results The incidence of calcification in benign and malignant nodules was 30.3％ (89/294)and 73.7％ (45/61) respectively.The difference had statistical significance(x2 =24.3,P ＜0.01).The rate of microcalcification in cancer was 47.5％ (29/61),higher than that in benign one 3.1％ (9/294)(x2 =99.1,P ＜ 0.01).Coarse calcification in benign nodules and malignant lesion was 27.2％ (80/294)and 26.2％ (16/61)respectively.The difference had no statistical significance(x2 =0.42,P ＞0.05).Conclusions Microcalcification of thyroid nodules is a specific index for thyroid carcinoma.Any type of sonographically detected calcification represents risk of malignancy.Not only microcalcification,these cases should raise the suspicion of malignancy in coarse calcification,especially involving a solitary nodule and irregular shape.
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ObjectiveTo compare the performance of color Doppler utrasonography (CDUS) alone,magnetic resonance imagine (MRI) alone, and the combination of the two in the diagnosis of thyroid carcinona (TC). MethodsCDUS and MRI results of 54 focuses of carcinoma in 45 cases diagnosed as TC by postoperative pathological results were reviewed. The sensitivity of CDUS, MRI, and the combination of the two in the diagnosis of TC was compared. ResultsThe sensitivity of CDUS and MRI was 77.78％ (42/54)and 81.48％(44/54) respectively. The difference had no statistical significance (P ＞ 0.05 ). The specificity of CDUS and MRI was 88.17％ and 92.47％ respectively, the positive predictive value was 79.25％ and 86.27％ respectively,and the negative predictive value was 87.23％ and 89.58％ respectively. The sensitivity of the combination of CDUS and MRI was 94.44％ (51/54). The difference between the combination and CDUS or MRI alone had statistical significance( P ＜0.05). ConclusionsCDUS has higher detection rate than MRI in microcalcification of TC focus. However, MRI can show more clearly of the peripheral invasion and cervical lymph node metastasis.The combination of the two can improve the accuracy of TC diagnosis.
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Objective To explore the value of color Doppler ultrasonography(CDU)as preoperative diagnosing and postoperative monitoring in patients with stenosis of subclavian or innominate artery(SIA)before and after percutaneous transluminal angioplasty and stent(PTAS).Methods A total of 45 patients with stenosis of SIA were selected.Their extracranial vertebral artery and subclavian artery were observed with CDU.In 36 patients with one-sided stenosis of SIA.blood flow direction and spectrum of extracranial vertebraI artery were analyzed.Subclavian steal grade confirmed by spectrum change of vertebral artery was compared with the stenosis grade on quantitative angiography(QA).Among 45 patients with stenosis of SIA,PTAS was performed successfully in 36 patients(36 stents implanted).After stents implanted, hemodynamie parameters such as peak systolic velocity(PSV)in stent, follow-up velocity ratio in stem(VR)were measured.Restenosis in stent were observed.Results In 36 patients with one-sided stenosis of SIA,the ultrasonographic steal grade correlated with the QA stenosis grade significantly(r=0.752,P<0.01).Among 36 patients with stent implanted,follow up 8-12 months, 4 patients with restenosis in stent were found.Compared with the patients without restenosis in stent,PSV and VR in stent increased significantly(P<0.01).Conclusions As a fast and non-invasive imaging technique,CDU could allow diagnosis of stenosis of SIA before PTAS,and detection of restenosis after PTAS.