The clinical application value of core needle biopsy guided by fully digital mammography threeGdimensional positioning system in the diagnosis of breast lesions / 实用放射学杂志

Objective To explore the clinical application value of core needle biopsy guided by fully digital mammography three-dimensional positioning system in the diagnosis of breast lesions.Methods A retrospective analysis of 21 patients who underwent guided core needle biopsy in a fully digital mammography system was performed.2 1 patients had 2 1 lesions,which included mass (4 cases),suspected calcification (15 cases)and glandular collection (2 cases)based on X-ray examination before biopsy.The needle depth was manually calculated according to the mammogram (0°and 90°),and automatically calculated with the full digital mammography three-dimensional positioning system. The needle depth was adjusted according to the combination of above two values with the patient’s skin elasticity and gland structure. After putting a small incision into the needle with local anesthesia,X-ray radiography was taken to observe the position of the puncture needle, and then the puncture gun was excited to take out the tissue at different positions of the lesion.Finally,X-ray radiography of the tissue was performed.Results 21 patients underwent biopsy with the average operation time of 45 minutes and puncture time of 25 minutes.The needle depth adjustment range was 3－5 mm,using 14G puncture needle and 4－8 pieces of tissue were pierced according to the lesions. X-ray radiographywas performed on the removed tissue strips. For all the cases of suspected calcification,the calcified lesions were found in the removed tissue strips.No serious adverse reactions occurred in 21 patients with lateral position (1 9 cases)and sitting position (2 cases).2 patients with sitting position developed dizziness, nausea,and palpitation,and recovered quickly after rest and psychological comfort.Puncture pathology confirmed 6 cases of breast cancer (1 case of intraductal papillary carcinoma,2 cases of ductal carcinoma in situ,3 cases of invasive breast cancer),and 1 5 cases of benign lesions,with no obvious changes after one year follow-up.Conclusion In the core needle biopsy guided by the fully digital mammography three-dimensional positioning system for breast lesions,the patient should be placed in the lateral position, which can effectively reduce the occurrence of adverse reactions.A 14G puncture needle and ≥4 tissue strips can achieve a higher pos-itive rate.The technology is simple and easy to perform with a high puncture accuracy,and has important application value.

Application of full-field digital mammography three-dimensional positioning system for localization of nonpalpable breast lesions / 实用放射学杂志

Objective To evaluate the clinical value of full-field digital mammography three-dimensional (3D) positioning system for localization and excision of nonpalpable breast lesions.Methods 106 patients with nonpalpable breast lesions and underwent preoperative localization were analyzed retrospectively.They underwent wire-localization operation guided by mammography 3D positioning system (GE Senogrphe DS).The depth of wire insertion was calculated manually and automatically.Combined with the manual measurement, systematic measurement, skin elasticity and breast parenchyma structure, the positioning wire was placed.Then, the clinical resection was performed according to the wire localization.Results The localization accuracy of mammography 3D positioning system was 100%.11 patients appearedsyncope.With the rest, psychological comfort and fluid infusion, patients recovered quickly.Conclusion Full-field digital mammography 3D positioning system can improve the accuracy of clinical resection of nonpalpable breast lesion.

Predictive factors for bone metastases of prostate cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation between a diverse of clinical factors and bone metastases of prostate cancer.</p><p><b>METHODS</b>The clinical data of 80 patients with prostate cancer were collected and analyzed. The correlations of age, alkaline phosphotase (ALP), prostate specific antigen (PSA), erythrocyte sedimentation rate (ESR), Gleason score, and expressions of androgen receptor (AR) and Ki-67 with bone metastases were analyzed by one-way ANOVA and Logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated.</p><p><b>RESULTS</b>Forty-five of the 80 patients (56%) were found to have bone metastasis, who had significantly older age and higher levels of ALP, PSA, ESR, Gleason score, and expressions of AR and Ki-67 than those without bone metastasis (P<0.05). Logistic regression analysis identified PSA, Gleason score and AR expression as independent factors correlated with bone metastasis with OR (95% CI) of 1.005 (1.001, 1.009) (P=0.008), 5.356 (1.431, 20.039) (P=0.013), and 18.594 (2.460, 140.524) (P=0.005), respectively. The cutoff values of PSA, Gleason Score and AR were 67.1 ng/ml, 7.5, and 2.5, respectively; their sensitivities were 55.6%, 75.6%, and 84.0% for predicting bone metastasis with specificities of 97.1%, 82.9%, and 91.4%, respectively.</p><p><b>CONCLUSION</b>Of the factors analyzed, PSA, Gleason score and AR expression, but not age, ALP, PSA, ESR, or Ki-67 expression, are the predictive factors of bone metastasis of prostate cancer.</p>

Risk factors for anastomotic leakage after anterior resection for rectal cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the risk factors associated with anastomotic leakage following an anterior resection for rectal cancer.</p><p><b>METHODS</b>Between June, 1999 and June, 2009, 628 patients underwent anterior resection for rectal cancer. A retrospective study of the cases was performed to identify the risk factors for anastomotic leakage following the resection.</p><p><b>RESULTS</b>The overall incidence rate of anatomic leak was 8.6% (54/628) in these patients. A low albumin level (less than 35 g/L), diabetes, absence of a protective stoma, a distance less than 7 cm from the tumor to the anal edge, and a tumor diameter over 5 cm were identified as the risk factors for anastomotic leakage after anterior resection.</p><p><b>CONCLUSION</b>For patients at a high risk for anastomotic leakage, a protective stoma can significantly decrease the rate of clinical leaks and subsequent reoperation after low anterior resection for rectal cancer.</p>

Therapeutic effect of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on type 2 diabetes mellitus in non-obese patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of Roux-en-Y anastomosis following subtotal gastrectomy on type 2 diabetes mellitus (T2DM) in non-obese patients.</p><p><b>METHODS</b>We performed a retrospective analysis of 16 non-obese patients with T2DM undergoing Roux-en-Y anastomosis following subtotal gastrectomy for stomach cancer and upper gastrointestinal tract ulcer.</p><p><b>RESULTS</b>All the patients were followed up for 6 months after the surgery. Roux-en-Y gastrojejunostomy significantly lowered the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c)(P<0.05). Of these patients, 8 (50%) achieved adequate glycemic control without antidiabetic medication and 5 (31.25%) showed obvious improvement. The total effectiveness rate of the surgery was 81.25%.</p><p><b>CONCLUSION</b>Roux-en-Y gastrectomy can effectively ameliorate the diabetic symptoms and might serve as a new treatment option for T2DM in non-obese patients.</p>

Comparison of treatment response in primary hepatocellular carcinomas with contrast-enhanced ultrasonography and contrast-enhanced helical CT / 中南大学学报(医学版)

OBJECTIVE@#To investigate the value of contrast-enhanced ultra sonography for non-surgical treatment response in hepatocellular carcinomas.@*METHODS@#Non-surgical therapies were performed on 56 patients (64 liver neoplasms) who were diagnosed by ultrasonography-guided biopsy before the therapy. Contrast-enhanced ultrasonography(CEUS) and contrast-enhanced helical CT were performed to assess the treatment response.@*RESULTS@#Forty-six of the 64 lesions were not enhanced with CEUS.Partial enhancement was demonstrated in the other 18 lesions. Forty-eight of the 64 lesions were not enhanced with contrast-enhanced helical CT. Partial enhancement were demonstrated in the other 16 lesions.The sensitivity, specificity, and accuracy were 94.4%, 97.8%, and 96.9% for CEUS and 83.3%, 97.8%, and 93.8% for contrast-enhanced helical CT (P>0.05).@*CONCLUSION@#CEUS is a good method in assessing the non-surgical treatment response in hepatocellular carcinomas and is more sensitive and useful than contrast-enhanced helical CT in assessing the treatment response of transcatheter hepatic arterial chemoembolization.

Laser inducing mucosal fibrosis for preventing recurrence of esophageal varices / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the prevention of esophageal varices recurrence by laser inducing esophageal mucosal fibrosis.</p><p><b>METHODS</b>Our study included 42 patients after esophageal varices eradicated by endoscopic varices ligation, and they were divided into 2 groups randomly, each group included 21 patients. One group was assigned to received laser treatment, and indocyanine green solution (1 mg/ml) was injected submucosally, a diode laser (power 10 watts) was applied to the surface from the esophagogastric junction to 5 cm above it. Another group was controlling without any treatments. All patient were followed up by endoscopy every 3 months until 12 months.</p><p><b>RESULTS</b>Laser irradiation was performed safely without any major complications. And lower esophageal mucosa produced fibrosis widely after laser irradiated 1 month. After 12 months follow up, the cumulative recurrence rate was significantly lower than the control group, 14% (3/21) vs 43% (9/21) (chi(2) = 4.20, P < 0.05).</p><p><b>CONCLUSIONS</b>Our study indicates that laser inducing mucous fibrosis is safely and can prevent recurrence of esophageal varices.</p>