ABSTRACT
Objective:To assess rapid on-line evaluation (ROLE) of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic masses.Methods:Data of patients with solid pancreatic masses who underwent EUS-FNA in Peking University First Hospital from October 2017 to October 2019 were retrospectively analyzed. Patients were divided into the ROLE group and the control group. The number of FNA passes in ROLE group was decided by the cytopathologist based on the number of pancreatic tissue cells or heteromorphic cells obtained, while that in the control group was decided by the endoscopy physician according to the visual observation of tissue strips. The cytological and histological diagnosis of EUS-FNA specimen were made by another cytopathologist. The gold standard for final diagnosis was based on the histological diagnosis of surgically resected specimens. For patients who did not undergo surgical treatment, the final diagnosis was made based on the clinical course, imaging, tumor markers and feedback on treatment. The diagnostic yield, the accuracy, the sensitivity, the specificity, FNA passes, puncture time and adverse events were compared between the two groups.Results:A total of 87 patients were enrolled, 51 in the ROLE group and 36 in the control group. The diagnostic yield of the ROLE group was higher than that of the control group without significant difference [98.0% (50/51) VS 86.1%(31/36), P=0.078]. The number of FNA passes in the ROLE group was significantly less than that in the control group (median 2 VS 3, P<0.001). No significant difference in mean FNA puncture time was found between the ROLE group and the control group (19.4 min VS 18.5 min, P=0.089). There were no significant differences between the two groups with regard to the diagnostic yield, the sensitivity, the specificity, the positive predictive value, the negative predictive value or the incidence of adverse events. Conclusion:ROLE of EUS-FNA for pancreatic solid tumor may improve tissue acquisition for puncture, reduce the number of FNA passes, and may not significantly increase the procedure time and risk of puncture.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of need-in-row combined with herb-partition moxibustion,need-in-row and conventional acupuncture for superior gluteal nerve entrapment syndrome.</p><p><b>METHODS</b>Totally 105 patients were randomly assigned into a combination group,a need-in-row group and an acupuncture group,35 cases in each one. In the combination group and needle-in-row group,needle-in-row therapy was used at the pain tendon region of the pathological waist-hip part,and TDP was combined. Also,herb-partition moxibustion was applied at the same part after needle-in-row in the combined group. In the acupuncture group,conventional acupuncture was implemented at Weizhong(BL 40),Yanglingquan(GB 34),Zhibian(BL 54),Huantiao(GB 30),Sanyinjiao(SP 6) and Jiaji of L-L(EX-B 2),and TDP was applied. All the treatment was given once a day for four weeks. The changes of pain scores were compared after treatment.</p><p><b>RESULTS</b>The pain scores decreased obviously after treatment in all the groups(all<0.05). The scores of the combination group and the needle-in-row group declined more apparently than that of the acupuncture group(both<0.05). The score of the combination group reduced more obviously than that of the needle-in-low group(<0.05). The markedly effective rates of the combination group and the needle-in-row group were 88.6%(31/35) and 68.6%(24/35),which were higher than 40.0%(14/35) of the acupuncture group(both<0.05),and the markedly effective rate of the combination group was better than that of the needle-in-row group(<0.05).</p><p><b>CONCLUSIONS</b>Need-in-row combined with herb-partition moxibustion show definite effect for superior gluteal nerve entrapment syndrome,and it is better than those of simple needle-in-row therapy and conventional acupuncture.</p>