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Objective:To compare the efficacy and safety of CT and ultrasound-guided percutaneous biopsy of lung or pleural lesions.Methods:The clinical data of 193 patients with lung space occupying lesions near the pleura who underwent CT or ultrasound-guided percutaneous puncture in Shiyan People's Hospital Affiliated to Hubei University of Medicine from February 2017 to October 2020 were analyzed retrospectively. According to the puncture mode, the patients were divided into CT-guided group ( n=115) and ultrasound-guided group ( n=78) . The general clinical data, pathological examination results, puncture success rate and complication rate were compared between the two groups. Logistic regression was used for univariate and multivariate regression analysis. Results:The detection rate of malignant tumors in the CT-guided group (60.00%, 69/115) was higher than that in the ultrasound-guided group (50.00%, 39/78) , with no statistically significant difference ( χ2=1.89, P=0.170) . The puncture success rate in the CT-guided group (88.70%, 102/115) was slightly lower than that in the ultrasound-guided group (93.59%, 73/78) , with no statistically significant difference ( χ2=1.32, P=0.251) . The incidence of postoperative complications in the CT-guided group (18.26%, 21/115) was higher than that in the ultrasound-guided group (6.41%, 5/78) , with a statistically significant difference ( χ2=5.60, P=0.018) . The incidence of pneumothorax in the CT-guided group (13.04%, 15/115) was higher than that in the ultrasound-guided group (3.85%, 3/78) , with a statistically significant difference ( χ2=4.65, P=0.031) . The incidence rate of bleeding in the CT-guided group (5.22%, 6/115) was higher than that in the ultrasound-guided group (2.56%, 2/78) , with no statistically significant difference ( χ2=0.82, P=0.364) . In the CT-guided group, 1 patient (0.87%) had severe bleeding requiring surgical treatment, 5 patients (4.35%) required closed thoracic drainage for treatment. In the ultrasound-guided group, no patients had pneumothorax or bleeding requiring drainage or surgery. Univariate analysis showed that the puncture method was an independent risk factor for the puncture success rate in patients with lesion-pleura contact arc length (LPCAL) ≥38 mm ( OR=7.82, 95% CI: 1.57-35.50, P=0.039) . Multivariate analysis showed that puncture method is an independent risk factor affecting the puncture success rate in patients with LPCAL≥38 mm ( OR=7.75, 95% CI: 1.44-41.36, P=0.042) . Among patients with LPCAL≥38 mm, the puncture success rates of CT- and ultrasound-guided puncture were 84.38% (54/64) and 98.00% (49/50) , respectively, and the puncture success rate of CT-guided puncture was lower than that of ultrasound-guided puncture, with a statistically significant difference ( χ2=4.52, P=0.034) . In LPCAL<38 mm patients, the puncture success rates of CT- and ultrasound-guided puncture were 94.12% (48/51) and 85.71% (24/28) , respectively, and the CT-guided puncture success rate was higher than that of the ultrasound-guided puncture, with a statistically significant difference ( χ2=0.71, P=0.399) . Conclusion:Ultrasound-guided percutaneous puncture biopsy of lung or pleural lesions has the advantages of high diagnostic rate and few complications. Both ultrasound-guided and CT-guided puncture biopsy are feasible methods for puncture of chest wall lesions. When LPCAL≥38 mm, ultrasound-guided puncture biopsy may have more advantages.
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Objective To investigate the acute side effect of 3D printing individual non-coplanar template for 125I seed implantation in head and neck recurrent/ metastatic carcinoma.Methods Between January 2016 and December 2016,42 patients of local recurrent malignant tumor of head and neck received 3D printing guide plate assist radioactive seeds implantations,and included in the study.The tumor volume ranged from 2.4 to 102.8 cm3 (median 28.6 cm3).The prescribed dose is 110-160 Gy,and the seeds activity were 0.34 to 0.70 mCi (1 Ci =3.7 × 1010 Bq).All patients carried out preoperative planning design,individual guide plate production,seed implantation,postoperative dose assessment,and followup.The side effects of skin,mucous membrane,blood and spinal cord were statistically analyzed.Results All patients were operated successfully.The follow-up time was 4-14 months (median 8.5 months).There were no adverse reactions at grade three or above.Three patients had grade one skin reaction.One patient experienced grade one mucosal reaction,two experienced grade two mucosal reactions.The skin response was correlated with the dose of the skin (x2 =7.067,P =0.032).No hematologic toxicity or radiation myelopathy was observed and no seed displacement was found.Conclusions 3D-printing guide plate can provide good accuracy for positioning and direction.For local recurrent malignant tumor of head and neck,there were no obvious adverse reactions and the operation was simple and the dosage was accurate.
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OBJECTIVE:To investigate the clinical efficacy and safety of Cinobufacin capsules combined with radiotherapy in the treatment of median and advanced nasopharyngeal carcinoma. METHODS:Ninety-five patients with median and advanced naso-pharyngeal carcinoma in cancer center of our hospital during 2011-2012 were analyzed retrospectively,and then divided into con-trol group (57 cases) and observation group (38 cases) according to therapy plan. Control group received radiotherapy alone, while observation group was additionally given Cinobufacin capsule 0.5 g,tid,till the end of radiotherapy. A treatment course last-ed for 4 weeks. The prolonged radiotherapy were compared between 2 groups. Clinical response rate was observed in 2 group,and 1-year and 3-year survival rate and the occurrence of ADR were followed up. RESULTS:The proportion of prolonged radiotherapy was 89.47% in control group,which was significantly higher than 52.63% of observation group,with statistical significance(P0.05). CONCLUSIONS:Cinobu-facin capsule combined with radiotherapy can significantly relieve the side effects of radiotherapy in median and advanced nasopha-ryngeal carcinoma patients.
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Objective To explore the effects of family empowerment model on medication adherence in youth patient with cerebral infarction.Methods By convenience sampling,a questionnaire survey was conducted among 84 patients and families of neurology department in a third-grade and a-level general hospital in Zhengzhou.The patients and families were randomly divided into the control group and the intervention group,each group consisted of 42 patients and families.Patients and families in the control group got routine health education,but patients and families in the intervention group were intervened under family empowerment.The medication adherence of the patients were compared between the two groups before and after health education.Results The medication adherence in both groups were higher after health education than that before health education,the diffidence in the comparison of medication adherence was statistically significant between the two groups after health education.Conclusions The family empowerment model can improve the medication adherence in youth patient with cerebral infarction.
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Objective To evaluate the short- and long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating metastatic nasopharyngeal carcinoma to the cervical lymph nodes. Methods A total of 154 cases of stage N2-N3 nasopharyngeal carcinoma (1992 stage system) were randomized into two groups: group A (76 cases, treated with microwave hyperthermia combined with chemoradiotherapy) and group B (78 ca-ses, treated with chemoradiotherapy alone). Both groups received 1 to 2 cycles of chemotherappy with cisplatin and 5-fluorouracil and then received regular radiotherapy. The total doses of radiotherapy were 70-78 Gy/35-39 f, 47-51 d for the primary loci of nasopharynx and 68-72 Gy/34-36 f,46-50 d for the metastatic loci in the neck. Group A received microwave hyperthermia on the metastatic cervical node at the beginning of radiotherapy, with the micro-wave hyperthermia administered for 45 min every time,two times a week, totaling 8 to 14 times. Results The complete extinction rates of neck metastatic carcinoma were 80.3% and 61.5% , respectively, in groups A and B (P<0.05). The overall response rates of neck metastasis in the two groups were 100% and 96.2% , respective-ly. When the cervical lymph node metastasis disappeared, the radiotherapy doses in group A and B were (45.8 ± 5.46 ) Gy and (58.8±5.03 ) Gy, respectively (P<0.01). The 5-year local control rates of cervical lymph node in group A and B were 97.4% and 76.9%(P<0.05 ), respectively. The one-, three- and five- year survival rates were 97.4% , 76.3% and 59.2% respectively, in group A, versus 93.6% (P>0.05) ; and 52.6% (P< 0.01) and 41.0% (P<0.05), respectively, in group B. Conclusions Microwave hyperthermia combined with chemoradiotherapy can elevate the complete extinction rate of cervical lymph node metastasis of nasopharyngeal carcinoma and reduce the radiotherapy dose needed of effective control. The 5-year local control rate of cervical lymph node metastasis in combined therapy group is superior to that in the chemoradiotherapy alone group,and can elevate the long-term survival rate of patients.
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Objective To evaluate long-term efficacy of microwave hyperthermia combined with chemoradiotherapy for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis. Methods A total of 154 patients with stage N2 or N3 NPC ('92 staging system) were randomized into two groups:microwave hyperthermia combined with chemoradiotherapy (Group A, 76 cases) and chemoradiotherapy alone (Group B, 78 cases). Both of the two groups received 1 -2 cycles of chemotherapy of cisplatin and 5-fluorouracil, followed by conventional radiotherapy of 70 - 78 Gy in 35 - 39 fraction to the nasopharynx and 68 -72 Gy in 34 - 36 fractions to the neck. Group A received microwave hyperthermia to the metastatic cervical nodes at the beginning of radiotherapy. The hyperthermia was given as 45 min every time, twice a week for 8 - 14 times totally. Results The 5-year complete response rates of cervical lymph nodes in group A and B were 97% and 77% (x2 = 14. 24,P<0. 01). The distant metastasis rates in the two groups were 37% and 44% (x2 = 0. 73, P > 0. 05). The disease-free survival rates were 51% and 21% (x2 = 15.91, P <0. 01). The 5-year overall survival rates were 59% and 41%, respectively (x2 = 5.09, P < 0. 05).Conclusions For patients with stage N2 or N3 NPC, microwave hyperthermia combined with chemoradiotherapy can improve the complete response, disease-free survival and overall survival.