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Objective To explore the suicide ideation and related factors in elderly with depressive disorder.Methods A sample of 60 old patients meeting the criteria of ICD-10 for depressive disorder and 60 normal controls were assessed by the Self-rating Idea of Suicide Scale(SIOSS),Trait Coping Style Questionnaire (TCSQ),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and Pittsburgh Sleep Quality Index(PSQI).Results The score of despair factor,optimistic factor,sleep factor,conceal factor and total score of SIOSS in patients with depressive disorders (6.22±3.28,2.43± 1.47,1.87± 1.58,1.17± 1.1 1 and 10.51±4.91,respectively) were significantly higher than those of normal controls(t=5.83-14.03,P＜0.01).The scores of SIOSS in patients were significantly positively related with the scores of SAS,SDS,PSQI and N C (r=0.311-0.792,all P＜0.05),but negatively related with the scores of PC(r=-0.761,P＜0.01).Moreover,regression analysis showed that the suicide ideation was increased in accordance with serious depression,anxiety,sleep quality,higher level of education and decreased ability to positive response in elderly with depressive disorder(R 2=0.853,F=62.768,P＜0.01).Conclusion The suicide ideation in elderly with depressive disorder is more serious than that of normal people,and may be influenced by depression,anxiety,sleep quality and coping style.
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Objective To observe the value of contrast-enhanced ultrasound (CEUS) in the evaluation of efficacy of Argon-Helium cryoablation therapy for liver malignancies.Methods A total of 27 patients with 27 lesions of liver malignancies underwent ultrasound-guided Argon-Helium cryoablation therapy.CEUS was used to evaluate the local response and compared with contrast-enhanced CT (CECT).Results One month after Argon-Helium cryoablation therapy,21 lesions (77.78%) were diagnosed as complete ablation with CEUS and 22 (81.48%) with CECT.Contrast enhancement within lesions was demonstrated in 6 lesions (22.22%) with CEUS and 5 (18.52%) with CECT.As compared to CECT,the sensitivity,specificity,positive and negative predictive value,and accuracy of CEUS in diagnosing tumor residue 1 month after treatment was 80.00% (4/5),90.91% (20/22),66.67% (4/6),95.24% (20/21),and 88.89% (24/27) .respectively.Conclusion CEUS is an effective alternative for the evaluation of efficacy of Argon-Helium cryoablation in the treatment of liver malignancies.
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Objective To explore the effectiveness of minimally invasive targeted Argon-Helium cryoablation in the treatment of hepatic carcinoma. Methods Ultrasound-guided Argon-Helium targeted cryoablation using the Cryo-Hit system was performed percutaneously or through laparotomy in 27 cases of hepatic neoplasms, including 10 cases of primary hepatic carcinoma, 11 cases of recurrent hepatic carcinoma, and 6 cases of metastatic carcinoma. Results No surgical death was found. There were no complications such as hepatic rupture, hemorrhage, or bile leakage. In 12 cases that had an increased AFP levels before the treatment (36.5~1200 ?g/L), a decrease was observed (8.0~254 ?g/L) and a recovery below the normal levels was noted in 6 cases. In 3 cases that had an increased CEA levels before the treatment, the levels reduced after the treatment and went down to the normal ranges in 2 cases. A follow-up survey was carried out for 1~3 months. CT scannings or MRI examinations found a complete tumor necrosis in 59.2% (16/27) of cases and a reduction of tumor size with various degrees in 25.9% (7/27) of patients. Conclusions Ultrasound-guided targeted Argon-Helium cryoablation using the fine-probe Cryo-Hit system is a safe, effective, and simple procedure for the treatment of hepatic carcinoma, although its effectiveness still needs further verification.
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Objective To investigate the practical value of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) and percutaneous transhepatic bile duct drainage (PTBD)in the treatment of hepatobiliary diseases. Methods A total of 68 times of ultrasound-guided PTGD/PTBD were performed in 60 patients from December 2000 to December 2003, including 15 cases of acute pyogenic cholecystitis, 8 cases of acute severe cholangitis and 37 cases of malignant obstructive jaundice. Results Out of the 15 cases of acute pyogenic cholecystitis, PTGD was completed successfully in 14 cases and failed in 1 case which then required a conversion to open operation. The 37 cases of malignant obstructive jaundice had undergone 45 times of PTBD, which consisted of 42 times of successful drainage tube placement and 3 times of failure (2 cases of conversions to open operation and 1 case of quitting treatment). Out of the 37 cases, resection of bile duct carcinoma or palliative cholangiojejunostomy was conducted in 14 cases, stents were inserted into the bile ducts under radioscopy in 8 cases, and the drainage tubes were left in place permanently in 15 cases (the maximum survival time was over 2 years and the mean survival time was 9 months). Of the 8 cases of acute severe cholangitis, successful drainage was achieved in 6 cases, a conversion to open surgery was required in 1 case because of blocked drainage, and 1 patient died of the multiple organ failure (MOF). Complications included 2 cases of bile leakage, 3 cases of hemorrhage, 1 case of portal vein-bile duct fistula, and 7 cases of drainage tube dislocation or blockage. Conclusions Ultrasound-guided PTGD/PTBD is an effective alternative for bile duct drainage, with advantages of minimal invasion, simplicity and accurateness of performance, safety and fewer complications. It presents much clinical value for hepatobiliary diseases, especially acute cholecystitis.
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Objective To discuss the value of ultrasonography in the evaluation of efficacy of radiofrequency (RF) thermal ablation for hepatic carcinoma. Methods A total of 49 patients with 66 lesions of hepatic carcinoma underwent ultrasound-guided multipolar radiofrequency ablation. Ultrasound examinations were carried out on tumor sizes, echo signals, vascular flows and frequency spectrums before and after the treatment. Moreover, AFP or CEA levels before and after the procedure were observed. And the CT scanning results were regarded as the control. Results Ultrasound examinations 1 month after the ablation found that “claw-like” heterogeneous hyperechoic changes covered the whole tumors without vascular flows inside in 42 patients with 59 lesions (89 4%). Afterwards, the tumors gradually reduced or remained unchanged in size, with a homogeneous echo texture. The serum levels of AFP or CEA markedly reduced or dropped down to normal. All of these were suggestive of an excellent curative effect. In the remaining 7 patients with 7 lesions (10 6%), intratumoral echo pattern kept unchanged, with arterial flow signals inside and unremarkable decrease of AFP or CEA levels, all of which were suggestive of an unsatisfactory outcome of the first radiofrequency treatment and a requirement of an additional radiofrequency treatment. CT examinations 1 month after the ablation revealed an enhancement of lesions in 9 patients with 9 lesions, among which the CT results were in agreement with the ultrasound outcomes in 7 patients with 7 lesions. Compared with the enhanced CT scans, ultrasonography in the detection of intratumoral vascular flows had a sensitivity of 55 6% (5/9), a specificity of 96 5% (55/57) and an accuracy of 90 9% (60/66). Conclusions Ultrasonography is an effective alternative for the evaluation of efficacy of radiofrequency thermal ablation in the treatment of hepatic carcinoma.
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Objective To explore the value of percutaneous radiofrequency ablation (PRFA) with or without transcatheter hepatic artery and portal vein chemoembolization in the treatment of primary and recurrent small hepatocellular carcinoma. Methods Ultrasound-guided percutaneous radiofrequency ablation was adopted in the treatment of 11 cases of primary small hepatocellular carcinoma (≤5 cm) and 13 cases of recurrent small hepatocellular carcinoma (≤3 cm) from September 2001 to September 2004. Among them, a combined use of transcatheter hepatic artery and portal vein chemoembolization was conducted in 4 cases of primary hepatocellular carcinoma and 8 cases of recurrent hepatocellular carcinoma. Results Out of the 11 cases of primary small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis of lesion in all 6 cases in which tumors were not more than 3 cm in diameter and in 4 out of 5 cases in which tumors were between 3 cm and 5 cm in diameter, the 1-, 1.5- and 2-year cumulative survival rates being 100%, 85 71% and 68 57%, respectively. Out of the 13 cases of recurrent small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis in all 7 lesions in cases of solitary tumor and in 12 out of 15 lesions in 6 cases of multiple tumors, the 1-, 1.5- and 2-year cumulative survival rates being 88.89%, 77 78% and 64 81%, respectively. Conclusions Percutaneous radiofrequency ablation provides a new alternative for the treatment of primary and recurrent small hepatocellular carcinoma. For patients with tumor more than 3 cm in diameter or with recurrent hepatocellular carcinoma, a combined use of transcatheter hepatic artery and portal vein chemoembolization conduces to a high tumor necrosis rate, a decrease of recurrence and an elevation of survival rate.
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Objective To investigate the therapeutic value of ultrasound-guided percutaneous drainage in the treatment of pancreatic pseudocyst. Methods Twelve patients with pancreatic pseudocyst underwent ultrasound-guided percutaneous drainage from December 2000 to October 2003 in this hospital, including 1 case of simple puncture aspiration and 11 cases of drainage placement. Results A conversion to open cyst-jejunum Roux-en-Y anastomosis was required in 1 case because the cyst and the main pancreatic duct opened into each other. Pseudocysts disappeared in the remaining 11 cases. The drainage time was 7～90 days, with a mean of 28 days. No complications occurred. Follow-up in the 12 cases for 6～34 months (mean, 18 months) found 1 case of recurrence of cyst which decreased remarkably in size. Conclusions Ultrasound-guided percutaneous puncture aspiration and drainage for pancreatic pseudocyst is simple and feasible, offering advantages of minimal invasion and fewer complications. The procedure may be applied repeatedly at early stage to multiple sites.