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Objective:To investigate the effectiveness and safety of the coaxial needle technique in percutaneous liver biopsy for patients with coagulation function abnormalities.Methods:Clinical data of 210 patients who underwent percutaneous liver biopsy using the coaxial needle technique under ultrasound guidance from December 2018 to May 2021 in 3 centers were collected. A retrospective analysis was conducted to compare the puncture success rate, number of samples obtained, pathology qualification rate, intraoperative and postoperative bleeding rates between the group with coagulation function abnormalities and the group with normal coagulation function.Results:After propensity score matching, there were 105 patients in each group, with a puncture success rate of 100% in both groups. The pathology qualification rate was 100% for all samples.Intraoperative bleeding occurred in 78 cases (74.3%, 78/105) in the coagulation function abnormalities group and in 64 cases (61.0%, 64/105) in the normal coagulation function group, with a statistically significant difference between the two groups ( P=0.006). Postoperative bleeding occurred in 3 cases (2.9%, 3/105) in the coagulation function abnormalities group and in 0 case in the normal coagulation function group, with no statistically significant difference between the two groups ( P=0.081). Conclusions:The use of the coaxial needle technique for percutaneous liver biopsy in patients with coagulation function abnormalities not only allows for obtaining an adequate tissue sample but also demonstrates good safety.
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Objective To evaluate the clinical value of artificial hydrothorax combined with one-lung ventilation to aid ablation treatment of liver carcinoma in the hepatic dome.Methods Twenty-one patients with liver carcinoma located in the hepatic dome and affected by the lung gas were enrolled.Double lumen endobronchial intubation anesthesia was used and thoracical tube was used to apply artificial pleural effusion.The lesions'ultrasound image were recorded for the patients without artificial hydrothorax,or with artificial hydrothorax only and artificial hydrothorax combined with one-lung ventilation.Ultrasound images were reviewed and scored as 1-5 according to the clarity and completeness of the lesion.Ablation efficacy and adverse reactions were recorded in the follow-up.Results Twenty-one patients were successfully applied artificial hydrothorax and one lung ventilation.The average normal saline used for artificial hydrothorax were (738± 260)ml.The ultrasound score for not using artificial hydrothorax,using artificial hydrothorax only and artificial hydrothorax combined with one lung ventilation were 1.13 ± 0.35 (1-2),3.00 ± 0.85 (2-5) and 4.53 ± 0.64(3-5),respectively,statistical difference was found between each method(P ＜0.05).Artificial hydrothorax combined with one-lung ventilation had much higher ultrasound score than the other 2 methods.No complication related to artificial hydrothorax or one-lung ventilation was found.CT/MRI at one month after ablation showed that all the lesions were completely ablated.In the follow-up for 2-14 months on average,1 case of local tumor progression and 1 case of intrahapetic relapse were found.Conclusions Artificial hydrothorax combine one-lung ventilation could effectively enhance ultrasound image for the lesions in the dome whose acoustic window was affected by lung gas.
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Objective To investigate the risk factors of hemorrhage after ultrasound-guided liver graft biopsy.Methods Clinical data of 51 liver transplant patients undergoing ultrasound-guided liver graft biopsy in the Third Affiliated Hospital,Sun Yat-sen University between February 201 3 and April 201 4 were retrospectively studied.Hemorrhage after biopsy was taken the dependent variable.Age,gender,coagulation, duration of biopsy,frequency of biopsy,number of biopsy tissues,medication of anticoagulant or not and cooperation in breathing and breath holding or not were taken as the independent variables.Multivariate non-conditional Logistic regression analysis was performed for all independent variables to screen out the risk factors associated with hemorrhage after ultrasound-guided liver graft biopsy.Results Fifty-one patients underwent 84 biopsies in total and 5 cases (6%)had hemorrhage after biopsy.The multivariate non-conditional Logistic regression analysis showed that obvious hemorrhagic tendency,medication of anticoagulant and poor cooperation in breathing were independent risk factors of hemorrhage after liver graft biopsy (OR was respectively 8.71 , 3.1 6 and 2.03,all in P <0.05).Conclusions Obvious hemorrhagic tendency,medication of anticoagulant and poor cooperation in breathing are independent risk factors of hemorrhage after ultrasound-guided liver graft biopsy.
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Objective To investigate the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in the diagnosis of bacterial pleural effusion. Methods The levels of sTREM-1 in pleural effusion were determined in 30 patients with bacterial pleural effusion, 33 patients with malignant pleural effusion,31 patients with tuberculous pleural effusion and 28 patients with transudate by quantitative ELISA assay. The levels of CRP in pleural effusion were assayed using immunonephelometry method. The diagnostic value was assessed by receiver operating characteristic ROC curve analysis. Results The levels of sTREM-1［(1255.2±248.6)ng/L］ in bacterial pleural effusion were significantly higher than those in malignant ［（125.6±22.4）ng/L］, tuberculous［（184.5±36.5）ng/L］ and transudate groups［（92.5±20.8）ng/L］ (P＜0.05). For ROC curve, when the cut off value of sTREM-1 was set at 425 ng/L, the sensitivity , specificity ,accuracy, positive predictive value and negative value was 93.3%,90.3%,91.9%,93.2% and 93.3%, respectively. Conclusions Detection of sTREM-1 in pleural effusion is helpful to differentiate pleural effusion of bacterial origin from those with other etiologies.
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f fibrosis-related factors in LX-2cells were significantly increased after co-cultured with QSG7701-HBx cells, which proved that HBx could induce fibrogenesis in vitro.