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Objective:To investigate the safety and efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the complex lymphatic malformations (LM) in children.Methods:The clinical data of 21 children with complex LM treated with ultrasound-guided sclerotherapy combined with radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from June 2018 to October 2021 were retrospectively analyzed.Intraoperative and postoperative complications were recorded.Imaging examinations were performed at 1, 3, 6, 9, 12, 18, 24 months postoperatively to observe the recurrence, the volume of the lesions and their reduction rate were calculated, and the efficacy was analyzed. Friedman test was used to compare the lesion volume at different time points before and after surgery, and the reduction rate of lesion volume at 1 month postoperatively and other time points after surgery. Results:A total of 21 children were included in this study, among them, there were 12 males and 9 females, age range from 1 month to 5 years and 6 months, with a median age of 23 months.A total of 26 LM in 21 children were successfully treated, and no serious complications like organ damage occurred during and after surgery.One patient with abdominal LM had a postoperative infection, which was controlled by 3 weeks of catheter drainage.Four LM in 3 children recurred at 3 or 6 months after surgery, while all lesions were significantly narrowed down than those before surgery and they were cured after 1-3 sessions of continued sclerotherapy.There were significant differences in the lesion volumes before surgery and 1, 3, 6, 9, 12, 18 and 24 months postoperatively [222.26(159.57, 316.40) cm 3vs.43.06(22.74, 62.53) cm 3, 31.56(15.49, 45.94) cm 3, 25.21(9.63, 36.22) cm 3, 19.80(6.79, 28.81) cm 3, 12.80(3.93, 20.38) cm 3, 7.13(0, 11.34) cm 3, and 2.79(0, 4.93) cm 3; all P<0.05]. There were significant differences between the volume reduction rates at 1 month postoperatively and 3, 6, 9, 12, 18, and 24 months postoperatively [79.36(73.30, 87.81)% vs.85.40(81.09, 91.61)%, 88.85(84.70, 93.61)%, 91.67(87.87, 95.05)%, 94.15(94.47, 97.35)%, 97.11(95.02, 100.00)%, and 99.04(97.93, 100.00)%; all P<0.05]. Patients were followed up for 24 months, and all of them were cured. Conclusions:Ultrasound-guided sclerotherapy combined with radiofrequency ablation is a minimally invasive, safe and effective therapeutic strategy for children with complex LM.
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Objective:To explore the relationship between family supportive supervisor behavior and compassion fatigue of operating room nurses and the mediating role of bidirectional work-family conflict, that is, work interference with family and family interference with work.Methods:In November 2021, a total of 350 operating room nurses in Qilu Hospital of Shandong University, the Second Hospital of Shandong University, and the First Affiliated Hospital of Shandong First Medical University were surveyed by convenience sampling method with questionnaires of self-made general information questionnaire, Work-Family Conflict Scale, Family Supportive Supervisor Behavior Short-Form, and Professional Quality of Life Scale.Results:Family supportive supervisor behavior was negatively correlated with work interference with family and compassion fatigue ( r= -0.211, -0.245, both P<0.01). Work interference with family was positively correlated with compassion fatigue and family interference with work ( r=0.383, 0.274, both P<0.01). Family interference with work was positively correlated with compassion fatigue ( r=0.249, P<0.01). There was no correlation between family supportive supervisor behavior and family interference with work ( r=0.040, P>0.05). The structural equation model showed that bidirectional work-family conflict had multiple chain mediating effects between family supportive supervisor behavior and compassion fatigue ( P<0.05), and the mediating effects were -0.082, accounting for 21.6% of the total effect. Conclusions:Family supportive supervisor behavior can directly or indirectly affect compassion fatigue through work-family conflict. Managers can adopt supportive human resource management policies by implementing family supportive supervisor behavior, to help operating room nurses flexibly balance work-family relationships and reduce role conflict, so as to alleviate the compassion fatigue of operating room nurses.
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Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous microwave ablation combined with hormone suppression therapy for solitary papillary thyroid microcarcinoma.Methods A total of 25 patients with 25 nodules pathologically proven solitary papillary carcinoma 3.7 to 10.0 mm in diameter without clinically apparent lymph node,or distant metastasis were treated with microwave ablation equipement.Microwaves were emitted at 40 W for 200 -400 seconds and prolonged as necessary to attain confluent ablation zones.All patients were treated with both extended ablation therapy and levothyroxine that maintain TSH levels below 0.1 mU/L.Thyroid function test,nodule volume and clinical symptom were evaluated before ablation and during 1 ,3,6,9 and 12 months after treatment according to changes in tumor size,adverse reactions,complications and metastatic tumors.Three out of 25 patients received surgical treatment and the other 22 patients were followed up with routine ultrasound and contrast enhanced ultrasound.Results All 25 tumors were completely ablated by using mutiple plane fixed melting method and no serious or permanent complications occurred.No recurrence at the treatment site or distant metastase were detected,with a mean follow-up of 1 8 months.Histological examination showed no evidence of a tumor in the treated lesions in the 3 surgery patients.Conclusions Ultrasound-guided percutaneous microwave ablation appears to be a safe and effective technique for the therapy of solitary papillary thyroid microcarcinoma.
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Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods A total 456 patients (912 nodules) underwent microwave ablation in our department.Microwave ablation was carried out using microwave antenna under local anesthesia.Nodule volume,thyroid function and clinical symptoms were evaluated before treatment and at 1 ,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications.Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed “black hole”sign.The mean follow-up period after microwave ablation was (9±6)months (range,3-24 months).At 6-month follow-up,the mean volume reduction ratio of the solid nodules,mixed nodules and the cystic nodules was (61 ± 50 )%,(81 ± 33 )%,(89 ± 46 )%, respectively.The treatment was well tolerated and no major complications were observed except pain and transient voice changes (2.4%).Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.