Ultrasound-guided percutaneous ethanol injection combined with microwave ablation for treatment of thyroid benign partially cystic masses / 中国医学影像技术

Objective To observe the value of ultrasound-guided percutaneous ethanol injection(PEI)combined with microwave ablation(MWA)for treating thyroid benign partially cystic masses.Methods A total of 100 patients with single benign partially cystic mass who would undergo ultrasound-guided ablation treatment were prospectively enrolled.The patients were randomly assigned into PEI group(received PEI combined with MWA sequential ablation)or control group(received simple MWA),each n=50.Data before and after treatments were compared within groups,the therapeutic efficacy were compared between groups after treatments,and the value of sequential ablation was analyzed.Results Ultrasound-guided ablation was successfully performed for all 100 masses.During follow-up,5 cases in PEI group and 3 cases in control group were lost.The operation time of MWA,total MWA energy and patients'pain level during treatments in PEI group were all lower than those in control group(all P＜0.05).Significant difference of thyroid mass volumes were found before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The volume reduction rate(VRR)in PEI group before and 1,3,6 and 12 months after treatments were all higher than that in control group(all P＜0.05).The success rate was 95.56％(43/45)in PEI group and 89.36％(42/47)in control group 12 months after treatments,respectively,without significant difference(P=0.451).There were significant differences of neck aesthetics scores and symptom scores before and 3,6 and 12 months after treatments in both groups(all P＜0.05).The incidence of complications in PEI group was 6.67％(3/45),while in control group was 14.89％(7/47),the former was lower than the latter(P＜0.05).Conclusion Ultrasound-guided PEI combined with MWA sequential ablation had better effect for treating thyroid benign partially cystic masses than single MWA.

Ultrasound-Guided Microwave Ablation for the Treatment of Abdominal Wall Endometriosis / 中国医学影像学杂志

Purpose To investigate the safety and effectiveness of ultrasound-guided microwave ablation(MWA)in the treatment of abdominal wall endometriosis(AWE).Materials and Methods A total of 17 patients(19 lesions)with AWE who underwent MWA in Beijing Friendship Hospital from August 2014 to June 2023 were retrospectively analyzed.Grey-scale and color Doppler flow ultrasonography,and contrast-enhanced ultrasonography were used to observe the lesions before and after treatment.The AWE lesion volume,volume reduction rate,pain relief,and complications were recorded 3,6,and 12 months after treatment to evaluate the treatment efficacy.Results Contrast-enhanced ultrasound showed that all lesions underwent successful treatment with single MWA.The average initial nodule volume was(7.46±5.82)ml,which decreased significantly to(4.32±2.76)ml,(2.47±1.68)ml,(1.72±1.16)ml at 3,6 and 12 months follow-up(t=0.423,P=0.005;t=0.198,P=0.001;t=0.556,P=0.002)with a mean volume reduction rate of(46.18±24.36)%,(61.43±18.72)%,(74.25±13.26)%,respectively.Notably,all 17 patients experienced a significant decrease or complete alleviation of periodic abdominal incision pain at 12-month after treatment.One patient experienced local skin burns after the procedure,while the remaining patients did not experience severe complications.Conclusion MWA is safe and effective for treating AWE,and further research is warranted.

Study on use of β-blocker and resting heart rate control among patients with coronary disease in community medical institutions / 中华全科医师杂志

A cross-sectional study was conducted on 1 052 patients with coronary heart disease (CHD) who visited 10 community health service centers in Chaoyang and Haidian districts of Beijing from March 2019 to September 2019. Basic information, medical history, cardiovascular risk factors, β-blocker use, height, weight, blood pressure level and resting heart rate were collected by face-to-face interview;biochemical tests and on-site physical examination were performed;and the influencing factors of heart rate control were analyzed by logistic regression. There were 563 males (53.5%) and 489 females(46.5%),with a mean age of (66.7±9.5) years. The rate of β-blockers use was 43.6% (459/1 052). The average resting heart rate was (70±8)/min, and only 14.5% (153/ 1 052) patients had the heart rate under control. The resting heart rate control rate in patients with β-blockers use was 17.9% (82/459), higher than that of those without β-blockers use [12.0% (71/593), χ 2=7.23, P=0.007]. Moderate leisure activities were beneficial to the control of resting heart rate ( OR=2.14, 95% CI: 1.26-3.62). The study shows that β-blockers use and resting heart rate control in CHD patients in Beijing community health institutions were both at low levels, and the resting heart rate was not well controlled even in patients taking beta-blockers.

The value of“Leopard pattern” in the diagnosis of breast hyperplasia by ultrasound / 中华医学超声杂志（电子版）

ObjectiveTo study the diagnostic value of sonographic “Leopard pattern” sign in breast hyperplasia.MethodsTwo hundred and twenty-three female patients in Beijing Friendship Hospital from October 2012 to April 2013 were choosen. All the cases were diagnosed as mammary gland hyperplasia clinically, and their breast ultrasound images show the breast imaging-reporting and data system (BI-RADS) grad was 0 or 1. These patients were divided into 3 groups according to their age, Group A: 20 to 35 age (36 cases), Group B: 36 to 50 age (102 cases), and Group C: order than 50 year-old (85 cases). The pathological diagnosis were obtained by ultrasound guided breast biopsy. With pathological diagnosis as the gold standard and “Leopard sign” as ultrasound diagnostic criteria, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The consistency between the ultrasonic and the pathological diagnosis were analyzed by Kappa statistical test.ResultThe diagnostic consistency test of the total sample of 223 cases: in terms of the ultrasonic Leopard sign” for the diagnosis of breast hyperplasia, the sensitivity was 69% (59/85),the specificity was 46% (64/138), the accuracy was 55% (123/223), the positive predictive value was 44% (59/133), the negative predictive value was 71% (64/90), the consistency was poor (Kappa=0.14,P<0.05). Group A:the sensitivity was 90% (18/20), the specificity was 50% (8/16),the accuracy was 72% (26/36), the positive predictive value was 69% (18/26), the negative predictive value was 80% (8/10), the consistency was good (Kappa=0.42, P<0.05);Group B:the sensitivity was 70% (33/47), the specificity was 49% (27/55),the accuracy was 59% (60/102), the positive predictive value was 54% (33/61), the negative predictive value was 66% (27/41), the consistency was poor (Kappa=0.19,P<0.05); Group C: the sensitivity was 44% (8/18), the specificity was 43% (29/67), the accuracy was 44% (37/85), the positive predictive value was 17% (8/46), the negative predictive value was 74% (29/39), the consistency was poor (Kappa=0.08,P<0.05).Conclusion“Leopard pattern” sign is not suitable as an independent standard in diagnosing breast hyperplasia disease.

Significance of ultrasound-guided core needle biopsy in diagnosis of thyroid nodules / 国际外科学杂志

Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.