弥散加权磁共振联合经直肠超声定位的前列腺穿刺活检诊断前列腺癌的价值

目的 探讨DWI在前列腺穿刺活检中的运用价值.方法 回顾性分析2009年1月至2010年12月在我院行常规经直肠超声(TRUS)定位下经直肠前列腺穿刺(A组)的410例患者和DWI联合TRUS定位下行前列腺穿刺(B组)的141例患者资料,按前列腺特异性抗原(PSA)＜10μg/L、10 μg/L≤PSA ＜20 μg/L、20 μg/L≤PSA ＜50 μg/L和PSA≥50 μg/L将A、B两组各分为4个亚组,分别比较DWI联合TRUS定位与单纯TRUS定位下经直肠前列腺穿刺活检的诊断率.结果 A组PSA＜ 10 μg/L、10μg/L≤PSA ＜20 μg/L、20 μg/L≤PSA＜ 50 μg/L和PSA≥50 μg/L的患者穿刺诊断率分别为12.1％、31.1％、48.0％和91.2％,B组中对应的患者穿刺诊断率分别为23.7％、35.5％、66.7％和96.3％,两种穿刺方法的诊断率在PSA＜ 10 μg/L的患者中有统计学差异(x2=4.405,P＜0.05).结论 对于PSA＜ 10 μg/L的可疑患者,建议行DWI及TRUS联合定位的可疑病灶加系统穿刺法,从而提高前列腺穿刺的诊断率.     

Mammary Analogue Secretory Carcinoma: The First Submandibular Case Reported Including Findings on Fine Needle Aspiration Cytology

We present the first case (male, 35 years old) of a mammary analogue secretory carcinoma occurring in a submandibular gland and document findings on fine needle aspiration cytology. On histology, the tumor displayed characteristic features: circumscribed nodules composed of bland, pink to light red neoplastic cells with low proliferative/mitotic activity arranged in tubular, vaguely cribriform, and microcystic structures containing Periodic acid Schiff-positive, diastase-resistant secretory material. Immunohistochemistry showed strong and diffuse positivity for cytokeratin 7, S100 protein, and vimentin, as well as moderate to strong immunoreactivity for c-kit in the majority of tumor cells. A rearrangement of the ETV6 gene on fluorescence in situ hybridization was documented. The patient underwent an ipsilateral selective (levels I–IV) neck dissection which showed metastasis in 3 out of 36 lymph nodes (levels 1–3). Adjuvant radiotherapy was administered. No local recurrence or metastatic disease has been detected during a follow up period of 28 months.     

Thyroid Hemangiomas Diagnosed on Sonography

Primary thyroid hemangiomas are extremely rare, and only a few cases have been previously reported. Primary hemangiomas are developmental anomalies resulting from the inability of the angioblastic mesenchyme to form canals. Thyroid hemangiomas are generally considered difficult to diagnose preoperatively because of their low incidence and nonspecific imaging findings. Here we report 2 cases of thyroid hemangiomas that were diagnosed correctly on preoperative sonography. Our cases showed similar sonographic findings, such as well‐circumscribed hypoechoic lesions with internal channel‐like linear lines, and bloody content was aspirated during fine‐needle aspirations. Our report shows that thyroid hemangiomas can be diagnosed correctly by sonography with or without confirmation of bloody content in the lesions by fine‐needle aspiration.     

Acute suppurative thyroiditis following fine‐needle aspiration biopsy in an immunocompetent patient

The thyroid gland is remarkably resistant to infectious agents owing to several protective mechanisms. Acute suppurative thyroiditis after fine‐needle aspiration (FNA) in an immunocompetent patient is very rare. We report the case of a 50‐year‐old immunocompetent male patient who presented with painful cervical swelling, fever, and chills after an FNA of the thyroid. His physical and laboratory examination suggested an acute suppurative thyroiditis. Repeat FNA results were consistent with thyroid abscess. Physicians should be aware of the probability of acute bacterial thyroiditis after FNA. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42:215–218, 2014     

单针射频治疗中度痤疮疗效评价

目的：比较单针射频和红蓝光治疗面部中度寻常型痤疮的临床疗效并评估单针射频治疗的安全性。方法：收集我院面部中度寻常型痤疮患者,分为射频组和对照组,分别给予单针射频治疗和红蓝光联合针清治疗,共治疗8周,比较两种不同治疗组的疗效,记录患者对单针射频治疗的主观评价和不良反应。结果：共纳入我院2019年8~12月40例患者,其中射频组20例,对照组20例。射频组痊愈+显效患者12例高于对照组（3例）,差异具有统计学意义（P＜0.05）。射频组总有效率90%与对照组（85%）比较,差异无统计学意义（P>0.05）。射频组14例患者自觉改善。两组患者均未出现明显不良反应。结论：单针射频治疗面部中度寻常型痤疮疗效优于传统红蓝光联和针清治疗。     

New device technologies for subcutaneous fat biopsy

Purpose: Subcutaneous fat biopsy is useful for the evaluation of amyloidosis, environmental contaminants, lipid metabolism, genetic studies and diabetes research. The present study examined new technologies for fat biopsy. Methods: Subcutaneous fat biopsy in 10 high-risk individuals was randomized to (i) a 10 ml reciprocating procedure device (RPD) mechanical syringe or (ii) a 60 ml vacuum syringe. Outcome measures included pain by the 10 cm Visual Analogue Pain Scale (VAS), adequacy of biopsied tissue, complications and diagnosis. The operator’s ability to control syringes was quantitatively measured by the linear displacement method. Results: Both syringes permitted facile aspiration of subcutaneous fat with adequate sample without complications. The mechanical and the vacuum syringes enhanced control of the needle compared to conventional syringes, reducing unintended forward penetration by 75% (3.6 ± 0.5 mm) and 87% (12.0 ± 1.4 mm), respectively (p < 0.0001). Free adipose cells were obtained in abundance as well as columnar biopsies containing intact blood vessels and connective tissue septa permitting precise microhistological examination. One case of primary AL amyloidosis (κ light chain disease) was diagnosed in each group. Conclusions: Subcutaneous fat biopsy by needle aspiration can be facilely achieved with new aspiration syringe technologies with improved needle control and enhanced patient safety.

Trial registration: ClinicalTrials.gov identifier: NCT00651625.     

Control of soft tissue deformation during robotic needle insertion

Accurate needle insertion into soft, inhomogeneous tissue is of practical interest because of its importance in percutaneous therapies. In procedures that involve multiple needle insertions such as transrectal ultrasound‐guided prostate brachytherapy, it is important to reduce tissue deformation before puncture and during needle insertion. In order to reduce this deformation, we have studied the effect of different trajectories for a 2‐DOF (degrees of freedom) robot performing needle insertion in soft tissue. To obtain an optimum trajectory, we have compared tissue indentation and frictional forces for different trajectories. According to the results of our experiments, infinitesimal force per tissue displacement is a useful parameter for online trajectory update. In addition, the results show that axial rotation can reduce tissue indentation before puncture and frictional forces after puncture. Our proposed position/force controller is shown to provide considerable improvement in performance with regard to minimizing tissue deformation before puncture.     

易筋经之出爪亮翅式对延长浅静脉留置针时间的效果观察

【】目的 延长静脉留置针使用时间,减轻患者的痛苦和医疗费用,得到安全、舒适的护理。方法 我们以留置浅静脉留置针并且肌力正常的患者为研究对象。对照组在留置期间实施常规护理。实验组在实施常规护理的基础上,指导患者输液完毕封管后习练出爪亮翅式。结果 实验组浅静脉留置针留置时间明显延长,并且浅静脉留置针并发症的发生率显著低于对照组。结论 出爪亮翅式可以降低浅静脉留置针并发症的发生率,延长置管时间。