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Effect of ultrasound-guided intra-articular injection of platelet-rich plasma in the treatment of osteonecrosis of the femoral head: a retrospective study

ObjectiveTo explore the clinical efficacy and safety of ultrasound-guided intra-articular injection of platelet-rich plasma (PRP) in the treatment of avascular necrosis of the femoral head.MethodsWe retrospectively collected and analyzed the clinical characteristics, imaging data, and clinical outcomes of patients with femoral head necrosis who received ultrasound-guided intra-articular PRP injection in the Department of Rehabilitation Medicine of Sun Yat-sen Memorial Hospital, Sun Yat-sen University between June 2019 and June 2020. All the patients received 4 injections at one-week intervals. The Visual Analogue Scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Harris Hip Joint Function Scale (HHS) were evaluated before treatment and 1 month, 3 months, and 6 months after the first injections. Adverse events were recorded. The normally distributed data were presented as mean±standard deviation, and analyzed by one-way repeated measures analysis of variance; the non-normally distributed data were presented as median (lower quartile, upper quartile), and analyzed by Friedman test.ResultsA total of 29 patients were included. According to the Association Research Circulation Osseous classification standard, 2 patients were classified as stageⅠ, 11 as stageⅡ, 11 as stage Ⅲ, and 5 as stage Ⅳ. Before treatment and 1 month, 3 months, and 6 months after treatment, the VAS scores were 7.0 (5.5, 8.0), 4.0 (3.0, 5.0), 3.0 (2.0, 3.0), and 3.0 (2.0, 5.0), respectively, the WOMAC scores were 39.27±11.70, 28.34±8.08, 22.82±6.09, and 24.13±7.55, respectively, and the HHS were 46.0 (40.0, 64.0), 71.0 (57.5, 75.0), 78.0 (68.0, 80.5), and 78.0 (64.0, 80.0), respectively. The time effects in VAS (χ2=65.423, P<0.001), WOMAC (F=46.710, P<0.001), and HHS (χ2=66.347, P<0.001) were all statistically significant. There were significant differences in each index between the values 1 month, 3 months, and 6 months after treatment and those before treatment respectively, and there was also a significant difference in each index between the value 1 month after treatment and that 3 months after treatment (P<0.05). There was no significant difference in any indicator between the value 6 months after treatment and that 3 months after treatment (P>0.05). Significant difference was shown between the value 6 months after treatment and that 1 month after treatment in WOMAC (P=0.016), but not in VAS or HHS (P>0.05). No obvious adverse event was reported during the follow-up period.ConclusionsUltrasound-guided intra-articular PRP injection can effectively alleviate the pain and improve the hip joint function of patients with femoral head necrosis for at least 6 months. However, randomized controlled studies with a larger sample size and longer-term follow-up are needed in the future to confirm the efficacy and safety of PRP injection in femoral head necrosis.

Application of Mammotome for Fibroadenoma of Breast

目的　探讨Mammotome切除乳腺纤维腺瘤的价值。方法　对我院2006年12月至2008年3月期间超声诊断为乳腺纤维腺瘤的107例患者共129枚病灶行超声引导下Mammotome旋切术。结果　129枚肿瘤超声显示完整切除，肿物切除时间5~40 min，平均16 min。1例发生血肿，3例皮下瘀血，2例乳头溢血，无一例感染。2例皮肤切割者以创可贴拉合后2 d愈合。病理结果显示124枚为良性病变，5枚为恶性。年龄≥40岁者共20例，其中恶性3例。超声显示有钙化灶者共6枚，其中3枚为恶性。103例获门诊随访，随访时间2～12个月，平均　5个月，超声发现2例复发。结论　Mammotome切除乳腺纤维腺瘤可同时达到诊断及治疗目的，美容效果好，对≥40岁及伴有钙化者要警惕恶性病变。

Value of Intraoperative Ultrasound Guided Precise Tru-Cut Biopsy for Diagnosis of Solid Pancreatic Masses

Objective　To explore the value of pathologic diagnosis for pancreatic head mass by using recise Tru-cut biopsy under intraoperative ultrasound guided.　Methods　Twenty-eight patients with solid pancreatic masses in People’s Hospital of Suqian，Affiliated Hospital Xuzhou Medical College from August 2010 to August 2011 were performed precise Tru-cut biopsy under intraoperative ultrasound guided. In all patients of 28 cases, male 20 cases and female 8 cases, the male-to-female ratio was 5∶2. The patients’ age was 34-78 years old（mean age： 64 years old）. Twenty-eight patients were divided into three groups based upon the greatest dimension of the masses as follows：equal or less than 1.5 cm （group S, 5 cases）, 1.5-3.0cm （group M, 7 cases）, and greater than 3.0cm （group L, 16 cases）. Three needlepasses in each mass were performed. The results of postoperative pathologic findings were compared with specimens in paraffin sections. Results　In all cases of 28, the diagnostic coincidence rate was 100%, there were no false positive finding and false negative. The coincidence ratio for pathological diagnosis of tissues with only 1 strip sample （1/3）, only 2 strip samples （2/3）, and with 3 strip samples （3/3） were 3/5, 2/5, and 0/0, respectivly in S group, 0/0, 5/7, and 2/7, respectivly in M group, and 0/0, 4/16, and 12/16, respectivly in L group. The false negative rate of single strip sample in S group and M group was higher than that in L group （χ2=9.833，P=0.002）. There was false negative finding with master single test in small focus of infection. Conclusion　Precise Tru-cut biopsy under intraoperative ultrasound guided is a safe and highly accurate method for pathological diagnosis of patients with solid pancreatic lesions, especially in small lesions，it is worthy of clinical application..

CLINICAL OBSERVATION OF PERCUTANEOUS ACETIC ACID INJECTION AND PERCUTANEOUS ETHANOL INJECTION IN THE TREATMENT OF PRIMARY HEPATIC CARCINOMA

Objective To study the efficiency of percutaneous acetic acid injection (PAI) or percutaneous ethanol injection (PEI) in the treatment of primary hepatic carcinoma (PHC). Methods Seventeen and 24 patients with PHC were treated, respectively by PAI or by PEI in our hospital. According to hepatic function test, soluble intereukin-2 receptor (sIL-2R), AFP, biopsy and size of tumor, the evaluation was made.Results Effective rate was 88.2% in PAI group and 87.5% in PEI group, respectively. There was no obvious influence to sIL-2R in serum in the two groups (Ｐ＞0.05). Obvious differences in impairment of hepatic functions between PAI and PEI groups were found (Ｐ＜0.01), it also showed that smaller amounts of acetic acid and less puncture frequency were required for the treatment than that of ethanol. Conclusion PAI is superior to PEI in the treatment of those patients who are complicated with cirrhosis or other vital disease.

超声引导在 125I 放射性粒子植入治疗近膈处肝癌中的安全性分析

目的 总结超声引导下经皮 125I 放射性粒子组织间植入治疗近膈处肝癌的临床安全性及优势。 方法 回顾性分析 2014 年 3 月至 2016 年 2 月期间于笔者所在医院接受超声引导下经皮 125I 放射性粒子植入治疗的 10 例近膈处肝癌患者的临床资料。 结果 10 例患者均按计划行粒子植入，植入 125I 粒子 19～108 枚，平均植入 58.1 枚。植入过程顺利，手术时间 30～90 min，平均 57 min。术后质量验证示粒子分布满意，无补种情况发生。2 例患者术后出现发热，经抗炎及对症治疗后痊愈。1 例患者出现穿刺部位疼痛，给予止痛治疗后好转。10 例患者术后复查均未发现腹腔出血及积液，无血、气胸等肺部并发症发生，无胆汁漏、肝功能衰竭等严重并发症发生。10 例患者均顺利出院。术后 10 例患者均获访，随访时间为 6～43 个月，中位数为 18.5 个月。随访期间，2 例出现粒子移位，未出现严重后果，未予处理；未发现其他远期并发症发生。 结论 超声引导下经皮 125I 放射性粒子植入治疗近膈处肝癌的并发症少，安全可靠，具有其优势。

增强型血流显像联合超声引导下穿刺活检技术在乳腺肿物诊断中的价值

【摘要】　目的　总结增强型血流显像（e-flow）联合超声引导下粗针穿刺活检技术在乳腺肿物诊断中的价值。　方法　将2008年1月-2009年12月住院的100例乳腺肿物患者随机分成两组，第1组50例，应用e-flow技术检测，联合超声引导下粗针穿刺活检技术，对乳腺肿物患者穿刺取材送病理检查；第2组50例，在超声引导下，对乳腺肿物患者直接行粗针穿刺取材送病理检查，并将两组穿刺结果与手术后病理结果进行对比分析。　结果　第1组50例穿刺病理检查结果均与术后病理检查结果符合，其中恶性48例，良性2例；第2组50例中46例与术后病理检查结果符合，其中恶性45例，诊断敏感性91.8%，良性1例，假阴性4例。　结论　e-flow联合超声引导下粗针穿刺活检技术在乳腺肿物诊断中具有定位准确、实时监测、可靠性高、创伤小、操作简单等优点，可用作乳腺肿物定性诊断的主要方法。

超声引导下穿刺术并发血管迷走神经性晕厥的护理

目的　探讨超声引导下穿刺术后并发血管迷走神经性晕厥患者的护理方法及要点。 方法　对2011年7月－2012年6月32例血管迷走神经性晕厥患者进行严密观察，并针对血管迷走神经性晕厥发生的相关因素采取积极的应对护理措施。 结果　所有患者经过及时正确的处理后生命体征恢复稳定。 结论　及时观察、早期发现及早期处理是超声引导下穿刺致血管迷走神经性晕厥并发症护理的正确原则。

超声引导下改良塞丁格技术在高龄患者中的应用

Application of B-Mode Ultrasound Locatization in Catheterization of Internal Jugular Vein (Report of 286 Cases)

目的 讨论B型超声定位下颈内静脉穿刺置管的经验。方法 回顾我中心2008年11月至2009年4月期间采用B型超声定位行颈内静脉置管的286例患者的临床资料。结果 一次性穿刺成功率为99.3%（284/286），置管成功率为100%（286/286）； 穿刺时间50 s~12 min，平均106.8 s； 带管时间5～64 d，平均13 d； 未出现血气胸、皮下血肿等并发症。结论 B型超声定位下颈内静脉穿刺操作简单、方便、安全，适用于各级别医院。在颈短肥胖，被动体位情况下，B型超声定位下置管优势大于传统的盲探法及彩色多普勒超声引导下置管法。

B型超声引导下经皮肾脏穿刺活组织检查分析

【摘要】　目的　总结超声引导下经皮肾脏穿刺活检术的临床应用价值。　方法　对2005年12月—2010年12月收治的200例肾病患者在B型超声引导下行经皮肾脏穿刺活检术临床资料进行回顾性分析。　结果　200例中195例肾小球取材个数为12~25个，3例肾小球取材个数10~12个，2例肾小球取材个数为4个以下，取材阳性率达99%。　结论　B型超声引导下经皮肾脏穿刺活检术可明确肾病病理分型，具有较高的临床应用价值。