ObjectiveTo explore the clinical efficacy of ultrasound debridement combined with autolytic debridement in the treatment of diabetic foot ulcers.MethodsA total of 60 diabetic foot ulcers patients who were diagnosed and treated in Jinshan Hospital of Fudan University from April 2019 to April 2020 were enrolled in the study and randomly divided into two groups, with 30 cases in each group. The trial group received autolytic cleansing combined with ultrasound debridement treatment, and the control group only received autolytic debridement treatment. The baseline conditions, wound treatment efficacy, number of dressing changes, length of hospital stay, treatment cost, wound healing time, wound shrinkage rate, and the time required for the wound to turn into 100% red granulation were compared between the two groups.ResultsThere was no statistically significant difference in gender, age, duration of diabetes or Wagner grade of diabetic foot between the two groups (P>0.05). The efficacy of wound healing in the trial group was better than that in the control group (Z=?2.146, P=0.032). The number of dressing changes [(11.76±2.23) vs. (17.34±4.43) times] and the length of stay [(18.03±3.73) vs. (25.43±4.43) d] in the trial group were lower than those in the control group, and the differences were statistically significant (P<0.05). The difference in treatment cost between the two groups was not statistically significant (P>0.05). The wound healing time of the trial group [(48.43±18.34) vs. (65.24±19.62) d], the wound shrinkage rate [(78.35±8.34)% vs. (56.53±6.54)%] and the time required for the wound to turn into 100% red granulation [(16.34±2.42) vs. (24.55±3.23) d] were better than those of the control group, and the differences were statistically significant (P<0.05). During the treatment process, no patient in the trial group had wound bleeding and had difficulty in stopping bleeding during ultrasonic debridement, and no patient had intolerable pain related to ultrasonic debridement. No patients in either group withdrew early.ConclusionsUltrasound debridement combined with autolytic debridement can effectively improve the curative effect of patients with diabetic foot ulcers and shorten the wound healing time. Therefore, it is worthy of promotion and application in the wound care of patients with diabetic foot ulcers.
Objective To compare the effectiveness of ultrasound-guided closed reduction with Kirschner wire fixation and open reduction with Kirschner wire fixation in the treatment of humeral lateral condyle fracture (HLCF) in children. Methods A clinical data of 53 children with HLCF admitted between May 2020 and April 2023 and met selective criteria was retrospectively analyzed. Of these, 25 cases were managed with closed reduction and Kirschner wire fixation under ultrasound guidance (closed group), while 28 cases underwent open reduction and Kirschner wire fixation (open group). There was no significant difference between the two groups in terms of gender, age, cause of injury, fracture side, fracture classification, and time from injury to operation (P>0.05). The following variables were recorded and compared between the two groups: operation time, intraoperative fluoroscopy frequency, fracture healing time, incidence of complications, and the Flynn elbow function score at last follow-up. Results In the closed group, the fractures were successfully reduced under ultrasound guidance, with no nerve damage reported in either group. The operation time and intraoperative fluoroscopy frequency were significantly less in the closed group than in the open group (P<0.05). One case of infection (Kirschner wire irritation) was observed in the closed group, while 3 cases in the open group (2 of Kirschner wire irritation and 1 of incision infection). However, the difference in the incidence of infection between the two groups was not significant (P>0.05). All patients in both groups were followed up 6-18 months (mean, 10.2 months). X-ray examinations confirmed that fractures had healed in both groups, with no significant difference in healing time (P>0.05). During follow-up, 5 cases of lateral humeral process formation were observed in the closed group, compared to 12 cases in the open group, although this difference was not significant (P>0.05). At last follow-up, the excellent and good rate of elbow joint function was evaluated as 96.0% (24/25) in the closed group and 92.9% (26/28) in the open group according to the Flynn scoring criteria, with no significant difference between the two groups (P>0.05). Both groups showed no occurrence of ossifying myositis or elbow internal/external rotation. Conclusion The effectiveness of ultrasound-guided closed reduction and Kirschner wire fixation in the treatment of HLCF in children is comparable to open reduction and Kirschner wire fixation, but the former can reduce operation time and intraoperative fluoroscopy frequency, and obtain lower the incidence of complications.
ObjectiveTo analyze the characteristics of ultrasound images for soft tissue lymphoma and discuss the diagnostic value of ultrasonography. MethodsBetween January 2008 and August 2014, the ultrasound images of 25 soft tissue lymphomas confirmed by histopathology and immunohistochemistry were retrospectively analyzed. ResultsOf the total 25 patients with soft tissue lymphoma (histological types of non-Hodgkin's lymphoma), there were 10 females and 15 males. Among them, 14 had diffuse large B-cell lymphoma (56%, 14/25). There was a primary lymphoma located in the lower leg, and all the rest 24 cases were secondary lymphoma. Of the 24 secondary cases, 19 presented solitary lesion located respectively in limbs (8 cases), trunk (7 cases) and head & neck (4 cases); the other 5 cases presented multiple lesions located respectively in limbs and trunk. Among all the lesions, 12 were located in muscular layer, presenting weak echo mass with irregular shape growing along the direction of muscular fibers; and 13 were located in skin and subcutaneous soft tissue, among which 4 cases showed diffused thickening of skin and subcutaneous layer with irregular hypoechoic areas on ultrasound examination, and 9 cases showed nodular or hypoechoic irregular shaped lesion, iso-hyperechoic, with heterogeneous internal echogenecity having unclear boundary. ConclusionUnderstanding the characteristics of soft tissue lymphoma on ultrasound images will help to improve diagnostic accuracy.
【Abstract】ObjectiveTo introduce the minimally invasive excision and biopsy of breast neoplasm with Mammotome vacuum device guided by ultrasound. MethodsFiftytwo breast masses were detected in 30 patients through color Doppler. The ages of these patients range from 18 years to 49 years. Forty-six of those masses (88.5%) were clinically impalpable. Complete excision and biopsy of 52 breast masses were performed using Mammotome vacuum device guided by ultrasound. The patients were followed up and their postoperative condition were recorded. ResultsFiftytwo breast masses of 30 cases were excised completely, which was verified by color Doppler.The tissue excised by Mammotome were enough for pathological examination. Fortysix masses were proved to be fibroadenoma and the other 6 were proved to be adenosis. Hematoma was found in four patients after operation. The incisions were small and hidden, and the appearance of breasts remained well. Twenty patients were followed up for a shot period of time and no residual nidus or recurrence of the mass was found.ConclusionMinimally invasive excision and biopsy of breast masses with Mammotome vacuum device is an accurate and safe method. It is an ideal minimally invasive operation in treating benign breast neoplasm with few complications. It can be applied to biopsy of breast masses and complete excision of benign breast masses which are less than 2 cm in the same time.
Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.
ObjectiveTo investigate the value of ultrasound contrast in the differential diagnosis for hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH). MethodsTwenty-three HCC patients and 23 cases hepatic FNH patients from January 1, 2012 to January 1, 2014 in our hospital were selected, all of them were underwent ultrasound contrast examination before operation. The ultrasound contrast results of 2 groups patients were comparative analyzed. ResultsIn HCC group, the contrast arrival time was (3.8±1.9) s, peak time was (21.8±11.9) s, and peak strength was (28.8 ±3.1) dB; in hepatic FNH group, these indicators was (2.3±1.4) s, (35.3±14.8) s, and (22.3±7.9) dB, respectively. These indicators of HCC group was longer or shorter or higher than those of hepatic FNH group, respectively (P < 0.05). The sensitivity, specificity, and accuracy of ultrasound contrast diagnosed HCC was 91.3% (21/23), 87.0% (20/23), and 95.7% (22/23), and diagnosed hepatic FHN was 87.0% (20/23), 91.3% (21/23), and 91.3% (21/23), respectively, the difference were not statistically significant between the two groups (P > 0.05). ConclusionUltrasound contrast has very important application value in the differential diagnosis of HCC and hepatic FNH, can be used in clinical application.
Objective To study clinical efficacy of irreversible electroporation in the treatment of advanced hepatic carcinoma. Methods Between July 2015 and September 2015, 8 patients with advanced hepatic carcinoma (10 tumors) were treated by ultrasound-guided irreversible electroporation, using pertacuneous, laparoscope or open surgery in the Rockets Army General Hospital of PLA. Prospectively collected and summarized the clinical data. Finally, analyzed the therapeutic effect of irreversible electroporation. Results Compared with before treatment, the quality of life score significantly increased 〔(37.75±4.65) scores vs. (22.25±2.87) scores, P=0.000〕 in 3 months after treatment of irreversible electroporation, but value of serum total bilirubin (56.37 mmol/L vs. 150.40 mmol/L, P=0.046), direct bilirubin (58.69 mmol/L vs. 71.60 mmol/L, P=0.012), alanine aminotransferase 〔(52.63±12.14) U/mL vs. (87.28±27.94) U/mL, P=0.003〕, asperate aminotransferase 〔(48.45±13.75) U/mL vs. (74.40±21.09) U/mL, P=0.000〕, and alpha fetoprotein (82.10 ng/mL vs. 159.20 ng/mL, P=0.042) significantly decreased. One patient suffered from persistent upper abdominal pain after irreversible electroporation, but no serious complications, such as infection, biliary fistula, hemorrhage, and liver or kidney failure occurred in all 8 patients. Abdominal enhanced CT scanning or MRI in 3 months after irreversible electroporation showed complete ablation in 7 patients and incomplete ablation with some residual in 1 patient. Eight patients were followed up for 3-5 months 〔an average of (4.0±0.9) months〕. During follow-up period, all patients had been alive with 1 case of recurrence. Conclusion The effect of ultrasound-guided irreversible electroporation in the treatment of advanced hepatic carcinoma is remarkable, and it may deserve clinical application in consideration of its safety and efficacy.
ObjectiveTo explore the clinical efficacy of the ultrasound-guided intra-articular injection of platelet-rich plasma (PRP) in the treatment of patients with different stages of knee osteoarthritis.MethodsWe retrospectively analyzed the clinical characteristics and X-ray data of patients with knee osteoarthritis who received ultrasound-guided intra-articular injection of PRP in the Department of Rehabilitation Medicine at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University between May 2018 and June 2019. The patients were grouped according to the Kellgren & Lawrence Classification (K&L 0, Ⅰ, Ⅱ, Ⅲ, and Ⅳ). All the patients received four injections with a one-week interval. The Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the clinical efficacy before the injection, and 3 and 6 months after the injection. Adverse reactions were recorded.ResultsA total of 102 patients were included without any grade 0 cases. There were 20 patients in K&L Ⅰ group, 37 in Ⅱ group, 31 in Ⅲ group, and 14 in Ⅳ group. No adverse event was reported. Significant differences of VAS scores and WOMAC index were observed in Ⅰ, Ⅱ and Ⅲ groups at the 3rd and 6th month follow-up (P<0.05). VAS and WOMAC scores of the three groups at the 3rd and 6th month after the treatment were significantly improved compared with those before the treatment (P<0.05). There was no significant difference in VAS score at the 3rd or 6th month after the treatment three groups (P>0.05). For K&L Ⅰ group, there was no statistically significant difference in WOMAC score at the 3rd or 6th month after the treatment (P>0.05). However, the WOMAC scores at the 3rd month after the treatment were better than those at the 6th month in K&L Ⅱ and Ⅲ groups (P<0.05). There was no significant time-depended changes in VAS score or WOMAC score in K&L Ⅳ group (P>0.05).ConclusionThe ultrasound-guided intra-articular PRP injection is safe and effective for pain relief and function improvement in patients with knee osteoarthritis at the early and middle stage.
Ultrasound Medicine has been through a rapid development during the past half century and has become an indispensable discipline for prophylactic medicine and clinical practice. Nowadays, the needs for ultrasound medicine diverse which leads to many challenges to the existing ultrasound physician scanning - diagnostic mode, including labor-intensiveness for the ultrasound physician, lacking of hierarchical management, contradiction of quality and quantity, irrational allocation of medical resources, and so on. This paper discussed several issues including the current situation of ultrasound education, domestic and western ultrasound work mode, necessity for ultrasound physician- sonographer integrated work mode, as well as the feasibility of standardized sonographer training. Combined with the experience of the West China Hospital, explore a Chinese way to carry out sonographer education and training program and try out ultrasound physician-sonographer integration mode.
ObjectiveTo examine the intrauterine residual tissue in patients with prolonged vaginal bleeding after drug abortion by both B-ultrasound and pathology through cleaning the remnant of uterine, in order to investigate the relationship between prolonged vaginal bleeding after medical abortion with mifepristone and the residual tissues (decidua/villi). MethodsBetween June and December 2011, 144 patients with vaginal bleeding after medical abortion were involved in the study. B-ultrasound and pathology through cleaning the remnant of uterine were adopted to study the residual tissue respectively. ResultsBased on the ultrasound results, the difference in residual tissues was statistically significant between patients with bleeding for 15 days or shorter and patients with bleeding for more than 15 days (P<0.05). The pathological results showed that the difference in decidua and villi on the residual tissues was not statistically significant between patients with bleeding for 15 days or shorter and patients with bleeding for more than 15 days (P>0.05). ConclusionAfter drug abortion, the prolonged vaginal bleeding was correlated with intrauterine residual tissues, and was not correlated with whether the residual tissue was villi or decidua.