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find Author "吴欢" 3 results
  • Ultrasound elastography and conventional ultrasound in diagnosis of benign and malignant breast lumps: a systematic review and meta-analysis

    Objective To evaluate the diagnostic value of conventional ultrasound, ultrasound elastography and their combination in benign and malignant breast nodules using meta-analysis. Methods The English databases (EMBASE, PubMed, Cochrane Library) and Chinese databases (China Biomedical Literature Database, China HowNet, VIP, Wanfang Database) were searched to collect the Chinese and English literatures about the diagnostic value of conventional ultrasound and elastography in differentiating the benign and malignant breast lesions up to April 20, 2021, the reviewers strictly followed the inclusion and exclusion criteria to screen the literature, extract the data and conduct quality assessment. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and 95%CI were calculated by using meta-DiSc1.4 software for heterogeneity analysis and data combining analysis. The forest map and receiver operating characteristic (ROC) curve was drew, and the area under the ROC curve was calculated. StataSE14.0 software was used to draw deek funnel plot to evaluate publication bias, and Fagan’s nomogram was used to evaluate the clinical utility of each test method. Results A final selection of 42 articles involving 6 009 nodules in 5 118 patients was included. The sensitivity for conventional ultrasound, elastosonography and two techniques combination was 0.80 [95%CI (0.79, 0.82)], 0.87 [95%CI (0.86, 0.89)] and 0.93 [95%CI (0.91, 0.94)], respectively; with specificity of 0.75 [95%CI (0.73, 0.76)], 0.85 [95%CI (0.84, 0.86)] and 0.94 [95%CI (0.93, 0.95)]. The summery area under curve was 0.86, 0.94 and 0.98, respectively. There were significant differences in the diagnostic efficiency among the three groups(all P<0.05). The Deek’s funnel plot showed no significant publication bias (all P>0.05). The pre-testprobability of conventional ultrasound, elastosonography and two techniques combination were both 20%, and the post-testprobability were 49%, 66%, and 82%, respectively. Conclusions The accuracy of elastography in distinguishing benign from malignant breast nodule is relatively high, while the accuracy of benign and malignant nodules in conventional ultrasound is generally acceptable. However, the accuracy of the combination of the two is higher, which is worthy of clinical application.

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  • 小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面

    目的总结小腿踝上穿支蒂螺旋桨皮瓣修复足底黑色素瘤切除后创面的疗效。方法2016 年 4 月—2018 年 6 月,收治 6 例足底黑色素瘤患者。男 2 例,女 4 例;年龄 32~53 岁,平均 36 岁。病程 1~320 个月,中位病程 58 个月。肿瘤扩大切除后,遗留创面范围为 5.8 cm×4.5 cm~10.6 cm×8.7 cm,切取小腿踝上穿支蒂螺旋桨皮瓣修复。皮瓣旋转后大桨无张力修复创面,小桨修复供区创面;皮瓣切取范围为 8.5 cm×6.8 cm~12.0 cm×10.5 cm。供区经皮瓣修复后 4 例直接拉拢缝合、2 例游离植皮修复。结果术后除 1 例皮瓣部分表皮坏死,其余皮瓣及植皮均顺利成活,创面及供区切口均Ⅰ期愈合。患者均获随访,随访时间 3~24 个月,平均 18 个月。除 3 例皮瓣臃肿行二期修整外,其余皮瓣外形良好,色泽、质地及弹性佳;足底浅感觉不同程度恢复。末次随访时,按美国矫形足踝协会(AOFAS)评分,获优 4 例、良 1 例、可 1 例,优良率为 83.3%。随访期间无肿瘤复发。结论小腿穿支蒂螺旋桨皮瓣质地与足底组织相似,皮瓣易于旋转,无需牺牲主要血管,适用于修复足底黑色素瘤切除后创面。

    Release date:2020-04-15 09:18 Export PDF Favorites Scan
  • Anatomy of pisiform blood supply and feasibility of vascularized pisiform transfer for avascular necrosis of lunate based on digital technique

    ObjectiveTo provide anatomical basis for vascularized pisiform transfer in the treatment of advanced avascular necrosis of the lunate (Kienböck’s disease) by studying its morphology and blood supply pattern based on digital technique.MethodsTwelve adult fresh wrist joint specimens were selected and treated with gelatin-lead oxide solution from ulnar or radial artery. Then the three-dimensional (3D) images of the pisiform and lunate were reconstructed by micro-CT scanning and Mimics software. The morphologies of pisiform and lunate were observed and the longitudinal diameter, transverse diameter, and thickness of pisiform and lunate were measured. The main blood supply sources of pisiform were observed. The number, diameter, and distribution of nutrient foramina at proximal, distal, radial, and ulnar sides of pisiform were recorded. The anatomic parameters of the pedicles (branch of trunk of ulnar artery, carpal epithelial branch, descending branch of carpal epithelial branch, recurrent branch of deep palmar branch) were measured, including the outer diameter of pedicle initiation, distance of pedicle from pisiform, and distance of pedicle from lunate. ResultsThere were significant differences in the longitudinal and transverse diameters between pisiform and lunate (t=6.653, P=0.000; t=6.265, P=0.000), but there was no significant difference in thickness (t= 1.269, P=0.109). The distal, proximal, radial, and ulnar sides of pisiform had nutrient vessels. The nutrient foramina at proximal side were significantly more than that at distal side (P<0.05), but there was no significant difference in the diameter of nutrient foramina between different sides (P>0.05). The outer diameter of pedicle initiation of the recurrent branch of deep palmar branch was significantly smaller than the carpal epithelial branch and descending branch of carpal epithelial branch (P<0.05). There was no significant difference in the distance of pedicle from pisiform/lunate between branch of trunk of ulnar artery and recurrent branch of deep palmar branch (P>0.05), and between carpal epithelial branch and descending branch of carpal epithelial branch (P>0.05). But the differences between the other vascular pedicles were significant (P<0.05). ConclusionThere are abundant nutrient vessels at the proximal and ulnar sides of pisiform, so excessive stripping of the proximal and ulnar soft tissues should be avoided during the vascularized pisiform transfer. It is feasible to treat advanced Kienböck’s disease by pisiform transfer with the carpal epithelial branch of ulnar artery and the descending branch.

    Release date:2020-06-15 02:43 Export PDF Favorites Scan
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