ObjectiveTo analyze therapeutic effect of ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage in treatment of granulomatous mastitis (GM).MethodsThe clinical data of 120 patients with GM from January 2018 to December 2018 in the Renmin Hospital of Wuhan University were analyzed. Sixty patients were treated with the ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage (control group), and the other 60 patients were treated with the metronidazole solution combined with dexamethasone on the basis of the control group (observation group). The therapeutic period, total effective rate, postoperative appearance of breast, and recurrence rate were analyzed. While the pathogenic bacteria was analyzed by the microbial culture and the pathogen gene detection.ResultsThere were no significant differences in the baseline data between the two groups (P>0.05). The ultrasound-guided vacuum-assisted rotary excisions were successfully performed in all 120 patients. The therapeutic period of the observation group was shorter than that of the control group (t=–3.633, P<0.001). The total effective rate and rate of excellent and good of postoperative breast appearance had no significant differences between the two groups (total effective rate: 96.7% versus 90.0%, χ2=1.922, P=0.166; rate of excellent and good of postoperative breast appearance: 96.7% versus 88.3%, χ2=1.205, P=0.272). The recurrence rate of the observation group was lower than that of the control group (χ2=5.175, P=0.023). The positive rates of bacteria were 25.8% and 58.8% in the 120 cases by the microbial culture and 52 cases by the pathogen gene detection, respectively, which had a statistical difference (χ2=16.974, P<0.001), the same conclusions were obtained in the observation group and the control group (χ2=6.691, P=0.010; χ2=9.379, P=0.002).ConclusionsUltrasound-guided vacuum-assisted rotary excision with tube irrigation drainage is well applied in treatment of GM. It could maintain a good shape of breast. Use of metronidazole solution combined with dexamethasone after surgery could shorten therapeutic period and reduce recurrence rate.
ObjectiveTo summarize the clinical characteristics of idiopathic granulomatous mastitis (IGM) and its experiences of diagnosis and treatment. MethodThe clinical data of 33 patients with IGM from January 2005 to December 2014 were analyzed retrospectively. ResultsThe mean age of the patients was 33 years. The pathological examination showed that 28 patients (85%) were typical granuloma, and 5 patients (15%) were immature granuloma, whom were confirmed after exclusion of other pathogens. Twenty-nine patients were received drugs treatment, among which 21 patients were cured by taking prednisone orally, 6 patients were cured by the combination of prednisone and methotrexate, 2 patients failed to be cured, and 13 patients relapsed after stopping taking medicine. Four patients with abscess ulceration were received surgical treatment, and 2 patients relapsed after the surgery. Fifteen recurrent patients all were took prednisone and methotrexate orally, among which 1 patient stopped taking medicine because of liver function damage, 1 patient was not fully relieved, and other 13 patients were cured again. ConclusionsThe clinical manifestations of IGM have no specificities. The diagnosis mainly relies on pathological examination. In the early phase of this disease, the treatment method of steroid or combined immunosuppressant has good effects. In case of ulceration and protracted course, surgical treatment should be considered as early as possible.
To investigate the diagnosis, pathological characteristics and clinical treatment of gastric eosinophilic granuloma (GEG). Twenty two cases with GEG diagnosed by operation and pathology were analyzed. In this series 14 cases subjected to partial gastrectomy, 6 cases to subtotal gastrectomy, 1 case to total gastrectomy, and 1 case to radical gastrectomy. After 1-10 years of follow-up, 1 case, who was combined with gastric carcinoma at the first operation, died of the recurrence and extensive metastasis of gastric carcinoma on the 4th year after operation, 2 cases were reoperated on the 2nd or 6th year respectively after operation for forward complication, and the others recoverd well. The authors consider that gastrofiberscopic diagnosis is key to lessen the preoperative misdiagnosis, and the scope of dissection mainly depends on the size and type of focus. It is no need for extensive dissection.
Abstract To observe the effect of fibroblast growth factor (FGF) on wound healing, 50 mice were divided into 5 groups. On the back of every mouse, 2 wounds were made by operative cuts, one for experiment and the other for control. The wounds of the experimental group were covered with 0.5ml FGF solution (contented FGF 300 μg/ml, heparin 100 μg/ml), whereas the wounds of the control group were covered with 0.5ml 0.9% NaCl solution. All of the wounds were dressed by sterilized gauze, and received the same treatment once a day. After 1,3,5,7,10 days, the mice in every group were sacrificed and the tissues of the wounds were collected and prepared for microscopic examination. The results showed that the capillaries and fibroblasts in the experimental group were markedly increased and reached the peak 2～3 days earlier than those in the control group. It was suggested that FGF promoted the formation of granulation tissue and the wound healing.
ObjectiveTo investigate etiology of granulomatous mastitis and it,s conservative treatment method. MethodThe clinical data of 120 patients with granulomatous mastitis given drugs for closed treatment plus massage dredge and ductal lavage from January 2011 to December 2012 in this hospital were analyzed retrospectively. ResultsOne hundred and one cases were cured following conservative treatment for 2 to 8 weeks,19 cases were underwent surgical treatment because of poor outcome.Nine of 101(8.9%) cured patients were relapsed for following-up of 30 to 42 months. ConclusionClosed treatment with drugs,which is effective,could keep patient with granulomatous mastitis from having mastectomy and reduce recurrence.
This patient was a 47-year female who underwent carinal resection and reconstruction because of left main bronchial mucoepidermoid carcinoma. She underwent four cycles chemotherapy when recovering from surgery because of subcarinal lymph node metastasis. However, the patient suffered from recurred productive cough and dyspnea during chemotherapy. Bronchoscopic assessment revealed stenosis at the reconstructed carina and left main bronchus five months after surgery. The granulation tissues of the left main bronchus showed no evidence of cancer recurrence. After repeated bronchoscopic resection of granulation tissue combined with bronchial stent placement, the left main bronchial stenosis gradually worsened with granulation tissue growth. Three acid-fast bacilli were found in the granulation tissue harvested ten months after surgery. The reason of postoperative bronchostenosis was confirmed as endobronchial tuberculosis, and antitubercular agents were added. Unfortunately, she had persistent left main bronchostenosis due to irreversible destruction and left pulmonary atelectasis thereafter. Therefore, for the recurring anastomotic granulomas after tracheobronchial reconstruction, the possibility of tuberculosis infection should be considered.