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1.
摘要 目的:比较超声引导下18针与20针穿刺活检对甲状腺结节的诊断效果。方法:选取我院超声科2018.8.6-2020.9.30共收治的167例甲状腺结节患者作为研究对象,将患者分为18针穿刺组(n=86)和20针穿刺组(n=81),分别对两组患者应用超声引导下18针和20针穿刺活检,比较不确定结果的发生率,包括非诊断性或异型性/滤泡性病变的未确定显著性,恶性肿瘤的诊断性能在最终诊断的结节中进行评估。比较两组并发症发生率及超声引导下的核心针穿刺活检标本产率。结果:对比20针穿刺组和18针穿刺组患者的临床特征发现,两组患者性别、年龄、结节大小、结节形状、方位、回声强度、表现和钙化情况对比无明显差异(P<0.05);在20针穿刺组中43个结节和18针穿刺组中46个结节最终确诊。恶性结节的比例在两组之间没有显著差异。在最终诊断分析中,20针穿刺组有38个结节,18针穿刺组中有40个结节。在20针穿刺组,38个结节包括6个非诊断结果、18个不典型/滤泡性病变(未确定显著性)和14个滤泡性肿瘤。在18针穿刺组中,40个结节包括1个非诊断结果,22个不典型/滤泡性病变未确定的显著性,17个滤泡性肿瘤;18针穿刺组的未确诊率(包括非诊断结果和未发现显著性的异型性/滤泡性病变)较低(29.1 % vs 37.0 %),尽管这一差异在统计学上没有显著性(P>0.05)。然而,18针穿刺组的非诊断性结果发生率(1.2 % vs 8.6 %;P<0.05)显著低于20针穿刺组。两组的不典型/滤泡性病变的发生率(27.8 % vs 28.4 %)相似。20针穿刺组的CNB显示出更高的敏感性(75.0 % vs 66.7 %),更高的阴性预测值(NPV;83.9 % vs 75.9 %)和更高的准确率(78.3 % vs 74.4 %),虽然结果没有达到统计显著性。两组的特异性(81.8 % vs 80.8 %)和阳性预测值(PPV;两者均为100 %)相似;18针穿刺组和20针穿刺组患者的并发症发生率对比无明显差异(P>0.05)。结论:18针芯针活检对甲状腺结节的诊断较20针更有效,且不增加并发症情况,安全性好,值得临床应用推广。  相似文献   

2.
Salmonella and other pathogenic bacteria use the type III secretion system (T3SS) to inject virulence proteins into human cells to initiate infections. The structural component of the T3SS contains a needle and a needle tip. The needle is assembled from PrgI needle protomers and the needle tip is capped with several copies of the SipD tip protein. How a tip protein docks on the needle is unclear. A crystal structure of a PrgI–SipD fusion protein docked on the PrgI needle results in steric clash of SipD at the needle tip when modeled on the recent atomic structure of the needle. Thus, there is currently no good model of how SipD is docked on the PrgI needle tip. Previously, we showed by NMR paramagnetic relaxation enhancement (PRE) methods that a specific region in the SipD coiled coil is the binding site for PrgI. Others have hypothesized that a domain of the tip protein—the N-terminal α-helical hairpin—has to swing away during the assembly of the needle apparatus. Here, we show by PRE methods that a truncated form of SipD lacking the α-helical hairpin domain binds more tightly to PrgI. Further, PRE-based structure calculations revealed multiple PrgI binding sites on the SipD coiled coil. Our PRE results together with the recent NMR-derived atomic structure of the Salmonella needle suggest a possible model of how SipD might dock at the PrgI needle tip. SipD and PrgI are conserved in other bacterial T3SSs; thus, our results have wider implication in understanding other needle-tip complexes.  相似文献   

3.
OBJECTIVE: To assess histologic alterations following fine needle aspiration (FNA) of the thyroid and differentiate these from ominous lesions, such as papillary carcinoma thyroid, as well as assess and compare the degree of tissue trauma from the techniques: needle only vs. needle with syringe, size of needle and number of aspirations. STUDY DESIGN: Thyroidectomy specimens of 100 cases with prior FNA biopsy were selected. The changes called "worrisome histologic alteration following fine needle aspiration of the thyroid" (WHAFFT) were studied. Number of FNAs, needle size and technique were tabulated for 73 of 100 cases. RESULTS: Worrisome changes were confined to areas near the needle tract and hence could be differentiated from ominous lesions. Control cases did not show WHAFFT lesions. Non-aspiration FNA cytology (FNAC) technique results in fewer, less frequent WHAFFT changes. The increasing number of FNAs leads to statistically significant increase in infarction, necrosis and vascular changes. A gradation in the WHAFFT changes, directly proportional to the increasing diameter of the needle, was observed. CONCLUSION: The pathologist should be aware of WHAFFT to avoid misinterpretation. The technique of non-aspiration FNAC is significantly less traumatic. An increase in FNAs or size of needle results in more severe WHAFFT changes.  相似文献   

4.
Effects of the needle tip bevel and the aspiration procedure on the morphology of cumulusoocyte-complexes (COCs) and the developmental capacity of the oocytes after IVF were studied in 2 in vitro oocyte pick-up (OPU) simulations using a disposable ovum pick-up needle guidance system. In Experiment 1, the influence of the length of the needle bevel was investigated using a short and a long bevelled 20-g disposable needle. After being aspirated from slaughterhouse ovaries, the retrieved COCs were divided into 3 categories: 1) oocytes surrounded by a compact cumulus, 2) oocytes with an expanded cumulus, 3) partially naked oocytes. In Experiment 2, the influence of 5 different levels of aspiration vacuum for 3 different needle diameters (18-g, 19-g, 20-g) and 2 different needle bevels (long, short) was tested on the recovery and on the morphology of the cumulus investment of a fixed number of previously scored compact cumulus oocytes complexes (CCOCs), retrieved after slicing slaughterhouse ovaries. The re-retrieved COCs were allocated to Categories 1 and 3. The results show that the length of the needle bevel has a significant effect on oocyte recovery, in favor of the long-bevelled needle. As soon as higher aspiration vacua are used, a decrease of the number of CCOCs can be observed, which is less prominent for the short-bevelled needle compared to the long-bevelled one. The final number of blastocysts is similar for both needle types. In Experiment 2, the disposable needle system proved to be highly effective since nearly 80% of the CCOCs were retrieved. At low aspiration vacuum, up to 90% of the CCOCs withstand the aspiration procedure undamaged. Increasing the aspiration vacuum results in a decrease of the number of CCOCs, which is less pronounced using thinner needles. Averaged over all needle types, the prevalence of blastocysts expressed relative to the number of recovered oocytes decreases with higher aspiration vacuum.  相似文献   

5.
 Variations in the partitioning of foliar carbon and nitrogen in combination with changes in needle and shoot structure were studied in trees of Picea abies along a vertical gradient of relative irradiance (RI). RI was the major determinant of needle morphology, causing all needle linear parameters – width, thickness and length – to increase. Due to the different responsiveness of needle thickness and width in respect of RI, the ratio of total to projected needle area increased with RI. Furthermore, shoot structure was also influenced by RI, and the ratio of shoot silhouette area to total needle area, which characterises the packing of needles and needle area within the shoot, was greater at lower values of irradiance. Needle dry weight per total needle area (LWAt) was also increased by RI. Similarly, irrespective of the measure for surface area, needle nitrogen content per area, as the product of needle dry weight per area and nitrogen content per needle dry weight (Nm), scaled quasi-linearly with needle weight per area. Thus, the changes in needle and shoot morphology made it possible to invest more photosynthesising weight per unit light-intercepting surface there, where the pay-back due to elevated irradiances was the highest. However, Nm behaved in an entirely different manner, decreasing hyperbolically with LWAt. Since non-structural (carbon in non-structural carbohydrates), and structural (total minus non-structural) needle carbon per dry weight also increased with LWAt, Nm was inversely correlated with both non-structural and structural carbon. Total tree height, increasing significantly LWAt, also influenced needle structure. It appeared that total height did not affect needle thickness or width, but larger trees had greater needle density (dry weight per volume). Because needle density was positively correlated with needle carbon content per dry weight, it was assumed that the greater values of needle carbon content can be attributed to increased lignification and thickening of needle cell walls. Thus, it appeared that the proportion of supporting structures was greater in needles of larger trees. Inasmuch as an increased fraction of supporting structures dilutes other leaf substances, including also leaf compounds responsible for CO2-assimilation, enhanced requirement for supporting structures may be responsible for lower rates of carbon assimilation per foliage dry weight observed in large trees. Increasing water limitation with increasing tree size is discussed as a possible cause for increased needle supporting costs in large trees. Received: 2 April 1995 / Accepted: 16 February 1996  相似文献   

6.
Thyroid large needle aspiration biopsy is disregarded because it is thought to be associated with pain. This is in contrast with our 32 years long experience. We surveyed reports of pain in patients examined with fine needle aspiration biopsy (78, 87.2% women, mean age 59 years) or FNAB+large needle aspiration biopsy (48, 87.5% women, mean age 60 years). Each patient was questioned regarding a) no unpleasant sensation (score “0”); b) unpleasant sensation (“1”); c) mild pain (no analgesic used; “2”); or d) pain (analgesic used; “3”). The mean size of the needle used was for FNAB 22.3±0.7 or 20.8±1 gauge in the fine needle aspiration or fine needle aspiration plus large needle aspiration biopsy group, respectively (p<.0001). The number of percutaneous punctures was higher in the fine needle aspiration plus large needle aspiration biopsy group. However, the pain score in the fine needle aspiration biopsy or fine needle aspiration biopsy plus large needle aspiration biopsy group was not significantly different. Large needle aspiration biopsy after fine needle aspiration biopsy does not add any discomfort or pain and therefore in light of the demonstrable benefits, should be included in clinical algorithms for the evaluation of thyroid nodules.  相似文献   

7.
The P22-like bacteriophages have short tails. Their virions bind to their polysaccharide receptors through six trimeric tailspike proteins that surround the tail tip. These short tails also have a trimeric needle protein that extends beyond the tailspikes from the center of the tail tip, in a position that suggests that it should make first contact with the host’s outer membrane during the infection process. The base of the needle serves as a plug that keeps the DNA in the virion, but role of the needle during adsorption and DNA injection is not well understood. Among the P22-like phages are needle types with two completely different C-terminal distal tip domains. In the phage Sf6-type needle, unlike the other P22-type needle, the distal tip folds into a “knob” with a TNF-like fold, similar to the fiber knobs of bacteriophage PRD1 and Adenovirus. The phage HS1 knob is very similar to that of Sf6, and we report here its crystal structure which, like the Sf6 knob, contains three bound L-glutamate molecules. A chimeric P22 phage with a tail needle that contains the HS1 terminal knob efficiently infects the P22 host, Salmonella enterica, suggesting the knob does not confer host specificity. Likewise, mutations that should abrogate the binding of L-glutamate to the needle do not appear to affect virion function, but several different other genetic changes to the tip of the needle slow down potassium release from the host during infection. These findings suggest that the needle plays a role in phage P22 DNA delivery by controlling the kinetics of DNA ejection into the host.  相似文献   

8.
BACKGROUND AND AIM: Needle injections are used daily by millions of people around the world for the administration of various drugs (e.g., insulin), venepuncture, and some neurophysiological procedures. The aim of this paper was to study the influence of the outer needle diameter on the pain evoked by controlled needle insertion. METHODS: An automated needle injection system was used to perform a series of insertions where velocity, angle of insertion, and depth of injection were controlled. The frequency of pain following needle insertions (23G, 27G, 30G, 32G) was recorded together with the pain intensity (measured using the visual analogue scale--VAS) and the occurrence of bleeding. RESULTS: The outer needle diameter was positively and significantly correlated to the frequency of the insertion pain; for example, 63% of insertions with 23G needles caused pain, 53% of insertions with 27G and 31% of insertions with the thinnest (32G) needle (p < 0.0001) caused pain. The thickest needle caused most insertions associated with bleeding. Bleeding insertions were approximately 1.3 times more painful (as indicated by VAS scores) than insertions without concomitant bleedings (p = 0.004). CONCLUSION: By decreasing the outer diameter of a needle, the frequency of insertion pain can be reduced and may encourage patients to adhere to demanding injection regimens such as recurrent insulin administration.  相似文献   

9.
The length of the Yersinia injectisome needle is determined by the protein YscP, which could act as a molecular ruler. The analysis of the correlation between the size of YscP and the needle length in seven wild-type strains of Yersinia enterocolitica reinforced this hypothesis but hinted that the secondary structure of YscP might influence needle length. Hence, 11 variants of YscP515 were generated by multiple Pro or Gly substitutions. The needle length changed in inverse function of the helical content, indicating that not only the number of residues but also their structure controls length. Taking the secondary motifs into account, Pro/Gly-variants were subjected to in silico modelling to simulate the extension of YscP upon needle growth. The calculated lengths when the helical content is preserved correlated strikingly with the measured needle length, with a constant difference of ∼29 nm, which corresponds approximately to the size of the basal body. These data support the ruler model and show that the functional ruler has a helical structure.  相似文献   

10.
11.
The fungal species involved in the decomposition of needle litter and their response to intraspecific genetic variation of trees are poorly known. First, we compared the needle decomposition and fungal decomposers underneath eight different Norway spruce clones in situ. This experiment revealed 60-70% loss of needle mass in two years. Although spruce clones differed considerably in growth (twofold height difference) and their needles differed in chemical composition, no significant difference was found for loss of needle mass under the spruce clones. Furthermore, the spruce clones did not affect the community structure of the fungal decomposers. Fungi inhabiting needle litter were identified by extracting ribosomal RNA (rRNA) and sequencing complementary DNA (cDNA) of internal trascribed spacer 1 (ITS1) region. The most frequent identifications were Lophodermium, Pezizales, Mycena, and Marasmius, suggesting that endophytic fungi were involved in the decomposition process. Second, we evaluated the potential of endophytes to decompose needle material in a microcosm experiment in which all other fungi than endophytes were excluded. Within 2 years, the endophytes had decomposed 35-45% of the needle mass. Sequences of Mollisia, Lophodermium, Lachnum, and Phialocephala were most frequently found in rRNA and rDNA extracted from the needles at the end of the microcosm experiment. The dominant needle endophyte in fresh, green needles was Lophodermium piceae, and this species was also found frequently in the needle material after 2 years of decay both in the field and laboratory experiments. Moreover, the relative abundance of Lophodermium-derived denaturing gradient gel electrophoresis (DGGE) bands correlated positively with the decomposition in the microcosm experiment. Hence, our results suggest a significant role of endophytic fungi, and particularly L. piceae, in the process of needle decomposition in boreal forests.  相似文献   

12.
Many biological surfaces possess unusual micro-nano hierarchical structures that could influence their wettability, which provide new methods for the construction of novel materials. In this work, silver nanoparticles were successfully coated on the surface of stainless steel needle by a simple electroless replacement reaction process between the AgNO3 solution and the activated stainless steel needle. After the replacement reaction, porous micro/nanostructures were formed on the surface of the stainless steel needle. By modifying long chains of thiol molecules, the stainless steel needle exhibited good super-hydrophobic property with a contact angle greater than 150°. Moreover, the silver coated stainless steel needle (bionic needle) showed strong antibacterial activity against the gram-negative bacterium Escherichia coli (E. coli). By calculating the area of the inhibition zone against E. coli formed on agar medium, the antibacterial activity of the bionic needle with the contact angle of 152° is much better than that with the contact angle of 138°. The as-prepared bionic needle with both super-hydrophobic and antibacterial properties has the potential to be applied in modern medical devices.  相似文献   

13.
The effects of aspiration vacuum and needle diameter on the morphology of the cumulusoocyte-complex (COC) and developmental capacity of the oocyte after IVF was studied in 2 experiments using a disposable ovum pick-up needle guidance system whose construction permits its use in vitro. In Experiment 1, the relationship was determined between the aspiration vacuum, expressed in millimetre of mercury, and the actual amount of water aspirated by the system, expressed in millilitre per minute. In Experiment 2, five different levels of aspiration vacuum for 3 different needle diameters (18g, 19g and 21g) were tested in slaughterhouse ovaries. The cumulus-oocyte complexes (COCs) were divided into 3 categories: 1) oocytes with a compact cumulus, 2) oocytes with an expanded cumulus and 3) naked oocytes. The results show that a change of needle diameter can triple the amount of fluid actually aspirated. The highest oocyte recovery rates are obtained when using the thickest needle (18-g), regardless of the aspiration vacuum. On the average, for all needle types, more oocytes are recovered at the highest aspiration vacuum. For all needle diameters, the proportion of oocytes surrounded by a compact cumulus decreases progressively as the vacuum increases. Regardless of the vacuum applied, thinner needles result in a higher proportion of recovered COCs with a compact cumulus. At a high aspiration vacuum, naked oocytes become predominant regardless of the needle diameter. The prevalence of blastocysts, expressed in proportion to the recovered COCs, decreases as the aspiration vacuum increases, being especially noticeable between 70 and 130 mm Hg.  相似文献   

14.
Two studies were conducted investigating the effect of injecting short acting insulin subcutaneously by means of a sprinkler needle; this needle has 14 small holes in the wall but is sealed at the tip. In the first study absorption of 8 U iodine-125 labelled Actrapid HM injected subcutaneously at two separate sites in the abdominal wall was measured in 10 patients. One injection was given with the sprinkler needle and the other with a conventional needle. The initial dose absorbed during the first 30 minutes was significantly higher with the sprinkler needle. In the second study 10 U Actrapid HM was given to 11 other patients (all negative for C peptide and with low insulin binding antibody titres) on two separate days immediately before a standardised breakfast either by the sprinkler needle or by a conventional needle (random order). Plasma free insulin increased more rapidly and to higher concentrations with the sprinkler needle and the glycaemic response was considerably diminished. The sprinkler needle improves both the insulin absorption rate and the glycaemic response to a meal and may reduce the 30 minutes or so before meals that diabetics must inject to minimise postprandial hyperglycaemia.  相似文献   

15.
Many Gram-negative bacteria that cause major diseases and mortality worldwide require the type III secretion system (T3SS) to inject virulence proteins into their hosts and cause infections. A structural component of the T3SS is the needle apparatus, which consists of a base, an external needle, and a tip complex. In Salmonella typhimurium, the external needle is assembled by the polymerization of the needle protein PrgI. On top of this needle sits a tip complex, which is partly formed by the tip protein SipD. How SipD interacts with PrgI during the assembly of the T3SS needle apparatus remains unknown. The central region of PrgI forms an α-helical hairpin, whereas SipD has a long central coiled-coil, which is a defining structural feature of other T3SS tip proteins as well. Using NMR paramagnetic relaxation enhancement, we have identified a specific region on the SipD coiled-coil that interacts directly with PrgI. We present a model of how SipD might dock at the tip of the needle based on our paramagnetic relaxation enhancement results, thus offering new insight about the mechanism of assembly of the T3SS needle apparatus.  相似文献   

16.
Predicted increases in the frequency and duration of drought are expected to negatively affect tree vitality, but we know little about how water shortage will influence needle anatomy and thereby the trees’ photosynthetic and hydraulic capacity. In this study, we evaluated anatomical changes in sun and shade needles of 20‐year‐old Norway spruce trees exposed to artificial drought stress. Canopy position was found to be important for needle structure, as sun needles had significantly higher values than shade needles for all anatomical traits (i.e., cross‐sectional needle area, number of tracheids in needle, needle hydraulic conductivity, and tracheid lumen area), except proportion of xylem area per cross‐sectional needle area. In sun needles, drought reduced all trait values by 10–40%, whereas in shade needles, only tracheid maximum diameter was reduced by drought. Due to the relatively weaker response of shade needles than sun needles in drought‐stressed trees, the difference between the two needle types was reduced by 25% in the drought‐stressed trees compared to the control trees. The observed changes in needle anatomy provide new understanding of how Norway spruce adapts to drought stress and may improve predictions of how forests will respond to global climate change.  相似文献   

17.
Arteriovenous (AV) grafts and fistulas used for hemodialysis frequently develop intimal hyperplasia (IH) at the venous anastomosis of the graft, leading to flow-limiting stenosis, and ultimately to graft failure due to thrombosis. Although the high AV access blood flow has been implicated in the pathogenesis of graft stenosis, the potential role of needle turbulence during hemodialysis is relatively unexplored. High turbulent stresses from the needle jet that reach the venous anastomosis may contribute to endothelial denudation and vessel wall injury. This may trigger the molecular and cellular cascade involving platelet activation and IH, leading to eventual graft failure. In an in-vitro graft/needle model dye injection flow visualization was used for qualitative study of flow patterns, whereas laser Doppler velocimetry was used to compare the levels of turbulence at the venous anastomosis in the presence and absence of a venous needle jet. Considerably higher turbulence was observed downstream of the venous needle, in comparison to graft flow alone without the needle. While turbulent RMS remained around 0.1 m/s for the graft flow alone, turbulent RMS fluctuations downstream of the needle soared to 0.4-0.7 m/s at 2 cm from the tip of the needle and maintained values higher than 0.1 m/s up to 7-8 cm downstream. Turbulent intensities were 5-6 times greater in the presence of the needle, in comparison with graft flow alone. Since hemodialysis patients are exposed to needle turbulence for four hours three times a week, the role of post-venous needle turbulence may be important in the pathogenesis of AV graft complications. A better understanding of the role of needle turbulence in the mechanisms of AV graft failure may lead to improved design of AV grafts and venous needles associated with reduced turbulence, and to pharmacological interventions that attenuate IH and graft failure resulting from turbulence.  相似文献   

18.
In this paper, we present the effect of the plasma needle on tumor cell surface. The plasma is generated at the tip of a metal needle by using a radio-frequency generator of 13.56 MHz, 100's V amplitude. In our study we investigated the interaction of non-thermal plasma (plasma needle) with living monolayer tumour cells in culture medium. We applied short needle to sample distance (1 mm) at temperature of 25 degrees C, 30 degrees C and 37 degrees C, respectively. Our data sugest that the plasma needle reduces the viability and induces apoptosis of tumour cells. These activities may be very useful in dermatology, where a part of the tissue must be removed with high-precision, without damage to the adjacent cells and without inflammatory reaction.  相似文献   

19.
Humidity in a small area of a Vicia faba L. leaf was perturbed with a flow of dry air from an 80 µm (inside diameter) needle, while the remainder of the leaf was maintained at high and constant humidity. The influence of the needle flow on the humidity at the leaf surface was quantified by using a spatially explicit dewpoint hygrometer to observe condensation patterns. When the dry air from a needle was applied to the leaf, stomata within the influence of the needle opened within the first few minutes of the perturbation, and local epidermal turgor pressure declined within the same time frame. When the needle flow was removed from the leaf, these responses were reversed, but with more variable kinetics. Stomata and epidermal cells outside the influence of the needle flow, which were exposed to a constant and high humidity, showed similar, but smaller, responses when the needle flow was applied to the leaf. Since the opening of these stomata should have had only a small effect on transpiration (because of the high humidity), it is likely that the reduction in epidermal turgor was the cause (rather than the result) of the stomatal opening. The magnitude of the turgor response was only loosely related to the distance from the needle flow up to distances of almost 400 µm. The data support the idea that neighbouring stomata can interact through the influence of transpiration on epidermal turgor.  相似文献   

20.

Background and aims

Freeze events can strongly influence many ecosystem processes. However, the effects of freeze events on litter production, litter quality, and decomposition are rarely documented.

Methods

In this study, litter fall was measured monthly for 2 years. Two litter decomposition experiments were also performed using freeze-damaged litter and non-damaged litter in a loblolly pine forest.

Results

The freeze event in November 2009 caused a pronounced pulse of needle litter fall. The freeze-damaged needle litter was shown to have higher N concentration and lower C/N ratio compared with the normal falling needle litter. This finding indicates that freeze damage significantly increased needle quality because of incomplete nutrient resorption. The decomposition of freeze-damaged needle litter was faster than that of normal falling yellow needle litter and slower than that of hand-picked green needle litter. The decomposition rate constant (k) was negatively correlated with the C/N ratio in the needle litter. Our results also showed that the different climatic conditions influence patterns of litter decomposition.

Conclusions

This study suggests that freeze events significantly alter litter quantity and quality, thus affecting litter decomposition rates in a loblolly pine forest in central China.  相似文献   

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