Can the wet suction technique change the efficacy of endoscopic ultrasound-guided fine-needle aspiration for diagnosing autoimmune pancreatitis type 1? A prospective single-arm study

BACKGROUND Other than surgery,endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)is the only procedure for histologically diagnosing autoimmune pancreatitis(AIP).However,adequate specimens are difficult to obtain.Recently,more adequate specimens were reported to be obtained with EUS-FNA with a wet suction technique(WEST)than with conventional EUS-FNA.AIM To histologically diagnose AIP by EUS-FNA with a WEST.METHODS Eleven patients with possible type 1 AIP between February 2016 and August 2018 underwent EUS-FNA with a WEST(WEST group),with four punctures by 19 or 22 G needles.As a historical control,23 type 1 AIP patients who underwent no fewer than four punctures with 19 or 22 G needles were enrolled(DRY group).Patient characteristics and histological findings were compared between the two groups.RESULTS Three histopathological factors according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than the DRY group[lymphoplasmacytic infiltrate without granulocytic infiltration:9(81.8%)vs 6(26.1%),P=0.003,storiform fibrosis:5(45.5%)vs 1(4.3%),P=0.008,abundant(>10 cells/HPF)IgG4-positive cells:7(63.6%)vs 5(21.7%),P=0.026].Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group[8(72.7%)vs 3(13.0%),P=0.001].CONCLUSION EUS-FNA with a WEST was more successful than standard EUS-FNA in histologically diagnosing AIP.

To investigate the clinical effect of modified closed negative pressure suction technique combined with flap transplantation on the treatment of deep chronic refractory wounds

Objective:To investigate the clinical effect of modified closed negative pressure suction technique combined with flap transplantation on the treatment of deep chronic refractory wounds.Methods:During March of 2015 to April of 2018,52 cases of patients with deep chronic refractory wounds were selected as research objects.They were divided into the control group and the treatment group by use of the random number table method,with 26 cases in each group.Among them,the control group was given conventional debridement combined with flap reconstruction,and the treatment group was treated with modified closed negative pressure suction technique combined with flap transplantation to observe the clinical effect.Results:(1)According to the analysis on the effect of flap transplantation,the excellent and good rate of the treatment group was 92.3%,and in the control group,it was 76.9%(p<0.05).(2)According to the statistics,the incidence of complications in the treatment group was lower than that in the control group(p<0.05).Conclusions:Modified closed negative pressure suction technique combined with flap transplantation has a good effect on the treatment of deep chronic refractory wounds with fewer complications.