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黃斑區微血管循環及臨床意義

黃斑區微血管循環對維持黃斑視功能有特殊作用.視網膜靜脈阻塞、糖尿病性視網膜病變、高血壓性、外傷性視網膜病變等多種眼底疾患可引起黃斑區微血管循環改變.熒光血管造影、電子計算機圖象分析儀、激光、血流動力學分析等現代新技術應用,對黃斑區微血管循環的生理及病理變化有了更進一步的認識.本文就近年來該領域內研究成果及新發展進行了綜述,并結合臨床及治療措施進行討論.黃斑區微血管缺血性病變尚待進一步開展研究. （中華眼底病雜志，1993，9：186-188）

Nurses' Awareness of High-Quality Nursing in Liangshan Prefecture

ObjectiveTo investigate the awareness of high-quality nursing among clinical nurses in Liangshan to serve as a guide for a comprehensive development of quality nursing. MethodsFrom June to December 2011, 196 nurses from four model hospitals of high-quality nursing were investigated with self-made questionnaires in Xichang City and Huili County in Liangshan Autonomous Region. ResultsThe difference in high-quality nursing awareness among nurses from different ethnic composition, education and job titles was not statistically significant (P>0.05), while the working years, hospital grades and academic titles were influencing factors. Nurses' awareness from secondary hospitals was lower than those from tertiary hospitals (P<0.01). ConclusionThe clinical nurses in Lianshan are aware of the importance of high-quality nursing at work, but they have different views on work performance evaluation due to their working years and hospital grades. Therefore, more scientific management should be strengthened to motivate nurses' working enthusiasm and improve the quality of nursing.

鈍挫傷視神經缺血17例的眼底熒光血管造影分析

眼底熒光血管造影(FFA)能早期發現鈍挫傷視神經病變時血循環障礙。我們報告17例(19眼)檢查結果。其中傷后20天內患者14例，PA主要表現為視盤弱熒光，盤周脈絡膜充盈缺損，視網膜中央動脈及/(或)視網膜中央靜脈充盈延遲。據此稱為挫傷性急性缺血性視神經病變較合理，并強調早期綜合治療。 （中華眼底病雜志，1994，10：32-33）

前房積血為首發癥狀的雙眼視網膜母細胞瘤一例

ULTRASOUND GUIDED CORE-NEEDLE BIOPSY OF NONPALPABLE BREAST LESIONS

目的 評價B超引導下核心針活檢術（CNB）對不可觸及的乳腺病變（NPBL）的診斷價值。方法 采用18G Tru-cut針結合活檢槍對88例患者的96個NPBL行B超引導下CNB，并與切除活檢病理結果比較。結果 NPBL大小4～23mm（平均13.1mm）。在CNB中，86個為良性，2個為可疑惡性，6個為惡性，2個取材不良。在切除活檢中9個為惡性，87個為良性。CNB可疑惡變的2個NPBL均為惡性，1個惡性NPBL誤診為乳腺腺病，取材不良的2個NPBL均為良性。本組NPBL中惡性病變占9.38%（9/96），B超引導下CNB對NPBL的良惡性診斷正確率為98.94%（93/94），診斷乳腺癌的敏感性為88.89%（8/9），特異性為100%（8/8），良性病變的病理診斷符合率為97.70%（85/87），取材不良為2.08%（2/96）。結論 B超引導下CNB對NPBL的診斷具有較高的敏感性和特異性，結果準確可靠。

A Comparative Study on Sensitivity of HE,IHC and RTPCR in Detection of Breast Cancer Metastases in Axillary Lymph Nodes

【Abstract】Objective To compare the sensitivity of HE,immunohistochemistry (IHC) and RT-PCR in detection of breast cancer metastases in axillary lymph nodes.MethodsTwenty female patients with newly diagnosed and clinically nodenegative breast cancers underwent modified radical mastectomy, including a complete axillary lymph node dissection. The ages of the patients ranged from 31 years to 65 years, and the diagnosis of breast cancer was approved by pathological finding. Two hundred and thirty-nine axillary lymph nodes were found in these 20 patients. Metastases in axillary lymph nodes were explored by HE， cytokeratin 19 IHC and RT-PCR for cytokeratin 19 respectively. ResultsSeven(2.9%) lymph nodes were found to have metastatic cancers by HE in 3 patients,all nodes were found in level Ⅰ. Metastatic cancers were found in 13(5.4%) nodes by IHC in 7 patients,11 nodes in level Ⅰ and 2 nodes in level Ⅱ; and 52(21.8%) nodes were found to contain tumor cells by RT-PCR in 14 patients,30 nodes in level Ⅰ and 22 nodes in level Ⅱ. All of 7 histologically(HE) positive nodes were found to contain tumor cells by IHC and RT-PCR. Among 232 histologically(HE) negative nodes,6(2.6%) nodes were found to contain tumor cells by IHC,and 45(19.4%) nodes were found to contain tumor cells by RT-PCR, all 6 IHC positive nodes showed the expected 460-base pair products on gel electrophoresis (P＜0.05).ConclusionThis study suggests that IHC and RT-PCR are more sensitive methods for the detection of micrometastases of breast cancer in lymph nodes than HE is,and RT-PCR is even better than IHC; the micrometastases of breast cancer in axillary lymph nodes could be detected accurately through these techniques.

Effect of Tumor Necrosis Factoralpha Genetransduced Tumor Vaccine in Mice Liver Cancer Implanted Tumors

;ObjectiveUsing human tumor necrosis factoralpha (TNFα) genetransduced human liver cancer cell BEL7404 as tumor vaccine, to study the effect of immune rejection to mice liver cancer implanted tumors. MethodsMice were divided into five groups, and were inoculated with TNFα genetransduced BEL7404 cells which irradiated with 60Co (BEL7404TNFCo group), TNFα genetransduced BEL7404 cells (BEL7404TNF group), BEL7404 cells (BEL7404 group), BEL7404 cell irradiated with 60Co (BEL7404Co group) respectively. Normal saline was injected in control group. Then mice liver cancer H22 cells were implanted to each group, the growth of mice liver cancer implanted tumors was observed. The apoptosis index of implanted tumors was detected by TUNEL method.ResultsCompared to BEL7404 group,BEL7404Co group and control group, the tumor vaccine which did not transduce with TNFα gene and the control group, the tumorigenesis rate of liver cancer implanted tumors was reduced, the growth of implanted tumors was inhibited and the apoptosis of implanted tumors was increased in BEL7404TNFCo group,P＜0.01.There was no difference between BEL7404TNFCo group and BEL7404TNF group,Pgt;0.05. ConclusionHuman tumor necrosis factoralpha genetransduced human liver cancer cell can be used as tumor vaccine, it has quite b effect of immune rejection to mice liver cancer implanted tumors.

Ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilatation in the treatment of frozen shoulder in different clinical stage

Objective To investigate the effect of ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilatation in the treatment of frozen shoulder in different clinical stage. Methods The clinical data of patients with frozen shoulder diagnosed in Zigong Fourth People’s Hospital from January 2020 to January 2021 were collected retrospectively. The patients were divided into three groups according to the clinical stage of frozen shoulder (stage Ⅰ, stage Ⅱ and stage Ⅲ). All patients volunteered to receive ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilatation for 3 consecutive times, with a 2-week interval for each treatment, and followed up for 6 months. Before treatment and 2 weeks, 4 weeks, 2 months, 4 months and 6 months after treatment, the patients were scored with Visual Analog Scale (VAS) and Active Range of Shoulder Motion (AROM), and the capsule thickness of shoulder were measured, respectively. Results A total of 150 patients were included, including 61 patients in stage Ⅰ, 74 patients in stage Ⅱ and 15 patients in stage Ⅲ. The thickness of shoulder joint capsule on the affected side was thicker than that on the healthy side (t=24.384, P<0.001). After treatment, the thickness of shoulder joint capsule and VAS score decreased (P<0.05), and the AROM score increased (P<0.05). Before treatment, the thickness of shoulder joint capsule in stageⅡpatients was higher than that in stageⅠand Ⅲ patients [(4.3±1.0) vs. (2.9±0.5) vs. (3.1±0.4) mm; F=57.195, P<0.001]. Four weeks, 2 months, 4 months and 6 months after treatment, the decrease of shoulder joint capsule thickness was the largest in stageⅡpatients (P<0.05). Compared with stageⅡand Ⅲ patients, stageⅠpatients had the highest VAS score before treatment (7.7±0.7 vs. 5.1±0.8 vs. 4.5±0.7; F=233.560, P<0.001). There was no significant difference in VAS scores among the three groups 4 weeks (F=1.679, P=0.190), 4 months (F=1.348, P=0.263) or 6 months (F= 0.940, P=0.393) after treatment, while there were significant differences in VAS scores among the three groups 2 weeks (F=66.924, P<0.001) and 2 months (F=9.598, P<0.001) after treatment. Compared with stageⅠand Ⅲ patients, stageⅡpatients had the lowest AROM score before treatment (15.2±1.8 vs. 23.5±1.9 vs. 26.1±3.5; F=343.718, P<0.001). Four weeks (F=0.034, P=0.967), 2 months (F=0.222, P=0.801), 4 months (F=0.634, P=0.532) or 6 months (F=0.001, P=0.999) after treatment, there was no significant difference in AROM scores among the three groups, while there was significant difference in AROM scores among the three groups 2 weeks after treatment (F=177.135, P<0.001).Conclusions Ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilation has good efficacy in the treatment of frozen shoulder in different clinical stage. Early injection treatment can shorten the course of the disease and relieve the pain of patients during the course of the disease.