目的 探討經陰道B型超聲（B超）在診斷早期宮外孕中的臨床應用價值。 方法 回顧分析2011年5月－2012年3月應用陰道B超與腹部B超對78例宮外孕患者進行對比檢查的臨床資料并回顧性分析，評價兩種檢查方法的臨床效果。 結果 78例宮外孕患者，應用經陰道B超檢查診斷準確率為97.44%，應用腹部B超準確率為61.54%，差異具有統計學意義（χ2=6.472，P＜0.05）；經陰道B超檢查診斷附件包塊、宮內假孕囊、心血管搏動、胚芽、盆腔積液的檢出率明顯高于經腹部B 超檢查的檢出率（P＜0.05）。 結論 陰道B超具有操作簡單、快速、無副作用、無需充盈膀胱等優點，在宮外孕的早期診斷中具有絕對的優越性，為臨床提供了更方便、更快捷的診斷手段，減輕了患者痛苦，提高了診斷的準確率，值得臨床廣泛推廣和應用。
【摘要】 目的 探討乳腺浸潤性導管癌中表皮鈣黏蛋白（E-cadherin，E-cad）的表達及其意義。 方法 選取2005年1月－2009年12月的組織病理切塊，用免疫組織化學EnVision二步法檢測63例乳腺浸潤性導管癌（invasive ductal carcinoma，IDC）組織中E-cad的表達情況，設為IDC組；另檢測15例乳腺纖維腺瘤及15例乳腺小葉增生癥乳腺組織中E-cad的表達情況，設為對照組；比較兩組的E-cad表達。 結果 E-cad在IDC組及對照組中表達陽性率分別為58.7%、80.0%；兩組間差異有統計學意義（Plt;0.05）。在乳腺IDC患者中，年齡lt;38歲和≥38歲組的E-cad陽性表達率分別是54.2%、61.5%，兩組間差異無統計學意義（Pgt;0.05）；腫塊直徑lt;3 cm和≥3 cm組的E-cad陽性表達率分別是54.8%、66.7%，兩組間差異無統計學意義（Pgt;0.05）；組織學分級為Ⅰ+Ⅱ級和Ⅲ級組的E-cad陽性表達率分別是76.3%、32.0%，兩組間差異有統計學意義（Plt;0.05）；無、有腋窩淋巴結轉移組的E-cad陽性表達率分別是78.3%、47.5%，兩組間差異有統計學意義（Plt;0.05）。 結論 E-cad的表達與患者年齡及腫塊大小無關，而與組織學分級、淋巴結轉移相關。在乳腺浸潤性導管癌中，無淋巴結轉移者E-cad表達高于有淋巴結轉移者，提示E-cad是乳腺浸潤性導管癌發生淋巴結轉移的重要指標。【Abstract】 Objective To explore the expression of the protein E-cadherin (E-cad) in invasive ductal carcinoma (IDC) of the breast and its significance. Methods We chose 63 cases of pathological wax with IDC between 2005 and 2009, and immunohistochemical EnVision method was used to detect the expression of E-cad protein in these cases which were designated to be the IDC group. At the same time, the E-cad expression in 15 cases of breast adenoma and another 15 cases of breast lobular hyperplasia were also detected, and these cases were designed to the the control group. The expression of E-cad in these two groups were compared. Results The positive rates of E-cad protein expression in the IDC group and the control group were respectively 58.7% and 80.0% with a significant difference between the two groups (Plt;0.05). In the IDC group, the positive rates of E-cad protein expression in patients agedlt;38 and ≥38 years old were respectively 54.2% and 61.5% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for tumors with a diameter lt;3 cm and ≥3 cm were respectively 54.8% and 66.7% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for class Ⅰ+Ⅱ tumors and class Ⅲ tumors were respectively 76.3% and 32.0% with a significant difference (Plt;0.05). The positive rates of E-cad protein expression for patients without and with axillary lymph node metastasis were respectively 78.3% and 47.5% with a significant difference (Plt;0.05). Conclusions The expression of E-cad is correlated with histological classification and lymph node metastasis and was not related to tumor size and age of the patients. The expression of E-cad is higher in IDC patients without lymph node metastasis than that in IDC patients with lymph node metastasis, which indicates that E-cad is an important index for lymph node metastasis of IDC.
ObjectiveTo explore the effect of precise management on life-saving equipment management in Surgical Intensive Care Unit (SICU). MethodsWe actualized precise management in the life-saving equipment management process in March 2014, including precise management control system, precise personnel training, and precise process management. ResultsAfter precise management, the knowledgement of life-saving equipment of the nurses increased from 90.2% (May, 2014) to 98.5%. The number of equipments repaired before (March-May, 2014) and after the management (June-August, 2014) was 65 and 47, respectively; the number of nonstandard management times in nurses after the equipments were used was 98 and 10, respectively. ConclusionPrecise management can drastically improve management efficiency, serviceability rate and service efficiency of life-saving equipment, obviously enhancing the degree of familiarity and using skills of clinical nurses, and ensuring quick and smooth emergency work. It plays an active role in securing severe patients' life.
目的：評價低分子肝素(Low molecular weight heparins，LMWH)皮下注射持續時間對注射后皮下出血和疼痛的影響。方法：納入2003年～2004年3月于我院行LMWH皮下注射的住院患者52例，以肚臍兩側作為注射點，任選一側行首次注射，12 h后于另一側以相同劑量注射。臍右注射持續10秒(對照組)，臍左持續30秒(實驗組)。于注射后48 h、72 h觀察注射點有無皮下出血，并用透明紙質毫米尺測量出血面積，用視覺類比量表(Visual analog scale，VAS)測量疼痛強度，記錄疼痛持續時間。采用卡方檢驗及配對t檢驗對兩組皮下出血發生率及面積、疼痛強度及持續時間等指標進行對比分析。結果：實驗組和對照組皮下出血的發生率分別為38.5%(n=20)和61.5%(n=32)(P=0.035)。注射后48h、72h，實驗組的出血面積均顯著低于對照組(48h：17.5±7.3 mm2 VS 101.2±15.0 mm2，P=0.008；72h：20.7±8.0 mm2 VS 110.4±13.5 mm2，P=0.016)。實驗組的注射后疼痛積分為13.0±6.4 mm，對照組為21.5±7.0 mm(P=0.021)。實驗組疼痛持續時間顯著低于對照組(42.5±14.2 s比73.2±20.0 s，P=0.030)。結論：肝素皮下注射持續時間能顯著影響注射后皮下出血和疼痛形成，注射時間持續至30秒能有效降低皮下出血發生率及面積，并顯著減輕疼痛強度、縮短疼痛時間。