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黄斑区微血管循环及临床意义

黄斑区微血管循环对维持黄斑视功能有特殊作用.视网膜静脉阻塞、糖尿病性视网膜病变、高血压性、外伤性视网膜病变等多种眼底疾患可引起黄斑区微血管循环改变.荧光血管造影、电子计算机图象分析仪、激光、血流动力学分析等现代新技术应用,对黄斑区微血管循环的生理及病理变化有了更进一步的认识.本文就近年来该领域内研究成果及新发展进行了综述,并结合临床及治疗措施进行讨论.黄斑区微血管缺血性病变尚待进一步开展研究. （中华眼底病杂志，1993，9：186-188）

钝挫伤视神经缺血17例的眼底荧光血管造影分析

眼底荧光血管造影(FFA)能早期发现钝挫伤视神经病变时血循环障碍。我们报告17例(19眼)检查结果。其中伤后20天内患者14例，PA主要表现为视盘弱荧光，盘周脉络膜充盈缺损，视网膜中央动脉及/(或)视网膜中央静脉充盈延迟。据此称为挫伤性急性缺血性视神经病变较合理，并强调早期综合治疗。 （中华眼底病杂志，1994，10：32-33）

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.

ULTRASOUND GUIDED CORE-NEEDLE BIOPSY OF NONPALPABLE BREAST LESIONS

目的 评价B超引导下核心针活检术（CNB）对不可触及的乳腺病变（NPBL）的诊断价值。方法 采用18G Tru-cut针结合活检枪对88例患者的96个NPBL行B超引导下CNB，并与切除活检病理结果比较。结果 NPBL大小4～23mm（平均13.1mm）。在CNB中，86个为良性，2个为可疑恶性，6个为恶性，2个取材不良。在切除活检中9个为恶性，87个为良性。CNB可疑恶变的2个NPBL均为恶性，1个恶性NPBL误诊为乳腺腺病，取材不良的2个NPBL均为良性。本组NPBL中恶性病变占9.38%（9/96），B超引导下CNB对NPBL的良恶性诊断正确率为98.94%（93/94），诊断乳腺癌的敏感性为88.89%（8/9），特异性为100%（8/8），良性病变的病理诊断符合率为97.70%（85/87），取材不良为2.08%（2/96）。结论 B超引导下CNB对NPBL的诊断具有较高的敏感性和特异性，结果准确可靠。

前房积血为首发症状的双眼视网膜母细胞瘤一例

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.