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视网膜母细胞瘤的彩色多普勒超声诊断分析

Analysis of Cause of High Incidence of Cervical Cancer of Xinjiang Area from 2000 to 2005

摘要:目的: 调查新疆地区维吾尔族与汉族子宫颈癌及癌前病变发病情况,分析宫颈癌高发原因。 方法 : 2000年1月至2005年12月新疆自治区人民医院妇产科门诊及病房行宫颈细胞学检查的维吾尔族、汉族妇女进行筛查,对宫颈病变阳性者(CINI以上)行病理组织学检查,对结果进行对比分析、综合评价。 结果 : 宫颈涂片人数共计23 205例,其中维吾尔族6 999例、汉族16 206例。宫颈病变阳性者237例,经阴道镜下病理活组织检查证实CINI以上(包括CINI、CINII、CINIII、原位癌、鳞癌、腺癌)病变人数173例,最小年龄31岁,原位癌(维吾尔族)、最大年龄76岁,宫颈磷癌(汉族)。维吾尔族105例(6069%)、汉族68例(3931%)。每年阳性例数中维吾尔族均高于汉族,其中2000年、2001年、2004年、2005年有极显著性差异(P lt;001),2002年、2003年有显著性差异(P lt;005),维吾尔族、汉族在各年龄组中的发病情况无显著性差异(P gt;005)。 结论 : 新疆地区宫颈癌及癌前病变的高发原因是由地区环境、医疗条件、医学发展、救助措施等因素综合作用的结果。Abstract: Objective: To investigate the incidence of cervical cancer and cervical precancerous lesion of uigur nationality and han nationality, in addition, to analysis the cause of cervical cancer’s high incidence. Methods : At first screen cervical cytology of Uigur and Han outpatient and inpatient of department of gynecology and obstetrics in the People’s Hospital of Xinjiang Uigur Autonomous Region from January 1, 2000 to December 31, 2004Secondly biopsy for those patients that cervix pathological change shows positive, then contrast analysis and comprehensive evaluation. Results : Cervix smears are 23205 samples. Uigur nation has 6999 samples and Han nation has 16206 samples. There are 237 patients whose cervix pathological changes shows positive. Among them 173 samples were over CINⅠ(include CINⅠ,CINⅡ,CIN Ⅲ,carcinoma in situ, squamous carcinoma and adenocarcinoma) through colposcopy. The youngest was 31 and diagnosed carcinoma in situ(Uigur), the eldest was 76 and diagnosed squamous carcinoma(Han).The samples of Uigur is 105(6069%) and Han is 68(3931%).The positive samples in Uigur is higher than Han each year, the incidence has extremely significant difference among 2000,2001 and 2004(P lt;001), while it has significant difference between 2002 and 2003 (P lt;005), but in each age group it has no significant difference between Uigur and Han (P gt;005). Conclusion : The high incidence of cervical cancer and cervical precancerous lesion in xinjiang is contribute to environment, medical condition, medical development and aid measures coaffect.

Multiple factor analysis of intraorbital hemodynamic results in diabetic retinopathy

Objective To determine the affected factors of intraorbital hemodynamic results in diabetic retinopathy (DR) and the risk factors related to the occurrence of DR. Methods Posterior ciliary artery (PCA), central retinal artery (CRA), central retinal vein (CRV), and vortex vein (VV) of 68 patients with DR were measured by color Doppler flow image (CDFI). Thirty-one hemodynamic parameters, including systolic velocity, diastolic velocity, mean velocity, resistive index, pulsatility index and accelerative velocity of ophthalmic artery (OA), and other variates (blood pressure, blood sugar, gender, age, duration of the disease, and so on) were collected and clustered in a principal components analys is following a forward, stepwise logistic regression on these components. Results Nine principal components were extracted from 37 original variates, reflecting the velocity of OA, velocity of PCA, resistance of OA, velocity of CRA,resistance of CRA, resistance of PCA, time-related factor, venous drainage factor and gender factor, respectively. In the result of logistic regression, resistance of OA, velocity of CRA, resistance of PCA, time-related factor, and venous drainage factor were the risk factors related to DR. Conclusion The first risk factor affecting DR is time, and intraorbital hemodynamic abnormity influencing the development of diabetic retinopathy may be the increase of resistance of OA, decrease of velocity of CRA, decrease of resistance of PCA, and increase of venous drainage. (Chin J Ocul Fundus Dis，2004，20：98-100)

Clinical Experience of Laparoscopic Choledocholithotomy and Primary Suture: a Report of 58 Cases

ObjectiveTo explore the clinical efficacy and surgical techniques of laparoscopic choledocholithotomy and primary suture. MethodsWe retrospectively analyzed the clinical data of 58 patients who underwent laparoscopic choledocholithotomy and primary suture between January 2009 and December 2014. ResultsAll the 58 patients underwent the surgery successfully. Operation time was 45-125 minutes, averaging 75 minutes. Intraoperative blood loss was between 10 and 50 mL with an average of 20 mL. Postoperative hospital stay was 5-14 days with an average of 7 days. Four cases of biliary leakage were cured by conservative treatment. ConclusionWith operation indications strictly grasped and skillful operation techniques, laparoscopic choledocholithotomy and primary suture are safe and reliable with a good curative effect.

Infection Rate of Acquired Immune Deficiency Syndrome Disease Combined with Penicillium Marneffei Laboratory Test Results and Analysis of Susceptibility

目的 探究艾滋病(AIDS)合并马尔尼菲青霉病(PSM)的感染率，以及常规实验室检查结果和5种抗真菌药物对马尔尼菲青霉菌(PM)的体外抗菌活性。 方法 2006年1月-2009年11月间确诊AIDS患者326例，从其血液、骨髓培养出65株PM，检测该65例患者的血常规、肝功能和肾功能，并对20株酵母相PM进行体外药敏进行分析。 结果 AIDS合并PSM的感染率为19.94%；外周血常规：WBClt;4.0×109/L者48例，HBlt;100 g/L者51例，PLTlt;100×109/L者46例。肝功能检查：ALTgt;40 U/L者49，ASTgt;40 U/L者51例，GGTgt;60 U/L者44例，ALPgt;150 U/L者36例，ALBlt;35 g/L者53例，A/G倒置者50例。肾功能检查：BUNgt;7.2 mmol/L者9例，Crgt;150 μmol/L者4例。20株酵母相PM对5-氟胞嘧啶(5FC)、两性霉素B(AMB)、氟康唑(FCA)、伊曲康唑(ITR)、伏立康唑(VRC)的敏感率分别为75%、90%、80%、90%、90%。 结论 AIDS合并PSM感染率较高；患者感染后外周血WBC、HB、PLT通常低于正常人，肝功能多表现异常，肾功能的改变较少；对PM的治疗以AMB、ITR、VRC为首选。

鼻内镜检查室工作流程再造及效果评价

目的　对鼻内镜检查室流程再造的措施及效果进行总结交流。 方法　2010年10月起，科室成立流程改造小组，剖析原检查流程中存在的不合理、不恰当环节，对检查环境、仪器更新、人员配备、工作模式等方面进行流程的重新设计和改造，并对流程改造后的工作量、就诊秩序、患者满意度与改造前同期指标进行比较。 结果　流程再造后鼻内镜室8个月总检查人数5 187例次，较改造前的3 436例次明显上升；患者之间的纠纷减少，就诊秩序明显改善；患者满意度明显提高。 结论　工作流程再造提高了鼻内镜检查的工作效率和患者满意度，增强了对鼻腔、鼻窦患者的术腔处理能力，更好地满足了患者的需求。

糖尿病视网膜病变激光光凝术后的超声生物显微镜检测

THE VALUE OF PREOPERATIVE ULTRASONOGRAPHY FOR PREDICTING TECHNICAL DIFFICULTIES AND COMPLICATIONS DURING LAPAROSCOPIC CHOLECYSTECTOMY

The aim of this study was to evaluate ultrasonic findings as predictor of potential operative difficulties and complications during laparoscopic cholecystectomy (LC). From Auguest 1995 to December 1996 a total of 328 patients with symptomatic cholelithiasis (92 males, 236 females, mean age 45±17 years) were examined by ultrasonography (US) 1 to 3 days before LC. The US examination assessed six paramenters: (GB) volume of gallbladder thichness of GB wal position of neck of GB, stone mobility, maximal size of stone, and GB adhesions. On the basis of these US findings, a predictive judgment of technical difficulties was expressed as easy, difficult, and very difficult. Two hundred and twenty five patients presented with uncomplicated symptomatic cholelithiasis, and 103 had acute cholecystitis. The operation was predicted to be easy in 38% of cases, difficult in 48% and very difficult in 14% with a good correlation with the surgeon’s intraoperative judgment (Ｐ＜0.01). A significant association was found between stone mobility (Ｐ＜0.01), presence of adhesions (Ｐ＜0.01) and the difficulty of the procedure. Our results suggest that preoperative US is a useful screening test for patients undergoing LC, and it can help predict technical difficulties during LC.

Effect of Visual and Audiovisual Distraction on Anxiety and Acceptance Levels in Patients Undergoing Colonoscopy

Objective　To evaluate the effect of visual and audiovisual distraction on anxiety and acceptance levels among patients undergoing colonoscopy. Methods　A total of 180 consecutive patients undergoing colonoscopy were randomly divided into three groups: group A received visual distraction; group B received audiovisual distraction; and group C received routine care alone. Levels of anxiety and willingness to accept the same intervention if the procedure needed to be repeated were compared among the three groups. Results　The reduction of anxiety score after colonoscopy in group A and group B was greater than that in group C, but the difference was not statistically significant. The rate of willingness to accept the same intervention if the procedure needed to be repeated was significantly different among the three groups: the rates for group A and group B were higher than for group C (Plt;0.05). Conclusions　Both visual distraction and audiovisual distraction can significantly improve patients’ acceptance of colonoscopy. Visual distraction and audiovisual distraction have no significant effect on reducing anxiety.

Study on the ultrastructural characteristic of segments of photoreceptors from retinas of neonatal calf

Objective To study on the ultrastructural characteristic of segments of photoreceptors from neonatal retinas for supporting donor retina choice of retinal transplantation． Methods Photoreceptors from neonatal calf and adult calf were analysed by scanning electron microscopy and transmission electron microscopy． Results Segments of photoreceptors from neonatal calf appeared the mushroom pattern, in which, distal end of outer segment which was ball-shaped formed the head with mushrooms appearance, and the inner segments along with some of outer segments formed the body with mushrooms appearance． Within the outer segment, plasma membranes of adjacent evaginations form a disk subsequently． The a rray of most disks were vertical to the entire length of segments, but some were parallel and slope to．Owing to the incomplete formation, some rim of disk near distal end of outer segment revealed step-shaped appearance． The distal end of outer segment displays some processes consisted of membranous discs, much vesicular material and mitochondria, much rough endoplasmic reticulum (RER) and numerous polyso mes．Segments of photoreceptor connected with outer nuclear layer via the external limiting membrane． Conclusion The typical morphol ogical structures of outer segments suggest the immature and b gowth ability of photoreceptors of the retina of neonatal calf, and therefore the competence for donor material of retinal transplantation． (Chin J Ocul Fundus Dis, 2001,227-229)