改良石蜡切片免疫荧光染色在肾脏病理诊断中的应用

以肾活检组织为例,采用双盲对照法,对石蜡切片、冰冻切片同时行免疫荧光染色,石蜡切片采用改良的方法,将只能用于冰冻切片的FITC标记的荧光抗体运用于石蜡切片,取得了较满意的结果。     

简便实用的快速冷冻切片固定剂

目的研究冷冻切片固定剂以缩小冷冻切片与石蜡切片的差距,减少误漏诊率。方法用新配方固定剂固定冷冻切片2min再进行常规染色制片。结果切片着色鲜明,细胞核、浆清晰,结构分明。结论新配方冷冻切片固定剂因其高效实用可以应用于临床快速病理诊断。     

一种超薄切片定位捞片技术的建立与应用

目的建立针对目标超薄切片的精准展片、捞片方法,以提高透射电子显微镜检测超薄切片的效率。方法以环氧树脂PON-812、丙烯酸树脂L R White 2种不同类型树脂包埋病毒感染的培养细胞及动物组织样本并进行超薄切片。用定位环套取漂浮在刀槽液面上的目标切片,以限制切片移动,以四氯甲烷气体展片,再以捞片环捞取目标切片,最后对切片进行染色及透射电镜观察。结果通过建立的定位捞片法能够对目标切片进行靶向性隔离、展片,实现超薄切片的靶向性精准捞片。结论建立了一种针对目标超薄切片进行精准定位捞片的方法。     

卵巢肿瘤快速冰冻切片212例病理诊断分析

目的:探讨术中冰冻切片病理诊断对卵巢肿瘤的诊断价值。方法:回顾性总结2001年~2005年绍兴市妇幼保健院212例卵巢肿瘤术中冰冻切片诊断与术后石蜡切片诊断的符合情况。结果:利用冰冻切片诊断卵巢肿瘤与石蜡切片比较,冰冻切片诊断的确诊率为94.34%,共有12例冰冻切片诊断错误,误诊率为5.66%。结论:术中冰冻切片病理诊断是术中确定卵巢肿瘤性质的有效方法,临床医师与病理医师团结协作是提高诊断准确性的有效途经。     

应用六西格玛缩短冰冻切片病理报告时间

冰冻切片又称冷冻切片.临床上,有的疾病在术前无法通过活检确定病变性质,而只有通过在术中切取病变组织,经病理诊断后方能确定治疗方案,此种方法称为术中冰冻切片,其本质是一项特殊的临床病理急会诊工作.冰冻切片与常规(石蜡)切片有所不同,主要体现在时间性与准确性上.前者要在极短的时间内做出病理诊断,因此其准确性较常规切片低.据国内外资料,三甲医院冰冻切片诊断误诊率可达5%左右.     

“宫颈切片”到底是什么

在妇科就诊的患者心中常常有这样的疑问:"宫颈切片"到底是什么?为什么要做"宫颈切片"?"宫颈切片"是不是会很疼?"宫颈切片"后要注意些什么?"宫颈切片"会不会对性生活产生影响?宫颈切片事实上,老百姓口中的"宫颈切片"是一个泛称,包括宫颈脱落细胞学病理切片和宫颈活检组织病理切片,是由妇科医生通过宫颈细胞学检查或者宫颈活检分别获取患者的宫颈脱落细胞和少量宫颈组织,送至病理科.     

不同固定液对冰冻切片质量的影响

目的探讨不同同定液对冰冻切片质量的影响以指导临床应用。方法冰冻切片采用五种不同固定液固定,HE染色,与同组织常规石蜡切片依照石蜡切片质量标准评判对照。结果五种固定液都可用于冰冻切片,制片技术操作未发现问题,但不同固定液的冰冻切片镜下组织细胞形态有一定差别。结论乙醚一无水乙醇固定液最佳,含有冰醋酸成分的周定液建议谨慎使用。     

GS组织标本制备及切片染色技术的应用体会

目的探讨GS组织标本制备及切片染色技术替代传统二甲苯透明、脱蜡制片技术的效果。方法应用GS组织标本制备及切片染色技术替代传统技术制作组织蜡块及切片染片技术。结果用此方法制作的组织蜡块,切片形成连续蜡带,制作常规HE切片,细胞核、质染色结构对比清晰。结论 GS组织标本制备及切片染色技术能够替代传统制片技术,并符合环保要求。     

甲状腺冰冻切片与石蜡切片病理诊断及意义对照

目的:对照分析甲状腺冰冻切片和石蜡切片的病理诊断结果,并比较其临床意义.方法:选取我院2016年10月到2017年5月收治的136例甲状腺疾病患者作为研究对象,术前切去病变组织进行冰冻切片病理检查,分别在术中、术后分别实施冰冻切片病理诊断、石蜡切片病理诊断.比较二者的诊断结果.结果:136例甲状腺疾病的术中冰冻切片病理诊断结果与术后石蜡切片诊断结果进行对照,完全符合96例,基本符合27例,总符合率为90.44％(123/136),延期诊断的患者7例,误诊患者6例,分别占5.14％、4.41％.结论:甲状腺术中冰冻切片和术后石蜡切片诊断的一致性较高,且术中冰冻切片病理诊断更为快速、方便,可对患者的术中手术方式、范围等的选择与确定进行指导;而术后石蜡切片病理诊断的可靠性强,可以作为术后确诊的手段.     

PDCA循环法在提高病理石蜡切片优良率中的应用

目的：运用PDCA循环法提高病理石蜡切片的优良率。方法：应用PDCA循环法持续改进石蜡切片质量,收集2019年实施PDCA改进前的1-6月石蜡病理切片2 820例以及实施PDCA改进后的7-12月石蜡病理切片3 360例作为研究对象,分析比较实施PDCA循环法前后的切片质量。结果：实施PDCA改进前,2 820例切片优良率92.34%;实施PDCA改进后,3 360例切片优良率97.35%,切片质量明显提高。结论：实施PDCA循环法可有效降低病理石蜡切片质量不良问题的发生率,值得推广应用。     

Cultivating a worldly repose: the contribution of Sally Gadow's work to interpretive inquiry

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of Gadow's contribution in opposition to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance.     

Factors related to outcome following a work hardening program

The purpose of this study was to determine factors related to a return to work following the completion of a work hardening program. Data from the Workers' Compensation Board of Alberta Millard Rehabilitation Centre for 1527 discharges, collected over 22 months, were examined retrospectively. Factors related to return to work were compared bivariately using logistic regression procedures. A multiple logistic regression model for return to work was also determined. The principle predictor of return to work was job-attached status to the pre-injury employer. Other factors related to return to work were education, primary diagnosis, injury to admission time, job attachment to the pre-accident employer, employer's annual payroll, and vocational direction. Due to the strength of the association between job-attached status to the pre-injury employer and a return to work, it was concluded that attempts to maintain this relationship should be a priority for rehabilitation providers and insurance carriers.     

基层医院医疗纠纷特点及防范对策

文章对基层医院医疗特点进行了分析,认为防范医疗纠纷的措施包括：强化医院内部管理、倡导医学人文精神、提高业务水平、增强法制观念、尊重患者权力、加强医患沟通、强化纠纷管理、注重解决纠纷技巧等。     

加快推进继续医学教育工作 为卫生事业发展奠定基础

探讨继续医学教育工作。结合我国继续医学教育工作的实际，应在以下方面加快推进继续医学教育工作：进一步提高认识，切实加强对继续医学教育工作的领导；进一步完善继续医学教育相关制度，加强和规范继续医学教育的监督管理；加大对农村和基层继续医学教育工作的支持力度；突出重点，加快推进医学继续教育工作：加强继续医学教育管理干部队伍建设。     

Reducing occupational exposure to chemical carcinogens

Strategies for controlling occupational exposure to chemicalcarcinogens are set out in the European Union Carcinogens Directiveand in national legislation such as the British Control of SubstancesHazardous to Health Regulations. While such legislative requirementsmust apply to all occupational chemical carcinogens, it is arguedthat priority should be given to controlling those agents thatcontribute most to the cancer burden. Examples of possible strategiesto reduce exposure to two agents (diesel exhaust particulateand paint emissions) are discussed. It is concluded that thereare no real technical difficulties in controlling exposuresto chemical carcinogens; however, for many of the key agents,we need to change attitudes to the potential risks and clearlydemonstrate to employers and employees how to reduce the exposures.     

Working ‘off the record’: polio eradication and state immunity in Chad

The reappearance of polio in Chad generates anxieties about governance as well as public health. Since Chad was declared polio-free in 2003, at least 180 cases of paralytic polio have been linked to importations of wild poliovirus from Nigeria. In efforts to eradicate polio through house-to-house vaccination campaigns, international agencies have aggressively implicated political leaders, placing those authorities in a bind. On the one hand, governments are required to demonstrate compliance in the form of universal vaccination. On the other hand, the legitimacy of political leaders and of local authorities in particular depends upon their ability to show compassion for their populations and to be responsive to individual circumstances and concerns about the drops. This article looks at how the obligation of the African state to adopt global public health policy as its own becomes problematic when the goals and protocols of international agencies rely on the assumption that the state controls its population. Under pressure to render account to international agencies, state officials deploy high-level politicians to enforce vaccination mandates at critical moments, create administrative forms to record campaign progress that conceal difficulties in vaccinating children, and use statistics to portray the campaigns as success stories. Local authorities, who feel the bind most acutely, grant exceptions to the mandate of universal vaccination to certain subjects and work with local vaccinators and supervisors to keep cases of unvaccinated children ‘off the record’. These efforts allow the vaccination campaigns to be carried out without incident even as they work against the goal of polio eradication.     

Timing of steps and reasons for delays in obtaining abortions in the United States

OBJECTIVE: We studied the steps in the process of obtaining abortions and women's reported delays in order to help understand difficulties in accessing abortion services. METHODS: In 2004, a structured survey was completed by 1209 abortion patients at 11 large providers, and in-depth interviews were conducted with 38 women at four sites. RESULTS: The median time from the last menstrual period to suspecting pregnancy was 33 days; the median time from suspecting pregnancy to confirming the pregnancy was 4 days; the median time from confirming the pregnancy to deciding to have an abortion was 0 day; the median time from deciding to have an abortion to first attempting to obtain abortion services was 2 days; and the median time from first attempting to obtain abortion services to obtaining the abortion was 7 days. Minors took a week longer to suspect pregnancy than adults did. Fifty-eight percent of women reported that they would have liked to have had the abortion earlier. The most common reasons for delay were that it took a long time to make arrangements (59%), to decide (39%) and to find out about the pregnancy (36%). Poor women were about twice as likely to be delayed by difficulties in making arrangements. CONCLUSIONS: Financial limitations and lack of knowledge about pregnancy may make it more difficult for some women to obtain early abortion.     

Leptin and Insulin Action in the Central Nervous System

Body adiposity is known to be carefully regulated and to remain relatively stable for long periods of time in most mammalian species. This review summarizes old and recent data implicating insulin and leptin as key circulating signals to the central nervous system, particularly the ventral hypothalamus, in communicating thesizeand thedistribution of body fat stores.This input ultimately alters food intake and energy expenditure to maintain constancy of the adipose depot. The key primary neurons in the arcuate nucleus containing NPY/AgRP and POMC/CART appear be critical constituents of the CNS regulating system, and are shown to contribute to anabolic and catabolic signaling systems to complete the feedback loop. New data to indicate shared intracellular signaling from leptin and insulin is provided. The satiety system for meals, consisting of neural afferents to the hind-brain from the gastrointestinal tract, is described and its effectiveness is shown to vary with the strength of the insulin and leptin signals. This provides anefferent mechanism that plays a key role in a complex feedback system that allows intermittent meals to vary from day to day, but provides appropriate long-term adjustment to need. Recently described contributions of this system to obesity are described and potential therapeutic implications are discussed.     

An activity week for children with cancer: who wants to go and why?

Many children now live with cancer rather than die from it, and such children need both to continue their social, emotional and cognitive development and to make long-term psychological adjustments. This paper presents the findings of a research project set up to explore issues pertinent to the current provision of an activity week experience for a group of British paediatric cancer patients. The aims of the study included finding out which factors discriminate between families who apply for a place to attend the week for their child and families who do not, and to develop a knowledge of what factors are considered by parents and children. The findings suggest that the week appeals to children who are confident, active and able to separate from parents and whose parents are keen to encourage independence and new experiences. Children diagnosed and treated at a younger age and further away from treatment were more likely to express concerns about being homesick and safety and to not apply for the week. Issues of protection, independence and disability are discussed with reference to the importance of parental attitude on children's psychological accommodation to disease and treatment and to the experiences of adult survivors of childhood cancer.     

Charging for NHSPlus: an inferential study based on the internal provision of occupational health services within the National Health Service

BACKGROUND: 'NHSPlus' was conceived as a national agency that would provide occupational health services to organizations, for a fee, without imposing any financial burden on the taxpayer. This self-funding requirement brings into focus the resource implications for such a service and the determination of the charges to be made to external clients. AIM: The existing provision of occupational health services to >100000 National Health Service (NHS) staff by 13 NHS occupational health services of various sizes was analysed, with the objective of determining an appropriate charge-out rate to third parties. METHOD: Two focus groups were questioned on their work external to the NHS. Data collected on the allocation of doctors and nurses to occupational health services in relation to the number of NHS clients serviced were used to investigate the nature of the resourcing relationship using regression analysis. RESULTS: The relationship was found to be stable enough to provide a good estimate of staff requirements (the key resource requirement). Combining this with costing information allowed inferences to be drawn concerning the economic cost and hence the break-even rate of charge for the service. This was then compared with the employer charge rates in the NHSPlus published case studies. CONCLUSIONS: The results suggest that the per capita charges to external clients are lower than the per capita cost of internal occupational health provision within the NHS, raising questions about the viability of the service.