介绍一种神经外科手术标本收集器

由于神经外科组织解剖的特殊性,手术医生很难把病灶完整地取出,多数病变组织被吸引器吸走,不能让病人家属更直观、全面地了解病情。为此,我们研制了一种神经外科手术标本收集器,用于临床,效果满意,现介绍如下。     

一种新的细胞学标本染色方法

目的　研究一种染色清晰、操作简便、成本较低的细胞学标本染色方法。方法　瑞氏染液初染及固定 ,姬姆萨染液复染 ,伊红酒精染色和分化。结果　胞核染成紫红色 ,染色质清楚 ,粗细松紧可辨 ;胞浆和核仁呈蓝色略带紫红色。结论　新方法具有配制省时省力、即配即用、成本较低、操作简便、染色时间缩短、细胞着色鲜艳、结构清晰等特点。宜于普及推广。     

介绍一种自制痰液收集器

临床上，为气管插管或气管切开的患者留取痰液标本比较困难。为此，我科自制了痰液收集器，应用效果满意，现介绍如下。     

宫颈细胞学几种细胞形态分析

[目的]讨论宫颈细胞学涂片中几种细胞形态特征，提高宫颈细胞学诊断的正确率。[方法]选择2006年～2007年在我院门诊就诊接受早期子宫颈癌筛查的对象共计2600例，进行宫颈细胞学涂片检查，以组织学诊断为标准，对结果进行分析。[结果]2600例宫颈涂片中，阳性涂片50例，50例作宫颈活检结果为：鳞状细胞癌2例，原位癌2例，CINⅢ级累腺5例，CINⅠ-Ⅱ级10例，其余31例为慢性宫颈炎。对31例的宫颈涂片进行回顾性阅片分析，发现5例涂片中有几种细胞形态特殊，不仔细辨认（或工作经验不足），易误认为癌细胞或可疑癌细胞。它们是：1．肿胀的裸核细胞2．小型的组织细胞3．淋巴样细胞。[结论]上述3种细胞虽然少见，但它的出现应引起临床诊断医师的注意，而且通过仔细辨认是可以掌握的。     

介绍一种滤纸片快速细胞学染色法

为了缩短染色时间，减少染色步骤，加快细胞学病理诊断的过程，我科尝试用伊红和美蓝做成的滤纸片进行快速染色。根据病理常规石蜡切片HE染色和检验血片快速染色的原理进行改进和设计，经过200多例滤纸片细胞学染色的反复摸索，取得了满意的效果。本方法所得到的诊断与普通HE染色结果相符合，同时制片质量好，适用于普查肿瘤和临床急需诊断的细胞学检查，现报告如下。     

介绍一种新的配药方法

1材料与方法1.1材料双管输液器,药物为密封瓶包装,液体溶媒为软包装。1.2方法常规核对并消毒液体瓶口及密封瓶口后,剪开输液器;取出双管输液器分叉以上的部分,一头插入液体瓶,一头插入密封瓶,将留在输液袋内调节输注速度的调节器关紧,用1条输液贴贴在输液器剪开处的中央处（以免剩余输液管调出输液袋外面）;     

介绍一种快速、简便测量细胞大小的方法

在细胞形态学描述中,细胞大小是首先要描述的重要参数之一,是一种客观、量化的指标,对于判断某些异常细胞的来源,及以此为基础的实验室和临床诊断都具有一定参考价值,如MDS、ITP中小巨核细胞的判定[1-3].以往测量细胞大小需要同时使用目镜测微计、镜台测微计,首先校正目镜测微计,然后计算目镜测微计刻度中每格相当于多少μm,再进行实际细胞测量[4],既不方便,结果也不十分精确.如今,基于计算机及相应软件的骨髓细胞电子成像系统越来越普及,为快速、精确地测量细胞大小提供了条件,而且只采用镜台测微计即可完成,不需要使用目镜测微计,简便、快速.现就这一方法介绍如下,供大家参考.     

介绍一种新的排气方法

由于我们门诊输液室的护理人员较少，且输液的患又不固定，所以在患集中时，有时未能及时更换液体，致使空气进入茂菲氏滴管下端的输液管。现介绍一种新的排气方法如下。     

介绍一种新的翻身方法

临床神经科护理中经常遇到脑出血深度昏迷的患者 ,如按常规翻身法常可致患者呼吸停止 ,故有的家属拒绝护士为患者翻身 ,这大大增加了褥疮发生的危险性 ,现介绍一种新的翻身方法。方　法　先在患者身体一侧肩关节、臀部、膝关节、踝关节处各放一个气圈 ,每隔 30ｍｉｎ按摩该侧皮     

介绍一种新的排气方法

在临床工作中,液状输完后未能及时更换,有时会有大量空气进入茂菲氏滴管下段的输液管内,传统方法是从头皮针与输液管接头处排气,既浪费药液,又增加了污染的机会,有时操作不当,可能有少量空气进入体内的危险.现介绍一种新的排气方法.     

Introduction to the novel techniques in microscopy feature issue

The editors introduce the feature issue on “Novel Techniques in Microscopy,” which was the topic of a symposium held on April 12–15, 2015, in Vancouver, BC. This symposium was part of the Optics in the Life Sciences Congress.OCIS codes: (000.0000) General, (000.1200) Announcements, awards, news, and organizational activitiesOptical microscopes emerged as extensions to the limited resolving power of the human eye. While the earliest instruments were mere magnifiers of minute details of the visible world, the tremendous developments in optical imaging technology have transformed the microscope into a device that brings multiple facets of the microcosm into clear view. Smart use of the physical properties of light and its interaction with matter have introduced novel ways to visualize the microscopic realm, as beautifully illustrated by the phase contrast microscope in the 1930s, the application of fluorescence as a contrast mechanism and the invention of the confocal microscope in the late 1950s. Each of these technologies enabled radically new views of biological cells and tissues.The synergy between technical developments in optical microscopy and biological discoveries continues to this day. With each seminal advance, new opportunities arise for uncovering previously hidden aspects of biological samples. Examples include nanoscopic details revealed by super-resolution techniques, fast cellular dynamics captured by high-speed cameras and tissue architecture visualized by label-free nonlinear optical imaging methods.The Novel Techniques in Microscopy (NTM) symposium, held on April 12–15, 2015, in Vancouver, BC, illuminated the enabling role that new optical techniques and approaches continue to play in biological imaging. The symposium presented a broad range of innovations in optical microscopy, from advances in optical tomography, to developments in nonlinear optical imaging, to new methods in super resolution fluorescence microscopy.In this feature issue of Biomedical Optics Express, we have collected several papers that represent some of the technologies discussed at the NTM symposium. These papers highlight advances in photoacoustic flow cytography [1], 3D phase microscopy [2], 3D reconstruction algorithms [3], second-harmonic generation microscopy [4], and ultrahigh-speed imaging [5]. Together, they paint a current portrait of the exciting new developments in optical microscopy.     

Use of a novel double-antibody technique to describe the pharmacokinetics of rapid-acting insulin analogs

OBJECTIVE: To measure the contribution of bedtime intermediate-acting human insulin on the morning plasma insulin profiles after injection of the rapid-acting insulin analogs lispro and aspart in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: A total of 14 patients with type 1 diabetes, aged 35 +/- 13 years (mean +/- SD), participated in this single-blind, randomized crossover study. After taking their usual injection of human intermediate-acting insulin the night before, they were given insulin aspart or insulin lispro (10 units) before a standardized breakfast. The contribution of continuing absorption of the human insulin was measured using a monoclonal antibody not cross-reacting with insulin aspart or lispro, whereas the contribution of the analogs was estimated by subtraction after measurement of all plasma free insulin using an antibody cross-reacting equally with human insulin and both analogs. RESULTS: The correlation coefficient of the fasting free insulin concentrations measured with both insulin methods was 0.95. Fasting free insulin was 95 +/- 25 pmol/l before administration of insulin aspart, when determined with enzyme-linked immunosorbent assay detecting only human insulin, and 71 +/- 20 pmol/l before administration of insulin lispro (NS). Both insulin analogs gave marked peaks of free insulin concentrations, lispro at 40 +/- 3 min and aspart at 55 +/- 6 min after injection (P = 0.01). The later part of the profiles, from 4.5 to 5.5 h after injection, were similar and showed almost no contribution of the insulin analogs. CONCLUSIONS: The combination of insulin assays that detect human insulin only or both human insulin and analogs provides a new tool for studying insulin pharmacokinetics. Using this technique, we showed that 4.5 h after administration of the rapid-acting insulin analogs lispro and aspart, the free insulin levels are almost only attributable to the intermediate-acting insulin given at bedtime.     

Inkjet printing as a novel medicine formulation technique

We demonstrate the viability of using an ink-jet printer to produce a formulation capable of controlling the release of a drug. This is shown for the drug felodipine, an antihypertensive, with polyvinyl pirrolidone (PVP) as an excipient. As felodipine is a poorly water soluble drug, its molecular dispersion in a soluble polymer (ie. PVP) is a commonly used approach to improve bioavailability. Various ratios of felodipine and PVP in an ethanol-DMSO mixture (95/5) were dispensed in picoliter quantities using a piezoelectric ‘ink-jet’ head onto a hydrophobic substrate. The resultant formulation spots were characterized using atomic force microscopy, localized nano-thermal analysis, ATR-IR and imaging confocal Raman spectroscopy. Intimate mixing of the felodipine and PVP within the micro-dots was observed. ATR-IR confirmed the known molecular level interaction of felodipine and PVP through hydrogen bonding. Nanothermal analysis indicated a single glass transition point, indicative of an intimate polymer drug mixture, which is lowered as the drug concentration increases. Confocal Raman microscopy mapping on single micro-scale droplets allowed the visualization of the drug distribution in the spots as well as facilitating characterization of the release of the drug. The drug release can be altered through control of the drug loading. As inkjet printing is an inherently scalable technology, this proof of principal work with single deposited micro-spot formulations demonstrates the potential of this approach to print practical dosage forms (e.g. as an array of many thousands of spots with different release profiles). This, for example, raises the possibility in the future of producing dosage forms at points of care with one or more drugs which have been formulated for the needs of individual patients.     

A novel technique to intubate patients without reliable pulse oximetry

Although advances have been made in the approach to airway management, intubating critically ill patients in the Emergency Department (ED) can still be perilous. In some cases, poor peripheral perfusion may preclude obtaining a consistent or reliable pulse oximetry waveform, and the intubator will not accurately know when the patient begins to desaturate. We describe a case of a patient requiring intubation in whom we were unable to obtain a consistent pulse oximetry waveform. We utilized a novel technique in which a Biphasic Cuirass Ventilation (BCV) device was applied to maintain oxygenation and ventilation during the performance of rapid sequence intubation (RSI). This technique has the potential to improve the safety of RSI, especially in the critically ill patient.     

A novel technique to quantify the instantaneous mitral regurgitant rate

Background

The systolic variation of mitral regurgitation (MR) is a pitfall in its quantification. Current recommendations advocate using quantitative echocardiographic techniques that account for this systolic variation. While prior studies have qualitatively described patterns of systolic variation no study has quantified this variation.

Methods

This study includes 41 patients who underwent cardiovascular magnetic resonance (CMR) evaluation for the assessment of MR. Systole was divided into 3 equal parts: early, mid, and late. The MR jets were categorized as holosystolc, early, or late based on the portions of systole the jet was visible. The aortic flow and left ventricular stroke volume (LVSV) acquired by CMR were plotted against time. The instantaneous regurgitant rate was calculated for each third of systole as the difference between the LVSV and the aortic flow.

Results

The regurgitant rate varied widely with a 1.9-fold, 3.4-fold, and 1.6-fold difference between the lowest and highest rate in patients with early, late, and holosystolic jets respectively. There was overlap of peak regurgitant rates among patients with mild, moderate and severe MR. The greatest variation of regurgitant rate was seen among patients with mild MR.

Conclusion

CMR can quantify the systolic temporal variation of MR. There is significant variation of the mitral regurgitant rate even among patients with holosystolic MR jets. These findings highlight the need to use quantitative measures of MR severity that take into consideration the temporal variation of MR.     

A novel ultrasound technique to estimate right ventricular geometry during fibrillation

Finite element modelling of the heart for the purpose of studying the electric fields of defibrillation shocks requires knowledge of the geometry of the heart during fibrillation. However, the standard method of measuring this geometry, MRI. cannot be used during fibrillation because the heart geometry changes rapidly and perhaps unpredictably. We present a new ultrasound approach to measuring the right ventricular geometry during fibrillation and preliminary data using this technique. In six anaesthetized pigs, we find that a short axis cross-sectional area of the right ventricle increases by 38% during a 30 s episode of ventricular fibrillation. A long axis cross-sectional area increases by 19% during this same time. By fitting parameters of a simple geometric model to the experimental data, we estimate that the volume of blood in the right ventricular cavity increases by approximately 30% during the episode of ventricular fibrillation. We present the first study of the RV area during-fibrillation with the estimated volume. Our data suggest changes in defibrillation threshold may be linked to current shunting through the increased blood volume.     

Reduction of multi-dimensional laboratory data to a two-dimensional plot: a novel technique for the identification of laboratory error.

BACKGROUND: The clinical laboratory generates large amounts of patient-specific data. Detection of errors that arise during pre-analytical, analytical, and post-analytical processes is difficult. We performed a pilot study, utilizing a multidimensional data reduction technique, to assess the utility of this method for identifying errors in laboratory data. METHODS: We evaluated 13,670 individual patient records collected over a 2-month period from hospital inpatients and outpatients. We utilized those patient records that contained a complete set of 14 different biochemical analytes. We used two-dimensional generative topographic mapping to project the 14-dimensional record to a two-dimensional space. RESULTS AND CONCLUSIONS: The use of a two-dimensional generative topographic mapping technique to plot multi-analyte patient data as a two-dimensional graph allows for the rapid identification of potentially anomalous data. Although we performed a retrospective analysis, this technique has the benefit of being able to assess laboratory-generated data in real time, allowing for the rapid identification and correction of anomalous data before they are released to the physician. In addition, serial laboratory multi-analyte data for an individual patient can also be plotted as a two-dimensional plot. This tool might also be useful for assessing patient wellbeing and prognosis.