聚丙交酯复合乙交酯微球经肝动脉化疗栓塞术治疗肝癌的动物实验

目的：在肝细胞癌动物模型上观察聚丙交酯复合乙交酯（PLcG)微球经肝动脉化疗栓塞术（TACE）治疗肝癌的疗效。方法：在雄性ACI大鼠（15例）肝包膜下植入Morris Hepatoma 3924A肝癌小瘤块（1mm3),移植术中13天时行磁共振检查,再经正中腹切开术和经胃十二指肠动脉逆行插管进行以下介入治疗：治疗组A（40mg PLcG 0.05mg丝裂霉素,4例）,对照组B（0．05mg丝裂霉素＋0．04mg碘化油＋肝动脉结扎,4例）和对照组C（1．5ml生理盐水,7例）,插管术后13天再次行磁共振术观察肝肿瘤体积变化。结果：在C组,肿瘤体积在实验期间增长27．12倍,在B组,肿瘤体积增长3．76倍,而在A组,肿瘤体积仅增长2．87倍。A组与C组肿瘤体积增长率在t检验时均有显著性差异（P＜0．05）,结论：在动物实验中将PLcG微球运用于TACE可明显抑制肝肿瘤生长。     

Ocular Damage Due to Chlorhexidine versus Eyeshield Thermal Injury

BACKGROUND: Ocular damage may occur from a number of mechanisms during laser use. OBJECTIVE: To review issues relevant to ocular protection during laser resurfacing. METHODS: The authors were consulted to evaluate the thermal energy transferred from the outer to the inner (ie, corneal contact) surface of stainless steel eyeshields following direct exposure to the carbon dioxide (CO2) resurfacing laser beam. Measurements were obtained using thermocouples (attached to the inner surface of the eyeshields) and analyzed with a computer-based acquisition system. RESULTS: A maximum eyeshield temperature increase of 13 degrees C above the ambient temperature was noted following one pass with a CO2 resurfacing laser (Sharplan continuous CO2 laser with Clinicon SureScan scanner, 15 W, 950 microsec pulse duration, square spot of 9 mm). CONCLUSION: The eyeshields analyzed in this study minimized thermal transfer following a single direct hit with a CO2 resurfacing laser. An understanding of the potential mechanisms of ocular injury is essential in preventing its occurrence.     

Peripheral Triangular Fibrocartilage Complex Tears Cause Ulnocarpal Instability: A Biomechanical Pilot Study

Background  

Instability at the ulnocarpal joint has many causes, but the common thread among these causes is the presence of abnormalities in the triangular fibrocartilage complex (TFCC). However, the biomechanical consequences at the ulnocarpal joint after detachment of the TFCC from the ulnar styloid are not clearly defined. Better delineation of whether peripheral TFCC detachments cause ulnocarpal instability will help to design surgical treatments.     

Humour in health‐care interactions: a risk worth taking

Background Humour is a complex, dynamic phenomenon that mainly occurs in social situations between two or more people. Most humour research reviews rehearsed as opposed to spontaneous humour and rarely review the patients’ perspective. Aim We explore patients’ perspectives on the use of humour in health care. We discuss the asymmetrical and divergent humour use between patients and clinical nurse specialists and posit nurses’ approaches to risk as a contributing factor. Design A constructivist grounded theory collated researcher‐provoked (interviews, observation, field notes, pre‐and post‐interaction audio diaries) and non‐researcher‐provoked data (naturally occurring interactions) over 18 months. This paper is based upon four patient focus groups. A constant comparison approach to data collection and analyses was applied using interpretative and illustrative frameworks that balanced what was ‘known’ and ‘unknown’ about humour. Setting and participants Patients were recruited from four patient–peer groups. Three audio‐taped (n = 20) and one observed focus group interactions (n = 12) were undertaken at the groups’ regular meeting places. Results Patients hold a broad appreciation of humour and recognize it as being evident in subtle and nuanced forms. Patients wish health‐care staff to initiate and reciprocate humour. Conclusion A chasm exists between what patients apparently want with regard to humour use in health‐care interactions and what actually transpires. Initiating humour involves risk, and risk‐taking requires a degree of self‐esteem and confidence. Nurses are, arguably, risk‐averse and have low self‐esteem. Future research could review confidence and self‐esteem markers with observed humour use in nurses and their interactions across a range of specialities.