Inadequate rates are lower when FNAC samples are taken by cytopathologists

Inadequate rates (IR) in FNAC from different sources were compared. The rates were lowest when FNAC was performed by a cytopathologist (12%) and highest when done by a non-cytopathologist (32%). These differences were mirrored in high IRs in breast cancer cases. IR was not significantly improved when non-cytopathologist FNAC was attended by a cytotechnician.     

Evaluation of the Cost Effectiveness of Establishing A Fine Needle Aspiration Cytology Clinic In A Hospital Out-Patient Department

In an attempt to reduce the number of inadequate smears processed by our laboratory and the false negative rate of fine needle aspiration cytodiagnosis, we have introduced a fine needle aspiration cytology service where aspirates are taken by the cytopathologist in a clinic. In the 12 month period since the introduction of this service, the number of inadequate smears fell sharply. Nine per cent of the specimens were inadequate compared with 43% of specimens from other sources. The establishment of the clinic resulted in a threefold reduction in the cost of diagnosing breast lesions.     

上海市医院预约诊疗服务实施效果分析

?????? 目的 对上海市医院预约诊疗服务的实施效果进行分析,为今后预约诊疗服务工作的推进提供参考依据。方法 通过现场问卷、专家小组访谈、数据采集等方式,了解预约诊疗服务实施效果。结果 预约诊疗服务的信息系统、服务系统、管理系统和评价系统逐渐完善,并在预约诊疗服务的实施过程中发挥出巨大作用。结论 预约就医模式已经逐步被患者所接受,其能有效减少患者就医中的无效等候时间,缓解目前存在“看病难”、医疗资源分配不合理等问题,但无法从根本上解决医疗资源稀缺、供求关系不均等的问题。     

No need for speed: slow development of fungi in extreme environments

Microbial growth under extreme conditions is often slow. This is partly because large amounts of energy are diverted into cellular mechanisms that allow survival under hostile conditions. Because this challenge is universal and diversity in extreme environments is low compared to non-extreme environments, slow-growing microorganisms are not overgrown by other species. In some cases, especially when nutrients are scarce, slow growth was even shown to increase stress tolerance. And in at least some species of extremotolerant and extremophilic fungi, growth rate appears to be coupled with their very unusual morphologies, which in turn may be an adaptation to extreme conditions. However, there is more than one strategy of survival in extreme environments. Fungi that thrive in extremes can be divided into (i) ubiquitous and polyextremotolerant generalists and (ii) rarely isolated specialists with narrow ecological amplitudes. While generalists can compete with mesophilic species, specialists cannot. When adapting to extreme conditions, the risk of an evolutionary trade-off in the form of reduced fitness under mesophilic conditions may limit the maximum stress tolerance achievable by polyextremotolerant generalists. At the same time, specialists are rarely found in mesophilic environments, which allows them to evolve to ever greater extremotolerance, since a reduction of mesophilic fitness is likely to have little impact on their evolutionary success.     

脑梗塞的临床表现与CT显示的关系

探讨脑梗塞的临床表现和ＣＴ显示关系。回顾性分析５８例脑梗塞病例的临床资料和ＣＴ图像。ＣＴ显示脑梗塞病灶８小时内阳性显示率最低,５％（１／２０）;２４￣４８小时阳性显示率最高,７８．２％（４３／５５）。脑干及小脑部位梗塞ＣＴ不易显示,ＭＲＩ能明确诊断。根据临床表现和熟悉脑梗塞的病理过程,采取合理的ＣＴ检查和复查时机极为重要,从而提高脑梗塞检查和诊断中ＣＴ检查的敏感性和准确性。提高临床的诊治率,减少后     

综合干预对原发性骨质疏松治疗依从性及生活质量的影响

目的:探讨骨质疏松防治综合干预对特需门诊原发性骨质疏松(POP)患者治疗依从性及生活质量的影响。方法:以2010年5月~2013年5月期间四川大学华西医院国际医疗中心收治的112例POP患者为研究对象,分为干预组和对照组,在药物治疗的同时给予不同的护理措施,6个月后比较两组干预前后POP知识掌握程度(OKT评分)、疼痛(VAS评分)、骨密度(BMD)以及生活质量(OQOLS评分)改善情况;随访1年后评价两组治疗依从性以及骨折发生率。结果:经过6个月的干预,干预组OKT评分、VAS评分以及BMD和治疗前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001)。干预组OQOLS评分的5个维度以及生活质量总评分和干预前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001),对照组心理维度和社会维度和干预前比较差异不大(P0.05)。两组随访1年,干预组完全依存比例明显高于对照组,不依从比例低于对照组(P0.001);干预组病理性骨折发生率低于对照组(P0.05)。结论:对特需门诊收治的原发性骨质疏松患者在药物治疗的基础上实施综合护理干预,能够明显提高患者的治疗依从性,提高骨密度增加比例,减少疼痛,降低骨折发生率,改善患者生活质量。     

鼻眶脑毛霉菌病16例临床病理分析

目的探讨鼻眶脑毛霉菌病(ROCM)的临床与病理特征,提高对该病的认识和病理诊断水平。方法回顾分析首都医科大学附属北京同仁医院1998～2008年16例ROCM患者的病历资料。用HE、PAS和GMS染色显示组织病变特点及真菌的形态特征,对1例石蜡组织行透射电镜观察。结果 14例(87.5%)有基础疾病,2例(12.5%)无特殊病史。死亡5例(31.3%),3例死于ROCM,2例死于原发病。CT示鼻腔鼻窦软组织密度影16例,MRI示眶内(15例)和颅内(5例)异常信号影。真菌培养7例阳性(43.8%)。组织病理:16例均见组织凝固性坏死、真菌性血管炎及肉芽肿,骨质破坏9例,外周神经纤维坏死7例。特殊染色菌丝形态均符合毛霉目真菌;透射电镜见菌丝形态不规则,菌壁电子密度高。结论 ROCM主要见于糖尿病和血液系统恶性肿瘤者,亦见于无基础疾病者。常见致病菌为根霉和毛霉。在病变组织中找到符合毛霉目真菌形态特点的菌丝可确诊。对临床症状、影像学、真菌培养及病理学表现等多方面进行综合分析可明确诊断。     

Cannibalism and intraguild predation in Typhlodromus exhilaratus and T. phialatus (Acari: Phytoseiidae) under laboratory conditions

Two species of Phytoseiidae are found in the same agroecosystem: Typhlodromus exhilaratus prevails in vine plots, while T. phialatus prevails in uncultivated surrounding areas. The objective of the present paper was to investigate whether the poor settlement of T. phialatus in vine plots can be explained by intraguild predation of these two species and/or cannibalism. Predatory abilities of the females on larvae and protonymphs were studied under laboratory conditions. A first experiment was conducted with only conspecific or heterospecific phytoseiid prey, in a second experiment Tetranychus urticae eggs were added to the phytoseiid prey. Oviposition, prey consumption, and escape rates of females were recorded. Oviposition and intraguild predation rates were higher for T. exhilaratus than for T. phialatus. Typhlodromus exhilaratus consumed fewer conspecifics than heterospecific phytoseiids, and oviposited when feeding on both diets. Typhlodromus phialatus consumed equal amounts of con- and heterospecifics. Although these two generalist predators belong to the type III defined by McMurtry and Croft (Annual Review of Entomology 42:291–321, 1997), our results suggest that they have different predation behaviour. However, because these results were obtained in experiments where no choice was given between the two phytoseiid species, they are difficult to link to previous studies conducted on the intraguild predation of the Phytoseiidae. The greater voracity and prolificacy of T. exhilaratus could partially explain the poor settlement of T. phialatus in vineyards and the predominance of T. exhilaratus. However, a full understanding of this phenomenon will require the study of other factors, such as susceptibility to pesticides and micro-climatic conditions, as well as the ability to cope with different food sources and host plants.     

Tracking the effects of one century of habitat loss and fragmentation on calcareous grassland butterfly communities

Habitat loss and fragmentation are known to reduce patch sizes and increase their isolation, consequently leading to modifications in species richness and community structure. Calcareous grasslands are among the richest ecosystems in Europe for insect species. About 10% (1,150 ha) of the total area of a calcareous ridge region (Calestienne, Belgium) and its butterfly community was analysed over a timeframe of about 100 years. Since 1905 to present day (2005), the Calestienne region has undergone both calcareous grassland loss and fragmentation: not only did calcareous grassland size decrease and isolation increase, but also, the number of calcareous grassland patches within the landscape increased until 1965, and subsequently decreased, clearly reflecting the effects of fragmentation. These processes have had a profound effect on the butterfly community: extinction and rarefaction affected significantly more often specialist species, which means that generalist species are more and more overrepresented. This ecological drift, i.e. the replacement of specialists by generalists in species assemblages is likely to be a general effect of habitat loss and fragmentation on natural communities.