Removal of Polyps with Fibreoptic Colonoscope: A New Approach to Colonic Polypectomy

By using a colonoscope diathermy snare a total of 75 polyps have been removed from sites throughout the colon in 43 patients. There was some haemorrhage in four cases but no other morbidity, and all patients were discharged home within 24 hours. The ease of this procedure suggests that it should replace colotomy and surgical polypectomy in the management of polyps inaccessible to the rigid sigmoidoscope.     

Hospital Topics: The Hospital Consultant's Secretary

Analysis of work done by the secretaries attached to one medical unit in a general hospital showed that much was discretionary in character and entailed making decisions. Work in the unit was made easier and more efficient by this intelligent use of initiative by the secretaries. At present the pay given to medical secretaries in hospital is below a level that would be commensurate with their responsibility.     

Preparation of Whole Rabbit Knee Joints for Microscopic Examination

A paraffin embedding method to prepare whole rabbit knee joints for histological examination is described. This method provides good quality microscopic sections thin enough for the study of cellular detail and does not require prolonged processing. When examining pathologic changes in experimental arthritis, it is advantageous to be able to examine the intact joint with the structural relations of the joint components preserved. Sections of the whole joint provide numerous areas where bone, cartilage and synovium are contiguous for examination. Having obtained poor results using methods recommended for small bony specimens, we modified several existing procedures to obtain a reliable method for preparing excellent microscopic sections of the whole rabbit knee joint.     

我院优化医技检查流程的实践探索

平均住院日是衡量医院医疗效率的重要指标之一。对临床一线医师 “平均住院日延长原因及管理瓶颈”的调查发现,“医技检查时间长”（45.75%）是影响平均住院日的主要原因。因此,将医技检查流程分解为开单预约、检查等待和报告出具三个阶段,对症下药,通过自动预约、分时段检查、电子签名体系和PACS系统上线等信息化手段,显著提升医技检查效率,同时缩短平均住院日,提高患者满意度。     

Fibreoptic bronchoscopy today: a review of 255 cases.

An analysis of 255 fibreoptic bronchoscopies showed that the major indication for bronchoscopy was suspected bronchial carcinoma (93% of cases). Of the 183 patients finally shown to have bronchial carcinoma 83% had abnormal bronchoscopy findings and 65% had bronchial biopsy specimens diagnostic of malignancy. These figures were superior to those obtainable with rigid bronchoscopy, particularly with upper lobe and peripheral tumours. Brush biopsy and bronchography were useful supplementary techniques. Sputum cytology gave poorer results than fibreoptic bronchoscopy, but enabled diagnosis in some otherwise undiagnosed cases. The complication rate was low and the claim of this new technique to be the investigation of choice in bronchial carcinoma seemed to be justified in clinical practice.     

Chromoendoscopy with a Standard-Resolution Colonoscope for Evaluation of Rectal Aberrant Crypt Foci

Colorectal cancer (CRC) is the second most common cause of death worldwide. According to the theory by Vogelstein, colorectal carcinogenesis involves a series of successive changes in the normal colonic mucosa, starting with excessive proliferation and focal disorders of intestinal crypts, followed by adenoma and its subsequent malignant transformation. The first identifiable changes in CRC carcinogenesis are aberrant crypt foci (ACF). ACF are invisible during routine colonoscopy yet are well identifiable in chromoendoscopy using methylene blue or indigo carmine. High-resolution colonoscopes are used for assessment of ACF. The aim of the present study was to evaluate the usefulness of standard-resolution colonoscopy for identification of rectal ACF. The following parameters were evaluated: duration of chromoendoscopy of a given rectal segment, type of ACF, sensitivity and specificity of endoscopy combined with histopathological evaluation. The mean duration of colonoscopy and chromoendoscopy was 26.8 min. In the study population, typical ACF were found in 73 patients (p = 0.489), hyperplastic ACF in 49 (p = 0.328), and dysplastic ACF in 16 patients (p = 0.107). Mixed ACF were observed in 11 individuals (p = 0.073). The sensitivity of the method was found to be 0.96 whereas its specificity 0.99.Identification of rectal ACF using standard-resolution colonoscopy combined with rectal mucosa staining with 0.25% methylene blue is characterised by high sensitivity and specificity.     

医院不良事件全过程信息化管理探讨

目前大部分医院实施了信息化不良事件管理机制,但缺乏对不良事件上报的事前、事中和事后的全过程精细化管理。系统阐述了不良事件全过程信息化的管理过程,设计了不良事件综合信息系统,充分利用信息化技术并创新的推进医院不良事件管理工作。     

Whole Mount Preparation of Chick Blastodermal Edge Tissue for Microscopic Examination

Three methods of preparation of chick blastodermal edge tissue for conventional microscopy were attempted: (1) Sections were cut from Water Wax (E. Gurr) embedded material. This method was unsatisfactory due to loss of morphological relationships produced by the inability to attach the tissue to a slide. (2) Frozen sections were cut from embryonic marginal tissue with its underlying white and yellow yolk which was embedded in a 25% gelatin solution. This method retained morphological relationships prior to 24 hr of egg incubation, but was technically impractical in excess of this period of incubation. Also, the gelatin could not be removed from the sections and cellular detail was obscured by its subsequent staining. (3) The blastoderm was removed from the yolk and adherent vitelline membrane, and the yolk dissected from a small piece of this blastodermal edge tissue under a dissecting microscope. The dissected tissue, primarily monocellular and dicellular in thickness, was transferred to a slide and attached to it by allowing a few drops of ether-alcohol (1:1) to flow over it. The plane of the tissue was, therefore, parallel with the plane of the slide. Most fixatives and staining techniques could subsequently be used. Fixing for 30-120 min in ether-alcohol (1:1) containing 0.5% glacial acetic acid gave excellent results with the staining techniques attempted. Fixation with Zenker's fluid for 24 hr followed by a 6 min hydrolysis with 1 N HC1 was best prior to the Feulgen technique.     

医院检查预约流程优化与设计

医院各医技科室的传统检查预约服务流程存在弊端,各检查系统各自管理检查预约登记和确认,无法做到资源共享,且患者等待时间过长。为了解决以上问题,对医院的检查预约流程进行了梳理和优化,提出对医院多个检查科室的预约登记进行统一管理,为各检查科室提供统一的检查预约平台,实现统一预约和自助预约相结合,并开通智能提醒服务将患者预约和排队信息告知患者。     

Colon tumor: enzymology of the neoplastic program

The biochemical strategy of colon tumor was investigated by comparing the enzymic programs of glycolysis, pentose phosphate production and purine and pyrimidine biosynthesis and degradation in liver, normal colon mucosa and transplantable colon adenocarcinoma in the mouse. In normal colon mucosa the carbohydrate and pentose phosphate enzymes were 2- to 9-fold higher in specific activity than those in liver. Among the enzymes of CTP synthesis, CTP synthetase was the rate-limiting one in both liver and colon. In colon tumor CTP synthetase, OMP decarboxylase, uracil phosphoribosyltransferase and thymidine kinase activities increased to 927, 863, 597 and 514% of activities of normal colon. In contrast, the activity of the catabolic enzymes, dihydrothymine dehydrogenase and uridine phosphorylase, decreased to 51 and 25%. The ratios of activities of uridine kinase/uridine phosphorylase and thymidine kinase/dihydrothymine dehydrogenase were elevated 6- and 10-fold. The activity of the key purine synthetic enzyme, glutamine PRPP amidotransferase, increased 7-fold and the opposing rate-limiting enzyme of purine catabolism, xanthine oxidase, decreased to 7%. The ratio of amidotransferase/xanthine oxidase was elevated to 8, 150%. Activities of glucose-6-phosphate dehydrogenase and transaldolase did not increase, but that of pyruvate kinase was elevated to 154%. Similar enzymic programs were observed in a transplantable adenocarcinoma of the colon in the rat. The alterations in gene expression in colon tumor manifested in an integrated pattern of enzymic imbalance indicate the display of a program, a segment of which is shared with rat and human liver and kidney tumors. These alterations in gene expression should confer selective advantages to colon tumor cells. The striking increases in the activities of CTP synthetase, OMP decarboxylase, glutamine PRPP amidotransferase and thymidine kinase mark out these enzymes as potentially sensitive targets for combination chemotherapy by specific inhibitors of these enzyme activities.