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【Objective】 To investigate the current status of incision sites to obtain intact specimens in laparoscopic nephrectomy by urologists in China, so as to provide reference for the standardized procedure. 【Methods】 During Jun.20, 2021 and Jul.4, 2021, more than 20 000 urologists in a WeChat group were surveyed with a questionnaire. The general data, incision sites and related complications were statistically analyzed. 【Results】 A total of 601 valid questionnaires were collected, covering urologists from 31 provinces, autonomous regions and municipalities. Surgical approaches: 68 urologists chose trans-abdominal approach, 432 chose posterior abdominal space approach, 101 chose both surgical approaches. Incision sites: 97 urologists chose lumbar transverse incision, 202 chose dorsal oblique incision of the waist, 119 chose ventral oblique incision, 93 chose the paramedian incision, 112 chose the lower abdominal oblique incision (Gibson), 11 chose the transverse lower abdominal incision (Pfannenstiel), 7 chose the median incision of the lower abdomen, 2 chose the median incision in the upper abdomen, 15 chose axillary midline direct incision; 399 chose to cut off the muscles, and 202 chose not to. Complications: 232 urologists reported pain after 2 weeks, 369 reported no pain; 325 reported numbness after 2 weeks, 276 reported no numbness; 66 reported incisional hernia, 535 reported no hernia. 【Conclusions】 Chinese urologists tend to choose retroperitoneoscopic nephrectomy and waist incision to obtain intact specimens. Transperitoneal laparoscopic nephrectomy has a variety of incisions for intact specimens. There is no standardized incision sites to obtain intact specimens.
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Introducción. Existen resultados inconsistentes con relación al planteamiento de la hipótesis que sugiere una mayor probabilidad de documentar un carcinoma papilar de tiroides en especímenes quirúrgicos con cambios compatibles con tiroiditis linfocítica crónica. En los metaanálisis existentes se han incluido estudios no comparables metodológicamente y no se proponen claras fuentes de sesgo, justificación para la realización del presente metaanálisis. Métodos. Se realizó una búsqueda bibliográfica en Pubmed y Embase. Fueron obtenidos estudios retrospectivos donde se comparaba la prevalencia de carcinoma papilar de tiroides en especímenes con y sin cambios por tiroiditis linfocítica crónica. La evidencia recolectada fue sintetizada estadísticamente. Resultados. Un total de 22 artículos fueron incluidos. La población estuvo conformada por 63.548 especímenes. El OR combinado fue 1,81 (IC95%: 1,51-2,21). Hubo heterogeneidad entre la distribución de las razones de oportunidad entre los estudios (I2= 91 %; p>0,00001). La forma del gráfico en embudo de los estudios incluidos en el análisis parece estar simétrica, lo que indica la ausencia del sesgo atribuible a los estudios pequeños. Conclusiones. La literatura actual sugiere que existe un mayor riesgo de documentar un carcinoma papilar de tiroides en especímenes quirúrgicos en los que se observan cambios compatibles con tiroiditis linfocítica crónica; sin embargo, existen fuentes de sesgo que no será posible controlar en estudios retrospectivos, por lo que recomendamos estudiar la hipótesis que sugiere una mayor probabilidad de diagnosticar un carcinoma papilar de tiroides en especímenes con cambios compatibles con tiroiditis linfocítica crónica mediante metodologías prospectivas
Introduction. Inconsistent results exist in the literature regarding the hypothesis statement suggesting an increased likelihood of documenting papillary thyroid carcinoma (PTC) in surgical specimens with changes compatible with chronic lymphocytic thyroiditis. Existing meta-analyses have included studies that are not methodologically comparable and do not propose clear sources of bias, thus, this is justification for the present meta-analysis. Methods. A literature search in Pubmed and Embase was performed from January 1, 1950 to December 31, 2020. Retrospective studies comparing the prevalence of papillary thyroid carcinoma in specimens with and without chronic lymphocytic thyroiditis changes were obtained. The collected evidence was statistically analyzed. Results. A total of 22 articles were included. The study population consisted of 63,548 surgical specimens. The pooled OR, based on the studies, was 1.81 (95% CI: 1.51-2.21). There was heterogeneity between the distribution of prevalence ratios and opportunity ratios across studies (I²= 91%; p>0.00001). The funnel plot shape of the studies included in the analysis appears to be symmetrical, indicating the absence of bias attributable to small studies. Conclusions. The current literature suggests that there is an increased risk of documenting papillary thyroid carcinoma in surgical specimens in which chronic lymphocytic thyroiditis-compatible changes are observed; however, there are sources of bias that will not be possible to control for in retrospective studies, so we recommend studying the hypothesis suggesting an increased likelihood of diagnosing PTC in specimens with chronic lymphocytic thyroiditis-compatible changes using prospective methodologies
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Humanos , Doença de Hashimoto , Câncer Papilífero da Tireoide , Manejo de Espécimes , Estudos Retrospectivos , Metanálise , Revisão SistemáticaRESUMO
Introduction:Plastination has been one of the most effective preservative methods for organic tissue during the last four decades. In this technique, water and lipid content present within biological tissue samples are substituted by polymers (silicone, epoxy, pol yester), resulting in dry, durable, and odourless specimens. Plastinated specimens are now used as teaching tools and various medical disciplines, such as anatomy, pathology, radiology, surgery, and so on across the world. Since its development by Gunther von Hagens in 1977, plastination is getting increasing acceptance by the day and proving itself to be an excellent resource material for both teaching and learning. This review highlights the origin, procedure, types, significance, and drawbacks of plastination along with its ethical aspects.
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Objective:To investigate the application value of the PDCA cycle in increasing the rate of timely completion of a rapid frozen-section pathological report.Methods:The basic data of 1 926 rapid frozen section pathological reports not managed by the PDCA cycle in the Department of Pathology, Zhoushan Hospital, during January to August 2019 were collected. The number of pathological reports completed within 30 minutes and the rate of timely completion of pathological reports were calculated and compared with those calculated based on 1 051 pathological reports managed by the PDCA cycle during September to December 2019.Results:After management by the PDCA cycle, the rate of timely completion of frozen-section pathological reports was significantly increased from (84.51 ± 3.61)% to (91.87 ± 1.37)% ( t = 3.86, P < 0.05). Conclusion:Application of the PDCA cycle to pathology management can help monitor the completion of pathological reports on frozen sections. This facilitates determination of reasonable intervention measures and thereby increases the rate of timely completion of pathological reports on frozen sections.
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In the standardized diagnosis and treatment process of advanced gastric cancer, there is a unappreciated key link between standard radical surgery and accurate pathological reports. That is, the process of dissection, fixation, sampling and recording of the specimen by the surgeons, starting from specimen isolation to the management of the pathologist. Standardizing this process can not only accurately reflect the detailed distribution and exact number of lymph nodes, but also clarify the pathological stage of gastric cancer, so as to make adjuvant treatment plans. Moreover, it can also reflect the scope of intraoperative lymph node dissection to ensure the standardized implementation of surgery, including the overall dissection principle (en bloc resection), and therefore can provide a solid foundation for later related researches. So far, there is still a lack of complete and unified standard for the surgical management of specimens after radical gastrectomy in China. On the basis of the relevant researches and clinical practice about specimen management at home and abroad, the Chinese Journal of Gastrointestinal Surgery, in the name of the Gastric Cancer Professional Committee, Chinese Anticancer Association, as well as the Oncogastroenterology Professional Committee, Chinese Anticancer Association, organized dozens of experts to formulate a consensus on the standardized surgical management of specimens after repeated discussions and revisions for two years. This consensus is aimed to standardize the preparations, basic requirements and sample processing procedures before the surgical treatment of postoperative specimens after a radical surgery for gastric cancer patients, including the processing time of specimens, the processing and data archiving of gastric specimens, and lymph node grouping, sorting and fine sorting records, etc and with the purpose of standardizing the surgical treatment of postoperative specimens on the basis of standardized diagnosis and treatment of gastric cancer, in order to further promote the high-quality development of gastric cancer surgery in China.
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Humanos , Consenso , Gastrectomia/métodos , Excisão de Linfonodo/métodos , Linfonodos/patologia , Neoplasias Gástricas/cirurgiaRESUMO
Standardized surgical management of postoperative specimens of gastric cancer is an important part of the standardized diagnosis and treatment of gastric cancer. It can reflect the accurate number and detailed distribution of lymph nodes in the specimen and lay the foundation for accurate and standardized pathological reports after surgery. Meanwhile, it can evaluate the scope of intraoperative lymph node dissection, the safety of cutting edge, and the standardization of surgery (principle of en-bloc dissection), which is an important means of surgical quality control. It also provides accurate research samples for further research and is an important way for young surgeons to train their clinical skills. The surgical management of postoperative specimens for gastric cancer needs to be standardized, including specimen processing personnel, processing flow, resection margin examination, lymph node sorting, measurement after specimen dissection, storage of biological specimens, documentation of recorded data, etc. The promotion of standardized surgical management of specimens after radical gastrectomy can promote the homogenization of gastric cancer surgical diagnosis and treatment in medical institutions and further promote the high-quality development of gastric cancer surgery in China.
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Humanos , Gastrectomia , Laparoscopia , Excisão de Linfonodo , Linfonodos/cirurgia , Neoplasias Gástricas/cirurgiaRESUMO
Abstract Residual DBS specimens from newborns diagnosed with Phenylketonuria, Congenital Hypothyroidism, Cystic Fibrosis, Congenital Adrenal Hyperplasia and Galactosemia collected within 1995-2018, stored in cardboard boxes at ambient temperature in uncontrolled conditions, were retested for phenylalanine (Phe), thyrotropin (TSH), immunoreactive trypsinogen (IRT), total galactose (TGal) and 17-hydroxyprogesterone (17OHP), to demonstrate how long are they stable in these conditions and useful to reconfirm a previous abnormal result. Recovery percentage at retesting and qualitative interpretation regarding the current cutoff were evaluated. Phe, TSH and IRT recoveries showed decreasing trends along time. Phe recovery was 64 % after 2-years storage; TSH decayed rapidly recovering 47.3 % at 1-year, while IRT showed recoveries of 60 % at 1-year. Although 17OHP recovery presented a wide variation of results, a decaying trend was also found. Results suggest 17OHP is more stable than TSH and IRT, as supported by recoveries > 71 % when stored ≤ 2-years. TGal recovery presented an erratic behavior, so that it was not possible to estimate expected concentrations as a function of storage time. TGal recoveries above 100 % were found in UDP-galactose-4-epimerase and galactose-1-phosphate uridyltransferase deficiencies, evidencing possible galactose liberation from other sources. These results make a very valuable contribution for programs storing residual DBS in uncontrolled conditions.
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BACKGROUND The high demand for adequate material for the gold standard reverse transcription real-time polymerase chain reaction (RT-qPCR)-based diagnosis imposed by the Coronavirus disease 2019 (COVID-19) pandemic, combined with the inherent contamination risks for healthcare workers during nasopharyngeal swab (NP) sample collection and the discomfort it causes patients, brought the need to identify alternative specimens suitable for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVES The aim of this work was to compare saliva and gingival fluid swabs to NP swabs as specimens for RT-qPCR-based SARS-CoV-2 diagnosis. METHODS We compared gingival fluid swabs (n = 158) and saliva (n = 207) to the rayon-tipped NP swabs obtained from mild-symptomatic and asymptomatic subjects as specimens for RT-qPCR for SARS-CoV-2 detection. FINDINGS When compared to NP swabs, gingival fluid swabs had a concordance rate of 15.4% among positive samples, zero among inconclusive, and 100% among negative ones. For saliva samples, the concordance rate was 67.6% among positive samples, 42.9% among inconclusive, and 96.8% among negative ones. However, the concordance rate between saliva and NP swabs was higher (96.9%) within samples with lower cycle threshold (Ct) values (Ct > 10 ≤ 25). MAIN CONCLUSIONS Our data suggests that whereas gingival fluid swabs are not substitutes for NP swabs, saliva might be considered whenever NP swabs are not available or recommended.
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Humanos , Teste para COVID-19 , COVID-19 , Saliva , Manejo de Espécimes , Nasofaringe , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2RESUMO
COVID-19, caused by SARS-CoV-2 virus which is declared as a pandemic by the WHO on March 2020 has made a huge difference in the practice and daily activities of the laboratory services. There are high chances of receiving potentially infectious samples to the laboratory for various tests. Authors propose a few biosafety measures in the preparation and processing of various pathology specimens received to the lab during this pandemic time in correlation with guidelines given by WHO. These safety measures aim at protecting and safe guarding the laboratory staff, trainees, and pathologists by minimizing the exposure to COVID-19.
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OBJECTIVE@#To explore the treatment conditions of acid decalcified specimens and improve the poor quality of sections and unclear structure of hematoxylin-eosin (HE) staining caused by the change in pH in tooth and hard tissue after acid decalcification.@*METHODS@#A total of 20 cases of oral pathological specimens that contain hard tissues were decalcified and treated with routine treatment, concentrated ammonia water immersion treatment, and saturated lithium carbonate solution immersion treatment. The quality and HE staining effects of hard tissue sections treated with different methods were compared.@*RESULTS@#Compared with routine treatment, lithium carbonate saturated solution treatment showed complete sections. Hematoxylin is strongly stained, the nucleus is clear, and the cytoplasm is bright.@*CONCLUSIONS@#Soaking acid decalcified specimens in lithium carbonate saturated solution before embedding in dehydration can neutralize the acidic environment of the tissue. The quality of sections and HE staining effect are improved and are suitable for the pretreatment of acid decalcified tissue samples of oral pathology.
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Amarelo de Eosina-(YS) , Hematoxilina , Coloração e Rotulagem , DenteRESUMO
Objective@#To develop RT-nPCR assays for amplifying partial and complete VP1 genes of human enteroviruses (HEVs) from clinical samples and to contribute to etiological surveillance of HEV-related diseases.@*Methods@#A panel of RT-nPCR assays, consisting of published combined primer pairs for VP1 genes of HEV A-C and in-house designed primers for HEV-D, was established in this study. The sensitivity of each RT-nPCR assay was evaluated with serially diluted virus stocks of five serotypes expressed as CCID @*Results@#The sensitivity of RT-nPCR assays for amplifying partial VP1 gene of HEVs was 0.1 CCID @*Conclusion@#This RT-nPCR system is capable of amplifying the partial and complete VP1 gene of HEV A-D, providing rapid, sensitive, and reliable options for molecular typing and molecular epidemiology of HEVs in clinical specimens.
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Humanos , Proteínas do Capsídeo/genética , Enterovirus Humano A/genética , Enterovirus Humano B/genética , Enterovirus Humano C/genética , Enterovirus Humano D/genética , Epidemiologia Molecular/métodos , Tipagem Molecular/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodosRESUMO
Abstract: We report range extensions for three species of Amazonian erethizontids, Coendou bicolor, C. ichillus, and C. nycthemera. We record C. ichillus for the first time in Brazil, from Rio Japurá, state of Amazonas. We record C. bicolor for the first time in the state of Amazonas, which represents a range extension of approximately 905 km. We also extend the occurrence of C. nycthemera 620 km to the south into Mato Grosso state. All records are based on museum specimens, highlighting the importance of scientific collections as biodiversity databases and emphasizing the lack of research on Amazonian porcupines.
Resumo: Aqui nós relatamos ampliação de distribuição de três espécies de eretizontídeos amazônicos: Coendou bicolor, C. ichillus e C. nycthemera. Nós registramos pela primeira vez C. ichillus no Brasil, no Rio Japurá, estado do Amazonas. Registramos C. bicolor pela primeira vez no estado Amazonas, o que representa uma ampliação de distribuição de aproximadamente 905 km. Também estendemos a ocorrência de C. nycthemera 620 km ao sul, no estado de Mato Grosso. Todos os registros são baseados em espécimes de museu, enfatizando a importância das coleções científicas como bancos de dados da biodiversidade e a destacando ausência de pesquisas para porcos-espinhos amazônicos.
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Introduction: Prostate gland involved by a no. of benignand malignant diseases is a common cause of morbidity andmortality in the elderly men. The present study was an attemptto understand the histopathological spectrum of prostaticlesions in the specimens received by a tertiary care hospital.Material and Methods: 433 cases of prostatic specimensincluding TURP chips, TRUS guided biopsies and Prostaticspecimens received in the Department of Pathology,Government Medical College Srinagar were included in thepresent study. There were 344 needle biopsies and 82 TURPchips. All the specimens were fixed in 10% neutral bufferedformalin and thin sections were stained with Hematoxylinand Eosin stain (H&E stain). Relevant clinical data includingage, the presenting complaints and S.PSA values in suspectedcases of carcinoma prostate were recorded.Results: A total of 433 prostate specimens were receivedduring the period of three years. The specimens included 344TURP chips and 82 TRUS guided biopsies. 7 prostectomyspecimens were also included. The age of the patients variedfrom 42 years to 89 years. There were 380 benign cases and53 malignant cases. The most common presenting featurewas increased frequency of micturition followed by difficultyin starting and stopping the stream of urine. Among benignlesions the most frequent histopathological entity observedwas benign nodular hyperplasia. The most common age ofpresentation was the sixth to seventh decade of life. Almostall neoplasms of the prostate were prostatic adenocarcinomaswith most of the cases seen in the sixth to seventh decade oflife with another peak in the seventh to eight decade of life.Conclusion: A variety of benign and malignant lesions areseen in prostatic specimens. These need to be differentiatedand classified. Benign nodular hyperplasia is the mostcommon benign lesion and prostatic adenocarcinoma isthe most common malignant lesion of Prostate. Perineuralinvasion is a significant finding and guide. Serum PSA is auseful adjunct in cases where the values are higher.
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Proper evaluation and management of surgical specimens of colorectal cancer,such as standardizing the macroscopic evaluation criteria of colorectal cancer specimens,standard processing procedure of specimens,decision criteria of routine histologic types,the method for determination of the resection specimen infiltration distance and curative degree,are of important clinical significance for surgical quality control,assessment of local lesion infiltration and diffusion,pathological classification and stage,which is able to predict prognosis and guide postoperative treatment.
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Objective@#To estimate the dietary salt and potassium intake by two 24 hour urine salt and potassium excretion in primary and secondary school students.@*Methods@#The boarders from Grade 5 to 6 in a rural primary school and Grade 1 to 3 in a rural middle school in Changde City, Hunan Province were recruited from October to December in 2017. Subjects who had 2 and more urinary incontinence episodes or a history of kidney disease or diarrhea and girls in menstruation were excluded. The final analysis included 284 subjects. Questionnaires on basic demographic information were collected, and height and weight were examined. Two inconsecutive 24-hour urine specimens were collected in weekdays. The differences and consistency between two 24-hour urine were tested and dietary salt and potassium intake were assessed by the average of two 24-hour urine collections.@*Results@#A Total of 284 participants was (12.1±1.5) years old, of which 148 (52.1%) were boys and 36 (12.7%) were overweight. In the first 24-hour urine, the volume [P50 (P25, P75)=670 (513, 868) ml], potassium concentration [P50 (P25, P75)=29 (21, 39) mmol/L] and potassium excretion [P50 (P25, P75)=0.7 (0.6, 1.0) g] were similar to those in the second 24-hour urine [P50 (P25, P75) values were 660 (490, 916) ml, 30 (21,40) mmol/L, and 0.8 (0.6, 1.0) g, respectively]. But the sodium and creatinine concentrations, salt excretion in the first 24-hour urine [P50 (P25, P75) values were 175 (123, 219) mmol/L, 7.20 (5.15, 10.86) mmol/L and 6.6 (5.0, 8.7) g, respectively] were lower than those in the second 24-hour urine [P50 (P25, P75) values were 188 (133, 248) mmol/L, 8.66 (5.99, 12.47) mmol/L and 7.3 (5.2, 9.2) g, respectively] (all P values<0.05). The intraclass correlation coefficients between salt and potassium excretions in the two 24-hour urine were 0.534 (95%CI: 0.412-0.631) and 0.478 (95%CI: 0.341-0.587) (P<0.001), respectively. The mean±SD of salt consumed was (7.3±2.5) g (range: 2.3 to 18.8 g) per day by all participants. Overweight children consumed more salt [(8.2±2.6) g/d] than those non-overweight [(7.2±2.4) g/d] (P<0.05). The mean±SD of potassium consumed was (1.1±0.3) g (range: 0.4 to 2.3 g) per day. Boys consumed more potassium [(1.1±0.3) g/d] than girls [(1.0±0.3) g/d] (P<0.05), and overweight children had higher potassium intake [(1.2±0.3) g/d] than those non-overweight [(1.0±0.3) g/d] (P<0.05). A total of 212 participants (74.6%) consumed more salt than the recommended level and all participants had inadequate potassium intake.@*Conclusion@#The problem of excessive salt intake and insufficient potassium intake of rural primary and middle school students was serious.
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Objective To compare the application of PCR-fluorescence probe, Bactec MGIT960 and Xpert MTB／RIF in diagnosis of tuberculosis from non-respiratory specimens.Methods Non-respiratory specimens from 225 patients with suspected tuberculosis admitted in Zhejiang Hospital of Integrated Chinese Medicine and Western Medicine from October 2017 to August 2018 were collected.There were 177 cases of tuberculosis and 48 cases of non-tuberculosis confirmed by clinical diagnosis.All specimens were tested with PCR-fluorescence probe, Xpert MTB／RIF and Bactec MGIT960.The clinical diagnostic results were used as the gold standard, and the receiver operating characteristic curve ( ROC) was drawn to evaluate the diagnostic values of three methods.The consistency of PCR-fluorescence probe method with Xpert MTB／RIF assay was analyzed.Results The sensitivity of PCR-fluorescent probe, Xpert MTB／RIF and Bactec MGIT960 in diagnosis of tuberculosis was 53.67%(95／177), 58.76%(104／177) and 31.07%(55／177), respectively.The sensitivity of PCR-fluorescent probe and Xpert MTB／RIF was higher than that of Bactec MGIT 960 culture ( χ2 ＝17.60 and 27.41, P＜0.01), while there was no significant difference between the PCR-fluorescent probe and the Xpert MTB／RIF (χ2 ＝0.93, P＞0.05).The specificity of three methods were 100.00%(48／48), 100.00%(48／48) and 97.92%(47／48), respectively (F＝1.83, P＞0.05).ROC curve analysis showed that the area under the ROC curve ( AUC) of PCR-fluorescent probe, Xpert MTB／RIF, and Bactec MGIT960 was 0.768, 0.794, and 0.645, respectively.The diagnostic value of PCR-fluorescent probe and Xpert MTB／RIF for tuberculosis was significantly higher than that of Bactec MGIT960 (Z＝5.19 and 6.52, P＜0.01); while Xpert MTB／RIF was superior to PCR-fluorescence probe (Z＝2.8, P＜0.05).In various types of specimens , there was no significant difference in the detection rate of tuberculosis between PCR-fluorescent probe method and Xpert MTB／RIF (χ2 ＝0.73, P＞0.05).The PCR-fluorescent probe and Xpert MTB／RIF had a good consistency (kappa＝0.829).Conclusion Xpert MTB／RIF is superior to PCR-fluorescence probe in the detection of tuberculosis in non-respiratory specimens such as tissues and pus, but the two have good consistency.The PCR-fluorescence probe method is economical and practical , and easy to promote, which has a high clinical application prospects.
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The purpose of this study was to investigate the sphenoidal sinus septation in a select South African population, and document the relation of the number and location of the septa to the structures intimately related to the sinus. The intersinus and intrasinus septa of the sinus, the number and attachments of the septa were recorded from forty five cadaveric head specimens. The sphenoidal sinus intersinus septa were recorded as follows: Type 0 (absent septum) in 7.5 %, Type 1 (single septum) in 65 % and Type 2 (double septa) in 22.5 % of cases. The incidence of intersinus septa deviating to the left was prevalent; hence, the right sphenoidal sinus was dominant. The occurrence of intrasinus septa was observed in 93.3 % of cases, with a higher prevalence in males. The intrasinus septa formed cave like chambers on the sinus walls in 65.6 % cases. Incidences of the intersinus septa attaching to sella turcica (ST) (46.25 %) were prevalent compared to cases where they attached to the internal carotid artery (ICA) (6.25 %), maxillary (MN) (1.25 %) and vidian (VN) (1.25 %) nerves. However, the intrasinus septa attached more to the ICA (52.63 %) compared to their attachment to the other neurovascular structures (ST - 26.32 %; MN - 5.36 % and VN - 2.63 %). Surgeons need to be aware of the complex anatomical variations of the sphenoidal sinus septation when performing endoscopic endonasal transsphenoidal surgeries.
El propósito de este estudio fue investigar la septación del seno esfenoidal en una población sudafricana y documentar la relación del número y la ubicación de los septos en relación a las estructuras íntimamente relacionadas con el seno. Los septos interseno e intraseno del seno, el número y las uniones de los septos se registraron a partir de cuarenta y cinco cadáveres. El septo interseno del seno esfenoidal se registró de la siguiente manera: Tipo 0 (tabique/septo ausente) en el 7,5 %, Tipo 1 (tabique/septo único) en el 65 % y Tipo 2 (tabiques/septos dobles) en el 22,5 % de los casos. La incidencia de septos intersenos desviados hacia la izquierda fue prevalente. Por lo tanto, el seno esfenoidal derecho fue dominante. La ocurrencia de septo intraseno se observó en el 93,3 % de los casos, con una mayor prevalencia en varones. Los septos intrasenos formaron cámaras, como cuevas, en las paredes del seno en un 65,6 % de los casos. La incidencia de septos intersenos que se adhieren a la silla turca (ST) (46,25 %) fueron prevalentes en comparación con los casos en que se unieron a la arteria carótida interna (ACI) (6,25 %), al nervio maxilar (NM) (1,25 %) y nervio vidiano (NV) (1.25%). Sin embargo, los septos intersenos se adhirieron más a la ACI (52,63 %) en comparación con su unión a otras estructuras neurovasculares (ST - 26,32 %; NM -5,36 % y NV - 2,63 %). Los cirujanos deben ser conscientes de las complejas variaciones anatómicas de la tabicación del seno esfenoidal cuando se realizan cirugías transesfenoideas endonasales endoscópicas.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Seio Esfenoidal/anatomia & histologia , Seios Paranasais/anatomia & histologia , CadáverRESUMO
Objective To study the influencing factors and quality control of chromosome preparation during chromosome aberration test in vitro,and to summarize and analyze the method and key points of successful preparation of chromosome specimens in vitro. Methods Chinese hamster lung cells(CHL)were used for cell culture and chromosome preparation. Mitomycin and cyclophosphamide were used as positive mutagens. After routine hypotonic treatment,fixation, and squash preparation, finally, to read the film under the microscope. Results The CHL chromosome aberration test showed that both the chromosome aberration rates of mitomycin- and cyclophosphamide-treated cells were significantly increased(>20%),while the aberration rates in the negative control group were less than 5%, either with and without metabolic activation. The success rate was high and the prepared chromosomes were well dispersed with a moderate length. Conclusions Many factors can affect the specimen preparation in chromosome aberration test. Every step is very important,and it should be strictly following the operating procedures. It is of importance to grasp the principle of each step and to operate carefully,patiently and scientifically in order to prepare good specimens.
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Objective To explore the effect of transanal total mesorectal excision (TaTME) structured training on the operation of frozen cadaver specimens in mainland China.Methods The retrospective crosssectional study was conducted.The data of 9 trainees who participated in the 1st TaTME structured training between April 12 and 13,2018 were collected.Chinese Society of Colorectal Surgery,Chinese Society of TaTME Surgeons and Beijing Anatomy Society were the host of TaTME structured training,Beijing Friendship Hospital of Capital Medical University and Clinical Applied Anatomy Science and Technology Training Center of Beijing Society for Anatomy Society were the undertakers.The courses included theoretical teaching,operation demonstration and frozen cadaveric specimens operation.Nine trainees were allocated into the 3 groups,including trainees A,C,E in group 1,trainees B,D,F in group 2 and trainees G,H,I in group 3.The special questionnaire survey was carried out on all the trainees at 3 months after the end of the training,contents included the number and proficiency of TaTME before and after training,reasons for not performing TaTME,learning curve of TaTME,TaTME-related complications and adverse reactions,whether or not to continue TaTME in future,effects of training,whether or not necessary to take training before TaTME.Observation indicators:(1) situations of trainees taking part in theoretical lectures and operation demonstration;(2) situations of trainees taking part in frozen cadaveric specimens operation;(3) questionnaire survey situations of trainees at 3 months after training.Comparison of trainees before and after training was done by the rank-sum test.Results (1) Situations of trainees taking part in theoretical lectures and operation demonstration:9 trainees received theoretical lectures and operation demonstration.The theoretical lectures helped deepen understanding of the TaTME,and operation demonstration gave an intuitive feel of technical points and considerations for TaTME.(2) Situations of trainees taking part in frozen cadaveric specimens operation:9 trainees performed successfully frozen cadaveric specimens operation under the guidance of the instructors to achieve training purposes.Overall evaluation of the instructors:anastomotic stoma was intact in 3 groups;grading 2 of Quirke grading of mesorectum was detected in group 1 and 2,and grading 3 in group 3;the main difficulty of complications was incorrect interstice operation and poor smog control,and urethral injury occurred in group 3.(3) Questionnaire survey situations of trainees at 3 months after training:2,2,2 and 3 trainees after training carried respectively on more than 10,6-10,1 and 0 times TaTME,2,2,1 and 4 trainees before training carried respectively on 6-10,2-5,1 and 0 in number of TaTME before and after training,with no statistically significant difference (Z =1.000,P＞ 0.05).Three trainees didn't perform TaTME due to no suitable patient,no equipment for TaTME and incompletely master operating of TaTME.After training,1 trainee was very proficient for TaTME,3,3 and 2 trainees respectively needed to 1/4,1/2 and 3/4 of guidance;before training,1,4 and 3 trainees needed to respectively 1/4,1/2 and 3/4 of guidance,and 3 trainees were very inaptitude for TaTME,with no statistically significant difference in proficiency of TaTME before and after training (Z=1.243,P＞0.05).Five of 9 trainees thought that finishing learning curve needed 10 times TaTME.TaTME-related complications and adverse reactions included urethral injury,bleeding,incorrect interstice operation and incomplete specimens.Eight of 9 trainees expressed that would continue to carry on TaTME.All trainees thought TaTME structured training was very necessary and training should be finished before TaTME.Conclusions The TaTME structured training program on the operation of frozen cadaver specimens is a new attempt.The structured and standardized TaTME training is a necessary condition for clinical performing of TaTME,which is conductive to improving the safety and effectiveness of TaTME.
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Objective To explore the effect of failure mode and effect analysis (FMEA)in the safety management of digestive endoscopic specimens. Methods From April to November 2016, the specimens by biopsy from the patients in the department of gastrointestinal endoscopy were assigned as the control group, where conventional sample management was used and those from December 2016 to July 2017 were all included in the intervention group, where FMEA was used to find the failure mode and improvement plan was worked out. The FMEA team was set up to discuss and determine the high risk factors leading to the safety management defects in the digestive endoscopy center and calculate the risk priority number (RPN). According to the potential risk factors, we optimized and implemented continuous improvement of the specimen safety management process. Results After the implementation of FMEA,the RPNs in the top 6 failure modes were less than 125,the risk coefficient value dropped from 126~175 to 0~40.The specimen error rate after the implementation of FMEA was statistically significantly lower than that before the implementation (P<0.001). Conclusion The FMEA reduces the incidence of specimen failure and improves the quality of the management of digestive endoscopy.