目的 了解佛山市南海区性传播疾病(STD)门诊病人单纯疱疹病毒感染的流行情况。方法 对2013年1月—2014年6月间前往佛山市南海区3个规范化性病门诊就诊的患者进行问卷调查、生殖器疱疹临床诊断和单纯疱疹病毒分类抗体检测、分泌物实时荧光定量聚合酶链反应(FQ-PCR)检测。结果 350例疑似生殖器疱疹患者中,HSV-I的IgM 和IgG的检出率分别是5.4%(19/350)和87.7%　(307/350),HSV-II的IgM 和IgG检出率分别是2.9%(10/350)和42%(147/350),两种血清型中以HSV-I感染为主,且IgG 阳性率高于IgM(HSV-I的χ²=238.1,P＜0.005;HSV-II的χ²=259.08,P＜0.005);HSV-ⅡIgG感染者147例(男115例,女32例),感染率分别为41.2% 和42.7%。男性HSV-ⅡDNA感染率高于女性,二者差异有统计学意义(χ²=3.94,P＜0.05)。结论 本地区性病门诊中HSV抗体检出率高,以HSV-I感染为主;对于疑似生殖器疱疹患者,同时进行HSV抗原及血清HSV-I、HSV-II的 IgM和 IgG抗体联合检测更有助于临床GH诊断;男性患者易于临床诊断。

Objective To investigate the epidemiological characteristics of herpes simplex virus infection in patients attending a sexually transmitted diseases(STD)clinic in Nanhai District of Foshan. Methods The 350 patients attending the three standardized STD clinic in Nanhai District of Foshan from January,2013 to June,2014 were interviewed with an anonymous questionnaire,blood-tested for HSV(IgM、IgG) antibody.And secretion was detected by FQ-PCR for HSV antigen. Results In 350 patients with suspected GH,the positive rate of HSV-I IgM and IgG were 5.4%(19/350)and 87.7%(307/350).The positive rate of HSV-II IgM and IgG were 2.9%(10/350)and 42%(147/350),respectively.HSV-I infection was principal in two serologic types,and the positive rate of IgG was higher than that of IgM (P<0.05).There were 147 patients infected HSV-II IgG(male 115,female 32).The infection rate is 41.2% and 42.7%.The infection rate of HSV-ⅡDNA in men was higher than that in women.There was a significant difference between them(P<0.05). Conclusion There was a high positive detection rate of HSV from sexually transmitted disease clinic in this region.And HSV-1 was principal.For patients with suspected genital herpes,detection of HSV antigen tests combined with HSV-I、HSV-II IgM and IgG serum antibody tests is more helpful in the clinical diagnosis of genital herpe.HSV infected men patients were likely to clinically diagnose.

目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.

目的 了解广州地区儿童患者分离的社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)临床分离株的分子特征。方法 收集2009年—2014年我院分离获得的65株CA-MRSA临床分离株,PCR法检测杀白细胞素(PVL)基因阳性菌株,多位点基因序列类型(MLST)测定MRSA菌株的序列类型,多重PCR法对MRSA菌株进行葡萄球菌mec盒式染色体(SCCmec)分型。结果 65株CA-MRSA分离株中PVL基因阳性31株,阳性率47.69%;MLST分型表明以ST5933.84%(22/65)及ST8823.07%(15/65)为主;SCCmec分型中发现3种类型,分别为SCCmecⅡ 32.30%(21/65)、SCCmecⅣ 49.23%(32/65)及SCCmecⅤ 18.46%(12/65),未存在未能分型菌株。结论 广州地区儿童患者分离的CA-MRSA临床分离株的PVL基因阳性率相对较高,SCCmecIV型、V型可形成小范围内的流行,其基因表型存在多种ST分型。

Objective To investigate the molecular characteristic of Community-acquired Methicillin-resistant Staphylococcus aureus(CA-MRSA) isolates from pediatric patients in Guangzhou. Methods 65 non-duplicate strains of Community-acquired Methicillin-susceptible Staphylococcus aureus(CA-MSSA) isolated from our hospital in 2009-2014 were investigated. Panton-valentine leukocidin(PVL) gene was detected by polymerase chain reaction(PCR). The sequence type (ST) of each strain was determined by muhilocus sequence typing (MLST). The genotypes of staphylococcal cassette chromosome mec(SCCmec) of the CA-MRSA isolates were confirmed by multiplex PCR. Results Among 65 isolates of CA-MRSA, the positive rate of PVL genes was 47.69%(31／65). The most common MLST type was ST59 (n=22, 33.84%), followed by ST88 (n=15, 23.07%). Three SCCmec types were found. The most common type was SCCmecIV (49.23%, 32/65), followed by SCCmecⅡ (32.30%, 21/65) and SCCmecV (8.46%, 12/65). Conclusion The PVL gene-positive rate of CA-MRSA isolates in our hospitals is at a relatively high level. SCCmec type IV and SCCmec type V could spread among hospitals and cause a small scale epidemic. Their phenotypes have a variety of ST types.

目的 对出生缺陷知信行健康教育模式效果进行策略分析与探讨,为进一步完善围产期保健服务及健康教育工作提供合理化建议。方法 采用《孕期妇女出生缺陷基本知识知晓率专题测评问卷》并结合实际情况设定有关信念、行为方面的7个问题,对2011年1月—2013年6月期间在中心孕妇学校参加健康教育活动课堂的孕妇进行调查,并应用决策树模型对中心现有的出生缺陷知信行健康教育模式效果进行探讨。结果 预防出生缺陷知识方面,对初高中及中专文化程度的孕期妇女加强出生缺陷预防知识健康教育的预期收益合计达到51.2%,可作为重点目标人群;预防出生缺陷信念方面,主要决定因素是户籍类型和年龄,加大对本地户籍及25岁以上流动妇女人群的健康教育,促进孕期妇女树立预防出生缺陷信念的预期收益累计达95.9%;预防出生缺陷行为方面,主要影响因素是产检医生的嘱咐,受到嘱咐的孕期妇女预期收益为62.3%。结论 为了达到出生缺陷防治目标与健康教育整体效果的提高,应将预防出生缺陷的健康教育工作重点放在初高中及中专文化程度人群,本地户籍孕期妇女和25岁以上流动性孕期妇女又是需要树立预防出生缺陷信念的重点人群,强化产检医生的嘱托义务是提高孕期妇女出生缺陷知信行健康教育模式效果的有力保证。

Objective To identify factors related to the knowledge, attitude and practice KAP of birth defects prevention among pregnant women, and provide reasonable suggestions to improve perinatal health services and health education. Methods Using cluster sampling method, 5500 participants from pregnant women school were enrolled. Information on “awareness of basic knowledge of birth defects” and 7 questions about attitudes and practice to participant actual situation was gathered through personal interviews using a structured questionnaire. The related factors were analyzed by classification tree model of SPSS 19.0. Results As to birth defects related knowledge, prospective return was more than 50% in the pregnant women with junior, senior high school and technical secondary school education level. As to birth defects prevention faith, the main determinant was census register types; prospective return of pregnant women who were local permanent residents and floating population aged ≥25 years was 95.9%. The main influencing factor of practice was prenatal doctor's education; prospected return was 62.3% after strengthening the health education of prenatal doctor. Conclusion In order to improve birth defects education effect, pregnant women who have junior, senior high school and technical secondary school education level and are local permanent residents or floating population aged ≥25 years should be key targeted population. Prenatal doctor's health education will be a powerful guarantee.

目的 探讨体外循环手术前后患者血清HMGB₁、CK、CK-MB、LDH、LD₁、AST水平变化及意义。方法 采用ELISA法检测57例体外循环患者手术前后血清HMGB₁表达水平,采用临床常规方法检测血清中CK、CK-MB、LDH、LD₁、AST水平。对体外循环手术前后血清HMGB1表达水平与CK、CK-MB、LDH、LD₁、AST的水平进行比较与相关分析。结果 体外循环手术患者HMGB₁、CK、CK-MB、LDH、LD₁、AST水平在手术后0.5小时、24小时、48小时、72小时均高于手术前(P<0.05);HMGB₁、CK、CK-MB、LD₁、AST水平在手术后24小时达高峰,LDH水平高峰出现于手术后48小时,其他各指标渐渐下降。体外循环手术阻断时间延长,则HMGB₁、CK、CK-MB、LDH、LD₁、AST水平升高。体外循环手术后患者血清中HMGB₁表达水平与CK、CK-MB、LDH、AST指标呈正相关关系(P<0.05)。结论 体外循环手术后患者血清HMGB₁、CK、CK-MB、LDH、LD₁、AST水平升高,HMGB1参与了心肌的缺血再灌注损伤过程。

Objective To investigate before extracorporeal circulation and after HMGB₁, CK, CK-MB, LDH, LD₁, AST levels and significance in serum of patients. Methods 57 cases before extracorporeal circulation surgery and after, the levels of HMGB₁ were detected by ELISA,while the levels of CK and CK-MB and LDH and LD₁ and AST were detected by using conventional methods of clinical. Difference of HMGB₁ and CK, CK-MB, LDH, LD₁ and AST levels were compared. The relationship were been analyzed on the patients before extracorporeal circulation surgery and after. Results In extracorporeal circulation surgery, HMGB₁, CK, CK-MB, LDH, LD₁, AST levels after surgery in 0.5 hours, 24 hours, 48 hours,72 hours were higher than before surgery (P<0.05); HMGB₁, CK, CK-MB, LD₁, AST levels peaked at 24 hours aftersurgery, LDH levels was peaked at 48 hours after surgery, and then gradually declined. Extracorporeal circulation blocking was prolonged, the levels of HMGB₁ and CK and CK-MB and LDH and LD₁ and AST were elevated. After extracorporeal circulation surgery in serum the levels of HMGB₁ expression and CK,CK-MB,LDH, AST indicators showed a positive correlation(P<0.05). Conclusion The levels of HMGB₁, CK, CK-MB, LDH, LD₁ and AST were elevated after extracorporeal circulation surgery. HMGB₁ was involved in myocardial ischemia and reperfusion injury.

目的 观察阵发性房颤(PAF)环肺静脉电隔离术(CPVI术)治疗对左心房结构和功能的影响。方法 对63例PAF患者行CPVI术,超声心动图测定术前及术后3天、6个月时左心房内径(LAD)、左心房面积(LAA) 、左心房最大容积(LAVmax)、收缩期前容积(LAVp)、最小容积(LAVmin),测量二尖瓣血流频谱A峰流速(VA)、左心房被动射血分数(LAPEF)、主动射血分数(LAAEF)、扩张指数 (LaexpI)。结果 63例患者中54例于术后6个月时仍维持窦性心律,维持窦性心律者 LAD、LAA、LAVmax、LAVp、LAVmin对比术前减小 (P<0.05); VA、LAAEF术后3天降低(P<0.05),6个月对比术前无变化(P>0.05); LaexpI、LAPEF术后3天及6个月时均无改变(P>0.05)。结论 阵发性房颤环肺静脉电隔离术后左心房结构逆重构,早期辅泵功能下降,6个月时左心房功能未受影响。

目的 统计医院眼科门诊病人前15位疾病的构成变化及不同年龄段间差异。方法 对2008年—2011年眼科门诊病人诊断及治疗信息作横断面研究,分析逐年门诊量变化及疾病谱的变化。结果 4年来门诊共接诊患者22356人次,初诊病人20915例。4年初诊患者分别为1476、3795、7177、8467人次。其中男12088例(59.9%),女8087例(40.1%),平均年龄 33.75岁。未成年人占20.23%,中青年占72.33%,老人占7.44%。前15位的疾病构成4年间有一定的波动,但结膜炎、角膜异物及屈光不正所占比例较高。三个年龄组构成最高的疾病分别为屈光不正、结膜炎、白内障。结论 该院眼科门诊4年来就诊人数增加5倍有余。患者中青年、未成年患者比例高、老年患者比例低,男性比例高于女性。角膜异物等外伤性疾病较多,不同年龄段疾病谱各有特点。

Objective Describe the distribution of diagnoses at the ophthalmic clinic of a tertiary hospital in the first four years since its inception. And also analyse the patterns of diagnoses of different age. Methods Cross-sectional study was administered on all new patients seen by ophthalmologists at Nansha Central Hospital from 2008 to 2011. Results 59.90% (12088 cases) were male and 40.10% (8087 cases) were female. Juveniles, adults and the elders accounts for 20.33%, 72.33%, and 7.44% of all visitors respectively. The most common conditions were conjunctivitis (27.00%), refractive error (9.87%) and corneal foreign bodies (9.07%). There were more diagnoses of refractive error (32.26%, P<0.01) among the juveniles, while the elders had higher percentage of cataract diagnoses (27.81%, P<0.01). Conclusion The number of new patients visiting the ophthalmic clinic had increased six-fold over the four years. The proportion of younger patients was much higher than that of older ones and the male to female ratio was high.compared to the results of literature, the marked characteristic of the disease distribution was the high rate of ocular traumatic diseases. The most common diagnoses varied with age.

目的 研讨阿司匹林广泛用于高危血栓、栓塞抗凝的预防治疗应用。方法 查阅参考文献,结合临床实践,新口服抗凝药疗效终点卒中和体循环栓塞方面为基准。结果 界於CHADS2和CHA2DS2-VASc 评分所涵盖的风险和差异因素,后期华法林与新口服抗凝药可能取舍或并存。结论 在危险分层,卒中抗拴防凝治疗中,我国房颤患者不建议继续服用阿司匹林。

Objective To Study and discuss the applications for prevention and treatment of high risky thrombosis and embolism anticoagulation of Aspirin. Methods Combining literature consultation and clinical practice,making stroke and general circulation embolism of oral anticoagulant curative effect terminal point as the base. Results According to the risky and different factors covered by CHADS2 and CHA2DS2-VASc in the later stage, warfarin and the new oral anticoagulant can be taken together or abandon one of them. Conclusion In the risky factors classification and stroke anticoagulant therapy, we suggest that the atrial fibrillation patients should not take Aspirin.