目的 对比观察单孔、单操作孔及三孔胸腔镜治疗早期非小细胞肺癌(NSCLC)的临床疗效。方法 选择125 例早期NSCLC患者,分为单孔组(38例)单操作孔组(42例)和三孔胸腔镜组(45例),观察3组手术结果和并发症发生率。结果 3组患者均顺利完成手术,无中转开胸。单孔组手术时间长于单操作孔及三孔组,差异有统计学意义(P＜0. 05)。对比所有3组手术患者的术中出血量及淋巴结清扫数目、术后总引流量及引流管留置时间、术后并发症发生率,差异无统计学意义(P＞0. 05)。单孔组及单操作孔组术后疼痛程度评分优于三孔组,差异有统计学意义(P＜0. 05)。结论 单孔及操作孔胸腔镜治疗早期NSCLC已可取代三孔胸腔镜技术,其术后恢复快,疗效确切,其中单孔手术对设备及胸腔镜医师操作技术熟练程度等要求更高,故在设备仍未有突破性的进展时,单操作孔胸腔镜手术可作为治疗早期NSCLC的优先选择。

Objective To compare the clinical effects of uniportal video-assisted thoracic surgery (VATS), single utility port VATS and 3-portal VATS lobectomy for patients with early stage non-small cell lung cancer. Methods Patients were divided into uniportal VATS lobectomy group(n=38), single utility port VATS lobectomy group(n=42) and 3-portal VATS lobectomy group (n=45). The surgical results and complication rates were observed. Results All patients completed the operation successfully, no one was changed to open operation. Operation time in uniportal VATS lobectomy group were longer than single utility port VATS lobectomy group and 3-portal VATS lobectomy group(P＜0. 05). There were no significant differences in intraoperative blood loss, number of lymph node dissection, the amount and time of postoperative extubation, and the incidence of postoperative complications(P＞0. 05). Post-operative pain score were higher in 3-portal VATS lobectomy group than in uniportal VATS lobectomy group and single utility port VATS lobectomy group (P＜0. 05). Conclusion Uniportal VATS lobectomy and single utility port VATS lobectomy can replace the 3-portal VATS lobectomy in treatment of early NSCLC, because of the faster postoperative recovery and curative effect. Uniportal VATS lobectomy requires special equipment and more operation skills, as there is no breakthrough in the equipment, single utility port VATS lobectomy may still be used as the first choice for treatment of early NSCLC.

目的 研究益精汤对改善男性不育症患者精子质量和提高生育率的临床疗效。方法 将符合纳入标准的100例男性不育症患者随机分为益精汤组和五子衍宗片组进行治疗,治疗后采用ZKPACS-E彩色精子质量分析系统检测精子各项参数标指和调查孕育人数,进行分析对比。结果 通过治疗前后对比,益精汤组的治愈率及临床治愈率较五子衍宗片组高,益精汤组、五子衍宗片组总有效率依次是82%、64%,差异有统计学意义(P<0.05)。益精汤组对患者的精液液化时间、精子活力等指标方面的恢复和改善优于对照组。结论 益精汤能显著提高精子的质量,在治疗男性不育症方面效果显著,值得进一步临床研究和推广。

目的 探讨纤维支气管镜吸痰联合镜下注药治疗慢性阻塞性肺疾病(COPD)的应用价值。方法 选择50例确诊慢性阻塞性肺疾病患者,随机分为A、B两组(每组25例),两组患者均予常规治疗,B组在常规治疗的基础上加予每周二次经纤维支气管镜吸痰和镜下注药治疗。通过观察比较2组治疗前后的症状、肺通气功能、动脉血气分析的变化及不良反应来评价疗效。结果 治疗两周后,B组患者的症状、肺通气功能、血气分析以及氧合指数较A组有明显改善,无明显不良反应。结论 纤维支气管镜吸痰联合镜下注药治疗慢性阻塞性肺疾病安全、有效,值得临床推广。

Objective To investigatethe utility of applying bronchoscopy combined with endoscopic injection in patients with chronic obstructive pulmonary disease. Methods 50 patients diagnosed with chronic obstructive pulmonary disease, were randomly divided into A, B groups (n=25,respectively). All the patients received internal routine treatment. Patients in group B received bronchoscopy and endoscopic injection therapy twice a week additionally. The efficacy was evaluated by comparing improvement of symptoms, pulmonary ventilation function and arterial blood gas analysis before and after treatment. The assessment of adverse reactions was also included. Results After two weeks of treatment, the patients in group B had been improved more significantly than the patients in group A, no significant adverse reactions were found. Conclusion It's safe and effective using bronchoscopy combined with endoscopic injection therapy for chronic obstructive pulmonary disease.

目的 对比紫杉醇脂质体(LEP)与紫杉醇(PTX)联合顺铂(DDP)治疗晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法 晚期NSCLC患者48例,随机分为对照组和试验组,对照组采用紫杉醇175 mg/m²,试验组采用紫杉醇脂质体175 mg/m²,均联合顺铂75 mg/m²化疗,21天为1个周期,治疗2个周期后评价疗效,记录近期疗效与治疗期间不良反应。结果 近期疗效:对照组有效率37.50%,疾病控制率为79.17%,试验组有效率为41.67%,疾病控制率为83.33%,两组差异均无统计学意义(P>0.05)。不良反应:白细胞减少、贫血及血小板减少的发生率两组差异无统计学意义(P>0.05),脱发和恶心、呕吐的发生率两组差异亦无统计学意义(P>0.05),但试验组皮疹、呼吸困难、肌肉痛及周围神经炎的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 紫杉醇脂质体治疗晚期NSCLC与紫杉醇疗效相当,但周围神经炎及过敏反应较紫杉醇为轻。

Objective To compare the efficacy and safety of paclitaxel liposome combined with cisplatin and paclitaxel combined with cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods 48 patients with advanced NSCLC were randomized into two groups, experimental group were given paclitaxel liposome at 175 mg/m²,and control group were given paclitaxel at 175 mg/m². Both groups combined with DDP at 75 mg/m² per cycle every 21 days.The efficacy and safety were evaluated after two cycles. Results The overall response rate was 37.50% in experimental group and 41.67% in control group, and the disease control rate was 79.17% in experimental group and 83.33% in control group. There was no significant difference between two groups(P>0.05). Though there was no significant difference in incidence of neutropenia,anemia, thrombocytopenia and alopecia, nausea and vomiting, but the occurred rates of rash、muscle pain and peripheral neuritis were significantly lower in experimental group than those in control group. Conclusion In the treatment of advanced NSCLC, both paclitaxel liposome combined with cisplatin and paclitaxel combined with cisplatin have similar efficacy, but paclitaxel liposome can significantly reduce the incidence of peripheral neuritis and serious hypersensitive reactions.

目的 研究血浆脂蛋白磷脂酶 A2(Lp-PLA2)在防治急性动脉硬化性脑梗死中的临床价值。方法 选取2014年1月—2015年12月在我院经头颅MRI+MRA及脑血管造影确诊为急性动脉硬化性脑梗死患者80例为病例组,选取同期来我院例行体检头MRI+MRA 正常的健康自愿者40名为对照组。病例组采取脑梗死规范治疗及肢体功能康复锻炼,以酶联免疫法分不同时段测定两组患者血浆Lp-PLA2的浓度,以及评价病例组神经功能缺损程度,经数据分析研究脑梗死患者血浆Lp-PLA2浓度与神经功能缺损程度相关性。结果 急性动脉硬化性脑梗死患者血浆 Lp-PLA2浓度高于健康对照组患者,经统计学分析,P<0.05,并且随着脑梗死时间的推移,Lp-PLA2浓度愈低。NIHSS评分显示,随着脑梗死时间推移,NIHSS评分越来越低,差异有统计学意义(P<0.05)。对比同时期NIHSS评分和患者 Lp-PLA2浓度,NIHSS与Lp-PLA2浓度呈正相关(r=2.376,P<0.01)。结论 血浆Lp-PLA2 浓度升高是脑梗死的危险因素之一,降低血浆 Lp-PLA2 浓度可在脑梗死的早期预防上起到积极作用。

Objective To explore clinical value of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in controlling acute atherosclerosis cerebral infarction. Methods 80 cases of acute atherosclerosis patients diagnosed by head MRI+MRA were selected as cases group, and 40 as normal controls. Cases treated with cerebral infarction specification therapy and lib function rehabilitation exercise. Using enzyme-linked immunoassay points at different times of measuring the concentration of plasma Lp-PLA2 in both groups, evaluating nerve function defect degree of cases, then analysis the correlation of cerebral infarction plasma concentration of Lp-PLA2 and neural function defect degree. Results Acute atherosclerotic cerebral infarction patients plasma concentration of Lp-PLA2 patients was significantly higher than healthy control group, by statistics analysis P<0.05, and with cerebral infarction time went by, the Lp-PLA2 concentration was lower. NIHSS score, with the time of cerebral infarction passed, was lower and lower, the change was statistically significant P<0.05.Compared with NIHSS score and concentration of Lp-PLA2, NIHSS and Lp- PLA2 concentration were positively correlated, r=2.376,P<0.01. Conclusion Plasma Lp-PLA2 is a risk factor for cerebral infarction. Reducing plasma concentration of Lp-PLA2 can play a positive role on the early prevention of cerebral infarction.

目的 探讨联合运用透明质酸钠及雌激素预防人工流产术后子宫内膜炎的临床疗效。方法 选择2015年1月—2015年6月在我院接受人工流产术者97例,随机分为观察组48例及对照组49例。对照组术后服用雌激素,观察组同时服用雌激素及透明质酸钠。于术后1周、3周时检测两组患者子宫内膜炎症状评分及宫颈分泌物炎症指标。结果 经过21天的干预之后,两组患者子宫内膜炎症状相比较,观察组患者下腹疼痛、白带增多及发热得分都低于观察组(P<0.05)。宫颈分泌物的CRP、IL-6、IL-9水平检测,术前两组患者之间差异不显著;治疗1周时,两组炎症因子水平均升高,但对照组变化更为明显;干预3周后,两组炎症因子水平较之1周时有所下降,但观察组基本降至正常水平,与对照组相比,差异有统计学意义(P<0.05)。结论 透明质酸钠联合雌激素预防人工流产术后子宫内膜炎效果明显,值得临床推广。

目的 探讨在待产孕妇中应用中医药辨证护理对促进气血虚弱型足月妊娠孕妇宫颈成熟的临产前护理策略及临床效果。方法 选取中医辨证为气血虚弱型的足月妊娠单胎头位初产妇180例,随机分为对照组即催产素组及常规护理组60例,中医药辨证护理组即在对照组的基础上入院后即给予中药口服加辨证护理60例,空白组即期待观察组及常规护理组60例。观察三组治疗前后宫颈Bishop评分,阴道及宫颈分泌物FFN(胎儿纤连蛋白)定性测定,分娩结局及对母胎的影响。结果 中医药辨证护理组在临产率、阴道分娩率及宫颈评分、FFN测定等方面较对照组及空白组均有差异,P<0.05。结论 对于气血虚弱型足月妊娠在入院后开展中医药辨证护理对临产前宫颈成熟有辅助作用,对于提高顺产率,降低高危分娩促进母儿健康有积极作用,值得推广。

Objective To explore the prenatal care strategy of applying Chinese medicine dialectical care to promoting cervical ripening of full-term pregnant women with qi-blood deficiency and its clinical effect. Methods We chose 180 first-time, full-term pregnant women with single fetus cephalic presentation who were diagnosed as with qi-blood deficiency and then randomly divided them into three groups, 60 in control group with oxytocin and usual care; 60 in group of Chinese medicine dialectical care, which provided oral use of Chinese medicine and dialectical care after those women being admitted to hospital; 60 in blank group with usual observation and care. We did Bishop assessment of neck of uterus before and after treatment in these three groups, conducted qualitative test in FFN (Fetal Fibronectin), the secreta from vagina and neck of uterus, and observed delivery outcome as well as the influence to mother and child. Results Compared with control group and blank group, the group ofChinese medicine dialectical care was outstanding in terms of labor rate, vaginal delivery rate, and FFN test(P<0.05). Conclusion Chinese medicine dialectical care boosts cervical ripening of full-term pregnant women with qi-blood deficiency. It is helpful to increase natural labor rate, reduce high-risk delivery, and promote health of mother and child. Therefore it is worth to be popularized.

目的 探讨青少年过敏性鼻炎与血清维生素D水平的相关性。方法 收集2012年4月—2014年4月经本院耳鼻喉科确诊的青少年过敏性鼻炎(AR)患者368例,为实验组;另选择同期本院健康体检者370例,为对照组。分别使用串联质谱仪检测其血清总维生素D、维生素D₂及维生素D₃浓度。结果 实验组中血清总维生素D、维生素D₂及维生的素D₃的检测结果分别为:20.92±3.35 ng/ml、3.64±0.82 ng/ml、18.83±3.62 ng/ml;对照组中血清总维生素D、维生素D₂及维生的素D₃的检测结果分别为:31.45±2.86 ng/ml、3.85±0.58 ng/ml、28.97±3.18 ng/ml;检测结果显示实验组与对照组总维生素D及维生素D₃水平均存在差异(P＜0.05),具有统计学意义,维生素D₂水平无差异(P＞0.05)。结论 青少年过敏性鼻炎血清维生素D水平比正常人群偏低,且以维生素D₃水平偏低为主,为临床诊治过敏性鼻炎患者提供重要依据。

目的 评价急性心肌梗塞患者转往有条件医院行PCI治疗前应用替罗非班(血小板Ⅱb/Ⅲa受体拮抗剂)的临床疗效与安全性。方法 选取从2013年1月—2014年9月诊断为急性心肌梗塞行PCI治疗的患者共66例。随机分为观察组(确定转院行PCI治疗前在我院应用替罗非班) 34例、对照组(转运到花都区人民医院心内科行PCI治疗后应用替罗非班) 32例。观察比较两组患者首次造影的冠脉血流情况与术后的冠脉血流情况、PCI时心电图抬高的ST回落情况与心肌标志物峰值前移情况、住院期间与随访30天期间不良心血管事件(MAGC)的发生情况(支架内血栓与二次血运重建发生率、再梗塞率、心绞痛、死亡率)以及两组的不良反应。结果 观察组首次造影的冠脉血流优于对照组;术后的冠脉血流观察组优于对照组(P<0.05);PCI时心电图ST回落≥1/2的情况与TNI、CK-MB峰值前移情况优于对照组(P<0.05);不良心血管事件发生率较对照组少(P<0.05);不良反应发生率差异无统计学意义(P>0.05)。结论 急性心梗转院PCI患者,转院前应用替罗非班比转院后应用获益更大,安全性尚可。这类病人,在确定转院之时即时应用替罗非班是合理时机。

目的 分析研究阿奇霉素治疗急性肠炎的临床疗效。方法 选取我院2012年5月—2014年6月期间收治急性肠炎患者52例,分成研究组和对照组各26例,研究组应用阿奇霉素治疗,对照组患者应用培氟沙星治疗,比较两组患者临床疗效、退热时间、止泻时间、症状体征好转时间、症状体征消失时间、治疗费用等指标。结果 研究结果显示,研究组患者临床疗效、退热时长、止泻时长、症状体征好转时间长、症状体征消失时间长、医疗费用等指标均优于对照组,差异有统计学意义(P<0.05)。结论 应用阿奇霉素治疗急性肠炎患者,临床效果显著,治疗时间短、安全,降低患者治疗费用。