目的 通过对中山大学中山眼科中心890例眼内异物病例进行分析,为眼内异物防治提供依据。方法 回顾性分析我中心2005年1月—2019年12月期间住院890例眼内异物病例的临床资料进行统计分析。结果 (1)15年间眼内异物病例中,2005年1月—2009年12月间例数最多,有477例,占总例数的53.6%;(2)发生眼内异物的患者年龄大部分在20~49岁之间,有716例,占80.44%;(3)眼内异物患者中,男性占大部分,有830例,占93.26%,男:女=14:1,右眼424例,左眼466例,右眼:左眼=1:1.1;(4)金属异物占大多数,约90%;(5)眼内异物的患者以工人最多,占60.5%;(6)眼内异物患者住院时间14天以内的患者共828人,占92.8%;(7)眼外伤种类:异物进入眼内为主,共614例,占68.98%;(8)眼外伤并发症:以外伤性白内障为主,共407例,占45.7%。结论 眼外伤发生以青壮年男性多见,异物入眼为主,住院时间为1~2周,治愈概率较高。眼内异物所导致的眼外伤发病率呈逐年下降趋势。

Objective To analyze 890 cases of intraocular foreign bodies in Zhongshan Ophthalmic Center of Sun Yat-sen University, and to provide a basis for the prevention and treatment of intraocular foreign bodies. Methods The clinical data of 890 cases of intraocular foreign body hospitalized in our center from January 2005 to December 2019 were retrospectively analyzed. Results (1) Among the 15-year intraocular foreign body cases, the number of cases from 2005 to 2009 was the highest, with 477 cases, accounting for 53.6%. (2) The majority of intraocular foreign bodies occurred between the ages of 20 and 49, with 716 cases (80.44%). (3) Among the patients with intraocular foreign bodies, males accounted for the majority, with 830 cases, accounting for 93.26%, male:female=14:1, right eye 424 cases, left eye 466 cases, right eye:left eye=1:1.1. (4) Metal foreign bodies account for the majority, about 90%. (5) Workers had the highest number of patients with intraocular foreign bodies, accounting for 60.5%. (6) The number of patients with hospitalization time of less than 14 days was 828, accounting for 92.8%. (7) Type of ocular trauma: foreign body into the eye was the main type, with 614 cases, accounting for 68.98%. (8) Complications of ocular trauma: traumatic cataracts was the mainstay, with a total of 407 cases, accounting for 45.7%. Conclusions Ocular trauma occurs more often in young and middle-aged men, which intraocular foreign bodies is the main reason, and the hospitalization time is about 1 to 2 weeks, with high probability of healing. The incidence of ocular trauma caused by ocular foreign bodies is decreasing year by year.

目的 学习母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床病理及免疫表型特征,总结该少见肿瘤的病理诊断经验。方法 回顾分析2例BPDCN患者临床资料,通过苏木素-伊红(HE)染色分析肿瘤组织及细胞形态,通过免疫组织化学染色分析肿瘤免疫表型,通过流式细胞学检测骨髓有无肿瘤侵犯,并结合文献分析。结果 本报道中1例为97岁女性,临床以皮肤瘀斑结节为首发症状,肿瘤细胞真皮内弥漫浸润,不侵犯表皮,细胞中等大小,核形不规则,核仁不明显。另1例为69岁男性,临床以淋巴结肿大为首发症状,淋巴结结构完全破坏,肿瘤细胞弥漫浸润,细胞呈中等大小的母细胞样,核仁明显。2例免疫表型均表达CD123、CD4、CD56、TDT,不表达B系、T系淋巴细胞及髓系标志物,肿瘤均累及骨髓。结论 BPDCN是一种罕见的淋巴造血肿瘤,临床常以皮肤病变或淋巴结肿大为首发症状,临床过程具高度侵袭性,通常伴有骨髓侵犯。该肿瘤需与具有母细胞形态的淋巴系肿瘤和白血病相鉴别,诊断需结合临床信息、HE形态及免疫组化结果综合判断。

Objective To summarize the diagnostic experiences of blastic plasmacytoid dendritic cell neoplasm (BPDCN) based on the study of its clinicopathological features and immunophenotypes. Methods The clinical data of 2 patients with BPDCN were collected, the structure alteration and cell morphology were observed by HE staining, the immunophenotype of tumor cells were studied by immunohistochemistry staining and flow cytometry was adopted to confirm the bone marrow involvement. Results Two patients, one of whom was a 97 year-old female, presented with cutaneous ecchymosis nodules as the first symptom. The epidermis, but not the dermal, was diffusedly infiltrated by tumor cells, which were medium-sized with irregular nuclei without prominent nucleoli. The other case was a 69 year-old male with lymph node enlargement as the first symptom. The skin was normal, but the lymph nodes were invasively destroyed by tumor cells, which were medium-sized blast-like with prominent nucleoli. The immunophenotypes of the two patients were both positive for CD123, CD4, CD56 and TDT, but negative for B, T lymphocyte derived and myeloid origin markers, both of which involved bone marrow. Conclusions BPDCN is a rare form of hematological neoplasm, skin symptoms or lymph node enlargement may be presented as the initial symptom, the clinical course were highly aggressive with high frequency of bone marrow involvement. The blastic-like lymphoma and leukemia entities should be considered into account for differential diagnose. The precise diagnosis of BPDCN should be established by integrating histomorphology, immunophenotype and clinical presentation information comprehensively.

分泌性中耳炎（SOM）的临床特征表现为听力下降和中耳积液,与中耳化脓性炎症常伴随耳部急性感染不同,SOM常伴随耳部闷胀、轻微耳痛等,致使听力出现障碍。SOM发病机制较为复杂,可能与感染、免疫、咽鼓管功能障碍等多种因素相关,治疗方法也因此呈现出多样化的特点。本文就SOM的病因病机及其治疗方式展开综述,以期为临床及早诊断和治疗SOM提供理论依据。

The clinical characteristics of secretory otitis media（SOM）are hearing loss and effusion in the middle ear．Different from acute ear infection of suppurative inflammation in the middle ear,SOM is often accompanied by ear tightness and mild earache,resulting in hearing impairment．The pathogenesis of SOM is complex,which may be related to infection,immunity,eustachian tube dysfunction and other factors．Therefore,the treatment methods are diversified．This paper reviews the etiology,pathogenesis and treatment of SOM,in order to provide theoretical basis for clinical early diagnosis and treatment of SOM.

目的 分析在临床治疗腰椎间盘突出症过程中采取脊柱微创手术的价值。方法 回顾研究2019年2月-2021年2月本院的102例腰椎间盘突出症患者,按照电脑排序将患者分为参照组51例与研究组51例。其中,接受传统手术治疗的为参照组,接受脊柱微创手术治疗的为研究组,将不同方案下的效果进行对比。结果 研究组切口长度指标更低于参照组,术中出血量指标比较差异有统计学意义少于对照组,手术时间更短于参照组,比较差异有统计学意义（P<0.05）。研究组术后引流量指标均更低于参照组,术后活动时间及住院时间指标均更低于参照组,比较差异有统计学意义（P<0.05）。两组患者接受治疗前疼痛程度评分对比,无比较差异有统计学意义差异性（P>0.05）,治疗后研究组患者疼痛评分均更低于参照组,比较差异有统计学意义（P<0.05）。研究组治疗后并发症发生概率5.88%更低于参照组的21.57%,比较统计差异比较差异有统计学意义（P<0.05）。结论 在临床治疗腰椎间盘突出症过程中采取脊柱微创手术效果良好,比较差异有统计学意义地降低患者手术损伤,缓解了患者手术疼痛感,促进患者尽快术后康复,防止并发症的发生,适合于临床中应用。

目的 探析化疗联合调强放疗（IMRT）治疗老年（≥65岁）局部晚期鼻咽癌的临床效果。方法 选取2018年1月—2019年1月我院诊治的90例老年局部晚期鼻咽癌患者为研究对象,使用随机数表法将此90例患者分为观察组及对照组,各45例。观察组行IMRT,对照组行化疗联合IMRT,对比2组的效果。结果 2组的治疗总有效率均为100%,组间差异不显著（P<0.05）。观察组的生活质量改善率（93.33%）高于对照组（77.78%）（P<0.05）。对照组出现3~4级白细胞减少、呕吐、黏膜炎人数明显高于观察组（P<0.05）,两者其他毒副反应比较无显著差异（P>0.05）。观察组的1年总体生存率（91.11%）及3年总体生存率（75.56%）均高于对照组（86.67%、68.89%）（P<0.05）。结论 对于老年局部晚期鼻咽癌,化疗联合IMRT相比单纯IMRT降低了远期生存率,增加了毒副反应并影响疗后生活质量的改善,不宜常规应用,单纯IMRT可能是更合适的治疗选择。

Objective To explore the clinical effect of chemotherapy combined with intensity modulated radiation therapy（IMRT）in the treatment of elderly（≥65 years old）locally advanced nasopharyngeal carcinoma．Methods The study was carried out from January 2018 to January 2019．During this period,90 elderly patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in our hospital were selected as the research objects．The random number table method was used to divide the 90 patients into observation groups,and the control group,each with 45 cases．The observation group was treated with IMRT,and the control group was treated with chemotherapy combined with IMRT．The effects of the two groups were compared．Results The total effective rate of the two groups was 100%,and there was no significant difference between the two groups（P<0.05）．The improvement rate of quality of life in the observation group（93.33%）was higher than that in the control group（77.78%,P<0.05）．The number of grade 3-4 leukopenia,vomiting and mucositis in the control group was significantly higher than that in the observation group（P<0.05）,and there was no significant difference in other side effects between the two groups（P>0.05）．The 1-year overall survival rate（91.11%）and 3-year overall survival rate（75.56%）of the observation group were higher than those of the control group（86.67%,68.89%,P<0.05）．Conclusions For locally advanced nasopharyngeal carcinoma in the elderly,chemotherapy combined with IMRT reduces the long-term survival rate,increases the toxic and side effects and affects the improvement of the quality of life after treatment．It is not suitable for routine application,and IMRT alone may be a more appropriate treatment choice.

目的 探讨尿液前列腺特异性抗原（u-PSA）预测老年良性前列腺增生（BPH）发生急性尿潴留（AUR）的价值。方法 选取东莞市中医院100例老年BPH患者（2020年1月—2021年4月）进行回顾性研究,均口服盐酸坦索罗辛+非那雄胺片治疗,随访1年,记录AUR发生情况,据此分为AUR组、非AUR组。比较2组一般资料,Logistic回归模型分析老年BPH发生AUR的危险因素,受试者工作特征（ROC）分析前列腺体积（PV）、u-PSA对老年BPH发生AUR的预测价值。结果 100例老年BPH患者AUR发生率为26%;AUR组u-PSA水平高于非AUR组,PV大于非AUR组（P<0.05）;Logistic回归模型分析,u-PSA水平及PV增高是老年BPH患者发生AUR的独立危险因素（P<0.05）;ROC曲线分析,u-PSA预测AUR的AUC=0.897,高于AUC_PV（P<0.05）。结论 u-PSA可作为老年BPH继发AUR的量化评估指标,有利于临床早期筛查、诊断,采取针对性干预措施,改善预后。

Objective To investigate the value of urinary prostate-specific antigen（u-PSA）in predicting acute urinary retention（AUR）in elderly patients with benign prostatic hyperplasia（BPH）．Methods A total of 100 elderly patients with BPH in our hospital（from January 2020 to April 2021）were selected for a retrospective study,all of whom were treated with oral tamsulosin hydrochloride + finasteride tablets,followed up for 1 year,and the occurrence of AUR was recorded．The patients were divided into AUR group and non-AUR group．The general data of the two groups were compared．Logistic regression model was used to analyze the risk factors of AUR in elderly BPH patients,and receiver operating characteristic（ROC）was used to analyze the predictive value of prostate volume（PV）and u-PSA for AUR occurrence．Results The incidence of AUR in 100 elderly patients with BPH was 26%;the level of u-PSA in the AUR group was higher than that in the non-AUR group,and the PV was greater than that in the non-AUR group（P<0.05）．Increased PV was an independent risk factor for AUR in elderly patients with BPH（P<0.05）．ROC curve analysis showed that the AUC of u-PSA for predicting AUR was 0.897,which was higher than that of PV（P<0.05）．Conclusions u-PSA can be used as a quantitative evaluation index for AUR secondary to BPH in the elderly,which is conducive to early clinical screening and diagnosing,and taking targeted intervention measures to improve prognosis.

现代人面临更大的工作与生活压力,每天的生活节奏较快,因此经常出现饮食不规律、饮食结构不合理等现象,这样就增加了肠胃疾病的发生率。胃肠道间质瘤（GIST）以人体胃肠道最为常见的肿瘤疾病,该病患者占全部胃肠道间叶性肿瘤患者人数的80%以上。GIST根据疾病进展、间质瘤体积等不同因素又能够分为不同的疾病类型,需采取对应的诊断措施与治疗措施。本文将针对胃小间质瘤的流行病学、临床症状、临床诊断以及治疗措施等进行研究与分析,以供参考。

Modern people are facing greater pressure in work and life,and the pace of daily life is fast．Therefore,irregular diet and unreasonable diet structure often occur,which increases the incidence of gastrointestinal diseases．Gastrointestinal stromal tumor（GIST）is the most common tumor disease in human gastrointestinal tract,accounting for over 80% of all patients with gastrointestinal mesenchymal tumors．GIST can be divided into different types according to different factors such as disease progression and stromal tumor volume,thus corresponding diagnostic and therapeutic measures should be taken．This paper studied and analyzed the epidemiology,clinical symptoms,clinical diagnosis and treatment of gastric small stromal tumors for reference．

目的 分析TIMELESS、鼠肉瘤病毒家族相关蛋白2A（RAB2A）、异常纺锤体样小头畸形相关基因（ASPM）在乳腺癌组织中的表达及与临床特征相关性。方法 选取2019年2月—2021年2月我院乳腺癌组织标本84例作为研究组、正常乳腺组织标本53例作为对照组,采用荧光定量聚合酶测定TIMELESS、ASPM,采用Western blot检测RAB2A蛋白表达情况,分析上述三个指标在乳腺癌中表达及与临床特征相关性。结果 对比对照组,研究组TIMELESS、ASPM表达较高,RAB2A较低（P<0.05）。TIMELESS、RAB2A、ASPM与乳腺癌淋巴结浸润、TNM分期、分化程度相关（P<0.05）。TIMELESS、RAB2A、ASPM为影响乳腺癌发生的危险因素（P<0.05）。TIMELESS、RAB2A负相关（r=-0.383、P=0.001）;TIMELESS、ASPM正相关（r=0.397、P=0.001）;RAB2A、ASPM负相关（r=-0.257、P=0.018）。对比TIMELESS、RAB2A、ASPM单一检测,三者联合检测对乳腺癌的诊断价值较高（P<0.05）。结论 乳腺癌患者TIMELESS、ASPM呈高表达,RAB2A呈低表达,上述三个指标与乳腺癌高度相关,可作为乳腺癌发生的检测指标。

Objective To analyze the expression of TIMELESS,murine sarcoma virus family related protein 2A（RAB2A）and abnormal spindle like microcephaly related gene（ASPM）in breast cancer tissues and their correlation with clinical features．Methods A total of 84 breast cancer tissue samples from our hospital from February 2019 to February 2021 were selected as the study group and 53 normal breast tissue samples were selected as the control group．Time,ASPM and RAB2A protein expression were determined by fluorescent quantitative polymerase,and RAB2A protein expression was detected by Western blot．The expression of the above three indicators in breast cancer and their correlation with clinical characteristics were analyzed．Results Compared with the control group,the study group had higher TIMELESS and ASPM expression levels and lower RAB2A level（P<0.05）．TIMELESS,RAB2A and ASPM expressions were correlated with lymph node infiltration,TNM stage and differentiation of breast cancer（P<0.05）．TIMELESS,RAB2A and ASPM were the risk factors of breast cancer（P<0.05）．TIMELESS and RAB2A were negatively correlated（r=-0.383,P=0.001）;TIMELESS and ASPM were positive correlated（r=0.397、P=0.001）;RAB2A and ASPM were negatively correlated（r=-0.257,P=0.018）．Compared with the single detection of TIMELESS,RAB2A and ASPM,the combined detection had higher diagnostic value for breast cancer（P<0.05）．Conclusions Patients with breast cancer had high expression of TIMELESS and ASPM,and low expression of RAB2A．The above three indicators were highly correlated with breast cancer and can be detection indicators for breast cancer．

目的 探讨消肿化瘀膏治疗骨性关节炎的临床疗效。方法 选择2017年5月—2022年1月在本院诊治的骨性关节炎患者124例作为研究对象,根据简单分配原则把患者分为消肿化瘀膏组与传统药物组各62例。传统药物组给予传统药物治疗,消肿化瘀膏组给予消肿化瘀膏治疗,判定2组患者治疗总显效率、疼痛评分、关节评分、血清中炎症因子水平变化。结果 消肿化瘀膏组治疗后的总显效率为98.4%,高于传统药物组的83.9%（P<0.05）。治疗后,2组的疼痛评分都低于治疗前（P<0.05）,且消肿化瘀膏组低于传统药物组（P<0.05）。2组治疗后的关节评分都高于治疗前（P<0.05）,且消肿化瘀膏组与传统药物组相比升高（P<0.05）。2组治疗后的血清白介素-1β、白介素-6水平都低于治疗前（P<0.05）,且消肿化瘀膏组较传统药物组降低更多（P<0.05）。结论 消肿化瘀膏治疗骨性关节炎能有效抑制血清炎症因子的表达,缓解疼痛,改善关节功能,提高患者的总体治疗效果。

Objective To explore the clinical efficacy of Xiaozhonghuayu ointment in the treatment of osteoarthritis．Methods From May 2017 to January 2022,124 patients with osteoarthritis who diagnosed and treated in our hospital were selected as the research subjects．According to the simple allocation principle,the patients were divided into the Xiaozhonghuayu ointment group and the traditional medicine group with 62 cases each．The traditional medicine group was treated with traditional medicine,and the Xiaozhonghuayu ointment group was treated with Xiaozhonghuayu ointment．The total therapeutic efficiency,pain score,joint score,and the changes of serum inflammatory factors were compared in the two groups．Results The total efficiency of Xiaozhonghuayu ointment group after treatment were 98.4%,which were higher than 83.9% in the traditional medicine group（P<0.05）．The pain scores in both groups after treatment were lower than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were lower than the traditional medicine group（P<0.05）．The joint scores of the two groups after treatment were higher than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were higher than the traditional medicine group（P<0.05）．After treatment,the levels of serum interleukin-1β and interleukin-6 in the two groups were significantly lower than those before treatment（P<0.05）,compared with the traditional medicine group,those levels in the Xiaozhonghuayu ointment group also decreased significantly after treatment（P<0.05）．Conclusions Xiaozhonghuayu ointment in the treatment of osteoarthritis can effectively inhibit the expressions of serum inflammatory factors,promote pain relief,improve joint function,and improve the overall therapeutic effect of patients．

目的 分析新生儿无乳链球菌（B族链球菌,GBS）败血症的临床特点、围产期高危因素及预后,提高临床对GBS败血症的认识。方法 选择21例GBS败血症新生儿（收集病例时间为2018年2月—2021年11月）,采用回顾性调查法分析临床资料;对新生儿临床资料、实验室检查、影像学资料进行统计和对比,分析临床特征,同时比较患儿合并症情况及评估治疗预后结果等。结果 GBS败血症新生儿中早发型（90.48%）明显高于迟发型（9.52%）,P<0.05;GBS败血症新生儿主要症状表现为发热、发绀、气促、呻吟、抽搐等,以气促、呻吟为主;通过实验室检查,发现患儿普遍存在C反应蛋白、降钙素原、白细胞计数等指标异常情况;经头颅MRI检查提示蛛网膜下腔出血6例;X线提示新生儿吸入性综合征6例、双肺新生儿肺炎4例;部分患儿存在合并症,其中1例合并脑膜炎、3例合并蛛网膜下腔出血、4例合并黄疸、2例合并新生儿低血糖;所有患儿接受抗菌药物治疗,以青霉素、头孢他啶为主,平均住院时间（14.86±2.33）d,治愈19例（占比90.48%）、1例患儿好转后家属要求签字出院,1例家属要求转上级儿童医院。结论 新生儿无乳链球菌败血症有早发型和迟发型之分,两者的临床表现及特征有明显差异,该病病情较凶险,临床需高度重视本病的防治工作,早期诊断及时治疗干预,以提高新生儿预后。

Objective To analyze the clinical characteristics,perinatal high-risk factors and prognosis of neonatal Streptococcus agalactiae（group B Streptococcus,GBS）sepsis,and to improve the clinical understanding of Streptococcus agalactiae sepsis．Methods Twenty-one newborns with GES sepsis were selected（the cases were collected from February 2018 to November 2021）,and the clinical data were analyzed by retrospective investigation．The clinical data,laboratory examination and imaging data of newborns were summarized and compared,and the clinical characteristics were analyzed．At the same time,the complications of children were compared and the prognosis of treatment was evaluated．Results In newborns with GBS sepsis,the early-onset rate（90.48%）was significantly higher than the late-onset（9.52%）,P < 0.05．The main symptoms of newborns with GBS sepsis were shortness of breath,moaning,fever,cyanosis,convulsions,etc．Through laboratory examination,it was found that there were common abnormalities in C-reactive protein,procalcitonin,leukocyte count and other indicators in children．Transcranial MRI results showed 6 cases with subarachnoid hemorrhage;X-ray showed 6 cases with neonatal aspiration syndrome and 4 cases with both lungs neonatal pneumonia．Some children had complications,including 1 case with meningitis,3 cases with subarachnoid hemorrhage,4 cases with jaundice,and 2 cases with neonatal hypoglycemia．All children were treated with antibiotics,mainly penicillin and ceftazidime．The average hospital stay was（14.86 ± 2.33）days,and 19 cases were cured（accounting for 90.48%）．One case of the child's family member asked to sign and leave the hospital after improvement,and one case of the family member asked to be transferred to a superior children's hospital．Conclusions Neonatal Streptococcus agalactiae sepsis can be divided into early-onset and late-onset type．There are significant differences in clinical manifestations and characteristics between them．The disease is dangerous,clinical attention should be paid to the prevention and treatment of the disease,early diagnosis and timely treatment and intervention,so as to improve the prognosis of newborns．