目的 了解南昌市某政府机关退休人员的健康状况,为制定有针对性的疾病防治措施提供依据。方法 根据南昌大学医院体检科常规体检项目,于2016—2018年对南昌市某政府机关退休职工进行健康体检,分析体检异常所占比例,采用χ²检验比较两样本率。结果 腹部彩超、甲状腺彩超、血脂、幽门螺杆菌（HP）、心电图、肝肾功能、宫颈刮片与白带（女）、血糖、肿瘤指标等为主要异常指标。2016—2018年的腹部彩超异常率分别高达82.98%、88.64%和82.95%,腹部彩超异常者中前列腺增生、脂肪肝和胆道系统异常所占比例较高。腹部彩超异常比例男性高于女性,甲状腺彩超和肿瘤指标异常比例女性高于男性（P<0.05）。结论 该政府机关退休职工健康体检指标异常所占比例较高,需要建立健康档案数据库进行健康管理,并对体检指标异常者安排定期复检,以实现对疾病的“早发现,早诊断,早治疗”。

Objective To understand the health status of retired people in a government agency in Nanchang city,and to provide evidence for the prevention and treatment of diseases. Methods According to the routine physical examination items of the department of physical examination of Nanchang university hospital,the health examination of retired staffs of a government agency in Nanchang city from 2016 to 2018 was carried out. The proportion of abnormal physical examination was analyzed,and the rate of two samples was compared by χ² test. Results Abdominal ultrasound,thyroid ultrasound,blood lipid,helicobacter pylori （HP）,electrocardiogram,liver and kidney function,cervical scraper and leucorrhea （female）,blood sugar,tumor index were the main abnormal indexes. The abnormal rate of color Doppler ultrasound was as high as 82.98% and 82.95%,respectively. The proportions of benign prostatic hyperplasia,fatty liver and abnormal biliary system were higher in the patients with abnormal abdominal color Doppler ultrasound. The abnormal rate of abdominal color Doppler ultrasound was higher in male than that in female,and the abnormal rate of thyroid ultrasound and tumor index were higher in female than that in male （P< 0.05）. Conclusion The proportions of abnormal health examination indexes of retired staffs in this government agency are relatively high. It is necessary to establish a health record database for health management,and arrange periodic reexamination for those who have abnormal physical examination indexes in order to realize importance of early detection and early diagnosis of diseases,and have early treatment.

目的 比较分析神经内镜和常规开颅手术在治疗高血压脑出血时的优劣。方法 回顾性分析我院神经外科2015年12月1日—2017年12月31日收治的60例高血压脑出血患者,根据治疗术式的不同,分为对照组和观察组,各30例。对照组行常规开颅手术,观察组给予神经内镜治疗,通过对比两组患者的手术时长、术中出血量、血肿清除率、住院时间、术后并发症及术后6个月随访效果,分析两组优劣。结果 观察组手术时长短于对照组,差异有统计学意义（P<0.05）;观察组术中出血量少于对照组,差异有统计学意义（P<0.05）;观察组血肿清除率高于对照组,差异有统计学意义（P<0.05）;观察组术后并发症（颅内感染、肺部感染）发生率低于对照组,差异有统计学意义（P<0.05）,而两组再次出血及死亡率差异均有统计学意义（P>0.05）;观察组患者术后预后效果优于对照组,差异有统计学意义（P<0.05）。结论 神经内镜在治疗高血压脑出血时对比常规开颅手术具有显著缩短手术时长及住院时间,提高血肿清除率,减少术中出血,降低颅内及肺部感染率等优势,值得临床推广应用。

Objective To compare and analyze the advantages and disadvantages of neuroendoscopy and conventional craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods 60 patients with hypertensive intracerebral hemorrhage admitted to our hospital from December 1,2015 to December 31,2017 were divided into the control group and the observation group,each with 30 cases. The control group underwent conventional craniotomy,and the observation group underwent neuroendoscopic treatment. The length of operation,intraoperative blood loss,hematoma clearance,length of hospital stay,postoperative complications,and follow-up after 6 months were compared between the two groups, to analysis the advantages and disadvantages of both groups. Results The duration of operation in the observation group was shorter than that in the control group （P<0.05）. The intraoperative blood loss in the observation group was less than that in the control group （P<0.05）;The hematoma clearance rate in the observation group was higher than that in the control group （P<0.05）;The incidence of postoperative complications （intracranial infection,lung infection） in the observation group was lower than that of the control group （P<0.05）. There was no statistically significant in rebleeding and mortality between the two groups （P>0.05）. The prognosis of the observation group was better than that of the control group. In the control group,the difference was statistically significant （P<0.05）. Conclusion Neuroendoscope in the treatment of hypertensive intracerebral hemorrhage compared with conventional craniotomy may shorten the length of operation and hospital stay,improve hematoma clearance rate,reduce intraoperative bleeding,reduce intracranial and pulmonary infection and other advantages. It is worthy of clinical promotion and application.

目的 通过生物信息分析途径,从分子水平揭示非酒精性脂肪性肝病（NAFLD）的发病发展机制,为NAFLD研究提供新的思路。方法 从公共数据库GEO中下载NAFLD相关的基因芯片数据GSE48452,利用Transcriptome Analysis Console软件筛选差异表达基因,FunRich软件和STRING在线分析工具对差异基因进行下一步的生物信息学分析。结果 正常组与NAFLD组差异基因52个,正常组与非酒精性脂肪性肝炎（NASH）基因64个,共同差异基因15个。这些差异表达基因参与脂质转运、胆汁酸合成、脂质和脂蛋白代谢、生物氧化等过程。通过通路分析及蛋白质相互作用分析进一步筛选出与NAFLD发病发展密切相关的18个差异表达基因。结论 通过生物信息学分析筛选出MSN、CDC45、ANXA5、PIK3CG和DTL基因可能为研究乃至阻断NAFLD发展进程的重要靶点,需进一步验证。

Objective To explore the molecular mechanism of nonalcoholic fatty liver disease （NAFLD） with bioinformatics analysis. Methods The microarray data of NAFLD were downloaded from the Gene Expression Omnibus （GEO） database and analyzed using Transcriptome Analysis Console （TAC） for screening differentially expressed genes. The further analysis of differentially expressed genes was conducted by FunRich software and the online tool STRING. Results For the comparison of control group vs. NAFLD group,52 genes have differentially expressed,while control groups vs. nonalcoholic steatohepatitis （NASH） group,64 genes have differentially expressed. 15 differentially expressed genes were found in both comparisons. These genes were involved in the biological pathway of lipid transport,bile acid biosynthesis,metabolism of lipids and lipoproteins and biological oxidations. With biological pathway analysis and protein-protein interaction analysis,18 differentially expressed genes were found closely associated with the progression of NAFLD. Conclusion MSN、CDC45、ANXA5、PIK3CG and DTL may be the important target for study the progression of NAFLD,which needs a further study to confirm.

目的 了解孕妇妊娠期运动现状及其影响因素,为优化妊娠期运动方案提供依据。方法 采用便利抽样法,使用自编《孕妇妊娠期运动现状及影响因素调查问卷》对广州市某三级甲等妇幼保健院214名孕周＞37周的孕妇进行调查。结果 妊娠期每次运动时长集中在30min~1 h的孕妇占43.0%;91.6%的孕妇选择散步和爬楼梯,仅有8.4%的孕妇接触过孕妇体操和瑜伽等其他运动形式;妊娠合并糖尿病与无合并症孕妇运动量相比,差异无统计学意义(P>0.05);家人朋友为孕妇主要获取妊娠期运动信息来源。认为妊娠期运动不重要、缺乏安全感、家庭及社会支持为妊娠期运动的主要影响因素。结论 孕妇运动量总体处于较低水平,运动形式单一,受认知、心理、生理、社会因素影响;孕妇尤其是患有妊娠合并糖尿病的孕妇对妊娠期运动的重要性和必要性没有给予足够的重视;医护人员对于妊娠期运动的引导作用较弱。

目的 分析不同性别学龄儿童行为问题影响因素,为促进儿童行为健康发展提供指导依据。方法 以儿童保健门诊就诊的学龄儿童200名,男童110例,女童90例,平均年龄为(7±15)a 为调查对象,采用儿童行为量表(CBCL)检测所有调查对象的行为问题。由男/女童父母在专业人员指导下进行问卷调查,对收集的数据使用SPSS 11.0统计软件进行资料分析。结果 本次调查中男、女童年龄差异无统计学意义,男、女童在检出儿童行为问题方面有明显的差异性(P<0.05,P<0.01)具有统计学意义。男童在强迫性、违纪方面明显高于女童,女童在抑郁、社交退缩、体诉方面高于男童。结论 儿童行为问题的发生,受多方面因素影响包括社会环境、家庭环境以及父母的教养方式,应根据男童和女童的不同行为特点,给予有效的干预让孩子的身心发展更趋稳定和健康,从而降低儿童行为问题的发生。

Objective To explore the influence factors of children's behavior problem in school-age children, and to provide the evidence for promoting healthier children's behavior. Methods The objects of our study included 200 school-aged children in health care clinic (110 boys and 90 girls ), the average age is 7(7±15)years, and we used the CBCL questionnaire to assess all the children's behavior problems. The CBCL questionnaire was finished by the parents of the children guided by the specialized investigator. The data was analyzed by the SPSS 11.0 software. Results The score of boys in compulsivity and disobey is significant higher than girls(P<0.05), and the girls have higher score in depression, social flinch and physical demands than boys(P<0.01). There is no significant difference between different genders in the age of the children. Conclusion Behavior problems of children were affected by many kinds of factors including social environment, family environment and parenting styles. We need to conduct appropriate behavior intervention according to the different behavior characteristics between boys and girls, to promote healthier children's behavior and to reduce the behavior problems of children.

目的 探讨精液白细胞和形态正常精子百分率的相关性。方法 随机选取2014年4月—2015年8月来生殖中心进行就诊的男性800例,分析患者精液中的白细胞数量以及分析患者的精子形态,比较二者的相关性。结果 正常形态精子百分率低于正常参考值的患者中有61.9％的白细胞数大于1×10⁶,精子形态正常的患者有38.9％患者的白细胞数大于1×10⁶,患者比例差异有统计学意义(P<0.05)。精子形态正常的患者(320例)和正常形态精子百分率低于正常参考值的患者(480例)相比,精子形态正常的比例远远大于正常形态精子百分率低于正常参考值的患者(P<0.05)。而正常形态精子百分率低于正常参考值的患者的头部异常、颈部和中间部分异常、尾部异常精子比例高于正常组(P<0.05)。正常形态精子百分率低于正常参考值的和正常形态的精子比例呈正相关;和大头精子百分率、锥形以及小头形态精子百分率呈负相关;和梨形以及其他形态的精子呈正相关。结论 精液中的白细胞可以影响精子的参数,使得患者精液中的颈部或中部异常形态、头部和尾部异常形态的精子比例提升,具体机制有待进一步研究。

目的 了解本地区住院疾病谱的特征,为疾病防治工作及合理配置医疗资源提供参考依据。方法 收集2014年佛山市主要二级以上医院的病案首页资料,根据ICD-10进行分类统计。结果 前五位疾病类型为:肿瘤、循环系统疾病、损伤和中毒、妊娠分娩和产褥期、消化系统疾病,与全国城市医院住院疾病谱不同。结论 佛山市的疾病控制重点有其特点,医院的发展和配置应围绕这些相关学科作为重点。

Objective To investigate the characteristics of the spectrum of diseases of inpatients in the region,which is aimed to provide reference for disease control and allocating medical resources reasonably. Methods Collecting the medical record front pages of inpatients of most secondary or above hospitals in Foshan city in 2014. The diseases identities of the included cases were counted according to ICD-10. Results The top five diseases spectrum were tumor, diseases of the circulatory system, injury, poisoning and certain other consequences of external causes, pregnancy, childbirth and the puerperium, diseases of the digestive system,which was different from that of the urban hospitals of the whole country. Conclusion There is a characteristic about the key emphasis in disease control in Foshan city. We should focus on these related subjects for the hospital development and configuration.

目的 研究不同剂量重组人干扰素α1b雾化吸入治疗毛细支气管炎的疗效及安全性。方法 选取2016年1月—2016年9月期间我院儿科收治的年龄≤2 a的毛细支气管炎患儿86例,均符合毛细支气管炎诊断标准,随机分为观察一组(29例)、观察二组(29例)和对照组(28例)。所有患儿均给予综合常规治疗,观察一组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+1 μg/(kg·次)重组人干扰素α1b,观察二组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+2 μg/(kg·次)重组人干扰素α1b。比较三组患儿治疗有效率、临床症状改善和不良反应发生情况。结果 观察一组与观察二组在治愈率和总有效率两个方面均显著高于对照组(P<0.05),但观察一组与观察二组治愈率和总有效率比较差异不显著(P>0.05);观察一组和观察二组患儿临床症状和体征持续时间明显少于对照组(P<0.05),但观察一组和观察二组患儿临床症状和体征持续时间无显著差异(P>0.05);三组患儿不良反应发生率差异不显著(P>0.05)。结论 低剂量与高剂量雾化吸入重组干扰素α1b对于小儿毛细支气管炎临床疗效接近,且均无严重不良反应,综合经济效益和社会效益考虑,在临床上推广低剂量雾化吸入重组干扰素α1b治疗小儿毛细支气管炎更具价值。

Objective To study the effects of different doses of recombinant human interferon α1b inhalation efficacy and safety in the treatment of bronchiolitis. Methods 86 cases of children, who were less than 2 years old were selected in department of pediatrics from January 2016 to September 2016. They were randomly divided into for observation group Ⅰ (29 cases), observation group Ⅱ(29 cases) and control group (28 cases). All the patients were treated with conventional therapy. Group Ⅰ with atomization inhalation of salbutamol and 0.02% with saline+1 μg /kg times of recombinant human interferon α1b were observed and the same as in the two groups Ⅱ with atomization inhalation of salbutamol and 0.02% with saline+2 μg /kg recombinant human interferon α1b. The treatment efficiency, the improvement of clinical symptoms and adverse reactions were compared. Results The cure rate and total effective rate of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the cure rate and total effective rate between observation group Ⅰand Ⅱ(P>0.05). The clinical symptoms and signs of the patients of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the clinical symptoms and signs of the patients between observation group Ⅰand Ⅱ(P>0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P>0.05). Conclusion There were no serious adverse reactions in low dose and high dose of atomization inhalation of recombinant interferon α1b for close to the clinical curative effect of children with bronchiolitis. Considering comprehensively economic benefits and social benefits, it is worth of promotion low dose of atomization inhalation of recombinant interferon 1b in the treatment of children with bronchiolitis.

目的 探讨直肠神经内分泌肿瘤的临床病理特征。方法 回顾性分析46例直肠神经内分泌肿瘤患者的临床病理资料,对不同病理分级的患者在性别、年龄、肿瘤直径、浸润深度、肝及淋巴结转移等方面进行比较。结果 直肠神经内分泌肿瘤男性多见,肿瘤多位于直肠中下段。免疫组化检测显示CgA、Syn、CD56阳性率分别为40.0%、97.8%、100%。36例Ki-67阳性指数≤2％,6例Ki-67阳性指数在3％～20％,4例Ki-67阳性指数＞20％。不同病理分级的肿瘤与患者年龄、肿瘤直径、浸润深度、淋巴结及肝转移相关,与性别不相关。结论 直肠神经内分泌肿瘤缺乏临床特异性症状,联合CgA、Syn和CD56染色可提高直肠神经内分泌肿瘤的诊断率。病理分级对预测肿瘤浸润深度、肝或淋巴结转移有重要参考价值。

Objective To investigate the pathological and clinical significance of 46 cases of rectal neuroendocrine tumors(NET). Methods Retrospectively analyzed the clinical and pathological feature of 46 patients with rectal NET, and assessed possible interactions between different pathological grades and gender, age, tumor diameter, depth of invasion, lymph node and liver metastasis. Results Rectal NET appeared more frequently in males than in females. Most tumors located in middle and distal third of rectum. The positivity rates of immunohistochemical marker CgA, Syn, CD56 were 40.0%, 97.8%, 100.0%, respectively. The cases of Ki-67 positivity rate under 2%, ranged between 3%-20%, above 20% were 36, 6, 4, respectively. Different pathological grades were significantly correlated with age, tumor diameter, depth of invasion, lymph node and liver metastasis, but not with gender. Conclusion Rectal NET had nonspecific symptoms. Combined immunohistochemical staining, such as CgA, Syn and CD56, was important in the evaluation of rectal NET. Pathological grading might be very useful for prediction of invasion depth, lymph node and liver metastasis.

目的 调查我院处方错误的数量和分类,保障门诊患者用药的安全性、有效性和经济性。方法 采用回顾性分析方法,对我院2016年1月—6月的门诊电子处方统计,对不合理处方及时电话沟通和改正,并将错误处方登记入册分析。结果 其中登记入册的错误处方占总处方数的0.24%,主要包括药物用法用量不合理、给药途径不当、药物相互作用不合理、禁忌证用药、重复用药、电脑输入剂量或单位错误等。结论 我院门诊电子处方仍存在一定的不合理现象,临床药师通过处方审核进行干预,并与医院管理和医师有机结合,努力开展药学监护,提高我院处方质量,促进合理用药,共同保证患者用药正确,有效,安全,经济,合理,降低医疗纠纷的发生。