目的 研究布拉氏酵母菌在合理治疗婴幼儿肠炎中的应用分析。方法 随机分组,观察组、对照组各60例病例,总例数120例,年龄均在2岁以下。观察组予以布拉氏酵母菌进行治疗;对照组采用常用的消化道黏膜保护剂(蒙脱石散)加微生态制剂(双歧杆菌四联活菌片)两联治疗。判定两组疗效。判定标准分为:大便次数及性状改变、发热、呕吐缓解、心酶下降、电解质紊乱、脱水纠正。结果 总有效率观察组为96.7％,对照组为86.7%,观察组临床疗效优于对照组(P<0.05),在各项症状及临床指标的改善上也优于对照组。结论 布拉氏酵母菌治疗婴幼儿肠炎临床疗效较常规方法能更好地缓解症状,使用更简单、合理,未监测到不良反应,值得在临床药物选择使用。

目的 探讨不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学。方法 本次医学研究选择我院2012年1月—2014年1月收治的200例慢性阻塞性肺病所致肺部感染患者为观察对象,随机将其分为A组、B组、C组和D组,A组观察对象接受盐酸莫西沙星治疗,B组观察对象接受硫酸依替米星治疗,C组观察对象接受头孢哌酮钠治疗,D组观察对象接受他唑巴坦钠/哌拉西林钠治疗,回顾分析四组观察对象药物经济学。结果 四组观察对象药物敏感度对比差异有统计学意义(P<0.05),而临床治疗效果和不良反应发生率对比则差异无统计学意义(P>0.05)。结论 慢性阻塞性肺病所致肺部感染患者接受C方案治疗,具有理想的临床效果和较高的药物经济学效率。

目的 研究探讨小儿支气管肺炎应用穿心莲内酯磺化物雾化吸入治疗的临床疗效及安全性。方法 选取2012年7月—2014年6月我院收治并确诊的128例小儿支气管肺炎患儿为研究对象,将所有患儿随机分为对照组和观察组各64例。两组患儿均给予常规退热,消炎、镇咳、平喘、抗病毒感染等治疗,对照组患儿在常规治疗基础上采用红霉素、青霉素和头孢等药物治疗,观察组患儿在常规治疗基础上采用喜炎平注射液雾化吸入治疗,观察两组患儿治疗后退烧时间、肺部啰音消失时间、咳嗽消失时间、临床总有效率以及住院天数。结果 治疗后观察组患儿的各症状消失时间以及住院天数均短于对照组患儿,差异有统计学意义(P<0.05)。观察组患儿总有效率为96.88%高于对照组的85.94%,两组差异有统计学意义(P<0.05)。结论 采用喜炎平注射液雾化吸入治疗小儿支气管肺炎有效果,能效缓解患儿的临床症状,值得大力推广。

Objective To Study and investigate the curative effect and security using nebulizer inhalation of Andrographolide Sulfonate to children's bronchopneumonia. Methods From July,2012 to June, 2014, we chose 128 children who had been diagnosed as bronchopneumonia by our hospital as our research subjects, and divided them into the contrast group and the observation group randomly with 64 children each. The both groups were all treated by using the methods of Antipyretic,anti-inflammatory,antitussive,antiasthmatic,anti-viral infection, treated by using erythromycin, penicillin and cefotaxime in the contrast group,treated the observation group by using Xiyanpin injection by nebulizer inhalation, of cause these two treatment were all on the basis of the conventional treatment. After treatment, we recorded the exact time of when the fever was gone, the disappearing time of pulmonary rales and their cough, the total effective rate and the time of being in hospital of the two groups. Results The time of all the observation group's symptom disappearing and being in hospital was obviously shorter than that of the contrast group after treatment. The difference between both groups was statistically significant(P<0.05). The total effective rate for the observation group was 96.88%, and it's higher than the contrast groups',which was 85.94%. The difference was statistically significant(P<0.05)too. Conclusion Using Xiyanpin injection by nebulizer inhalation for children's bronchopneumonia could effectively relieve the children's clinical symptom. It is worth popularizing for its good clinic medical value.

目的 探讨妇女阴道健康状况及阴道分泌物清洁度、线索细胞及唾液酸酶法检测细菌性阴道病(BV)的相关性。方法 随机抽取2013年4月—2014年6月本院妇科疑似细菌性阴道病患者标本835例,分别采用生理盐水直接涂片及分泌物直接涂片进行革兰氏染色两者相结合检查清洁度、线索细胞;唾液酸酶法检测BV。结果 清洁度Ⅰ～Ⅱ占27.55%,BV阳性率为2.40%,线索细胞检出率1.32%;清洁度Ⅲ～Ⅳ占72.45%,病原菌阳性率为46.23%,其中BV阳性率为30.55%,线索细胞检出率为23.48%。结论 清洁度异常率比正常率偏高;清洁度正常不一定没有细菌性阴道病; BV的出现严重威胁妇女身体健康,正确的诊断有重要意义,唾液酸酶法检测BV虽有快速、操作简单、显色结果易判断,但温度、时间、取材问题等受多种因素影响。

Objective To explore the correlation between the health of women's vagina and vaginal cleanness, clue cells and bacterial vaginosis(BV)which is tested by the sialic acid enzymatic method. Methods Randomly select 835 suspected cases of bacterial vaginosis in our hospital gynecology department in April 2013-June 2014. Every case was respectively done saline direct smear and vaginal secretion direct smear gram staining to check vaginal cleanness and clue cells. BV is tested by sialic acid enzymatic method. Results The cleanness of I-II accounted for 27.55%, BV positive rate was 2.40%, the positive rate of clue cells was 1.32%;the cleanness of degree III-IV accounted for 72.45%, the positive rate of pathogenic bacteria was 46.23%, the positive rate of BV was 30.55%, the positive rate of clue cells leads to 23.48%. Conclusion The rate of abnormal vaginal cleanness is higher than the normal.The nomal vaginal cleaness does not show no bacterial vaginosis. The emergence of BV seriously affects women's health, so the correct diagnosis is of great importance. Although the of the saliva acid enzyme to test BV is fast, operates easily and the color results are easily to be judged, but it can be influenced by other factors such as temperature, time, materials issues.

目的 探讨NCPM理论指导下的临床营养诊疗工作在疾病治疗中解决临床营养问题的重要作用与临床价值。方法 对我院临床营养医师运用NCPM理论参与治疗的典型病例进行分析与总结。结果 临床营养医师运用NCPM理论指导临床诊疗工作,可按照临床营养诊疗工作流程,梳理临床营养诊疗思路,确定并围绕临床营养问题诊断,制定和调整临床治疗方案,提高临床疗效、缩短疗程、降低患者医疗风险。结论 临床营养医师将NCPM理论知识和临床实践相结合,有助于医院临床营养工作流程建立并有效实施;有助于临床医生与临床营养医生建立规范临床营养诊疗思路;在参与制定住院患者临床营养诊疗工作中,体现为提高临床疗效、缩短疗程、降低患者医疗风险,改善临床疗效等临床价值,应推广应用NCPM开展临床诊疗工作。

Objective The purpose of this article was to explore the clinical value of clinical nutrition diagnosis and treatment which was in the instruction of NCPM theory and the important role to solve the problem of clinical nutrition in treating disease. Methods We analyzed and summarized the typical cases that were treated using the theory of NCPM by clinical dietitians in our hospital. Results Clinical dietitians applied the theory of NCPM to guide clinical diagnosis and treatment work,and organizedthe clinical nutrition diagnosis and treatment clearly, indentified the clinical nutrition issues and around the issues they made and adjusted clinical treatment plan according to clinical nutrition diagnosis process, which increased the clinical curative effect,shortened period of treatment and reduced the patients' medical risk. Conclusion Clinical dietitiansorganizedNCPM theoretical knowledge with clinical establishment and implement effectively of clinical nutrition work process in hospital, practice, which contributed to the meamwhile whichhelp clinical doctors and clinical dietitians estabish the thought of clinical nutrition diagnosis and during the clinical nutrition diagnosis work which reflected improving the clinical curative effect, shortened period of treatment and reduced the patients' medical risk and improving the clinical outcome. Therefore it is important to popularize NCPM to carry out clinical diagnosis and treatment work.

目的 分析立体定向体部放射治疗(SBRJ)应用于孤立性肺肿瘤的疗效,探讨其临床价值。方法 采用拓能(TOPSLANE)全身X线立体定向放射治疗系统治疗15例孤立性肺肿瘤患者,其中I期非小细胞肺癌患者8例,单个肺转移瘤患者7例。单次剂量为5~8Gy／次,每天1次,每周3次,共8~10次,总剂量50~64Gy,生物有效剂量(BED)75~115Gy。分析治疗的近期疗效、急性放射损伤和局部控制率。结果 3例患者完全缓解(20.0%),10例患者部分缓解(66.7%),2例患者病灶稳定(13.3%),没有疾病进展的患者。15例患者总有效率为86.7%(13/15)。BED<90Gy的患者有效率为33.3%,而BED>90Gy的患者有效率为100%,差异有统计学意义(P＜0.05)。3例患者出现2级急性放射损伤,未见3级以上毒副反应。1年和2年局控率分别为92.3%和81.2%。结论 SBRT治疗孤立性肺肿瘤可获得较好的近期疗效和局部控制率,急性放射损伤较轻。

Objective To analyze the efficacy of stereotactic body radiation therapy(SBRT) onsolitary pulmonary tumor and explore its clinical value. Methods TOPSLANE X-ray stereotactic body radiation therapy system was used for treatment of fifteen patients with solitary pulmonary tumor, including eight patients with stage I non-small cell lung cancer and seven patients with single lung metastasis. Fraction dose of 5 to 8Gy was prescribed once a day, three times a week, totally 8 to 10 times to a total dose of 50 to 64 Gy and biological effective dose(BED) of 75 to 115Gy. Short-term efficacy, acute radiation injury and local control rate were analyzed. Results After treatment, there were three patients with complete response (CR) (20.0%), ten patients with partial response (PR) (66.7%), tow patients with stable disease (SD) (13.3%), and no patients with progressive disease (PD). The total response rate was 86.7% (13/15). The response rate was 33.3% in patients with BED <90 Gy, while it was 100% in patients with BED> 90 Gy, and the difference was statistically significant (P<0.05). Grade 2 acute radiation injuries were observed in three patients, and no toxicity greater than grade 3 was observed. The 1-year and 2-year local control rate was 92.3% and 81.2%, respectively. Conclusion SBRT on solitary pulmonary tumor has good short-term efficacy and local control rate with mild acute radiation injury.

目的 调查I-IIa期宫颈鳞状细胞癌患者术后随诊和复发情况,并探索随诊和复发的相关因素。方法 分析2011年1月—2012年6月中山市妇幼保健院收治的128例宫颈鳞状细胞癌患者的临床资料,分析他们的术后随诊情况及其影响因素。将有液基薄层细胞学(TCT)及盆腔检查者视为有效随诊的患者,分析肿瘤复发情况及其影响因素。结果 128例患者中,有效随诊104例(占总人数的81.25%)。年龄组越小,随诊率越高(P=0.034);城市患者较农村患者,随诊率高(P=0.028);文化程度越高,随诊率越高(P=0.028);职业为公务员、教师、公司职员或自由职业、个体,随诊率比职业为家庭妇女和工人更高(P=0.030)。在104例随诊者中,2年复发8例(占7.7%)。临床分期较晚,肿瘤直径>4cm,病理类型,脉管内瘤栓阳性,淋巴结转移阳性是影响患者2年复发的危险因素(P<0.05)。结论 临床分期,肿瘤直径,脉管内瘤栓阳性,淋巴结转移等临床病理特征与患者复发密切相关。应针对宫颈癌患者社会人口学特点制定措施,提高随诊率。

Objective To investigate the follow-up rate after surgical treatment and the recurrence rate among patients with cervical squamous cell carcinoma in I-IIa stage, and identify associated factors. Methods The clinical data of 128 cases of cervical squamous cell carcinoma from January 2011 to June 2012 in Zhongshan maternal and child health hospital was collected. Follow up record of these cases was analyzed and factors associated with follow up were identified. Patients having taken thinprep liquid-based cytology test (TCT) and pelvioscopy were treated as cases being followed effectively, and their recurrence and associated factors were analyzed. Results Among the 128 patients, 104(81.25%) were effectively followed. Patients with younger age(P=0.034), living in city (P=0.028), with higher education level(P=0.028) had higher follow-up rate. Civil servants, teachers and freelancers had higher follow-up rate than housewives and workers (P=0.030).Eight of the 104 effectively followed cases recurred within two years after surgery, accounting for 7.7%. The associated factors of recurrence included clinical stage, tumor diameter, larger than 4cm, the depth of myometrial invasion, deeper than 2/3, vascular tumor thrombus positive, and lymph node metastasis positive (P<0.05). Conclusion Clinical stage, tumor size, vascular tumor thrombus positive, lymph node metastasis positive were associated with recurrence. Tailored strategies should be developed to improve the follow up rate based on the social and demographic characteristics of patients.

目的 设计并验证适合Beckman AU5811全自动生化分析仪试剂针和搅拌棒的交叉污染分析方法,找到产生的原因并制定有效的污染避免措施。方法 以反应盘内圈项目(ALT、TBIL、GGT、ALB、TBA、LDH1、CK、Cr、GLU、CO2、TC、HDL-C、APOA1、Ca 、Fe、Cu、HCY 、AFU、PA)作为实验项目,按设计的检测顺序进行交叉污染实验,各项目间的污染率以不超过95%～105%为判断标准。结果 内圈项目中TC、HCL-C对TBA分别存在试剂针和搅拌棒的污染,Ca对Cr存在搅拌棒的污染,Cu对Fe存在试剂针的污染,GGT、ALB、LDH1对CO2都有搅拌棒的污染,TC、TBIL对Cu也存在搅拌棒的污染。结论 采用该方法能有效快速地对Beckman AU5811生化分析仪上的所有项目进行交叉污染实验,确定交叉污染产生的关联项目并采取污染避免措施减少交叉污染,保证检验结果的准确。

Objective To design and verify an analytical method for the cross contamination of Beckman AU5811 automatic biochemical analyzer's reagent needle and stir bar and find the reasons, and make effective measures to avoid contamination. Methods Use the inner ring items (ALT,TBIL,GGT,ALB, TBA,LDH1,CK,Cr,GLU,CO2,TC,HDL-C,APOA1,Ca,Fe,Cu,HCY,AFU,PA) as theexperiment objects and do the cross contamination experiment according to the test order. The standard for the cross contamination level is limited to 95-105% among all items. Results TC and HCL-C were found to have contaminated TBA both in reagent needle and stir bar model, Ca contaminated Cr in the stir bar model; Cu contaminated Fe in the reagent needle model; GGT,ALB and LDH1 contaminated CO2 in stir bar model; TC and TBIL contaminated Cu in the stir bar model. Conclusion The method used in this experiment can effectively identify and analyze the cross contamination of all the items in Beckman AU5811 automatic biochemical analyzer. In addition, it can help to adopt corresponding measures to reduce cross contamination.

目的 探讨优质护理对于提高白内障手术患者术后恢复的影响。方法 选取本院自2014年1月—2014年6月收治的56例实施白内障手术的患者,将患者平均分配为对照组和实验组,对照组实行常规护理服务,观察组实施优质护理服务,建立完善的护理人员工作机制,提高护理人员素质;加强对患者的健康教育和心理护理,及时给患者进行检查。统计两组患者的治疗效果,分析优质护理服务的效果。结果 在术后接受优质护理服务的实验组患者的恢复效果好于对照组患者,术后的不良事件发生率较对照组低,患者的疼痛程度低,二组数据差异具有统计学意义。结论 给白内障术后的患者以优质护理服务能提高护理质量,缩短患者恢复时间,提高患者恢复效果。

目的 通过对比观察常规西药和当归芍药散加减治疗哺乳期子宫上环术后子宫异常出血的临床效果,探讨其安全有效的治疗方法。方法 选取在哺乳期行子宫上环术的妇女96例,随机分为两组,西药组采用常规西药治疗,中药组采用当归芍药散加减方剂治疗。观察术前、术后及治疗后月经量的变化,并对实验结果进行分析和评价。结果 所有96例患者在行子宫上环术后均出现月经量较术前增多(P<0.05),在经过药物治疗后,所有患者月经量较治疗前减少(P<0.05),并治疗后月经量与术前月经量相比波动较小,差异无统计学意义(P>0.05)。中药组与西药组比较,治疗后月经量稍增多,差异无统计学意义(P>0.05)。西药组有5例患者出现头痛、头晕、恶心、呕吐等不适,对症处理或减量后好转,中药组无不良反应病例。结论 西药及中药治疗哺乳期子宫上环术后子宫异常出血效果相当,当归芍药散加减方剂副作用小,具有较高的可靠性和安全性,值得借鉴与推广。