目的 探讨分析胃肠道套细胞淋巴瘤的临床病理学特点分析及预后情况。方法 选取2019年1月—2021年2月间赣州市人民医院收治的50例胃肠道套细胞淋巴瘤患者为观察组,选取本院同期就诊的50例非胃肠道套细胞淋巴瘤患者为对照组。结果 50例胃肠道套细胞淋巴瘤患者的主要临床表现以腹痛为主占比50.00%;好发于回盲部、回肠、升结肠、直肠、乙状结肠,占比依次为54.00%、42.00%、36.00%、36.00%、28.00%;以多发性黏膜息肉样病变40.00%多见,死亡16例(32.00%)。年龄＞60岁、伴有脾脏肿大的胃肠道套细胞淋巴瘤死亡率更高(P<0.05)。观察组患者浅表淋巴结侵犯的比例明显高于对照组(P<0.05)。结论 胃肠道套细胞淋巴瘤主要表现为腹痛等,多发于结直肠,浅表淋巴结侵犯相对更多,以多发性黏膜息肉样病变多见,年龄＞60岁、伴有脾脏肿大的患者预后相对较差。

目的 分析中山市博爱医院妊娠合并哮喘急性发作患者相关危险因素。方法 选取2019年7月—2021年2月中山市博爱医院收治100例的妊娠合并哮喘患者作为研究对象,将100例妊娠合并患者分为哮喘急性发作组(n=46)与未发作组(n=54),采用多因素Logistic回归分析进行调查分析。结果 100例患者中发作人数为46例,占46.0%。Logistic回归分析显示孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的危险因素(P<0.05)。发作组剖宫产率发生率、住院时间以及并发症发生率均高于未发作组,差异有统计学意义(P<0.05)。结论 孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的独立危险因素,应对此类患者给予高度重视。

Objective To analyze the risk factors of pregnancy complicated with acute attack of asthma in Zhongshan Bo'ai Hospital.Methods A total of 100 patients with pregnancy complicated with asthma treated in Zhongshan Bo'ai Hospital from July 2019 to February 2021 were selected as the research objects.Patients were divided into acute attack group (n=46) and no attack group (n=54).Multivariate logistic regression analysis was used for investigation and analysis.Results The patient number of attack was 46,accounting for 46.0%. The incidence of cesarean section,length of hospital stay and complications in the attack group were higher than those in the no attack group,and the difference was statistically significant (P<0.05).Conclusions Gestational age,use of asthma drugs,anxiety and IL-17 level were independent risk factors for pregnancy complicated with acute attack of asthma.Great attention should be paid to these patients.

目的 评估产后女性的认知功能,并分析其认知功能受损的特点,以及分析可能的影响因素。方法 病例组选取健康单胎足月顺产初产妇、二胎产妇,对照组选取一般资料匹配的未生育女性,选用蒙特利尔认知评估(Montreal Cognitive Assessment Test,MoCA)北京版、伯明翰认知评估量表(Birmingham Cognitive Screen test,BCoS)普通话版评估认知功能。结果 实际入组病例组80例产妇,均完成MoCA量表,共42例产妇完成BCoS量表,对照组30例均完成MoCA、 BCoS评估。产妇组(80例)MCA得分为(26.26±2.28)分,低于未生育女性对照组MoCA分数(27.47±1.28)分(P<0.05),产妇组认知障碍发生率为30%高于对照组6.7%(P<0.05)。初产妇组MoCA分数(26.52±2.13)分,认知障碍发生率为26%,二胎产妇组MoCA分数(25.83±2.49)分,认知障碍发生率为36.7%,两者对比无明显差别(P>0.05)。产妇组(80例)在MoCA量表视空间与执行功能分项得分低于对照组(P<0.01);产妇组BCoS评分在故事瞬时回想、苹果删除总数、听觉注意、规则转换、手势模仿5个分项低于对照组(P<0.05)。产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素(P<0.05)。结论 ①产后妇女可能发生认知功能障碍,但初产妇与二胎产妇的认知障碍发生率无明显差别。②MoCA量表可以用于产妇产后认知功能筛查,BCoS量表可做为全面评估产妇产后认知功能的工具,产妇产后认知受损主要在视空间、注意力、执行功能(实践与行动能力)、记忆力领域。③产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素。

Objective To evaluate the cognitive function of postpartum women, and analyze the characteristics of cognitive dysfunction and the possible affecting factors. Methods The case group selected healthy single-born full-term primiparae (50 cases) and second birth parturient (30 cases), and the control group (30 cases) selected non-fertile women with general data matching. The Montreal Cognitive Assessment Test (MoCA) Beijing version and Birmingham Cognitive Screen test(BCoS) were used to evaluate cognitive function. Results Of the 80 cases in the case group, all completed the MoCA test, only 42 cases completed the BCoS test. The 30 cases in the control group all completed the MoCA and BcoS.The MoCA score of the case group (80 cases) was (26.26±2.28), which was lower than that of the control group (27.47±1.28) (P<0.05). The incidence of cognitive impairment in the case group was 30%, higher than the control group 6.7% (P<0.05). The MoCA score of the primiparae group was (26.52±2.13); the incidence of cognitive impairment was 26%; the MoCA score of the second birth parturient group was (25.83±2.49); the incidence of cognitive impairment was 36.7%.There was no significant difference in the MoCA score and the incidence of cognitive impairment between primiparae and second birth parturient (P> 0.05).The case group had lower scores on visual space and executive function of MoCA test than the control group (P<0.01).The score of BCoS test in the case group was lower than that in the control group in the five items of the instantaneous recall item of the story, apple deletion, auditory attention, Birmingham rule conversion and gesture imitation (P<0.05).The years of education, labor analgesia, and the total duration of labor were the factors that affected the cognitive function of postpartum women (P<0.05). Conclusion ①Postpartum women may have cognitive dysfunction, but there was no significant difference in the incidence of cognitive impairment between primiparae and second birth parturient group. ②The MoCA test can be used for the screening of cognitive impairment of postpartum women, and the BCoS test can be used as a tool to comprehensively evaluate the cognitive function of postpartum women. The cognitive impairment of postpartum women was mainly in the fields of visual space, attention, executive function (practice and action ability), and memory. ③The years of education, labor analgesia, and the total duration of labor were the factors that affect the cognitive function of postpartum women.

目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 分析晚期三阴性乳腺癌(TNBC)的危险因素并建立有效的预后列线图。方法 通过检索美国SEER(surveillance, epidemiology, and end results)数据库筛选晚期TNBC患者,采用单因素和多因素分析来确定晚期TNBC的独立预后因素,并以此构建了列线图,通过校准曲线检验和C指数(C-index)评估已建立的列线图。结果 共纳入4 687例晚期TNBC患者,与同期其他分子分型的乳腺癌相比较,TNBC的预后最差。单因素分析发现,年龄、性别、分期、手术、化疗、放疗、转移与更好的预后相关(P<0.05)。多因素分析发现年龄、性别、种族、分期、手术、化疗、放疗、各器官转移是患者预后的独立影响因素(P<0.05),并以此构建了列线图,其C-index为0.75(95％CI,0.71～0.79),校准图显示了预测的总生存期(OS)与观察到的OS之间的最佳一致性。结论 我们分析了晚期TNBC的临床特征,为TNBC患者的OS提供了一些预后因素,并根据这些预后因素制定了列线图,帮助临床医生进行风险管理并选择TNBC患者的长期生存策略。

Objective To analyze the risk factors of advanced triple-negative breast cancer (TNBC) and establish an effective prognostic nomogram. Methods Screening patients with advanced TNBC by searching the SEER (surveillance, epidemiology, and end results) database, using univariate and multivariate analysis to determine the independent prognostic factors of advanced TNBC, and constructing a nomogram based on it. Results A total of 4 687 patients with advanced TNBC were included. Compared with other types of breast cancer over the same period, TNBC had the worst prognosis. Univariate analysis found that age, gender, stage, surgery, chemotherapy, radiotherapy, and metastasis were associated with a better prognosis (P<0.05). Multivariate analysis found that age, gender, race, stage, surgery, chemotherapy, radiotherapy, and metastasis of the organs were independent factors affecting the prognosis of patients (P<0.05), and constructed a nomogram with a C-index of 0.75 ( 95% CI, 0.71～0.79). The calibration chart showed the best agreement between the predicted overall survival (OS) and the observed OS. Conclusion We analyzed the clinical features of advanced TNBC, provided some prognostic factors for the OS of TNBC patients, and developed a nomogram based on these prognostic factors to help clinicians manage risk and choose long-term survival strategies for TNBC patients.

目的 本研究旨在探讨肺癌合并肺栓塞的相关危险因素及肺栓塞对肺癌患者预后的影响。方法 检索2000年1月—2020年3月万方、中国知网、维普期刊、Medline Pubmed及EMBASE数据库中所有相关文献,并使用RevMan 5.3软件进行统计分析。结果 9项临床病例对照研究共1 179例患者纳入本研究。分析结果显示肺癌合并肺栓塞患者的中位生存时间明显低于单纯肺癌患者(HR=2.82,95%CI[2.06,3.87],P＜0.000 1)。危险因素分析显示腺癌发生肺栓塞的风险高于非腺癌(比值比(OR)=3.07, P＜0.000 1),III-IV期患者发生肺栓塞的风险明显高于I-II期患者(OR=2.97,P＜0.000 1),D-二聚体水平高的患者发生肺栓塞的风险是正常患者的4.32倍(P<0.000 1),白细胞(WBC) >11×109/L的患者发生肺栓塞的风险是WBC≤11×109/L患者的6.62倍(P＜0.000 1)。化疗史和中心静脉置管显著增加肺栓塞风险,OR值分别为3.02 (P＜0.000 1)和2.30 (P＜0.000 1)。然而,吸烟史、饮酒史、性别、糖尿病、COPD、高血压病等临床因素与肺栓塞发生无统计学相关性。结论 肺栓塞的发生明显影响肺癌患者的预后,其相关的危险因素为病理类型、分期、化疗史、中心静脉导管置入史、D-二聚体升高、白细胞＞11×10⁹/L。

Objective To investigate the risk factors of developing pulmonary embolism and its influence on the prognosis of lung cancer patients. Methods The following databases such as Wanfang Database, China National Knowledge Infrastructure (CNKI), Chinese Weipu Database, Medline Pubmed and EMBASE were searched to identify relevant articles which were published during January 2000 to March 2020. Statistical analysis was performed using RevMan 5.3 software. Results 9 controlled trials incorporating 1 179 patients were included in this study. The results showed that the overall survival of lung cancer patients complicated with pulmonary embolism was significantly lower than that of lung cancer patients without pulmonary embolism (HR=2.82, 95%CI[2.06,3.87], P<0.000 1). The analysis on risk factors of developing pulmonary embolism showed that adenocarcinoma had a higher risk of pulmonary embolism than non-adenocarcinoma with Odds Ratio (OR)=3.07 (P<0.000 1). Patients in stage III-IV encountered significantly higher risk of pulmonary embolism than those in stage I-II (OR=3.07,P<0.000 1). Furthermore, the risk of pulmonary embolism in patients with high level of D-dimer was 4.32 times higher than in normal patients (P<0.000 1), and 6.62 times higher than those with WBC ≤11×10⁹/L (P<0.000 1). Additionally, the history of chemotherapy and central venous catheterization significantly increased the risk of pulmonary embolism, with OR of 3.02 (P<0.000 1) and 2.30 (P<0.000 1), respectively. However, smoking, alcohol consumption, gender, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular disease, hypertension were not statistical correlated with the occurrence of pulmonary embolism in lung cancer patients. Conclusion The occurrence of pulmonary embolism significantly affects the prognosis of patients with lung cancer, and the related risk factors were pathological type, stage, chemotherapy, central venous catheterization, increased D-dimer level, and WBC>11×10⁹/L.

目的 了解城市围绝经期妇女绝经综合征的发生现状及分析相关影响因素,为进一步加强围绝经期妇女的保健工作提供理论依据。方法 纳入2019年2月—2020年2月就诊于广州市妇女儿童医疗中心中西医妇科门诊、天河及越秀区某社区的40～60岁女性共1 013名,采用问卷调查及Kupperman评分表收集出生日期,月经情况(初潮、绝经年龄等),孕产史,既往疾病史,身高、体质量,工作性质、家庭收入及个性等特征。结果 1 013例妇女的平均年龄是(47.70±4.95)岁,已绝经267例,未绝经女性中月经规律458例、月经紊乱288例,平均绝经年龄(49.49±3.26)岁。Kupperman评分超过15分(即诊断为绝经综合征)392 例(38.7%),其中轻度(15～20分) 222例(56.63%),中度(21～35分)162例(41.33%),重度(>35分)8例(2.04%)。多因素Logistic 回归分析表明,有慢性疾病较无慢性疾病史,月经紊乱、绝经较月经规律,家庭情况一般较和睦女性出现围绝经期症状风险升高,未观察到婚姻状况、个性特征、上班时长、社会适应、负性事件经历与围绝经期症状的出现相关。结论 广州城市存在绝经综合征的女性以轻中度为主,有慢性疾病、月经紊乱、绝经、家庭关系一般女性的绝经综合征发生风险较高,故应重视对全社会进行围绝经相关知识的宣教,重视家庭关系的和谐维护,当围绝经期妇女出现相关症状须及时寻求帮助,以保障广大围绝经期妇女顺利度过围绝经期阶段。

Objective To investigate the menopause symptoms and factors of the premenopausal women in urban areas, and thereby provide theoretical basis for their health care. Methods The research data was collected from 1 013 patients (age between 40-60) in the gynecology clinic and adult traditional Chinese medicine clinic in Guangzhou Women and Children's Medical Center, and the communities in Tian'he and Yue'xiu during February 2019—February 2020. By applying the questionnaire and Kupperman score table, the survey was conducted on the dates of birth, menstruations, times of menarche and menopause, records on pregnancy and childbirth, previously diagnosed diseases, heights, weights, classifications of work, family incomes, and personalities, etc. Results The average age of the 1 013 women was 47.70±4.95. Among them, 267 were with menopause (happening in 49.49±3.26 years old), 458 had regular menstruation, while 288 were with menstrual disorder. In the Kupperman scale, the scores of 392 cases (38.7%) were above 15, which can be diagnosed with menopause symptoms. Among them, the majority (222 cases, 56.63%) were with slight symptoms (15-20 scores), followed by 162 cases (41.33%) with moderate symptoms (21-35 scores), and 8 cases (2.04%) with severe symptoms (above 35 scores) respectively. Logistic regression analysis demonstrated that compared with women having satisfactory family relationship, participants suffering from chronic diseases, menstrual disorder, and poor family relationships, had higher risks of perimenopause. However, it had no relations with the marital status, personalities, working hours, social adaptabilities, and negative life events. Conclusion Guangzhou urban women with menopause symptoms are mainly slight and moderate. Participants with chronic diseases, menstrual disorders and poor family relationships are at a higher risk of having menopause symptoms. Therefore, it is recommended to popularize the knowledge of menopause in the society and attach importance to the maintenance of satisfactory family relationship. When perimenopausal women have relevant symptoms, they should seek medical help in time thus they can smoothly pass the peri-menopausal stage.

目的 通过对不同职业人群前列腺疾病患病情况及相关危险因素进行分析,探讨不同职业人群前列腺疾病的患病率及相关危险因素。方法 选择2019年1月—2019年12月在我院健康管理中心进行前列腺超声检查的不同职业人群3 219例,按其职业分为5类:医务人员、国企职工、私企职工、高校教职工和银行职工,分析不同职业人群前列腺疾病患病情况及其相关影响因素。结果 3 219例受检者中,前列腺疾病的患病率为43.96%,前列腺疾病患病率随着年龄的增长而升高(P＜0.001);20～29岁及30～39岁年龄组前列腺钙化患病率均高于其他三种类型前列腺疾病(P＜0.001),而60岁以上年龄组前列腺增生和合并两种及以上前列腺疾病患病率均高于其他两种类型前列腺疾病(P＜0.001);前列腺增生和合并两种及以上前列腺疾病的患病率均随着年龄的增长而递增(P＜0.001);不同职业人群前列腺疾病的患病率不同(P＜0.001),银行职工的前列腺疾病患病率最高,为52.36%;体质量指数升高组、血压升高组和血脂升高组的前列腺钙化患病率均高于其对应的正常组(P＜0.05);体质量指数升高组、血糖升高组、血压升高组和血脂升高组的前列腺增生患病率均高于其对应的正常组(P＜0.001)。结论 不同的职业群体前列腺疾病的患病情况不一样,体质量指数升高、血压升高、血脂升高及血糖升高等相关因素增加患前列腺疾病的风险,应加强前列腺疾病预防保健方面的健康宣传,提倡健康的生活方式,从而降低前列腺疾病的患病率。

Objective To study on epidemic situation of prostate disease and related risk factors in different occupational groups by analyzing the prevalence and related risk factors of prostate disease in different occupational groups. Methods 3 219 cases of five different occupations including medical staffs, state-owned enterprise staffs, private enterprise staffs,college staffs and bank staffs who had underwent prostate ultrasonography in the health management centre department of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2019 were included as study objects to analyze the prevalence of prostate disease and its related factors in different occupational groups. Results The prevalence of prostate disease was 43.96% in 3 219 cases of different occupational groups, and the prevalence of prostate disease increased greatly with age(P＜0.001). The detection rates of prostate calcification in the age group of 20-29 and 30-39 were greatly higher than the other three types of prostate diseases(P＜0.001). The detection rate of BPH and with two or more prostate diseases in the age group over 60 years old was greatly higher than the other two types of prostate diseases(P＜0.001);The detection rates of BPH and with two or more prostate diseases were significantly increased with age (P＜0.001). There was an obvious difference inthe prevalence of prostate diseasesamong different occupational groups(P＜0.001). The prevalence of prostate disease in bank staffs was 52.36%, which was the highest among the five occupations. The prevalence of prostate calcification in the group with high body mass index, high blood pressure and high blood lipid were greatly higher than that of their normal group(P＜0.05). The prevalence of BPH in the group with high body mass index, high blood glucose, high blood pressure and high blood lipid were higher than that of their greatly normal group(P＜0.001). Conclusions The prevalence of prostate diseases is different among different occupational groups. Relative factors such as high body mass index, high blood glucose, high blood pressure and high blood lipid will increase the risk of prostate disease. By strengthening the health promotion of prostate disease prevention and health care, promoting a healthy lifestyle, it may reduce the prevalence of prostate disease.

目的 探讨继发性肺结核合并肺部真菌感染的临床特点及相关高危因素。方法 收集广州市胸科医院2017年7月—2019年10月收治的继发性肺结核患者资料,病程均大于3个月,分为真菌感染组106例和非真菌感染组100例进行回顾性分析。结果 单因素分析结果显示,合并肺部其他疾病、非初治、咯血、空洞、应用广谱抗生素>l周、侵袭性操作存在统计学差异(P<0.05)。Logistic多因素分析结果显示,广谱抗生素使用>l周、侵袭性操作为真菌感染的独立危险因素(P<0.05)。结论 对于应用广谱抗生素、进行侵袭性操作的肺结核患者应警惕真菌感染风险,及早预防及诊治。

Objective To investigate the clinical characteristics and related high risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection. Methods Data of patients with secondary tuberculosis admitted to Guangzhou Chest Hospital from July 2017 to October 2019 were collected. All patients with a course of disease longer than 3 months were divided into the fungal infection group (n =106) and the non-fungal infection group (n =100) for retrospective analysis. Results Univariate analysis results showed that there were statistical differences in combined other pulmonary diseases, non-initial treatment, hemoptysis, cavity, application of broad-spectrum antibiotic > for 1 week, and invasive operation (P<0.05). Logistic multivariate analysis showed that >1 week of broad-spectrum antibiotics and invasive procedures were independent risk factors for fungal infection (P<0.05). Conclusion Patients with tuberculosis who are treated with broad-spectrum antibiotics and invasive procedures should be alert to the risk of fungal infection, early prevention and treatment should be undertaken.

目的 探讨老年急性缺血性脑卒中并发肺部感染患者的临床特征和相关危险因素。方法 采用回顾性研究方法,选择2017年7月— 2019年10月深圳市第二人民医院神经内科收治的1 113例老年急性缺血性脑卒中患者,其中卒中并发肺部感染患者(108 例)纳入感染组,未并发肺部感染患者(1 005例)纳入对照组。以单因素对比分析两组患者的临床资料,采用 Logistic多因素回归分析方法分析合并肺部感染的高危因素。结果 单因素分析提示两组年龄(尤其是高龄患者)、住院天数、房颤、脑梗死史、慢性肺疾病、吞咽困难、言语不清、意识障碍差异有统计学意义(P <0.05)。多因素 Logistics 回归分析显示,高龄(≥80岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍与老年急性缺血性脑卒中并发肺部感染密切相关。结论 老年急性缺血性脑卒中并发肺部感染的独立危险因素主要是高龄(≥80 岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍,临床应高度重视。

Objective Objective To investigate the clinical characteristics and risk factors of elderly patients with acute ischemic stroke complicated with pulmonary infection. Methods A retrospective study was conducted on 1 113 elderly patients with acute ischemic stroke admitted to the department of neurology, Shenzhen Second People's Hospital from July 2017 to October 2019. Among them, 108 patients with stroke complicated with pulmonary infection were included in the infection group and 1 005 patients without concurrent pulmonary infection were included in the control group. The clinical data of the two groups were analyzed by single factor comparison, and the risk factors for pulmonary infection were analyzed by logistic multiple factor regression analysis. Results Single factor analysis showed there were statistically significant differences between the two groups in age (especially elderly patients), length of stay in hospital, atrial fibrillation, history of cerebral infarction, chronic pulmonary disease, dysphagia, slurred speech, and disturbance of consciousness (P <0.05). Multi-factor logistic regression analysis showed that old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech, and disturbance of consciousness were closely related to pulmonary infection in elderly patients with acute ischemic stroke. Conclusion The independent risk factors of acute ischemic stroke complicated with pulmonary infection in the elderly mainly include old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech and disturbance of consciousness, which should be paid more attention to clinically.