目的 探讨不同清洗方法对聚甲基丙烯酸甲酯（PMMA）骨水泥附着的骨科外来医疗器械清洗效果。方法 以河源地区某三级医院消毒供应中心2023年7—12月同型号PMMA骨水泥术后附着的215件骨科外来医疗器械为研究对象,所有器械均为不锈钢材质,表面光滑,无明显磨损,利用随机数字表将其分为对照组与观察组。对照组（107件）采用常规预处理后清洗消毒器清洗,观察组（108件）预处理采用95%乙醇浸泡15 min后联合快干增亮剂清洗消毒器清洗。比较两种不同清洗方法的清洗效果。结果 观察组的器械清洗消毒后更加光滑且清洁,对照组的器械表面有部分磨损且仍存在一定程度的残留物。采用10倍光源放大镜清洁度检查,对照组清洗合格100件,清洗合格率为93.5%;观察组清洗合格108件,清洗合格率为100%。采用杰力试纸法检测,观察组清洗合格率为100%,对照组清洗合格率为94.4%,采用快速检测三磷酸腺苷（ATP）生物荧光法检查,观察组清洗合格率为99.1%,对照组清洗合格率为93.5%,观察组的清洗合格率高于对照组,差异有统计学意义（P<0.05）。结论 PMMA骨水泥附着的骨科外来医疗器械采用95%乙醇浸泡15 min后联合快干增亮剂和清洗消毒器可以提高清洗合格率以及外来器械再处理技术的安全性,为安全质量管理提供了有利依据。该技术适合推广使用,能有效排除医疗隐患,确保医疗安全。

Objective To compare the cleaning effects of different methods on external orthopedic medical devices contaminated with PMMA bone cement. Methods A total of 215 external orthopedic medical devices contaminated with PMMA bone cement were selected from the disinfection supply center of a tertiary hospital in Heyuan from July to December 2023．All devices were made of stainless steel,with smooth surfaces and no significant abrasion．The devices were randomly divided into control group and observation group using a random number table．The control group（107 devices）was cleaned using conventional pre-treatment followed by a cleaning and disinfection machine．The observation group（108 devices）was pre-treated by soaking in 95% medical ethanol for 15 minutes,followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine．The cleaning effects of the two methods were compared．Results The study showed that the devices in the observation group were smoother and cleaner after cleaning and disinfection,while the devices in the control group had some abrasion and residual contaminants．Using a 10 x magnifying glass to check cleanliness,the control group had 107 devices passed the cleaning test,with a pass rate of 93.5%,while the observation group had 108 devices passed,with a pass rate of 100%．Using the Geri test paper method,the observation group had a cleaning pass rate of 100%,and the control group had a pass rate of 94.4%．Using the ATP bioluminescence method,the observation group had a cleaning pass rate of 99.1%,and the control group had a pass rate of 93.5%．The cleaning pass rate of the observation group was higher than that of the control group,with a statistically significant difference（P<0.05）．Conclusions Soaking external orthopedic medical devices contaminated with PMMA bone cement in 95% medical ethanol for 15 minutes,followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine,can improve the cleaning pass rate and enhance the safety of reprocessing external devices．This technique provides a strong basis for safety and quality management,is suitable for widespread use,which effectively eliminates medical hazards,and ensures medical safety．

目的 对比乏白细胞富血小板血浆（LP-PRP）与富白细胞富血小板血浆（LR-PRP）联合体外冲击波疗法（ESWT）治疗慢性非止点跟腱腱病（NIAT）的临床价值。方法 选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者,以随机数表法分为两组,即对照组和观察组各40例,观察组予LP-PRP联合ESWT治疗,对照组予LR-PRP联合ESWT治疗;于治疗前、第一次治疗后1个月、3个月比较两组疼痛度[视觉模拟量表（VAS）评分]、跟腱病变程度[维多利亚体育研究所跟腱评估问卷（VISA-A）]、跟腱功能（Arner-Lindholm跟腱功能评分）,并比较两组并发症的发生率。结果 两组在治疗后1个月、3个月的VAS评分下降,VISA-A评分升高,且观察组治疗后3个月的VAS评分（1.05±0.31）分低于对照组的（1.82±0.45）分,VISA-A评分（83.35±5.58）分高于对照组的（76.28±5.35）分（F组间与时点交互=338.478、106.663,均P<0.05）;治疗后3个月,观察组跟腱功能（优、良、差各有24、13、3例）优于对照组（优、良、差各有14、16、10例）,差异有统计学意义（Z=2.529,P=0.012）。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义（均P>0.05）。结论 与LR-PRP比较,LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度,改善患者跟腱功能。

Objective To compare the clinical value of leukocyte-poor platelet rich plasma（LP-PRP）and leukocyte-rich platelet rich plasma（LR-PRP）combined with extracorporeal shock wave therapy（ESWT）in the treatment of chronic non -insertional Achilles tendinopathy（NIAT）．Methods Eighty patients with chronic NIAT admitted to Ganzhou People's Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method：a control group and an observation group,with 40 patients in each group．The observation group received LP-PRP combined with ESWT treatment,while the control group received LR-PRP combined with ESWT treatment．The pain level（Visual Analog Scale[VAS]score）,degree of Achilles tendon lesion（Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire[VISA-A]）,and Achilles tendon function（Arner Lindholm Achilles tendon function score）between the two groups were compared before treatment,one month after the first treatment,and three months after treatment,as well as the incidence of complications between the two groups．Results The VAS scores of both groups decreased and the VISA-A scores increased one and three months after treatment．The VAS score of the observation group（1.05±0.31）was lower than that of the control group（1.82±0.45）three months after treatment,while the VISA-A score of the observation group（83.35±5.58）was higher than that of the control group（76.28±5.35）（interaction between group and time point F=338.478,106.663,both P<0.05）．After three months of treatment,the Achilles tendon function of the observation group（24 cases of excellent,13 cases of good,and three cases of poor）was better than that of the control group（14 cases of excellent,16 cases of good,and 10 cases of poor）,and the difference was statistically significant（Z=2.529,P=0.012）．There was no statistically significant difference in VAS score,VISA-A score,and Achilles tendon function between the two groups one month after treatment（all P>0.05）．Conclusions Compared with LR-PRP,LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT,and improving Achilles tendon function．

目的 对比中成药镇痛活络酊和非甾体抗炎药(Nonsteroidal Anti-inflammatory Drugs,NSAIDs)治疗肱骨外上髁炎(lateral epicondylitis,LE)的短期临床疗效差异。方法 筛选后符合纳入标准的LE患者60例,随机分为镇痛活络酊组(n=30)和NSAIDs组(n=30)。镇痛活络酊组外用镇痛活络酊,NSAIDs组外用法斯通凝胶(酮洛芬),两组均连续用药3周,3次/d。用药后3 周、6 周和12 周连续随访,主要观测指标包括视觉模拟评分(visual analog scale,VAS);肩、肘和手的功能评分(Disabilities of the arm, Shoulder And Hand,DASH);无痛握力(Pain-free grip strength,PFGS)。VAS评分分别测量患者1周前用力活动时的VAS评分和正常休息时的VAS评分,记为VAS(活动时)和VAS(休息时)。运用统计学方法对比分析两组患者在VAS评分(活动时)、VAS评分(休息时)、DASH评分和PFGS上的差异。结果 两组患者在VAS评分(活动时)、VAS评分(休息时)和DASH评分上均未见组间差异(P>0.05)。两组患者在用药前、用药后3周、用药后6周的PGFS对比同样无组间差异(P=0.91,P=0.42,P=0.13)。但是,在用药后12周,镇痛活络酊组的PFGS高于NSAIDs组(P=0.02)。结论 镇痛活络酊缓解LE疼痛的效果与外用NSAIDs相当,对提升伸肌力效果则更优。

Objective To compare the short-term clinical effects difference between analgesic tincture and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of lateral epicondylitis (LE). Methods 60 cases of LE patients were randomly divided into an analgesic tincture group (n=30) and a NSAIDs group (n=30). Analgesic tincture was chosen for the analgesic tincture group and topical ketoprofen gel for the NSAIDs group to treat LE. Two groups were treated continuously for 3w, 3 times/day. Clinical results of each drug were followed-up at the time point of 3w, 6w and 12w after usage. Observational indexes included the visual analogue scale (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and pain-free grip strength (PFGS). The inter-group difference of VAS (at activity), VAS (at rest), DASH score and PFGS were compared subsequently. Results No difference of the VAS (at activity), VAS (at rest), DASH score were ascertained (P> 0.05) between groups. Inter-group difference of PGFS was also not discerned at the time points of pre-treatment and 3 weeks and 6 weeks (P=0.91, P=0.42, P=0.13) post-treatment. However, PFGS of the analgesic tincture group was found to be higher than that of the NSAIDs group (P=0.02) after 12 weeks post-treatment. Conclusion Effect of analgesic tincture in releasing pain is almost the same to that of tropical NSAIDs, but a better effect in improving muscle strength.

目的 探讨A超和IOL Master测量人工晶状体度数的精确性,为白内障手术提供客观的临床数据。方法 选取300例300眼老年性白内障患者,术前采用A 超和IOL Master测量眼轴长度、自动验光仪测量角膜曲率,A超组利用自动验光仪的角膜曲率数据,IOL Master组利用仪器自带的角膜曲率数据,均使用SRK-T公式计算需要植入的人工晶状体度数,观察术后3 m的屈光状态,使用自动验光仪检测患者屈光状态并分析。结果 所有被列入研究的患眼随机分为A超组和IOL Master组, A超组测得的平均眼轴长度为(23.21±0.59)mm,IOL Master组测得的眼轴长度为(23.22±0.59)mm,两组数据对比差异无统计学意义(P>0.05);利用自动验光仪测量的术前平均角膜曲率为(44.01±1.79)D,利用IOL Master测量的术前平均角膜曲率为(44.13±1.62)D,两者比较差异无统计学意义(P＞0.05);A超组和IOL Master组术后的平均绝对屈光误差(mean absolute refractive error,MAE)分别为(0.43±0.26)D、(0.42±0.17)D,两组比较差异无统计学意义(P>0.05)。结论 IOL Master在操作上略优于A超,但在人工晶体度数测量上与A超比较没有发现明显优势,不能完全取代A超,两者结合更能确保人工晶体度数测量的精确性。

Objective By discussing the accuracy of A-scan and IOL Master in intraocular lens power measurement, to offer Objective clinical data for cataract surgery.Methods Three hundred patients(300 eyes)with age-related cataract were included in the study. Before surgery,axial length was measured by A-scan and IOL Master respectively and corneal curvature was measured by auto refractometer. A-scan group used the corneal curvature data of the auto refractometer. IOL Master group used the corneal curvature data from the instrument. Intraocular lens power was calculated according to the SRK-T formula.We observed the refractive state of 3m after operation, detected and analyzed the patient's refractive data by the auto refractometer.Results All patients who were included in the study were randomly divided into A-scan group and IOL Master group.The mean axial length was (23.21±0.59) mm measured by A-scan, the mean axial length was (23.22±0.59) mm measured by IOL Master. There was no significant difference between them (P>0.05). The preoperative mean corneal curvature measured by the auto refractometer was (44.01±1.79)D. The preoperative mean corneal curvature measured by IOL Master was (44.13±1.62)D. There was no statistically significant difference between them (P＞0.05). The mean absolute refractive error ( MAE) in A－scan group was (0.43±0.26)D and in IOL Master group was (0.42±0.17)D. There was no statistically significant difference between them (P＞0. 05).Conclusion IOL Master group operated slightly better than A-scan group, but we did not find a significant advantage in intraocular lens power measurement with A-scan group. IOL Master may not completely replace A-scan. The combination of the two ensures the accuracy of the measurement in intraocular lens power.

目的 探讨粪菌移植(FMT)在两种肠镜下盲肠置管术的临床应用。方法 将2016年1月—2017年6月在我院通过肠镜下盲肠置管术进行粪菌移植的200例患者,随机分为A组和B组,各100例。A组采用直接肠镜置管法完成置管,B组采用二次肠镜置管法完成置管,对两组操作的置管成功率、置管时间、平均疼痛评分、并发症等情况进行对比。结果 与A组相比较,B组到达盲肠时间略长但无统计学意义(14.95min vs 15.26min,P=0.68)、疼痛评分低(5.7 vs 4.8,P<0.05)、更低的并发症发生率(6 % vs 23 %,P<0.05)。结论 在粪菌移植内镜下盲肠置管术患者中,采用通过采用二次肠镜置管法与直接肠镜法相比较完成置管手术时间无统计学差异,但置管成功率高、患者的痛苦小、风险低,值得临床推广。

Objective To investigate the clinical application of fecal microbiota transplantation (FMT) in two kinds of colonoscopic cecal catheterization. Methods From January 2016 to June 2017, 200 patients who took colonoscopic cecal catheterization for fecal microbiota transplantation in our hospital were randomly divided into group A and group B, with 100 patients in each group.Group A used direct colonoscopy catheterization to complete catheterization, group B was treated by the second colonoscopy catheterization. The success rate of catheterization, catheterization time, average pain score and complication were compared between the two groups. Results Compared with group A, the time to reach the cecum in group B was slightly longer but not statistically significant (14.95min vs 15.26min,P=0.68). It had lower pain score (5.7 vs 4.8, P<0.05), lower complication rate. Conclusion Among the patients with colonoscopic cecal catheterization for fecal microbiota transplantation, there was no significant difference in the time of catheterization between the second colonoscopy and the direct colonoscopy, but it has the high success rate of catheterization and low pain, low risk, worthy of clinical promotion.

目的 比较腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后发生尿失禁(postprostatectomy incontinence,PPI)与没有发生PPI的患者在尿动力学上的差异,为临床诊疗提供尿动力学依据。方法 对87例LRP术后的患者按术后是否并发PPI分成两组,行尿动力学检查后进行比较分析。结果 PPI组患者术中保留一侧或双侧神经血管束的比例少于非PPI组,且最大尿道闭合压(maximum urethral closure pressure,MUCP)、最大膀胱容量(maximum cystometric capacity,MCC)、排尿时膀胱开口压力和最大逼尿肌压均较非PPI组低。而腹压漏尿点压试验阳性与临床上是否漏尿并不完全相符。多变量回归分析表明,术中保留神经血管束、MUCP和MCC是PPI的相关因素。结论 PPI与LRP术中保留神经血管束、MUCP和MCC独立相关。尿动力学检查能为更精准有效指导临床治疗提供依据。

Objective To compare the urodynamic parameters in men with and without postprostatectomy incontinence(PPI) after laparoscopic radical prostatectomy(LRP). Methods 87 patients of prostatic carcinoma after LRP were divided into two groups according to have PPI or not. After urodynamic study, the data were collected to find the difference. Results Overall, the proportion of preservation of unilateral or bilateral neurovascular bundles(NVBs) during LRP was lower in PPI group than that in non-PPI group. Besides, the patients in PPI group had lower maximum urethral closure pressure (P=0.04), maximum cystometric capacity (P=0.04), detrusor pressure during opening (P=0.02)and maximum detrusor pressure (P<0.001), as compared with those in non-PPI group. In the multivariate logistic regression, the preservation of unilateral or bilateral NVBs, MUCP and MCC were identified as the related factor with PPI. Conclusion PPI is significantly associated with the preservation of unilateral or bilateral NVBs, MUCP and MCC. Urodynamic test can be used to make the treatment for PPI. It will be more accurate and effective in clinical practice.

目的 对比分析二氧化锆全瓷冠与钴铬合金烤瓷冠修复牙体牙列缺损的临床疗效。方法 选择2008年3月以来广东工业大学医院口腔科和江西省萍乡市安源区现代口腔门诊部牙体牙列缺损全冠修复患者150例364颗,随机分为2组,实验组采用二氧化锆全瓷冠75例185颗,对照组采用钴铬合金烤瓷冠75例179颗,修复后随访2年对比观察,结果采用χ²检验分析。结果 两组在修复体完整性、固位、边缘密合度、牙敏感症状、继发龋、邻面接触点、过敏反应方面差异无统计学意义(P＞0.05);但在牙龈状况、龈缘着色、颜色匹配方面差异有统计学意义(P＜0.01)。结论 二氧化锆全瓷冠修复体美学效果和生物相容性优于钴铬合金烤瓷冠。

Objective To compare and analyze the clinical effects of restoring tooth dentition defect by using zirconium dioxide full porcelain crowns and cobalt chromium alloy porcelain crowns. Methods 150 patients with 364 teeth suffering from tooth dentition defect in hospital of guangdong university of technology and modern stomatology clinic in pingxiang since March of 2008 are chosen and randomly divided into two groups. 75 patients with 185 teeth in the experimental group are restored with zirconium dioxide full porcelain crowns and 75 patients with 179 teeth in the control group are restored with cobalt chromium alloy porcelain crowns, which was followed up with 2-year observation. Results There is no statistical significance between the two groups in terms of repair integrity, retention, edge adaptation, tooth sensitivity symptoms, secondary caries, contact points, and allergic reaction(P＞0.05). But statistical significance exists in gingival status, gingival coloration, and color matching(P＜0.01). Conclusion Zirconium dioxide full porcelain crowns are superior to cobalt chromium alloy porcelain crowns in aesthetic effect and biocompatibility.

       目的   对比乏白细胞富血小板血浆（LP-PRP）与富白细胞富血小板血浆（LR-PRP）联合体外冲击波疗法（ESWT）治疗慢性非止点跟腱腱病（NIAT）的临床价值。方法   选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者，以随机数表法分为两组，即对照组和观察组各40例，观察组予LP-PRP联合ESWT治疗，对照组予LR-PRP联合ESWT治疗；于治疗前、第一次治疗后1个月、3个月比较两组疼痛度［视觉模拟量表（VAS）评分］、跟腱病变程度［维多利亚体育研究所跟腱评估问卷（VISA-A）］、跟腱功能（Arner-Lindholm跟腱功能评分），并比较两组并发症的发生率。结果   两组在治疗后1个月、3个月的VAS评分下降，VISA-A评分升高，且观察组治疗后3个月的VAS评分（1.05±0.31）分低于对照组的（1.82±0.45）分，VISA-A评分（83.35±5.58）分高于对照组的（76.28±5.35）分（F组间与时点交互=338.478、106.663，均P＜0.05）；治疗后3个月，观察组跟腱功能（优、良、差各有24、13、3例）优于对照组（优、良、差各有14、16、10例），差异有统计学意义（Z=2.529，P=0.012）。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义（均P＞0.05）。结论   与LR-PRP比较，LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度，改善患者跟腱功能。

       Objective  To compare the clinical value of leukocyte-poor platelet rich plasma（LP-PRP）and leukocyte-rich platelet rich plasma（LR-PRP）combined with extracorporeal shock wave therapy（ESWT）in the treatment of chronic non insertional Achilles tendinopathy（NIAT）．Methods 

Eighty patients with chronic NIAT admitted to Ganzhou People’s Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method：a control group and an observation group，with 40 patients in each group．The observation group received LP-PRP combined with ESWT treatment，while the control group received LR-PRP combined with ESWT treatment．The pain level（Visual Analog Scale［VAS］score），degree of Achilles tendon lesion（Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire［VISA-A］），and Achilles tendon function（Arner Lindholm Achilles tendon function score）between the two groups were compared before treatment，one month after the first treatment，and three months after treatment，as well as the incidence of complications between the two groups．Results  The VAS scores of both groups decreased and the VISA-A scores increased at one and three months after treatment．The VAS score of the observation group（1.05±0.31）was lower than that of the control group（1.82±0.45）at three months after treatment，while the VISA-A score of the observation group（83.35±5.58）was higher than that of the control group（76.28±5.35）（interaction between group and time point F=338.478，106.663，both P＜0.05）．After three months of treatment，the Achilles tendon function of the observation group（24 cases of excellent，13 cases of good，and three cases of poor）was better than that of the control group（14 cases of excellent，16 cases of good，and  10 cases ofpoor），and the difference was statistically significant（Z=2.529，P=0.012）．There was no  statistically  significant difference in VAS score，VISA-A score，and Achilles tendon function between the two groups one month after treatment（all P＞0.05）．Conclusions  Compared with LR-PRP，LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT，and improving Achilles tendon function．

       目的   探讨不同清洗方法对聚甲基丙烯酸甲酯（PMMA）骨水泥附着的骨科外来医疗器械清洗效果。方法   以河源地区某三级医院消毒供应中心2023年7—12月同型号PMMA骨水泥术后附着的215件骨科外来医疗器械为研究对象，所有器械均为不锈钢材质，表面光滑，无明显磨损，利用随机数字表将其分为对照组与观察组。对照组（107件）采用常规预处理后清洗消毒器清洗，观察组（108件）预处理采用95%乙醇浸泡15 min后联合快干增亮剂清洗消毒器清洗。比较两种不同清洗方法的清洗效果。结果   观察组的器械清洗消毒后更加光滑且清洁，对照组的器械表面有部分磨损且仍存在一定程度的残留物。采用10倍光源放大镜清洁度检查，对照组清洗合格100件，清洗合格率为93.5%；观察组清洗合格108件，清洗合格率为100%。采用杰力试纸法检测，观察组清洗合格率为100%，对照组清洗合格率为94.4%，采用快速检测三磷酸腺苷（ATP）生物荧光法检查，观察组清洗合格率为99.1%，对照组清洗合格率为93.5%，观察组的清洗合格率高于对照组，差异有统计学意义（P＜0.05）。结论  PMMA骨水泥附着的骨科外来医疗器械采用95%乙醇浸泡15 min后联合快干增亮剂和清洗消毒器可以提高清洗合格率以及外来器械再处理技术的安全性，为安全质量管理提供了有利依据。该技术适合推广使用，能有效排除医疗隐患，确保医疗安全。

       Objective  To compare the cleaning effects of  different methods on external orthopedic medical  devices contaminated with PMMA bone cement．Methods  A total of 215 external orthopedic medical devices contaminated with PMMA bone cement were selected from the disinfection supply center of a tertiary hospital in Heyuan from July to December 2023．All devices were made of stainless steel，with smooth surfaces and no significant abrasion．The devices were randomly divided into control group and observation group using a random number table．The control group（107 devices）was cleaned using conventional pre-treatment followed by a cleaning and disinfection machine．The observation group（108 devices）was pre-treated by soaking in 95% medical ethanol for 15 minutes，followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine．The cleaning effects of the two methods were compared．Results  The study showed that the devices in the observation group were smoother and cleaner after cleaning and disinfection，while the devices in the control group had some abrasion and residual contaminants．Using a 10 x magnifying glass to check cleanliness，the control group had 107 devices passed the cleaning test，with a pass  rate of 93.5%，while the observation group had 108 devices passed，with a pass rate of 100%．Using the Geri test paper method，the observation group had a cleaning pass rate of 100%，and the control group had a pass rate of 94.4%．Using the ATP bioluminescence method，the observation group had a cleaning pass rate of 99.1%，and the control group had a pass rate of 93.5%．The cleaning pass rate of the observation group was higher than that of the control group，with a statistically significant difference（P＜0.05）．Conclusions  Soaking external orthopedic medical devices contaminated with PMMA bone cement in 95% medical ethanol for 15 minutes，followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine，can improve the cleaning pass rate and enhance the safety of reprocessing external devices．This technique provides a  strong basis for  safety and quality management，is suitable for widespread use，which effectively eliminates medical hazards，and ensures medical safety．