论著

多参数 MRI 在鉴别 BI-RADS 4 类乳腺病变良恶性中的应用

Application of multiparametric MRI in differentiating benign and malignant BI-RADS category 4 breast lesions

:1555-1562
 
      目的   探讨多参数MRI在鉴别乳腺影像报告和数据系统(BI-RADS)4类乳腺病变良恶性中的应用。法   回顾性分析2022年1月—2024年12月于同济大学附属东方医院庐江分院行乳腺MRI检查为BI-RADS 4类且病理结果明确肿瘤的病例268例,其中良性组166例(包括乳腺纤维腺瘤93例,导管内乳头状瘤39例,乳腺囊性增生24例,乳腺分叶状肿瘤2例,浆细胞性乳腺炎8例),恶性组102例(包括浸润性导管癌89例,浸润性小叶癌6例,黏液癌2例,炎性乳腺癌5例)。对比分析单一序列和多序列联合诊断BI-RADS 4类乳腺病变良、恶性的效能;绘制基于多参数MRI受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)、特异度和灵敏度,量化多序列对于BI-RADS 4类乳腺病变良恶性的诊断效能。结果   基于多参数MRI联合诊断效能最高(AUC:0.912,95%CI:0.871~0.953),特异度为0.922,灵敏度为0.902;基于ADC值评估BI-RADS 4类乳腺病变最佳截断值为0.84×10-3 mm2 /s,且均具有统计学意义(P<0.05)。结论   基于多参数MRI能够有效诊断BI-RADS 4类乳腺病变的良、恶性,为乳腺外科疾病进一步诊疗提供影像学诊断依据。
       Objective  To explore the application of multiparametric MRI in differentiating benign and malignant lesions classified as BI-RADS category 4 in breast imaging.Methods  A total of 268 cases of breast MRI classified as BI-RADS category 4 with confirmed tumor pathology were retrospectively analyzed from January 2022 to December 2024 at the Tongji University Oriental Hospital Lujiang Branch. Among them,166 cases were categorized as benign lesions(including 93 cases of breast fibroadenoma,39 cases of intraductal papilloma,24 cases of cystic hyperplasia,2 cases of lobular tumor,and 8 cases of plasma cell mastitis),while 102 cases were categorized as malignant lesions(including 89 cases of invasive ductal carcinoma,6 cases of invasive lobular carcinoma,2 cases of mucinous carcinoma,and 5 cases of inflammatory breast cancer).The efficacy of single-sequence versus combined multiple-sequence imaging in diagnosing benign and malignant BI-RADS category 4 breast lesions was compared and analyzed.The diagnostic efficacy of the multiparametric MRI sequences was quantified by plotting a receiver operating characteristic curve and calculating the area under the curve(AUC),as well as the specificity and sensitivity.Results  The combined diagnostic efficacy of multiparametric MRI yielded the highest performance,with an AUC of 0.912(95%CI:0.871-0.953),demonstrating a specificity of 0.922 and a sensitivity of 0.902.The optimal cutoff value for differentiating BI-RADS category 4 breast lesions based on apparent diffusion coefficient values was determined to be 0.84×10-3  mm2 /s,with all results being statistically significantP<0.05).Conclusions  Multiparametric MRI can effectively diagnose benign and malignant lesions classified as BI-RADS category 4,providing a reliable imaging basis for further diagnosis and treatment in breast surgery.
论著

支气管镜灌洗对儿童重症肺部感染合并肺实变的应用效果及对CT特征、肺功能影响

Application effects of bronchoalveolar lavage in children with severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function

:951-956
 
目的 探讨支气管镜灌洗用于儿童重症肺部感染合并肺实变的治疗效果及对CT特征、肺功能的影响。方法 选取2022年5月—2024年5月铜仁市人民医院收治的100例重症肺部感染合并肺实变患儿开展前瞻性研究,应用随机数表法分为对照组和观察组,每组各50例。对照组患儿采取常规治疗,观察组则采取常规治疗加支气管镜灌洗治疗。对比其临床疗效,治疗前后炎症因子、CT特征及肺功能变化。结果 观察组治疗总有效率高于对照组(P<0.05);治疗后观察组患儿白细胞计数(10.36±2.52)×109/L、白细胞介素-6(20.57±5.05)ng/L、C反应蛋白(13.12±2.64)mg/L、降钙素原(101.62±12.16)pg/L均低于对照组白细胞计数(13.25±3.32)×109/L、白细胞介素-6(31.69±4.11)ng/L、C反应蛋白(16.16±4.44)mg/L、降钙素原(113.46±18.11)pg/L(P<0.05);治疗后两组患儿胸腔积液、支气管壁增厚、空气支气管征、肺部实变、磨玻璃影等相关CT影像特征占比下降,且观察组低于对照组(P<0.05);治疗后两组患儿呼气流量峰值水平均升高,观察组(90.67±18.45)L/s高于对照组(81.27±17.69)L/s,用力肺活量水平均更高,观察组(3.33±0.68)L高于对照组(2.68±0.25)L(P<0.05)。结论 针对儿童重症肺部感染合并肺实变,在常规治疗基础上增加支气管镜灌洗可提升临床疗效,减轻机体炎症反应,改善胸部CT各种表现及肺功能。
Objective To explore the therapeutic effects of bronchoalveolar lavage in children with severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function.Methods A prospective study was conducted on 100 children with severe pulmonary infection complicated with pulmonary consolidation in a hospital from May 2022 to May 2024.They were randomly divided into observation group and control group using a random number table method,50 cases in each group.The control group of children received routine treatment,and the observation group received conventional treatment plus bronchoalveolar lavage.Clinical efficacy,inflammatory factors,CT features,and alterations in pulmonary function before and after therapy were compared.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the white blood cell count(10.36±2.52)×109/L,interleukin-6(20.57±5.05)ng/L,C-reactive protein(13.12±2.64)mg/L,and procalcitonin(101.62±12.16)pg/L in the observation group were all lower than those in the control group(13.25±3.32)×109/L,interleukin-6(31.69±4.11)ng/L,C-reactive protein(16.16±4.44)mg/L,and procalcitonin(113.46±18.11)pg/L(P<0.05).After treatment,the proportion of CT imaging features such as pleural effusion,bronchial wall thickening,air bronchogram sign,lung consolidation,ground glass opacities,decreased in both groups of children,and the observation group was lower than the control group(P<0.05).After treatment,the peak levels of expiratory flow in both groups of children increased,with the observation group(90.67±18.45)L/s higher than the control group(81.27±17.69)L/s.The forced vital capacity levels were also higher,with the observation group(3.33±0.68)L higher than the control group(2.68±0.25)L(P<0.05).Conclusions Adding bronchoalveolar lavage to routine treatment for children with severe pulmonary infection complicated with pulmonary consolidation can improve their clinical efficacy,alleviate inflammatory reactions,and improve various chest CT manifestations and lung function.
论著

术前肾功能对急性Stanford A型主动脉夹层术后重度AKI的影响

Preoperative renal function and postoperative severe AKI in patients with acute type A aortic dissection

:1290-1296
 
目的 探讨术前血清肌酐(sCr)、估测肾小球滤过率(eGFR)对急性A型夹层术后急性肾损伤3级(AKI 3级)及连续性肾脏替代治疗(CRRT)的影响。方法 回顾性分析广州市第一人民医院2017年1月—2022年12月6年间收治的143例行Bentall或升主动脉置换+Sun’s手术的急性Stanford A型夹层患者术前sCr及eGFR、术后24 h及48 h sCr、尿量、术后AKI及CRRT情况。应用ROC曲线(受试者特征曲线)分析术前sCr、eGFR对术后AKI 3级及CRRT的影响。结果 术后AKI 3级27例(18.9%),CRRT 14例(9.8%)。发生AKI 3级及CRRT的患者术前sCr水平升高(AKI3级与AKI0-2级组间比较t’=-2.722,P=0.011,CRRT与非CRRT组间比较t’=-2.184,P=0.048)、eGFR降低(AKI3级与AKI0-2级组间比较t=4.585,P<0.001,CRRT与非CRRT组间比较t=4.932,P<0.001)。ROC曲线分析提示术前sCr可有效预测术后AKI 3级(AUC 0.768,临界点123 μmol/L,灵敏度67%,特异度85%)及CRRT(AUC 0.848,临界点137.5 μmol/L,灵敏度71%,特异度88%)。eGFR可预测AKI 3级[AUC 0.761,临界点56.25 mL/(min·1.73 m2),灵敏度67%,特异度83%]及CRRT[AUC 0.855,临界点47.6 mL/(min·1.73 m2),灵敏度71%,特异度87%]。手术合并低心排血量等肾灌注不良时,eGFR低于75.9 mL/(min·1.73 m2),术后CRRT发生率增加。结论 急性A型夹层术前sCr及eGFR影响术后AKI 3级及CRRT的发生。sCr>123 μmol/L、eGFR低于58.25 mL/(min·1.73 m2)的患者术后AKI 3级发生率增加。sCr>137.5 μmol/L、eGFR低于47.6 mL/(min·1.73 m2),或合并肾灌注不良的患者术后CRRT发生率增加。
Objective To explore the influences of preoperative serum creatinine(sCr)and estimated glomerular filtration rate(eGFR)on postoperative stage 3 acute kidney injury(AKI)or continuous renal replacement treatment(CRRT)in patients with acute Stanford type A aortic dissection(ATAAD).Methods From July 2017 to December 2022,143 ATAAD patients who underwent Bentall or ascending aortic replacement and total arch replacement and stented elephant trunk were retrospective analyzed.Data included preoperative sCr and eGFR,postoperative sCr,eGFR,urine volume,AKI and CRRT at 24 h and 48 h.Receiver operating characteristic(ROC)curve were used to analyze the influences of preoperative sCr and eGFR on stage 3 AKI and CRRT.Results Stage 3 AKI occurred in 27(18.9%)patients,including 14 patients who required CRRT.sCr was significantly higher in stage 3 AKI or CRRT group(AKI 3 vs AKI 0-2 group:t’=-2.722,P=0.011,CRRT vs non-CRRT group:t’=-2.184,P=0.048),and eGFR was significantly lower(AKI 3 vs AKI 0-2 group:t=4.585,P<0.001,CRRT vs non-CRRT group:t=4.932,P<0.001).Preoperative sCr could effectively predict postoperative stage 3 AKI(AUC 0.768,the best cut-off value was 123 μmol/L,sensitivity 67%,specificity 85%)and CRRT(AUC 0.848,the best cut-off value was 137.5 μmol/L,sensitivity 71%,specificity 88%).Preoperative eGFR could predict postoperative stage 3 AKI(AUC 0.761,the best cut-off value was 56.25mL/(min·1.73 m2),sensitivity 67%,specificity 83%)and CRRT(AUC 0.855,the best cut-off value was 47.6 mL/(min·1.73 m2),sensitivity 71%,specificity 87%).CRRT requirement significantly increased in patients with eGFR lower than 75.9 mL/(min·1.73 m2) who complicated with peripheral malperfusion.Conclusion sPreoperative sCr and eGFR have significant influences on incidence of postoperative stage 3 AKI and CRRT.Postoperative stage 3 AKI significantly increase in patients with sCr more than 123 μmol/L or eGFR lower than 56.25mL/(min·1.73 m2).Postoperative CRRT significantly increase in patients with sCr more than 137.5 μmol/L,eGFR lower than 47.6mL/(min·1.73 m2),or peripheral malperfusion.
论著

乳果糖联合莫沙必利治疗功能性消化不良的疗效及对肠道菌群的影响

Efficacy of lactulose combined with mosapride in treating functional dyspepsia and its effect on intestinal flora

:42-45
 
目的 探讨功能性消化不良(FD)患者应用乳果糖联合莫沙必利治疗的临床疗效及药物对肠道菌群的影响。方法 选取2019年1月—2021年12月来院诊治的180例FD患者作为研究对象,随机分为2组,每组90例,对照组口服莫沙必利片,观察组服用莫沙必利片+乳果糖口服液,4周后观察2组患者治疗后临床症状改善率及肠道菌群数量的情况。结果 治疗4周后,观察组的总有效率(86.67%)高于对照组(72.22%),P<0.05;观察组的乳杆菌菌群数多于对照组,肠球菌、肠杆菌菌群数少于对照组,P<0.05。结论 乳果糖联合莫沙必利用于FD患者临床治疗,总有效率高于单用莫沙必利,患者症状获得有效改善,明显改善FD患者肠道菌群水平。
Objective To explore the clinical efficacy and effect on intestinal flora of lactulose combined with mosapride in patients with functional dyspepsia(FD).Methods A total of 180 FD patients admitted to the hospital in January 2019 and December 2021 were selected as the study subjects and randomly divided into two groups,90 cases in each group.The control group took oxapride orally and the observation group took lactulose oral solution additionally.After 4 weeks,the improvement rate of clinical symptoms and the number of intestinal flora of patients were observed.Results After 4 weeks of treatment,the total effective rate of the observation group(86.67%)was obviously higher than that of the control group(76.67%),P<0.05;the number of Lactobacillus in the observation group was higher than that of the control group,and the numbers of Enterococcus and Enterobacteria were less than that of the control group,P<0.05.Conclusions The total effective rate of lactulose combined with mosalabin for FD patients is higher than that of mossalapride alone.The symptoms are effectively improved,and the intestinal flora level of FD patients is significantly improved.
论著

四金石灵膏配合间苯三酚治疗输尿管结石伴肾绞痛的疗效观察

Analysis of curative effect of four-gold-stone-ling confection combined with phloroglucinol in the treatment of ureteral calculus with renal colic

:53-56
 
目的 探讨四金石灵膏联合间苯三酚治疗输尿管结石伴肾绞痛的应用价值。方法 随机将76例输尿管结石伴肾绞痛患者分为两组,以接受中药安慰剂联合间苯三酚治疗者为对照组,以接受四金石灵膏联合间苯三酚治疗者为观察组,每组38例。对比两组临床治疗效果,并分析尿液相关指标的变化情况。结果 两组7 d治疗过程中VAS评分及尿Ga水平呈降低趋势、WHOQL-BREF评分及尿OPN水平呈升高趋势(P<0.05),而治疗3 d及7 d后,治疗组VAS评分及尿Ga水平低于对照组、WHOQL-BREF评分及尿OPN水平高于对照组(P<0.05)。同时,治疗7 d后,观察组排石率高于对照组(P<0.05),而观察组排石时间及止痛时间短于对照组(P<0.05)。此外,治疗7 d后,治疗组治疗总有效率高于对照组(P<0.05),而两组间治疗不良反应发生率比较未见差异有统计学意义(P>0.05)。结论 四金石灵膏联合间苯三酚可有效的提高输尿管结石伴肾绞痛的临床治疗效果,具有较为理想的应用价值。
Objective To explore the application value of four-gold-stone-ling confection and phloroglucinol in the treatment of ureteral calculus with renal colic. Methods 76 patients with ureteral calculus with renal colic were randomly divided into two groups, with those receiving traditional Chinese medicine placebo combined with phloroglucinol as the control group, and those receiving four-gold-stone-ling confection combined with phloroglucinol as the observation group,38 cases in each group. The clinical treatment effects of the two groups were compared, and the changes of urine-related indicators were analyzed. Results The VAS score and urine Ga level of the two groups showed a decreasing trend during 7d treatment, and the WHOQL-BREF score and urine OPN level showed an increasing trend(P<0.05). After 3d and 7d treatment, the VAS score and urine Ga level of the treatment group were lower than that of control group, the WHOQL-BREF score and urine OPN level were higher than that of control group(P<0.05). Meanwhile, After 7d of treatment, the rate of stone drainage in the observation group was higher than that of control group(P<0.05), while the time of stone drainage and pain relief in the observation group was shorter than control group(P<0.05). In addition, after 7d treatment, the total effective rate of the treatment group was higher than control group (P<0.05), while the difference of incidence of adverse reactions between the two groups was not significant(P>0.05). Conclusion Four-gold-stone-ling confection combined with phloroglucinol may effectively improve the clinical effect of ureteral calculi with renal colic, and have ideal application value.
论著

13例重症急性胰腺炎诊治特点临床分析

Analysis on clinical characteristics of diagnosis and treatment of 13 severe acute pancreatitis

:54-56
 
目的 探讨重症急性胰腺炎诊治特点。方法 回顾性分析13例重症急性胰腺炎患者临床资料,包括一般资料、生化检测及影像资料、治疗措施与预后结果,纳入标准为急性胰腺炎合并器官衰竭>48 h(改良Marshall评分≥2分)。结果 重症急性胰腺炎患者一般资料中普遍突出存在心率增快(121.07±28.09)次/分、APACHE II评分偏高(18.92±7.34),病因排序则是高脂血症(38.5%)>胆石症(30.8%)>酒精性(23.1%),SAP合并ARDS发生率可达46.2%,合并AKI则高达69.2%;WBC(12.60±5.57)×109/L、CRP(138.16±67.06)mg/L及PCT(15.76±27.33)ng/L等炎症指标升高提示SAP普遍存在炎症反应,影像学中69.2%患者合并发生肺炎及腹腔积液则提示多处感染部位,其他脏器指标异常升高也提示SAP患者心肺肝肾均存在不同程度的受损;接受CRRT治疗及呼吸支持可分别达46.2%及76.9%,7天内死亡例数为1例(7.7%),28天内死亡例数为4例(30.8%),ICU及总住院时间为(10.77±7.38)及(19.61±13.40)天。结论 重症急性胰腺炎是全身及局部性的炎症反应累及全身各个脏器的急性复杂病变,以合并发生ARDS及AKI为临床特征,需要多器官功能保护与替代、外科干预等多学科综合协作治疗。
Objective To evaluate characteristics of diagnosis and treatment on severe acute pancreatitis. Methods To respective analysis clinical data of 13 patients with severe acute pancreatitis. The data included baseline characteristics, biochemical tests and imaging data, treatment and prognosis, inclusion criteria for acute pancreatitis with organ failure > 48 h (modified Marshall score > 2). Results Higher heart rate(121.07±28.09) times/min and APACHEII scores(18.92±7.34) were universally found in SAP, which primary disease contained hyperlipidemia (38.5%) > cholelith disease (30.8%) > alcohol (23.1%) with incidence of ARDS and AKI being 46.2% and 69.2%; Higher inflammatory biomarkers including WBC(12.60±5.57)×109/L, CRP(138.16±67.06)mg/L and PCT(15.76±27.33)ng/L indicated widespread inflammation with many infection sites revealing by 69.2% pneumonia and peritoneal effusion on imaging; Other abnormally biochemical index prompted some injury of viscera including heart, lungs, kidney and liver; 1 case suffered death within 7 days and 4 cases also did within 28 days, ICU and total length of hospital stay was (10.77±7.38) and (19.61±13.40) days, CRRT treatment and respiratory support respectively reached 46.2% and 46.2%. Conclusion Severe acute pancreatitis is a acute complex pathological changes on various organs induced by acute systemic and local inflammation with feature of mergence with the ARDS and AKI, which need the multidisciplinary integrated collaborative treatment on organ function protection and sustain and surgical intervention.
论著

腹腔镜前列腺癌根治术后尿失禁与否的尿动力学对比研究

Urodynamic evaluation in men with and without urinary incontinence after laparoscopic radical prostatectomy

:22-25
 
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.
论著

RhoA-Rho激酶通路在鼻咽癌细胞的表达

The expression of RhoA-Rho kinase pathway in nasopharyngeal carcinoma cells

:1-3
 
目的 观察鼻咽癌患者癌组织中RhoA蛋白-Rho激酶蛋白表达情况。方法 收集增城市人民医院2009年2月—2014年6月耳鼻喉科住院治疗,进行活检的鼻咽癌患者切除标本共62例,包括癌组织及癌旁组织。通过SABC免疫组织化学法检测患者癌组织及癌旁组织中RhoA蛋白-Rho激酶蛋白表达情况。结果 鼻咽癌组织RhoA蛋白阳性表达率及Rho激酶蛋白阳性率高于癌旁组织(P=0.00);鼻咽癌癌组织RhoA及Rho激酶表达在年龄及性别分布上无差异,而TNM分期中Ⅲ期+Ⅳ期RhoA及Rho激酶表达阳性率高于Ⅰ期+Ⅱ期患者,同时存在淋巴结转移患者其RhoA及Rho激酶表达阳性率高于未转移患者。结论 鼻咽癌患者癌组织中RhoA蛋白及Rho激酶表达阳性率高,TNM分期越高及存在淋巴结转移者其RhoA蛋白及Rho激酶表达阳性率越高。RhoA-Rho激酶信号通路参与了鼻咽癌发生发展的过程。
Objective To observe the expression of RhoA-Rho kinase protein in patients with nasopharyngeal carcinoma tissue. Methods Collecting 62 cases of patients with nasopharyngeal carcinoma who hospitalized and hadbiopsyof specimens, including carcinoma tissues and adjacent tissues in department of otolaryngology-head and neck surgery from February 2010 to October 2014. The expression of RhoA-Rho kinase protein in carcinoma tissues and adjacent tissues was detected with SABC immune histochemical method. Results Positive expression rate of nasophryngeal carcinoma tissue RhoA protein and Rho kinase protein was significantly higher than that of adjacent tissues, and there was no obvious difference in age and sex between the expression of nasopharyngeal carcinoma tissue RhoA and Rho kinase(P=0.00), while patients being in the third and fourth periods of TNM stage had a higher positive expression rate of RhoA and Rho kinase than those being in the first and second periods. At the same time, RhoA and Rho kinase positive expression rate in patients with lymph node metastasis was higher than that in those without lymph node metastasis. Conclusion Positive expression rate of RhoA protein and Rho kinase in patients with nasopharyngeal carcinoma. The higher TNM stage is, the higher positive expression rate of RhoA protein and Rho kinase in lymph node metastasis is. RhoA-Rho kinase signaling pathways involved in the occurrence and development of nasopharyngeal carcinoma.
临床诊疗

佛山市南海区重入组美沙酮维持治疗患者治疗依从性及相关因素分析

Study on the Treatment Compliance Among the Re enrolled Patients Receiving Methadone Maintenance in Nanhai District of Foshan City

:92-95
 
目的 了解佛山市南海区美沙酮治疗门诊重入组维持治疗患者与长期维持治疗患者的治疗依从性。方法 选择佛山市南海区第五人民医院美沙酮治疗门诊自2007年12月—2013年12月30日的全部重入组治疗者作为研究组,同时选择部分长期维持治疗者作为对照组。对全部研究对象通过查阅社区门诊美沙酮维持治疗管理系统及问卷调查获取患者资料。结果 MMT重入组患者与长期维持治疗患者的职业状况、经济来源、居住情况之间的差异有统计学意义(P<0.05);重入组MMT治疗者与对照组相比,无业/待业的比例较大(88.7% vs 73.3%),多数为独居(26.1% vs 5.3%);而对照组MMT治疗者的经济来源大多来自家庭朋友供给(85.3%)。两组患者首次吸毒年龄和吸毒方式的分布之间存在差异(P<0.05)。重入组MMT治疗者与对照组相比,患者的首次吸毒年龄主要集中在20~30岁,占61.4%;重入组患者注射吸毒比例更高。重入组在治者的服药剂量低于对照组;且重入组在治者的服药参与率、尿检参与率均低于对照组,而重入组在治者的尿检阳性率低于对照组。结论 MMT门诊患者中重入组者占较大比例,重入组在治MMT患者的服药依从性较长期维持治疗患者差。
眼科专题:近视防控

羽毛球颠球运动对低年级小学生近视影响的研究

Study on the impact of badminton juggling on myopia in lower grade primary school students

:26-31
 
    目的   研究羽毛球颠球运动对低年级小学生近视的改善效果,为制定儿童青少年近视干预方案提供依据。方法   采用方便抽样方法,抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后,以班为单位,采用随机数字表法将4个班分为干预组(2个班,91例)和对照组(2个班,91例),干预组安排羽毛球颠球项目体育活动,对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果  干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较,差异均无统计学意义(P>0.05)。两组干预后的等效球镜度数(SE)比较,差异无统计学意义(P>0.05);对照组干预后的裸眼远视力(UDVA)低于干预组,△UDVA、△SE均高于干预组,差异均有统计学意义(P<0.05)。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度,均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度,差异均有统计学意义(P<0.05)。结论   羽毛球颠球运动能降低低年级小学生视力不良进展速度,减少近视的发生率及近视程度,学校可结合引起近视的因素进行灵活应用,以预防近视的发生发展。
      Objective  To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents.Methods  By using the convenience sampling method,182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects.After completing the baseline survey,the four classes were divided into an intervention group(2 classes,91 students)and a control group(2 classes,91 students)using a random number table.The intervention group was arranged to participate in badminton juggling sports activities,while the control group followed the original teaching plan without ball games.The study compared the screening rate of myopia,the rate of poor vision,and the degree of myopia progression before and after the study in both groups.Results  On baseline,there were no statistically significant differences between the two groups in terms of age,gender,rate of screening myopia,poor vision,and myopia grading(P>0.05).After 12 months,there was no statistically significant difference in the spherical equivalent(SE) comparison between the two groups(P>0.05).However,the uncorrected distance visual acuity(UDVA) of the control group after 12 months was significantly lower than that of the intervention group,and both △UDVA and △SE were significantly higher than those of the intervention group,with all differences being statistically significant(P<0.05).Incidence of screening myopia in the control group (29.13%),the cumulative rate of screening myopia(49.45%),the cumulative rate of poor vision (68.13%),and the degree of myopia progression was significantly higher than those in the intervention group,which had incidence of screening myopia at 7.69%,the cumulative rate of screening myopia at 34.07%,cumulative rate of poor vision at 52.74%.All these differences were statistically significant(P<0.05).Conclusions  Badminton juggling can slow down vision deterioration,reduce the incidence and severity of myopia in lower grade primary school students.Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development.
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