目的 探讨沙丁胺醇与M胆碱受体阻断剂应用于支气管哮喘患儿对其症状改善及肺功能的影响。方法 选择我院2018年9月—2019年9月收治的88例支气管哮喘患儿,采用随机数表法分为观察组(n=44)和对照组(n=44)。在对症治疗基础上,对照组给予沙丁胺醇治疗,在对照组基础上,观察组加入M胆碱受体阻断剂(异丙托溴铵气雾剂)治疗。比较两组患儿治疗效果、症状表现、肺功能指标、生活质量及不良反应发生率。结果 与对照组总有效率77.27%(34/44)相比,观察组93.18%(41/44)较高,差异有统计学意义(P＜0.05);治疗7 d后,观察组咳嗽消失时间(5.12±1.88)d、憋喘消失时间(1.88±0.95)d、肺啰音消失时间(5.45±1.21)d均较对照组[(8.03±1.22)d、(3.65±1.04)d、(7.02±1.62)d]短,差异有统计学意义(P＜0.05);治疗7 d后,观察组FVC、FEV₁、PEF水平[(3.38±0.42)、(2.13±0.48)、(435.79±40.75)L/min]均高于对照组[(2.67±0.46)、(1.75±0.43)、(388.94±35.93)L/min],差异有统计学意义(P＜0.05)。治疗7 d后,观察组SGRQ评分(34.11±4.25)分低于对照组(42.52±4.48)分,差异有统计学意义(P＜0.05)。两组不良反应发生率比较[13.64%(6/44),9.09%(4/44)],差异无统计学意义(P＞0.05)。结论 沙丁胺醇与M胆碱受体阻断剂应用于支气管哮喘患儿,可提高其治疗效果,可缩短咳嗽消失、憋喘消失及肺啰音消失时间,改善其肺功能,提高生活质量,降低不良反应发生率,值得临床推广应用。

目的 探讨复方丹参滴丸联合阿托伐他汀治疗对伴有颈动脉粥样硬化短暂性脑缺血发作患者脑循环动力的影响。方法 将2017年12月—2018年12我院收治入院的98例伴有颈动脉粥样硬化短暂性脑缺血发作患者为研究对象,随机分为观察组(49例,给予复方丹参滴丸联合阿托伐他汀治疗)和对照组(49例,给予阿托伐他汀治疗)。观察对比治疗前及治疗后2组患者每日短暂性脑缺血发作频率及持续时间,血脂水平、血流变指标、粥样硬化斑块及斑块面积。结果 治疗前,两组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比,差异无统计学意义(P>0.05);治疗后,2组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比均有所改善,其中观察组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比优于对照组,差异有统计学意义(P<0.05)。结论 在伴有颈动脉粥样硬化短暂性脑缺血发作患者中采用复方丹参滴丸联合阿托伐他汀治疗效果确切,可有效降低伴有颈动脉粥样硬化的短暂性脑缺血发作患者发作频率及持续时间,同时可有效调节患者血脂水平,改善对脑循环动力学指标,值得临床推广普及。

Objective To investigate the effect of compound Danshen dripping pills combined with atorvastatin on cerebral circulation dynamics in patients with transient ischemic attack accompanied by carotid atherosclerosis. Methods A total of 98 patients with transient ischemic attack with carotid atherosclerosis admitted to our hospital from December 2017 to December 2018 were randomly divided into observation group (49 cases, receiving compound danshen drop pill combined with atorvastatin) and control group (49 cases, receiving atorvastatin), to observe and compare the frequency and duration of transient ischemic attack, blood lipid level, hemorheological indexes, atherosclerotic plaque and plaque area of the two groups before and after treatment. Results Before treatment, there was no significant difference in frequency, duration, blood lipid levels, IMT and plaque area between the two groups (P>0.05). After treatment, 2 groups of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were improved. Compared with observation group of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were better than control group, the differences were statistical significance (P<0.05). Conclusion Patients in associated with carotid atherosclerosis with transient ischemic attack using compound danshen dropping pill with atorvastatin therapy have good effects. This may effectively reduce frequency and duration in patients with transient ischemic attack associated with carotid atherosclerosis, regulate blood lipid levels at the same time, and improve the dynamics of cerebral circulation index. It is worthy of clinical popularization.

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 研究集体呼吸操对慢阻肺稳定期患者的执行率影响效果。方法 选取连州市人民医院呼吸内科、ICU 2019年6月—2020年6月收治的120例慢阻肺稳定期患者为研究对象,以随机数字表法分为试验组与对照组,每组各60例,对照组采取一对一训练,试验组采取集体呼吸操,对两组执行率、肺功能、六分钟步行距、圣乔治呼吸问卷(St. George's Respiratory Questionnaire Application,SGRQ)评分进行对比。结果 试验组执行率90.00%,与对照组75.00%相比较,差异有统计学意义(P＜0.05);护理前两组肺功能、六分钟步行距离、SGRQ评分相比较,差异无统计学意义(P＞0.05),护理后4周、护理后8周与护理前相比较,差异有统计学意义(P＜0.05); 试验组护理后4周、护理后8周肺功能、六分钟步行距、SGRQ评分与对照组相比较,差异有统计学意义(P＜0.05)。结论 集体呼吸操有助于提高慢阻肺稳定期患者执行率,进一步改善其肺功能以及运动耐力水平,值得在今后护理工作中推广使用。

Objective To study the effect of collective breathing exercises on the execution rate of patients with stable COPD. Methods A total of 120 patients with stable chronic obstructive pulmonary disease admitted to the department of respiratory medicine and ICU of Lianzhou People's Hospital from June 2019 to June 2020 were selected as the research objects. They were divided into the experimental group and the control group by a random number table. For 60 cases, the control group took one-to-one training, and the test group took collective breathing exercises. The performance rate, lung function, six-minute walk distance, and St. George's Respiratory Questionnaire Application (SGRQ) scores were compared between the two groups. Results The execution rate of the experimental group was 90.00%, compared with 75.00% of the control group, the difference was statistically significant (P<0.05); there was no statistically differences in lung function, six-minute walking distance, and SGRQ score between the two groups before nursing ( P>0.05), 4 weeks after nursing, 8 weeks after nursing, and before nursing, the difference was statistically significant (P<0.05); in the experimental group, 4 weeks after nursing, 8 weeks after nursing, lung function, six-minute walking distance, SGRQ score was compared with the control group, the difference was statistically significant (P<0.05). Conclusion Group breathing exercises may help improve the performance rate of patients with chronic obstructive pulmonary disease in stable phase, and further improve their lung function and exercise endurance. It is worth popularizing in future nursing work.

目的 探讨家庭医生契约式服务对婴儿生长发育及肺炎发生率的影响。方法 选取2019年7月—2020年2月龙凤社区出生的婴儿200例作为研究对象,随机分为签约组与未签约组,每组100例。其中,签约组婴儿接受家庭医生契约式服务,未签约组婴儿则接受社区常规儿童保健服务。记录两组婴儿出生后第1、3、6、9、12个月时的生长发育指标(身长、体质量)、神经心理发育指标(大动作、精细动作、个人-社会、语言、适应性)以及肺炎发生率,进行对比分析。结果 出生后第1个月和第3个月,两组婴幼儿身高与体质量差异无统计学意义(P＞0.05)。自出生后第6个月开始,签约组婴幼儿的身高与体质量水平均高于未签约组婴幼儿(P＜0.05)。两组中出生后1月龄的婴幼儿在发育商5项指标中差异均无统计学意义(P＞0.05)。在12月龄时,签约组婴幼儿的大动作、精细动作、个人-社会、语言、适应性5项指标评分均高于未签约组婴幼儿(P＜0.05)。截止出生后第12个月,签约组共发生2例肺炎患儿,肺炎发生率2%;未签约组发生10例肺炎患儿,肺炎发生率10%,高于签约组肺炎发生率。所有肺炎患儿均给予积极对症治疗后痊愈。结论 家庭医生契约式服务能够促进婴幼儿出生后第1年内身心发育水平,同时还能有效降低肺炎的发生风险,有利于婴幼儿身心全面、健康地发育和生长,具有比较显著的卫生和社会学价值,值得推广应用。

Objective To explore the effect of family doctor contract service on infant growth and development and incidence of pneumonia. Methods From July 2019 to February 2020, 200 infants in Longfeng community were selected as the research objects and randomly divided into contract group and non contract group, with 100 cases in each group. Among them, the infants in the contract group received the family doctor contract service, while the infants in the non signing group received the community routine child health care services. The growth and development indexes (body length, body weight), neuropsychological development indexes (big movements, fine movements, personal society, language, adaptability) and the incidence of pneumonia were recorded and analyzed in the first, third, sixth, ninth and twelfth months after birth. Results There were no significant differences in height and weight between the two groups at the first and third month after birth (P>0.05). From the 6th month after birth, the height and weight of infants in the signing group were higher than those in the non signing group (P<0.05). There were no significant differences in the 5 indexes of development quotient between the two groups (P>0.05). At the age of 12 months, the scores of big movement, fine movement, personal society, language and adaptability of infants in contract group were higher than those in non contract group (P<0.05). By the end of the 12th month after birth, there were 2 cases of pneumonia in the signing group, the incidence of pneumonia was 2%; in the non signing group, there were 10 cases of pneumonia, the incidence of pneumonia was 10%, which was higher than that of the signing group. All children with pneumonia were cured after active symptomatic treatment. Conclusion Family doctor contract service can promote the physical and mental development level of infants and young children in the first year after birth, at the same time, it can effectively reduce the risk of pneumonia, which is conducive to the comprehensive and healthy development and growth of infants and young children. It has significant health and sociological value and is worthy of promotion and application.

目的 研究电针治疗对重性抑郁障碍患者的抑郁状态的影响。方法 本研究共分为3组,药物组、和药物+电针组及对照组(每组各50 例),药物组给予艾司西酞普兰抗抑郁治疗连续6周,药物+电针组在给予艾司西酞普兰抗抑郁治疗的基础上,进行电针治疗6周。比较治疗前后三组的HAMD 24 项评分,并对三组的HAMD 24 项评分与血清细胞炎症因子IL-1β、IL-2、IL-6、TNF-α水平进行相关性分析。采用多元逐步回归法,分析影响基线药物组和药物+电针组HAMD 24 项评分的主要因素。结果 与治疗前比较,药物组和药物+电针组患者治疗后HAMD 24 项评分均降低,差异有统计学意义(P＜0.05或P＜0.01),与药物组比较,治疗后药物+电针组HAMD 24 项评分较低,差异有统计学意义(P＜0.05或P＜0.01)。药物组HAMD 24 项评分与血清细胞炎症因子IL-6(r=0.335,P<0.001)、TNF-α(r=0.269,P<0.001)、IL-2(r=0.257,P=0.001)和IL-1β(r=0.205,P=0.021)呈正相关。药物+电针组HAMD24 项评分与血清细胞炎症因子IL-6(r=0.338,P<0.001)、TNF-α(r=0.271,P<0.001)、IL-2(r=0.255,P=0.015)和IL-1β呈正相关(r=0.208,P=0.026)。影响药物组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-1β、IL-2、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.585、0.516、0.452、0.318、-0.290、0.262(P＜0.05或P＜0.01)。影响药物+电针组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-2、IL-1β、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.592、0.521、0.448、0.323、-0.295、0.271(P＜0.05或P＜0.01)。结论 药物联合电针治疗能有效改善重性抑郁障碍患者的抑郁状态,细胞炎症因子与HAMD24 项评分相关,可影响重性抑郁障碍患者的抑郁状态。

Objective To explore the effect of electroacupuncture on patients with severe depression. Methods Patients was divided into three groups, acupuncture group, drug group and the control group. Each group had 50 patients. The drug group was treated with escitalopram for 6 weeks.The acupuncture group were treated with escitalopram and electroacupuncture for 6 weeks. We compared the HAMD24 among 3 groups before or after treatment. The correlation of the levels of IL-1 β, IL- 2, IL- 6, TNF-α and the total HAMD24 score among 3 groups were taken by the correlation analysis. And the main factors influencing the total HAMD24 score before the study were analyzed by the multiple inear step regression method. Results Compared with the pre-treatment group, the HAMD score of the drug group and the acupuncture group decreased after treatment, the difference was statistically significant (P<0.05 or P<0.01). Compared with the drug group, the HAMD score of the acupuncture group was lower after treatment; the difference was statistically significant (P<0.05 or P<0.01). The drug group, HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β (r=0.335, 0.269, 0.257 and 0.205, respectively, P<0.05 or P<0.01). The acupuncture group HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β(r=0.338, 0.271, 0.255 and 0.208, respectively, P<0.05 or P<0.01). The main factors influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors influencing the HAMD score of the drug group before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors of the acupuncture group influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.592,0.521,0.448,0.323,- 0.295,0.271(P＜0.05 or P＜0.01). Conclusion Escitalopram combination with electroacupuncture may improve the the depressive state. Inflammatory cytokines were associated with HAMD24 scores and it affects the depressive state of patients with major depressive disorder.

目的 观察免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、白介素-6(IL-6)和CXC趋化因子13(CXC13)水平影响。方法 选取2017年1月—2020年3月本院收治的60例自身免疫性脑炎患者,采用随机数字表法分为观察组30例与对照组30例。对照组给予甲泼尼龙疗法,观察组在对照组结合免疫球蛋白治疗。两组均以4周后评价。比较两组疗效,治疗前后T淋巴细胞亚群、免疫球蛋白、IL-6、CXC13及简易智能精神状态检查量表(MMSE)变化。结果 观察组总有效率(83.33%)高于对照组(60.00%)(P<0.05)。观察组治疗后CD⁺₃、CD⁺₄和CD⁺₄/CD⁺₈高于对照组(P<0.05)。观察组治疗后血清IgA、IgG和IgM水平低于对照组(P<0.05)。观察组治疗后血清IL-6和CXC13水平低于对照组(P<0.05)。观察组治疗后MMSE评分高于对照组(P<0.05)。结论 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者疗效良好,且可增强机体细胞和体液免疫功能,降低IL-6和CXC13水平。

Objective To observe the effect of immunoglobulin combined with methylprednisolone on T lymphocyte subsets, immunoglobulin, interleukin-6 (IL-6) and CXC chemokine 13 (CXC13) in patients with autoimmune encephalitis. Methods 60 patients with autoimmune encephalitis admitted to our hospital from January 2017 to March 2020 were divided into 30 cases of observation group and 30 cases of control group. The control group was treated with methylprednisolone, and observation group was treated with immunoglobulin compared with the control group. The course of treatment in both groups was 4 weeks. The effects of the two groups were compared. The changes of T lymphocyte subsets, immunoglobulin, IL-6, CXC13 and MMSE before and after treatment were compared. Results Total effective rate (83.33%) of the observation group was higher than that of control group (60.00%) (P<0.05). After treatment, in the observation group, CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ were higher than that of control group (P<0.05); levels of serum IgA, IgG and IgM were lower than that of control group (P<0.05); serum levels of IL-6 and CXC13 were lower than that of control group (P<0.05); MMSE score was higher than that of control group (P<0.05). Conclusion Immunoglobulin combined with methylprednisolone is effective in the treatment of autoimmune encephalitis. It may enhance the cellular and humoral immune function, and reduce the levels of IL-6 and CXC13.

目的 探讨双靶点微创联合尼莫地平治疗丘脑出血破入脑室患者的安全性及对NIHSS评分的影响。方法 选择2017年1月—2020年1月期间本院收治的54例丘脑出血破入脑室患者作为研究资料,随机分组各27例,对照组行单纯侧脑室体外引流术治疗,观察组行立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗,均实施尼莫地平治疗,观察两组手术并发症,测定治疗不同阶段患者NIHSS评分、ADL评分、神经损伤指标、创伤应激指标变化。结果 并发症率比较,观察组7.41%低于对照组29.63%,P＜0.05;治疗后,观察组NSE、NGF、β-EP、Cor均降低,且低于对照组,P＜0.05;治疗后,观察组NIHSSL评分降低且低于对照组,ADL评分升高且高于对照组,P＜0.05。结论 针对丘脑出血破入脑室患者采取立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术及尼莫地平治疗可进一步改善神经功能及生活质量,且手术安全性高,创伤应激恢复改善,神经损伤恢复快,并发症少,值得推广。

Objective To investigate the safety of double target minimally invasive surgery combined with nimodipine in the treatment of patients with thalamic hemorrhage breaking into ventricle and its influence on NIHSS score. Methods From January 2017 to January 2020, 54 patients with thalamic hemorrhage ruptured into ventricles in our hospital were selected as the research data, and they were randomly divided into 27 cases in each group. The control group was treated with external drainage of lateral ventricle alone, and the observation group was treated with stereotactic double target minimally invasive puncture and drainage of hypothalamic hematoma. The changes of NIHSS score, ADL score, nerve injury index and trauma stress index in different stages of treatment were determined. Results The complication rate of the observation group was 7.41%, lower than that of the control group 29.63%, P<0.05; after treatment, NSE, NGF, β-EP, Cor in the observation group were decreased, and lower than those in the control group, P<0.05; after treatment, NIHSSL score of the observation group was decreased, lower than that of the control group, ADL score was increased and higher than that of the control group, P<0.05. Conclusion For patients with thalamic hemorrhage breaking into ventricles, stereotactic double target minimally invasive puncture drainage combined with thalamic hematoma and nimodipine treatment may further improve the neurological function and patients’ quality of life, and the operation safety is high, the recovery of traumatic stress is improved, the recovery of nerve injury is quick, and the complications are less, which is worthy of promotion.

目的 通过回顾分析广州地区Rh阴性血的采供情况,了解Rh阴性红细胞的供应特点,更好地实施Rh阴性血液库存管理,保障输血安全。方法 统计2011—2017年广州血液中心Rh阴性血液采集量与供应量,血型及医院供血量的分布情况。结果 2011—2017年广州血液中心Rh阴性全血采集量为11 283 U,占总采血量的0.39%(11 283/2 902 485),供应总量为11 693 U,占红细胞类成分血总供应量的0.43%(11 693/2 762 229),其中悬浮红细胞供应比例逐年增加,冰冻解冻去甘油红细胞供应比例逐年下降,并从2014年起Rh阴性悬浮红细胞供应增长率明显高于血液采集增长率;4种血型供应量总体比较,差异有统计学意义(F=22.217,P＜0.05),A、B型Rh阴性悬浮红细胞供应增长最快,增长率分别为137.3%和134.1%,医院分布以三级以上及综合医院为主。结论 应根据广州地区Rh阴性红细胞采供特点,来持续改进Rh阴性血源招募和采供策略。通过建立一支Rh阴性定期献血者队伍,加强Rh阴性血液统筹管理和临床科室-输血科-采供血机构的沟通,促进Rh阴性血液的供需平衡,保障Rh阴性患者输血安全。

Objective To understand the characteristics of Rh-negative red blood cells (RBC) supply, improve the management of storage and guarantee the safety of blood transfusion. The collection and supply of Rh-negative RBC in Guangzhou city was retrospectively analyzed. Methods The amount of Rh-negative RBC collection and supply, the distribution of ABO blood type and the consumption of blood by different hospitals in Guangzhou Blood Center from 2011 to 2017 were statistically analyzed. Results During 2011-2017, 11 283 U Rh-negative RBC was collected in Guangzhou Blood Center, accounting for 0.39% of total RBC collection (11 283/2 902 485); 1 693 U Rh-negative RBC was supplied, accounting for 0.43% of the total blood supply (11 693/2 762 229). The proportion of suspended RBC supply increased year by year, in contrast with the decease of proportion of frozen defrosteddeglyceal RBC supply. In addition, the growth rate of Rh-negative suspended RBC supply was higher than that of RBC collection since 2014 (F=217, P<0.05). A-and B-Rh negative suspended RBC supply increased, with growth rates of 137.3% and 134.1%, respectively. The Rh negative RBC was predominantly supplied to Grade III and general hospitals. Conclusion By establishing a team of Rh-negative regular blood donors, the strategies for recruitment, collection and supply of Rh-negative RBC should be continuously improved according to the characteristics of Rh-negative RBC collection and supply in Guangzhou. The coordinating management of Rh-negative, as well as the communication of clinical departments, departments of transfusion and blood banks should be improved. In addition, the balance between supply and demand of Rh-negative blood should be promoted, and the safety of blood transfusion for Rh-negative patients can be improved.

目的 研究氯吡格雷联合低分子肝素对老年急性心肌梗死(acute myocardial infarction, AMI)患者血清中血脂及炎性因子的影响,为临床AMI的治疗提供参考依据。方法 选取新乡医学院第一附属医院于2016年10月—2019年11月期间收治的老年AMI患者112例,按照随机分配的原则分成两组,即对照组和观察组,每组病例各56例,治疗方式为对照组单给予口服氯吡格雷进行治疗,观察组给予口服氯吡格雷与皮下注射低分子肝素联合治疗,比较治疗前后两组患者血清中甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDH-C),炎性因子的水平变化及心功能的改变情况。结果 与治疗前相比较,治疗后对照组和观察组患者血清TG、TC及LDH-C水平均降低,炎性因子TNF-α,IL-1β,CRP,IL-6的水平均降低,患者的左心室后壁厚度、左心室舒张末期内径均有降低,射血分数升高;而与对照组治疗后相比较,治疗后观察组患者血清TG、TC及LDH-C水平进一步降低,炎性因子TNF-α,IL-1β,CRP,IL-6的水平进一步降低,患者的左心室后壁厚度、左心室舒张末期内径均降低,而射血分数升高,差异有统计学意义。结论 氯吡格雷联合低分子量肝素可通过降低血清中血脂的水平,抑制AMI过程中的炎症反应,减少炎性因子的释放,提高患者的心功能,改善患者的病情。

Objective To explore the effects of clopidogrel combined with low molecular weight heparin on serum lipids and inflammatory factors in elderly patients with acute myocardial infarction, and provide reference for clinical treatment of AMI. Methods 112 elderly patients with AMI admitted to the First Affiliated Hospital of Xinxiang Medical University from October 2016 to November 2019 were randomly divided into control group and observation group,56 cases in each group.The control group was treated with clopidogrel alone, and the observation group was treated with clopidogrel combined with low molecular weight heparin. The levels of serum TG, TC and LDH-C, inflammatory factors and cardiac function were compared between the two groups before and after treatment. Results Compared with before treatment, the levels of serum TG, TC and LDH-C decreased, and the levels of inflammatory factors TNF-α, IL-1β, CRP and IL-6 decreased in the observation group and the control group after treatment. The left ventricular posterior wall thickness and LVEDD decreased, but LVEF increased in the observation group and control group after treatment. Compared with control group after treatment, the levels of serum TG, TC and LDH-C decreased, and the levels of inflammatory factors TNF-α, IL-1β, CRP and IL-6 decreased, the left ventricular posterior wall thickness and LVEDD decreased, but LVEF increased further in observation group after treatment. Conclusion Clopidogrel combined with low molecular weight heparin may improve the patient's cardiac function, then improve the patient's condition through reducing the level of serum lipids, inhibit the inflammatory reaction in AMI, reduce the release of inflammatory factors.