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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.
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目的 氧气雾化吸入体位对颈椎前路减压植骨融合术后吞咽困难的影响。方法 将在2017年2月—2019年10月期间行颈椎前路减压植骨融合术患者(2~3节段)123例随机分成两组:A组(n=56,半卧位行氧气雾化), B组(n=67,平卧位行氧气雾化)。比较两组术后吞咽困难发生及程度、持续时间情况和患者对氧气雾化吸入方法满意度。结果 A组术后吞咽困难发生率低于B组(P=0.042),并且吞咽困难程度动态变化中总体优于B组;两组吞咽困难持续时间无统计学差异(P=0.826)。A组患者对氧气雾化吸入方法满意度优于B组患者(P=0.022)。结论 半卧位氧气雾化吸入能降低颈椎前路术后吞咽困难的发生及严重程度。
Objective To investigate the effect of aerosol inhalation position on dysphagia after multi-segment anterior cervical decompression and bone graft fusion. Methods 123 patients undergoing anterior cervical decompression and bone graft fusion during February 2017 to October 2019 were randomly divided into two groups: group A (n=56, aerosol inhalation in semireclining position), group B (n=67, aerosol inhalation in the supine position). The incidence, extent and duration of dysphagia were compared between the two groups. Results The incidence of postoperative dysphagia in group A was lower than that in group B (P=0.042), and the degree of dysphagia were better than that in group B in the dynamic changes. There was no statistical difference in the duration of dysphagia between the two groups (P=0. 826). Patients in group A had greatly better satisfaction with the aerosol inhalation position than patients in group B (P=0.022). Conclusion Aerosol inhalation in semireclining position can reduce the incidence and severity of dysphagia after anterior cervical spine surgery.
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目的 探究小分子化合物逆转素(reversine,Rev)对胆管结扎(BDL)诱导的大鼠胆汁淤积性肝损害、纤维化、上皮细胞-间充质转化以及胆管反应的影响。方法 雄性Lewis大鼠随机分成三组,每组各5只。按照如下处理:BDL组大鼠行2周的胆管结扎;BDL+Rev组行胆管结扎同时给予腹腔注射逆转素;对照采用假手术(Sham)。2周后获取血液和肝组织。血指标检测总白蛋白(TP)、总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)。H&E染色检测肝组织病理。Azan染色检测组织胶原蛋白。免疫组化检测肝组织α平滑肌肌动蛋白(α-SMA)、结蛋白(Desmin)、波形蛋白(Vimentin)、细胞角蛋白(CK7,CK19)、β-连环蛋白(β-Catenin)以及上皮细胞粘附分子(EpCAM)蛋白的表达情况。结果 胆管结扎导致肝脏合成的总白蛋白量下降,总胆红素(TBIL)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)水平明显上升,逆转素处理使下降的总白蛋白上升,使上升的总胆红素(TBIL)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)水平向正常水平回复。逆转素可以缓解胆汁淤积引起的肝纤维化,表现为下调BDL引起的胶原蛋白和α-SMA蛋白沉积。逆转素可以抑制胆汁淤积引起的上皮细胞-间充质转化表现为逆转素明显降低BDL导致的Desmin和Vimentin的表达。逆转素可以抑制胆汁淤积引起的胆管反应表现为明显减少CK7和CK19阳性胆管的表达含量。逆转素抑制胆汁淤积引起的胆管反应与调节β-Catenin和EpCAM的表达有关。结论 逆转素可以缓解胆汁淤积引起的大鼠肝损害,具有一定的保护作用。逆转素可以成为一种潜在治疗药物。
Objective To investigate the effect of reversine (REV) on bile duct ligation (BDL) -induced hepatic damage, fibrosis, epithelial-mesenchymal transformation, and ductular reaction in rats. Methods Male Lewis rats were randomly divided into three groups with 5 rats in each group. Bile duct ligation was performed in the BDL group for two weeks. BDL+ REV group was treated with bile duct ligation and intraperitoneal injection of reversine. The control group was Sham operation (Sham). Blood and liver tissue were obtained after 2 weeks. Blood indexes were determined for total albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase. Hepatic histopathology was detected by H&E staining. Azan staining was used to detect tissue collagen deposition. Immunohistochemistry was used to detect the expression of α-SMA, desmin, vimentin, cytokeratin, β-catenin and epithelial cell adhesion molecule (EpCAM) protein. Results Bile duct ligation resulted in the decrease of total albumin synthesis in liver, and the increase of total bilirubin, glutamic-oxalacetic transaminase, alkaline phosphatase and γ-glutamyltranspeptidase. The levels of total bilirubin, aspartate transaminase, alkaline phosphatase and γ-glutamyltranspeptidase returned to the normal level with reversine treatment. Reversine could alleviate cholestasis-induced liver fibrosis by downregulating BDL-induced deposition of collagen and α-SMA protein. Reversine inhibited cholestasis-induced epithelial-mesenchymal transformation by significantly reducing BDL-induced desmin and vimentin expression. Reversine could inhibit cholestasis-induced ductular reaction by significantly reducing the expression of CK7 and CK19 positive biliary cells. Inhibition of cholestasis induced ductular reaction by reversine was associated with regulation of β-catenin and EpCAM expression. Conclusion Reversine can alleviate liver damage caused by cholestasis in rats and have a protective effect. Reversine may be a potential treatment that need further investigation.
论著
目的 观察佩戴软弹性咬合板对磨牙症患者牙周组织应力的影响。方法 创建颌骨和牙列的三维有限元模型,对模型右侧上、下颌的每颗牙加载与牙体长轴呈0°、45°、90°的成人最大咬合力,分析使用不同厚度软弹性咬合板(1 mm、2 mm)后,牙槽骨及牙周膜所受应力的大小及分布,设不使用软弹性咬合板组做阴性对照。结果 在各咬合力加载角度下,与对照组相比,1 mm软弹性咬合板对牙周膜应力的缓冲效率平均为16%,对牙槽骨应力的缓冲效率平均为15%。2 mm软弹性咬合板对牙周膜及牙槽骨应力缓冲效率平均为26%及25%。在所有组别中,牙周组织的最大应力均集中于颊、舌侧牙槽嵴顶附近,但使用软弹性咬合板后应力集中范围减少,应力分布更均匀。结论 软弹性咬合板可以作为咬合应力的缓解装置,它有助于消减磨牙症产生的额外应力对牙周组织造成的破坏。
Objective To observe the effect of wearing an elastic soft occlusal splint on the stress of periodontal tissue in patient with bruxism. Methods A three-dimensional finite element model of jaw and dentition was created. Each tooth in the test area was loaded with the maximum adult occlusal force at 0°, 45°, and 90° with respect to the long axis of the tooth. 1 mm and 2 mm elastic soft occlusal splint were used, and the stress of the alveolar bone and periodontal ligament with and without elastic soft occlusal splint were analyzed and compared. Results Compared with the control group, 1 mm splint reduced the periodontal ligament stress of patient by an average of 16% and the alveolar bone stress by an average of 15%. After wearing a 2 mm splint, the patient's periodontal ligament and alveolar bone stress were reduced by 26% and 25% respectively. In all groups, the maximum stress of the periodontal tissue was on the buccal and lingual alveolar ridge crest, but the stress distribution was more uniform after using the soft occlusal splint. Conclusion The soft occlusal splint can be used to relieve occlusal stress and help eliminate the damage to periodontal tissue caused by the extra stress in bruxism.
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目的 探讨延续性健康指导联合预见性干预对慢性脑卒中患者脑功能影响。方法 选取2019年6月—2020年6月我院收治的慢性脑卒中患者118例,使用随机数字表法将其分为两组,对照组进行预见性干预,研究组进行延续性健康指导联合预见性干预。比较两组效果、神经运动功能、不良反应。结果 研究组效果大于对照组(P<0.05);研究组神经运动功能大于对照组(P<0.05);研究组不良反应少于对照组(P<0.05)。结论 慢性脑卒中护理中,延续性健康指导联合预见性干预效果较好,值得应用。
Objective To investigate the effects of continuous health guidance and combined predictive intervention on cerebral function in patients with chronic stroke. Methods A total of 118 patients with chronic stroke admitted to our hospital from June 2019 to June 2020 were selected and divided into two groups using the random number table method. The control group received predictive intervention, and the study group received continuous health guidance combined predictive intervention. The effects, neuromotor functions and adverse reactions of the two groups were compared. Results The effect of the study group was greater than that of the control group (P<0.05). The neuromotor function of the study group was higher than that of the control group (P<0.05). The adverse reactions in the study group were less than those in the control group (P<0.05). Conclusion In the nursing of chronic stroke, the effect of continuous health guidance combined with predictive intervention is good, and it is worth applying.
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目的 探讨瑞格列奈联合胰岛素治疗2型糖尿病临床疗效及对患者血糖水平的影响效果。方法 选取我院2019年1月—2021年1月收治的2型糖尿病患者324例,用随机数字法分为两组,每组各52例,对照组应用胰岛素治疗,研究组应用瑞格列奈联合胰岛素治疗。对两组2型糖尿病患者的临床疗效、血糖水平(FPG指数、2 h PG指数、HbA1c指数)以及胰岛素水平(HOMA-β水平、HOMA-IR水平)进行比较。结果 研究组疗效高于对照组(P<0.05);研究组治疗后血糖指数优于对照组(P<0.05);研究组治疗后胰岛素水平优于对照组(P<0.05)。结论 2型糖尿病患者在治疗时,应用瑞格列奈联合胰岛素治疗,可增强治疗疗效,有效控制血糖水平,改善胰岛功能,从而促进疾病转归,具有极大的推广价值。
Objective To investigate the clinical efficacy of repaglinide combined with insulin in the treatment of type 2 diabetes mellitus and its effect blood glucose level. Methods A total of 324 patients with type 2 diabetes admitted to our hospital from January 2019 to January 2021 were randomly divided into two groups with 52 patients in each group. The control group was treated with insulin, and the research group was treated with repaglinide combined with insulin. Clinical efficacy, blood glucose level (FPG index, 2HPG index, HbA1c index) and insulin level (HOMA-β level, HOMA-IR level) of patients with type 2 diabetes were compared between two groups. Results The therapeutic effect of the research group was higher than that of the control group (P<0.05). The glycemic index of the research group was better than that of the control group (P<0.05). The insulin level in the research group was better than that in the control group (P<0.05). Conclusion In the treatment of type 2 diabetes mellitus, the application of repaglinide combined with insulin can enhance the therapeutic effect, effectively control the blood glucose level, improve the islet function, so as to promote the outcome of the disease, which has great promotion value.
论著
目的 探讨选择性会阴侧切术对会阴体及产后盆底功能的影响。方法 选取2018年1月—2019年12月在广州市红十字会医院顺产的初产妇作为研究对象,研究组为选择性会阴侧切组、对照组为常规治疗,统计两组的会阴裂伤情况,盆底Ⅰ类肌、Ⅱ类肌肌力分级,POPQ评分的分级,肛提肌裂孔扩张情况。结果 会阴裂伤率:研究组2.5%,对照组为56.22%,连续性校正χ2为53.14,连续性校正P<0.05。盆底Ⅰ类、Ⅱ类肌力<3级发生率:研究组分别为30%、23%,对照组分别为 49%、38%,χ2分别为9.03、5.96,P<0.05。POPQ 0级率:研究组26.25%,对照组12.5%,χ2为4.84,P<0.05。肛提肌裂孔无扩张率:研究组16.25%,对照组为5%,χ2为5.33,P<0.05。结论 在本研究中,与对照组相比,研究组会阴裂伤率、盆底肌力<3级发生率更低;盆腔器官无脱垂率、肛提肌裂孔无扩张率更高。选择性会阴侧切术对会阴体及盆底功能具有保护作用。
Objective To investigate the effect of selective lateral episiotomy on perineal body and pelvic floor function. Methods The primiparas who delivered naturally in Guangzhou Red Cross Hospital from January 2018 to December 2019 were selected as the research subjects. The research group were given selective lateral episiotomy, while the control group were given conventional treatment. The incidence of perineal laceration, pelvic floor muscle strength lower than grade 3, the POPQ score and levator ani hiatus dilatation were analyzed. Chi-square test was used to analyze the incidence of the two groups. Results The incidence of perineal laceration in the research group was 2.5% vs 56.22% in the control group(χ2=53.14, P<0.05). The incidence of pelvic floor muscle(group I) strength lower than grade 3 in the research group was 30% vs 49% in the control group(χ2=9.03, P<0.05). The incidence of pelvic floor muscle(group II) strength lower than grade 3 in the research group was 23% vs 38% in the control group(χ2=5.96, P<0.05). The rate of the incidence of POPQ 0 in the research group was 26.25% vs 12.5% in the control group (χ2=4.84,P<0.05). The incidence of levator ani hiatus dilatation in the research group was 16.25%, while 5% in the control group (χ2=5.33, P<0.05). Conclusion Compared with conventional treatment group, selective lateral episiotomy group has a lower incidence of perineal laceration and pelvic floor muscle strength lower than grade 3. Selective lateral episiotomy group has a higher incidence of POPQ 0 and no levator ani hiatus dilatation. Selective lateral episiotomy can protect the perineal body and pelvic floor function.
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目的 探讨I131联合促甲状腺激素(TSH)抑制治疗对术后中高危组甲状腺乳头状癌(PTC)患者心肌纤维化及心房颤动(AF)的影响。方法 选取2016年8月—2017年8月南华大学附属第一医院收治的因PTC行甲状腺双侧腺叶全切术或近全切除术患者69例,根据复发危险度分层分为中危组(49例)和高危组(20例), 两组患者均行I131 联合TSH抑制治疗,治疗后嘱患者3个月进行1次复诊或自觉不适及时复诊,观察患者心血管系统症状、心房颤动及心肌纤维化发生情况,患者治疗前后可溶性基质溶素-2(sST2)、生长分化因子-15(GDF-15)、半乳糖凝集素-3 (GAL-3)及血清乳酸脱氢酶(LDHA)含量变化。结果 I131联合TSH抑制治疗后患者心房颤动发生率和心肌纤维化相关指标水平明显高于治疗前,且高危组患者治疗后心房颤动发生率和心肌纤维化相关指标水平高于中危组,差异均有统计学意义(P<0.05)。结论 I131联合TSH抑制治疗会增加PTC患者心肌纤维化和心房颤动的发生概率,且高危组PTC患者心肌纤维化和房颤的发生率高于中危组。
Objective To investigate the impact of I131 combined with thyroid-stimulating hormone(TSH) for suppressive treatment on myocardial fibrosis(MF) and atrial fibrillation(AF) in patients with papillary thyroid (PTC). Methods 69 patients with PTC undergoing total or subtotal thyroidectomy admitted into First Affiliated Hospital of University of South China from Aug. 2016 to Aug. 2017 were selected and divided into middle-risk group (49 cases) and high-risk group (20 cases) according to the recurrence risk stratification. Two groups of patients were given I131 combined with thyroid-stimulating hormone for suppressive treatment. The patients were instructed to undergo a follow-up visit every 3 months after treatment or whenever felt unwell. The incidences of cardiovascular system symptoms, atrial fibrillation and myocardial fibrosis, changes of contents of serum soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), galectin-3 (GAL-3) and lactate dehydrogenase A (LDHA) were observed. Results After I131 combined with thyroid-stimulating hormone suppressive treatment, the incidences of atrial fibrillation and myocardial fibrosis after treatment were higher than that before treatment, and the incidences of atrial fibrillation and myocardial fibrosis of high-risk group were higher than those of the middle-risk group, with statistically significant differences (P<0.05). Conclusion Combined use of I131 and thyroid-stimulating hormone for suppressive treatment can increase the incidences of atrial fibrillation and ventricular remodeling of patients with PTC, and the incidences of high-risk group were higher than those of the middle-risk group.
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目的 探究椎间孔镜下治疗腰椎间盘突出症切除黄韧带对腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度的影响。方法 选择120例腰椎间盘突出症患者,随机分为观察组与对照组各60例。观察组患者椎间孔镜术中切除部分黄韧带;对照组患者保留黄韧带。比较两组患者术后半年、1年及2年的腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度。结果 观察组术后半年、1年腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度与对照组比较(P>0.05)。观察组术后2年与对照组比较(P<0.05)。结论 椎间孔镜下治疗腰椎间盘突出症保留黄韧带术后腰椎前凸角、骶骨倾斜角、腰椎曲线指数及椎间隙高度远期效果优于切除黄韧带。
Objective To explore the effects of ligamentum flavum resection on lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space. Methods 120 patients with lumbar disc herniation were randomly divided into observation group and control group. In the observation group, part of the ligamentum flavum was excised by endoscope and in the control group, the ligamentum flavum was preserved. The lumbar lordosis angle, sacral inclination angle, lumbar curve index and intervertebral space height of the two groups were compared at 6 months, 1 year and 2 year after operation. Results At 6 months, 1 year after operation, the lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space in the observation group were compared with those in the control group(P>0.05). 2 years after operation, the observation group was compared with the control group(P<0.05). Conclusion The long-term effect of ligamentum flavum preserving on lumbar lordosis angle, sacral inclination angle, lumbar curve index and height of intervertebral space is better than that of ligamentum flavum resection.
论著
目的 探讨不同年龄儿童性早熟的影响因素及预防措施。方法 本文将2020年1月—2021年1月的性早熟儿童45例(观察组)与正常健康儿童45例(对照组)作为研究对象,通过问卷调查的形式了解所选儿童的家庭因素、饮食、生活方式与社会因素等方面的情况,通过单因素分析与多因素分析探讨相关影响因素。结果 观察组不同年龄段儿童在骨龄、身高、体质量、BMI方面存在统计学差异,P<0.05;观察组性激素水平明显高于对照组,P<0.05。结论 儿童性早熟的发生与生活习惯、家庭关系、饮食习惯、母亲初潮年龄等因素有关,帮助其养成科学合理的生活习惯与饮食习惯,改善家庭关系可很好的降低并预防儿童性早熟的发生。对于已经出现性早熟现象的儿童来说,学校与家庭要及时给予其合理的健康教育,包括心理方面与生殖健康方面,及时有效的疏导可有效避免性早熟对儿童心理方面造成不良影响。
Objective To explore the influencing factors and preventive measures of precocious puberty in children of different ages. Methods 45 cases of precocious puberty children (observation group) and 45 cases of normal healthy children (control group) from January 2020 to January 2021 were selected as the research objects. The family factors, diets, lifestyles and social factors of the selected children were investigated by questionnaire survey, and the related influencing factors were discussed by single factor analysis and multi factor analysis. Results There were statistical differences in bone age, height, weight and BMI among children of different ages in the observation group, P<0.05. The levels of sex hormones in the observation group were higher than those in the control group, P<0.05. Conclusion The occurrence of children's precocious puberty is related to living habits, family relations, eating habits, mother's menarche ages and other factors. To help them develop scientific and reasonable living habits and dietary habits and improve family relations can reduce and prevent the occurrence of children's precocious puberty. For children with precocious puberty, schools and families should give them proper health education in time, including psychological and reproductive health. Timely and effective counseling can effectively avoid the adverse effects of precocious puberty on children's psychology.