目的 探讨妊娠中晚期服用奥司他韦对罹患甲流孕妇症状及母婴结局的影响。方法 选择2018年1月—2019年12月在某三甲医院进行就诊且罹患甲型H1N1的20名孕妇作为研究组对象;同时随机选择同一孕期在该医院产检和分娩,妊娠期间未患甲流H1N1的80名正常孕妇作为对照组对象。在给予口服奥司他韦后,记录研究对组对象流感症状的缓解时间。在妊娠结束后,记录两组研究对象的母婴结局,并进行比较。结果 两组孕妇的年龄≥30岁(65.0% vs 56.3%)、孕周≥32周(60.0% vs 52.5%)、汉族(100.0% vs 95.0%)、中学及以下(40.0% vs 45.0%)、月收入≥3500元(70.0% vs 65.0%)比较,差异均无统计学意义(P＞0.05)。服药时间＜48 h和服药时间≥48h研究对象的发热缓解时间[(2.9±0.3)d vs(3.4±0.4)d]、肌肉和关节酸痛的缓解时间[(3.3±0.4)d vs(3.8±0.5)d]、流涕的缓解时间[(5.6±0.5)d vs(6.8±0.7)d]、咽痛的缓解时间[(2.7±0.3)d vs(3.4±0.5)d]、咳嗽的缓解时间[(8.1±0.6)d vs(9.6±0.8)d]、体力恢复时间[(7.8±0.9)d vs(9.2±0.7)d]比较,服药时间＜48 h者低于服药时间≥48 h者,差异均有统计学意义(P＜0.05)。两组孕妇的自然流产(5.0% vs 2.5%)、死胎(0.0 vs 1.3%)、胎膜早破(10.5% vs 13.8%)、顺产(79.0%vs 81.8%)、低出生体重(15.8%vs 19.5%)比较,差异均无统计学意义(P＞0.05)。结论 奥司他韦对于缓解善中晚期孕妇的甲型H1N1流感症状和预防甲型H1N1带来的不良母婴结局具有良好作用,具有良好的临床推广意义。

目的 观察乳腺癌术后辅助化疗联用槐耳颗粒对内分泌激素及生存期的影响。方法 选取我院肿瘤科于2016年7月—2019年7月进行乳腺癌治疗术的80例乳腺癌患者,将患者按照随机数表法分为观察组与对照组,两组各40例。两组患者均给予预防性止吐等常规治疗,对照组予以表柔比星联合紫杉醇静脉注射,观察组在对照组的基础上给予槐耳颗粒,两组患者均治疗6个月,对比两组患者治疗3个月后血清黄体生成素(LH)、卵泡雌激素(FSH)、雌二醇(E₂),对比两组患者生存时间、无疾病进展生存期及1年生存率。结果 观察组与对照组LH、FSH、E₂水平对比均P＜0.05。在治疗后通过电话、视频等对所有患者进行随访,随访期间两组患者均无失访,生存时间、无疾病进展生存期、1年生存率对比均有P＜0.05。结论 在乳腺癌术后辅助化疗期联用槐耳颗粒可有效改善内分泌激素指标,并使生存时间获益。

Objective To observe the effect of adjuvant chemotherapy combined with Huaier granule on endocrine hormone and survival time after breast cancer operation. Methods A total of 80 cases of breast cancer patients underwent breast cancer treatment in the oncology department of our hospital from July 2016 to July 2019 were selected and divided into two groups according to the random number table method. The control group and the observation group had 40 cases each.Two groups of patients were given preventive anti-nausea and other conventional treatment, the control group was treated with epirubicin and paclitaxel intravenous injection, the observation group was treated with Huaier granuleon the basis of treatment of the control group, two groups of patients were treated for 6 months.The serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E₂) were compared between the two groups after 3 months of treatment. The survival time, progression free survival and 1-year survival rate of the two groups were compared. Results The levels of LH, FSH and E₂ in the comparison between two groups were all P<0.05.After treatment, all patients were followed up by telephone or video. During the follow-up period, there was no loss of follow-up in the two groups. The survival time, progression free survival and 1-year survival rate of the two groups were all P<0.05. Conclusion Huaier granule can effectively improve endocrine hormone indexes and survival time in adjuvant chemotherapy period after breast cancer surgery.

目的 探讨微量喂养对早产儿早期喂养不耐受喂养结局的影响。方法 选择我院2019年1月—2020年6月胎龄≤34周、出生后1周内反复出现喂养不耐受的早产儿78例,采用随机数字表法分为微量喂养组(38例)和中断喂养组(40例),比较两组患儿喂养不耐受的改善及喂养结局的差异性。结果 相对于直接中断喂养,微量喂养3～5天的患儿喂养不耐受改善率更高、体质量增长速度更快、更早达完全肠内喂养时间、静脉营养时间和住院时间也缩短了。而且胆汁淤积症发生率也低于中断喂养组,差异具有统计学意义,两组坏死性小肠结肠炎发生率比较无差异。结论 对于胎龄≤34周、生后1周内反复出现喂养不耐受的早产儿,在排除了外科或败血症早期表现的情况下,相对于中断喂养,选择微量喂养可改善患儿的喂养结局,而且不会增加坏死性小肠结肠炎的发生。

Objective To investigate the effect of minimal feeding on the outcome of early feeding intolerance in premature infants. Methods Seventy-eight premature infants with gestational age＜34 weeks and recurrent feeding intolerance within 1 week after birth in our hospital from January 2019 to June 2020 were selected. They were randomly divided into minimal feeding group (38 cases) and interrupted feeding group (40 cases) to compare the improvement of feeding intolerance and the difference of feeding outcome between the two groups. Results Compared with discontinuation of feeding, the rates of feeding intolerance improvement were higher in children who were given minimal feeding for 3-5 days,and they had faster weight gainand, the time to complete enteral feeding got earlier, intravenous nutrition time and hospitalization time were also shortened. Moreover, the incidence of cholestasis was also lower than that of the interrupted feeding group, and the difference was statistically significant. There was no difference in the incidence of necrotizing enterocolitis between the two groups. Conclusion For premature infants with gestational age＜34 weeks and feeding intolerance happened within 1 week after birth, excluding the early manifestation of surgery or sepsis, minimal feeding can improve the feeding outcome of the infants compared with discontinuation of feeding, without increasing the incidence of necrotizing enterocolitis.

目的 分析慢性肾衰竭患者接受肾衰康方治疗对其血清微炎症状态的影响及肾功能的保护作用。方法 将2020年1月—2020年12月作为研究时间段,选取期间广东祈福医院接诊的50例慢性肾衰竭患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入25例)、观察组(加用肾衰康方治疗,纳入25例),对组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标展开分析。结果 组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗前无明显差异,P>0.05;观察组中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗后优于对照组,P<0.05。结论 肾衰康方对改善慢性肾衰竭患者血清微炎症状态、氧化应激水平、临床症状均有较好效果,且能保护肾功能,值得推广。

Objective To analyze the effect of Shenshuaikang decoction on serum microinflammation and renal function in patients with chronic renal failure. Methods From January 2020 to December 2020, 50 patients with chronic renal failure treated by Clifford Hospital were selected, and the random number table method was used for grouping. All cases were divided into control group (n=25) and observation group (n=25). The TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index were analyzed. Results There were no significant differences in TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index between the two groups before treatment, P>0.05; the TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index of the observation group were better than those of the control group after treatment, P<0.05. Conclusion Shenshuaikang decoction has good effect on improving serum microinflammation, oxidative stress level and clinical symptoms of patients with chronic renal failure, and also can protect renal function, which is worthy of promotion.

目的 探讨超声引导下宫颈癌根治术的应用效果及对患者远期生存率的影响。方法 选取本院2015年1月—2017年12月共收治的70例宫颈癌患者作为研究对象,将2016年7月—2017年12月纳入的患者作为观察组,2015年1月—2016年6月纳入的患者作为对照组,各35例,给予对照组患者常规腹腔镜根治术,给予观察组患者超声引导定位下腹腔镜宫颈癌根治术联合高强度凝聚超声热凝技术治疗。对比两组患者的治疗效果、远期生存率与复发率以及术后6个月、1年、2年、3年的FACT-G评分情况。结果 两组疾病控制率对比无差异(97.14% vs 85.71%,P＞0.05);观察组的治疗总有效率为高于对照组的(85.71% vs 60.00%,P＜0.05);观察组和对照组患者1年生存率对比无差异(P＞0.05),观察组2年、3年生存率高于对照组(P＜0.05),观察组和对照组1年局部复发率对比无差异(P＞0.05),观察组的2年、3年局部复发率低于对照组(P＜0.05);观察组术后6个月、1年、2年、3年的FACT-G评分高于对照组(P＜0.05)。结论 应用超声引导定位下腹腔镜宫颈癌根治术联合高强度凝聚超声热凝技术治疗宫颈癌能够提升患者的治疗效果,减少疾病复发和提高远期生存率,提升患者的生存质量,值得临床应用推广。

Objective To investigate the application effect of ultrasound-guided radical hysterectomy for cervical cancer and its influence on the long-term survival rate of patients. Methods A total of 70 patients with cervical cancer admitted from January 2015 to December 2017 were selected as the research subjects, and the patients enrolled from July 2016 to December 2017 were selected as the observation group, patients from January 2015 to June 2016 as the control group, each with 35 cases. The control group was given conventional laparoscopic radical hysterectomy, and the observation group was given ultrasound-guided laparoscopic radical hysterectomy combined with high-intensity ultrasound coagulation technology. The treatment effect, long-term survival rate, recurrence rate and FACT-G scores 6 months, 1 year, 2 years and 3 years after operation were compared between the two groups. Results There were no significant differences in disease control rates between the two groups (97.14% vs 85.71%, P>0.05); the total effective rate of treatment in the observation group was higher than that in the control group (85.71% vs 60.00%, P<0.05). There was no significant difference in the 1-year survival rate between the observation and the control group (P>0.05). The 2-year and 3-year survival rate of the observation group were higher than that of the control group (P<0.05). There was no significant difference in comparison of 1-year local recurrence rate between the observation group and the control group (P>0.05). The 2-year and 3-year local recurrence rate of the observation group were lower than that of the control group (P<0.05). FACT-G scores in the observation group after surgery at 6 months, 1 year, 2 years, and 3 years were significantly higher than the control group (P<0.05). Conclusion The application of ultrasound-guided laparoscopic radical hysterectomy combined with high-intensity ultrasound coagulation in the treatment of cervical cancer can improve the treatment effect, reduce disease recurrence rate, increase long-term survival rate, and improve the quality of life of patients, which is worthy of clinical application and promotion.

目的 探讨维持性血液透析患者症状负担的现状,并分析影响因素。方法 采用一般状况调查表、血液透析患者症状评估量表、慢性病自我效能量表对96名维持性血液透析患者进行调查。结果 维持性血液透析患者症状负担总得分为63.76±46.70,平均每位患者经历14.10±7.91个症状;其中自我效能、原发病、是否进行日常运动、碱性磷酸酶、血清钠是独立影响因素(P＜0.05)。结论 根据影响因素采取针对性的干预措施,有望缓解患者的症状负担。

Objective To explore the symptom burden and evaluate the risk factors in maintenance hemodialysis patients.Methods A total of 96 patients were retrospectively investigated by Karnofsky Performance Status, dialysis symptom index and chronic disease self-efficacy scale.Results The total score of symptom burden in patients was 63.76±46.70. The average experienced symptoms were 14.10±7.91 per patient. The result by multiple regression analysis indicated that self-efficacy, the primary disease, daily exercises, the level of alkaline phosphatase and sodium in serum were independent risk factors for symptom burden in patients.Conclusion Tailored treatments based on risk factors for hemodialysis patients may relieve their symptom burden.

目的 探讨高通量透析模式对改善维持性血液透析(MHD)患者β2微球蛋白清除率及高血压的影响。方法 选择2018年9月1日—2018年10月31日期间在广州市增城区新塘医院血液净化中心接受MHD患者40例为实验对象(除外因自身耐受因素长期使用低通量透析患者)。采用随机数表法分两组,每组20例。对照组接受低通量血液透析,观察组接受高通量血液透析。比较两组治疗效果,并记录0个月、3个月、6个月、12个月、18个月治疗前后β2微球蛋白(β2-MG)、全段甲状旁腺激素(iPTH)、心率、血压变化,并对两组心血管疾病情况进行统计。结果 观察组总有效率为95.00%,高于对照组的20.00%(P<0.05);治疗后,观察组β2-MG、iPTH均降低,而3个月后对照组略有升高,观察组[(12.48±2.10)mg/L、(210.13±18.12)ng/L]低于对照组[(30.21±2.37)mg/L、(289.41±17.02)ng/L],观察组治疗3个月、6个月、12个月、18个月的β2-MG清除率高于对照组(P<0.05);与治疗前比较,两组的平均动脉压、收缩压均降低,且观察组低于对照组(P<0.05);对照组各时间点24小时舒张压及收缩压差异无统计学意义(P>0.05);与治疗前比较,观察组24小时舒张压、收缩压治疗后1个月、3个月、6个月、12个月、18个月均降低,且低于对照组(P<0.05);两组患者心血管疾病发生率比较:观察组有1例因急性心肌梗死住院行PCI术;对照组有2例因心力衰竭住院治疗,1例因急性冠脉综合症住院治疗。两组并发症发生率比较P>0.05。结论 高通流量透析模式可有效提高MHD患者的治疗效果,有效清除血液毒素,降低患者的高血压,减少并发症,可在临床推广使用。

Objective To investigate the effect of high flux dialysis mode on the improvement of β2-microglobulin clearance and hypertension in maintenance hemodialysis (MHD) patients. Methods Patients who received MHD at the Blood Purification Center of Xintang Hospital, Zengcheng District, Guangzhou from September 1, 2018 to October 31, 2018 (except for long-term low-flux dialysis patients due to self-tolerance factors)were selected. Random number table method was used to divide the patients into two groups,20 patients in each group. The control group received low flux hemodialysis, and the observation group received high flux hemodialysis. The treatment effects of the two groups were compared, levels of β2-microglobulin (β2-MG), intact parathyroid hormone (iPTH), changes in heart rate and blood pressure, and statistics on cardiovascular disease in the two groups before and after treatment at 3, 6, 12, and 18 months were recorded. Results The total effective rate in the observation group was 95.00%, which was higher than the 20.00% in the control group (P<0.05). After treatment, the levels of β2-MG and iPTH of the two groups decreased, and the observation group [(13.02±2.10) mg/L, (210.13±18.12) ng/L] was lower than the control group [(19.78±2.37) mg/L, (289.41±17.02)ng/L]; the β2-MG clearance rate of the observation group was higher than that of the control group at 3 months, 6 months, 12 months, and 18 months (P<0.05).Compared with that before treatment, the average arterial pressure and systolic blood pressure of the two groups were reduced, and the observation group was lower than that of the control group (P<0.05); the differences between diastolic blood pressure and systolic blood pressure at each time point in the control group were not significant (P>0.05); the 24-hour diastolic blood pressure and systolic blood pressure of the observation group decreased after 1, 3, 6, 12 and 18 months, compared with those before treatment (P<0.05), and were lower than those in the control group (P＜0.05).Comparison of the incidence of cardiovascular disease between the two groups: 1 case in the observation group was hospitalized for acute myocardial infarction; 2 cases in the control group were hospitalized for heart failure and 1 case was hospitalized for acute coronary syndrome; complications incidence in the two groups were compared (P>0.05). Conclusion The high flux dialysis mode can effectively improve the treatment outcomes of MHD patients, effectively remove blood toxins, lower blood pressure, and reduce the incidence of complications. It can be used in clinical practise.

目的 探讨将宫腔镜电切手术与高效孕激素治疗相联合,治疗青年女性子宫内膜癌的临床效果以及对患者生育功能的影响。方法 选取2018年5月—2020年5月我院收治的70例青年子宫内膜癌患者作为本次研究对象,根据患者入院时间单双号将患者分为对照组(n=35)和实验组(n=35),对照组患者应用高效孕激素治疗,实验组患者则在对照组的基础上联合应用宫腔镜电切术进行治疗。比较两组患者的临床疗效、再次妊娠的成功率,及血清CA125水平变化情况。结果 研究组患者在治疗后3个月的治疗有效率为94.2%,高于对照组患者治疗有效率74.2%,差异具有统计学意义(P<0.05);研究组在治疗后一年内成功受孕率91.4%高于对照组51.4%,差异具有统计学意义(P<0.05);治疗后,研究组血清CA125水平低于对照组(P<0.05)。结论 将宫腔镜电切术与高效孕激素治疗方式相结合,对治疗青年子宫内膜癌患者效果显著,能够保留患者生育功能的同时,降低血清CA125水平。

目的 观察四通道FES对脑卒中患者下肢运动功能的影响,为其临床应用及推广提供依据。方法 将入组的49例脑卒中患者随机分为四通道FES组(17例)、单通道FES组(16例)和对照组(16例),三组患者均进行(除电刺激)综合康复训练,四通道FES组模仿正常人行走时肌肉收缩的时序刺激患侧下肢的股四头肌、胫骨前肌、腓肠肌及腘绳肌。单通道FES组患者仅在迈步时刺激患侧下肢的胫骨前肌,而股四头肌、腓肠肌、腘绳肌三块肌肉仅作安慰刺激。对照组患者在上述四块肌肉处做安慰刺激(即仅在这四处肌肉贴电极片,但没有电流)。治疗时间为每周5次,持续2周共10次,在治疗前、治疗后1周、治疗后2周分别进行患侧下肢运动功能评定及平衡功能评估。结果 组内前后比较:两组患者治疗前、治疗后一周、治疗后两周下肢功能(FMA)及平衡功能(Berg)逐步提高(P＜0.05)。组间比较:治疗后一周三组差异无统计学意义(P＞0.05);治疗后两周三组有统计学意义,经过两两比较发现,只有四通道组与对照组之间差异有统计学意义(P＜0.05),其他两组之间均无统计学意义。结论 应用基于正常行走模式四通道FES治疗可以改善患者的下肢功能及平衡功能。

目的 探究序贯器官衰竭评分(sequential organ failure assessment,SOFA)联合可溶性程序性死亡因子-1(soluble programmed death-1,sPD-1)水平对脓毒症患者的预后影响。方法 选我院2019年3月—2021年3月期间86例脓毒症患者为研究对象,依据其预后情况(28 d转归)分为生存组(59例)、死亡组(27例),记录两组患者sPD-1、炎症细胞因子水平、SOFA评分及急性生理学与慢性健康状况评价系统Ⅱ(APACHEⅡ)评分情况,分析28 d死亡危险因素,并以ROC曲线分析SOFA+sPD-1对脓毒症患者预后评估价值。结果 死亡组年龄、C反应蛋白、降钙素原、sPD-1水平及SOFA、APACHEⅡ评分均较生存组高(P＜0.05);经Logistic回归分析,sPD-1、SOFA、APACHEⅡ为28 d死亡脓毒症患者独立预测因素(P＜0.05);联合预测后,SOFA+sPD-1的ROC曲线下面积最大,为0.862,敏感度、特异度分别为88.89%、88.14%。结论 在对脓毒症患者预后评估中,sPD-1、SOFA评分均为28 d病死独立预测因素,且SOFA+sPD-1对脓毒症患者转归预测能力更为理想。

Objective To explore the effect of sequential organ failure assessment (SOFA) combined with soluble programmed death factor-1 (sPD-1) level on the prognosis of patients with sepsis. Methods A total of 86 patients with sepsis in our hospital from March 2019 to March 2021 were selected and divided into survival group (59 cases) and death group (27 cases) according to their prognosis (28-day outcome). The levels of sPD-1, inflammatory cytokines, SOFA and APACHEⅡ scores of two groups were recorded. The risk factors of 28-day mortality were analyzed. The prognostic values of SOFA+sPD-1 in patients with sepsis were analyzed by ROC curve. Results Age, C-reactive protein (CRP), procalcitonin (PCT) and sPD-1 levels and SOFA, APACHEⅡ scores of death group were higher than those of survival group (P＜0.05). By Logistic regression analysis, sPD-1 level, SOFA and APACHEⅡ scores were identified as independent predictors of 28-day death in patients with sepsis (P＜0.05). After combining prediction, the area under the ROC curve of SOFA+sPD-1 was the largest (0.862), and the sensitivity and specificity were 88.89% and 88.14% respectively. Conclusion In the prognosis evaluation of patients with sepsis, both sPD-1 level and SOFA score were independent predictors of 28-day mortality, and SOFA+sPD-1 was more effective in predicting the prognosis of patients with sepsis.