目的 观察控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响。方法 将我院2016年3月—2017年2月治疗的94例重型颅脑损伤患者作为研究对象,入选者均依据随机数表法分为两组,各47例。对照组实施大骨瓣减压术,观察组实施控制性减压术。观察手术前后两组神经功能、颅内压及预后等。结果 术前2组神经行为认知状态检查表(NCSE)评分、颅内压对比,差异无统计学意义(P＞0.05);术后观察组NCSE评分高于对照组,颅内压低于对照组,差异有统计学意义(P＜0.05);2组预后等级相比,观察组优于对照组,差异有统计学意义(P＜0.05)。结论 将控制性减压术应用于重型颅脑损伤患者中降颅内压效果良好,可恢复受损神经功能,提升患者康复效果,改善预后。

目的 探讨生脉注射液联合环磷腺苷治疗慢性心力衰竭的临床疗效及对其心功能的影响。方法 选择本院2016年3月—2017年4月收治的90例慢性心力衰竭患者,随机将其分为2组,各45例。对照组采用环磷腺苷静脉滴注治疗,在此基础上观察组加用生脉注射液治疗,比较两组临床疗效、心功能及药物不良反应。结果 2个疗程后,观察组总有效率、LVEF、CI及CO水平均较对照组高,差异有统计学意义(P＜0.05);两组治疗期间药物不良反应率相比,差异无统计学意义(P＞0.05)。结论 生脉注射液联合环磷腺苷可提高慢性心力衰竭临床疗效,改善心功能,且用药安全性较高。

目的 探讨布地奈德联合特布他林对中度哮喘患儿血清变态反应及Th相关指标的影响。方法 选择本院2016年3月—2017年4月收治的中度哮喘患儿100例,将其随机分为2组,各50例。对照组采用布地奈德雾化吸入治疗,观察组采用布地奈德联合特布他林雾化吸入治疗,比较两组临床疗效、血清变态反应与Th相关指标、药物不良反应。结果 1周后,观察组治疗总有效率较对照组高,MCP-1、IgE、IL-10及IL-6水平均较对照组低,差异具有统计学意义(P＜0.05);观察组药物不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 布地奈德联合特布他林可提高中度哮喘患儿临床疗效,减轻血清变态反应,改善Th相关指标,且用药安全性较高。

目的 研究结肠黑变病(melanosis coli,MC)对结肠息肉的影响。方法 从2014年1月—2017年1月在石河子大学医学院第一附属医院行电子结肠镜的21 708例患者中选取符合条件的522例结肠黑变病患者组成MC组,随机选取569例患者组成非MC组,分析比较2组的一般情况及与结肠息肉的关系,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 结肠黑变病组年龄中位数为64岁(51～73岁),非结肠黑变病组年龄中位数为54岁(47～64岁),2组性别无统计学差异;MC组、非MC组结肠息肉检出率分别为47.8%和40.2%,P=0.013,差异有统计学意义;在病理类型上2组均为炎性息肉检出率最低,腺瘤性息肉检出率最高分别达 58.0%和51.5%,病理类型无统计学差异;在盲肠及降结肠检出率均很低,多发部位、直肠、乙状结肠检出率相对较高,但差异均无统计学意义;结肠息肉大小集中在0~9 mm范围内,2组所占百分比分别高达92.0%和91.3%,≥20 mm息肉检出率均很低,分别为0.40%,0.44%,息肉大小无统计学差异。结论 MC组息肉检出率高于非MC组,差异有统计学意义;2组结肠息肉病理类型、发病部位、息肉大小差异均无统计学意义。

Objective Studying the effect of melanosis coli (MC) on colonic polyps.Methods This is a reospectively review of patients with electronic colonoscopy in our hospital from January 2014 to January 2017. A total of 522 cases of colorectal melanosis (MC) were composed of MC group, and 569 patients were randomly selected to form a non-mc group. The comparison of basic information between the two groups and the relationship of colon polyp and colon cancer was analyzed.Results The median age of the colon melanosis group was 64 years (51~73 years old), and the median age of the non-colonic melanosis group was 54 years (47 to 64 years old), with no statistically significant differences between the two groups.The detection rate of colon polyps in MC group was 47.8%. The detection rate of colon polyps in non-mc group was 40.2%, P= 0.013, and the difference was statistically significant.The two groups of polyps had the lowest detection rate of inflammatory polyps in pathological types, and the detection rate of adenomatous polyps was up to 58.0% and 51.5% respectively, but there was no statistically significant difference between the two groups. In the cecum, the detection rate of the descending colon was low, and the detection rate of multiple sites, rectum and sigmoid colon was relatively high, but the difference was not statistically significant.The size of colon polyps was concentrated in the range of 0~9 mm, and the percentages of the two groups were as high as 92.0% and 91.3% respectively, while the detection rate of the size being more than 20mm was low, that is 0.40% and 0.44%. But there was no statistical difference between the two groups.Conclusion The detection rate of polyps in MC group was higher than that in non-mc group, and the difference was statistically significant.There was no statistically significant difference between the two groups of colon polyps pathology, pathogenesis, and polyp size.

目的 探讨前列地尔联合依帕司他对糖尿病足患者创面肉芽组织肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白介素-6 (interleukin-6,IL-6)及血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的影响。方法 将90例糖尿病足患者随机分为研究组和对照组,每组45例,对照组予常规治疗,研究组在常规治疗基础上给予前列地尔+依帕司他联合治疗。监测两组患者创面愈合率,患肢足背血流动力学及腓总神经传导速度,创面肉芽组织TNF-α、IL-6、VEGF含量及基因表达变化。结果 治疗后第2、4周研究组较对照组创面愈合率升高,差异有统计学意义(P<0.05);治疗后两组患者足背动脉血流动力学及腓总神经传导速度均有改善,而研究组疗效更明显(P<0.05);治疗后研究组患者创面肉芽组织TNF-α、IL-6含量及基因表达较对照组降低,VEGF含量及基因表达则升高(P<0.05)。结论 前列地尔联合依帕司他联合治疗可改善糖尿病足患者足背动脉血流动力学,促进受损神经功能恢复;降低糖尿病足患者创面肉芽组织TNF-α、IL-6表达,减轻免疫损伤;增加VEGF基因表达,促进血管生成,加速创伤愈合。

Objective To investigate the effects of alprostadil combined with epalrestat on the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in granulation tissue in patients with diabetic foot patients.Methods Totally 90 cases with diabetic foot were randomly divided into study group (45 cases)and control group(45 cases). The control group received conventional treatment for 4 weeks and the study group additionally received combination of alprostadil and epalatone for 4 weeks. The curative rate of wound healing, limb dorsal hemodynamics, peroneal nerve conduction velocity and the levels of TNF-α, IL-6 and VEGF in the granulation tissue of the wound were monitored in the two groups.Results The wound healing rate of the study group was significantly higher than that of the control group at the 2nd and 4th week after treatment (P<0.05). After treatment, the hemodynamics and peroneal nerve conduction velocity were improved (P<0.05). The contents and expressions of TNF-α and IL-6 in the granulation tissue of the treatment group were significantly lower than that of the control group, and the content of VEGF and gene expression were significantly increased in the study group (P<0.05).Conclusion The combination therapy of alprostadil and epalrestat may improve the hemodynamics of dorsalis pedis artery in patients with diabetic foot and promote the recovery of damaged nerve function.Also it may reduce the expression of TNF-α and IL-6 in the granulation tissue of diabetic patients and reduce the immune injury. It promotes angiogenesis and accelerates wound healing by increasing VEGF gene expression.

目的 探讨无创呼吸机辅助常规药物治疗重症哮喘的疗效及对肺功能的影响。方法 选取我院于2014年2月—2017年6月间收治的60例重症哮喘患者作为研究对象,按照随机数字法分为对照组和研究组,对照组30例予以常规药物治疗,研究组30例予以无创呼吸机辅助常规药物治疗。比较两组患者临床疗效、肺功能指标、气血指标、心率、哮喘症状评分以及药物使用情况。结果 研究组临床有效率(96.66%)高于对照组(76.66%)(P＜0.05)。2组患者干预前肺功能指标、气血指标及心率比较无差异(P＞0.05),干预后两组心率、PaCO₂均较干预前降低,PaO₂、FEV1、FEV1/FVC均较干预前升高(P＜0.05),研究组较对照组改善明显(P＜0.05)。两组患者干预前哮喘症状评分比较无差异(P＞0.05),干预后两组哮喘症状评分均较干预前降低,且研究组较对照组降低明显(P＜0.05)。研究组使用茶碱类药物、糖皮质类激素、受体激动剂药物比例均低于对照组(P＜0.05)。结论 无创呼吸机辅助常规药物治疗重症哮喘可显著改善患者血气指标及肺功能,疗效确切。

目的 探究血必净联合乌司他丁治疗重症急性胰腺炎的疗效及对血清细胞因子水平的影响。方法 选择2016年2月—2017年3月我院收治的重症急性胰腺炎患者88例,随机将其为两组,各44例。对照组采用乌司他丁治疗,在此基础上给予观察组血必净治疗,比较2组临床疗效、血清细胞因子及药物不良反应。结果 观察组总有效率较对照组高,TNF-α、IL-6、hs-CRP水平较对照组低,差异有统计学意义(P＜0.05);观察组不良反应率略低于对照组,但差异无统计学意义(P＞0.05)。结论 血必净联合乌司他丁可提高重症急性胰腺炎临床疗效,减轻炎性反应,且不增加不良反应率,安全性较高。

目的 探讨炔雌醇环丙孕酮联合二甲双胍对多囊卵巢综合征(PCOS)患者促排卵结局及性激素水平的影响。方法 选择2015年3月—2016年12月我院收治的多囊卵巢综合征(PCOS)患者90例,将其参照随机数字表法分为2组,各45例。对照组给予炔雌醇环丙孕酮治疗,在此基础上给予观察组二甲双胍治疗,1个疗程后评估两组临床疗效、性激素水平、药物不良反应,并观察治疗6个月后2组促排卵结局。结果 观察组治疗总有效率、排卵率、妊娠率均较对照组高,T、E₂、LH水平较对照组低,差异具有统计学意义(P＜0.05);观察组不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 炔雌醇环丙孕酮联合二甲双胍可显著提高PCOS临床疗效,改善性激素水平及促排卵结局,且不增加不良反应率,安全性较高。

目的 观察平胃散联合耳穴治疗单纯性肥胖的临床疗效及其对血清神经肽Y(Neuropeptide Y,NPY)和瘦素(Leptin,LP)水平的影响。方法 64例单纯性肥胖患者,采用数字表法随机分为治疗组33例和对照组31例。治疗组予口服平胃散免煎颗粒配合耳穴治疗,对照组予口服奥利司他胶囊治疗,疗程4周。观察治疗前后体质量、体质量指数(bodymass index,BMI)、体脂百分比(Fat%,F%)、腰臀比(Waist Hip Ratio,WHR)、NPY、LP的变化。结果 治疗后,治疗组和对照组体质量、BMI、F%、WHR、相关疾病的危险度均下降(P＜0.001)。比较治疗前后体质量、BMI、F%、WHR差值,治疗组下降均比对照组明显(P＜0.01、P＜0.001)。治疗组临床疗效优于对照组(P＜0.05)。治疗组和对照组血清NPY、LP水平均下降(P＜0.001),且治疗组较对照组下降(P＜0.001)。结论 平胃散联合耳穴有较好的减肥作用,其机制可能是通过降低血清中NPY、LP含量。

Objective Clinical observation of Pingwei Powder combined with auricular point therapy in treating simple obesity and the effect on serum NPY and leptin Levels. Methods 64 cases of simple obesity patients were randomized into treatment group(33 cases) and control group(31 cases). The treatment group was given Pingwei Powder combined with auricular point therapy.The control group was given Orlistat capsules. After being treated for 4 weeks, body weight, bodymass index(BMI), fat% (F%), waist hip ratio (WHR),neuropeptide y (NPY) and leptin(LP) were determined. Results After post-treatment in treatment group and control group, body weight, BMI, F%, WHR, the risk of related diseases all decreased (P＜0.001), The body weight, BMI, F%, WHR before and after treatment were lower than those in the control group(P＜0.01, P＜0.001). The clinical efficacy of the treatment group was better than that of the control group(P＜0.05). Serum NPY and LP levels in treatment group and control group were decreased (P＜0.001), and that the treatment group were lower than of the control group (P＜0.001). Conclusion Pingwei Powder combined with auricular point therapy have better in weight loss, which is possibly by way of reducing serum NPY, LP Levels.

目的 探讨高压氧对FVB小鼠旷场行为的影响。方法 对9只4周龄高压氧组FVB小鼠进行2个疗程共21天高压氧干预;对13只4周龄对照组FVB小鼠不做任何处理,正常饲养。21天后对2组小鼠进行旷场实验,观察高压氧对FVB小鼠旷场行为的影响。结果 高压氧组小鼠在中央区停留时间(3.73±3.69,17.97±6.82,t=-5.564,P=0.000)和运动路程较对照组小鼠减少(189.65±199.32,525.67±244.22,t=-3.298,P=0.040),在外周区停留时间增加(296.07±3.69,281.79±6.79,t=5.597,P=0.000);进入中央区、外周区次数及穿越各区总次数都减少(3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008);2组小鼠总路程和平均速度无差异(8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726)。结论 高压氧改变FVB小鼠的旷场行为的表型,使小鼠趋避性增加,对环境的认知能力及焦虑程度增强,探索性下降。

Objective To explore the effect of hyperbaric oxygenation(HBO)on behaviors of FVB mice in the open field test. Methods 9 mice of four-week-old in the HBO group were treated with hyperbaric oxygenation for a total of 21 days during two courses while 13 control mice of four-week-old did not do any treatment. After 21-day normal breeding, the mice of two groups were tested with open field test. Then, researchers observed the effect of hyperbaric oxygenation on mice behaviors after open field test. Results Compared to 13 control mice, residence time (3.73±3.69,17.97±6.82,t=-5.564,P=0.000) and the range of movement (189.65±199.32,525.67±244.22,t=-3.298,P=0.040)in central region decreased while the residence time in external region increased (296.07±3.69,281.79±6.79,t=5.597,P=0.000). The times of entering the central region and external region and crossing both of the regions decreased (3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008). There was no difference in the total range of movement and the average velocity (8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726). Conclusion Hyperbaric oxygenation may change the behaviors of FVB mice in open field test to enhance its phobotaxis, anxiety degree and the cognitive ability in environment and inhibiting its exploration ability.