摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 纳入2024年3月至2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊NAFLD患者120例。按照随机数字表法分为2组，观察组（实施高蛋白饮食）和对照组（实施限能量平衡膳食），每组 60 例。结果 两组患者干预后两组患者的体质量指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、体脂率（BFR）、内脏脂肪指数（VAI）、CAP 值、血尿酸（UA）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆固醇（TC）、甘油三酯（TG）及低密度脂蛋白胆固醇（LDL-C）水平均较本组干预前显著降低，高密度脂蛋白胆固醇（HDL-C）较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

目的 明确亚甲基四氢叶酸还原酶（MTHFR）C677T、A1298C基因多态性与成人患者使用大剂量甲氨蝶呤（MTX）治疗急性淋巴细胞白血病（ALL）毒性反应和24、48、72 h MTX血药浓度关系。方法 收集2014年6月—2020年6月就诊于新疆医科大学第一附属医院成人急性淋巴细胞白血病75例患者血样检测MTHFR C677T及A1298C基因多态性, 根据抗癌药物常见毒性反应分级标准对毒性反应进行分级,采用非条件Logistic回归分析MTHFR C677T、A1298C基因多态性与HD-MTX毒性反应及血药浓度的关系。结果 MTHFR 677TT型发生贫血风险显著高于CC型（P=0.027, OR=4.694, 95%CI：1.195~18.438）; 未发现MTHFR C677T与白细胞减少、血小板计数减少、中性粒细胞计数减少、淋巴粒细胞计数减少、骨髓抑制、谷丙转氨酶升高、谷草转氨酶升高、肝功能损伤、急性肾损伤及黏膜损伤、24 h、48 h及72 h MTX血药浓度有相关性（P>0.05）; 未发现MTHFR A1298C与HD-MTX毒性反应及血药浓度有相关性（P>0.05）。结论 MTHFR C677T基因多态性与成人急性淋巴细胞白血病患者大剂量MTX化学治疗后血液毒性存在相关性。

Objective To determine the relationship among C677T and A1298C gene polymorphisms of methyltetrahydrofolate reductase（MTHFR）and adult acute lymphocytic leukemia（ALL）, the relationship between the toxicity of high-dose methotrexate（HD-MTX）after chemotherapy and the MTX blood concentration of 24 h, 48 h and 72 h in patients with ALL．Methods Blood samples were collected from 75 adult patients with ALL who were treated at the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2020．The samples were used to detect the genetic polymorphisms of MTHFR C677T and A1298C, and the toxic reactions were graded according to the common toxic reaction classification criteria of anti-cancer drugs．Unconditional Logistic regression was used to analyze the relationship between MTHFR C677T and A1298C gene polymorphisms and HD-MTX toxic reactions and blood drug concentration．Results The risk of anemia in MTHFR 677TT was significantly higher than that in CC type（P=0.027, OR=4.694, 95% CI：1.195-18.438）．No correlation was found between MTHFR C677T and leukopenia, thrombocytopenia, neutropenia, lymphogranulocytopenia, bone marrow suppression, elevated alanine aminotransferase, elevated aspartate aminotransferase, liver function injury, acute kidney injury and mucosal injury, 24 h, 48 h and 72 h MTX plasma concentrations（>0.05）．No correlation was found among MTHFR A1298C and HD-MTX toxicity and blood concentration（P>0.05）．Conclusions MTHFR C677T gene polymorphism is associated with hematotoxicity after HD-MTX chemotherapy in adult patients with ALL．

目的 探讨成人全身麻醉（全麻）腹腔镜下腹股沟疝修补日间手术的可行性及安全性。方法 回顾性分析2021年1月—2023年12月广州市第一人民医院收治的进行全麻腹腔镜下疝修补手术治疗的成人患者病历资料,根据患者住院手术模式分为日间手术组、传统手术组。日间手术组采用日间手术模式下全麻腹腔镜腹股沟疝修补术,传统手术组采用传统入院模式下择期全麻腹腔镜下腹股沟疝修补术,对比分析两组可行性（住院时间、住院费用、患者满意度）、安全性（手术时间、手术的出血量、手术并发症的发生率）等。结果 最终纳入199例病例,日间手术组52例（26.1%）,传统手术组147例（73.9%）。与传统手术组相比较,日间手术组住院时间、术前住院时间、术后住院时间缩短,满意度评分升高,差异具有统计学意义（P<0.05）。在手术费用、住院总费用、术后24 h疼痛评分、手术时间、手术的出血量、手术并发症的发生率方面,组间比较差异均无统计学意义（P>0.05）。结论 成人全麻腹腔镜下腹股沟疝修补日间手术,能够缩短患者的住院时间,提高患者的住院满意程度,不增加手术风险和并发症发生率,是安全、有效的。

Objective To explore and analyze the feasibility and safety of laparoscopic inguinal hernia repair surgery under general anesthesia in adults．Methods A retrospective analysis was conducted on the medical records of patients admitted to a hospital from January 2021 to December 2023 who underwent laparoscopic hernia repair surgery under general anesthesia．The patients were divided into day surgery group and traditional surgery group based on their hospitalization surgery mode．The daytime surgery group underwent laparoscopic inguinal hernia repair under general anesthesia in the daytime surgery mode,while the traditional surgery group underwent elective laparoscopic inguinal hernia repair under general anesthesia in the traditional admission mode．The feasibility（hospitalization duration,hospitalization cost,patient satisfaction）and safety（surgery duration,surgical bleeding volume,incidence of surgical complications）of the two groups were compared and analyzed．Results A total of 199 cases were enrolled,with 52 cases（26.1%）in the day surgery group and 147 cases（73.9%）in the traditional surgery group．Compared with the traditional surgery group,the daytime surgery group showed a decrease in length of hospital stay,preoperative hospital stay,and postoperative hospital stay,while the satisfaction score increased,and the difference was statistically significant（P<0.05）．There was no difference（P>0.05）between the two groups in terms of surgical costs,total hospitalization costs,postoperative 24-hour pain scores,surgical time,surgical bleeding volume,and incidence of surgical complications．Conclusion sLaparoscopic inguinal hernia repair under general anesthesia during the day for adults is safe and effective．

目的 系统评价胰岛素联用α-葡萄糖苷酶抑制剂(AGIs)治疗成人1型糖尿病(T1DM)的疗效和安全性。方法 检索中英文数据库,纳入关于胰岛素联用AGIs治疗成人T1DM患者的随机或非随机对照试验。使用Review Manager 5.3软件进行Meta分析。结果 共纳入10项研究,616例患者。与安慰剂或空白对照相比,在有效性方面,胰岛素联合AGIs可改善成人T1DM患者的糖化血红蛋白;降低平均血糖、空腹血糖和餐后2小时血糖;改善血糖波动情况,包括平均血糖波动幅度和最大血糖波动幅度(均P<0.05)。在安全性方面,AGIs增加总不良反应发生的风险(P<0.05),其中主要是胃肠道不适,但未增加低血糖的发生率和发生次数(均P>0.05)。胰岛素联合AGIs减少了每日胰岛素总剂量(P<0.05),但对体重、甘油三酯和高密度脂蛋白胆固醇无显著影响(均P>0.05)。结论 胰岛素联合AGIs可降低成人T1DM患者的糖化血红蛋白,改善血糖水平和血糖波动情况。AGIs不会增加低血糖的风险,但需重视其不良反应,特别是胃肠道不良反应。

Objective To systematically evaluate the efficacy and safety of adding alpha-glucosidase inhibitors (AGIs) to insulin therapy in adult patients with type 1 diabetes (T1DM). Methods Articles about randomized or non-randomized controlled trials of insulin combined with AGIs in adult patients with T1DM were retrieved from Chinese and English database. Meta-analyses were performed by using Review Manager 5.3. Results A total of 616 patients were included from 10 clinical trials. Compared with adding placebo or nothing, in terms of efficacy, the addition of AGIs resulted in decreased HbA1c, mean blood glucose, fasting plasma blood glucose and 2-hour postprandial blood glucose levels (all P<0.05). And this scheme improved the glucose variability including mean amplitude of glycemic excursions and the largest amplitude of glycemic excursions (P<0.05, respectively). As to safety, AGIs increased the risk of total adverse reactions (P<0.05), most of them were gastrointestinal complaints, while the occurrence and the frequency of hypoglycemia were similar (P>0.05, respectively). This scheme could also lead to the reduced total daily insulin dose (P<0.05) but had no significant effect on body weight, triglyceride or cholesterol concentration (P>0.05, respectively). Conclusions The addition of AGIs to insulin therapy in adult patients with T1DM may reduce HbA1c and improve the glucose levels and glucose variability. But total adverse effects especially the gastrointestinal complaints should also be considered in the use of AGIs although it does not increase the risk of hypoglycemia.

目的 探讨DPP-4抑制剂西格列汀对成人隐匿性自身免疫性糖尿病(LADA)早期患者胰岛β细胞功能的影响。方法 把14例新诊断为LADA患者随机分为两组,胰岛素治疗100 mg/d西格列汀(A组,n=7)或无西格列汀(B组,n=7)共治疗9个月。结果 9个月后两组之间的血糖和糖化血红蛋白水平无差异。9个月后A组空腹C肽(FCP),餐后C肽(CP),和ΔCP(ΔCP=2 h CP-FCP)水平与基线相比无明显差别(P＞0.05),B组FCP,2 h的CP和ΔCP进行比较基线显著下降(P<0.05)。A组2 h CP水平明显高于B组(P<0.05)。结论 胰岛素与西格列汀联用较单用胰岛素治疗成人隐匿性自身免疫糖尿病早期患者似乎能更好保护胰岛β细胞功能,西格列汀或可延长LADA非胰岛素依赖期的时间。

Objective The Objective of the study was to investigate the effects of the DPP-4 inhibitor on β-cell function in patients with recent-onset latent autoimmune diabetes in adults LADA. Methods Fourteen recently diagnosed LADA patients were randomized into two groups, A and B, to receive insulin therapy with 100 mg/d sitagliptin (group A, n=7) or without sitagliptin (group B, n=7) for 9 months. Results There were no differences in the clinical baseline data between the two groups. During the 9 months of follow-up, there were no significant differences in glucose and glycosylated hemoglobin levels between the two groups. At 9 months, there were not different in group A including fasting C-peptide (FCP), 2-hour postprandial C-peptide (CP), and ΔCP(ΔCP=2 h CP-FCP) levels (P>0.05). Compared with baseline, whereas in group B the levels of FCP, 2-hour CP and ΔCP were significantly decreased compared with baseline (P<0.05). Levels of 2-hour CP were higher in group A, it was higher than group B at 9 months (P<0.05). Conclusion LADA patients treated with sitagliptin and insulin was more likely maintain β-cell function by comparison with insulin alone. Sitagliptin administration in patients with LADA might prolong the insulin-free period.

目的 观察不同疗程吗替麦考酚酯(MMF)治疗激素依赖或激素抵抗成人微小病变肾病(MCD)的疗效和复发率。方法 2011年2月—2013年8月我院收治的25例激素依赖或抵抗成人MCD,随机分为短疗程组12例和长疗程组13例。短疗程组给予MMF联合口服泼尼松治疗6个月,观察12月,长疗程组治疗18个月,前6个月治疗同短疗程组,此后单用小剂量MMF维持,观察两组的疗效及复发率。结果 长疗程组有1例因严重感染在第2月退出研究,其余24例均完成18月的随诊;两组在治疗第6月时尿蛋白定量降低、血浆白蛋白升高,均与治疗前有差异(均P<0.05);与第6月比较,疗程结束时短疗程组尿24小时蛋白定量升高(P<0.05),长疗程组尿24小时定量无明显改变(P>0.05);治疗第6月两组均有9例完全缓解(75%),两组无差异(χ²=0.372,P>0.05);治疗第18月时与第6月比较,短疗程组6例复发(54.54%),长疗程组有2例复发(18.18%),两组复发率比较无差异(χ²=0.076,P>0.05)。结论 MMF能有效诱导缓解成人MCD,小剂量维持治疗可以有效降低复发率。

Objective To observe the efficacy and recurrence rates of mycophenolate mofetil (MMF) on hormone-dependent or steroid-resistant adult minimal change disease (MCD). Methods We retrospectively reviewed the records of adult patients at Shunde district hospital of traditonal Chinese medicine of Foshan for minimal change from February 2011 to August 2013. All patients who were hormone-dependent or steroid-resistant were collected. Twenty-five patients were randomly divided into short or long course group. The patient at short course group was given MMF combined with oral prednisone for 6 months, and the long course group was given for 18 months. Patient demographics, efficacy of medicines and recurrence rates were observed. Results Except one case of the long course group quitting at the second month because of severe infection, the other cases all finished the 18 months of follow up. At the 6 month after therapy with MMF, in both group, the 24h urine protein had lowered significantly (P<0.05) and the serum albumin level had risen remarkably (P<0.05). At the end of the follow up, compared with the 6 month after therapy, the 24 h urine protein of the short course group had increased (P<0.05), while those of the long course group had no obvious difference (P>0.05). At the 6 month after therapy, there were 9 cases achieved complete remission.There was no significant difference between the two groups (χ²=0.372, P>0.05). At the end of the follow up, compared with the 6 month after therapy, there were 6 cases experienced relapse (54.54%) in the short course group and 2 cases of those in the long course group (18.18%), but with no significant difference between them (χ²=0.076, P>0.05). Conclusion MMF can induce the remission of adult MCD efficiently, and its low dose maintenance treatment can decrease recurrence rates.

目的 探讨健康成人颈段气管的体外高频超声影像特点,为开展体外超声在检测颈段气管病变应用作前期研究。方法 应用体外高频超声观察120例健康成人颈段气管结构的声像表现,并对气管环T1-T4的内外横径、气管环厚度、相邻气管环间距进行测量和统计学分析。结果 120例志愿者均获得了颈段气管前、侧壁声像图,以及气管环T1-T4内外横径、气管环厚度、相邻气管环间距测值。结论 体外高频超声可以清晰显示气管形态和细微支撑结构,并进行部分径线测量,有望成为评估颈段气管病变的一种有价值的辅助手段。

Objective We investigated features of the healthy adult cervical tracheas in order to studying cervical tracheal lesions by extracorporeal high-frequency ultrasound EHFUS. Methods EHFUS examination of the trachea was performed in 120 asymptomatic adult volunteers. We observed imaging features of the healthy adult cervical tracheas, and measured TRID, TRED, TRTh and TRAS to analysis. Results The cervical tracheal anterior and side wall ultrasonograms, and measurements were obtained in all subjects. Conclusion The cervical tracheal shape and the fine structure of support can be seen in EHFUS, and partly of diameter measurements were obtained. Thus EHFUS may be a valuable assistant method to assess cervical tracheal lesions of support structure.