目的 探讨影响颈内动脉闭塞（ICAO）患者预后的相关因素,为临床改善ICAO患者预后提供理论依据。方法 回顾性分析2017—2022年广西医科大学附属武鸣医院因ICAO入住神经内科的131例患者,根据ICAO发病时间分为急性颈内动脉闭塞（AICAO）和慢性颈内动脉闭塞（CICAO）,根据预后的不同,分为预后良好和预后不良组,比较两组的基本信息（性别、年龄等）、既往病史（包括高血压、糖尿病、冠心病等）、发病时神经功能损害程度（美国国立卫生研究院卒中神经功能缺损评分NIHSS评分）、侧支循环代偿评分、介入手术开通治疗、出血转化之间的差异,分析影响患者预后的相关因素。结果 CICAO患者总体预后良好,AICAO预后良好组患者发病时NIHSS评分<6分、侧支循环代偿良好比例高于预后不良组,而出血转化率低于预后不良组,组间比较差异均有统计学意义（P<0.05）。二分类Logistic回归分析显示,发病时NIHSS评分、侧支循环代偿评分、介入手术开通治疗、出血转化、次全闭塞对AICAO预后影响有统计学意义（P<0.05）。两组间的基本信息、既往病史、介入手术开通治疗等比较差异无统计学意义（P>0.05）。结论 CIACO较AICAO总体预后良好,发病时NIHSS评分<6分、侧支循环代偿良好、无出血转化是IACO预后良好的相关因素。发病时NIHSS评分高、侧支循环代偿不良、出血转化是ACAO预后不良的危险因素

Objective To evaluate the prognostic significance of a group of clinical indices in the patients with internal carotid artery occlusion（ICAO）. Methods From 2017 to 2022,a total of 131 patients with ICAO were enrolled．All eligible patients were divided into acute ICAO（AICAO）and chronic ICAO groups（CICAO）,which were subdivided into good and poor prognosis groups．A respective analysis was performed to identify a practical profile for the outcome prediction of the patients with ICAO. Results The overall prognosis of CIACO was good．The proportion of NIHSS score < 6 in AICAO group with good prognosis and good collateral circulation compensation was significantly higher than that in poor prognosis group,while bleeding conversion was lower than that in poor prognosis group,with statistical significance（P<0.05）．Dichotomous logistic regression analysis showed that the prognostic effects of NIHSS score,collateral circulatory compensation score,interventional initiation,hemorrhagic transformation,and subtotal occlusion on the prognosis of AICAO were statistically significant．There were no significant differences in basic information,past medical history,interventional operation between the two groups（P>0.05）. Conclusions The patients with CICAO have a better prognosis than those with AICAO．NIHSS score < 6,good collateral circulation and no-hemorrhagic transformation may have strong prognostic relevance to ICAO．High NIHSS score,poor collateral circulation and hemorrhagic transformation at the time of onset are risk factors for poor prognosis of ACAO ．

目的 比较早产胎膜早破(PPROM)≥34周的肥胖孕妇与非肥胖孕妇的早产儿住院结局。方法 回顾性分析2016年1月—2020年12月在本院出生并入住新生儿科的所有出生胎龄≥34周的PPROM早产儿。根据孕妇分娩时体质量指数(BMI),分为肥胖组(BMI≥30 kg/m²)和非肥胖组(BMI＜30 kg/m²),比较2组间的一般情况、妊娠结局及所生晚期早产儿的住院结局,组间比较采用两独立样本t检验及χ²检验。结果 与非肥胖孕妇相比,肥胖孕妇的晚期早产儿分娩后呼吸道并发症发病率高,主要表现为新生儿呼吸窘迫综合征,辅助通气、吸氧和表面活性物质的使用、败血症、感染性肺炎发病率高,母亲妊娠期糖尿病发病率增高,差异均具有统计学意义(P＜0.05),其余新生儿高胆红素血症、新生儿坏死性小肠结肠炎、脑室内出血、早产儿支气管肺发育不良等并发症比较无统计学意义(P＞0.05)。结论 PPROM≥34周的肥胖孕妇与非肥胖孕妇相比,所生晚期早产儿呼吸道并发症和败血症等不良结局的发生率增加。

Objective To compare the hospitalization outcomes of 34 weeks or over preterm infants with preterm premature rupture of membranes (PPROM) in obese and non-obese pregnant women. Methods A retrospective analysis of PPROM preterm infants born in our hospital and admitted to the neonatology department from January 2016 to December 2020 with a gestational age of 34 weeks or over was carried out. According to the pregnant women's body mass index (BMI) at delivery, they were divided into obese group (BMI≥30 kg/m²) and non-obese group (BMI<30 kg/m²). The general conditions, pregnancy outcomes and late premature infants hospitalization outcomes between the two groups were compared using two independent samples t test and χ² test. Results Compared with non-obese pregnant women, the incidence of respiratory complications after delivery in late preterm infants of obese pregnant women was higher, mainly manifested as high incidence of neonatal respiratory distress syndrome, assisted ventilation, oxygen inhalation and the use of surfactants, sepsis, and pneumonia, also maternal gestational diabetes incidence was increased, and the differences were statistically significant (P<0.05); other complications of neonatal hyperbilirubinemia, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia were not statistically significant (P>0.05). Conclusions Compared with non-obese pregnant women with 34 weeks or over PPROM, obese pregnant women had an increased incidence of adverse outcomes in late preterm infants such as respiratory complications and sepsis.

目的 研究黄连水煎剂对体外建立的金黄色葡萄球菌生物膜(bacterial biofilm,BF)的作用,及黄连水煎剂联合苯唑西林钠对金黄色葡萄球菌作用。方法 由广西医科大学第一附属医院检验科提供金黄色葡萄球菌菌株34134,采用二倍稀释法分别测出黄连水煎剂和苯唑西林钠对金黄色葡萄球菌的最低抑菌浓度(minimum inhibitory concentration MIC),在体外使用腹膜透析管建立金黄色葡萄球菌生物膜模型,加入不同浓度的黄连水煎剂和苯唑西林钠作用3天和7天后,琼脂平板菌落计数法评估细菌粘附腹透管的能力,结晶紫染色法行载体表面BF半定量,银染法快速鉴定BF。结果 黄连水煎剂MIC为16 mg/mL,苯唑西林钠MIC为4 μg/mL,3天BF模型中,1/2MIC黄连水煎剂、1/4MIC黄连水煎剂、1/8MIC黄连水煎剂、1/16MIC黄连水煎剂、1/2MIC苯唑西林钠、1/4MIC苯唑西林钠作用下的金黄色葡萄球菌的菌落计数分别为(39.333 3±3.994 2)×10⁶ CFU/mL、(52.366 7±3.537 8)×10⁶ CFU/mL、(81.266 7±3.341 8)×10⁶ CFU/mL、(90.900 0±2.040 1)×10⁶ CFU/mL、(50.866 7±2.208 6)×10⁶ CFU/mL、(77.666 7±2.880 7)×10⁶ CFU/mL,空白组的菌落计数为(92.033 3±3.890 6)×10⁶ CFU/mL,与空白组相比较,1/2MIC黄连水煎剂,1/4MIC黄连水煎剂、1/8MIC黄连水煎剂、1/2MIC苯唑西林钠、1/4MIC苯唑西林钠的差异有统计学意义(P<0.001),1/16MIC黄连水煎剂与空白组比较,差异无统计学意义(P=0.173)。7天的BF模型中,1/2黄连水煎剂比1/2苯唑西林钠抑制金黄色葡萄球菌生物膜形成的作用更强(P<0.001),结晶紫、银染也得到相似的结果,进一步的研究发现在1/16MIC黄连水煎剂的作用下,加入不同浓度的苯唑西林钠,此时苯唑西林钠的最低抑菌浓度为0.25 μg/mL。结论 黄连水煎剂能抑制金黄色葡萄球菌生物膜的形成,并且在苯唑西林钠联合黄连水煎剂时,能有效地提高苯唑西林钠的疗效,为治疗金黄色葡萄球菌导致的腹膜透析相关性腹膜炎提供新的治疗方案,同时也提高了抗生素的疗效,为临床上减少耐药菌的产生提供了帮助。

Objective To study the effect of Coptis chinensis decoction on bacterial biofilm(BF)in vitro and the effect of Coptis chinensis decoction combined with oxacillin sodium on Staphylococcus aureus. Methods Staphylococcusaureus strain 34 134 was provided by the First Affiliated Hospital of Guangxi Medical University. Using doubling dilution method to measure the minimum inhibitory concentration of Coptis decoction and Oxacillin sodium on Staphylococcus aureus,respectively. In vitro, peritoneal dialysis tube was used to establish Staphylococcus aureus biofilm model after adding different concentrations of Coptis decoction and Oxacillin sodium for 3 days and 7 days, we used Agar plate count method to assess bacterial adhesion on the dialysis tube, crystal violet staining and semi quantitative method to measure the BF of the surface of the carrier and silver staining(light microscopy) rapid identification of BF. Results The MIC of Coptidis decoction was 16 mg/ml, and that of Oxacillin sodium was 4 μg/mL. In the BF model after 3 days, the colony counting of bacteria of 1/2MIC Coptis decoction, 1/4MIC Coptis decoction, 1/8MIC Coptis decoction,1/16MIC Coptis decoction, 1/2MIC Oxacillin sodium,1/4MIC Oxacillin sodium were(39.333 3+3.994 2)×10⁶(52.366 7+3.537 8),CFU/mL×10⁶, CFU/mL×10⁶(81.266 7+3.341 8), CFU/mL(90.900 0+2.040 1)×10⁶,CFU/mL(50.866 7+2.208 6)×10⁶, CFU/mL(77.666 7+2.880 7)×10⁶ CFU/mL, colony counting of blank group was(92.033 3+3.890 6)×10⁶ CFU/mL, respectively. Compared with the blank group, 1/2MIC Coptis decoction, 1/4MIC Coptis decoction,1/8MIC Coptis decoction,1/2MIC Oxacillin sodium,1/4MIC Oxacillin sodium all had differences in statistical significantce(P=0.001), but 1/16MIC Coptis decoction had no statistically significant(P=0.173). In the BF model after 7 days, colony counting bacteria, crystal violet and silver staining showed similar results. Further studies showed that under the effect of 1/16MIC Coptis decoction, the minimum inhibitory concentration of oxacillin sodium was 0.25 μg/mL. Conclusion Coptis decoction could inhibit the formation of Staphylococcus aureus biofilm, and oxacillin sodium combined with Coptidis decoction was effective to improve the curative effect of oxacillin sodium, providing new treatment for peritoneal dialysis related peritonitis that is caused by Staphylococcus aureus improving the efficacy of antibiotics, and providing help for the clinical on reducing the generation of antibiotic resistant bacteria.

急性肾损伤(acute kidney injury,AKI)是由各种因素导致的临床综合征,尽管科学在发展,发病率、死亡率一直居高不下,并且严重影响患者的预后,这主要是由于对肾脏损伤的早期诊断缺乏敏感的、特异性的指标,使得患者错过了最佳的治疗窗口。研究发现在AKI的早期给予干预,能够明显提高患者的预后,达到满意的治疗效果。所以AKI的早期诊断是提高患者的生活质量的关键措施,期间出现了一系列AKI 的早期分子标志物,包括NGAL、IL-18、miRNA、KIM-1、NAG、L-FABP、TIMP-1、IGFBP-7、TFF-3、GST-π、MYL12B等。本文就这些AKI分子标志物进行总结,阐述这些分子标志物在AKI 诊断及预后预测中的价值,以便于及早制定有针对性的 AKI 治疗及护理策略,使早期诊断、早期干预 AKI 成为可能。