目的 探讨湿化高流量鼻导管通气(HHFNC)联合枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效。方法 选取2016年1月—2017年12月我院收治的58例呼吸暂停的早产儿为研究对象,随机分为两组:HHFNC组和对照组,HHFNC组除采用枸橼酸咖啡因治疗方案外,联合HHFNC法进行治疗;对照组采取鼻导管吸氧联合枸橼酸咖啡因治疗。结果 HHFNC组较之对照组治疗早产儿呼吸暂停的总有效率更高,差异有统计学意义(P<0.05);HHFNC组较之对照组总用氧时间、无创辅助通气的时间减少,住院时间缩短,差异有统计学意义(P<0.05)。结论 湿化高流量鼻导管通气(HHFNC)联合枸橼酸咖啡因减少早产儿呼吸暂停的发生,改善早产儿呼吸状况。

目的 探讨玻璃体切除术联合玻璃体腔注射曲安奈德治疗特发性黄斑前膜患者疗效观察。方法 选取我院2018年1月—2020年1月特发性黄斑前膜(idiopathic macular epiretinal membrane, IMEM)患者38例。随机分为治疗组(18例,18眼)与对照组(20例,20眼)。治疗组在术中予以玻璃体切除联合黄斑前膜剥除及内界膜剥除术,并注入曲安奈德(triamcinolone acetonide,TA),对照组术中单纯行玻璃体切除联合黄斑前膜剥除及内界膜剥除术。比较两组患者手术前及手术后1月、3月、6月的最佳矫正视力(BCVA)及黄斑中心凹厚度数值(CMT)及房水白细胞介素-6(IL-6)的变化情况。结果 术中所有患者成功剥除黄斑前膜,术后所有患者均未出现玻璃体积血、视网膜脉络膜脱离及眼压增高等并发症。两组患者中,所有患者手术后BCVA均较手术前有所提高,且治疗组优于对照组,差异有统计学意义(P＜0.05)。手术后治疗组CMT下降幅度优于对照组,差异有统计学意义(P＜0.05)。手术后治疗组房水中IL-6水平明显低于对照组,差异有统计学意义(P＜0.05)。结论 玻璃体切割及内界膜剥除术联合玻璃体腔内注射TA治疗IMEM,有助于提高患者术后视力,降低患者黄斑中心凹厚度,减轻患者黄斑水肿程度,减少房水中白细胞介素-6的表达。

目的 分析广州北部区域某胸痛中心不同性别的急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗的结果。方法 纳入广州市花都区人民医院2016年12月—2020年1月期间接受直接经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者。按照不同的性别,评估患者的危险因素、治疗时限性和主要心血管不良事件情况。结果 入选389名患者,73名(18.8%)为女性。和男性患者对比,女性患者年龄更大(69.3±10.8岁vs 55.8±13.1 岁,P＜0.05),具有更高比例的2型糖尿病(26.0% vs 17.7%,P＜0.05)、高血压病(58.9.0% vs 43.0%,P＜0.05)病史。女性患者的症状-首次医疗接触时间和总缺血时间均长于男性患者(分别为229.2 min vs 174.5 min,P＜0.05;424.9 min vs 317.4 min,P＜0.05),PCI术中出现慢血流/无复流的比例更高(26.0% vs 16.5%,P＜0.05)。女性患者主要住院心血管事件风险更高(11.0% vs 4.4%, P＜0.05),其中院内死亡率(4.1% vs 1.6%, P＜0.05)。女性患者在院期间发生心衰及心源性休克的比例更高(分别为34.2% vs 21.2%,P＜0.05; 30.1% vs 18.7%,P＜0.05)。结论 在行急诊介入治疗的急性ST段抬高型心肌梗死患者中,女性患者预后差于男性,具有更高的心血管事件风险,死亡率更高。

Objective We investigated sex-based outcomes after primary percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) in a chest pain center of northern Guangzhou. Methods From December 2016 to January 2020, consecutive STEMI patients who underwent PPCI in Guangzhou Huadu District People's Hospital were recruited. Risk factors, time variables, and major cardiovascular adverse events (MACE) were assessed according to gender. Results A total of 389 patients were enrolled,with 73(18.8%)women. Compared to men, women patients presented higher risk profiles with old age(69.3±10.8 years vs 55.8±13.1 years,P＜0.05),diabetes (26.0% vs 17.7%,P＜0.05), hypertension (58.9.0% vs 43.0%,P＜0.05).Women had longer symptom onset to first medical contact time and total ischemic time than men had(229.2min vs 174.5min,P＜0.05;424.9min vs 317.4min,P＜0.05).During PCI procedure,women presented higher ratio of slow flow/no reflow(26.0% vs 16.5%,P＜0.05).Women had increased major adverse events(11.0% vs 4.4%, P＜0.05), and higher in-hospital mortality(4.1% vs 1.6%, P＜0.05).Women presented more heart failure incidence (34.2% vs 21.2%,P＜0.05),and cardiac shock incidence(30.1% vs 18.7%,P＜0.05). Conclusion Women with acute STEMI who underwent PPCI had worse outcomes compared to men.They had higher MACE and in-hospital mortality.

目的 探讨在关节镜下膝关节前交叉韧带损伤重建术治疗的临床效果。方法 选取2018年3月—2020年3月之间我院接受住院治疗的80名膝关节前交叉韧带损伤患者作为研究对象。根据手术方式的不同,常规手术进行交叉韧带损伤的重建术治疗为常规组,关节镜下膝关节前交叉韧带损伤重建术治疗为研究组,每组各40名患者,比对两组的治疗效果。结果 通过数据得出常规组的膝功能评分(71.8±12.6)及膝功能不稳评分(13.2±1.6)要低于研究组膝功能评分(83.9±12.9)及膝功能不稳评分(19.3±2.3),差异有统计学意义(P＜0.05)。在术后疼痛评分上研究组(3.35±0.23)各项数据均优于常规组(4.35±1.69),差异有统计学意义(P＜0.05)。研究组并发症发生率仅为5%,常规组并发症发生率有17.5%,研究组数据远要低于常规组,差异有统计学意义(χ^<sup>2=5.178,P=0.023)。结论 在膝关节镜下前交叉韧带损伤重建术治疗可有效改善膝关节活动性、稳定性、有效减轻患者的疼痛感,减少并发症的发生,促进膝关节功能的康复。关节镜下进行膝关节前交叉韧带损伤重建术治疗具有临床推广和采纳的价值。

Objective To investigate the clinical effect of arthroscopic anterior cruciate ligament (ACL) reconstruction. Methods 80 patients with ACL injury in our hospital from March 2018 to March 2020 were selected as the research objects. According to the different surgical methods, patients underwent the traditional open surgery for cruciate ligament injury reconstruction treatment were selected as the control group,patients underwent arthroscopic anterior cruciate ligament injury reconstruction treatment were as the study group, 40 patients in each group, the treatment effect of the two groups were compared. Results The Lysholm score (71.8±12.6) and and Lysholm instability score (13.2±1.6) of the control group were lower than those of the study group (83.9±12.9 and 19.3±2.3), the differences were statistically significant (P <0.05). In the postoperative pain score, the study group (3.35±0.23) data was better than the control group (4.35±1.69), the difference was statistically significant (P <0.05). The incidence of complications in the study group was only 2.5%, and that in the control group was 17.5%, which was significantly lower than the control group, and the difference was statistically significant (χ²= 5.178, P= 0.023). Conclusion Arthroscopic anterior cruciate ligament reconstruction can effectively improve the activity and stability of knee joint, effectively reduce the pain of patients, reduce the occurrence of complications, and promote the rehabilitation of knee joint function. Arthroscopic anterior cruciate ligament reconstruction has the value of clinical promotion and adoption.

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.

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.

目的 探讨无症状感染者在新冠肺炎家庭聚集性疫情中的传播风险,分析家庭聚集性疫情中所有患者的住院治疗情况,为防控策略和治疗方案制定提供依据。方法 通过现场流行病学调查获得旅居史和暴露危险因素,并收集临床治疗资料,利用统计软件进行作图和分析。结果 指示病例的潜伏期为15天,其余4名家庭成员的潜伏期为1～15天,其中指示病例作为无症状感染者,在感染后第4～6天内具有传染性相继导致4名成员感染;指示病例携带病毒8天以上,其余4人从2天到31天不等; 症状持续时间5~20天,住院期间共进行CT检查次数为4～10次,肺部炎症最快在住院第三天好转。发病初期只有1个病例出现白细胞、淋巴细胞降低。发病到就诊和住院的时间间隔为1～10天,平均住院时间为23.4天。结论 无症状感染者在家庭聚集性疫情传播中具有关键作用,难以及时发现,存在较大传播风险,为新冠肺炎疫情防控带来较大难度。

Objective To study the transmission risk of asymptomatic patient in a family-clustered outbreak of new coronavirus pneumonia, analyze the hospitalization,and provide a basis for prevention strategies and treatment plan. Methods We collected the information about residence history and exposure risks by onsite epidemiological investigation, and collected clinical treatment-related data, used statistical software for mapping and analysis. Results The incubation period of the indicated case was 15 days, and the incubation period of the remaining four family members were 1-15 days. The indicated case as an asymptomatic patient had infectious succession within 4-6 days after infection,and four family members were infected one after another. The indicated case carried the virus for more than 8 days, and the remaining 4 patients ranged from 2 to 31 days. The duration of symptoms was 5-20 days of all 5 patients, and the number of CT examinations during hospitalization was 4-10 times. The pulmonary inflammation was improved on the third day of hospitalization at best. In the early stage of the disease, only one patient had leukopenia and lymphopenia decreased. The interval between onset and hospitalization was 1-10 days for five family members, with an average hospitalization time of 23.4 days. Conclusion The asymptomatic infected patient of COVID-19 plays a key role in the family convergence epidemic transmission. The symptoms are inapparent, so it is difficult to find in time. It will cause the risk of infection and increase the difficulty of COVID-19 prevention and control.

前列腺癌作为最常见的男性泌尿系统恶性肿瘤之一,目前常规治疗手段主要为手术、放化疗、内分泌治疗等,但后期并发症、治疗副作用等问题突出,且多转化为去势抵抗性前列腺癌,预后极差。既往研究已然证实,中医药在前列腺癌的治疗中可有效减少复发、减轻症状,提高患者生活质量。本文旨在总结近几年中医药对前列腺癌的研究,为往后的研究与临床治疗提供一些新的思路。

Prostate cancer(PCa) is one of the most common male urinary system malignancies.At present,conventional treatment methods are mainly surgery, radiotherapy and chemotherapy, endocrine therapy,etc.However, late complications, treatment side effects and other problems are prominent, and prostate cancer tends to develop as castration-resistant prostate cancer (CRPC), and the prognosis is very poor. Previous studies have confirmed that Chinese medicine can effectively reduce recurrence incidence, relieve symptoms and improve the quality of life of patients in the treatment of prostate cancer. This article summarizes the research of traditional Chinese medicine on prostate cancer in recent years, and provides some new ideas for future research and clinical treatment.

目的 研究鼻内镜下应用低温等离子高选择性翼管神经分支切断治疗变应性鼻炎患者的临床疗效。方法 选取我院2019年1月—2020年12月收治的60例变应性鼻炎患者,随机数字表法分为对照组(30例)和观察组(30例)。对照组行保守治疗,观察组行鼻内镜下低温等离子高选择性翼管神经分支切断术治疗。比较两组治疗前后Lund—Kennedy内镜黏膜形态评分、视觉模拟量表(VAS)评分,分析两组治疗前后炎症细胞因子[血清肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)]及鼻黏膜功能指标[血管活性常态肠肽(VIP)、鼻腔阻力(NR)、鼻黏膜纤毛传输时间(MTT)、鼻黏膜纤毛输送率(MTR)]变化情况。结果 两组治疗后VAS评分、Lund—Kennedy评分较治疗前降低(P＜0.05);观察组治疗后VAS评分、Lund—Kennedy评分低于对照组(P＜0.05)。两组治疗后TNF-α、IL-4、IL-6水平较治疗前降低(P＜0.05);观察组治疗后TNF-α、IL-4、IL-6水平低于对照组(P＜0.05)。两组治疗后VIP、NR、MTT水平较治疗前降低(P＜0.05),MTR水平较治疗前升高(P＜0.05);观察组治疗后VIP、NR、MTT水平低于对照组(P＜0.05),MTR水平高于对照组(P＜0.05)。结论 鼻内镜下应用低温等离子高选择性翼管神经分支切断术治疗变应性鼻炎疗效显著,可改善鼻腔黏膜功能,减轻炎症反应,值得推广。

目的 观察牙周基础治疗联合口腔正畸对牙周炎患者炎症细胞因子的疗效分析。方法 以2017年4月—2018年5月于我院医院进行治疗的82例牙周炎患者为研究对象,按随机数字表法分为研究组(41例,给予牙周基础治疗联合口腔正畸)和对照组(41例,口腔正畸)。观察两组患者治疗后临床疗效,对比治疗前后两组患者牙周指数情况、血清炎症因子及咀嚼功能。结果 治疗1周后,研究组有效率高于对照组(97.56% vs 82.93%),组间比较(P<0.05)。治疗前,两组SBI、PLI、GI比较(P＞0.05);治疗1周后,两组SBI、PLI、GI均低于治疗前,与对照组SBI、PLI、GI比较,研究组降低,组间比较(P<0.05)。治疗前,两组AL、PD比较(P＞0.05);治疗1周后,两组AL、PD均低于治疗前,与对照组AL、PD比较,研究组降低,组间比较(P<0.05)。治疗前,两组TNF-α、IL-8及IL-6水平比较(P＞0.05);治疗1周后,两组TNF-α、IL-8及IL-6水平均低于治疗前,与对照组TNF-α、IL-8及IL-6水平比较,研究组下降明显,组间比较(P<0.05)。治疗前,研究组及对照组的咀嚼功能分别为(51±2)分、(52±2)分,两组比较(P＞0.05);治疗后1周,研究组及对照组的咀嚼功能分别为(85±4)分、(73±3)分,研究组咀嚼功能明显高于对照组,组间比较(P<0.05)。结论 牙周基础治疗联合口腔正畸治疗牙周炎患者效果确切,可降低炎症反应,值得临床推广应用。