目的 分析口腔种植修复和常规修复在牙列缺损治疗中的有效性。方法 选定本院2019年1月—2020年12月接诊的120例牙列缺损患者,根据修复治疗方法的不同分组,参照组60例患者采取常规修复治疗,实验组60例患者采取口腔种植修复,比较两组临床疗效、龈沟炎症因子水平、并发症发生率、满意度评分。结果 实验组临床总有效率(96.67%)高于参照组(78.33%),实验组治疗后龈沟TNF-α、IL-8、IL-6因子均低于参照组,实验组并发症发生率(1.67%)低于参照组(13.33%),实验组患者满意度评分均高于参照组,差异均有统计学意义(P＜0.05)。结论 口腔种植修复可有效改善牙列缺损患者语言、咀嚼功能,减轻龈沟炎症反应,减少并发症,提高患者满意度。

Objective To analyze the efficacy of dental implant and conventional repair in the treatment of dentition defects. Methods A total of 120 patients with dentition defects in our hospital from January 2019 to December 2020 were selected and divided into two groups according to different treatment methods. Sixty patients in the control group were treated with conventional repair, and 60 patients in the experimental group were treated with dental implant repair. The clinical efficacy, gingival crevicular inflammatory factors level, complication incidence and satisfaction score of the two groups were compared. Results The clinical efficacy of the experimental group (96.67%) was higher than that of the control group (78.33%), the levels of TNF-α, IL-8 and IL-6 in the gingival sulcus of the experimental group were lower than those of the control group after treatment, the complications incidence of the experimental group (1.67%) was lower than that of the control group (13.33%), and the satisfaction score of the experimental group was higher than that of the control group, the differences were statistically significant (P＜0.05). Conclusion Dental implant repair could effectively improve the language and chewing function of patients with dentition defects, reduce gingival crevicular inflammatory reaction, complications and improve patients' satisfaction.

目的 分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇接受胰岛素治疗对妊娠结局的影响及安全性。方法 将2018年7月—2020年7月接诊且行常规治疗的50例GDM孕妇作为对照组,将同期接诊且在对照组基础上行胰岛素治疗的50例GDM孕妇作为观察组,对组间血糖控制效果、生活质量(SF-36)、治疗效果、不良妊娠结局、不良反应展开分析。结果 (1)组间血糖指标在治疗前无明显差异(P＞0.05);治疗后,观察组血糖控制效果优于对照组(P<0.05);(2)观察组SF-36评分高于对照组,且治疗效果(96.00%)优于对照组(82.00%,P<0.05);(3)观察组出现3例不良妊娠结局(6.00%),对照组出现11例不良妊娠结局(22.00%,P<0.05);(4)观察组发生3例不良反应(6.00%),对照组发生2例不良反应(4.00%,P＞0.05)。结论 对GDM孕妇实施胰岛素治疗,可以改善孕妇血糖水平,减少不良妊娠结局,提高孕妇生活质量,安全可靠,值得推广。

Objective To analyze the effect and safety of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus (GDM). Methods A total of 50 pregnant women with GDM who received conventional treatment from July 2018 to July 2020 were induded in the control group, and 50 pregnant women with GDM who received insulin treatment on the basis of the control group were induded in the observation group. Results (1) There was no significant difference in blood glucose index between two groups before treatment(P＞ 0.05); after treatment, the blood glucose control effect of the observation group was better than that of the control group(P<0.05); (2) SF-36 score of the observation group was higher than that of the control group, and the treatment effect (96.00%) was better than that of the control group (82.00%,P<0.05); (3) there were 3 cases of adverse pregnancy outcomes (6.00%) in the observation group and 11 cases (22.00%) in the control group; (4) there were 3 cases of adverse reactions (6.00%) in the observation group and 2 cases (4.00%) in the control group(P＞ 0.05). Conclusion Insulin therapy for pregnant women with GDM could improve the blood glucose level of pregnant women, reduced adverse pregnancy outcomes, improved the quality of life of pregnant women, which is safe and reliable, and is worthy of promotion.

目的 探究硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤的疗效及对患者不良反应发生的影响。方法 研究对象为我院2016年1月—2020年12月收治的60例骨髓瘤患者,将其随机分为研究1组(n=20)、研究2组(n=20)与对照组(n=20)。对照组给予硼替佐米联合沙利度胺及地塞米松化疗,研究1组给予硼替佐米联合环磷酰胺及地塞米松化疗,研究2组给予硼替佐米联合来那度胺及地塞米松化疗。对比三组治疗效果、免疫功能变化情况、相关血清因子水平以及骨代谢因子水平变化情况。结果 对照组治疗有效率85.0%比研究1组95.0%、研究2组90.0%低(P＜0.05);三组治疗前的免疫对比无较大差异(P＞0.05),对照组经治疗后的免疫功能比研究组差(P＜0.05);三组治疗前的相关血清因子水平比较无较大差异(P＞0.05),对照组经治疗后的相关血清因子水平比研究1组、研究2组高(P＜0.05);对照组经治疗后的骨代谢因子水平变化比研究1组、研究2组差(P＜0.05)。结论 硼替佐米、地塞米松联合环磷酰胺治疗骨髓瘤效果理想,药物不良反应发生率下降,患者生活质量得到改善,可在临床推广应用。

Objective To investigate the clinical efficacy of bortezomib,dexamethasone combined with cyclophosphamide in the treatment of myeloma and the effect on the occurrence of adverse reactions in patients. Methods The subjects were 60 myeloma patients admitted to our hospital from January 2016 to December 2020, and they were randomly divided into study group 1 (n=20), study group 2 (n=20) and control group (n=20). The control group received bortezomib combined with thalidomide and dexamethasone chemotherapy, the study group 1 received bortezomib combined with cyclophosphamide and dexamethasone chemotherapy, and the study group 2 received bortezomib combined with lenalidomide and dexamethasone chemotherapy. The therapeutic efficacy, the changes of immune function,serum factors and bone metabolism factors were compared among the three groups. Results The effective rate of control group was 85.0%, which was lower than those of study group 1 and study group 2 (P＜0.05). There was no significant difference of immune function among the three groups before treatment (P＞0.05), which of the control group after treatment was worse than that of the study groups (P＜0.05). There were no significant differences in the levels of related serum factors among the three groups before treatment (P＞0.05),which in the control group after treatment was higher than those in the study group 1 and study group 2 (P＜0.05). After treatment, the changes of bone metabolic factors in control group were worse than those in study group 1 and study group 2 (P＜0.05). Conclusion Bortezomib, dexamethasone combined with cyclophosphamide in the treatment of myeloma had ideal effect, and the incidence of adverse drug reaction was reduced, the quality of life of patients was improved, which can be popularized in clinical application.

目的 探讨大黄穴位贴联合直肠指力刺激在脑卒中后便秘患者的应用效果。方法 本研究选择2019年1月—2019年12月间我院收治的脑卒中后便秘患者90例,随机分成A组(大黄穴位贴组),B组(直肠指力刺激组),C组(大黄穴位贴联合直肠指力刺激组)三组,每组30例。记录三组患者便秘治疗有效率,采用Wexner便秘评分系统评估三组患者治疗前后的便秘程度并进行自身前后对比。结果 三组干预前后Wexner评分采用自身配对非参数秩和检验,差异有统计学意义(P＜0.05)。三组干预前后差值采用Kruskal-Wallis H检验结果差异有统计学意义(H=26.211,P＜0.05),经过两两对比,差异有统计学意义(P＜0.05)。值得注意的是,干预后C组Wexner评分下降。干预后C组患者的有效率高于其他两组,有效率结果为C组(90%)＞B组(80%)＞A组(53.5%),差异有统计学意义(P＜0.05)。结论 相较于单一应用大黄穴位贴或直肠指力刺激,大黄穴位贴联合直肠指力刺激治疗效果更好,可有效降低便秘发生率,提高病人生活质量。

Objective To explore the effect of rhubarb acupoint application combined with rectal finger force stimulation in patients with constipation after stroke. Methods In this study, 90 patients with post-stroke constipation admitted to our hospital from January 2019 to December 2019 were randomly divided into group A (rhubarb acupoint application group), group B (rectal finger force stimulation group) and group C (rhubarb acupoint application combined with rectal finger force stimulation group), 30 cases in each group. The effective rates of constipation treatment in the three groups were recorded, and the Wexner constipation scoring system was used to evaluate the degree of constipation before and after treatment among three groups. Results The Wexner scores of the three groups before and after treatment were analyzed by self-paired non-parametric rank sum test, and the differences were statistically significant (all P<0.05). The difference among the three groups before and after treatment using Kruskal-Wallis H test was statistically significant (H=26.211, P<0.05), and after pairwise comparison, the differences were statistically significant (P<0.05). It was worth noting that the Wexner score of group C dropped significantly after treatment. The effective rate of treatment in group C was significantly higher that those in the other two groups. The result showed effective rate of group C (90%)＞ group B (80%)＞group A (53.5%), the difference was statistically significant (P<0.05). Conclusion Compared with the single treatment of rhubarb acupoint application or rectal finger force stimulation, the combined treatment had better efficacy, which reduced incidence of constipation and improved the quality of life of patients.

目的 盾叶冠心宁片与复方丹参滴丸治疗冠心病稳定型心绞痛临床疗效比较。方法 选取于2017年10月—2018年10月至延安大学附属医院诊治的120例冠心病稳定型心绞痛患者。随机将所有患者分为2组,观察组患者在常规西药治疗基础上加服盾叶冠心宁片,对照组患者在常规西药治疗基础上加服复方丹参滴丸,比较两组患者治疗6个月后的临床疗效。结果 经过6个月治疗后,观察组患者的治疗有效率为66.7%,对照组患者的治疗有效率为40.0%。观察组与对照组治疗效果相比,差异有统计学意义(P＜0.05)。盾叶冠心宁片治疗冠心病稳定型心绞痛的综合疗效优于复方丹参滴丸。结论 冠心病稳定型心绞痛患者在常规西药治疗不变的基础上加用盾叶冠心宁片,不仅能改善临床心绞痛症状,还能调节血脂异常及降低同型半胱氨酸水平,以及缓解患者情绪及睡眠问题,且安全性高,有较高临床应用价值。

Objective To compare the clinical efficacy of Dunye Guanxinning tablets and Compound Danshen dropping pills in the treatment of stable angina pectoris caused by coronary heart disease. Methods 120 patients with stable angina pectoris were selected from the affiliated hospital of Yan'an University from October 2017 to October 2018.All patients were randomly divided into two groups. The observation group was treated with Dunye Guanxinning tablets on the basis of conventional western medicine, while the control group was treated with Compound Danshen dropping pills on the basis of conventional western medicine. The clinical efficacy of the two groups was compared after 6 months of treatment. Results After 6 months of treatment, the effective rate was 66.7% in the observation group and 40.0% in the control group. The treatment effect of the observation group was statistical different from that of the control group (P<0.05). The comprehensive curative effect of Dunye Guanxinning tablets in treating stable angina pectoris of coronary heart disease is better than that of Compound Danshen dropping pills. Conclusion The use of Dunye Guanxinning tablets in patients with stable angina pectoris after conventional western medicine treatment may not only improve the symptoms of clinical angina pectoris, but also regulate dyslipidemia and reduce homocysteine level, as well as alleviate the patients' emotional and sleep problems. It has high safety and high clinical application value.

目的 探讨增生期糖尿病视网膜病变患者经全视网膜激光光凝治疗的临床效果。方法 选取2016年2月—2019年3月我院收治的增生期糖尿病视网膜病变患者97例,使用随机数表法分为观察组(49例)与对照组(48例)。对照组患者接受黄斑格栅样光凝治疗,观察组患者则接受全视网膜激光光凝治疗。收集2组患者手术前后视力、黄斑中心凹容积、乳头周边视网膜神经纤维层厚度及视网膜厚度变化情况等数据进行分析,并对比生活质量评分。结果 治疗前,2组患者视乳头旁视网膜神经纤维层厚度、黄斑中心凹容积以及视网膜厚度之间差异无统计学意义(P＞0.05),具有可比性。接受不同治疗后,观察组患者上述3项指标均优于对照组患者(P＜0.05)。观察组患者治疗总有效率为79.59%,高于对照组患者治疗总有效率59.18%(P＜0.05)。此外,观察组患者在精细动作、调节能力、日常生活及远视力、光感和移动4个维度评分均高于对照组患者(P＜0.05)。结论 与黄斑格栅样光凝治疗相比,增生期糖尿病视网膜病变患者接受全视网膜激光光凝治疗有助于改善其乳头周边视网膜神经纤维层厚度和黄斑区视网膜厚度,能够显著促进视力恢复,提升患者生活质量,疗效确切。

Objective To investigate the clinical effect of panretinal laser photocoagulation for proliferative diabetic retinopathy. Methods 97 cases of proliferative diabetic retinopathy in our hospital from Feb 2016 to Mar 2019 were enrolled in the study, and were divided into 2 groups randomly. The control group received treatment of macular grid photocoagulation, while the observation group received whole retina laser photocoagulation. Data of visual acuity, macular fovea volume, retinal nerve fiber layer thickness around nipple and retinal thickness before and after operation were collected and analyzed, and quality of life scores were compared. Results Before treatment, there was no significant difference in retinal nerve fiber layer thickness, macular fovea volume and retinal thickness between the two groups (P>0.05), which was comparable. After different treatments, the three indexes mentioned above in the observation group were better than those in the control group (P<0.05). The total effective rate of the observation group was 79.59%, which was higher than that of the control group (59.18%, P<0.05). In addition, the scores of fine motion, accommodation ability, daily life and distant vision, light perception and movement in the observation group were higher than those in the control group (P<0.05). Conclusion Compared with macular grid-like photocoagulation, panretinal laser photocoagulation may improve the retinal nerve fiber layer thickness around the nipple and macular retinal thickness in patients with proliferative diabetic retinopathy. It promotes the recovery of visual acuity, improves the quality of life of patients, and has definite curative effect.

目的 探讨不同甲状腺结节手术治疗方案的合理性及临床效果。方法 选取本院2018年1月—2019年1月收治的120例患有甲状腺结节患者为研究对象,将其随机分为A组和B组各60例,A组患者未进行甲状腺细针抽吸细胞学检查直接进行甲状腺结节切除手术,B组患者接受超声负压引导甲状腺细针抽吸细胞学检查后给予手术治疗方案,比较两组患者手术前、后良恶性结节患者变化、术后复发率、并发症发生率及手术疗效。结果 术后A组残余恶性结节患者比例高于B组(P=0.001),A组健康无结节病变患者占比低于B组(P=0.002),A组患者恶性结节复发率高于B组患者(P<0.05);两组术后并发症发生率无差异(P>0.05),A组手术治疗总有效率低于B组(P<0.05)。结论 甲状腺结节患者术前有效超声穿刺诊断、术中超声引导手术及术后抗癌化疗治疗方案可以提高甲状腺结节患者手术有效率,B组方案具有重要临床推广价值。

Objective To investigate the rationality and clinical effect of different thyroid nodules surgical treatment. Methods A total of 120 patients with thyroid nodules admitted to our hospital from January 2018 to January 2019 were randomly divided into group A and group B, respectively. Group A patients did not undergo fine needle extraction. Aspiration cytology was performed directly for thyroid nodule resection. Group B patients underwent ultrasound negative pressure guided thyroid fine needle aspiration cytology and were given surgical treatment. The changes of benign and malignant nodules before and after surgery were compared between the two groups including postoperative recurrence rate, complication rate and surgical outcome. Results The proportion of patients with residual malignant nodules in group A was higher than that in group B (P=0.001). The proportion of patients with healthy no-nodular lesions in group A was lower than that in group B (P=0.002). The recurred rate of malignant nodules in group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The total effective rate of group A was lower than that of group B (P<0.05). Conclusion Preoperative effective ultrasound puncture diagnosis, intraoperative ultrasound guided surgery and postoperative anticancer chemotherapy treatment may improve the efficiency of thyroid nodules in patients with thyroid nodules. Group B has important clinical value.

目的 基于网络药理学方法预测银杏叶治疗心肌缺血的潜在靶点及信号通路。方法 利用 TCMSP 平台筛选生物利用度(OB)≥ 30% 和类药性(DL)≥ 0.18 的活性成分及作用靶点。利用GeneCards和OMIM数据库检索心肌缺血疾病相关靶点,并提取药物成分和心肌缺血疾病的共有靶点作为关键靶点。通过在线TRING平台构建PPI网络,并采用Cytoscape 软件构建可视化的“化合物-靶点-通路”网络,进一步进行GO 功能富集分析和KEGG通路富集分析。结果 筛选得到 27种潜在的药效成分,2 164个化合物靶点,531个心肌缺血相关靶基因。两者取交集后获得疾病-类药活性成分40个共同靶点,PPI 蛋白互作网络自由度较高的节点依次为:IL6、VEGFA、CASP3、MAPK8、MYC、NOS3。GO 功能富集分析得到42个 GO 条目,KEGG 通路富集分析得到42条信号通路。结论 银杏叶治疗心肌缺血主要GO 能力富集在半胱氨酸肽链内切酶活性,内肽酶活力,激活转录因子结合,DNA结合转录激活剂活性,RNA聚合酶II特异性等功能,调控TNF信号通路,糖尿病并发症的年龄愤怒信号, 细胞凋亡,PI3K-Akt信号通路等信号,进一步达到对心肌缺血疾病的治疗。

Objective To predict the potential targets and signal pathways of ginkgo leaf in the treatment of myocardial ischemia based on network pharmacology. Methods The active components and targets of bioavailability (OB) ≥ 30% and drug-like (DL) ≥ 0.18 were screened by TCMSP platform.The related targets of myocardial ischemic diseases were searched by GeneCards and OMIM database, the components and the common targets of myocardial ischemic diseases were extracted as the key targets. To build the PPI network through the online STRING platform, a visual “compound-target-pathway” network was constructed to further analyze the functional enrichment of GO and the enrichment of KEGG pathway. Results 27 potential active components, 2 164 compound targets and 531 myocardial ischemia related target genes were screened. After the intersection of the two, 40 common targets of disease-class active components were obtained. The nodes with higher degree of freedom of PPI protein interaction network were IL6、VEGFA、CASP3、MAPK8、MYC and NOS3.42 entries were obtained by GO functional enrichment analysis and 42 signal pathways were obtained by KEGG pathway enrichment analysis. Conclusion Ginkgo leaf may be a target of cysteine-type endopeptidase activity,endopeptidase activity,activating transcription factor binding,DNA-binding transcription activator activity, RNA polymerase II-specific function. TNF signaling pathway, AGE-RAGE signaling pathway in diabetic complications, apoptosis, PI3K-Akt signaling pathway were regualted to achieve the treatment of myocardial ischemia disease.

目的 探讨替诺福韦酯单药治疗在慢性乙型肝炎(CHB)后肝硬化失代偿期(DCC)治疗中的长期应用价值。方法 随机将84例CHB后DCC患者分为对照组及观察组,每组42例。对照组接受拉米夫定联合阿德福韦酯治疗,观察组接受替诺福韦酯治疗。对比两组12个月内治疗时间内的死亡率及肝癌发生率,并分析两组肝功能、肝硬化指标及Child-Pugh评分变化趋势,同时对比两组治疗过程中HBeAg转阴率、HBV-DNA转阴率及失代偿好转率。此外,对比两组治疗不良反应的发生率。结果 在12个月的治疗时间内,两组死亡率及肝癌发生率比较,差异无统计学意义(P>0.05)。而两组治疗过程中ALT、AST、HA、LN、PCⅢ及Child-Pugh评分呈降低趋势,ALB呈升高趋势(P<0.05);治疗6个月及12个月时,治疗组ALT、AST、HA、LN、PCⅢ及Child-Pugh评分低于对照组,ALB高于对照组(P<0.05)。而两组12个月治疗完成后,HBeAg转阴率比较差异无统计学意义,但观察组HBV-DNA转阴率高于对照组(P<0.05)。此外,两组治疗不良反应发生率比较差异无统计学意义(P>0.05)。结论 在CHB后DCC的治疗中,替诺福韦酯单药治疗方案具有良好的长期治疗效果。

Objective To evaluate the long-term value of tenofovir disoproxil monotherapy in the decompensated cirrhosis(DCC) after chronic hepatitis B(CHB). Methods Eighty-four patients with DCC after CHB were randomly divided into control group and observation group, 42 cases in each group. The control group received lamivudine combined with adefovir dipivoxil, and the observation group received tenofovir disoproxil. Mortality and incidence of liver cancer within 12 months of treatment between the two groups were compared, and the change trend of liver function, liver fibrosis index and child-pugh score in the two groups were analyzed. At the same time,we compared the conversion rate of HBeAg, HBV-DNA and decompensated positive rate between the two groups. In addition, the incidence of adverse reactions were compared between the two groups. Results Within 12 months of treatment, there were no statistically significant differences in mortality and liver cancer incidence between the two groups(P>0.05). And during the treatment, the ALT, AST, HA, LN, PC Ⅲ and Child-Pugh score showed a decrease trend, ALB showed a increase trend(P<0.05). After 6-month and 12-month treatment, ALT, AST, HA, LN, PC Ⅲ Child-Pugh score of treatment group were lower than that of control group, ALB was higher than that of control group(P<0.05). After 12 months of treatment, the negative conversion rate of HBV-DNA in the observation group was higher than that of control group(P<0.05). In addition, there was no statistically difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Tenofovir disoproxil monotherapy has a good long-term therapeutic effect in the treatment of DCC after CHB.

目的 探讨食管胃静脉曲张精准断流术与改良“三明治”法治疗食管胃静脉曲张的临床疗效。方法 选取共50例食管胃底静脉曲张患者,按随机数字法分为精准治疗组和对照组,精准治疗组(n=25)行内镜下食管胃静脉曲张精准断流术,对照组(n=25)接受改良“三明治”法内镜治疗。分析对比两组的止血成功率、再出血率、治疗显效率、并发症发生率、聚桂醇和组织胶用量、治疗时间及住院天数等指标。结果 治疗后随访3个月,术后3天内止血率两组均为100％。再出血率精准治疗组为4%,对照组为32%,差异有统计学意义(P=0.010)。静脉曲张治疗显效率精准治疗组为84%,对照组出血率为52%,差异有统计学意义(P=0.015)。并发症发生率在两组间差异无统计学意义(P>0.05)。聚桂醇和组织胶平均用量在两组间差异无统计学意义(P>0.05)。精准治疗组平均治疗时间为(32.60±6.44)min,对照组为(40.60±7.26)min,差异有统计学意义(P<0.0001);精准治疗组平均住院天数为(8.12±1.24)d,对照组为(9.12±1.39)d,差异有统计学意义(P=0.010)。结论 内镜下精准断流术治疗食管胃静脉曲张再出血率低、效果好、安全性高。

Objective To investigate the clinical efficacy of endoscopic selective varices devascularization and the modified Sandwich method on the treatment of esophagogastric varices. Methods 50 patients with esophagogastric varices were divided into therapy (endoscopic selective varices devascularization)group (n=25) and control group (n=25) by random number table method. The therapy group (n=25) received the treatment of endoscopic selective varices devascularization. The control group (n=25) was treated with modified Sandwich method injection. The success rate of hemostasis, rate of recurrent bleeding, rate of varices disappearance, complication rate, dosage of lauromacrogol and tissue adhesive, time of therapy and hospitalization days were compared and analyzed between the two groups. Results During the 3-month followup, the success rates of hemostasis were 100% in both groups 3 days after the treatments. The rates of recurrent bleeding in therapy group and control group were 4% and 32% respectively, with statistically significant difference (P=0.010). The rates of varices disappearance in therapy group and control group were 84%and 52% respectively, the difference (P=0.015) was statistically significant. There was no statistically significant difference in complication rates between the two groups(P>0.05). There was also no statistically significant difference in the average dosage of lauromacrogol and tissue adhesive between the two groups(P>0.05). The average time of therapy in therapy group and control group were(32.60±6.44)minutes and(40.60±7.26)minutes respectively, with statistically significant difference between the two groups(P=0.000). The average hospitalization days in therapy group and control group were(8.12±1.24)days and(9.12±1.39)days respectively, which is statistically significant difference between the two groups(P=0.010). Conclusion Endoscopic selective varices devascularization has the obvious advantage of a significant efficacy, low recurrence rate and high safety.