目的 本研究观察应用鼻喷激素联合白三烯受体拮抗剂在腺样体肥大患儿中治疗的效果。方法 选择2016年2月—2018年3月期间在广州市某区妇幼保健院耳鼻咽喉科确诊腺样体肥大的患儿,在患儿及家长知情同意的基础上,按照随机数字表法将87例耳鼻咽喉科诊断为腺样体肥大的儿童分为研究组和对照组。前者给予鼻喷激素联合白三烯受体拮抗剂进行治疗,后者独立使用白三烯受体拮抗剂进行治疗,比较两组患儿的临床治疗效果和不适症状的改善程度。结果 研究组腺样体肥大患儿临床症状得分小于对照组,优于对照组的治疗效果,差异有统计学意义(P＜0.05);且对比对照组,研究组患儿经鼻呼吸困难、入睡时打鼾、鼻部阻塞感等不适症状明显减轻。结论 鼻喷激素联合白三烯受体拮抗剂治疗儿童腺样体肥大,临床症状改善较为明显,具有经济性,家属及患儿接受度较高,相比手术创伤小,在基层医院推广有一定的价值。

目的 探讨Meis1在人子宫内膜细胞中的表达及其受雌、孕激素调控的规律。方法 通过免疫细胞化学和western blot的方法检测雌、孕激素对体外培养的在子宫内膜基质细胞(ESC)及Ishikawa细胞中Meis1的表达及调控。结果 Meis1在ESC和Ishikawa细胞均有表达,且均表达于细胞核中;在ESC中,E2、P4和 E2＋P4三组中Meis1平均蛋白表达水平均高于对照组(P<0.05)。Meis1在E2、P4和 E2＋P4组之间的表达水平亦差异有统计学意义(P<0.05),表达强度E2＋P4组>P4组>E2组;在Ishikawa细胞中,E2、P4和 E2＋P4使Meis1表达增强,表达强度P4组>E2＋P4组>E2组,但与对照组比较无差异(P>0.05),E2、P4和 E2＋P4各组间亦无差异(P>0.05)。结论 转录因子Meis1在ESC和Ishikawa细胞中受到雌、孕激素的调控,可能在子宫内膜容受性分子网络的构建中发挥着重要的作用。

Objective To investegate the expression and regulation discipline of Meis1 in human ESC and Ishikawa cells in vitro by estrogen and progesterone stimuli. Methods Immunocytochemistry and western blot were used to detect the expression and regulation discipline of Meis1 in human normal endometrial cells. Results Meis1 expressed both in endometrial stromal cells (ESC) and in ishikawa cells, and both situ in nucleus. In ESC, the expression of Meis1 was up-regulated by E₂/P₄ and E₂＋P₄, and the up-regulated effect may be superposition by E₂＋P₄, the differences between the groups were statistically difference(P<0.05). In Ishikawa cells, western blot showed that the expression of Meis1 was up-regulated by E₂/P₄ and E₂＋P₄. The differences weren't statistically significant when compared with the control group or between themselves(P>0.05). Conclusion The expression of transcription factor Meis1 is regularly regulated by estrogen and progesterone, which may be a key role during the formation of endometrial receptivity molecular network.

目的 探讨广东汉族儿童ACE2基因A9570G多态性与儿童激素敏感型肾病综合征(SSNS)复发的关系。方法 选取广东汉族SSNS患儿92例,按发病后1年复发情况分为频复发组31例、非频复发组61例,健康体检者60例为对照组,采用聚合酶链反应-DNA直接测序技术观察患儿与对照组ACE2基因A9570G基因型分布和等位基因频率。结果 在女性,SSNS组G等位基因频率及GG基因型分布均低于对照组(39％ vs 65％,P<0.05;27％ vs 50％,P<0.05);在男性,SSNS组G等位基因/GG基因型分布亦低于对照组(35％ vs 60％,P<0.05 )。亚组分析发现,在女性,频复发组G 等位基因频率及GG 基因型分布均高于非频复发组(58％ vs 29％,P<0.05;42％ vs 19％,P<0.05);在男性,频复发G基因型/G等位基因频率高于非频复发(58％ vs 24％,P<0.05)。结论 ACE2基因A9570G多态性与儿童SSNS复发相关,携带G等位基因的患儿容易表现为频复发。

Objective To investigate the association between the A9570G polymorphism of ACE2 gene and the relapse of steroid-sensitive nephrotic syndrome (SSNS) in Han childhood of Guangdong.Methods Ninety-two children with SSNS were selected from Guangdong Han nationality. According to the relapse frequency during the first year of the disease, 31 cases with more than 3 relapses were as frequency relapse group, 61 cases with less than 3 relapses were as non-frequent relapse group, and 60 healthy children were as control group. The gene distribution and allele frequency of ACE2 gene A9570G were observed by polymerase chain reaction-DNA direct sequencing technology.Results In female,the distribution of G allele frequency and GG genotype in SSNS group were significantly lower than that in the control group(39％ vs 65％, P<0.05; 27％ vs 50％, P<0.05). In male, the distribution of G allele/GG genotype in SSNS group was also significantly lower than that in the control group(35% vs 60%, P<0.05). Subgroup analysis found that the distribution of G allele frequency and GG genotype in female of the frequency relapse group were significantly higher than that of the non-frequency relapse group(58% vs 29%, P<0.05; 42% vs 19%, P<0.05), and the distribution of G allele/GG genotype in male of the frequency relapse group was significantly higher than that of the non-frequency relapse group (58% vs 24%, P<0.05).Conclusion The A9570G polymorphism of ACE2 gene was associated with the recurrence of children's SSNS, and the children with G allele were susceptible to recurrence.

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。

雄激素性脱发是一种人群中常见的损容性疾病,其发病与多种因素有关,而遗传因素在发病率中具较大的影响。低能量激光疗法(Low-Level Laser Therapy)是近年来用于治疗雄激素性脱发的光疗技术。低能量激光是一种低能量,短波长的激光,因早期研究发现其具有促进毛发生长的作用而被用于研究治疗雄激素性脱发(AGA)。在低功率激光疗法中,通过使用低能量激光照射毛囊,使毛囊炎性反应得以减轻,同时促进细胞新陈代谢,从而使休止期毛囊复苏,达到促进毛发生长的作用。本文通过对低能量激光疗法治疗雄激素性脱发的机制及效果进行论述,并讨论局部治疗、系统治疗等其他方法联合低功率激光在AGA治疗中的研究进展。

Androgenetic alopecia is a common and ashamed disease in the human population. Its incidence is related to a variety of factors, and the gene have a greater impact on the incidence. Low-level laser therapy LLLT is a phototherapy technique for the treatment of androgenetic alopecia in recent years. Low-level laser means low-energy, short-wave length that have been used for research and treatment of androgenetic alopecia because of the early discovery which is promoting hair growth. In LLLT, the laser irradiates hair follicles, so that reduces the folliculitis, while promoting cell metabolism.From this, the dormant hair follicles resume growth. This article discusses the mechanism and effect of low-level laser therapy for the treatment of androgenetic alopecia, and further discusses the advancement of topical treatment, systemic treatment, and other methods which combined with low-level laser in the treatment of AGA.

目的 探讨广州地区老年人维生素D水平及其与骨密度、甲状旁腺激素的相关性。方法 收集2016年6月—12月在广州市第一人民医院老年病科就诊的患者。检测25-羟维生素D、甲状旁腺激素、Ⅰ型前胶原氨基端前肽、β-Ⅰ型胶原C端肽、腰椎和髋部骨密度。将患者分为维生素D缺乏组(≤20 ng/mL)、维生素D不足组(20～30 ng/mL)、维生素D充足组(≥30 ng/mL)。结果 ①426例研究对象的平均年龄是(79.77±7.69)岁,25羟维生素D平均值是(20.38±8.20)ng/mL。维生素D缺乏、不足、充足者比例分别是53%(226/426)、34.3%(146/426)、12.7%(54/426)。②25羟维生素D水平随年龄增加而降低。25羟维生素D与股骨颈和全髋骨密度呈正相关(r=0.18,P＜0.001),与甲状旁腺激素呈负相关(r=-2.05,P＜0.001)。结论 广州地区老年人维生素D不足及缺乏十分普遍。维生素D与股骨颈、髋部骨密度呈正相关,与甲状旁腺激素呈负相关。

Objective To investigate the vitamin D level of elder people in Guangzhou and the relationship in vitamin D, bone mineral density and parathyroid hormone. Methods To screening elderly patients in the geriatric department of Guangzhou First peoples Hospital from June to December 2016.Serum 25-hydroxy vitamin D,parathyroid hormone,procollagen typeⅠN-terminal propeptide,β-crosslaps of C-telopeptide of typeⅠcollagen,bone mineral density were measured.Three groups were divided according to the serum 25(OH)D level,including deficiency group(≤20 ng/mL),insufficiency group(20-30 ng/mL) and sufficiency group(≥30 ng/mL). Results The mean age of the 426 subjects was 79.77±7.69 years old. The average level of 25(OH)D was 20.38±8.20 ng/mL. The proportion of vitamin D deficiency, insufficient and sufficient persons were 53% (226/426), 34.3% (146/426), and 12.7% (54/426). The level of 25 hydroxy vitamin D was decreased with age.Correlation analysis showed that 25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density(r=0.18,P＜0.001),was negatively correlated with parathyroid hormone(r=-2.05,P＜0.001). Conclusion Vitamin D deficiency or insufficiency is highly prevalent in elderly men in Guangzhou.25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density, negatively correlated with parathyroid hormone.

目的 比较阿那曲唑与他莫昔芬治疗激素受体阳性绝经后转移性乳腺癌[HR（+）MBC]的疗效和安全性。方法 本次研究对象为在我院诊治的80例HR（+）MBC患者,选取时间段为2016年1月—2018年1月,随机分为各40例的阿那曲唑组与他莫昔芬组,比较两组临床疗效及安全性差异。结果 治疗3个月后,阿那曲唑组的临床缓解率（92.50%）优于他莫昔芬组（72.50%）,性激素E2、LH、P水平低于他莫昔芬组,T水平高于他莫昔芬组（P<0.05）;治疗期间,两组患者的不良反应发生率（30.00%、25.00%）比较无统计学意义（P>0.05）。结论 阿那曲唑治疗HR（+）MBC效果确切,有利于调节机体性激素水平,减慢癌症进展,对于提高患者的生存质量有重要意义。

目的 观察尝试采用激素替代疗法(hormonereplace menttherapy,HRT)治疗更年期疾病的干眼症的临床疗效。方法 将80例(160眼)干眼症患者随机分成2组,治疗组40例(80眼)在滴人工泪液的基础上采用激素替代疗法(HRT)口服治疗。对照组40例(80眼)单纯采用人工泪液滴眼液滴双眼。两组同时给予综合护理。3个月后观察疗效。结果 治疗组总有效率82.5%,对照组总有效率60%,两组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论 在人工泪液滴眼液滴双眼的基础上尝试采用激素替代疗法(HRT)治疗更年期疾病的干眼症患者,效果优于单纯应用人工泪液点眼。

Objective To investigate the role of hormone replace menttherapy (HRT) in treating xerophthalmia among patients with climacteric disease. Methods Eighty xerophthalmia patients (160 eyes) were randomly divided into two groups. Forty patients in the treatment group (80 eyes) were treated using combined HRT and artificial drops. Forty patients in the control group (80 eyes) were treated using artificial drops alone. All patients were provided comprehensive nursing. The evaluation of clinical effects was performed after 3 months of treatment. Results The total effective rate of both groups was 82.5% in the treatment group and 60% in the control group, respectively (P<0.05). Conclusion Combined HRT and artificial drops is more effective in treating climacteric disease-related xerophthalmia than using artificial drops only.

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 评估SCORTEN评分与我国SJS/TEN患者疾病严重程度的一致性,比较单用糖皮质激素(TCS)和糖皮质激素—丙种球蛋白冲击(TCS-IVIG)联合治疗SJS/TEN的临床效果。方法 收集我院2005年6月—2015年5月住院的SJS/TEN患者,计算每例患者的SCORTEN评分,采用Hosmer-Lemeshow检验评估SCORTEN模型的预期死亡率和实际死亡率的拟合度;比较单用TCS和TCS-IVIG联合治疗的患者在疾病严重程度、住院天数、疾病控制时间和死亡率方面的差异。结果 SCORTEN模型的预期死亡率和实际死亡率之间的拟合度良好(各组P值均大于0.5);二组患者在住院天数、疾病控制时间和死亡率方面的差异没有统计学意义(P分别为0.105,0.910,0.701),但TCS-IVIG组患者的疾病严重程度显著高于TCS组(P=0.017)。结论 SCORTEN评分可以用于评估国内SJS/TEN患者的病情严重程度,并预测患者预后;与单用TCS相比,联合IVIG有助于提高重症SJS/TEN患者的救治效果。

Objectivs To evaluate the performance of SCORTEN in severity of SJS/TEN in China, and to compare the efficacy of corticosteroid therapy (TCS) and intravenous immunoglobulin combined therapy (TCS-IVIG). Methods Collected retrospectively the data of the SJS/TEN patients from June 2005 to May 2015 in our hospital. Hosmer-Lemeshow statistic were used to assess SCORTEN model calibration. And the differences between TCS group and TCS-IVIG group were compared in severity-of-illness, length of hospitalization, disease control time and mortality. Results A good calibration were found in all groups (all P＞0.5). Although the severity-of-illness in the TCS-IVIG group was significantly higher than that in the TCS group (P=0.017), there was no statistical significance between the two groups in length of hospitalization, disease control time and mortality (P=0.105, 0.910, 0.701, respectively). Conclusion SCORTEN can be used to assess the severity-of-illness in Chinese patients with SJS/TEN and to predict the prognosis. Compared with single TCS, It could improve the clinical outcomes of patients with severe SJS/TEN combined with IVIG.