目的 调查与分析儿童结直肠息肉的临床特征及腹腔镜联合结肠镜下手术对其的治疗效果。方法 选择2019年2月—2021年10月在郑州大学附属儿童医院诊治的98例结直肠息肉患儿,记录患儿的临床特征,根据患儿的手术方法分为腹腔镜组（腹腔镜联合结肠镜下手术治疗,n=40）与结肠镜组（采用结肠镜手术治疗,n=58）,对比不同手术方法的治疗效果、并发症发生率、疼痛视觉模拟评分法（VAS）评分、息肉复发与再手术率。结果 98例患儿中,息肉部位为直肠44例、横直肠38例、其他16例;息肉最大直径（1.65±0.24）cm;息肉单发83例、多发15例。腹腔镜组的围手术期指标比结肠镜组改善（P<0.05）。腹腔镜组术后7 d的感染、出血、肠穿孔、肠梗阻等并发症发生率为5.00%,低于结肠镜组的17.24%（P<0.05）。腹腔镜组术后1个月的总有效率为97.50%,高于结肠镜组的82.76%（P<0.05）。腹腔镜组术后1、3、7 d的疼痛VAS评分低于结肠镜组（P<0.05）。所有患儿术后随访1年,联合的息肉复发率与再次手术率为5.00%、2.50%,均低于结肠镜组的18.97%、13.79%（P<0.05）。结论 儿童结直肠息肉主要位于直肠、横直肠,多为单发,腹腔镜联合结肠镜下手术治疗能促进患儿康复,提高总体治疗效果,也能缓解患儿疼痛,减少并发症的发生,降低随访息肉复发率与再次手术率。

Objective To investigate and analyze the clinical features of children with colorectal polyps and the efficacy of laparoscopic surgery combined with colonoscopy. Methods A total of 98 children with colorectal polyps diagnosed and treated in our hospital from February 2019 to October 2021 were selected as subjects of this study. The clinical characteristics of all children were recorded,and they were divided into the laparoscopic group(laparoscopic surgery combined with colonoscopy,n=40)and the colonoscopy group(colonoscopy,n=58)according to the differences in surgical methods. The therapeutic effect,complication rate,VAS pain score,polyp recurrence and reoperation rate of different surgical methods were compared. Results Among the 98 children,the polyps of 44 cases were in rectum,38 cases in transverse rectum and 16 cases in other sites. The maximum diameter of polyp was(1. 65±0. 24)cm. Polyps were solitary in 83 cases and multiple in 15 cases. The perioperative indexes in the laparoscopic group were significantly improved compared with those in the colonoscopy group(P<0. 05). The incidence of postoperative complications such as infection,bleeding,intestinal perforation and intestinal obstruction was 5. 00% in the laparoscopy group,which was significantly lower than 17. 24% in the colonoscopy group(P<0. 05). The total effective rate of laparoscopic group was 97. 50% one month after operation,which was significantly higher than that of colonoscopy group(82. 76%,P<0. 05). The VAS pain score of the laparoscopic surgery group was significantly lower than that of the colonoscopy group at 1,3 and 7 days after surgery(P<0. 05). After 1 year of follow-up,the combined polyp recurrence rate and reoperation rate were 5. 00% and 2. 50%,which were significantly reduced compared with 18. 97% and 13. 79% in colonoscopy group(P<0. 05). Conclusions The main sites of colorectal polyps in children are rectum and transverse rectum,and most of them are solitary. Laparoscopic and colonoscopic surgery for colorectal polyps in children can promote the recovery of children,improve the overall treatment effect of patients,relieve the pain of children,reduce the occurrence of complications,and reduce the recurrence rate and reoperation rate of follow-up polyps in children.

目的 探讨子宫内膜癌构成及临床病理特征。方法 以南平市第一医院2020年1月—2022年6月期间收治的82例子宫内膜癌患者为研究对象,收集其临床资料,通过免疫组织化学染色法检测4种错配修复蛋白表达,并分析错配修复蛋白表达与临床病理特征的关系。结果 82例患者中,70例（85.37%）为子宫内膜样癌,病理组织学类型以G1级30例（42.86%）为主,其他类型较为少见。错配修复蛋白表达总缺失率为35.71%,其中MUTL同源物1（MLH1）单独缺失率为2.86%,错配修复蛋白2抗体（MSH2）为4.29%,错配修复蛋白6抗体（MSH6）为14.29%,肿瘤错配修复基因PMS2抗体（PMS2）为14.29%;错配修复表达缺失（dMMR）组患者年龄50岁以上、伴脉管侵犯和淋巴结转移、组织学G3级和FIGO分期Ⅲ期占比高于错配修复表达正常（pMMR）组患者（P<0.05）;MSH6蛋白表达缺失易发生在年龄50岁以上、有家族相关疾病史的患者（P<0.05）;PMS2蛋白表达缺失易发生在组织学G2级、FIGO分期Ⅲ期、妊娠1次及以上、脉管内癌栓和淋巴结转移的患者（P<0.05）。结论 子宫内膜癌错配修复蛋白表达与其部分临床病理特征存在密切关联,可为患者后续治疗提供有价值的指导。

Objective To investigate the composition and clinicopathological features of endometrial carcinoma．Methods A total of 82 cases of endometrial carcinoma patients admitted to the First Hospital of Nanping City from January 2020 to June 2022 were studied．Epidemiological data were collected,and the expression of 4 mismatch repair proteins were detected by immunohistochemical staining,and their relationship with clinicopathological features was analyzed．Results Among 82 patients,70 cases（85.37%）were endometrioid carcinoma,and 30 cases（42.86%）were mainly G1 grade,other types were rare．The total deletion rate of mismatch repair proteins expression was 35.71%,in which MLH1 alone was 2.86%,MSH2 was 4.29%,MSH6 was14.29% and PMS2 was14.29%．The proportions of dMMR patients over 50 years old,with vascular invasion and lymph node metastasis,G3 grade histology and FIGO stage Ⅲ were significantly higher than those of the pMMR group（P<0.05）．The loss of MSH6 protein expression was more likely to occur in patients over 50 years old with a family history of related diseases（P<0.05）．The deletion of PMS2 protein expression was more likely to occur in patients with histological G2 grade,FIGO stage III,pregnancy of once or more and intravascular cancer thrombin and lymph node metastasis（P<0.05）．Conclusions The expression of mismatch repair proteins in endometrial carcinoma is closely related to some clinicopathological features,which provides valuable guidance for follow-up treatment．

目的 上消化道出血发作急、变化快,具有较高的危险性,本研究目的在于分析急性上消化道出血患者的临床特征及危险因素,为临床诊治提供参考。方法 将2019年1月—2021年2月年我院的242例疑似急性上消化道出血患者作为研究对象,收集患者的年龄、性别、是否有长期抽烟史、饮酒史,是否有合并症以及并发症等一般资料,运用单因素分析其临床特征,运用多因素Logistic回归分析其独立危险因素。结果 患者年龄、长期饮酒史、消化性溃疡、门脉高压、急性胃黏膜病变、服用阿司匹林(ASA药物)、Hp感染等临床特征与急性上消化道出血具有相关性,与患者的性别、长期抽烟史不具有相关性;年龄、消化性溃疡、门脉高压、服用ASA药物、Hp感染是急性上消化道出血的危险性因素。结论 急性上消化道出血病势程度较重,死亡率高,出血需及时针对性治疗;对于急性上消化道出血高危患者,严密监测病情变化,评估其风险系数。

Objective Upper gastrointestinal bleeding has a high risk because of its rapid change. The purpose of this study is to analyze the clinical characteristics and risk factors of patients with acute upper gastrointestinal bleeding, so as to provide reference for clinical diagnosis and treatment. Methods A total of 242 patients with suspected acute upper gastrointestinal bleeding in our hospital from January 2019 to February 2021 were selected as the research objects. The general data such as patients' age, gender, whether they had a long-term history of smoking or drinking, whether they had complications and data of complications were collected. The clinical characteristics were analyzed by univariate analysis, and the independent risk factors were analyzed by multivariate Logistic regression analysis. Results Age, long-term drinking history, peptic ulcer, portal hypertension, acute gastric mucosal lesions, taking aspirin (ASA drugs), Hp infection and other clinical characteristics were correlated with acute upper gastrointestinal bleeding, but gender and long-term smoking history were not. Age, peptic ulcer, portal hypertension, taking ASA drugs and Hp infection were the risk factors of acute upper gastrointestinal bleeding. Conclusion The acute upper gastrointestinal bleeding is a serious disease, with high mortality, and the bleeding needs timely targeted treatment. For patients with high-risk acute upper gastrointestinal bleeding, closely monitor the changes of the disease and evaluate the risk coefficient are needed.

目的 探讨广州地区儿童2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)感染筛查/疑似病例的流行病学特点、发病特点、可能的原因及防控建议。方法 回顾性分析2020年1月20日—2020年2月29日广州市唯一一家儿童2019-nCoV感染隔离定点医疗单位隔离病房收治住院的符合儿童2019-nCoV感染筛查/疑似病例129例,对其流行病学、发病特点、临床特征、实验室检查及转归、随访等进行总结分析。 结果 男 79例,女 50例,最小1个月,最大13岁,中位数2岁,51例(39.5%)有武汉疫区旅游或居住史,20例(15.5%)有与来自疫区有呼吸道症状人员接触史,17例(13.1%)周边或社区有确诊病例,3例(2.3%)有确诊病人接触史(其中2例为家庭确诊病例密切接触史),38例(29.5%)为临床符合或聚集性发病;临床症状:发热121例(93.8%),咳嗽92例(71.3%),流涕50例(38.8%),32例伴有腹泻、呕吐/腹痛(24.8%),102例(79.0%)白细胞降低或正常,C反应蛋白(C-reactive protein,CRP)＜20 mg/L有103例(79.8%),57例(44.2%)胸片或CT示肺部斑片状影或实变;病原学检查:2019-nCoV实时荧光定量反转录PCR检测结果:所有患儿及陪同家属都有行咽拭子检查,只有21例患儿(16.3%)有行肛拭子检查,仅有1例(0.78%)家庭确诊病例密切接触者肛拭子阳性,但连续多次咽拭子结果阴性,余患者肛拭子和咽拭子及陪同家属咽拭子结果均阴性。其他病原学检查结果61例(47.3%),包括14例RSV阳性,9例流感病毒A,8例人偏肺病毒,6例肠道病毒,6例流感病毒B,6例肺炎支原体,4例副流感病毒1型,1例副流感病毒3型,2例人博卡病毒,3例腺病毒,1例肺炎克雷伯菌,1例人型葡萄球菌,其中1例合并副流感病毒1型及人博卡病毒。跟踪唯一1例确诊患者咽拭子多次检查均阴性,肛拭子持续19天后才转阴,一直无任何症状。其余患者好转出院后第3天、7天及14天进行随访,无异常发现。结论 儿童2019-nCoV感染筛查/疑似病例临床多表现为呼吸道或消化道症状,确诊主要依靠核酸检测,新冠病毒感染确诊率极低,而其将近50%病例能找到除新冠病毒外的其它相关病原体;高危患者为密切接触者,但存在漏诊的可能,肛拭子阳性率或高于咽拭子。

Objective To explore the epidemiological characteristics, onset characteristics, pathogenic mechanism of 2019-nCoV infection in children, and its control and prevention in Guangzhou. Methods From January 20, 2020 to February 29, 2020, a retrospective analysis was carried out on 129 suspected cases of 2019-nCoV infection admitted to the isolation ward of the only medical unit designated for children in Guangzhou. The epidemiology, disease characteristics, clinical characteristics, laboratory examination, outcome and follow-up were summarized and analyzed. Results There were 79 males and 50 females, with a minimum age of 1 month and a maximum age of 13 years. Anong them, 51 cases (39.5%) had a history of tourism or residence in the epidemic area of Wuhan, 20 cases (15.5%) had a history of contact with people with respiratory symptoms from the epidemic area, 17 cases (13.1%) with a confirmed case in the surrounding area or community, 3 cases (2.3%) had a history of contact with a confirmed patient (2 of them were family clustering cases), 38 cases (29.5%) were clinically suspected cases. Clinical symptoms: 121 cases with fever (93.8%), 92 cases with coughing (71.3%), 50 cases with runny nose (38.8%), 32 cases with diarrhea, vomiting or abdominal pain (24.8%). In 102 cases (79.0%), white blood cells were decreased or normal, 103 cases (79.8%) with CRP＜20 mg/L, and 57 cases (44.2%) showed focal infection on chest X-ray or CT scan. Etiological examination: only one case (0.78%) of the family confirmed cases had positive anal swab result, but the throat swab results were negative all the time. The anal swab and throat swab results of other patients and the throat swab results of their accompanying family members were negative. Other pathogens were detected in 61 cases (47.3%), including 14 RSV positive cases, 9 influenza A positive cases, 8 human metapneumovirus positive cases, 6 enterovirus positive cases, 6 influenza B positive cases, 6 Mycoplasma pneumoniae positive cases, 4 parainfluenza virus type 1 positive cases, 1 parainfluenza virus type 3 positive cases, 2 human bocavirus positive cases, 3 adenovirus positive cases, 1 Klebsiella pneumoniae positive cases, 1 Human Staphylococcus positive case, and 1 case with parainfluenza virus type 1 and human bocavirus. The only confirmed patient was followed up while multiple pharyngeal swab results were negative, and the positive anal swab results lasted for 19 days before turning negative and remained asymptomatic. Other patients were followed up on the 3rd, 7th and 14th day after discharge, and no abnormal findings were found. Conclusion Screening/suspected cases of 2019-nCoV infection in children were mostly clinically manifested as respiratory or gastrointestinal symptoms. The diagnosis rate of nucleic acids was extremely low, and there was a possibility of missed diagnosis. Nearly 50% of cases could find other relevant pathogens excluding the 2019-nCoV. The positive rate of anal swab results was higher than that of pharyngeal swab.

目的 探究乙型病毒性肝炎不同状态合并2型糖尿病患者的临床特点。方法 对62例乙型肝炎病毒携带合并2型糖尿病(组1)、129例乙型病毒性肝炎合并2型糖尿病(组2)和83例乙型病毒性肝炎肝硬化合并2型糖尿病(组3)患者的临床资料进行回顾性分析。结果 各组间在性别和年龄上差异有统计学意义(χ²=11.133、P=0.004,F=7.640、P=0.001)。3组研究对象糖化血红蛋白(HbA1c)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)和总胆汁酸(TBA)水平差异有统计学意义(F=4.028、P=0.019,F=4.140、P=0.017,F=3.172、P=0.044,F=6.701、P=0.002,F=53.156、P<0.001,F=4.920、P=0.008,F=4.173、P=0.017,F=7.181、P=0.001,F=9.170、P<0.001)。进一步两两比较,肝炎肝硬化组HbA1c、Tch 、LDL-C、ALB水平降低,但TBIL、IBIL、TBA增高,分别与另2组比较差异有统计学意义(P<0.05);组2空腹血糖(FBG)、HDL-C水平最高,前者高于组1,后者高于组3。各组糖尿病并发症居前三的都是周围神经病变、糖尿病肾病和糖尿病视网膜病变。结论 乙型病毒性肝炎合并2型糖尿病时其不同状态间具有不同的疾病特点,主要体现在携带状态Tch、TG、LDL-C高水平,肝炎状态FBG高水平,肝炎肝硬化状态HbAlc、ALB低水平但胆红素、胆汁酸水平高,在糖尿病并发症方面均以周围神经病变、糖尿病肾病和糖尿病视网膜病变为主。

Objective To study the clinical feature of different viral hepatitis B status with type 2 diabetes. Methods A retrospective analysis was carried out on 62 hepatitis B virus carriers with type 2 diabetes (group 1),129 viral hepatitis B patients with type 2 diabetes (group 2) and 83 viral hepatitis B cirrhosis patients with type 2 diabetes (group 3). Results The differences in gender and age among the three groups were significantly different (χ²=11.133, P=0.004 and F=7.640,P=0.001). The levels of HbA1c, total cholesterol (Tch), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum albumin (ALB), total bilirubin(TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL)and total bile acid (TBA)in three groups were significantly different (F=4.028, P=0.019.F=4.140, P=0.017.F=3.172, P=0.044.F=6.701, P=0.002.F=53.156, P<0.001.F=4.920, P=0.008.F=4.173, P=0.017.F=7.181, P=0.001.F=9.170, P<0.001). In further pairwise comparison, the levels of HbA1c, Tch, LDL-C and ALB of group 3 decreased significantly compared with other two groups, but the levels of TBIL, IBIL and TBA increased, with significant differences.The levels of fasting blood glucose(FBG) and HDL-C in group 2 were the highest,and the FBG was significantly higher than that in group 1, while the HDL-C was significantly higher than that in group 3.In the three groups, the top three diabetic complications were peripheral neuropathy, diabetic nephropathy and diabetic retinopathy. Conclusion Different statuses of viral hepatitis B with type 2 diabetes had different disease characteristics, mainly reflected in the high levels of Tch, TG and LDL-C in the hepatitis B virus carriers, high FBG level in the viral hepatitis B patients, low levels of HbAlc and ALB but high levels of bilirubin and bile acid in the cirrhosis patients.Peripheral neuropathy, diabetic nephropathy and diabetic retinopathy were the main complications of diabetes.

目的 分析区级医院甲型流行性感冒患者的临床特征,为基层医院甲型流感的早期诊断及防控工作提供科学依据。方法 对2019年12月广州市番禺区中心医院发热门诊就诊的具有流感样症状的发热患者共628例,进行咽拭子甲型流感病毒核酸检测,收集患者临床资料,包括性别、年龄、体温、症状、血常规,根据核酸检测结果分为阴性组及阳性组,2组结果进行比较。结果 甲型流感病毒核酸检测阳性患者共116例,阳性率为18.5%。阳性组发病年龄以14～19岁所占比例最大,共91例(78.4%)。阳性组平均年龄小于阴性组(P＜0.05)。阳性组发病体温以38.1～39 ℃所占比例最大,共47例(46.5%)。阳性者平均体温高于阴性组(P＜0.01)。症状方面,阳性组仅鼻塞流涕比例较阴性组高(P＜0.05)。阳性组白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值、淋巴细胞百分比均低于阴性组(P＜0.01)。结论 2019年冬季甲型流感患者以青少年为主,单纯症状较难区分甲型流感及普通感冒,需结合血常规特别是白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值的降低进行分析。

Objective The clinical characteristics of patients with influenza A in district hospital were analyzed to provide scientific basis for early diagnosis, prevention and control of influenza A in primary hospital. Methods A total of 628 patients with influenza-like symptoms from Guangzhou Panyu Central Hospital in December 2019 were enrolled, and the clinical data was collected, including gender, age, body temperature, symptoms, and blood test results. According to the result of influenza A nucleic acid detection, patients were divided into negative group and positive group, and the clinical data of these two groups were compared. Results A total of 116 patients were positive in influenza A virus nucleic acid detection, which positive rate was 18.5%. In the positive group, patients aged 14-19 accounted for the largest proportion, with 91 patients (78.4%). The mean age of the positive group was significantly lower than that of the negative group (P＜0.05). Body temperature ranged from 38.1 to 39 ℃ accounted for the largest proportion in the positive group, with 47 patients (46.5%). The mean body temperature of the positive group was significantly higher than that of the negative group (P＜0.01). In terms of symptoms, only the proportion of nasal congestion in positive group was higher than that in negative group (P＜0.05). In terms of blood test results, WBC count, neutrophil absolute value, lymphocyte absolute value and lymphocyte percentage in the positive group were significantly lower than those in the negative group (P＜0.01). Conclusions The majority of patients with influenza A in the winter of 2019 were teenagers, and it was difficult to distinguish influenza A from the common cold only by symptoms. The differential diagnosis should be carried out in combination with the blood routine analysis, especially the decrease in the white blood cell count, the absolute value of neutrophil and the absolute value of lymphocytes.

目的 分析76例工业区来源的结核性胸膜炎患者的患病相关因素及临床特征。方法 回顾性收集2018年1月—2020年12月于深圳市中西医结合医院住院的76例工业区来源的结核性胸膜炎患者(观察组)的病历资料和57例同期同区域来源的健康体检者(对照组)的病历资料。运用统计学分析工业区结核性胸膜炎的患病相关因素及临床特征。结果 2组的比较当中,年龄、白蛋白水平、身高、体质量、体质量指数之间的差异具有统计学意义(P<0.05);而多因素Logistic回归分析结果显示,年龄及白蛋白水平则是工业区结核性胸膜炎的独立保护因素(P<0.001,OR=0.728,95% CI:0.634～0.836以及P<0.001,OR=0.908,95% CI:0.874～0.944);工业区结核性胸膜炎的临床症状为咳嗽(71.05%)、发热(48.68%)、胸痛(47.37%),发病季节以春秋季节(27.63%和32.90%)为主。结论 工业区结核性胸膜炎的独立影响因素是年龄及白蛋白水平,临床症状主要为咳嗽、发热、胸痛,好发于春秋季节。

Objective To analyze the relative factors and clinical characteristics of 76 patients with tuberculous pleurisy from industrial area. Methods The medical records of 76 patients with tuberculous pleurisy from industrial areas (observation group) and 57 healthy subjects from the same period and region (control group) who were hospitalized in Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2020 were retrospectively collected. The correlative factors and clinical characteristics of tuberculous pleurisy in industrial area were analyzed by statistics. Results There were statistically significant differences in age, albumin level, height, weight and body mass index between the two groups (P<0.05). Multivariate logistic regression analysis showed that age and albumin level were independent protective factors for tuberculous pleurisy in industrial areas (P<0.001, OR=0.728, 95% CI: 0.634~0.836 and P<0.001, OR=0.908, 95% CI: 0.874~0.944). The clinical symptoms of tuberculous pleuritis in industrial areas were cough (71.05%), fever (48.68%) and chest pain (47.37%), and the onset season was mainly in spring and autumn (27.63% and 32.90%). Conclusions The independent influencing factors of tuberculous pleuritis in industrial area are age and albumin level. The main clinical symptoms are cough, fever and chest pain, which usually occur in spring and autumn.

目的 分析人类疱疹病毒(EBV)致传染性单核细胞增多症(IM)患儿病毒量与临床特征的关系。方法 选取我院2016年1月—2021年1月收治的EBV定量阳性的IM患儿128例,按照患儿EBV含量分为低病毒量组(n=64)和高病毒量组(n=64)。比较不同病毒含量组患儿的症状体征、实验室检查及临床特征,并分析具有统计学差异的指标与病毒量之间的相关性。结果 高EBV含量组患儿丙氨酸氨基转移酶、乳酸脱氢酶、血沉、外周血白细胞计数指标水平均高于低EBV含量组(P<0.05)。患儿的退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间均随着EBV含量的增加而延长(P<0.05)。EBV含量与退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间成正相关(r=0.453,0.458,0.402,0.415,P<0.05)。结论 EBV含量越高,IM患儿住院时间及临床指标恢复时间越长,因此临床治疗IM患儿时可以根据EBV含量的高低进行病情评估。

Objective To analyze the relationship between viral load and clinical characteristics in children with infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV). Methods A total of 128 children with IM who tested positive for EBV and admitted to our hospital from January 2016 to January 2021 were selected and divided into low virus group (n=64) and high virus group (n=64) according to their EBV level. The symptoms and signs, laboratory examinations and clinical characteristics of two groups were compared, and the correlation between the statistically different indicators and the amount of virus were analyzed. Results In children with high EBV level, the levels of alanine aminotransferase, lactate dehydrogenase, erythrocyte sedimentation rate, and peripheral blood white blood cell count were higher than low EBV level group (P<0.05). The time of fever, lymph node shrinkage, hepatosplenomegaly to subside, and hospitalization time of the children were all prolonged with the increase of EBV level (P<0.05). The level of EBV was positively correlated with the time to allay fever, the time to shrink the lymph nodes, the time to improve hepatosplenomegaly, and the length of hospital stay (r=0.453, 0.458, 0.402, 0.415,P<0.05). Conclusions The higher EBV level, the longer hospitalization time and recovery time of clinical indicators in children with IM. Therefore, the disease assessment of children with IM can be based on EBV level.

目的 分析闽西南地区在院炎症性肠病患者流行病学资料,从而加强对炎症性肠病的认识。方法 回顾性研究炎症性肠病患者临床特点及用药情况。结果 纳入317例炎症性肠病,克罗恩病占212例,男女之比 2.07:1,溃疡性结肠炎占105例,男女比例1.84:1。克罗恩病患者确诊平均年龄29岁,以患A2型为主,溃疡性结肠炎者确诊平均年龄44岁。女性B2型比例明显高于男性。溃疡性结肠炎患者的病变部位主要为E3型(44.8%)。结论 炎症性肠病患者临床表现多样。克罗恩病确诊年龄主要是A2型, L3型是主要病变部位分型,B2型是疾病行为主要分型。E3型是溃疡性结肠炎患者的主要病变部位。克罗恩病多以免疫抑制剂和生物制剂治疗,糖皮质激素和5-ASA类制剂是轻中度的UC患者主要治疗措施。生物制剂、糖皮质激素治疗多用于重度UC患者。

Objective To analyze the epidemiological data of inflammatory bowel disease (IBD)patients in southwest Fujian Province, so as to improve the understanding of IBD. Methods To retrospectively study the clinical characteristics and medication of inflammatory bowel disease patients. Results A total of 317 IBD patients were included.Crohn's disease accounted for 212 cases, with a male-to-female ratio of 2.07:1, and ulcerative colitis accounted for 105 cases, with a male-to-female ratio of 1.84:1.Patients with Crohn's disease were diagnosed at an average age of 29, mainly with type A2, while patients with ulcerative colitis were diagnosed at an average age of 44. The proportion of female with type B2 was significantly higher than that of male.The lesions of ulcerative colitis patients were mainly type E3 (44.8%).Conclusions Patients with IBD had diverse clinical manifestations.The age of diagnosis of Crohn's disease was mainly type A2, type L3 was the main lesion, type B2 was the main disease classification.Crohn's disease was mainly treated with immunosuppressive and biological therapy. Glucocorticoids and 5-ASA were the main treatment for patients with mild-to-moderate ulcerative colitis. Biological agents and glucocorticoid therapy were mostly used in severe patients.

目的 了解广州市肾综合征出血热住院病例临床表现和流行病学特征,分析患者出现重症的影响因素,为加深疾病认知和识别重症提供科学依据。方法 回顾性选取2014年1月以来在广州市二级及以上医疗机构住院的明确诊断为肾综合征出血热的患者572例作为本研究研究对象,自行设计问卷,收集患者流行病学史、临床表现和实验室检测结果,采用多因素Logistic回归分析识别患者重症HFRS的影响因素。结果 572例患者中男406人,女166人,男女比2.45:1,年龄最小者14岁,最大89岁,平均年龄(41.21±14.16)岁。临床表现以发热、起病急、乏力为主,三者分别占比96.33%、88.29%和82.32%,重症病例93例,重症率16.26%,不同颈红、胸红、腹痛、腹泻、恶心、呕吐、眼睑浮肿、黄疸、少尿或无尿、低血压、休克、白细胞计数减少、尿膜状物情况和鼠类暴露情况的患者重症发生率差异有统计学意义(均 P<0.05),多因素Logistic回归分析结果显示年龄为40～49岁、呕吐、休克、房内有老鼠及食物粮食无防鼠设备是患者发生重症的危险因素,其OR值和95%CI分别为2.712(95%CI:1.039~7.077)、2.99(95%CI:1.462~6.114)、5.822(95%CI:1.891~17.927)和3.292(95%CI:1.479 ~7.327)。结论 临床表现有呕吐和休克症状以及有明确的啮齿类动物暴露史者重症的风险更高,在今后的防治中,应进一步加强健康宣传教育,广泛开展灭鼠活动,临床上对存在高危风险的病例进行早期干预以提高患者的预后效果。

Objective To understand the clinical manifestations and epidemiological characteristics of hospitalized cases of hemorrhagic fever with renal syndrome in Guangzhou, analyze the influencing factors of patients with severe illness, and provide scientific basis for deepening disease recognition and identifying severe illness. Methods A retrospective selection of 572 patients with a clear diagnosis of hemorrhagic fever with renal syndrome who were hospitalized in second-level and higher medical institutions in Guangzhou since January 2014 were selected as the research objects. Questionnaires were designed and the epidemiological history clinical manifestations and laboratory test results of patients were collected. Multivariate logistic regression analysis was used to identify the influencing factors of patients with severe HFRS. Results Among the 572 patients, there were 406 males and 166 females. The male-to-female ratio was 2.45:1. The youngest was 14 years old, the oldest was 89 years old, and the average age was (41.21±14.16)years old. The clinical manifestations were mainly fever, acute onset, and fatigue, which accounted for 96.33%, 88.29% and 82.32%. There were 93 severe cases with a severe rate of 16.26%. Different neck redness, chest redness, abdominal pain, diarrhea, nausea, and nausea, vomiting, eyelid edema, jaundice, oliguria or anuria, hypotension, shock, decreased white blood cell count, urine membranes and rodent exposure, there were statistically significant differences in the incidence of severe illness (all P<0.05). The logistic regression analysis of factors showed that the age of 40-49 years, vomiting, shock, the presence of rats in the room, and food without rodent-proof equipment were risk factors for severe illness. The OR values and 95%CI were 2.712 (95 %CI: 1.039-7.077), 2.99 (95%CI: 1.462-6.114), 5.822 (95%CI: 1.891-17.927) and 3.292 (95%CI: 1.479-7.327). Conclusion Patients with clinical manifestations of vomiting and shock symptoms and a clear history of rodent exposure are at higher risk of severe illness. In the future prevention and treatment, health promotion and education should be further strengthened, rodent control activities should be carried out extensively, and early intervention is taken clinically to improve the patient's healing effect.