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 了解住院老老年心房颤动(atrial fibrillation,AF)患者的临床特征及抗凝现况。方法 收集2015年6月—2017年9月住院老老年(≥80岁)房颤患者的抗凝用药,合并疾病,合并用药等临床信息,统计并分析,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 621例老老年患者根据性别分为男女两组,男354人,女267人,159例患者(25.6%)使用华法林,33例患者(5.31%)使用达比加群,30例患者(4.83%)使用利伐沙班,抗凝总人数为222例(35.75%)。174例患者(28.02%)使用阿司匹林,27例患者(4.35%)使用氯吡格雷,抗血小板总人数为201例(32.37%)。余198例患者(31.89%)未使用任何抗血小板或抗凝药物。结论 老老年房颤患者目前抗凝率低,抗凝药物以华法林为主。

Objective This study investigated the clinical characteristics and antithrombotic status in elderly patients with atrial fibrillation AF. Methods In this study, we collected, analyzed and characterized the data of the patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results 621 cases of elderly patients were divided into two groups according to their gender between men and women, 159 patients (25.6%) take warfarin, 33 patients (5.31%) with dabigatran, 30 patients (4.83%) uses of rivaroxaban, the total number of anticoagulation is 222 (35.75%),174 patients (28.02%) were treated with aspirin, and 27 patients (4.35%) used clopidogrel, and the total number of antiplatelet agents was 201 (32.37%). 198 patients (31.89%) did not use any antiplatelet or anticoagulant drugs. Conclusion patients with atrial fibrillation anticoagulant rate is low, and the anticoagulant is mainly warfarin.

目的 研究音乐疗法对新生儿喂养不耐受的保护作用,以及对胃动素和胃泌素水平的影响。方法 将2013年3月—2015年6月在我院新生儿科住院治疗的40例喂养不耐受新生患儿随机分为音乐治疗组和常规治疗组,治疗干预后,比较两组的喂养不耐受情况以及GAS和MOT水平。结果 音乐治疗组腹胀缓解时间、吸吮吞咽功能建立时间、达足量喂养时间、静脉营养应用时间明显的短于常规治疗组,体重增加量明显的高于常规治疗组(P＜0.05);治疗后,音乐治疗组的GAS和MOT水平明显的高于常规治疗组(P＜0.05)。结论 音乐疗法可以促进新生儿喂养不耐受症状改善,提高患儿血清GAS和血浆MOT水平,促进其生长发育。

Objective To study music therapy for neonatal feeding intolerance protection, and the effects of levels of gastrin and motilin. Methods From March 2013 to June 2015 in newborn Department of Pediatrics in our hospital 40 cases feeding tolerance of newborns were randomly divided into music therapy group and routine treatment group, after treatment, compared feeding tolerance and GAS and MOT level in the two groups. Results Abdominal distension relieving time, sucking and swallowing function establishment time, full enteral feeding time, use of the parenteral nutrition in the music therapy group was fewer than the conventional therapy group. Weight gain was higher than that in the conventional treatment (P<0.05). After the treatment, GAS and MOT levels in the music therapy group were higher than conventional treatment group, the difference is statistical significant (P<0.05). Conclusion Music therapy may promote neonatal feeding intolerance symptoms and improve patients serum GAS and plasma MOT levels, promote their growth and development.

目的 探讨用捏脊联合中药外洗治疗脾胃气虚型儿童功能性消化不良的效果。方法 随机选取脾胃气虚型功能性消化不良的儿童120例,分为联合组、捏脊组、外洗组、对照组4个组,每组30例,分别采用捏脊、中药外洗、捏脊联合中药外洗、吗丁啉进行治疗,两周后观察4组治疗效果及唾液淀粉酶活性比值、D-木糖排泄率的变化,进行分析。结果 联合组的有效率优于捏脊组、外洗组、对照组,差异有统计学意义(P<0.05)。治疗后联合组的唾液淀粉酶活性比值比捏脊组、外洗组、对照组提高,差异有统计学意义(P<0.05)。治疗后D-木糖排泄率均较治疗前有增加,两两比较,联合组与对照组比较差异有统计学意义(P<0.05)。结论 捏脊联合中药外洗可改善脾胃气虚型儿童功能性消化不良,疗效良好,其机理同改善唾液淀粉酶活性有关。

       目的   探讨与分析实时图像引导系统对乳腺癌保乳术后放射治疗（放疗）摆位误差的影响。方法   选取安阳市肿瘤医院2021年9月—2023年12月收治的乳腺癌保乳术后108例患者为研究对象，按照随机信封抽签法把108例患者分为实时组54例与对照组54例。两组的放疗观察时间均为3个月，对照组给予热塑体模定位，实时组给予实时图像引导系统定位，记录两组的摆位误差与放疗不良反应发生情况。结果   实时组X轴、Y轴、Z轴方向的配准结果误差发生率分别为1.85%、7.41%、1.85%，均低于对照组的14.81%、22.22%、16.67%（χ ² =5.939，P=0.015；χ ² =4.696，P=0.030；χ ² =7.053，P=0.008）。实时组摆位纠正前X轴、Y轴、Z轴误差大于对照组（t分别为38.888、28.106、50.102，P＜0.05），摆位纠正后两组摆位误差对比差异无统计学意义（P＞0.05）。实时组放疗3个月期间的心脏平均受量、肺脏平均受量均少于对照组（t分别为49.942、13.996，P＜0.001）。实时组放疗3个月期间的急性放射性皮肤反应发生率为3.70%，对照组为16.67%，实时组低于对照组（χ ² =4.960，P＜0.05）。结论   实时图像引导系统在乳腺癌保乳术后放疗的应用可减少摆位误差，也能减少患者的心脏平均受量、肺脏平均受量，降低急性放射性皮肤反应发生率。

       Objective  To investigate and analysis the effects of image-guided radiation therapy on the positioning error of radiotherapy after breast conserving surgery for breast cancer．Methods  from September 2021 to December 2023，108 patients with breast cancer after breast conserving surgery in Anyang Cancer Hospital were selected as the study subjects．According to the principle of random envelope drawing，108 patients were divided into the real-time group of 54 patients and the control group of 54 patients．The observation time for radiotherapy in both groups was 3 months．The control group was given thermoplastic phantom positioning，while the real-time group was given image-guided radiation therapy positioning．The positioning errors and incidence of radiotherapy adverse reactions were recorded in both groups．Results  The error rates of registration results in the X-axis，Y-axis，and Z-axis directions of the real-time group were 1.85%，7.41% and 1.85%，respectively，which were significantly lower than the control group（14.81%，22.22% and 16.67%；χ ² =5.939，P=0.015；χ ² =4.696，P=0.030；χ ² =7.053，P=0.008）．The errors in the X-axis，Y-axis and Z-axis before the pendulum correction were greater than that in the control group（t=38.888，28.106，50.102，P＜0.05），and there were no statistically significant difference in positioning errors compared between the two groups after positioning correction（P＞0.05）．The average cardiac and lung uptake during the 3-month period of real-time radiotherapy in the group were significantly lower than those in the control group（t=49.942，13.996，P＜0.001）．The incidence of acute radiation-induced skin reactions during the 3-month period of real-time group radiotherapy was 3.70%，compared to 16.67% in the control group，the real-time group showed a significant decrease（χ ² =4.960，P=0.026＜0.05）．Conclusions  The application of image-guided  radiation therapy in radiotherapy after breast conserving surgery for breast cancer can reduce the positioning error，the average cardiac and pulmonary dose，and the incidence of acute radiation skin reaction．

       目的   探讨预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果及对术后生活质量影响。方法   选取2020年6月—2023年10月安阳市肿瘤医院收治的66例肌层浸润性膀胱癌患者，应用抽签法分为观察组（n=33）与对照组（n=33）。所有患者均采取根治性全膀胱切除术与淋巴清扫术治疗，对照组患者术后实施常规护理，观察组在对照组基础上增加预防性风险管理。对比两组术后尿量、胃肠功能恢复时间、术后住院时间，干预前后病耻感及负面情绪、术后并发症发生率，最后对比两组干预前后生活质量变化。结果   两组患者术后尿量对比差异无统计学意义（P＞0.05），观察组术后胃肠功能恢复时间为（5.27±0.82）d，术后住院时间为（18.31±3.27）d，短于对照组的（7.25±1.12）（23.27±4.18）d，对比差异有统计学意义（t分别为8.194、5.369，P＜0.05）；干预后两组患者病耻感量表（SSCI）、抑郁自评量表（SDS）和焦虑自评量表（SAS）评分均降低，观察组分别为（35.67±7.45）（40.02±2.43）（45.36±4.17）分，低于对照组的（48.27±10.69）（54.54±3.54）（51.37±4.38）分，对比差异有统计学意义（t分别为5.555、19.426、5.709，P＜0.05）；观察组术后并发症发生率为9.09%，低于对照组的30.30%（χ ² =4.690，P=0.030）；干预后两组膀胱癌特异性模块、功能状况、精神状况、家庭/社会状况及躯体状况相关维度膀胱癌患者生活质量量表（FACT-BL）评分均升高，观察组分别为（34.27±3.26）（25.11±4.23）（21.51±4.23）（25.02±4.43）（20.56±3.11）分，高于对照组的（27.00±4.34）（21.11±3.24）（16.12±2.12）（21.54±5.54）（15.87±4.13）分，对比差异有统计学意义（t分别为7.694、4.313、6.544、2.818、5.211，P＜0.05）。结论   预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果显著，可缩短患者术后胃肠功能恢复时间及住院时间，改善患者负面情绪，有助减少术后并发症，提升患者生活质量。

       Objective  To explore the effect of preventive risk management on postoperative application and quality of life of myometrial invasive bladder cancer patients after radical surgery．Methods  A total of 66 patients with myometrial invasive bladder cancer admitted to Anyang Cancer Hospital from June 2020 to October 2023 were selected as research objects，and were divided into observation group（n=33）and control group（n=33）by lot drawing．All patients were treated with  radical total cystectomy and lymph node dissection．The control group received routine nursing care after surgery，while the observation group received preventive risk management in addition to the control group．The postoperative urine output，recovery time of gastrointestinal function，and hospitalization time between two groups were compared，as well as the shame and negative emotions before and after intervention，the incidence of postoperative complications，and the changes in quality of life between the two groups before and after intervention．Results  There was no significant difference in postoperative urine volume between the two groups of patients（P＞0.05），and the postoperative gastrointestinal function recovery time（5.27±0.82）d，postoperative hospitalization time（18.31±3.27）d were shorter than the control group［（7.25±1.12）d，（23.27±4.18）d］，with statistical significantce（t=8.194，5.369，P＜0.05）．After intervention，the Stigma Scale of Chronic Illness（SSCI），Self Rating Depression Scale（SDS），and Self-Rating Anxiety Scale（SAS）in both groups of patients decreased，and the observation group［（35.67±7.45），（40.02±2.43），（45.36±4.17）］scored lower than the control group［（48.27±10.69），（54.54±3.54），（51.37±4.38）］，statistically significant（t=5.555，19.426，5.709，P＜0.05）．The incidence of postoperative complications in the observation group was significantly lower at 9.09% compared to the control group at 30.30%（χ ² =4.690，P=0.030，P＜0.05）．After intervention，the scores of bladder cancer specific module，functional status，mental status，family/social status and physical status  related dimensions of bladder cancer patients’ quality of life scale for bladder cancer patients（FACT-BL）in both groups increased，and the observation group［（34.27±3.26），（25.11±4.23），（21.51±4.23），（25.02±4.43），（20.56±3.11）］ scored higher than the control group［（27.00±4.34），（21.11±3.24），（16.12±2.12），（21.54±5.54），（15.87±4.13）］，the comparison was statistically significant（t=7.694，4.313，6.544，2.818，5.211，P＜0.05）．Conclusions  Preventive  risk management has a significant effect on the application of myometrial invasive bladder cancer after radical surgery，which can shorten the recovery time of gastrointestinal function and hospital stay，improve patients’ negative emotions，assist in preventing postoperative complications，and improve patients’ quality of life．