目的 探讨依奇珠单抗对中重度斑块型银屑病的治疗效果。方法 选取厦门大学附属第一医院2022年1月—2023年8月收治的75例中重度斑块型银屑病患者,应用抽签法进行分组,分为试验组（n=35）与对照组（n=40）。对照组采取常规外用药物治疗,试验组采取依奇珠单抗治疗。对比两组临床疗效,治疗前后外周血调节性T细胞（Treg）和辅助性T细胞17（Th17/Treg）细胞水平变化,并对所有患者进行6个月门诊复查随访,对比复发率及不良反应。结果 试验组总有效率88.57%,高于对照组的67.50%（χ²=4.730,P=0.028）;治疗后两组患者Treg细胞升高,试验组（5.59±1.24）%高于对照组（4.12±1.13）%,对比差异有统计学意义（t=5.371,P<0.001）,Th17细胞、Th17/Treg细胞降低,试验组[（1.06±0.14）%、0.19±0.05]低于对照组[（1.71±0.28）%、0.42±0.14],对比差异有统计学意义（t=12.434、9.212,P<0.001）;试验组停药后6个月复发率低于对照组（5.71% vs 27.50%,χ²=6.180,P=0.013）;试验组不良反应发生率略高于对照组,组间对比差异无统计学意义（14.29% vs 5.00%,χ²=1.900,P=0.168）。结论 依奇珠单抗治疗中重度斑块型银屑病疗效显著,可调节Th17/Treg平衡,降低停药后复发率,且安全性较高。

Objective To explore the therapeutic effect of Ixekizumab on moderate to severe plaque psoriasis. Methods Seventy-five patients with moderate to severe plaque psoriasis who were admitted to the First Affiliated Hospital of Xiamen University from January 2022 to August 2023 were selected and allocated by lottery into an experimental group（n=35）and a control group（n=40）．The control group received routine external medication while the experimental group received Ixekizumab treatment．The clinical efficacy of two groups,changes in Th17/Treg cell values before and after treatment were compared,and a 6-month outpatient follow-up for all patients was conducted to compare recurrence rates and incidence of adverse reactions. Results The total response rate in the experimental group was 88.57%,which was higher than the 67.50% in the control group（χ²=4.730,P=0.028）．After treatment,the level of Treg cell in the two groups was significantly higher,and the level of Treg cell experimental in the group was higher than that in the control group[（5.59±1.24）% vs （4.12±1.13）%,t=5.371,P<0.001]．After treatment,the level of Th17 and Th17/Treg cell in the two groups were lower,and the level of Th17 cell and Th17/Treg in the experimental group[（1.06±0.14）%,0.19±0.05] were significantly lower than those in the control group[（1.71±0.28）%,0.42±0.14],which was statistically significant（t=12.434、9.212,P<0.001）．The relapse rate at 6 months after drug withdrawal in the experimental group was significantly lower than that in the control group（5.71% vs 27.50,χ²=6.180,P=0.013）．The incidence of adverse reactions in the experimental group was higher than that in the control group,but with no statistical significance（14.29% vs 5.00%,χ²=1.900,P=0.168）. Conclusions Ixekizumab has a significant therapeutic effect on moderate to severe plaque psoriasis．It can regulate the Th17/Treg balance and reduce the recurrence rate after discontinuation,and with high safety．

目的 探讨80例局部宫颈癌根治性同步放化疗的临床疗效及预后影响因素。方法 选取鹤壁市妇幼保健院2018年1月—2021年1月收治的80例宫颈癌患者进行回顾性分析,患者依照其病变程度均采取积极的手术与同步放化疗,其中40例患者采取单纯化疗,将其分为化疗组,40例患者采取同步放化疗,将其分为同步放化疗组,分析其近远期临床疗效与不良反应发生率。对所有患者进行3年随访,将患者分为两个亚组,即预后不良组（n=20）和预后良好组（n=60）,对比两组患者一般临床特征,应用Logistic回归模型分析局部宫颈癌根治性同步放化疗的预后影响因素。结果 同步放化疗组ORR、DCR高与化疗组（P<0.05）,对照组中位无进展生存期为5.4（2.38~14.52）个月。观察组中位无进展生存期为6.66（2~20.1）个月,观察组高于对照组（χ²=4.536,P=0.041）;同步放化疗组盆腔积液、阴道炎症、泌尿生殖道反应、直肠反应、骨髓抑制、胃肠道反应发生率略高于化疗组,但两组对比差异无统计学意义（P>0.05）;预后良好组与预后不良组患者年龄、是否绝经、病理类型、肿瘤大小对比差异无统计学意义（P>0.05）,预后良好组与预后不良组患者临床分期、组织分化程度、淋巴结转移、是否同步放化疗、治疗前血红蛋白水平对比差异有统计学意义（P<0.05）;组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为局部宫颈癌的预后不良影响因素（P<0.05）。结论 对局部宫颈癌患者采取根治性同步放化疗与单一化疗相比可提升其临床疗效与远期生存率,同时安全性较高。组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为宫颈癌预后不良影响因素。

Objective To explore the clinical efficacy and prognostic factors of 80 cases of local cervical cancer treated with radical synchronous radiotherapy and chemotherapy．Methods A retrospective analysis was conducted on 80 cervical cancer patients admitted to Hebi Maternal and Child Health Hospital from January 2018 to January 2021．Patients underwent surgery and synchronous radiotherapy and chemotherapy according to their degree of lesion．Among them,40 patients received simple chemotherapy and were divided into a chemotherapy group,while 40 patients received synchronous radiotherapy and chemotherapy and were divided into a synchronous radiotherapy and chemotherapy group．The short-term and long-term clinical efficacy and incidence of adverse reactions were analyzed．A 3-year follow-up was conducted on all patients,and patients were divided into two subgroups,namely the poor prognosis group（n=20）and the good prognosis group（n=60）．The general clinical characteristics of the two groups of patients were compared,and a Logistic regression model was used to analyze the prognostic factors of local cervical cancer radical synchronous radiotherapy and chemotherapy．Results The objective relief rate and disease control rate of the synchronous radiotherapy and chemotherapy group were significantly higher than those of the chemotherapy group（P<0.05）,and the median progression free survival of the control group was 5.4（2.38-14.52）months．The median progression free survival of the observation group was 6.66（2-20.1）months,which was higher than that of the control group（χ²=4.536,P=0.041）．The incidence of pelvic fluid accumulation,vaginitis,urogenital reactions,rectal reactions,bone marrow suppression,and gastrointestinal reactions in the synchronous radiotherapy and chemotherapy group was slightly higher than that in the chemotherapy group,but there was no statistically significant difference between the two groups（P>0.05）．There was no statistically significant difference in age,menopause,pathological type,and tumor size between the patients with good prognosis and those with poor prognosis（P>0.05）．However,there was a statistically significant difference in clinical stage,tissue differentiation,lymph node metastasis,synchronous radiotherapy and chemotherapy,and pre-treatment hemoglobin levels between the patients with good prognosis and those with poor prognosis（P<0.05）．Low degree of tissue differentiation,lack of synchronous radiotherapy and chemotherapy,and low hemoglobin levels before treatment were adverse prognostic factors for local cervical cancer（P<0.05）．Conclusion sCompared with single radiotherapy,radical synchronous radiotherapy and chemotherapy can improve the clinical efficacy and long-term survival rate of patients with local cervical cancer,with higher safety．The severe tissue differentiation,unsynchronized chemoradiotherapy and hemoglobin before treatment were the adverse prognostic factors of cervical cancer．

目的 探讨表皮生长因子受体酪氨酸酶抑制剂（EGFR-TKIs）一线治疗耐药后,二线化学治疗（化疗）联合程序性死亡蛋白1及其配体（PD-1/L1）免疫检查点抑制剂方案对晚期非小细胞肺癌（NSCLC）的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期（PFS）,化疗前后血清中人细胞角蛋白21-1片段（Cyfra21-1）、糖类抗原125（CA125）、碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组（P<0.05）,对照组PFS为10（2.38,24.13）个月,观察组PFS为14（5.27~,5.27）个月,观察组高于对照组（χ²=4.536,P=0.041）;化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[（17.85±3.32）ng/L、（310.51±88.37）ng/L、（51.62±13.66）U/mL、（10.26±3.37）ng/mL]低于对照组[（19.62±3.24）ng/L、（366.26±49.42）ng/L、（59.26±9.35）U/mL、（12.62±2.73）ng/mL],对比差异有统计学意义（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）;两组不良反应发生率对比差异无统计学意义（P>0.05）;化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[（98.62±8.24）、（101.53±12.62）、（95.28±11.15）、（97.79±10.47）分]高于对照组[（84.25±7.32）、（93.58±15.75）、（82.24±9.34）、（83.47±8.38）]分,对比差异有统计学意义（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。

Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer（NSCLC） after epidermal growth factor receptor-tyrosine kinase inhibitors（EGFR-TKIs）resistance in first-line chemotherapy．Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022．Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group．The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live．Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared．Results The ORR and DCR of the observation group were significantly higher than those of the control group（P<0.05）．The mean PFS of the control group was 10（2.38-24.13）months,while the mean PFS of the observation group was 14（5.27-35.27）months．The observation group was higher than the control group（χ²=4.536,P=0.041）．After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [（17.85±3.32）ng/L,（310.51±88.37）ng/L,（51.62±13.66）U/mL,（10.26±3.37）ng/mL] was lower than the control group [（19.62±3.24）ng/L,（366.26±49.42）ng/L,（59.26±9.35）U/mL,（12.62±2.73）ng/mL],which showed statistically significant difference in the comparison（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[（98.62±8.24）,（101.53±12.62）,（95.28±11.15）,（97.79±10.47）] were higher than the control group scores[（84.25±7.32）,（93.58±15.75）,（82.24±9.34）,（83.47±8.38）],which showed statistically significant difference．（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）．Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients．

乳腺癌是女性最常见的原发恶性肿瘤之一。目前,通过采用综合治疗手段,包括手术、新辅助治疗、辅助放化疗等多种手段,乳腺癌已成为疗效最佳的实体肿瘤之一。其中,新辅助治疗（NAT）包括新辅助化疗、靶向治疗和内分泌治疗,目的是使肿瘤降期、保乳、保腋窝,并可观察药物敏感性,是当前乳腺癌综合治疗中非常重要的组成部分,其治疗疗效对患者手术方式的选择和预后至关重要。尽管病理学评价在评估NAT疗效方面被公认为金标准,但其局限性在于只能通过有创手段在治疗后进行,无法在治疗前对患者做出准确预测。磁共振成像（MRI）作为一项广泛使用的乳腺成像技术,在评估NAT疗效中扮演着关键角色。近年来,人工智能技术,尤其是影像组学（Radiomics）和深度学习（Deep Learning）,在医学影像分析领域取得了显著进展。这些技术能够从医学图像中提取大量肉眼难以识别的特征,揭示病变内部的微观结构和生物学行为,全面反映肿瘤的异质性,这不仅有助于临床医生更准确地区分良、恶性肿瘤,还能对恶性肿瘤的预后进行更为精确的评估。本文系统综述了近年来基于MRI的人工智能技术在乳腺癌新辅助治疗疗效评估中的应用研究,旨在促进人工智能在NAT临床实践中的应用和发展,为乳腺癌NAT治疗策略的优化和个性化医疗的实现提供科学依据。

Breast cancer is one of the most common primary malignant tumors in women．Currently,breast cancer has become one of the most effective solid tumors by using comprehensive treatment methods,including surgery,neoadjuvant therapy,adjuvant radiotherapy and chemotherapy．Among them,neoadjuvant therapy（NAT）,including neoadjuvant chemotherapy,targeted therapy and endocrine therapy,is a very important part of the current comprehensive treatment of breast cancer．It aims to reduce the tumor stage,preserve the breast,preserve the armpit,and observe the drug sensitivity．Its therapeutic effect is crucial to the choice of surgical methods and prognosis of patients．Although pathological evaluation is recognized as the gold standard in evaluating the response to NAT,its limitation is that it can only be performed after treatment by invasive means,and cannot accurately predict response before treatment．As a widely used breast imaging technology,magnetic resonance imaging（MRI）plays a key role in evaluating the response to NAT．However,traditional MRI evaluation methods are limited by the individual differences of interobserver and the low repeatability of evaluation results,which affects the accuracy of efficacy evaluation to a certain extent．In recent years,artificial intelligence technology,especially radiomics and deep learning,has made significant progress in the field of medical image analysis．These techniques can extract a large number of features that are difficult to be recognized by the naked eye from medical images,reveal the internal microstructure and biological behavior of the lesion,and fully reflect the heterogeneity of the tumor．This not only helps clinicians to distinguish benign and malignant tumors more accurately,but also makes a more accurate assessment of the prognosis of malignant tumors．This article reviews the application and progress of MRI-based artificial intelligence technology in evaluating the response to neoadjuvant therapy for breast cancer in the past five years,aiming to promote the application and development of artificial intelligence in NAT clinical practice,and provide a scientific basis for the optimization of NAT treatment strategy and the realization of personalized medicine for breast cancer．

目的 研究氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2019年2月—2021年1月我院收治的98例NRDS患儿,根据治疗方案不同分为对照组(49例)和观察组(49例)。2组均给予常规治疗,对照组采用氨溴索静脉用药、常规机械通气治疗,观察组采用氨溴索静脉用药、高频振荡通气(HFOV)治疗。比较2组临床疗效、胸部X线评分、新生儿评分(Apgar评分)、不同时间点(治疗前、治疗后2 h、治疗后12 h)动脉血气指标[氧合指数(OI)、动脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)]、呼吸力学指标[呼吸指数(RI)、呼吸道阻力(R)、肺动态顺应性(Crs)]、并发症发生率、死亡率。结果 2组治疗后总有效率比较,观察组93.88%高于对照组77.55%(P＜0.05);治疗后,观察组胸部X线评分、Apgar评分均高于对照组(P＜0.05);治疗后2 h、治疗后12 h时观察组OI、PaCO₂均低于对照组,PaO₂高于对照组(P＜0.05);治疗后,观察组RI、AR水平低于对照组,Crs水平高于对照组(P＜0.05);观察组死亡率2.04%低于对照组14.29%(P＜0.05)。结论 氨溴索静脉用药联合HFOV治疗NRDS的临床疗效显著,可有效促进患儿呼吸功能、动脉血气改善,降低新生儿死亡率。

目的 探讨透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的效果。方法 收集2019年7月—2021年7月在本院就诊的膝骨关节炎患者120例,采用随机数字表法分组,即对照组、观察组,均60例。对照组患者注入富含血小板的血浆(4 mL),观察组患者注射透明质酸钠(2 mL)联合富含血小板的血浆(3.5 mL),1次/周,3次为1个疗程,共2～3疗程。统计2组患者膝关节功能、临床疗效及并发症发生率。结果 ①组内比较:治疗后2月、3月及6月平均Lysholm膝关节评分均升高,P<0.05;②组间比较:治疗前及治疗后2月,2组患者平均Lysholm膝关节评分比较,P>0.05,治疗后3月、6月,2组平均Lysholm膝关节评分比较,P<0.05。2组患者Lysholm膝关节评分均较治疗前有所改善,P<0.05;观察组疼痛评分(18.92±4.11、17.61±3.83)分、肿胀度评分(10.64±2.82、9.66±1.21)分均高于对照组疼痛评分(14.02±3.52、13.54±3.21)分、肿胀度评分(9.62±2.63、8.71±1.93)分(P<0.05)。观察组临床总有效率98.33%高于对照组临床总有效率88.33%(χ²=4.821,P=0.028)。经过6个月的随访后,2组均1例出现局部肿胀,未发生其他并发症。结论 透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者,可以有效改善患者膝关节功能,减轻患者疼痛及肿胀程度等,安全性高,值得推广应用。

Objective To investigate the effect of sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis. Methods A total of 120 patients with knee osteoarthritis who were treated in our hospital from July 2019 to July 2021 were collected and randomly divided into control group and observation group,60 cases each.The patients in the control group were injected with platelet-rich plasma(4 mL),and the patients in the observation group were injected with sodium hyaluronate(2 mL)combined with platelet-rich plasma(3.5 mL),once a week,3 times as a course of treatment,total 2-3 courses of treatment.The knee joint function,clinical efficacy and complication rates of the two groups were compared. Results ①Intra-group comparison:the average Lysholm knee joint scores were significantly increased in 2 months,3 months and 6 months after treatment,P<0.05. ②Comparison between groups:before and 2 months after treatment,the average Lysholm knee joint scores of the two groups were significantly increased (P<0.05). After 3 months and 6 months treatment,the comparison of the average Lysholm knee score between the two groups were statistic significant (P<0.05).The Lysholm knee joint scores in both groups were improved compared with those before treatment (P<0.05). Three months after treatment,the pain score(18.92±4.11, 17.61±3.83)and swelling score(10.64±2.82, 9.66±1.21)in the observation group were significantly higher than those in the control group(14.02±3.52, 13.54±3.21, 9.62±2.63, 8.71±1.93, P<0.05).The total clinical effective rate of the observation group was 98.33%,which was significantly higher than that of the control group (88.33%, χ²=4.821,P=0.028).After 6-month follow-up,local swelling occurred in 1 case in both groups,and no other complications occurred. Conclusions Sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis can effectively improve the knee joint function and reduce the pain and swelling of the patients.It is safe and worthy of popularization and application.

目的 研究颅内压(ICP)监测联合浮动骨瓣减压术在治疗颅脑损伤中对颅内压及脑血流指标的影响。方法 选取我院2019年3月—2021年3月收治的拟行骨瓣减压术的颅脑损伤患者106例作为研究对象,按照手术方法不同分为对照组(n＝53)、观察组(n＝53)。对照组采用传统去骨瓣减压术(DC)治疗,观察组采用ICP监测联合浮动骨瓣减压术治疗。对比2组ICP、脑血流指标[平均流速(Vm)、收缩期血流速度(Vs)、血管搏动指数(PI)]及并发症发生情况。结果 术后1、3、7 d观察组ICP、PI低于对照组,Vm、Vs高于对照组(P＜0.05);术后观察组并发症总发生率9.43%低于对照组37.74%(P＜0.05)。结论 采用ICP监测联合浮动骨瓣减压术治疗颅脑损伤能降低患者ICP,改善脑血流状态,降低术后并发症,避免二次手术,减轻患者经济负担。

Objective To study the effect of intracranial pressure (ICP) monitoring combined with floating bone flap decompression on intracranial pressure and cerebral blood flow index in the treatment of craniocerebral injury. Methods A total of 106 patients admitted to our hospital from March 2019 to March 2021 were selected as study subjects and divided into control group (n=53) and observation group (n=53).The control group was treated with traditional decompressed craniectomy (DC), and the observation group was treated with ICP monitoring combined with floating bone flap decompression.The ICP, cerebral blood flow index [mean flow velocity (Vm), systolic flow velocity (Vs), vascular pulsatility index (PI)] and complications were compared between the two groups. Results ICP and PI were lower in observation groups on 1,3 and 7 d, Vm and Vs were higher (P <0.05); the incidences of complications in observation group (9.43%), such as electrolyte disorder, pulmonary infection, abnormal renal function and incisional hernia, were lower in the control group (37.74%, P<0.05). Conclusions ICP monitoring combined with floating bone flap decompression could reduce ICP, improve cerebral blood flow, reduce postoperative complications, avoid secondary surgery and reduce economic burden.

目的 探究腔内微波消融(EMA)联合泡沫硬化剂治疗与腔内射频消融(RFA)联合泡沫硬化剂治疗下肢静脉曲张的临床疗效和并发症情况。方法 回顾性选择收集106例下肢静脉曲张患者的临床资料,其中54例患者(观察组)接受EMA联合泡沫硬化剂治疗,52例患者(对照组)接受RFA联合泡沫硬化剂治疗。比较2组患者相关临床指标及并发症发生情况。结果 观察组手术时间(34.92±2.35)min,对照组手术时间(46.33±2.71)min,观察组手术时间较短,差异有统计学意义(P＜0.05),其余手术参数差异不明显(P＞0.05)。观察组的住院费用(21 063.74±850.47)元,对照组住院费用(23 312.40±1 035.86)元,观察组住院费用较低,有统计学差异(P＜0.05)。2组间并发症发生率、总有效率和总满意度均无显著差异。对比2组患者手术前和手术治疗后1年的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分,组间对比没有统计学差异(P＞0.05);而在患者手术1年之后的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分均呈现出明显的下降趋势(P＜0.05)。结论 微波消融是有效治疗下肢静脉曲张的术式,与射频消融比较,具有同样良好的短期效果;微波消融所需的手术时间较短且费用较低。

Objective To compare the clinical efficacy and complications between endovascular microwave ablation (EMA) combined with foam sclerotherapy and radiofrequency ablation (RFA) combined with foam sclerotherapy in patients with varicose veins of lower extremity. Methods A total of 106 patients with varicose veins of lower extremity were included in the retrospective study.Among them, 54 patients (observation group) were treated with EMA combined with foam sclerotherapy, and 52 patients (control group) were treated with RFA combined with foam sclerotherapy.The related clinical indexes and complications between the two groups were compared. Results The observation group had a shorter procedure time than the control group (34.92±2.35 minutes vs 46.33±2.71 minutes, P＜0.05), and no significant differences were observed in the other procedure parameters.The hospitalization cost was (21063.74±850.47) yuan for the observation group and (23312.40±1035.86) yuan for the control group, and the hospitalization cost of the observation group was lower(P＜0.05).No significant differences were found in the total effective rate,total satisfaction and complication rate between the two groups.Comparison of venous clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scores before and one year after operation between the two groups showed no statistical differences (P＞0.05). While the VCSS and AVVQ scores of the patients showed a significant downward trend one year after operation (P＜0.05). Conclusions Microwave ablation is an effective treatment for varicose veins in the lower extremity, which has the same good short-term effect as radiofrequency ablation. Microwave ablation requires a shorter operation time and less cost.

目的 探讨加味益气固冲汤在生育期血瘀证崩漏患者治疗中的应用价值及对雌激素水平的影响。方法 按照随机数字表法将2018年11月—2021年1月我院符合诊断标准及选例标准的112例生育期血瘀证崩漏患者分为常规组、实验组,每组56例。常规组予以基础治疗,实验组在常规组基础上采用加味益气固冲汤治疗。比较2组治疗效果、不良反应情况、治疗前后经期出血量、子宫内膜厚度、雌激素水平及血液流变学指标。结果 同常规组总有效率82.14%相比,实验组96.43%较高(P＜0.05);治疗后实验组经期出血量、子宫内膜厚度改善幅度大于常规组(P＜0.05);治疗后实验组黄体生成素、孕酮、卵泡刺激素、雌二醇水平较常规组低(P＜0.05);治疗后实验组红细胞聚集指数、纤维蛋白原、全血低切黏度、血浆黏度均小于常规组(P＜0.05);实验组不良反应总发生率5.36%与常规组10.71%对比,无差异(P＞0.05)。结论 加味益气固冲汤联合西药治疗生育期血瘀证崩漏患者效果显著,调节性激素水平,改善子宫形态,改善血液微循环,缓解经期出血症状。

Objective To explore the application value of Jiawei Yiqi Guchong Decoction in the treatment of patients with blood stasis syndrome of metrorrhagia and metrostaxis and its influence on estrogen level. Methods According to the random number table method, 112 patients with blood stasis syndrome of metrorrhagia and metrostaxis in their reproductive period, who met the diagnostic criteria and case selection criteria in our hospital from November 2018 to January 2021, were divided into conventional group and experimental group, with 56 cases in each group. The conventional group was given basic treatment, and the experimental group was treated with Jiawei Yiqi Guchong Decoction on the basis of the conventional group. The treatment effect, adverse reactions, menstrual bleeding, endometrial thickness, estrogen level and hemorheology indexes before and after treatment were compared between the two groups. Results The total effective rate of experimental group was 96.43%, higher than that of conventional group (82.14%, P<0.05). After treatment, the improvement of menstrual bleeding and endometrial thickness in the experimental group was greater than that in the conventional group (P<0.05). After treatment, the levels of luteinizing hormone, progesterone, follicle stimulating hormone and estradiol in the experimental group were lower than those in the conventional group (P<0.05). After treatment, erythrocyte aggregation index, fibrinogen, whole blood low shear viscosity and plasma viscosity in the experimental group were lower than those in the conventional group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group (5.36%) and the conventional group (10.71%, P>0.05). Conclusions Jiawei Yiqi Guchong Decoction combined with Western medicine had a significant effect on the treatment of patients with blood stasis syndrome of metrorrhagia and metrostaxis in reproductive period, which can regulate the levels of sex hormones, improve the morphology of uterus, blood microcirculation and relieve the symptoms of menstrual bleeding.

目的 探析化疗联合调强放疗（IMRT）治疗老年（≥65岁）局部晚期鼻咽癌的临床效果。方法 选取2018年1月—2019年1月我院诊治的90例老年局部晚期鼻咽癌患者为研究对象,使用随机数表法将此90例患者分为观察组及对照组,各45例。观察组行IMRT,对照组行化疗联合IMRT,对比2组的效果。结果 2组的治疗总有效率均为100%,组间差异不显著（P<0.05）。观察组的生活质量改善率（93.33%）高于对照组（77.78%）（P<0.05）。对照组出现3~4级白细胞减少、呕吐、黏膜炎人数明显高于观察组（P<0.05）,两者其他毒副反应比较无显著差异（P>0.05）。观察组的1年总体生存率（91.11%）及3年总体生存率（75.56%）均高于对照组（86.67%、68.89%）（P<0.05）。结论 对于老年局部晚期鼻咽癌,化疗联合IMRT相比单纯IMRT降低了远期生存率,增加了毒副反应并影响疗后生活质量的改善,不宜常规应用,单纯IMRT可能是更合适的治疗选择。

Objective To explore the clinical effect of chemotherapy combined with intensity modulated radiation therapy（IMRT）in the treatment of elderly（≥65 years old）locally advanced nasopharyngeal carcinoma．Methods The study was carried out from January 2018 to January 2019．During this period,90 elderly patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in our hospital were selected as the research objects．The random number table method was used to divide the 90 patients into observation groups,and the control group,each with 45 cases．The observation group was treated with IMRT,and the control group was treated with chemotherapy combined with IMRT．The effects of the two groups were compared．Results The total effective rate of the two groups was 100%,and there was no significant difference between the two groups（P<0.05）．The improvement rate of quality of life in the observation group（93.33%）was higher than that in the control group（77.78%,P<0.05）．The number of grade 3-4 leukopenia,vomiting and mucositis in the control group was significantly higher than that in the observation group（P<0.05）,and there was no significant difference in other side effects between the two groups（P>0.05）．The 1-year overall survival rate（91.11%）and 3-year overall survival rate（75.56%）of the observation group were higher than those of the control group（86.67%,68.89%,P<0.05）．Conclusions For locally advanced nasopharyngeal carcinoma in the elderly,chemotherapy combined with IMRT reduces the long-term survival rate,increases the toxic and side effects and affects the improvement of the quality of life after treatment．It is not suitable for routine application,and IMRT alone may be a more appropriate treatment choice.