目的 探讨激光心肌血运重建(Transmyocardial Laser revascularization, TMLR)辅助冠状动脉旁路移植术治疗严重冠心病的临床疗效及 11年随访结果。方法 25例严重冠心病患者行不停跳冠状动脉旁路移植术(off-pump coronary artery bypass, OPCAB)并辅以激光心肌血运重建术(TMLR组),回顾性总结了其术前、术中、术后及 11年随访资料,并与同期进行的 95例单纯不停跳冠状动脉旁路移植术(OPCAB组)病人资料进行比较分析。结果 TMLR组在平均远端吻合口数比 OPCAB组少,而手术时间、术后硝普钠用量比OPCAB组多,其他如术后机械通气时间、ICU停留时间、术后住院天数和术后常见并发症,2组之间均无差异;平均 11年随访资料中,胸闷痛、心衰、新出现 ST-T改变发生率、再发急性心梗、再次 PCI处理、LVEF和血管桥闭塞率,2组间无明显区别;死亡率二者之间也没有区别。结论 TMLR术辅助冠状动脉旁路移植术虽然手术时间比较长,血管活性药物应用较多,但术后康复和 11年随访资料显示与单纯 OPCAB术有相似的结果,说明 TMLR术作为冠状动脉旁路移植术的补充,对那些冠脉血管细小且钙化狭窄严重而不适合冠状动脉旁路移植术的冠心病患者是获益的。

Objective To explore and analyze the clinical effect of off-pump coronary artery bypass (OPCAB) combined transmyocardial laser revascularization(TMLR) of severe coronary artery disease and 11 years follow-up. Methods 25 cases with sever coronary artery disease were treated through OPCAB and TMLR, and the clinical data and 11 years follow-up data were summarized and analyzed retrospectively, compared with the data of the patients treated by only OPCAB. Results There were less mean bypass graft numbers in TMLR group than in OPCAB group. Operation time and the amount of sodium nitroprusside in TMLR group were more than that in OPCAB group. But intubation time, ICU stay time, postoperative stay time and postoperative common complications were not different between two groups. 11 years postoperative follow-up results indicated that chest pain, heart disfunction, ST-T alteration, AMI, PCI treatment again, LVEF and bypass graft occlusion rate were not obviously between two groups. Conclusion TMLR combined OPCAB may result in good outcome and improve long term survival.

目的 研究过表达miR-29a-3p对IL-22诱导的HaCaT细胞增殖的影响。方法 将HaCaT细胞分为Cell组、IL-22组、IL-22+NC组和IL-22+ miR-29a-3p组,荧光定量PCR检测miR-29a-3p的表达水平,CCK8检测细胞的活力,流式细胞仪检测细胞凋亡及周期。结果 与0 μg/L组相比,25 μg/L组、50 μg/L组和100 μg/L组HaCaT细胞的增殖率在24 h、48 h和72 h均出现升高(F值分别为33.27、36.19、52.29,均P<0.000 1)。与0 μg/L组相比,miR-29a-3p在50 μg/L组和100 μg/L组HaCaT中的表达水平降低(F=129,P<0.000 1),分别降低83%和80%。与IL-22+NC组相比,IL-22+ miR-29a-3p组的增殖率在24 h、48 h和72 h均降低(P值分别为0.002 1、0.001 6、0.023 1),细胞总凋亡率增加(6.67±1.06 vs 30.55±1.86,P=0.000 1),G1期细胞比例增加(P=0.000 1),S期细胞比例降低(P=0.000 1)。结论 IL-22可降低HaCaT中miR-29a-3p的表达量,过表达miR-29a-3p通过促进凋亡和引起细胞G1期阻滞抑制IL-22诱发的HaCaT细胞过度增生。

Objective To investigate the effect of miR-29a-3p overexpression on IL-22-induced proliferation of HaCaT cells. Methods HaCaT cells were divided into four groups, Cell group, IL-22 group, IL-22 +NC group and IL-22+miR-29a-3p group. The expression level of miR-29a-3p was detected by fluorescence quantitative PCR. Cell viability was detected by CCK8. Apoptosis and cell cycle were detected by flow cytometry. Results Compared with the 0 g/L group, the proliferation rate of HaCaT cells in the 25 μg/L group, 50 μg/L group and 100 μg/L group was increased at 24 h, 48 h and 72 h (F value was 33.27, 36.19, 52.29,respectively, all P<0.000 1). Compared with the 0 μg/L group, miR-29a-3p expression level in HaCaT in 50 μg/L and 100 μg/L groups was decreased (F=129, P<0.000 1), with a decrease of 83% and 80%, respectively. Compared with the IL-22+NC group, proliferation rate of IL-22+miR-29a-3p group was decreased at 24 h, 48 h and 72 h (P value was 0.002 1, 0.001 6, 0.023 1, respectively), total apoptosis rate was increased (6.67±1.06 vs 30.55±1.86, P=0.000 1), cell proportion in G1 phase was increased (P=0.000 1), and the cell proportion in S phase was decreased (P=0.000 1). Conclusion Il-22 can reduce miR-29a-3p expression level in HaCaT, and miR-29a-3p overexpression can inhibit the excessive proliferation induced by IL-22 in HaCaT cells by promoting apoptosis and inducing G1 phase arrest.

目的 筛选九头狮子草治疗小鼠细菌性阴道炎的有效部位。方法 采用金黄色葡萄球菌、大肠埃希菌菌悬液注入小鼠阴道建立小鼠细菌性阴道炎动物模型,观察九头狮子草各极性部位对细菌性阴道炎的治疗作用。结果 九头狮子草水提液、石油醚提取部位和70%乙醇提取部位对病原菌转阴率和阴道黏膜炎症的治愈程度均有提高,其中,对金黄色葡萄球菌的转阴率分别为60%、50%、40%,对大肠埃希菌的转阴率分别为80%、70%、50%。结论 九头狮子草石油醚提取部位和70%乙醇提取部位为其治疗细菌性阴道炎的有效部位。

Objective To study the active parts of Peristrophe japonica of vaginitis treatment effect. Methods The bacterial vaginitis model was established by injecting the bacteria of Staphylococcus aureus and Escherichia coli into the vagina of the mice and the treatment effect of each extract of Peristrophe japonica was observed. Results Three drug administration groups (including water extract of Peristrophe japonica, ligarine fraction and 70% ethanol fraction) showed marked treatment effect on the vaginitis models. The effect of water extract of Peristrophe japonica group were stronger than that of the ligarine fraction and 70% ethanol fraction groups. The pathogens seroconversion rates in Staphylococcus aureus were orderly as follows: 60%, 50%, 40%. The pathogens seroconversion rates in Escherichia coli were orderly as follows: 80%, 70%, 50%. Conclusion The ligarine fraction and 70% ethanol fraction of Peristrophe japonica might be the active extracts of curing vaginitis.

目的 探讨具有不同载脂蛋白E4等位基因(Apolipoprotein E4 alleles,APOE4)阿尔茨海默病患者的神经心理学量表差异。方法 纳入2014年1月—2017年12月广州市第一人民医院收治阿尔茨海默病患者28人,分别予简易精神状态检查量表、阿尔茨海默病评定量表-认知部分、临床医师通过面谈对变化的印象、日常生活活动能力量表、神经精神问卷,并检测量表间相关关系。之后随访18个月,观察量表评测的各功能变化及互相间相关性。检测不同载脂蛋白E4等位基因等阿尔茨海默病相关基因分布及与量表间相关关系。结果 认知评定量表间、认知评定量表与整体评价量表间、以及认知评定量表与日常活动能力评定量表间具有相关性。精神与行为症状量表分数与其他评定量表无明显相关性。随访中各量表分数变化间均无相关性。各基因组间功能变化无显著性差异,载脂蛋白E4等位基因变异主要影响患者的认知功能。等位基因分布与患病年龄,日常活动能力及精神与行为症状无相关性。结论 阿尔茨海默病量表评测的各认知领域间相关性不同,功能变化间无相关关系。载脂蛋白E4等位基因变异主要影响患者的认知功能。

Objective The present study aimed to elucidate the performance of multiple psychological tests among different Apolipoprotein E4 alleles (APOE4) in people with Alzheimer's disease (AD). Methods 28 patients were enrolled from January 2014 to December 2017 in Guangzhou First People'S Hospital. All patients were tested by using Mini-mental State Examination (MMSE), Alzheimer's disease Assessment Scale (ADAS-cog), Clinician's Interview-Based Impression of Change (CIBIC-Plus), Activities of Daily Living (ADL) and the NeuroPsychiatric Inventory (NPI). After 18 months follow-up visit, the change of the tests points were recorded. AD pathogenic genes, including Apolipoprotein E4 allele's variations, were detected in all patients. Then the correlations of APOE4 alleles and multiple psychological tests were analyzed. Results The correlations were confirmed between MMSE and ADAS-cog, MMSE and CIBIC-plus, MMSE and ADL, ADAS-cog and CIBIC-plus, ADAS-cog and ADL. NPI showed no correlation with the others. No correlation was found between changes of multiple psychological tests after 18 months follow-up. APOE4 alleles' variation affected cognitive function mainly. The effects of APOE4 on ADL and NPI showed no statistical significance in AD patients. No correlation was found among patients groups with different APOE4 alleles in all psychological tests and age of onset. Conclusion The correlations were existed among multiple cognitive domains while levels were different. The changes between psychological tests showed no correlations. APOE4 alleles' variation affected cognitive function mainly.

目的 本研究通过调查中国华南地区一间大型医疗机构(综合医院)中护士日间过度嗜睡的发生率及相关影响因素。方法 纳入了1 102名在职护士要求他们在一段规定的时间内完成一份自我报告问卷,其中包括人口学资料采集、生活习惯(BMI、小睡习惯、打鼾等)、失眠、抑郁、焦虑、MEQ分型、倒班、工作兴趣等与工作及睡眠相关的特征。了解EDS在被试人群中的发生率及其影响因素。结果 共有1 048名护士有效的完成了问卷(应答率为95.1%)。其中169名(16.1%)护士存在日间过度嗜睡(EDS)。抑郁症状(校正后的OR值= 2.24,95%的可信区间 1.51～3.31)、焦虑症状(1.65; 1.02～2.67)、失眠(2.29; 1.56～3.36)、倒班工作(1.98; 1.03～3.83)和对工作的低兴趣(1.74; 1.01～2.99)是EDS发生的独立危险因素。结论 日间过度嗜睡(EDS)在华南地区的综合医疗机构中的青年护士群体中普遍存在。EDS的发生可能与抑郁症状、焦虑症状、失眠、倒班工作和对工作的低兴趣存在相关。

Objective To investigate the prevalence and correlates of excessive daytime sleepiness EDS in a population of hospital nurses in South China. Methods A total of 1 102 nurses working in a large medical center were invited to participate in this cross-sectional study (females 96.9%,mean age 29.6 years). They all completed a self-reported questionnaire consisting of items on demographic variables,lifestyle factors,insomnia,anxiety,depression,and both work-related and sleep related characteristics. Results A total of 1 048 nurses gave a valid response (response rate 95.1%). Among them,169 (16.1%) reported EDS as defined as an Epworth Sleepiness Scale≥14. Depression (adjusted odds ratio=2.24,95% confidence interval 1.51～3.31),anxiety (1.65; 1.02 ～2.67),insomnia (2.29; 1.56～3.36),rotating shift work (1.98; 1.03～3.83) and low interest in work (1.74; 1.01～2.99) were all independent risk factors of the occurrence of EDS. Conclusion EDS were common among this relatively young and healthy nurse population in south China. There were clear associations with EDS and depression,anxiety,insomnia,rotating shift work and low work-related interest.

目的 研究NR3C1(核受体亚科3,C组,成员1)又称糖皮质激素受体(GR)表达量对前列腺癌恶性程度的影响及其与前列腺癌生化复发的相关性。方法 通过组织芯片免疫组化染色检测的方法检验NR3C1在不同恶性程度前列腺癌组织的表达情况,结合Taylor数据库分析NR3C1表达水平与前列腺癌临床病理特征关系,再采用Kaplan-Meier法分析NR3C1对前列腺癌生化复发生存率的影响,最后用Cox回归分析临床病理特征与生化复发的相关性。结果 组织芯片免疫组化结果显示NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.028)。结合Taylor公用数据库分析,NR3C1在前列腺癌组织中的表达低于癌旁组织(P＜0.001),NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.005),NR3C1低表达与PSA复发(P=0.028)和转移(P=0.003)相关。Kaplan-Meier结果提示:NR3C1高表达组患者术后的生化复发生存率更高(P=0.043),总体生存率没有明显区别(P=0.872)。单因素分析结果显示:NR3C1(P=0.002),病理分期(P＜0.001),Gleason评分(P＜0.001),是否转移(P=0.012)是前列腺癌生化复发的影响因素。多因素分析结果显示:高Gleason 评分(P=0.017)和转移(P<0.001)均为生化复发危险因素。结论 NR3C1影响前列腺癌的发病进程,检验NR3C1的表达情况,能预测前列腺癌患者生化复发的概率,可协助判断前列腺癌预后。

Objective We study the role of NR3C1 (nuclear receptor subfamily 3,group C,member 1) in PCa progression,and the correlation between its expression level and the biochemical recurrence of PCa. Methods Immunohistochemistry was used to detect the expression of NR3C1 in PCa tissues of different degrees of malignancy. The associations of NR3C1 expression and clinical pathological features were analyzed using the Taylor dataset. Kaplan-Meier was used to detect the relationship between NR3C1 expression and biochemical recurrence survival rate in PCa. Cox-regressive analysis was used to detect the relationship between clinical pathological features and biochemical recurrence. Results Immunohistochemistry analysis showed the expression of NR3C1 was higher in which its Gleason Score was lower(P=0.028). Base on the Taylor dataset,the expression of NR3C1 was higher in the adjacent benign tissues than that in PCa(P＜0.001). The expression of NR3C1 was higher in which its Gleason Score was lower(P=0.005). Furthermore,low NR3C1 expression was associated with PSA failure(P=0.028) and Metastasis(P=0.003). Kaplan-Meier showed the biochemical recurrence-free time of PCa patients in low NR3C1 expression groups reduced(P=0.043). The overall survival time of PCa patients was not correlated to NR3C1 expression levels(P=0.872). Single factor analysis showed the biochemical recurrence is associated with NR3C1 expression(P=0.002),pathological stage(P＜0.001),Gleason score(P＜0.001), Metastasis status(P=0.012). Multivariate analysis by Cox regression further identified the high Gleason Score(P=0.017) and Metastasis status (P<0.001)were hazards of the biochemical recurrence. Conclusion Our study showed that the expression of NR3C1 critically connected with the process of PCa,which indicated that we can predict the probability of the biochemical recurrence and determine the prognosis of prostate cancer by detecting the expression of NR3C1 in PCa patients.

目的 对比中成药镇痛活络酊和非甾体抗炎药(Nonsteroidal Anti-inflammatory Drugs,NSAIDs)治疗肱骨外上髁炎(lateral epicondylitis,LE)的短期临床疗效差异。方法 筛选后符合纳入标准的LE患者60例,随机分为镇痛活络酊组(n=30)和NSAIDs组(n=30)。镇痛活络酊组外用镇痛活络酊,NSAIDs组外用法斯通凝胶(酮洛芬),两组均连续用药3周,3次/d。用药后3 周、6 周和12 周连续随访,主要观测指标包括视觉模拟评分(visual analog scale,VAS);肩、肘和手的功能评分(Disabilities of the arm, Shoulder And Hand,DASH);无痛握力(Pain-free grip strength,PFGS)。VAS评分分别测量患者1周前用力活动时的VAS评分和正常休息时的VAS评分,记为VAS(活动时)和VAS(休息时)。运用统计学方法对比分析两组患者在VAS评分(活动时)、VAS评分(休息时)、DASH评分和PFGS上的差异。结果 两组患者在VAS评分(活动时)、VAS评分(休息时)和DASH评分上均未见组间差异(P>0.05)。两组患者在用药前、用药后3周、用药后6周的PGFS对比同样无组间差异(P=0.91,P=0.42,P=0.13)。但是,在用药后12周,镇痛活络酊组的PFGS高于NSAIDs组(P=0.02)。结论 镇痛活络酊缓解LE疼痛的效果与外用NSAIDs相当,对提升伸肌力效果则更优。

Objective To compare the short-term clinical effects difference between analgesic tincture and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of lateral epicondylitis (LE). Methods 60 cases of LE patients were randomly divided into an analgesic tincture group (n=30) and a NSAIDs group (n=30). Analgesic tincture was chosen for the analgesic tincture group and topical ketoprofen gel for the NSAIDs group to treat LE. Two groups were treated continuously for 3w, 3 times/day. Clinical results of each drug were followed-up at the time point of 3w, 6w and 12w after usage. Observational indexes included the visual analogue scale (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and pain-free grip strength (PFGS). The inter-group difference of VAS (at activity), VAS (at rest), DASH score and PFGS were compared subsequently. Results No difference of the VAS (at activity), VAS (at rest), DASH score were ascertained (P> 0.05) between groups. Inter-group difference of PGFS was also not discerned at the time points of pre-treatment and 3 weeks and 6 weeks (P=0.91, P=0.42, P=0.13) post-treatment. However, PFGS of the analgesic tincture group was found to be higher than that of the NSAIDs group (P=0.02) after 12 weeks post-treatment. Conclusion Effect of analgesic tincture in releasing pain is almost the same to that of tropical NSAIDs, but a better effect in improving muscle strength.

目的 调查口腔专科医院门诊不同层级护士急救能力的现状,进一步探讨优化口腔门诊护士急救培训模式。方法 选取2019年1月—2020年1月我院口腔门诊护士97名,采用自设问卷调查及现场操作技能评估对护士进行考核,调查护士的急救能力。结果 口腔科门诊不同层级护士的急救能力(包括相关知识与操作能力)差异有统计学意义(P＜0.05)。其中,N1级(工作1~＜3年)的护理人员急救能力低于N2级(工作3~5年)的护理人员。N3级(工作6~10年)的急救知识考核分、操作考核分略低于工作N2级护士,但差异无统计学意义。而不同年龄、学历、职称、科室的护士急救能力的差异无统计学意义。结论 口腔门诊护士急救培训应分层级进行,特别应加强N1级以下护理人员的急救技能培训,保证护士急救培训效果同质化,对口腔门诊诊疗中提高医疗安全及护理质量具有重要意义。

Objective To investigate the current status of the first-aid ability of nurses at different levels in outpatient clinics of stomatological hospitals, and to further explore the optimization of the training model of first-aid nurses in outpatient clinics. Methods A total of 97 nurses in our outpatient clinic from January 2019 to January 2020 were selected. The nurses were assessed by self-designed questionnaire surveys and on-site operation skills assessment to investigate the nurses' first aid ability. Results The difference in first aid ability (including relevant knowledge and operation ability) of nurses at different levels in the dental clinic was statistically significant (P<0.05). Among them, the first-aid ability of nursing staff of N1 grade (working 1 ~<3 years) is lower than that of nursing staff of N2 grade (working 3 ~ 5 years). The N3 level (working 6～10 years) first aid knowledge assessment and operation assessment scores are slightly lower than those of working N2 nurses, but the difference is not statistically significant. There was no statistically significant difference in the first aid ability in nurses of different ages, educational backgrounds, titles, and departments. Conclusion The first-aid training of nurses in oral clinics should be conducted in different levels, especially the first-aid skills training of nurses below N1 level. We should be strengthened to ensure the homogenization of nurse's first-aid training effect, which is of great significance to improve medical safety and quality of care in oral clinics.

目的 探讨臭氧水在外科手消毒中的消毒效果和医护人员的舒适度。方法 将参加手术的医务人员80例按时间段分为对照组、低浓度组、高浓度组,于消毒后分别进行手采样培养,并进行分析。结果 消毒后三组在菌落数比较差异有统计学意义(P<0.01);消毒后三组皮肤在发痒、脱屑、干燥评分比较差异有统计学意义(P<0.05);在气味、粘腻感、干燥速度比较差异有统计学意义(P<0.05)。结论 臭氧水用于外科手消毒效果可靠,无刺激气味和粘腻感,医护人员感觉更舒适。

Objective The aim of this study was to explore the disinfection effect of ozone water in surgical hand disinfection and the comfort of medical staffs. Methods 80 medical staffs who participated in surgeries were divided into control group, low-concentration group and high-concentration group according to the time period. After disinfection, hand samples were cultured and analyzed. Results After disinfection, there were statistically significance in colony number (P<0.01), itching, scaling and drying scores (P<0.05), odor, stickiness and drying speed (P<0.05). Conclusion Ozone water for surgical hand disinfection is reliable, no irritating odor and stickiness, and makes medical staffs feel more comfortable.

目的 探索冻融胚胎移植周期胚胎移植前宫腔灌注胚胎培养上清液对胚胎种植及妊娠结局的影响。方法 纳入我院 2019 年 3 月—2019 年 12 月 共计198个冻 融 胚 胎 移 植 ( frozen-thawed embryo transfer,FET)周期。根据 FET 术前是否予胚胎培养液上清液宫腔灌注操作分成 2 组,灌注组93 个周期,对照组即未灌注组105个周期。灌注组分别于FET术前 4 周和术前 1 天行宫腔灌注胚胎培养上清液,对照组未行胚胎培养上清液宫腔灌注,对比两组患者胚胎着床率、临床妊娠率、流产率。结果 灌注组患者的胚胎着床率高于对照组,差异有统计学意义(P＜0.05)。两组间的临床妊娠率、流产率未见统计学差异(P>0.05)。结论 FET术前宫腔灌注胚胎培养上清液可提高胚胎种植率。

Objective To investigate the potential impact of intrauterine perfusion of embryo culture supernatant before frozen-thawed embryo transfer (FET) on pregnancy outcome. Methods From March to December 2019, a total of 198 FET cycles were enrolled for the present study.Patients were divided into two groups: the study group included 93 cycles, patients in this group received intrauterine perfusion of embryo culture supernatant four weeks and one day before the embryo transfer, respectively; the control group included 105 cycles, and patients in this group did not receive intrauterine perfusion. Rates of implantation, pregnancy, and miscarriage were compared between the two groups. Results The implantation rate in the study group was higher than that in the control group (P<0.05). There were no significant differences in clinical pregnancy rate and abortion rate between the two groups (P>0.05). Conclusion With the performance of intrauterine perfusion of embryo culture supernatant before embryo transfer, the implantation rate may be improved in FET cycles.