学术前沿

戊型肝炎病毒感染诊疗的研究进展

Research progress on diagnosis and treatment of hepatitis E virus infection

:735-745
 
       戊型肝炎病毒(HEV)是导致急性肝炎的重要病原体,部分HEV感染者可进展为肝衰竭,此外,慢性感染和肝外表现可也在HEV感染者中发生。全球每年感染HEV的患者数达2000万,其中330万例患者有肝炎相关的临床症状,年死亡例数约为4.4万(2015年数据)。在我国,HEV以散发流行为主。近年来由于对其研究的重视,HEV病原学、流行病学、临床诊疗和预防取得较大的进展,文章拟对目前HEV防治热点以及新进展进行总结和分析。
       Hepatitis E virus(HEV)is an important pathogen that causes acute hepatitis.Some HEV-infected individuals 
may progress to liver failure.In addition,chronic infection(including liver fibrosis and cirrhosis)and extrahepatic manifestations can also occur in HEV infection.Worldwide,there are 20 million cases of HEV infection each year,with  3.3 million cases presenting clinical symptoms related to hepatitis,and an annual death toll of approximately 44,000(data from 2015).In China,HEV mainly present as sporadic outbreaks.In recent years,there has been significant progress in the pathogenesis,epidemiology,clinical diagnosis and treatment,and prevention of HEV.This review aims to summarize and analyze the current hotspots and new developments in the prevention and treatment of HEV.
护理研究

医院 - 社区 - 家庭一体化康复护理模式干预对慢性创面患者生活质量及创面愈合的影响研究

Impact of hospital-community-home integrated rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds

:694-700
 
       目的   评估医院-社区-家庭一体化康复护理模式对慢性创面患者生活质量及创面愈合的潜在影响。   选择2023年1月—2024年6月在广州市第一人民医院接受治疗的慢性创面患者80例作为研究对象,所有患者在住院期间均接受基于溃疡面积、深度及是否合并感染等因素的综合治疗,包括彻底清创、创缘处理、负压治疗、感染控制等治疗,并接受常规护理。出院前,通过随机数字表法将患者分为两组,每组40例。两组患者在住院期间均接受常规护理,出院后,对照组接受延续护理并定期复查。干预组40例患者在出院后接受医院-社区-家庭一体化康复护理模式。入组时及护理3个月后,使用生活质量调查表(SF-36)对患者生活质量和创面愈合率进行评估。结果   干预组创面愈合率为(32.61±4.26)%,高于对照组(11.48±1.04)%,差异具有统计学意义(t=19.473,P<0.05)。两组患者在护理3个月后的数字评定量表评分和创面疼痛频率评分均较入组时降低(P<0.05)。其中干预组护理3个月后的创面VAS评分为(1.82±0.17)分,创面疼痛频率评分为(1.28±0.25)分;而对照组分别为(3.91±0.22)分和(2.63±0.37)分,干预组低于对照组(P<0.05)。此外,干预组在护理后3个月的总体健康、生理功能、生理职能、精神健康、情感功能、社会功能评分均高于对照组(P<0.05)。在居家3个月期间,干预组的感染发生率为5.00%,而对照组为17.50%,干预组感染发生率低于对照组(χ 2 =3.781,P<0.05)。结论   本研究表明,医院-社区-家庭一体化康复护理模式干预能够促进慢性创面患者的创面愈合,降低居家期间感染的风险,并提升患者的生活质量。
       Objective  To assess the potential impact of the integrated hospital-community-home  rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds.Methods  A total of 80 patients with chronic wounds treated at the Guangzhou First People’s Hospital from January 2023 to June 2024 were selected as the study subjects.All patients received comprehensive treatment during their hospital stay,including thorough debridement,edge treatment,vacuum therapy,infection control and routine nursing care.Prior to discharge,the patients were  randomly divided into two groups using a random number table,with 40 patients in each group.Both groups received routine nursing care during their hospital stay,and the control group received continuing nursing care and regular follow-up after discharge.Forty patients in the intervention group received the integrated hospital-community-home rehabilitation nursing model after discharge.Quality of life(QoL)and wound healing rates were assessed using the Short Form 36(SF-36)questionnaire at the time of enrollment and 3 months after nursing.Results  The wound healing rate in the intervention group was significantly higher than that in the control group ([32.61±4.26]% vs [11.48±1.04]%),with a statistical difference(t=19.473,P<0.05).The numerical rating scale(NRS)scores and frequency of wound pain scores decreased in both groups 3 months after nursing compared to the enrollment period(P<0.05).Specifically,the VAS score for wound pain in the intervention group 3 months after nursing was(1.82±0.17),and the frequency of wound pain was(1.28±0.25),in the control group,these scores were(3.91±0.22)and(2.63±0.37),respectively,with the intervention group scoring significantly lower than the control group(P<0.05).Furthermore,the scores for overall health,physical function,role physical,mental health,emotional function,and social function in the intervention group were higher than those in the control group 3 months after nursing(P<0.05).During the 3-month home recovery period,the incidence of infection in the intervention group was 5.00%,whereas it was 17.50% in the control group,with the intervention group  showing a lower incidence of infection(χ 2 =3.781,P<0.05).Conclusions  This study demonstrates that the hospital-community-home integrated rehabilitation care model intervention can promote wound healing in chronic wound patients,reduce the risk of infection during home care,and significantly improve patients’ quality of life.
论著

NXT629 调控脂质代谢改善肝胆结石的机制研究

The mechanism of NXT629 regulating lipid metabolism to improve hepatolithiasis

:644-649
 
       目的   探讨NXT629改善肝胆结石形成的相关机制。方法   对C57BL/6J小鼠分别采用常规饮食或成石饮食(LD)喂养,并在LD组小鼠注射PPAR-α拮抗剂NXT629。通过苏木精-伊红染色法染色分析肝脂肪病变,油红O染色检测肝脏脂质的积累,分光光度法检测胆汁或血清中总胆固醇、甘油三酯、磷脂、总胆汁酸、胆固醇饱和指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇指标;qPCR法检测小鼠肝组织中ABCG5/8、CYP7A1、CYP7B1、PPAR-α和ABCB11 mRNA的表达情况。结果  NXT629通过靶向PPAR-α降低LD组小鼠肝脏中的ABCG5、ABCG8、ABCB11 mRNA水平以及增加CYP7A1、CYP7B1 mRNA水平,进而减少LD诱导的肝胆结石形成并改善脂质代谢紊乱。结论  NXT629可能通过影响脂代谢相关基因表达改善肝胆结石。
       Objective  To explore the mechanism on NXT629 improves hepatolithiasis formation.Methods  C57BL/6J mice were fed either a regular diet or a lithogenic diet(LD),with the LD group receiving injections of PPAR-α inhibitor NXT629.Liver steatosis was analyzed via HE staining,hepatic lipid accumulation was detected by Oil Red O staining,and total cholesterol,triglycerides,phospholipids,total bile acids,cholesterol saturation index,low density lipoprotein cholesterol,and high density lipoprotein cholesterol levels in bile or serum were measured using assay kits.RT-qPCR was employed to determine the mRNA expression of ABCG5/8,CYP7A1,CYP7B1,PPAR-α,and ABCB11 in mouse liver tissues.Results  The results showed that NXT629 target PPAR-α to down-regulate the mRNA levels of ABCG5,ABCG8,and ABCB11 in the livers of LD-fed mice,while increasing the mRNA levels of CYP7A1 and CYP7B1,thereby  reducing LD-induced hepatolithiasis formation and improving lipid metabolism disorders.Conclusions  NXT629 can improve cholesterol gallstones by affecting the expression of genes related to lipid metabolism.
论著

可注射型载阿霉素水凝胶治疗胶质瘤的实验研究

Experimental study on the treatment of glioma with injectable doxorubicin hydrogel

:616-621
 
       目的   初步探讨可注射型载阿霉素水凝胶对胶质瘤的治疗作用。方法   使用透析法检测载阿霉素水凝胶在体外释放药物的情况。构建大鼠皮下C6胶质瘤模型,按不同给药途径分为空白对照组、经静脉注射组、水凝胶组。给药15 h后,经免疫荧光检测阿霉素在肿瘤内部的分布情况。给药7 d后,计算出各组的抑瘤率;并对肿瘤组织进行苏木精-伊红染色。结果   在体外,载阿霉素水凝胶具有缓释药物的性能。在体内,与经静脉给药相比,局部注射载阿霉素水凝胶使瘤内分布更多阿霉素,抑瘤率更高(42% vs 64%),肿瘤细胞坏死更明显。结论   载阿霉素水凝胶可为胶质瘤局部化学治提供新的载体。
      Objective  To investigate the therapeutic effect of injectable doxorubicin-containing hydrogel on glioma.Methods  The release of doxorubicin hydrogel in vitro was detected by dialysis.The subcutaneous C6 glioma model of  rats was constructed and divided into blank control group,intravenous injection group and hydrogel group according to different administration methods.The distribution of doxorubicin in the tumor was detected by immunofluorescence 15 hours after administration.After 7 days of administration,the tumor inhibition rate of each group was calculated.The tumor tissue was stained with hematoxylin eosin.Results  In vitro,doxorubicin-containing hydrogels had sustained drug release properties.In vivo,compared with intravenous administration,local injection of doxorubicin-containing hydrogel resulted in more doxorubicin distribution,higher tumor inhibition rate(42% vs 64%)and more obvious tumor cell necrosis.Conclusions  Doxorubicin-containing hydrogel can provide a new carrier 
for local chemotherapy of glioma.
人工智能与医学

超声引导结合机器学习技术的智能针灸精准诊疗系统研究

Study on acupuncture and moxibustion system using ultrasound and machine learning for precision diagnosis and treatment

:599-604
 
      作为中医药文化瑰宝,针灸在疾病治疗中展现出独特价值,但其标准化操作、疗效量化评价及安全风险控制仍是制约现代化转型的关键问题。随着人工智能技术的突破性发展,机器学习在医疗领域引发的技术革命为针灸创新提供了新机遇。超声医学凭借可视化、定量化及动态监测优势,与机器学习算法形成技术协同,推动传统针灸向精准化、智能化方向迈进。通过超声成像实时定位穴位层次结构与针体轨迹,结合机器学习对多维数据的深度分析,显著提升了针刺治疗的精准性与安全性,同时为建立客观疗效评价体系提供了技术支撑。文章旨在全面回顾超声引导下机器学习技术在针灸研究领域的应用状况,深入剖析现有研究中存在的挑战与局限,并前瞻性地探讨未来的研究方向与趋势,旨在为针灸实践与应用研究的深化与发展提供理论指导与实践启示。
      As an invaluable component of traditional Chinese medicine,acupuncture boasts a distinctive value in the 
treatment of diseases.However,the standardization of its practice,the quantitative assessment of its therapeutic efficacy,and the implementation of safety risk control measures remain pivotal challenges hindering its modernization and transformation.The advent of artificial intelligence technology has precipitated a technological revolution in the medical field,thereby generating novel opportunities for innovation in acupuncture.The integration of ultrasound medicine and machine learning algorithms,leveraging their respective strengths in visualization,quantification and dynamic monitoring,has emerged as a technological synergy.This synergy is poised to propel traditional acupuncture towards precision and intelligence.The integration of ultrasound imaging with machine learning algorithms enables real-time localization of acupoints and needle trajectory,enhancing the precision and safety of acupuncture treatment.Additionally,it facilitates the development of objective efficacy evaluation systems.The present article aims to comprehensively  review the application of ultrasound-guided machine learning technology in the field of acupuncture and moxibustion research.It does so by first analyzing the challenges and limitations of existing research and then prospectively exploring future research directions and trends.The article’s ultimate aim is to provide theoretical guidance and practical inspiration for the deepening and development of acupuncture and moxibustion practice.
论著

便携式超声仪 e-FAST 技术在批量伤员军地联合院前救治中的应用研究

The application of portable ultrasound e-FAST technology in pre hospital treatment of batch injured soldiers in military civilian joint hospitals

:537-541
 
          目的   探讨便携式超声仪超声重点评估(e-FAST)技术在批量伤员军地联合院前救治中的应用效果。方法    抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度(CRAMS)评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果   观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义(χ 2 =2.222,P=0.136);观察组患者的诊断时间(13.56±2.36)min、初次医疗接触—进入手术室时间(30.42±8.99)min均短于对照组[(23.64±5.69)、(52.27±12.60)min],差异有统计学意义t=10.349、8.928,P<0.05);观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义(χ 2 =0.346,P=0.556);治疗后两组患者的CRAMS评分均升高,且观察组(9.87±2.62)分高于对照组(8.60±2.98)分,差异有统计学意义(t=2.024,P=0.046);观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组(χ 2 =3.914,P=0.048)。结论    本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。
       Objective  To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals.Methods  Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment.They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group.The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans after ambulance return to the hospital for corresponding injury treatment,the observation group  received CRAMS scores at the treatment site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process.After preliminary diagnosis,corresponding injury treatment was carried out.The treatment effects of the two groups of patients were compared,and the diagnosis time and initial diagnosis of the two groups of patients were compared.The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared.Results  The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant(χ 2 =2.222,P=0.136).The time to diagnosis(13.56±2.36)min,time to the operating room(30.42±8.99)min were shorter than that in the control group[(23.64±5.69),(52.27±12.60)min],with significant difference(t=10.349,8.928,P<0.05).The consistency  between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the control group patients was 95.0%.There was no significant difference between the groups(χ 2 =0.346,P=0.556).After treatment,the CRAMS scores of both groups of patients increased,the observation group(9.87±2.62)was higher than that of the control group(8.60±2.98)(t=2.024,P=0.046).The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%,while the success rate in the control group was 85.00%.The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group(χ 2 =3.914,P=0.048).Conclusions  This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces,aiming at the development path of military civilian integration strategy in military hospitals.The application scope of portable ultrasound e-FAST has been moved forward,which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue.It is worth clinical reference.
论著

自行设计教育路径在非内分泌科糖尿病患者同质化管理中的应用研究

Construction and application of self-design education path and homogeneity management in diabetic patients of non endocrine department

:529-536
 
       目的   探讨自行设计教育路径在非内分泌科糖尿病患者同质化管理中的应用效果。方法    采用时间分段法将200例非内分泌科住院糖尿病患者分为对照组和研究组各100例,对照组所在非内分泌科各科室责任护士在糖尿病联络护士指导下进行糖尿病常规健康教育,研究组自行设计非内分泌科糖尿病健康教育路径并实施同质化管理,观察比较两组患者糖尿病知识知晓程度、血糖水平、自我管理能力、护理满意度。结果   出院时研究组患者密西歇根糖尿病知识测试问卷(DKT)评分(18.37±3.06)分,对照组为(16.01±3.59)分,研究组高于对照组(t=5.004,P<0.05);管理6个月空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbAlc)分别为[7.00(7.00,8.00)]mmol/L、[8.00(6.00,9.00)]mmol/L、[7.50(6.00,8.00)]%,对照组分别为[8.00(7.00,10.00)]mmol/L、[9.00(8.00,11.00)]mmol/L、[8.00(7.00,9.00)]%,研究组均低于对照组(Z=6.398、5.248、3.034,均P<0.05);研究组糖尿病自我管理能力行为量表(SDSCA-6)评分、纽卡斯尔护理满意度量表(NNSS)评分分别为(35.36±4.75)分、(83.42±6.92)分,对照组分别为(30.90±7.56)分、(72.31±9.26)分,研究组均高于对照组(t=4.998、9.614,均P<0.05)。结论   糖尿病教育路径结合同质化管理能提高非内分泌科住院糖尿病患者糖尿病知识的掌握程度,有效控制血糖水平,提高患者自我管理能力和对护理工作满意度。
      Objective   To explore the application effect of self-designed education path in homogenization management of non-endocrinology diabetic patients.Methods   A total of 200 inpatients with diabetes in non-endocrinology departments were divided into control group and research group with 100 cases in each group.The  responsible  nurses in the  non-endocrinology departments of the control group conducted routine diabetes health education under the guidance of diabetes liaison nurses.The research group designed its own non-endocrinology diabetes health education path and implemented homogenized management.The knowledge level of diabetes mellitus,blood sugar level,self-management ability and nursing satisfaction of the two groups were observed and compared.Results   At discharge,the DKT score of the study group was(18.37±3.06) and that of the control group was(16.01±3.59),which was higher than that of the control group(t=5.004,P<0.05).After 6 months management,FBG,2 HPBG and HbAlc of study group were[7.00(7.00,8.00)] mmol/L,[8.00(6.00,9.00)] mmol/L,[7.50(6.00,8.00)]%,respectively,while those in the control group was[8.00(7.00,10.00)]mmol/L,[9.00(8.00,11.00)]mmol/L and[8.00(7.00,9.00)]%,respectively.The study group was lower than the control group(Z=6.398,5.248,3.034,all P<0.05).SDSCA-6 scores and NNSS scores in the study group were(35.36±4.75)scores and(83.42±6.92)scores,respectively,while those in the control group were(30.90±7.56)scores and(72.31±9.26)scores,which were higher in the study group than in the control group(t=4.998,9.614,all P<0.05).Conclusions   The combination of diabetes education pathway and homogenized management can improve the mastery of diabetes knowledge,effectively control blood sugar level,improve patients’ self-management ability and satisfaction with nursing work.
论著

达泊西汀联合达克罗宁胶浆治疗早泄的临床研究

Clinical study on the treatment of premature ejaculation with dapoxetine combined with dacronine mucilage

:523-528
 
       目的   探讨盐酸达泊西汀联合达克罗宁胶浆治疗早泄的临床疗效。方法   选取男科门诊146例早泄患者,随机分组,对照组服用达泊西汀片,研究组为达泊西汀片和达克罗宁胶浆联合治疗,再将研究组分为阴茎头敏感度高组和敏感度正常组,记录各组治疗前、治疗8周后早泄相关指标。结果   治疗后对照组阴道内射精潜伏期(IELT)、早泄诊断量表(PEDT)和早泄指数量表(IPE)中Q6+Q7分别为(4.68±2.79)、(9.52±2.14)、(6.48±1.30),研究组IELT、PEDT和Q6+Q7分别为(6.09±3.09)、(7.52±1.92)、(7.85±1.36),各组相关指标均较治疗前改善(P<0.05),研究组各指标改善程度优于对照组(P<0.05);治疗后敏感度高组IELT、PEDT和Q6+Q7分别为(6.76±2.99)、(6.84±1.53)、(8.16±1.10),敏感度正常组IELT、PEDT和Q6+Q7分别为(5.13±3.02)、(8.50±2.03)、(7.40±1.59),敏感度高组各指标改善程度优于敏感度正常组(P<0.05);对照组、研究组总有效率分别为69.86%(51/73)、84.93%(62/73),研究组治疗效果优于对照组(P<0.05);敏感度高组、敏感度正常组总有效率分别为93.02%(40/43)、73.33(22/30),敏感度高组治疗效果优于敏感度正常组(P<0.05)。结论    达泊西汀联合达克罗宁胶浆治疗早泄效果显著,阴茎头敏感患者联合达克罗宁胶浆治疗受益更大。
       Objective  To investigate the clinical efficacy of dapoxetine hydrochloride combined with dclonine mucilage in the treatment of premature ejaculation.Methods  A total of 146 patients from andrology department with premature ejaculation were selected and randomly divided into control group and research group.The control group was treated with dapoxetine alone,while the research group was treated with dapoxetine combined with dacronine mucilage.The  research group was divided into high sensitivity group and normal sensitivity group.The indexes  related to premature ejaculation were  recorded before treatment and 8 weeks after treatment.Results  After treatment,intravaginal ejaculatory latency time(IELT),Premature Ejaculation Diagnosis Tool(PEDT)and Q6+Q7 of the index of premature ejaculation(IPE)in control group were(4.68±2.79),(9.52±2.14)and (6.48±1.30),respectively,while IELT,PEDT and Q6+Q7 in research group were(6.09±3.09),(7.52±1.92) and (7.85±1.36),respectively.The relevant indexes in all groups were significantly improved compared with those before treatment(P<0.05),and the improvement of all indexes in research group was better than that in control group(P<0.05).After treatment,IELT,PEDT and Q6+Q7 in the highly sensitivity group were(6.76±2.99),(6.84±1.53)and(8.16±1.10),respectively,while IELT,PEDT and Q6+Q7 in the normal sensitivity group were(5.13±3.02),(8.50±2.03)and(7.40±1.59),respectively.The improvement of all indexes in the high sensitivity group was better than that in the normal sensitivity group(P<0.05).The total effective rate of the control group and the research group was 69.86%(51/73)and 84.93%(62/73),respectively.The therapeutic effect of the research group was significantly better than that of the control group(P<0.05).The total effective rate of the high sensitivity group and the normal sensitivity group was 93.02%(40/43)and 73.33%(22/30),respectively.The therapeutic effect of the high sensitivity group was significantly better than that of the normal sensitivity group(P<0.05).Conclusions  Dapoxetine combined with dacronine mucilage has significant effect in the treatment of premature ejaculation,and the patients with high sensitivity of penile head will benefit more from combined dacronine mucilage therapy.
论著

复方黄芪颗粒对小鼠抗疲劳的作用及其机制研究

Study on the anti-fatigue effect of compound Huangqi granules on mice and its mechanism

:509-515
 
       目的   探讨复方黄芪颗粒(CHG)的抗疲劳作用及其机制。方法  48只雄性BALB/C小鼠随机分为空白对照组、低剂量(9.1 g/kg)、中剂量(18.2 g/kg)、高剂量(27.3 g/kg)CHG 3个试验组,每组12只。试验组给予不同剂量的复方黄芪颗粒溶液灌胃,空白对照组小鼠给予等体积生理盐水。给药30 d后,检测小鼠体内相关指标变化,观察其抗疲劳作用并分析相关机制。结果   与空白对照组相比,试验组小鼠体质量差异无统计学意义(P>0.05),小鼠力竭游泳时间及转棒耐力时间均明显延长(P<0.01),血尿素氮(BUN)、乳酸脱氢酶(LDH)、丙二醛(MDA)水平明显降低P<0.01),肝糖原和肌糖原水平升高(P<0.05),超氧化物歧化酶(SOD)活性升高(P<0.01)。体外抗氧化试验表明CHG以剂量依赖性方式清除2,2-联氮-二(3-乙基-苯并噻唑-6-磺酸)二铵盐(ABTS)和1,1-二苯基-2-三硝基苯肼(DPPH)自由基。当CHG质量浓度为100.000 0 mg/mL时,CHG对DPPH自由基清除能力可达85.030 3%。当CHG质量浓度为25.000 0 mg/mL时,CHG对ABTS自由基清除能力可达96.357 2%。结论  CHG具有抗疲劳的作用,其作用机制可能与抗氧化作用相关。
      Objective  To investigate the anti-fatigue effects of compound Huangqi granules(CHG)and its mechanism.Methods  Forty-eight male BALB/C mice were randomly divided into blank control group,9.1,18.2,27.3 g/kg CHG group(test groups).The test groups received different concentrations of CHG solution by gavage,and the blank control group mice were given equal volume saline.After 30 days of administration,the mice were tested,meanwhile the anti-fatigue effect and mechanism were investigated.Results  Compared with blank control group,there was no significant difference in body weight(P>0.05).The exhaustive swimming time and rod turning endurance time of mice were significantly prolonged(P<0.01).The serum levels of blood urea nitrogen,lactate dehydrogenase and malondialdehyde were significantly decreased(P<0.01),while the liver and muscle glycogen levels(P<0.05)and superoxide dismutase activity were increased(P<0.01).In vitro antioxidant tests showed that CHG can remove (1,1-Diphenyl-2-picrylhydrazyl,ABTS) and (2,2’-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid,DPPH) free radicals in a dose-dependent manner.When the CHG concentration is 100 mg/mL,the DPPH free  radical scavenging ability of CHG can reach 85.030 3%.When the CHG concentration was 25 mg/mL,the scavenging ability of CHG to ABTS free radicals reached 96.357 2%.Conclusions  CHG has anti-fatigue effect,and its mechanism may be related to anti-oxidation effect.
论著

女性医务人员月经改变的影响因素及与心理状态的相关性研究

Study on the influencing factors of menstrual changes of female medical staff and the correlation with psychological status

:486-493
 
       目的   探讨女性医务人员月经改变的影响因素及与心理状态的相关性。方法   对深圳市3家医院女性医护人员进行随机抽样得到869份问卷调查样本,均为知情自愿参与本项调查研究。统计女性医务人员出现女性月经改变的比率和月经改变的基本特征,并采用单因素和多因素分析的方法分析影响月经改变因素。并以抑郁症筛查量表(PHQ-9)评估女性医护人员的心理状态,分析女性医务人员月经改变与心理状态评分间相关性。结果  869名女性医护人员中有293例发生月经改变,改变率为33.72%,其中月经周期改变94例、经期时间改变86例、月经量改变68例、痛经改变45例。将869例女性医护人员分为月经正常组和月经改变组,经单因素分析,两组间的年龄、职业、值夜班频率、既往病史、新冠感染等比较差异无统计学意义(P>0.05)。月经改变组的护士占58.36%高于月经正常的24.48%,月经改变组的新冠一线抗疫人员占64.51%高于月经正常的27.08%,月经改变组合并妇科疾病史的占比20.82%(61例)高于月经正常组的占比11.98%(69例)。而月经改变组的护士、新冠一线抗疫人员、合并妇科疾病史、新冠感染的比较差异有统计学意义(P<0.05)。多因素分析显示,职业为护士、合并妇科疾病史、新冠一线抗疫人员的P值分别为0.001、0.004、<0.001,故而职业为护士、合并妇科疾病史、新冠一线抗疫人员是女性医务人员月经改变的危险因素。月经改变组PHQ-9评分为9.10±2.57,月经正常组PHQ-9评分为5.98±1.06,月经改变组PHQ-9评分高于月经正常组(P<0.001)。两组受试者PHQ-9评分比较差异具有统计学意义,月经改变组PHQ-9评分中0~4分受试者为26.3%,月经正常组为47.2%,月经改变组PHQ-9评分中0~4分者比例小于月经正常组,差异具有统计学意义(P<0.05)。结论   女性医务人员中职业为护士、合并妇科疾病史、新冠一线抗疫人员是月经改变的主要危险因素,且月经改变与心理状态有密切的相关性,需引起医疗机构的关注。
      Objective  To analyze the influencing factors of menstruation changes of female medical staff and the correlation with their psychological status.Methods  The female medical staff in three hospitals of Shenzhen were  randomly sampled to get 869 questionnaires,with informed and willing to participate in this research.The rate of female menstruation changes and the basic characteristics of menstruation changes in female medical staff were calculated,and the influencing factors of menstruation changes were analyzed by single factor and multi factor analysis.And the psychological status of female medical staff was using the Depression Screening Scale (PHQ-9),and the correlation between menstrual changes and psychological status scores of female medical staff were analyzed.Results  Among 869 female medical staff,293 had hemorrhagic menstrual disease,with a change rate of 33.72%.Among them,94 had changes in menstrual cycle,86 had changes in menstrual period days,68 had changes in menstrual volume,and 45 had changes in dysmenorrhea.These 869 female medical staff were divided into normal menstruation group and menstrual change group.Through single factor analysis,there was no statistical difference between the two groups in terms of age,careers,night shift frequency,previous medical history,COVID-19 infection (P>0.05).The percentage of nurses in the menstrual change group was 58.36%,higher than that of 24.48% in the normal menstruation group.The percentage of frontline medical staff combating COVID-19 in the menstrual change group was 64.51%,higher than that of 27.08% in the normal menstruation group.And the percentage of menstrual change group with a history of combined gynecological diseases was 20.82% (61 cases),higher than that of the normal menstruation group was 11.98% (69 cases).And the difference was statistically significant when comparing the ratio of nurses,the frontline medical staff combating COVID-19,the history of gynecological diseases,and COVID-19 infection in the menstrual change group (P<0.05).Multivariate analysis showed that the occupation of nurses,frontline medical staffs combating COVID-19,and history of gynecological diseases were the risk factors for menstrual changes.The PHQ-9  score of the menstrual change group was higher than that of the normal menstrual group,and the difference was statistically significant.Conclusions  The main risk factors for menstrual changes are nurses,frontline anti-epidemic staff,and women with gynecological disease history.Menstrual changes are closely related to mental status,attention from healthcare organizations.
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