目的:探讨早期康复治疗对中青年脑卒中患者肢体运动功能恢复等影响。方法：从我院选取中青年脑卒中患者90例作为实验对象，分为实验组和观察组各45例，两组同时接受相同常规治疗并给予早期康复介入，并对其进行患侧上肢和下肢功能评定量表（ Fugl-Meyer, FMMS），以及患者日常生活活动能力（Modified Barthel Index,MBI）评定。实验组给予进一步强化康复运动治疗，以加速提高患者康复速率；2周结束时对实验组和观察组再次进行评估，比较2组患者治疗前后组内和组间治疗疗效。结果：早期康复2周后，实验组FMMS量表上肢评分为(29.82±15.43)分，观察组上肢评分为(21.33±11.98)分，组间存在统计学差异（P=0.005）。实验组FMMS量表下肢评分为(21.18±8.97)分，观察组下肢评分为(15.40±7.40)分，实验组得分高于观察组且两组间存在显著统计学差异（P=0.002）；随访1个月后实验组上下肢功能呈持续改善趋势，且两组间差异具有显著统计学意义。实验组MBI量表评分为(35.56±18.93)分，高于对照组（28.56±14.68）分，但未见统计学意义；1个月后两组间差异具有显著统计学意义（P＜0.001）。结论：研究表明，早期康复治疗对改善中青年脑卒中患者肢体功能和日常生活活动能力具有显著康复效果。
Objective:Exploring the impact of early rehabilitation therapy on the recovery of limb motor function and other aspects in young and middle-aged stroke patients. Methods: Ninety young and middle-aged stroke patients were selected from our hospital as experimental subjects and divided into two groups, namely the experimental group and the observation group, with 45 cases in each group. Both groups received the same conventional treatment and early rehabilitation intervention simultaneously, and were evaluated using the Fugl-Meyer Motor Scale (FMMS) for the affected upper and lower limbs, as well as the Modified Barthel Index (MBI) for activities of daily living. The experimental group received further intensive rehabilitation exercise therapy to accelerate the rehabilitation rate. At the end of 2 weeks, both groups were reassessed, and the therapeutic effects within and between the two groups before and after treatment were compared. Results: After 2 weeks of early rehabilitation, the FMMS upper limb score in the experimental group was (29.36±15.27) points, while that in the observation group was (25.18±11.99) points, with no statistically significant difference observed between the groups. The FMMS lower limb score in the experimental group was (20.93±8.93) points, higher than that in the observation group (15.40±7.40) points, with a significant statistical difference between the two groups (P=0.002). The MBI score in the experimental group was (33.22±15.96) points, higher than that in the control group (28.56±14.68) points, but no statistical significance was observed. Conclusions: Our study indicates that early rehabilitation therapy has certain effects on upper limb function and activities of daily living in patients, particularly demonstrating significant rehabilitation effects in improving lower limb functional recovery in young and middle-aged stroke patients.
目的 探讨131I治疗儿童及青年格雷夫斯病（GD）的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例：男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例（69%）患者获得治愈,22例（31%）未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义（均P>0.05）。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease（GD）in children and young adults and its influencing factors．Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed．The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass．According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured．The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect．Results Seventy-one patients were included：23 males and 48 females,aged 11-22．The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g．The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi．Forty-nine patients（69%）were cured and 22（31%）were not cured．Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group（all P>0.05）．Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%．
目的 应用高频超声观察眼轮匝肌的解剖信息和动态特征,探究肉毒毒素注射前超声评估的可行性,为个体化、精准化的治疗提供可能,以实现更加安全、更加高效的治疗效果。方法 采用高频超声获取40名20~30岁健康志愿者的双侧80条眼轮匝肌的长轴、短轴切面声像图,观察其全程形态、内部回声,并测量外眦水平眼轮匝肌最外侧缘与外眦之间的距离、外眦水平眼轮匝肌最厚处的前后径、外眦水平眼轮匝肌最厚处与表皮之间的距离,并对数据进行统计学分析。结果 高频超声可以清晰地显示眼轮匝肌全程的走形和整体肌束结构。微笑时可见外眦外侧的眼轮匝肌向内收缩,并出现不同程度的增厚。男性和女性外眦水平眼轮匝肌最外侧缘与外眦之间的距离分别为左侧（27.50±2.58）（25.32±2.17）mm,右侧（27.35±2.15）（25.11±2.08）mm;外眦水平眼轮匝肌最厚处的前后径分别为左侧（1.055±0.209）（0.770±0.172）mm,右侧（1.010±0.171）（0.775±0.162）mm;外眦水平眼轮匝肌最厚处与表皮之间的距离分别为左侧（2.450±0.274）（2.860±0.375）mm,右侧（2.430±0.252）（2.825±0.424）mm。上述3种指标在左右侧对比差异无统计学意义（P>0.05）。与男性对比,女性外眦水平皮下组织较厚、眼轮匝肌较薄,其最外侧缘与外眦之间的距离较短（P<0.05）。结论 高频超声为观察青年人群眼轮匝肌结构的有效影像学工具,可用于肉毒毒素注射前的面部评估。
Objective To observe the anatomical information and dynamic characteristics of the orbicularis oculi muscle by high-frequency ultrasound,to explor the feasibility of ultrasound evaluation before botulinum toxin injection,and to provide the possibility for personalized and precise treatment to achieve safer and more efficient therapeutic effects．Methods High frequency ultrasound was used to obtain long axis and short axis sectional ultrasound images of 80 bilateral orbicularis oculi muscles from 40 healthy volunteers aged 20-30．The overall morphology and internal echoes were observed,and the distance between the outermost edge of the orbicularis oculi muscle and the outer canthus,the anterior posterior diameter of the thickest part of the orbicularis oculi muscle at the outer canthus level,and the distance between the thickest part of the orbicularis oculi muscle and the epidermis at the outer canthus level were measured．Statistical analysis was performed on the data．Results High frequency ultrasound can clearly display the entire course of the orbicularis oculi muscle and the overall muscle bundle structure．When smiling,the orbicularis oculi muscle on the outer side of the outer canthus can be seen to contract inward and show varying degrees of thickening．The distance between the outermost edge of the orbicularis oculi muscle and the outer canthus of males and females were（27.50±2.58）（25.32±2.17）mm on the left side and（27.35±2.15）（25.11±2.08）mm on the right side,respectively．The anterior posterior diameters of the thickest part of the orbicularis oculi muscle at the level of the outer canthus were left（1.055±0.209）（0.770±0.172）mm and right（1.010±0.171）（0.775±0.162）mm,respectively．The distance between the thickest part of the orbicularis oculi muscle at the level of the outer canthus and the epidermis were（2.450±0.274）（2.860±0.375）mm on the left side and（2.430±0.252）（2.825±0.424）mm on the right side．There was no statistically significant difference in the comparison of the above three indicators on the left and right sides（P>0.05）,while there was a statistically significant difference in the mean values of both males and females（P<0.05）．Compared with males aged 20-30,females had thicker subcutaneous tissue at the level of the outer canthus and thinner orbicularis oculi muscle,with a shorter distance between the outermost edge and the outer canthus． Conclusions High frequency ultrasound is an effective imaging tool for observing the structure of the orbicularis oculi muscle in young population,and can be used for facial assessment before botulinum toxin injection．
目的 探讨将宫腔镜电切手术与高效孕激素治疗相联合,治疗青年女性子宫内膜癌的临床效果以及对患者生育功能的影响。方法 选取2018年5月—2020年5月我院收治的70例青年子宫内膜癌患者作为本次研究对象,根据患者入院时间单双号将患者分为对照组(n=35)和实验组(n=35),对照组患者应用高效孕激素治疗,实验组患者则在对照组的基础上联合应用宫腔镜电切术进行治疗。比较两组患者的临床疗效、再次妊娠的成功率,及血清CA125水平变化情况。结果 研究组患者在治疗后3个月的治疗有效率为94.2%,高于对照组患者治疗有效率74.2%,差异具有统计学意义(P<0.05);研究组在治疗后一年内成功受孕率91.4%高于对照组51.4%,差异具有统计学意义(P<0.05);治疗后,研究组血清CA125水平低于对照组(P<0.05)。结论 将宫腔镜电切术与高效孕激素治疗方式相结合,对治疗青年子宫内膜癌患者效果显著,能够保留患者生育功能的同时,降低血清CA125水平。
目的 探讨追踪护理模式对中青年保留神经宫颈癌根治术后膀胱功能恢复的影响效果。方法 按住院先后顺序将82例患者分为对照组40例、实验组42例,对照组给予常规护理,实验组实施追踪护理模式,3个月后对两组患者的尿失禁、尿潴留发生率,膀胱功能恢复情况及尿失禁严重程度进行测评。结果 实验组尿失禁、尿潴留的发生率分别为2%、4% ,膀胱功能Ⅰ级、Ⅱ级达100%,68%患者无尿失禁,与对照组比较差异均有统计学意义(P>0.05)。结论 对中青年保留神经宫颈癌根治术实施追踪护理模式,可提高患者膀胱功能锻炼的有效性,促进膀胱功能的早日恢复,改善其生活质量。
Objective To explore the effect of follow-up nursing on the recovery of bladder function in young and middle-aged patients with cervical cancer after radical operation. Methods 82 patients were divided into control group (n = 40) and experimental group (n=42). The control group was given routine nursing care, experimental group to implement the follow-up nursing model. After 3 months, the incidence of urinary incontinence and urinary retention were observed in the two groups, including bladder function recovery and severity of urinary incontinence. Results The incidence of urinary incontinence and urinary retention in the experimental group were 2% and 4%, respectively. Bladder function level I and II reached 100%. There was no urinary incontinence in 68% patients. Compared with the control group, the difference was statistically significant (P>0.05). Conclusion It may improve the effectiveness of bladder function training, promote the early recovery of bladder function and improve the quality of life of young and middle-aged patients with cervical cancer.
目的 探讨治疗青年原发性高血压,联合使用硝苯地平控释片(CCB)与厄贝沙坦(ARB)对降压效果、肾功能及不良反应的影响。方法 2012年1月—2015年1月到我院就诊的青年原发性高血压患者共计180例。将患者按照首次就诊顺序编号,分为A、B两组各90例。A组患者CCB治疗,B组患者CCB联合ARB治疗。两周后比较两组患者降压效果、肾功能及不良反应发生率。结果 两组患者治疗前的收缩压、舒张压无差异(P>0.05); 治疗两周后,收缩压、舒张压均有下降,与治疗前相比,差异有统计学意义(P<0.05)。 B组患者血压下降幅度更大。两组患者间治疗后收缩压、舒张压的比较,差异具有统计学意义(P<0.05)。 两组患者治疗前24 h尿蛋白、24h尿白蛋白无显著性差异(P>0.05), 经两周治疗后,两项指标均有下降,与治疗前相比,差异有统计学意义(P<0.05)。 B组患者下降幅度更大。两组患者治疗后24 h尿蛋白、24 h尿白蛋白比较,差异有统计学意义(P<0.05)。 两组患者各项不良反应发生率均相当(P>0.05)。结论 在青年原发性高血压治疗中,联合使用CCB与ARB,能提高降压效果,改善肾功能,不增加不良反应,值得临床推广。
目的 探讨中青年医护人员血尿酸(UA)水平与心血管危险因素的关系。方法 利用国人缺血性心血管疾病发病危险的评估方法及简易评估工具“心血管危险积分”评价982名中青年医护人员的心血管危险因素,计算其危险评分积分值,用四分位法根据UA值将研究对象分为四组,比较不同分组间的临床资料,分析UA水平与心血管危险因素的关系。结果 UA水平与心血管危险因素存在正相关(P＜0.01);Ⅲ、Ⅳ组心血管危险积分均高于Ⅰ、Ⅱ组,差异有统计学意义(P＜0.01)。结论 UA增高是心血管疾病的一个重要危险因素,重视高尿酸血症的防治,对预防中青年医护人员的心血管疾病的发生具有重要意义。
Objective To study the relationship between serum uric acid levels and risk factor of cardiovascular disease in young and middle-aged medical staff. Methods Using of risk assessment method and simple assessment tools of cardiovascular risk score of Chinese ischemic cardiovascular disease, the study appraised risk factors of cardiovascular disease about 982 young and middle-aged medical staffs, calculated the risk score integral value. The study divided objects of study into four groups with quartile's method according to serum uric acid levels, compared clinical data between different groups, analyzed the correlation between uric acid level and cardiovascular risk factors. Results Serum uric acid level and cardiovascular risk factors had positive correlation(P<0.01); Ⅲ,Ⅳ group's cardiovascular risk score were higher than Ⅰ, Ⅱ group; the difference had statistics significance(P<0.01). Conclusion Hyperuricemia is an important risk factors in cardiovascular disease. Paying attention to hyperuricemia prevention has important significance to prevention of cardiovascular disease in young and middle-aged medical staff.
目的 探讨OAB与CP/CPPS的症状及诊断的重叠情况,为临床诊疗提供参考。方法 151例中青年男性患者入选为研究对象,按OAB及CP/CPPS的定义及诊断标准将其分为OAB组、CP/CPPS组及OAB+CP/CPPS组,并对OAB+CP/CPPS组进行诊断性治疗对研究对象进行明确诊断;根据年龄分为:18~25岁组、26~35岁组和36~49岁组,比较各年龄组患者OAB及CP/CPPS的重叠情况;对各组患者的临床症状进行分析比较,了解其重叠情况。结果 在151例研究对象中,可诊断为OAB、CP/CPPS、OAB+CP/CPPS的分别有62例(41.06%)、32例(21.19%)、57例(37.75%),因此OAB与CP/CPPS的诊断重叠率为37.75%,明显大于CP/CPPS患者的诊断率;各年龄组间诊断重叠率无差异(P>0.05);症状的重叠方面,OAB+CP/CPPS组有尿急、尿频、夜尿症、急迫性尿失禁、尿不尽感、排尿困难、泌尿生殖系疼痛和或不适症状的分别为57例(100.00%)、50例(87.72%)、21例(36.84%)、2例(3.51%)、12例(21.05%)、2例(3.51%)、57例(100.00%),其中,尿急、尿频及泌尿生殖系疼痛或不适症状的重叠率最高;OAB+CP/CPPS组经诊断性治疗后诊断为OAB患者约61.40%,而CP/CPPS患者为38.60%。结论 OAB与CP/CPPS两者间有相当高的重叠率且远高于CP/CPPS的诊断率,在OAB与CP/CPPS两者诊断重叠的患者中为OAB的可能性更大。
Objective To explore symptoms and diagnosis of overlap between OAB and CP/CPPS, providing reference for clinical treatment. Methods 151 cases of young men were enrolled in the study. According to the definition and diagnostic criteria of OAB and CP/CPPS, we divided the study subjects into OAB group, CP/CPPS group and OAB+CP/CPPS group. And OAB+CP/CPPS group would get a two-week diagnostic treatment to study a clear diagnosis. We also divided the subjects into 18-25 age group, 26-35 year-old age group and 36-49 group according to the age, comparing the overlap of OAB and CP/CPPS in different age groups. The symptoms of the subjects in each group were analyzed to compare and study the overlap. Results Among these 151 cases, 62 cases (41.06%) can be diagnosed as OAB, 32 cases (21.19%) as CP/CPPS, 57 cases (37.75%) as OAB+CP/CPPS. Therefore, OAB and CP/CPPS diagnostic overlap was 37.75%, significantly higher than the diagnosis of CP/CPPS patients; no significant difference (P>0.05) among all age groups diagnostic overlap rate; overlapping terms of symptoms, OAB + CP/CPPS group urgency, urinary frequency, nocturia, urgency incontinence, urine not the flu, difficulty urinating, or genitourinary pain and discomfort were 57 cases (100.00%), 50 cases (87.72%), 21 cases (36.84%), 2 cases (3.51%), 12 cases (21.05%), 2 cases (3.51%), 57 patients (100.00%), which overlap ratio urgency, frequency, and genitourinary pain or discomfort was high; OAB+CP/CPPS group after diagnosis diagnostic treatment of OAB patients was about 61.40%, while CP/CPPS patients was 38.60%. Conclusion There is high overlap rate between OAB and CP/CPPS, which is much higher than the diagnostic rate of CP/CPPS. It is likely to have an OAB when a patient is diagnosed as OAB or CP/CPPS at the same time.
目的 旨在通过实证了解广东省青年中医人才岗位胜任力现状，探讨青年中医人才岗位胜任力素质特征，为青年中医人才培养提供策略。方法 通过专家咨询制定《青年中医人才岗位胜任力评价框架》并开展问卷调查，采用SPSS 26.0进行数据分析。结果 构建了包含8个一级指标、76个二级指标的《青年中医人才岗位胜任力评价框架》；广东省青年中医人才岗位胜任力自评总分整体处于及格以上水平。女性在职业价值和职业素养、临床技能、交流与沟通技能、管理能力和团队合作、批判性思维与学术科研能力的评分高于男性；不同职称在其他附加维度的评分比较具有统计学差异（P＜0.05）。结论 构建的评价框架能够有效评估青年中医人才岗位胜任力；广东省青年中医人才岗位胜任力整体处于及格水平，需重视补强短板；女性青年中医人才岗位胜任力多个维度的得分优于男性，着重提升各人群的弱项维度岗位胜任力；进一步建立健全职称评聘制度，以破五唯为导向构建符合不同级别职称的青年中医人才评价机制。
Objective To understand the current job competence status of young TCM talents in Guangdong Province through empirical research，to explore the characteristics of job competence and quality of young TCM talents，providing strategy for cultivating young talents in TCM．Methods The “Competency Evaluation Framework for Young TCM Talents” was developed through expert consultation and a questionnaire survey was conducted．SPSS 26.0 was used for data analysis．Results “Job Competency Evaluation Framework for Young TCM Talents” was constructed，which included 8 primary indicator items and 76 secondary indicator items．The overall self-evaluation score of the overall job competence of young TCM talents in this study was above the passing level．Female score was higher than male in terms of professional value and professional ethics，clinical skills，communication and interpersonal skills，management ability and teamwork，critical thinking and academic research ability．There were statistically significant differences in the scores of different job titles in other additional dimensions（P＜0.05）．Conclusions The constructed evaluation framework can effectively assess the job competence of young TCM talents．The overall competence of young TCM talents in Guangdong Province is at a passing level，and attention should paid to strengthening their weaknesses．Female young TCM talents have better multidimensional scores in job competence than males，and efforts should be made to focus on improving the weak dimensional job competence of various groups of people．The professional title evaluation and appointment system needs to be established and improved．A talent evaluation mechanism should be built for young TCM talents that meets different levels of professional titles，guided by the principle of breaking the five criteria．
