目的 观察有创-无创序贯通气治疗慢性阻塞性疾病(COPD)急性加重并呼吸衰竭的疗效。方法 选取2013年3月—2015年3月在兴宁市人民医院呼吸科收治的COPD急性加重并II型呼吸衰竭、需行机械通气的患者80例,随机进行有创-无创序贯通气治疗组A和单一有创通气治疗组B,两组除了机械通气的方式不同之外,其他的常规治疗均相同,主要观察两组患者进行相关机械通气方式前后的呼吸、循环及血气指标的变化情况以及进行机械通气的总时间和住院时间及呼吸机相关肺炎(VAP)的发生例数。结果 治疗组患者的血气、呼吸及循环内的各项生化指标改善程度均与对照组无统计学意义(P>0.05),同时治疗组患者的VAP的发生率,总的住院时间,进行机械通气的总时间少于对照组患者,有统计学意义(P<0.05)。结论 采用有创-无创序贯通气治疗慢性阻塞性疾病(COPD)急性加重并呼吸衰竭综合治疗效果要好于采用单一有创通气治疗,值得临床推广应用。

目的 探讨DPP-4抑制剂联合二甲双胍治疗2型糖尿病的临床疗效及安全性。方法 选取医院近3年收治的糖尿病病人70例,随机分为对照组(35例)和治疗组(35例),对照组给予二甲双胍治疗,治疗组给予二甲双胍联合DPP-4抑制剂控制血糖,经3个月治疗,比较治疗后血糖指标、胰岛功能指标及低血糖、不良反应情况。结果 对照组和治疗组治疗后FPG、2hPG、HbA1c水平均有降低,治疗组治疗后血糖检测指标优于对照组(P＞0.05)。胰岛功能监测显示治疗组治疗后空腹胰岛素、服糖后2小时胰岛素浓度升高优于对照组,胰高血糖素水平降低幅度大于对照组,治疗前后胰岛素及胰高血糖素均有变化,组间比较P＞0.05,有临床意义。治疗期间两组患者均未发生低血糖、药物不良反应。结论 DPP-4抑制剂联合二甲双胍可显著提高降糖效果,改善胰岛功能,并且无低血糖、药物不良反应发生。

目的 分析呼吸康复治疗对农村地区慢性阻塞性肺疾病(COPD)稳定期患者BODE评分系统的影响。方法 将我院收治的60例COPD稳定期患者作为研究对象,随机分为对照组与观察组,每组30例。对照组常规治疗,观察组则给予呼吸康复治疗方案。比较两组患者治疗前后BOBE评分系统的变化。结果 治疗后,观察组BMI、FEV1%、MMRC分级、6MWD分别为(22.4±1.1)kg/m²,(68.6±3.6)%,(1.3±0.2)级,(256.3±36.3)m,BODE指数评分降低至(3.4±1.0)分,ADL为(78.2±6.4)分,QOL为(67.8±2.6)分,与对照组相比差异有统计学意义(P<0.05);且观察组炎性因子水平下降幅度高于对照组(P<0.05)。结论 在农村地区COPD稳定期患者的临床治疗中,采用呼吸康复治疗方案,患者BODE评分系统指标改善显著,值得推广。

Objective To analyze the influence of respiratory rehabilitation treatment on BODE coring system of patients with chronic obstructive pulmonary disease (COPD) in stable phase in rural areas. Methods 60 patients with COPD in stable phase admitted into the hospital were selected as the research object and were randomly divided into control group and observation group with 30 cases in each. The control group received conventional treatment while the observation group received respiratory rehabilitation treatment. The changes of BOBE coring system in the two groups before and after the treatment were compared. Results After the treatment, BMI, FEV1% MMRC classification and 6MWD of the observation group were (22.4±1.1) kg/m², (68.6±3.6)%, (1.3±0.2) and (256.3±36.3) m respectively. The BODE index score decreased to (3.4±1.0), ADL (78.2±6.4), and QOL (67.8 + 2.6).compared with those of the control group, the difference was statistically significant (P< 0.05). And the decline level of inflammatory factors in the observation group was significantly higher than that of the control group (P<0.05). Conclusion In the clinical treatment of patients with COPD in stable phase in rural areas, respiratory rehabilitation treatment were adopted, the improvement of BOBE coring system indexes is significant. It is worthy to be popularized.

目的 回顾性分析采用内镜下氩离子凝固术治疗胃出血的治疗效果,为临床治疗胃出血提供经验及理论基础。方法 选取2010年1月—2014年7月我院收治的胃出血患者199例,随机分为两组,分别对其进行内镜下氩离子凝固术治疗和内镜下高频电凝治疗,总结对比其治疗效果,并对其并发症情况进行统计。结果 经治疗后,A组28例胃黏膜溃烂出血患者未再出血27例(96.43%),E组22例胃黏膜溃烂出血患者未再出血例数17例(77.27%),差异有统计学意义(P<0.05);A组治疗后形成局部炎性肉芽肿及发生胃穿孔的百分比低于E组,差异有统计学意义(P<0.05)。结论 采用内镜下氩离子凝固术治疗胃出血,止血率高,并发症发生率低,效果良好,值得在临床中推广使用。

Objective A retrospective analysis was performed using endoscopic argon plasma coagulation treatment of stomach bleeding, to provide experience and theoretical basis for the clinical treatment of stomach bleeding. Methods January 2010-July 2014 199 cases of bleeding in patients admitted to our hospital.They were randomly divided into two groups and had therapeutic endoscopic argon plasma coagulation. We summarized the treatment effect and its complications statistics. Results After therapy, 27 gastric mucosa fester patients(96.43%) of 28 patients in group A stopped bleeding and 17 gastric mucosa fester patients(77.27%) of 22 patients in group B stopped bleeding and the difference is statistical significance(P<0.05), and the incidence rate of inflammatory granuloma and gastric perforation of group A is significant lower than that of group B (P<0.05). Conclusion Endoscopic argon plasma coagulation therapy is taken to treat gastrorrhagia, hemostasis rate is higher and complication rate is lower. It is worth widely using in the clinic.

目的 评估CO₂激光治疗宫颈上皮内瘤变Ⅱ级（CIN2）病例的疗效。方法 收集2021年11月至2023年10月在本院行CO2激光治疗的92例CIN2患者的临床资料, 采用液基细胞学检查（LCT）和人乳头状瘤病毒（HPV）联合筛查随访,随访6~12个月, 任一结果异常者转诊阴道镜检查, 必要时行病理活组织检查（活检）观察鳞状上皮内病变情况。结果 92例CIN2患者中, 年龄25~45岁、有人工流产史、性伴侣人数3个及以上、因发现宫颈病变就诊者占比较多,患者均未生育。所有患者就诊时均发现HPV阳性, 20.65%患者报告HPV16阳性, HPV18阳性者占比1.09%, HPV其他12种阳性占60.87%, HPV16阳性伴其他12种阳性占17.39%。79例患者随访6个月后总HPV+LCT均阴率为74.68%（59/79）,LCT和HPV阴转率分别为92.41%（73/79）和74.68%（59/79）。所有患者术后12个月LCT均转阴。29例患者在术后12个月均无病变持续或病变发展。25岁以下患者术后6个月及12个月HPV持续率最低, 45~55岁患者术后HPV持续率最高,且多发生HPV16阳性及合并其他HPV亚型阳性的情况。结论 CO₂激光治疗可提高患者术后HPV与LCT阴转率, 所有患者术后6个月及12个月随访均无病变加重,且可明显改善年轻患者HPV感染情况。对于有生育要求且具备适应证的CIN2患者, 应积极采取CO₂激光治疗以获得更高健康收益。

Objective To evaluate the therapeutic efficacy of CO₂ laser treatment in cervical intraepithelial neoplasia grade 2（CIN2）patients. Methods We retrospectively analyzed data from 92 CIN2 patients who underwent CO₂ laser therapy at the institution from November 2021 to October 2023. Postoperative followed-up for 6-12 months, screening with liquid-based cytopathology test（LCT）and high-risk human papilloma virus（HPV）testing. Patients with abnormal results in either test were referred for colposcopy, with biopsy performed to evaluate residual or recurrent squamous intraepithelial lesions. Results Among total of 92 patients, most patients aged 25-45 years old, with a history of induced abortion, had three or more sexual partners, and visited hospital due to cervical lesions, and none of the patients gave birth. All patients were found to be HPV positive at hospital visits, with 20. 65% of HPV16 positive, 1. 09% of HPV18 positive, 60. 87% of other 12 kinds HPV positive, while HPV16 positive with other 12 kinds accounted for 17. 39%. Among the 79 patients after 6-month follow-up, the dual-negative conversion rate（HPV+LCT）was 74. 68%（59/79）, with LCT and HPV negative rates reaching 92. 41%（73/79）and 74. 68%（59/79）, respectively. After 12-month follow-up, all patients achieved LCT negativity, 29 patients with no documented lesion persistence or disease progression. Notably, patients aged <25 years exhibited the lowest postoperative HPV persistence rates between 6- to 12-month follow-up, whereas those aged 45-55 years demonstrated the highest persistence rates, frequently associated with HPV16 positivity or co-infection with other HPV subtypes. Conclusions CO₂ laser therapy significantly increases postoperative negative conversion rates for HPV and LCT. No lesion progression was observed in patients between 6- to 12-month follow-ups. The therapy also notably improves HPV clearance in younger patients. For patients with CIN2 who have fertility requirements and meet the indications, CO2 laser therapy should be actively adopted to achieve greater health benefits.

        儿童孤立性直肠溃疡综合征（SRUS）是一种较为罕见的慢性直肠疾病,儿童发病率低且缺乏明确统计学数据。该病主要表现为便血、排黏液便和排便不尽感,临床诊断较为困难,常易误诊为其他疾病。其发病机制尚不明确,可能与排便习惯异常、直肠黏膜异常、血管异常以及遗传易感性等多种因素有关,其中 CHEK2 基因的 p.H371Y 突变可能在发病机制中起关键作用。诊断需综合病史、体格检查以及排粪造影、超声内镜、肠镜检查与组织病理活检等多种辅助检查手段。治疗上目前尚无统一指南,主要包括改善饮食和排便习惯、生物反馈治疗、药物治疗、内镜下治疗和外科手术治疗等,但总体治疗难度较大且复发率较高。本文对儿童 SRUS 的流行病学、发病机制、临床表现、诊断和治疗等方面的研究进展进行综述,旨在提高临床医师对该病的诊疗水平,为未来进一步的研究提供参考依据。

       Solitary rectal ulcer syndrome（SRUS）in children is a chronic and benign disease of the rectum characterized by ulcers. The clinical incidence of SRUS in children is not high, but it is prone to misdiagnose and miss diagnosis,which can delay the optimal treatment opportunity. This article reviews the research progress on the epidemiology,pathogenesis, clinical manifestations, diagnosis and treatment of SRUS in children, aiming to improve the diagnostic and therapeutic level of clinicians.

        目的   比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效，以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法   连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例，采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d，阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前（基线）以及连续用药治疗2、4、6周后的PANSS量表评分，以及治疗后的代谢指标［体质量指数（BMI）、血清空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE），并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果   两组的总有效率比较差异无统计学意义（χ ² =1.569，P＞0.05）；两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义（χ ² =0.466、3.640，P=0.926、0.056），时间主效应显著（χ ² =363.24，P＜0.001）。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应（χ ² =7.562、5.991、6.163、6.958、4.397，P=0.006、0.014、0.013、0.008、0.036），两组TG、ApoA时间主效应显著（χ ² =33.473、8.846，P＜0.001、0.003），两组ApoA组别效应显著（χ ² =4.889，P=0.027）。结论   与奥氮平相比，鲁拉西酮治疗女性急性期精神分裂症的疗效相当，且对代谢指标影响更小。

        Objective  To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia，as well as their effects on body mass，glucose and lipid metabolism risk．To provide  reference for the selection of antipsychotic drugs for female patients with acute schizophrenia．Methods  From April 2022 to April 2024，80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study．The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison．The treatment group took oral lorazepine tablets（40 cases；40-80 mg/d），while the positive drug control group took oral olanzapine tablets（40 cases；5-20 mg/d）．The Positive and Negative Symptom Scale（PANSS）scores of two groups before treatment（baseline）and after 2，4，and 6 weeks of continuous medication treatment were measured，as well as metabolic indicators after treatment （body mass index［BMI］，serum fasting blood glucose［FPG］，total cholesterol［TC］，triglycerides［TG］，high-density lipoprotein［HDL］，low-density lipoprotein［LDL］，apolipoprotein A［ApoA］，apolipoprotein B［ApoB］，apolipoprotein E［ApoE］），and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed．Results  The total effective  rate of the two groups was not statistically significant（χ ² =1.569，P＞0.05）．The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant（χ ² =0.466，3.640，P=0.926，0.056），while the time main effect was significant（χ ² =363.24，P＜0.001）．There was a group-time interaction effect between two groups of TG，TC，HDL，ApoA，and ApoB（χ ² =7.562，5.991，6.163，6.958，4.397，P=0.006，0.014，0.013，0.008，0.036）．The time main effect of TG and ApoA was significant in both groups（χ ² =33.473，8.846，P＜0.001，0.003），and the group effect of ApoA was significant in both groups（χ ² =4.889，P=0.027）．Conclusions  Compared with olanzapine，the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable，and it has a smaller impact on metabolic indicators．

       目的   评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1（sICAM-1）的影响。方法   纳入2022年1月—2024年8月的70例正畸拔牙患者，按照治疗方法分组，即对照组（35例，给予固定矫治）、观察组（35例，给予无托槽隐形矫治），评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果   治疗结束时，两组均出现牙根吸收情况，但是观察组无牙根吸收＞3 mm病例，而对照组存在牙根吸收＞3 mm、＞4 mm病例，P＜0.05。治疗前，两组牙周指标［龈沟出血指数（SBI）、牙龈指数（GI）、菌斑指数（PLI）］、炎症因子［白介素-1β（IL-1β）、sICAM-1］比较差异无统计学意义（P＞0.05）。治疗后，两组SBI、GI、PLI、IL-1β、sICAM-1升高，且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组（P＜0.05）。与对照组比较，观察组矫治时间更长（P＜0.05）。结论   对正畸拔牙患者进行无托槽隐形矫治，虽然治疗时间长，但是可以抑制牙根吸收，减轻炎症反应，提高牙周健康水平。

       Objective  To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1（sICAM-1）．Methods  Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods：a control group（35 cases，receiving fixed orthodontic treatment）and an observation group（35 cases，receiving clear aligner treatment）．The root resorption，periodontal indicators，inflammatory factors，and orthodontic treatment time between groups were evaluated．Results  At the end of treatment，both groups showed root resorption，but there were no cases of root resorption＞3 mm in the observation group，while there were cases of root resorption＞3 mm and＞4 mm in the control group，P＜0.05．Before treatment，there was no difference in periodontal indicators（gingival bleeding index［SBI］，gingival index［GI］，plaque index［PLI］），inflammatory factors（interleukin-1 β［IL-1 β］，sICAM-1） between the groups，P＞0.05．After treatment，SBI，GI，PLI，IL-1 β，sICAM-1 increased in both groups，but SBI，GI，PLI，IL-1 β，sICAM-1 were lower in the  observation group，P＜0.05．Compared with the control group，the observation group had a longer orthodontic treatment time，P＜0.05．Conclusions  Although the clear aligner treatment time for orthodontic extraction patients is longer，it can inhibit root resorption，reduce inflammatory reactions，and improve periodontal health．

       目的   探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势，为本领域研究者提供借鉴。方法   检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量，运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇，年发文量整体呈现波动上升的趋势；发文量最多的作者为姜之炎；发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队；研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主；研究热点逐渐从临床研究转向作用机制等实验研究；应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

       Objective  To explore the research status，research hotspots，and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children，to provide a reference for researchers in this field．Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1，2005，to January 31，2024．Excel 2019 was applied to analyze the number of published papers，and CiteSpace 6.2.R6 software was applied to analyze its authors，institutions，and keywords．Results  A total of 395 papers were included，and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core  research teams including JIANG Zhiyan，YU Jingmao，and YAN Zhaojun were initially formed．The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods，clinical efficacy．Conclusions  The research content in this field is mainly based on internal treatment，external treatment，and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．

       肿瘤治疗仍然是生物医学研究的一个突出领域。围绕各种化学治疗（化疗）药物和其他治疗药物的不良反应和靶向疗效的研究推动了各种药物载体的发展。这些载体聚焦于提高肿瘤部位的药物浓度，最大限度地减少全身不良反应，并改善治疗效果。在已报道的递送系统中，可注射水凝胶由于其微创的药物递送特性，已成为化疗药物体内递送的重要载体形式。文章系统地总结了可注射水凝胶的类型和特征，并进一步概括了可注射水凝胶装载药物的方式，同时深入讨论可注射水凝胶在治疗肿瘤的各种药物的递送应用。文章对原位注射水凝胶在治疗肿瘤方面存在的潜在性挑战和可能的解决方案提供了动态前瞻性的参考。可注射的水凝胶作为药物传递系统用于肿瘤治疗具有良好的发展前景。

       Tumor treatment remains a prominent area of biomedical research．The  researches surrounding the adverse 

reactions and targeted efficacy of various chemotherapy drugs and other therapeutic drugs have driven the development of various drug carriers．These carriers focus on increasing drug concentration at tumor site，minimizing systemic adverse reactions，and improving treatment outcomes．In the reported delivery systems，injectable hydrogels have become an important carrier for the delivery of chemotherapeutic drugs in vivo due to their minimally invasive characteristics．This review systematically summarized the types and characteristics of injectable hydrogels，and further summarized their drug loading methods．At the same time，the application of injectable hydrogels in the delivery of various drugs for tumor treatment was discussed in depth．This  review provides dynamic and prospective reference for the potential challenges and possible solutions of the in situ injectable hydrogels for tumor therapy．Injectable hydrogels as drug delivery systems are with good prospects for tumor treatment．