目的 探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D₃水平的相关性。方法 本研究选择在2019年1月—2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和 25(OH)D₃,将 25(OH)D₃分为不足[25(OH)D₃<30 ng/mL]和缺乏[25(OH)D₃<20 ng/mL]2组,对数据进行比较分析。结果 与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D₃在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D₃呈负相关关系(P值均<0.05)。25(OH)D₃缺乏组的AMH水平高于25(OH)D₃不足组,对照组和PCOS组的25(OH)D₃缺乏组的AMH水平均高于25(OH)D₃不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D₃缺乏率为67.1%(57/85),而PCOS组的25(OH)D₃缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ²=22.68,P<0.001)。结论 青春期多囊卵巢综合征患者体内 25(OH)D₃水平与AMH 水平显著相关。AMH 和25(OH)D₃可用于评估青春期PCOS发病风险的替代指标。

Objective To explore the correlation between serum anti-Müllerian hormone (AMH) and 25(OH)D₃ levels in adolescent patients with polycystic ovary syndrome (PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index (BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D₃, 25(OH)D₃ was further divided into insufficient [25(OH)D₃<30 ng/mL] and deficient [25(OH)D₃<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group (all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D₃ was the opposite (all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D₃ (all P values<0.05). The AMH level in the 25(OH)D₃ deficiency group was higher than that in the 25(OH)D₃ insufficient group, the AMH levels of the 25(OH)D₃ deficient group and control group were higher than that in the 25(OH)D₃ insufficient group,the differences were statistically significant (P<0.05). The 25(OH)D₃ deficiency rate in the healthy control group was 67.1% (57/85), while the 25(OH)D₃ deficiency rate in the PCOS group was 96.2% (76/79). The difference between the two groups was statistically significant (χ²=22.68, P<0.001). Conclusions Serum 25(OH)D₃ level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D₃ levels may be used as surrogate markers of PCOS risk in adolescents.

目的 探讨负性调节细胞CD4⁺CD25⁺T及其相关细胞因子在慢性阻塞性肺病(COPD)患者外周血中的表达与合并细菌感染的相关性。方法 纳入2018年1月—2019年12月间收治的66例COPD患者作为研究对象,其中急性加重期COPD患者(AECOPD)36例、稳定期患者30例,并纳入同期体检健康者30例作为对照组。对所有纳入的研究对象外周血标本中的CD4⁺CD25⁺T调节性T细胞及其相关细胞因子[白介素-4(IL-4)、白介素-10(IL-10)、干扰素-γ(IFN-γ)]表达水平进行检测,分析相关指标水平与COPD是否合并细菌感染的关系,及预测细菌感染的效能。结果 AECOPD和稳定期COPD患者CD4⁺、CD4⁺CD25⁺、IFN-γ/IL-4水平均低于对照组(P<0.05),IL-4、IL-10水均高于对照组(P<0.05);AECOPD患者IFN-γ水平高于对照组(P<0.05);AECOPD患者CD4⁺、CD4⁺CD25⁺水平低于稳定期COPD患者(P<0.05),IL-4、IL-10、IFN-γ均高于稳定期COPD患者(P<0.05);CD4⁺、CD4⁺CD25⁺水平与IL4、IFN-γ均呈负相关关系(P<0.05),CD4⁺水平与IL-10呈负相关关系(P<0.05);COPD合并感染者CD4⁺水平低于未合并感染者(P<0.05),IL-4、IFN-γ水平均高于未合并感染者(P<0.05);COPD合并革兰氏阴性菌感染者CD4⁺CD25⁺水平低于未合并感染者(P<0.05),IL-10水平均高于未合并感染者(P<0.05);CD4⁺、IL-4、IL-10、IFN-γ均是预测COPD患者合并细菌感染的有效指标(P<0.05),其中IL-4和IFN-γ效能较高。结论 CD4⁺、CD4⁺CD25⁺Treg细胞及其相关细胞因子参与COPD发生发展和患者细菌感染,监测其水平变化有利于为临床诊治提供信息。

Objective To investigate the correlation between the expressions of negative regulatory cell CD4⁺CD25⁺T and its related cytokines in peripheral blood and bacterial infection of patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-six COPD patients admitted between January 2018 and December 2019 were included as the research subjects, including 36 patients with acute exacerbation of COPD (AECOPD) and 30 patients with stable COPD. Another 30 healthy people undergoing physical examination during the same period were included in control group. The expression levels of CD4⁺CD25⁺ regulatory T cell and its related cytokines [interleukin-4 (IL-4), interleukin-10 (IL-10), interferon-γ (IFN-γ)] in the peripheral blood samples were detected among the included subjects. The relationship between levels of related indicators and presence or absence of bacterial infection in COPD and the efficacy of predicting infection were analyzed. Results The levels of CD4⁺, CD4⁺CD25⁺ and IFN-γ/IL-4 in patients with AECOPD and patients with stable COPD were lower than those in control group (P<0.05), while the levels of IL-4 and IL-10 were higher than those in control group (P<0.05). The IFN-γ level of AECOPD patients was higher than that of control group (P<0.05). The levels of CD4⁺ and CD4⁺CD25⁺of AECOPD patients were lower than those of stable COPD patients (P<0.05), while the levels of IL-4, IL-10 and IFN-γ were all higher than those of stable COPD patients (P<0.05). The levels of CD4⁺ and CD4⁺CD25⁺were negatively correlated with IL-4 and IFN-γ (P<0.05), and the CD4⁺level was negatively correlated with IL-10 (P<0.05). The CD4⁺ level in COPD patients with infection was lower than that in patients without infection (P<0.05), while the levels of IL-4 and IFN-γ were higher than those in patients without infection (P<0.05). The CD4⁺CD25⁺level of COPD patients with Gram-negative bacteria infection was lower than that of patients without infection (P<0.05), while the IL-10 level was higher than that of patients without infection (P<0.05). CD4⁺, IL-4, IL-10 and IFN-γ were effective indicators in predicting bacterial infection in COPD patients (P<0.05), and IL-4 and IFN-γ had higher efficacy. Conclusions CD4⁺, CD4⁺CD25⁺ T cell and related cytokines are involved in the occurrence and development of COPD and bacterial infection in patients. Monitoring changes of those levels is helpful to provide information for clinical diagnosis and treatment.

目的 探讨重组人干扰素α2b喷雾剂治疗儿童流行性感冒的疗效及安全性。方法 选取我院2017年1月—2020年2月所收治的80例儿童流行性感冒患者,按1:1随机分为实验组及对照组,每组患儿40例,对照组患者给予奥司他韦治疗,实验组患者在对照组治疗基础上联合重组人干扰素α2b喷雾剂治疗,对比2组患者的疗效及安全性。结果 实验组患儿咽痛症状消失时间(2.01±0.23)d、体温恢复正常时间(2.18±0.30)d、咳嗽症状消失时间(1.68±0.52)d、治疗时间(5.41±0.36)d均短于对照组(t=26.001、9.766、19.277、28.089,P＜0.05);实验组患儿治疗有效率95.0%高于对照组治疗有效率(χ²=4.114,P＜0.05);实验组患儿的不良反应发生率低于对照组(χ²=4.021,P＜0.05)。结论 重组人干扰素α2b喷雾剂治疗儿童流行性感冒的方案可获取较为理想的治疗效果,保证患儿用药安全性,尽快缓解患儿的临床症状,促使患儿病情康复,促进患儿健康生长,该治疗方案可在临床中推广应用。

Objective To explore the efficacy and safety of recombinant human interferon α2b spray in the treatment of influenza in children. Methods Eighty children with influenza who were admitted to our hospital from January 2017 to February 2020 were randomly divided into experimental group and control group evenly, with 40 children in each group. Oseltamivir treatment was given to the control group, the experimental group was treated with recombinant human interferon α2b spray on the basis of oseltamivir, and the efficacy and safety of the two groups were compared. Results In the experimental group, the time for the disappearance of sore throat was (2.01±0.23) d, the time for the body temperature returned to normal was (2.18±0.30) d, the time for the cough to disappear was (1.68±0.52) d, and the treatment time was (5.41±0.36) d, which were all shorter than the control group (t=26.001, 9.766, 19.277, 28.089, P<0.05). The treatment effective rate of children in the experimental group was 95.0%, which was significantly higher than that in the control group (χ²=4.114, P<0.05); the incidence of adverse reactions in experimental group was significantly lower than that in the control group (χ²= 4.021, P<0.05). Conclusions The recombinant human interferon α2b spray for the treatment of influenza in children could obtain a more ideal therapeutic effect, ensure the safety of the children's medication, relieve the clinical symptoms as soon as possible, promote the improvement of the children's condition, and promote the healthy growth of the children. The treatment plan can be promoted and applied in clinical practice.

目的 介绍基层妇幼保健院成功开展126例小儿先天性心脏病(先心病)外科治疗经验。方法 2018年9月开始,在基层妇幼保健院设立小儿先心病治疗中心,开展小儿先心病外科治疗。结果 共收治126例小儿先心病患儿进行先心病手术治疗,全部痊愈出院。结论 在有经验的先心病治疗中心的协助下,基层妇幼保健院可以成功开展小儿先心病外科治疗。

目的 分析ABCC2基因表达水平与肺腺癌预后之间的关联性,并对其影响机制进行初步探索。 方法 采用TCGA数据库和HPA数据库对肺腺癌病人癌组织和癌旁组织基因表达数据进行差异性分析,单因素及多因素COX回归评估ABCC2与肺腺癌预后之间的关联性,GSEA用于探讨与ABCC2显著关联的信号通路。 结果 ABCC2在肺腺癌肿瘤组织中存在过表达现象,Kaplan-Meier生存分析曲线结果显示ABCC2基因过表达使肺腺癌病人的死亡风险显著升高(HR=1.46,95%CI=1.09~1.95; P=0.010)。单因素及多因素COX回归结果显示ABCC2基因过表达是肺腺癌病人不良预后的独立危险因素。GSEA结果显示ABCC2可能通过调节药物代谢从而对肺腺癌的发展进行调控。 结论 ABCC2基因过表达使肺腺癌病人的死亡风险显著升高,ABCC2可能是肺腺癌不良预后的潜在分子生物标志物。

Objective To estimate the association between ABCC2 mRNA expression and the prognosis of lung adenocarcinoma and explore the potential influencing mechanism.Methods Difference analysis was used to evaluate the gene expression in tumor tissues and adjacent normal tissues based on The Cancer Genome Atlas database and Human Protein Atlas database.Multivariate COX regression and Kaplan-Meier analysis were performed to evaluate the association between ABCC2 gene expression and the prognosis of lung adenocarcinoma.Gene-set enrichment analysis (GSEA) was performed to screen differentially enriched pathways associated with the ABCC2 high expression phenotype.Results ABCC2 was overexpressed in lung adenocarcinoma tumor tissues compared with adjacent normal tissues.Kaplan-Meier survival analysis showed a significant relationship between ABCC2 mRNA expression and lung adenocarcinoma prognosis (HR=1.16,95% CI=1.09-1.95; P=0.010).Univariate and multivariate Cox regression analysis showed that ABCC2 mRNA expression was an independent risk factor affecting the survival of patients with lung adenocarcinoma.The results of GSEA suggested that ABCC2 may influence the development of lung adenocarcinoma by regulating the metabolism of targeted drug the treatment.Conclusions ABCC2 overexpression can significantly increase the risk of death in patients with lung adenocarcinoma,ABCC2 may be a potential molecular marker for poor prognosis in lung adenocarcinoma.

目的 通过测定川崎病(KD)患儿血清1,25(OH)₂D₃水平,探讨其与冠脉损伤(CAL)之间的关系。方法 选取在我院儿科住院的KD患儿200例,依据是否发生CAL分成CAL组(172例)和非冠脉损伤组(NCAL,28 例),并分别检测静脉内丙种球蛋白(IVIG)注射前后血清1,25(OH)₂D₃水平。选取35例健康儿童作为对照组,检测其血清1,25(OH)₂D₃水平,并进行比较。结果 IVIG输注前:CAL组和NCAL组血清1,25(OH)₂D₃水平较对照组低下(P＜0.05),CAL组最低(P＜0.05);IVIG输注后:NCAL组血清1,25(OH)₂D₃水平与对照组相比,差异无统计学意义(P＞0.05),CAL组血清1,25(OH)₂D₃水平较NCAL组和对照组低(P＜0.05);IVIG输注前后比较:CAL组和NCAL组血清1,25(OH)₂D₃水平在IVIG输注后均较输注前升高(P<0.001)。结论 KD患儿血清1,25(OH)₂D₃水平低下,而且血清1.25(OH)₂D₃水平越低,出现CAL的几率越大。

Objective The serum level of 1,25(OH)₂D₃ was detected to investigate the its relationship with coronary artery lesion (CAL) in children with Kawasaki disease (KD).Methods A total of 200 children with KD in our hospital were divided into CAL group (172 cases) and no CAL group (NCAL,28 cases) according to the CAL situation.Serum 1,25(OH)₂D₃ level before and after intravenous immunoglobulin (IVIG) injection was detected respectively.While 35 healthy children were enrolled as control group, comparing with KD children.Results Before IVIG injection,the levels of 1,25(OH)₂D₃ in the CAL and NCAL groups were lower than that in the control group (P＜0.05),and which in the CAL group was the lowest (P＜0.05).After IVIG injection,the level of 1,25(OH)₂D₃ showed no significant difference between the NCAL group and the control group (P＞0.05),and the level of 1,25(OH)₂D₃ in CAL group was lower than that in the NCAL group and control group (P＜0.05).Serum 1,25(OH)₂D₃ level in both CAL and NCAL groups increased after IVIG injection compared with that before injection (P<0.001).Conclusions The serum 1,25(OH)₂D₃ level was low in children with KD,and the lower serum 1,25(OH)₂D₃ level,the higher the incidence of CAL.

目的 分析妊娠中期血清25(OH)D₃水平对妊娠期糖尿病(gestational diabetes mellitus,GDM)的预测价值。方法 选取2019年7月—2020年3月在广州市妇女儿童医疗中心及广东省计划生育专科医院进行产前检查的孕中期妇女,根据孕妇的空腹血糖(FBG)水平和口服糖耐量试验(OGTT)结果分为GDM组(100例)和对照组(320例)。分别测定两组孕妇的年龄、孕前BMI、空腹血糖、服糖后l h血糖、服糖后2 h血糖、空腹胰岛素及25(OH)D₃等指标,进行统计分析与比较。结果 GDM组维生素D不足及缺乏的发病率高于对照组(P＜0.05)。年龄、空腹胰岛素在两组之间无统计学差异(P＞0.05);GDM组25(OH)D₃水平低于对照组(P＜0.05);GDM组空腹血糖、服糖后1 h、2 h血糖及孕前BMI均高于对照组(P＜0.05)。血清25(OH)D₃水平与空腹血糖、服糖后1 h、2 h血糖呈负相关(P＜0.05),而与年龄、BMI及空腹胰岛素无显著相关性(P＞0.05)。25(OH)D₃水平与妊娠期糖尿病发生风险呈负相关。结论 妊娠中期血清25(OH)D₃水平降低可能增加GDM的发生风险,联合检测妊娠中期血清25(OH)D₃水平有助于GDM的早期预测。

Objective To analyze the predictive value of serum 25(OH)D₃ level in the second trimester of pregnancy for gestational diabetes mellitus. Methods From July 2019 to March 2020, pregnant women who had prenatal examinations in Guangzhou Women and Children's Medical Center and Guangdong Family Planning Hospital were selected and divided into GDM group (100 cases) and control group (320 cases) according to FBG level and oral glucose tolerance test (OGTT) results.The age, pre-pregnancy BMI, fasting blood glucose, l h blood glucose after taking sugar, 2 h blood glucose after taking sugar, fasting insulin, 25(OH)D₃ and other indicators of the two groups of pregnant women were measured, respectively, for statistical analysis and comparison. Results The incidence of vitamin D deficiency and deficiency in GDM group was higher than that in control group (P<0.05).There was no significant difference in age and fasting insulin between the two groups (P>0.05).The level of 25(OH)D₃ in the GDM group was lower than that in the control group (P<0.05).Fasting blood glucose, blood glucose at 1 h and 2 h after taking sugar and BMI before pregnancy were all higher in the GDM group than in the control group (P<0.05).Serum 25(OH)D₃ level was negatively correlated with fasting blood glucose and blood glucose at 1 h and 2 h after taking sugar (P<0.05), but not significantly correlated with age, BMI and fasting insulin (P>0.05).The level of 25(OH)D₃ was negatively correlated with the risk of gestational diabetes. Conclusion Reduced serum 25(OH)D₃ levels in the second trimester may increase the risk of GDM, and combined detection of serum 25(OH)D₃ levels in the second trimester is helpful for early prediction of GDM.

目的 观察新疆石河子地区绝经后女性2型糖尿病(T2DM)患者糖、脂、骨代谢特征及骨密度(BMD)情况,探讨该人群中低密度脂蛋白受体相关蛋白5(LRP5)基因rs3736228、rs3781586位点的基因多态性及突变与糖、脂、骨代谢指标的关系。方法 将新疆石河子地区2016年10月—2017年10月社区、医院门诊及住院绝经后女性按照纳入标准和排除标准选取136例为研究对象,根据患者病史、糖耐量实验及骨密度仪测定骨密度分4组,糖耐量正常与骨量正常组(A组),糖耐量正常与骨量异常组(B组),T2DM与骨量正常组(C组),T2DM与骨量异常组(D组)。测定并记录患者年龄、绝经年限等基线资料,计算体质指数(BMI)等,并检测糖代谢指标(空腹血糖等)、骨代谢指标(血Ca等)、脂代谢指标(甘油三酯等)。采用MALDI-TOF-MS法测定LRP5基因该两个位点基因多态性并进行统计分析。结果 ①糖代谢指标:与A组比较,C组、D组FPG、HbA1c均高于A组(P<0.01)。脂代谢指标:与A组比较,B组、D组TG低于A组(P<0.05)。骨代谢指标:与A组比较,B组、D组BMD(L1-4)、BMD(股骨颈)低于A组(P<0.01)。②LRP5基因该两个位点SNP基因分型分布符合Hardy-Weinberg遗传平衡定律(P>0.05);同时,该两个位点不同基因型的分布频率和等位基因频率在组间的比较经Pearson Chi-Square检验后发现暂无显著差异(P>0.05)。③LRP5基因rs3736228位点:A组,与CC型(野生型)相比,CT/TT型(突变型)甘油三酯(TG)降低(P<0.05),BMD(L1-4)降低(P<0.05);C组,与CC型(野生型)相比,CT/TT型(突变型)高密度脂蛋白(HDL-C)升高(P<0.01),磷(P)升高(P<0.05);LRP5基因rs3781586位点:B组,与GG型(野生型)相比,GT/TT(突变型)高密度脂蛋白(HDL-C)升高(P<0.05)。结论 在新疆石河子地区绝经后女性2型糖尿病人群中,LRP5基因rs3736228、rs3781586位点的基因多态性可能与糖代谢无关,但LRP5基因rs3736228位点的突变可能与脂代谢(TG、HDL-C)、骨代谢(P、BMD)有关,rs3781586位点的突变可能与脂代谢(HDL)有关。

Objective To observe the characteristics of glucose, lipid and bone metabolism and bone mineral density (BMD)in postmenopausal women with type 2 diabetes mellitus (T2DM)in Shihezi district of Xinjiang province, and to investigate the relationship in the polymorphism and mutation of rs3736228 and rs3781586 of LRP5 gene and glucose,lipid and bone metabolism indexes in this population. Method A total of 136 postmenopausal Han women, who were related in the outpatient department, community, and hospital after hospitalization in Shihezi district of Xinjiang province from October 2016 to October 2017, were selected as the study subjects by the inclusion criteria and exclusion criteria.According to the patient's medicalhistory, glucosetolerance test results and bone mineral density (BMD), they were divided into 4 groups: normal glucose tolerance and normal bone mass (group A), normal glucose tolerance and abnormal bone mass (group B), type 2 diabetes and normal bone mass (group C), and type 2 diabetes mellitus and abnormal bone mass (group D). Baseline data such as patient's age, menopause years were measured and recorded, and body mass index (BMI)was calculated. Simultaneously, glucose metabolism indicators including fasting blood glucose (FBG, etc), bone metabolism indicators (blood Ca, etc), lipid metabolism indicators(triglycerides, etc)were detected. The polymorphisms of rs3736228 and rs3781586 of LRP5 gene were determined by Maldi-Tof-Ms and those data were analyzed statistically. Results ①Glucose metabolism index: compared with group A: FPG and HbAlc in group C, group D were all higher than group A (P<0.01). Lipid metabolism index: compared with group A, TG in group B and group D was lower than that in group A (P<0.05). Bone metabolism index: compared with group A, BMD (L1- 4)and BMD (femoral neck)in group B and group D were lower than those in group A (P<0.01). ②The distribution of SNP genotypes at rs3736228, rs3781586 of LRP5 conformsed to the Hardy-Weinberg genetic equilibrium law (P>0.05). The distribution frequency and allele frequency of LRP5 genotypes rs3736228, rs3781586 were compared among the groups. Pearson chi-square test showed no significant difference (P>0.05). ③Rs 3736228 locus of LRP5 gene:in group A, compared with CC (wild type), CT/TT (mutated type)triglyceride (TG)decreased (P<0.05), BMD (L1- 4)decreased (P<0.05). In group C, compared with CC (wild type), CT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05), phosphorus increased (P<0.05). Rs 3781586 locus of LRP5 gene: in group B, compared with GG (wild type), GT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05).Conclusion In the Xinjiang Shihezi district among postmenopausal women with type 2 diabetes, rs3736228, rs3781586 loci of LRP5 gene polymorphism may be irrelevant to glucose metabolism, but the mutation of rs3736228 of LRP5 gene locus may be related to lipid metabolism and bone metabolism (TG, HDL-C, BMD, P), and the mutation of rs3781586 may be related to lipid metabolism (HDL-C).

目的 对我院静脉用药调配中心2017年1月—2019年12月期间的不合理医嘱情况进行汇总及分析,以提高合理用药水平。方法 收集2017年1月—2019年12月广州市第一人民医院静脉用药调配中心的不合理医嘱资料进行回顾性分析,归纳不合理医嘱类型、汇总分析不合理医嘱表现以及改正不合理情况。结果 主要不合理医嘱类型包括溶媒选择错误、溶媒量过多或过少、药物剂量不合理、药物配伍禁忌、其他(用药频次错误、药物选择错误、重复用药等)。结论 根据不合理医嘱情况的汇总分析,及时与临床科室沟通改正,保证合理用药。

Objective To summarize and analyze their rational prescriptions in pharmacy intravenous admixture services(PIVAS)of our hospital from January 2017 to December 2019,so as to improve the level of rational drug use. Methods The data of irrational prescriptions from January 2017 to December 2019 in the pharmacy intravenous admixture services of Guangzhou First People's Hospital were collected for retrospective analysis, and the types of irrational prescriptions were summarized, the performance of irrational prescriptions was analyzed and the irrational situation was corrected. Results The main types of irrational prescriptions include incorrect selection of solvent, improper consumption of solvent, improper drug dosage, incompatibility and others(improper frequency of administration, incorrect selection of drug, repeated administration, etc.). Conclusion According to the summary and analysis of irrational prescriptions, we timely communicate with clinical departments and ensure rational drug use.

目的 通过血常规分析和C反应蛋白(CRP)水平检测,探讨其对儿童甲型和乙型流感的辅助诊断价值,为临床治疗提供参考依据。方法 选择3 069名甲型流感患儿、2 307名乙型流感患儿、855名健康儿童,统计分析血常规参数以及CRP水平。采用ROC曲线分析血常规对甲乙型流感的区分效能。结果 甲组白细胞计数(WBC)均值高于正常组,乙组则相反,甲乙组中性粒细胞百分比(Neut%)、中性粒细胞与淋巴细胞百分比比值(NLR)、单核细胞百分比(Mono%)的均值高于正常组,甲乙组淋巴细胞百分比(Lymph%)、血小板计数(PLT)的均值低于正常组。甲组中性粒细胞计数(Neut#)、单核细胞计数(Mono#)、CRP、PLT的均值均高于乙组,Lymph%和淋巴细胞计数(Lymph#)的均值低于乙组。甲组在WBC>13×10⁹/L、Neut%>70.7、Lymph%<19.1的构成比高于乙组。NLR预测甲型流感临界值为2.08(敏感度为75.9%,特异度为89.4%),预测乙型流感临界值为2.11(敏感度为50.5%,特异度为89.8%)。结论 血常规参数和CRP水平变化可用于判断流感患儿是否存在细菌感染,指导临床用药;NLR作为一种新型预测标志物,其变化可以对区分甲型、乙型流感,尤其是甲型流感具有临床价值。

Objective Through blood analysis and C-reactive protein (CRP) level detection, to explore its value in the auxiliary diagnosis of influenza A and B in children, and to provide reference for clinical treatment. Methods 3 069 children with influenza A, 2 307 children with influenza B, and 855 healthy children were selected, and blood routine parameters and CRP levels were statistically analyzed. The ROC curve was used to analyze the discriminatory efficacy of blood routine on influenza A and B. Results The mean value of white blood cell count (WBC) in group A was higher than that in normal group, but in group B it had the opposite result. The percentage of neutrophils (Neut%), the ratio of neutrophils to lymphocytes (NLR), and the percentage of monocytes (the mean value of Mono%) is higher than that of normal group, and the mean value of lymphocyte percentage (Lymph%) and platelet count (PLT) of group A and B is lower than that of normal group. The mean values of neutrophil count (Neut#), monocyte count (Mono#), CRP and PLT in group A were higher than those in group B, and the mean values of Lymph% and lymphocyte count (Lymph#) were lower than those in group B. The composition ratios of group A in WBC>13×10⁹/L, Neut%>70.7, Lymph%<19.1 were higher than that in group B. The NLR predicted the critical value of influenza A was 2.08 (sensitivity 75.9%, specificity 89.4%), and the predicted influenza B threshold value was 2.11 (sensitivity 50.5%, specificity 89.8%). Conclusion Changes in blood routine parameters and CRP levels can be used to determine whether there is a bacterial infection in children with influenza and to guide clinical medication; NLR as a new predictive marker, its changes can distinguish influenza A or B. Especially in influenza A determination, it has clinical value.