目的 探讨结肠粪性穿孔的发病原因、临床特点、诊断和治疗方法。方法 回顾性分析广州市第一人民医院2012年1月—2015年1月收治的12例结肠粪性穿孔病人的临床资料。结果 本组病人共12例,均因腹膜炎体征行剖腹或腹腔镜探查术,术中根据Maurer标准诊断为结肠粪性溃疡穿孔。本组病人术后治愈出院10例,治愈率为83.3%,2例80岁以上病人因感染中毒性休克、多器官功能衰竭分别于术后第2天及第3天在重症监护病房死亡,死亡率为16.7%,术后主要合并症为肺炎(10例,83.3%)及胸腔积液(12例,100%)。结论 在临床工作中,了解结肠粪性穿孔发生的危险因素,及时进行有针对性的辅助检查,快速手术干预是降低病死率的关键。

Objective To explore the causes, clinical characteristics, diagnosis and treatment of stercoral perforation of colon. Methods The clinical data of 12 cases of stercoral perforation of colon from Jan 2012 to Jan 2015 were retrospectively analyzed. Results There were twelve patients who were diagnosed stercoral perforation of colon according to accurate diagnostic criteria during the open or laparoscopic operation. Of the 12 cases, 10 cases (83.3%) were cured, 2 cases (16.7%) died because of septic shock and multiple organ failure in the intensive care unit. After operation 10 cases (83.3%) had pulmonary infection and 12 cases (100%) had pleural effusion. Conclusion The key of improve the prognosis of stercoral perforation of colon depends on the full understanding of risk factors, proper preoperative examination and prompt surgical procedures.

目的 探讨CYP2C19不同基因分型对急性冠状动脉综合征(ACS)患者服用氯吡格雷后血小板聚集率的影响。方法 选取2015年1月—2016年3月入住心内科的ACS患者258例为研究对象。入院时及服用氯吡格雷三日后分别抽取静脉血检测血小板聚集率及CYP2C19基因型。结果 快代谢型组(extensive metabolisers, EM)和中代谢型组(intermediate metabolisers, IM)服药前后血小板最大聚集率分别为(58.76±15.45)% vs(35.17±10.26)%和(59.35±11.58)% vs(47.66±12.59)%(P<0.05), 而慢代谢型组(poor metabolisers, PM)的血小板最大聚集率无明显降低。快代谢型组的最大血小板聚集率的降低幅度比慢代谢型组大(23.58±12.39% vs 11.65±13.56%,P<0.05)。 共有33例(12.79%)患者为氯吡格雷抵抗, 其中快代谢型组中氯吡格雷抵抗者2例(1.67%), 中代谢型组中氯吡格雷抵抗者3例(2.80%), 慢代谢型组中氯吡格雷抵抗者28例(90.32%) (三组比较P=0.038)。结论 ACS患者CYP2C19基因分型与服用氯吡格雷后血小板最大聚集率有关,与氯吡格雷抵抗有关。

Objective To explore the relationship between platelet aggregation rate and CYP2C19 gene polymorphisms. Methods A total of 258 cases diagnosed as acute coronary syndrome (ACS) from January 2015 to March 2016. The platelet aggregation rate was tested before and 3 days after taking clopidogrel. CYP2C19 gene polymorphisms was tested by Gene chip hybridization technique. Results The platelet aggregation rate before and after taking clopidogrel was(58.76±15.45)% vs(35.17±10.26)% and(59.35±11.58)% vs(47.66±12.59)%(P<0.05)in EM group and IM group. But there was no change in PM group. The PM group were associated with a significant increase risk of clopidogrel resistance compared with EM group and IM group. Conclusion CYP2C19 gene polymorphisms influence the rate of platelet aggregation rate after taking clopidogrel and are associated with clopidogrel resistance in ACS patients.

目的 研究前列腺癌细胞中miR-221的表达情况及其对癌细胞增殖的影响。方法 运用实时荧光定量PCR(qRT-PCR)检测miR-221在前列腺正常细胞株与前列腺癌细胞株中表达的差异情况,利用细胞转染构建miR-221过表达LNCaP和DU145细胞株,再通过CCK8细胞增殖实验检测细胞增殖情况的变化。结果 qRT-PCR检测细胞株发现miR-221在PC3、LNCaP和DU145三种前列腺癌细胞株中表达量均比前列腺正常细胞株PrEC低 (F=254.197,P<0.001),其中两两比较差异也均有统计学意义。细胞转染技术构建的miR-221过表达LNCaP和DU145细胞株,经qRT-PCR结果显示,miR-221在LNCaP和DU145细胞株中的表达水平明显升高(LNCaP,倍数变化=2.24,t=3.46,P<0.01;Du145,倍数变化=2.24,t=4.29,P<0.01)。细胞增殖实验结果显示,过表达了miR-221的LNCaP(P<0.001)和DU145(P<0.001)细胞生长速度慢于对照组。结论 实验证明miR-221表达过度能减慢前列腺癌细胞的增殖,miR-221有可能成为前列腺肿瘤治疗的生物学标志物。

Objective To investigate miR-221 expression in prostate cancer cells and its influence on prostate cancer cell proliferation. Methods miR-221 expressions in prostate normal cell lines and cancer cell lines were measured by qRT-PCR. Overexpression of the miR-221 in LNCaP and DU145 cell lines used by cell transfection. Effects of the depletion on cell proliferation were assessed in vitro with CCK8. Results qRT-PCR showed miR-221 was lower expressed in PC3, LNCaP and DU145 than in PrEC(F=254.197, P<0.001), in which pairwise comparison also had significant differences. qRT-PCR showed miR-221 expression rose significantly in LNCaP and DU145 cell lines whose miR-221 was overexpression with cell transfection(LNCaP, Fold Change=2.24,t=3.46,P<0.001;Du145, Fold Change=2.24,t=4.29,P<0.001). Cell proliferation assay showed that growth of LNCaP(P<0.001) and DU145(P<0.001) cells whose miR-221 was overexpression was slower than the control group. Conclusion This study demonstrates miR-221 overexpression can inhibited the proliferation of prostate cancer cells for the first time, it also suggests that miR-221 has the potential to serve as a biomarker for PCa therapy.

目的 通过对我院健康体检人群眼科体检的数据分析,探讨眼科健康管理对眼部疾病防治的重要性。方法 分析2015年1月—12月眼科体检人群的数量、来源、性别、年龄。分析各类眼部疾病的检出率及不同年龄、性别的分布情况。结果 眼科疾病主要为屈光不正、结膜炎、白内障、眼底动脉硬化、黄斑变性等。屈光不正多以青壮年为主,结膜炎在中老年人群中检出率较高,白内障及眼底疾病的检出率在中老年人群中随年龄的增加而增加。结论 对于常见病和隐匿性疾病的防治,眼科体检具有较好的指导意义。

Objective Through the data analysis of eye common diseases in our hospital physical examination population to discuss the importance of eye health management for eye common disease prevention and control. Methods To analyze the quantities, source, gender and age of the eye examination population from Jan to Dec 2015.To analyze relevance ratio of all kinds of eye common disease and the distribution of different age and gender. Results Ophthalmic diseases included mainly ametropia, conjunctivitis, cataracts,fundus arteriosclerosis,macular degeneration and so on. Ametropia mainly happened at young adults, conjunctivitis detection rate was higher in the elderly crowd. The detection rate of cataract and retinal diseases in the elderly crowd increased with their ages. Conclusion For the prevention and treatment of common diseases and latent glomerular diseases, ophthalmic examination has a good guiding significance.

目的 了解近五年某地市级综合医院传染病病例疫情情况,分析其流行病学特征,为探索医院传染病预防控制工作提供科学依据。方法 采用描述性流行病学方法和Excel 2007软件对传染病疫情报告资料进行分析。结果 2010—2014年法定报告的传染病发病例数基本呈持续上升趋势。2010—2014年共报告传染病11 673例次,发病数居前5位的传染病依次为手足口病、乙型肝炎、梅毒、生殖道沙眼衣原体感染、肺结核,分别占21.17%、12.44%、12.16%、8.51%和7.52%;总死亡数为21例,病死率为1.799‰。5年来,不同传染病发病数呈现出不同的变化趋势。结论 及时掌握当地传染病的发病情况,加强对常见传染病的防控力度,提高病原检测力度,做好传染病的筛查工作,防止传染病在医院内传播。

Objective To analyze the characteristic features of notifiable diseases in a general hospital from 2010 to 2014, and provide basis information for notifiable diseases' prevention and control. Methods Using descriptive epidemiological methods and microsoft Excel 2007, the report data of notifiable diseases was statistically analyzed. Results The number of notifiable diseases increased during 2010 to 2014. 11 673 cases of notifiable diseases were reported in the hospital at the same time.The top five reported cases of notifiable diseases were hand-foot-and-mouth disease(HFMD),hepatitis B virus, syphilis, chlamydia trachomatis infection and tuberculosis, account for 21.17%,12.44%,12.16%,8.51% and 7.52% accordingly. Moreover, there are total 21 death cases have been reported and case fatality rate was 1.799‰.Different infectious diseases showed different trend variation during the above mentioned period. Conclusion We should understand and grasp the local incidence of infectious disease, strengthen the prevention and control, improve the pathogen detection, make an effort on screening, and prevent the spread of infectious diseases in the hospital.

目的 探讨Bcl-2、COX-2在宫颈癌新辅助化疗前后表达的意义, 以及新辅助化疗(NACT)对宫颈癌的近期临床疗效。方法 对32例宫颈癌患者,采集NACT治疗前后的宫颈癌组织标本,采用免疫组织化学SP法检测组织中的Bcl-2及COX-2表达。结果 ①经NACT后,治疗总有效率(CR+PR)为75%,无效率(PD+SD)为25%。②宫颈癌组织中Bcl-2、COX-2的表达均出现明显下降,差异均有统计学意义(P<0.05);临床有效组中Bcl-2、COX-2的表达在NACT后出现显著下降(P<0.05),无效组中Bcl-2、COX-2的表达在NACT前后无明显统计学意义(P>0.05)。结论 Bcl-2、COX-2的表达情况对评价宫颈癌患者新辅助化疗效具有肯定的临床意义,宫颈癌行NACT后近期疗效良好。

Objective To investigate the expression of Bcl-2 and COX-2 in cervical cancer before and after neoadjuvant chemotherapy; To evaluate the efficacy of neoadjuvant chemotherapy(NACT) for cervical cancer in the recent clinical effects. Methods To select 32 cases of patients with cervical cancer, collect the cervical cancer tissues before and after NACT, immunohistochemical SP method was used to detect the expression of Bcl-2and COX-2 in the tissues. Results After neoadjuvant chemotherapy, total effective rate (CR+PR) was 75%(24/32), inefficient rate(PD+SD) was 25%(8/32). The expression of Bcl-2 and COX-2 of cervical cancer patients who had neoadjuvant chemotherapy (NACT), before and after, had great differences. The difference had statistical significance (P<0.05); The expression of Bcl-2 and COX-2 were significantly lower after neoadjuvant chemotherapy in clinical effective group(P<0.05), there is no statistical significance in clinical non-effective group(P>0.05). Conclusion The expression of Bcl-2 and COX-2 of cervical cancer patients has certain clinical significance in evaluating the effect of neoadjuvant chemotherapy in cervical cancer patients. Recent curative effect after NACT in the cervical cancer patients is good.

目的 探讨胃癌组织中刺猬信号通路(Hedgehog signaling pathway, Hh)中的音猬因子(Sonic hedgehog, Shh)和胶质瘤相关癌基因同源物-1(Glioma-associated oncogene homolog -1, Gli-1)与金属基质蛋白酶-2(Matrix metalloproteinase-2, MMP-2)的表达和临床意义。方法 采用免疫组织化学方法检测40例人胃癌组织、人胃息肉组织和40例正常胃黏膜组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2蛋白的表达。结果 胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的阳性表达率分别为62.5%、67.5%、72.5%,高于胃息肉组织(阳性表达率分别为27.5%、37.5%、32.5%)和正常胃黏膜组织(阳性表达率分别为22.5%、17.5%、12.5%)(P<0.05);以上三者的表达与患者性别、年龄、组织学类型无关(P>0.05);而与分化程度、浸润深度、淋巴结转移相关(P<0.05);音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2表达呈正相关。结论 刺猬信号通路可能通过某些机制可上调金属基质蛋白酶-2的表达,从而增强胃癌的侵袭性。联合检测胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的表达水平在一定程度上可以作为胃癌预后的客观参考指标。

Objective To investigate the expression and clinical significance of Sonic hedgehog(Shh), Glioma-associated oncogene homolog -1(Gli-1) and Matrix metalloproteinase-2(MMP-2) in gastric cancer.Shh and Gli-1 are the molecules of Hedgehog(Hh) signaling pathway. MMP-2 is the member of matrix metalloproteinase family. Methods The expression of Shh,Gli-1 and MMP-2 proteins was examined by immunohistochemistry in the human gastric cancer tissues and the human gastric polyp and the normal gastric mucosa tissues of 40 cases. Results The positive expression rates of Shh,Gli-1 and MMP-2 in gastric cancer were 62.5%,67.5% and 72.5% respectively, which were significantly higher than those in the gastric polyp tissues (the positive expression rates were 27.5%,37.5% and 32.5% respectively) and normal gastric mucosa tissues (the positive expression rates were 22.5%,17.5% and 12.5% respectively),P<0.05.The expression of Shh,Gli-1 and MMP-2 was not correlated with the sex,age or histological type(P>0.05),but was correlated with depth of invasion,differentiation level and lymphonode metastasis in gastric cancer(P<0.05). The expression of Shh and Gli-1 was positive correlated with MMP-2. Conclusion Hedgehog(Hh)signaling pathway may have great effects on enhancing the invasive ability of gastric cancer by upregulating MMP-2 protein through some unknown mechanisms.The combined detection of the expression level of Shh,Gli-1 and MMP-2 in gastric cancer tissues might be used as an Objective references for assessing the prognosis of gastric cancer.

目的 调查住院患儿的营养风险及营养状况,探讨儿科营养风险筛查新方法的应用。方法 使用新的儿科营养风险筛查工具,对住院患儿进行营养风险筛查,根据体格测量评价儿童营养状况;与国外三种儿科营养风险筛查工具比较一致性。结果 402例住院患儿中高营养风险患儿占24.1%,营养不良的检出率为18.4%。有36.8%的患者接受营养支持,其中肠外营养支持率为23.1%,肠内营养支持率为16.7%,PN:EN为1.39:1。结论 对住院患儿采用新方法做营养风险筛查,能客观地反映住院患儿的营养风险,为临床营养支持提供依据。

Objective To investigate nutritional risk and the nutritional status in hospitalized children,and to validate the new screening tool of nutritional risk in hospitalized pediatric patients. Methods The nutritional risk of hospitalized pediatric patients was investigated using the new screening tool,and compared with other three pediatric nutritional risk screening tools;the nutritional status was assessed according to children physical measurement. Results Among 402 hospitalized children,children with high nutritional risk accounted for 24.1%.The overall prevalence of malnutrition was 18.4%.The proportion of patients receiving nutritional support was 36.8%.The rate of parenteral and enteral nutrition support was 23.1% and 16.7%,respectively.The ratio of parenteral nutrition to enteral nutrition was 1.39:1. Conclusion The new screening tool can reflect the possible nutritional risk in hospitalized pediatric patients objectively and provide the basis for clinical nutritional support.

近年来的研究已经报道证实了白细胞介素-33(IL-33)及其受体ST2可以保护心衰病人因机械应力过度牵拉所导致的心肌细胞肥大、心肌纤维化的发生以及可溶性ST2受体可作为潜在的心脏机械超负荷生物标志物。而对IL-33与受体ST2在动脉粥样硬化过程中发挥的作用少有涉及。本文主要探讨的是IL-33和ST2对抑制Th1/Th2漂移从而影响到动脉粥样硬化的进展以及血浆中可溶性ST2受体蛋白升高的意义。

Recent study has reported that interleukin-33(IL-33) and its receptor ST2 could prevent cardiomyocyte hypertrophy and exaggerated interstitial fibrosis which is because of the over harmful biomechanical force in patients with heart failure and soluble ST2 receptors is the potential biomarker of cardiac biomechanical overload. But few studies mentioned the sort of IL-33/ST2 complex plays a role in atherosclerosis. The purpose of this article is to explore the IL-33 and ST2 could reduce a Th1/Th2 shift. Consequently, it may improve the development of atherosclerosis and significance of soluble ST2 receptor increased in plasma.

目的 了解老年患者医院感染的发生情况及相关因素,为有效降低医院感染提供临床依据。方法 对我院2010年6月—2014年6月452例60岁以上的老年患者医院感染情况进行回顾性分析,调查并分析其年龄、住院天数、医院感染部位及相关因素。结果 老年患者医院感染的发生与年龄增长、住院天数延长、感染部位、基础病及抗生素不合理应用等因素密切相关。结论 根据医院感染的相关因素,对老年人加强病房管理及基础护理,不仅改善治疗操作中易感染的环节,减少感染途径,还可以降低医院感染发生率。