目的 探讨广州市区小学生的性格发展状况,为了解和促进广州市儿童的性格和身心健康发展提供科学依据和建议。方法 采取横断面调查研究,通过整群随机抽样的方法抽取广州市区两所小学三年级学生共405名,采用儿童艾森克个性问卷(Junior Eysenck Personality Questionnaire, JEPQ)量表进行问卷调查,采用两独立样本t检验比较性别、年龄组、不同地区间的JEPQ各维度得分,采用卡方检验比较不同地区间JEPQ各维度的高分比例。 结果 广州市区小学生JEPQ的内外向(extroversion and introversion, E)、神经质(neuroticism, N)、精神质(psychoticism, P)、掩饰性(lie, L)维度标准分T分分别为50±11、50±16、42±18、50±10。其中,20.6%的儿童情绪不稳定(N维度T分>61.5);22.3%和32.7%的儿童分别为内向(E维度T分<43.3)和外向(E维度T分>56.7)倾向;6.3%的儿童性格孤僻或有攻击性(P维度T分>61.5)。与重庆、滁州、和西安地区相比,广州地区男女生的E维度得分较高(除西安女生,P<0.05)。结论 广州市区的两成小学生有焦虑、紧张的倾向,与其他城市相比更为外向。建议打造学校-社区-家庭“三位一体”的支持网络,为儿童的身心健康发育保驾护航。

Objective To explore the personality status of urban primary school students in Guangzhou, to provide evidence and suggestions for personality traits, as well as physical and psychological health improvement of children in Guangzhou city.Methods This is a cross-sectional study. Cluster sampling was applied to the survey of personality traits in 405 grade-3 pupils from two primary schools of Guangzhou, using Junior Eysenck Personality Questionnaire (JEPQ). Independent t test was used to compare scores of all the dimensions in JEPQ between genders, age groups, and districts. Chi-square was used to compare proportion of high score in each dimension between districts. Results The standard T points of JEPQ in the dimensions of extroversion & introversion (E), neuroticism (N), psychoticism (P), lie (L) of Guangzhou city pupils were 50±11, 50±16, 42±18 and 50±10, respectively. Among them, 20.6% of subjects were emotionally unstable (T score＞61.5 in N dimension). 22.3% and 32.7% of children were introverted (T score＜43.3 in E dimension) and extroverted (T score＞56.7 in E dimension) respectively, and 6.3% of children were unsocial or aggressive (T score＞61.5 in P dimension). Compared with Chongqing, Chuzhou and Xi-an cities, the scores of E dimension were higher in both boys and girls of Guangzhou city (except for Xi-an girls, P<0.05). Conclusion Around twenty percent of Guangzhou city primary students tend to be anxious and nervous. Compared with the other cities, pupils in Guangzhou city are more extroverted. We suggested a three-in-one support network of school-community-family should be built to facilitate the children's physical and mental health development.

目的 总结一种新的技术在心脏术后纵隔感染的应用经验。方法 回顾性分析2017年2月—2019年6月15日心脏术后发生纵膈感染成人患者,共有5例(1.2%),其中男性4例,女性1例,平均年龄(49±19)岁,平均体质量(70±15)kg,2例为急性A型主动脉夹层,2例为冠心病,1例为感染性心内膜炎合并白塞氏病,患者确诊后出现创面感染重、分泌物多,行VSD(负压封闭引流)进行过渡治疗,待创面清洁、肉芽新鲜后入手术室行清创术,术中4例采用SternaLock胸骨固定系统进行固定,1例因未累及至胸骨后,仅在胸骨前方行清创缝合。结果 4例完全治愈并顺利出院,1例因出现多器官功能衰竭死亡,但伤口愈合良好。结论 通过VSD引流增加了胸骨血流,加速肉芽组织形成,防止感染进一步加重,稳定胸骨,为进一步清创创造了良好的基础,同时运用SternaLock^®胸骨固定系统(8孔型钛板及2.4 mm自钻锁螺钉)进行固定,明显增加了胸骨的稳定性,进一步改善患者预后。

Objective To summarize the application experience of a new technique in mediastinal infection after cardiac operation. Methods A retrospective analysis of adult patients with mediastinal infection after cardiac surgery from February 2017 to June 15, 2019 were taken including a total of 5 cases (1.2%), of which 4 were male and 1 was female, with an average age (49±19) years old, average weight (70±15) kg;2 cases had acute type A aortic dissection, 2 cases had coronary heart disease, 1 case had infective endocarditis with Behcet's disease. After diagnosed, the patients developed severe wound infection and excessive secretion. VSD (vacuum sealing drainage) was performed for transitional treatment. After the wounds were cleaned and the granulation were still fresh, the wounds were for debridement in the operating room. During the operation, 4 cases were fixed with the SternaLock^® plating system, and 1 case was only treated with debridement and suture in front of the sternum because it did not involve the sternum. Results Four cases were cured and discharged smoothly, and 1 case died due to multiple organ failure, but the wound healed well. Conclusion The VSD increased sternum blood flow, which accelerated the granulation tissue formation, further to prevent infection and stable sternum, create a good foundation for further debridement, meanwhile the SternaLock ^® plating system(consists of eight pass since the titanium plate and 2.4 mm drill lock screw) was used for fixation, which significantly increased the stability of the sternum, further improved the prognosis of patients.

目的 探讨个体化低速率对比剂注射方案联合低管电压扫描在低体质量指数(body mass index,BMI)受检者头颈部CT血管成像的可行性。方法 选取我科2020年1月—2020年11月低BMI受检者头颈部CTA检查90例进行研究,随机分成三组,每组30例。A组80 kV扫描,低流速、低总量注射方案; B组120 kV扫描,高流速、低总量注射方案;C组为120kV扫描条件,高流速、高总量注射方案。对比各组注射流速、注射总量、辐射剂量长度乘积(dose legth product,DLP),评价各组图像的主动脉弓、颈总动脉、基底动脉、胸锁乳突肌中段的CT值、信噪比及对比信噪比,由两名有经验的放射科医生对各组图像质量进行主观评价。结果 图像质量主观评价A、B两组图像评分集中在4分段,C组图像评分集中在3分段,A、B组与C组主观评分比较差异有统计学意义(P<0.05)。A组对比剂注射流速和DLP比B、C组分别下降27.75%、47.10%;A、B组对比剂注射总量较C组下降39.87%,差异有统计学意义(P<0.05)。A组各血管CT值对应比B、C组数值稍高,除主动脉弓CT值外其余血管客观参数对比均有差异(P<0.05)。结论 低BMI受检者头颈部CT血管个体化低流速精准对比剂注射方案联合低管电压扫描技术在获得满足诊断要求图像质量的前提下,既能降低受检者对比剂注射速率和注射风险,又能降低辐射剂量,值得推广应用。

Objective To explore the feasibility of individualized low rate contrast agent injection scheme combined with low tube voltage scanning in CTA imaging of low body mass index(BMI) subjects' head and neck. Methods Ninety cases of head and neck CTA examination of low BMI subjects in our department from January 2020 to November 2020 were selected for the study, and randomly divided into three groups with 30 cases in each group. Group A applied 80 kV scanning, low flow rate and low total volume injection scheme. Group B applied 120 kV scanning, high flow rate, low total volume injection scheme. Group C applied 120 kV scanning, high flow rate and high total volume injection scheme. The injection velocity, injection volume, radiation dose length product (DLP) among three groups were compared. In each image of the aortic arch, common carotid artery, basilar artery and the central part of sternocleidomastoid, the CT value, the signal-to-noise ratio and contrast-to-noise ratio were evaluated. Two experienced radiologists performed image quality evaluation. Results Image quality in group A and B by subjective evaluation got 4 points out of 4, and group C got 3 points out of 4, and there was statistical difference between group A, B and C in subjective evaluation of image quality (P<0.05). The injection velocity and DLP of contrast agent in group A were 27.75% and 47.10% lower than those in group B and C, respectively. The total amount of contrast agent injection in groups A and B was decreased by 39.87% compared with group C, with statistical difference (P<0.05). The corresponding CT values of each vessel in group A were slightly higher than those in group B and C, and there were statistically significant differences in the Objective parameters of other vessels except for aortic arch (P<0.05). Conclusion The combination of individualized low flow rate and precise contrast agent injection scheme with low tube voltage scanning technology for low BMI subject could not only reduce the injection rate and risk of contrast agent, but also reduce radiation dose, on the premise of meeting the diagnostic requirements of image quality. It is worthy of popularization and application.

目的 探讨PBL联合SOAP门诊药历在提高门诊药师药学服务质量的效果。方法 开展SOAP门诊药历工作,并围绕实践中的典型案例开展PBL培训,由学员发现案例中的问题进行提问、分析、讨论,培训药师给予适当指导,并及时对问题解答与讨论过程中的问题进行总结。结果 PBL联合SOAP门诊药历提高了门诊药师的处方审核与处方干预水平,促进门诊药学服务工作顺利开展。结论 PBL联合SOAP门诊药历有利于培养药师独立思考和解决具体问题的临床思维能力,让门诊药师在临床实践中逐渐成长,在医院门诊药师向临床转型的实践中有良好的应用前景。

Objective To discuss the effects over the method of combining PBL with SOAP outpatient medicine records to improve the quality of pharmaceutical service of outpatient pharmacists. Methods We put the SOAP outpatient medicine records into practice and carry out the PBL training based on the typical cases in practice. In this process, the trainees can ask questions, analyze and discuss the problems in the cases, while the trainers should give some guidance, answer the questions immediately and conclude what were discussed. Results The method of combining PBL with SOAP outpatient medicine records has improved the outpatient pharmacists' level of prescription audit and intervention, it is helping to smoothly carry out the outpatient pharmaceutical service. Conclusion Combining PBL with SOAP outpatient medicine records will be helpful for pharmacists to develop their independent clinical thinking which may solve the specific problems, making them much more expert in the clinical practice. It is promising in the practice of outpatient pharmacists transforming to be clinical ones.

目的 探讨不同甲状腺结节手术治疗方案的合理性及临床效果。方法 选取本院2018年1月—2019年1月收治的120例患有甲状腺结节患者为研究对象,将其随机分为A组和B组各60例,A组患者未进行甲状腺细针抽吸细胞学检查直接进行甲状腺结节切除手术,B组患者接受超声负压引导甲状腺细针抽吸细胞学检查后给予手术治疗方案,比较两组患者手术前、后良恶性结节患者变化、术后复发率、并发症发生率及手术疗效。结果 术后A组残余恶性结节患者比例高于B组(P=0.001),A组健康无结节病变患者占比低于B组(P=0.002),A组患者恶性结节复发率高于B组患者(P<0.05);两组术后并发症发生率无差异(P>0.05),A组手术治疗总有效率低于B组(P<0.05)。结论 甲状腺结节患者术前有效超声穿刺诊断、术中超声引导手术及术后抗癌化疗治疗方案可以提高甲状腺结节患者手术有效率,B组方案具有重要临床推广价值。

Objective To investigate the rationality and clinical effect of different thyroid nodules surgical treatment. Methods A total of 120 patients with thyroid nodules admitted to our hospital from January 2018 to January 2019 were randomly divided into group A and group B, respectively. Group A patients did not undergo fine needle extraction. Aspiration cytology was performed directly for thyroid nodule resection. Group B patients underwent ultrasound negative pressure guided thyroid fine needle aspiration cytology and were given surgical treatment. The changes of benign and malignant nodules before and after surgery were compared between the two groups including postoperative recurrence rate, complication rate and surgical outcome. Results The proportion of patients with residual malignant nodules in group A was higher than that in group B (P=0.001). The proportion of patients with healthy no-nodular lesions in group A was lower than that in group B (P=0.002). The recurred rate of malignant nodules in group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The total effective rate of group A was lower than that of group B (P<0.05). Conclusion Preoperative effective ultrasound puncture diagnosis, intraoperative ultrasound guided surgery and postoperative anticancer chemotherapy treatment may improve the efficiency of thyroid nodules in patients with thyroid nodules. Group B has important clinical value.

目的 通过对43种融合基因在儿童白血病中的结果分析,探讨融合基因阳性的儿童急性B淋巴细胞白血病(acute B-lymphoblastic leukemia,B-ALL)的免疫表型特征。方法 应用实时荧光探针PCR法对2016年10月—2018年12月在深圳市儿童医院就诊的初发或复发B-ALL患儿进行融合基因检测,采用多参数流式细胞术(flow cytometry,FCM)对B-ALL患者进行免疫表型检测。结果 120例B-ALL患儿融合基因筛选总阳性率为37.5%(45/127),包括TEL/AML1 27例、E2 A/PBX1 7例、BCR/ABL1 6例、MLL 4例、TLS/ERG 1例;不同年龄段白血病融合基因阳性率差异有统计学意义(P<0.01),性别分布差异无统计学意义(P>0.05)。各融合基因阳性组CD19阳性率为100%,TEL/AML1阳性表达患者普通-B-ALL表型占比最高(77.8%),干/祖细胞抗原CD34的阳性率为81.5%;E2 A/PBX1阳性表达患者以前-B-ALL表型为主,不表达已知的T系及髓系抗原;各融合基因阳性组及阴性组患儿髓系抗原阳性率比较差异有统计学意义(P<0.01),以BCR/ABL1基因表达组阳性率最高(100%)。结论 5种融合基因在患者年龄构成及免疫表型中具有一定的分布特点;B-ALL特征性免疫表型的改变可用于融合基因表达的预测,提高融合基因结果判读的准确率。

Objective To investigate the immunophenotype features of children with acute B-lymphoblastic leukemia(B-ALL) combined with fusion gene expressing after to analyze the results of the 43 fusion genes. Methods Real-time fluorescent probe PCR assay was used for the detection of fusion genes in 120 cases of children from Shenzhen Children's Hospital with B-ALL newly or recurrently diagnosed from Oct 2016 to Dec 2018. Multi-parameter flow cytometry(FCM) was used for the detection of the immunophenotype in children with B-ALL. Results Of all the 120 cases, the fusion genes were detected at positive rate of 37.5%(45/120), included TEL/AML1 27 cases, E2 A/PBX1 7 cases, BCR/ABL1 6 cases, MLL 4 cases, TLS/ERG 1 cases. The positive rate of leukemia fusion gene had statistically difference among fusion genes positive groups based on age(P<0.01). There was no statistically difference in the gender distribution(P>0.05). The expressing of CD19 was at positive rate of 100% in all of the groups. The rate of the common-B-ALL was the highest B-ALL subtype in the TEL/AML1 positive groups(77.8%). The stem /progenitor associated antigen CD34 was at positive rate of 81.5%. The pre-B-ALL was the main subtype in the E2 A/PBX1 group, which was no expression of the known T-ALL associated antigen MyAg antigen. There was statistically difference in the positive rate of MyAg expression among all of the groups(P<0.01), with the highest rate in the BCR/ABL1 group(100%). Conclusion There were certain distribution features in age composition and immunophenotype of children with B-ALL carrying five kinds of common fusion genes. The characteristic changes of the immunophenotype of B-ALL may be used to predict the expression of fusion genes and improve the accuracy of fusion genes by the supplementary role of immunophenotype analysis.

目的 分析广州血液中心以“生日献血纪念章”(下称生日纪念章)个性化专属纪念品对献血者的招募保留效果进行分析和研究。方法 2017年—2019年期间,广州血液中心生日当天献血者共11 790名,每半年生日当天献血的献血者人数,绘制折线图,分析2018年7月起“生日纪念章”活动前后,生日当天献血的献血者人数变化;卡方检验对比2组献血人群特征差异,分析该活动敏感人群。结果 2017年—2019年每半年生日当天献血人数总体持续增长,其中2018年7—12月较2018年1—6月,生日当天献血人数增长了406%,增长比例最大。活动前后2组人群性别、年龄、职业及既往献血次数分布差异均有统计学意义(P<0.05)。活动后男性、35岁及以上献血者、工人/职员及其他职业,固定献血者比例增加。结论 广州血液中心的“生日纪念章”活动对生日当天献血有明显的促进效果,其中,男性,年龄35岁及以上,工人/职业/其他职业及固定献血者对该活动更敏感,更可能选择生日当天献血。今后针对女性、25岁以下、学生及初次献血者,注意增加其他招募保留措施。

Objective To analyze the effect of the “Birthday Blood Donation Medal” (hereinafter referred to as the Birthday Medal) personalized souvenir to the blood donor recruitment and retention effect of blood donors in Guangzhou Blood Center. Methods From 2017 to 2019, there were a total of 11 790 blood donors donated blood on their birthday in Guangzhou Blood Center. Aline chart was drawn of the number of blood donors who donated blood on birthday to observe the trends every half a year from 2017 to 2019; Chi-square test was used to compare the characteristics of blood donors in two groups (before and after the “Birthday Blood Donation Medal” activity) and we analyzed the sensitive population of the activity. Results The number of blood donors on the birthday every half year from 2017 to 2019 continued to increase. Among them, the number of blood donors donated on birthday on July-December 2018 increased by 406% compared to the first six months of 2018, which was the largest increase. The differences in gender, age, occupation, and previous blood donation times between the two groups were statistically significant (P<0.05). After the activity, the percentage of male, 35-year-old and above blood donors, workers/clerks and other occupations, and regular blood donors increased. Conclusion The “Birthday Blood Donation Medal” activity in Guangzhou Blood Center has a significant promotion effect on blood donation on birthday. Among them, males, aged 35 and above, workers/occupations/other occupations and regular blood donors are more sensitive to this activity and are more likely to donate blood on birthday. In the future, other recruitment and retention measures should be taken to pay attention to women, under 25 years old, students and first-time blood donors.

目的 本研究通过已建立的稳定表达人血小板CD36的HEK293T细胞系,制备鼠源的抗人CD36单克隆抗体并进行特性鉴定。方法 利用已经建立的稳定表达人血小板CD36的HEK293T细胞系对CD36(-/-)C57小鼠进行免疫,取脾脏与小鼠骨髓瘤细胞融合,筛选出阳性克隆。纯化单克隆抗体后,利用Western blot检测抗体结合活性。利用小鼠IgG类/单抗亚型鉴定试剂鉴定单克隆抗体的抗体亚型。通过流式细胞检测和血小板抗原单克隆抗体特异性免疫固定检测(MAIPA)鉴定其诊断应用价值。结果 经筛选后得到一株杂交瘤细胞,抗体亚型为IgG2a,轻链为κ链,Western blot试验表明该单克隆抗体特异性识别人血小板CD36抗原。MAIPA结果显示,与商业化单克隆抗体FA6-152相比,该单克隆抗体灵敏度更高。结论 成功制备了一种鼠抗人CD36单克隆抗体,为临床鉴定CD36抗体,筛选CD36阴性献血员提供了新的工具,也为今后进一步研究CD36在血液免疫疾病中作用机制提供了实验基础。

Objective In this study, by the established HEK293T cell line with stable expression of human platelet CD36, murine anti-human CD36 monoclonal antibody was prepared and characterized. Methods The established HEK293T cell line with stable expression of human platelet CD36 was used to immunize CD36 (-/-) C57 mice, and the spleen was fused with mouse myeloma cells to screen for positive cloning.After the purification of monoclonal antibody, the antibody binding activity was detected by Western blot.Mouse rapid antibody isotyping reagent was used to identify the subtype of monoclonal antibody.Its diagnostic value was evaluated by flow cytometry and monoclonal antibody-specific immobilization of platelet antigen (MAIPA). Results After screening, a high-producing hybridoma cell was obtained, the subtype of monoclonal antibody was IgG2a and the light chain was κ chain. Western blot analysis showed that the monoclonal antibody could specifically recognize CD36 antigen of human platelet. MAIPA results showed that the monoclonal antibody was more sensitive than the commercial monoclonal antibody FA6-152. Conclusion It is concluded that a mouse anti-human CD36 monoclonal antibody with biological activity has been obtained, which provides a new tool for the clinical identification of CD36 antibody and the screening of CD36 negative blood donors, and also provides an experimental basis for further research on the mechanism of CD36 in blood immune diseases.

目的 研究富血小板血浆联合强骨胶囊对大鼠骨质疏松性骨折骨愈合的影响。方法 80只未交配、3月龄雌性健康SD大鼠作为研究对象,将以上大鼠分为空白组(K组)、PRP组(P组)、强骨胶囊组(Q组),联合组(L组),每组大鼠20例,分析四组大鼠的骨痂显微形态、组织形态学以及生物力学指标之间的差异。结果 经过两两比较,联合用药组患者的骨小梁体积、数量、厚度、连接密度高于单独用药组,分离度、表面积体积比低于对照组(P＜0.05);联合用药组患者的最大载荷、结构能量吸收、材料最大应力、材料能量吸收高于单独用药组;经过两两比较,联合用药组患者的骨架面积及软骨或骨性骨痂面积比高于单独用药组。结论 富血小板血浆联合强骨胶囊通过对骨折部位骨质密度以及骨质强度的增强,大鼠骨质疏松性骨折骨愈合情况良好。

Objective To study the effect of platelet rich plasma combined with Qianggu capsule on osteoporotic fracture healing in rats. Methods 80 unmatched and 3-month-old female healthy SD rats were divided into blank group (group K),PrP group (group P),Qianggu capsule group (group Q),combined group (group L) and 20 rats in each group. The differences of callus morphology,histomorphology and biomechanical indexes among the four groups were analyzed. Results After comparing the two groups,the volume,quantity,thickness and connection density of trabecula in the combined group were higher than those in the single drug group,and the separation and surface area volume ratio were lower than those in the control group (P< 0.05); the maximum load,structural energy absorption,material maximum stress and material energy absorption in the combined group were higher than those in the single group; after comparing the two groups,in the combined group,skeleton area and area ratio of cartilage or osteotylus in the treatment group were higher than that in single-drug group. Conclusion Platelet rich plasma combined with Qianggu capsule may enhance the bone density and bone strength of the fracture site,and the osteoporotic fracture healing in rats is good.

目的 对胎儿中枢神经系统发育异常的患者进行回顾性分析,探讨处理及预后。方法 收集2016—2018年在本院因胎儿畸形就诊的275例患者行病案追踪和电话随访。结果 275例产前彩超提示胎儿神经系统异常中,侧脑室增宽比列最高,112例(40.73%,112/275)。其他类型的异常包括后颅窝池增宽、脉络丛囊肿、胼胝体发育不全、Dandy-Walker综合征、脊柱裂、小脑病变、蛛网膜囊肿、室管膜囊肿、复杂性畸形等,共163 例(59.27%,163/275)。112例胎儿侧脑室增宽病例中,产前或产后消退 80例(71.43%,80/112),引产25例(22.32%,25/112),其引产病例中15例(60%,15/25)为重度侧脑室增宽。结论 胎儿侧脑室增宽是一动态发展过程,产前超声发现轻中度胎儿侧脑室增宽,不用盲目引产,可定期追踪观察。对严重侧脑室增宽,或存在其他明显脑结构异常的胎儿,致残率和致死率很高,一旦发现,应给予高度重视,综合评估以明确诊断、评估预后,告知患者及家属保留胎儿可能存在的风险及近远期并发症,充分沟通,减少严重畸形儿的出生。