目的 研究益精汤对改善男性不育症患者精子质量和提高生育率的临床疗效。方法 将符合纳入标准的100例男性不育症患者随机分为益精汤组和五子衍宗片组进行治疗,治疗后采用ZKPACS-E彩色精子质量分析系统检测精子各项参数标指和调查孕育人数,进行分析对比。结果 通过治疗前后对比,益精汤组的治愈率及临床治愈率较五子衍宗片组高,益精汤组、五子衍宗片组总有效率依次是82%、64%,差异有统计学意义(P<0.05)。益精汤组对患者的精液液化时间、精子活力等指标方面的恢复和改善优于对照组。结论 益精汤能显著提高精子的质量,在治疗男性不育症方面效果显著,值得进一步临床研究和推广。

目的 了解广东省某区级三甲综合医院住院老年人慢性非传染性疾病(慢非病)疾病谱及性别差异随年度推移的变化。方法 回顾性分析南方医科大学附属南海医院2006—2014年老年人出院资料。结果 住院老年人疾病谱中名列前位的疾病除了肺炎、急性胃肠道疾病,余为慢非病。慢非病比例逐年下降(65.8%~57.8%, P<0.01),疾病谱明显变化:脑血管疾病由第一位占21.3%降至17.0%居第二,恶性肿瘤从10.4%升至18.8%居第一。性别有差异:男性慢阻肺和恶性肿瘤的构成比多于女性;慢非病比非慢非病、男性比女性慢非病的人均住院总费用高(P<0.05)。结论 总结9年来南海区三甲综合医院住院诊治的慢非病居高及攀升病种、性别差异,制定措施优化医疗资源配置、减轻社会经济负担。

Objective To analyze the alteration of disease distribution and gender-differences of chronic non-communicable diseases (NCD) in hospitalized elderly from a large Comprehensive Hospital of Guangdong province. Methods Retrospective observational study including profile of discharged elderly in Nanhai hospital attached to Southern medical university from the year 2006 to 2014. Results In the top rank of diseases in hospitalized elderly, all were NCDs other than pneumonia and acute gastrointestinal diseases. The proportion of NCD accounted for all hospitalized elderly was reduced year by year, changed from 65.8% to 57.8%, P<0.01. Disease distribution of NCD altered obviously, showing that cerebrovascular disease (CVD) decreased from the first 21.3% to the second 17.0%, malignancy increased from 10.4% to 18.8% ranking as the first. Gender-differences did exist. Greater constituent ratio of chronic obstructive pulmonary disease (COPD) and malignancy were found in men than women yearly. NCD showed higher hospitalized expenses than non-NCD per capita, that of men were higher than women (P<0.05). Conclusion Summarizing the top and increasing rank of NCD and gender-differences in hospitalized elderly in a large comprehensive hospital, Nanhai district, Foshan city of 9 years, policy and program could be guided to optimize the distribution of medical resources and try to reduce the output of social economic burden.

目的 探讨年轻恶性肿瘤化疗女性的发病情况及保留生育功能和卵巢功能的意义。方法 回顾性分析和总结在我院行化疗的17～40岁年轻恶性肿瘤女性患者的年龄、肿瘤类别、构成等临床资料。结果 5年间在我院化疗的1261例女性恶性肿瘤患者中,年龄15～40岁者共786例(占62.3％),其中乳腺癌355例、大肠癌89例、白血病80例、宫颈癌67例、卵巢癌46例、恶性淋巴瘤39例,胃癌38例,肺癌30例,肝癌18例。15～25岁年龄段的女性恶性肿瘤化疗以白血病和卵巢癌为主。随年龄增长,大部分女性恶性肿瘤化疗的发生率增高。结论 15～40岁年轻恶性肿瘤化疗女性中乳腺癌占首位,其次为大肠癌、白血病和宫颈癌。保留年轻患者卵巢功能和生育功能的保守治疗具有重要意义。

Objective To analyze the clinical characteristics of malignant tumor in young women receiving chemotherapy aged from 15 to 40 and investigate the role of conservative treatment. Methods The clinical data of female aged from15 to 40 years old who were received chemotherapy in our hospital between 2010 and 2014 were retrospectively analyzed. Results 786 cases were identified from 1261 cases of malignant tumor receiving chemotherapy. Including 355 cases of breast cancer,89 cases of colorectal cancer,80 cases of leukemia,67 cases of cervical carcinoma,46 cases of ovarian cancer,39 cases of lymphoma,38 cases of gastric cancer,30 cases of lung cancer and 18 cases of liver cancer. Leukemia and ovarian cancer is the most common malignant tumor in young female between 15 to 25 years old. The cases of malignant tumor receiving chemotherapy increased with increasing age. Conclusion Breast cancer is the most common malignant tumor in young female receiving chemotherapy, followed by colorectal cancer, leukemia, and cervical carcinoma. It is very important to conserve young women's ovary function and fertility function.

目的 评价综合营养干预措施与传统的单纯药物治疗对花都区老年原发性骨质疏松 (OP)患者生命质量的影响。方法 采用随机法将符合标准的OP患者随机分配到干预组(A组)和对照组(B组)接受相应的干预处理。干预组给予综合营养干预措施,而对照组只给予单纯的抗骨质疏松药物。结果 干预组人群干预前后生命质量的8个维度中的6个维度得分与干预前比较,差别有统计学意义(P<0.05)。 对照组人群生命质量的8个维度中只有2个维度与干预前比较,得分间差别有统计学意义(P<0.05)。结论 综合营养干预措施可以提高老年OP患者的生命质量。

目的 探讨难治性肠易激综合征(RIBS)患者的生活质量及影响因素。方法 采用症状严重程度量表(IBS-SSS)、汉密尔顿焦虑/抑郁量表(HAMA/HAMD)和生活质量量表(IBS-QOL)对601例消化专科门诊连续IBS患者和同期匹配的100例健康体检者进行测评,并通过多重线性回归分析探讨RIBS患者生活质量的影响因素。结果 RIBS组IBS-QOL总评分及IBS-QOL8个维度评分低于非RIBS组和健康对照组(P<0.05)。RIBS不同亚型间的IBS-QOL总评分无统计学意义(P>0.05),但在冲突行为、健康忧虑、社会反映3个维度方面有统计学意义(P<0.05)。IBS-SSS症状评分和焦虑症状评分为RIBS患者生活质量的影响因素。结论 难治性IBS患者的生活质量差,临床症状和焦虑情绪为其重要影响因素。

Objective To explore quality of life and its risk factors in patients with refractory irritable bowel syndrome(RIBS). Methods 601 IBS patients in gastroenterology clinic and 100 healthy volunteers were invited to complete irritable bowel syndrome- symptom severity scale (IBS-SSS), the Hamilton Rating Scale of Anxiety/ Depression (HAMA/HAMD), Irritable bowel syndrome-quality of life(IBS-QOL). And multiple linear regression analysis was used to explore the determinants of quality of life in patients with RIBS. Results The overall score and subscale scores of IBS-QOL in RIBS group were lower than those in the non-RIBS and healthy group (P<0.05). There were no significant differences in the overall scores of IBS-QOL among different subtypes of RIBS. However, the interference with activities, health anxious, social reaction scores were different among the subtypes (P<0.05). Multiple linear regression analysis demonstrated that quality of life in RIBS was independently associated with the scores in IBS-SSS and HAMA. Conclusion Quality of life in RIBS is obviously decreased. Quality of life in RIBS is closely related to clinical symptoms and anxiety condition.

目的 分析ITP患者血清中IgG型抗体糖基化的特异性,初步探讨其特异性与临床症状的相关性。方法 选取健康献血员30例、ITP患者13例及健康怀孕妇女23例,纯化血清中的IgG型抗体,应用nano-LC-MS法分析糖基化种类及水平,对比分析ITP患者血清中IgG型抗体的糖基化特异性。结果 ① ITP 患者血清中IgG型抗体的半乳糖糖基化水平为47.08±2.69,低于健康怀孕妇女(50.93±2.21),高于健康献血员(42.88±2.00)(P<0.05);② ITP 患者岩藻糖基化水平为81.16±2.49低于健康献血员(82.60±2.56)(P>0.05),同时低于健康怀孕妇女(86.17±2.23)(P<0.05);③ITP 患者唾液酸化水平为3.93±1.20,高于健康献血员(3.69±1.19),低于健康怀孕妇女(4.28±0.88)(P>0.05)。④ITP 患者乙酰葡糖氨基化水平为10.53±1.41,低于健康献血员(11.54±1.76),高于健康怀孕妇女(10.13±1.45)(P>0.05)。结论 ITP患者血清中的IgG型抗体的岩藻糖基化、半乳糖糖基化水平的特异性可能是其产生有别于健康怀孕妇女的临床症状的的分子基础。

Objective To investigate the glycosylation specificity of the IgG antibody in ITP. Methods Choose 30 healthy donors, 23 healthy pregnants and 13 ITP patients, purified the IgG antibody from serum, analysied the level of all kinds of glycosylation. Compared with healthy donor and healthy pregnants to find the specificity of the IgG antibody in ITP patients. Results ① The galacosylation of IgG antibody in ITP patients was 47.08±7.24,lower than healthy pregnants (50.93±4.91), higher than healthy donor (42.88±4.01), and the healthy pregnants were higher than healthy donor (P<0.05). ② The fucosylation in ITP patients was 81.16±6.2, lower than healthy donors (82.60±2.56) (P>0.05), higher than healthy pregnants(86.17±2.23)(P<0.05); ③The sialylation in ITP patients was 3.93±1.20, higher than healthy donors (3.69±1.19), lower than healthy pregnants (4.28±0.88)(P>0.05); ④The GlcNAc in ITP patients was 10.53±1.41, lower than healthy donors (11.54±1.76), higher than healthy pregnants (10.13±1.45)(P>0.05). Conclusion The specificity of IgG antibody in ITP patients in galacosylation and fucosylation may be the molecule base of ITP's clinic symptom.

大数据时代的到来,给各行各业及整个社会文化带来了深刻变革。医学图书馆经受这一领域洗礼时,其数据处理方法和用户服务模式会发生显著变化,也对馆员素质提出了新的要求。文章就大数据时代医学图书馆馆员素质教育提出了几点建议。

目的 分析个体化营养指导对双胎妊娠的结局影响。方法 将2014年2月—2015年12月在新疆喀什疏附县人民医院分娩的80例双胎妊娠,接受过个体化营养指导的42例为治疗组;未能或不自愿接受个体化营养指导的38例为对照组,观察比较对照组和治疗组的妊娠结局。结果 治疗组妊娠期糖尿病(GDM)、贫血、妊娠期高血压疾病、产后出血、新生儿窒息、低出生体重儿发生率小于对照组差异有统计学意义(P<0.05)。结论 利用个体化营养指导双胎妊娠孕妇饮食,可以减少并发症,取得理想的妊娠结局。

目的 了解非结核分枝杆菌肺病患者营养风险、营养不足发生率,以及营养支持的应用状况,为临床实施营养干预提供参考依据。方法 对2012年10月—2014年10月在广州市胸科医院就诊的非结核分枝杆菌肺病患者(符合NRS2002评定标准)的营养风险筛查与营养支持状况进行回顾性分析。结果 402例患者中,营养不足和营养风险的发生率分别为35.8％(144/402)和66.7％(268/402);所有患者中,总体营养支持率为60.0%(241/402), 使用肠外营养与肠内营养的比例为3.2∶1;老年患者,女性患者,复治患者更是发生营养风险和营养不足的高危人群;存在营养风险患者的营养支持率为82.1%(220/268),不存在营养风险患者营养支持率为15.7%(21/134)。结论 非结核分枝杆菌肺病患者存在较高比例的营养不足和营养风险,肠外肠内营养临床应用存在不合理性;应推广和使用NRS2002营养评定方法和肠内肠外营养指南,作为实施营养支持的依据。

Objective To investigate prevalence of nutritional risk, undernutrition, and nutritional support of hospitalized patients with non-tuberculosis mycobacteria. Methods Adult patients in Guangzhou Chest Hospital from October 2012 to October 2014 were enrolled by fix-point consecutive sampling. Nutritional Risk Screening 2002 (NRS2002) was performed and nutritional support was evaluated in all patients. Results A total of 402 patients were enrolled.Overall prevalence of undernutrition was 35.8%, and nutritional risk was 66.7%. Among all the patients, the rate of nutritional support was 60.0%, including 82.1%of patients with nutritional risk and 15.7% of non-risk patients. Gerontal patients, retreatment patients and female patients are in the greater possibility of being expose to nutritional risk or undernutrition. Conclusion A large proportion of inpatients with non-tuberculosis mycobacteria were at nutritional risk or undernutrition.The application of parenteral or enteral nutritional support currently maybe inappropriate. NRS2002 and parenteral or enteral nutrition guideline are required to affording nutritional support.

目的 探讨罗伊适应模式对肺癌患者术后生活质量的影响。方法 将2012年3月—2015年7月来我院就诊的178例肺癌术后患者,随机分为试验组85例和对照组93例;对照组患者按护理常规进行护理,试验组在常规护理基础上给予罗伊适应模式护理干预;出院时分别比较两组患者住院适应性、治疗依从性、病人满意度及患者生活质量评分。结果 试验组住院适应率为87.1%(74例),对照组住院适应率为66.7%(62例),两组差异有显著性(P<0.01);试验组治疗依从性优良率为88.2%(75例)、对照组治疗依从性优良率72.0%(67例),两组差异有显著性(P<0.01);试验组患者满意度为89.4%(76例),高于对照组患者满意度73.1%(68例),两组差异有显著性(P<0.01);试验组生活质量评分,总体健康得分(74.1±8.3)高于对照组(56.7±5.9),且差异有统计学意义(P<0.01)。结论 罗伊适应模式护理干预,可以提高肺癌患者手术后的住院适应性、治疗依从性及病人满意度,显著改善患者生活质量,在临床推广罗伊适应模式护理干预具有现实意义。

Objective To investigate　the effect of Roy adaptation model on quality of life in patients for lung cancer after surgery. Methods 178 cases of　patients with lung cancer after surgery operation　were randomly divided into observation groups(85 cases) and control groups(93 cases). The control group was treated with routine nursing care and the observation group was treated on the basis of routine nursing care plus Roy adaptation model nursing interventions. When the two groups were compared in patients hospitalized and discharged adaptability, treatment compliance, patient satisfaction and patient quality of life score. Results Hospitalization adaptation in the observation group was 87.1%(74 cases) and control group was 66.7%(67 cases). There was statistically significant difference between two groups(P<0.01); Excellent treatment compliance of observation group was 88.2%(75 cases) and control group was 72.0%(67 cases). There was statistically significant difference between two groups(P<0.01); the observation group patient satisfaction were 89.4%(76 cases), it was higher than 73.1%(68 cases) of control group. There was statistically significant difference between two groups(P<0.01); quality of life in general health score(74.1±8.3) in the observation group was higher than that of control group(56.7±5.9),and there was statistically significant difference between two groups(P<0.01). Conclusion Roy adaptation model nursing intervention may improve the adaptability hospitalized the patients with lung cancer after surgery, treatment compliance and the patient satisfaction, and significantly improve the quality of life of patients. It is worthy of promotion clinically.