目的 比较甲苯磺酸瑞马唑仑和丙泊酚在超声胃镜检查中的有效性和安全性。方法 采用随机对照的研究方法,选择接受超声胃镜病人60例,分为观察组(29例)和对照组(31例)。观察组采用甲苯磺酸瑞马唑仑麻醉,对照组采用丙泊酚。观察麻醉过程中不同时点的血流动力学指标、改良警觉/镇静(MOAA/S)评分各时刻的变化、苏醒及离室时间、围术期不良事件。结果 观察组的血流动力学影响更小;观察组可进入足够的镇静深度,而对照组的镇静程度更深;2组起效时间相似,且迅速苏醒而离室,但在苏醒及离室时间方面观察组稍短;不良事件对照组高于观察组。结论 甲苯磺酸瑞马唑仑应用于无痛超声胃镜检查,其对血流动力学影响小,能产生足够的镇静深度,能使患者迅速苏醒,且不良事件发生率低,总体有效性和安全性优于丙泊酚。

Objective To compare the efficacy and safety of remimazolam tosilate and propofol in painless ultrasonic gastroscopy. Methods In a randomized, single-blind controlled study, 60 patients undergoing ultrasonic gastroscopy were selected and divided into observation group (31 cases) and control group (29 cases). Observation group was anesthetized with remimazolam tosilate, while control group was anesthetized with propofol. Two groups' hemodynamic index, perioperative adverse events, changes of MOAA/S score, awakening and departure time were observed at different time points during anesthesia. Results The observation group had less changes on hemodynamics. The observation group had enough depth of sedation, while the control group had a deeper degree of sedation. The onset time of the two groups was similar and both awoke quickly and left, but the awakening time and leaving time in the observation group were slightly shorter. Adverse events in the control group were more than those in the observation group. Conclusions Remimazolam tosilate for painless ultrasonic gastroscopy had little effect on hemodynamics, which can generate enough depth of sedation, and make patients wake up quickly. In addition, the incidence of its adverse events was low, and the overall effectiveness and safety were superior to those of propofol.

目的 探究应用烤瓷+活动义齿修复在牙列重度磨耗伴缺失患者治疗中对咀嚼效能的影响。方法 选定本院2019年2月—2021年2月口腔科接诊的71例牙列重度磨耗伴缺失患者,按随机数字表法分为2组,对比组和病例组各35例,对比组接受常规义齿修复治疗,病例组接受采纳烤瓷+活动义齿修复,对比2组临床疗效、咀嚼功能、Fricton指数、并发症总发生率。结果 临床总有效率病例组(94.44%)高于对比组(74.29%),病例组治疗后咀嚼效率、咬合力均比对比组高,P均＜0.05。病例组治疗后Fricton指数低于对比组,病例组并发症总发生率(2.78%)低于对比组(20.00%),P均＜0.05。结论 烤瓷+活动义齿修复可有效提高牙列重度磨耗伴缺失患者咬合力、咀嚼功能,改善颞下颌关节功能,且并发症较少,效果确切。

目的 分析团体认知行为干预联合揿针全程护理对胃癌晚期癌痛患者心理状态的影响。方法 选取我院115例胃癌晚期癌痛患者(2018年3月—2021年1月),依照干预方案不同分为3组。对照1组(37例)接受团体认知行为干预,对照2组(38例)接受揿针全程护理干预,观察组(40例)接受团体认知行为干预联合揿针全程护理干预,比较3组干预效果。结果 疼痛爆发时疼痛缓解情况:观察组疼痛爆发时疼痛缓解率均较对照1组、对照2组高(P＜0.05);心理状态:干预1个月后,3组心理状态均得到改善,且观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均较对照1组、对照2组低(P＜0.05);护理满意度:与对照1组、对照2组对比,观察组护理满意度较高(P＜0.05)。结论 团体认知行为干预联合揿针全程护理应用于胃癌晚期癌痛患者,能有效缓解疼痛,改善心理状态,且护理满意度高。

Objective To analyze the effect of group cognitive behavior intervention combined with whole-process nursing of pressing needle on the psychological state of patients with advanced gastric cancer pain. Methods A total of 115 patients with advanced gastric cancer pain in our hospital (from March 2018 to January 2021) were selected and divided into 3 groups according to different intervention methods. Control group 1 (37 cases) received group cognitive behavioral intervention, control group 2 (38 cases) received whole-course nursing intervention of pressing needle, and observation group (40 cases) received whole-process nursing intervention of group cognitive behavioral intervention combined with pressing needle. The intervention effects of the three groups were compared. Results Pain relief when pain burst: the pain relief rate of observation group was higher than control group 1 and control group 2 (P<0.05). Mental state: after 1 month of intervention, the mental state of the 3 groups was improved, and the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the observation group were lower than those in control group 1 and control group 2 (P<0.05). Nursing satisfaction: compared with control group 1 and control group 2, nursing satisfaction of observation group was higher (P<0.05). Conclusions Group cognitive behavior intervention combined with whole-process nursing of pressing needle applied to patients with advanced gastric cancer pain could effectively relieve pain, improve psychological state, and nursing satisfaction.

目的 探讨胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的临床疗效。方法 研究资料来自广州市花都区人民医院肝胆胰外科自2018年—2020年收治的72例高脂血症性重症胰腺炎患者资料,所有患者按照不同治疗方案随机分为3组,每组各24例。对照组采用急性胰腺炎常规治疗(即生长抑素+液体疗法);乌司他丁组则于常规组上联用乌司他丁;而研究组在常规及联合乌司他丁治疗基础上加用胰岛素强化治疗,比较3组患者腹痛及胃肠功能恢复的时间、甘油三酯下降的水平,治疗前、治疗后第3天、7天的APACHE Ⅱ评分的变化情况。结果 研究组患者腹痛症状缓解及胃肠功能恢复时间均较对照组明显缩短、腹痛症状缓解时间较乌司他丁组缩短,且研究组甘油三酯下降水平较对照组和乌司他丁组快,而研究组第3天和第7天的APACHE-Ⅱ评分较常规组及乌司他丁组低,以上差别均有统计学意义(P<0.05)。结论 胰岛素联合乌司他丁可明显改善高脂血症合并重症急性胰腺炎腹部症状、缩短胃肠功能恢复时间、迅速降低血清甘油三酯水平,对患者近期疗效确切。

Objective To explore curative effect of insulin combined with ulinastatin in therapy of severe hyperlipidemic pancreatitis. Methods A total of 72 patients with hyperlipidemia complicated with severe acute pancreatitis were randomly divided into three groups according to different treatment plans, 24 cases in each group. The regular treatment of acute pancreatitis (somatostatin+liquid therapy) was carried out in control group. Base on the regular treatment of acute pancreatitis, ulinastatin was added in ulinastatin group. Base on the treatment of ulinastatin group, insulin was added in study group, and the time of abdominal pain and gastrointestinal function recovery, glycerin level and the APACHE Ⅱ score before and after treatment among three groups were compared. Results Compared with the control group and ulinastatin group, the time of abdominal pain relief and gastrointestinal function recovery in the study group were significantly shorter, the time of triglycerides level back to normal in the study group was shorter than the other two groups, while at the third and seventh day, the APACHE Ⅱ score of the study group was lower than that of other two groups, with statistical significance (P<0.05). Conclusions Insulin combined with ulinastatin could significantly improve abdominal symptoms of hyperlipidemia complicated with severe acute pancreatitis, promote the recovery of gastrointestinal function, and rapidly reduce the level of serum triglyceride.

目的 探讨不同剂量阿托伐他汀治疗能否作用于脑血管储备能力机制,进而影响卒中后轻度认知功能障碍患者的认知功能水平及神经功能。方法 纳入2018年5月—2020年5月期间,在本院神经内科住院的100例卒中后轻度认知障碍患者。随机分为大剂量(阿托伐他汀40 mg/d)组和小剂量(阿托伐他汀10 mg/d)组。记录半年后的简易精神状态量表(MMSE)评分、神经功能评分(NIHSS)和脑血管储备能力。结果 大剂量组的MMSE评分、NIHSS评分优于小剂量组,大剂量组的脑血管储备能力改善明显,2组之间有统计学差异。脑血管储备能力提高与认知功能改善有相关性。结论 大剂量阿托伐他汀治疗可明显改善卒中后轻度认知功能障碍患者的脑血管储备能力,并促进患者认知功能及神经功能恢复。

Objective To investigate whether different doses of atorvastatin can contribute to the mechanism of cerebrovascular reserve capacity, and then affect the level of cognitive function and neurological function in patients with mild cognitive impairment after stroke. Methods A total of 100 patients with mild cognitive impairment after stroke hospitalized in the department of neurology from May 2018 to May 2020 were recorded. They were randomly divided into high-dose (atorvastatin 40 mg/d) group and low-dose (atorvastatin 10 mg/d) group. The Mini-Mental State Examination (MMSE), National Institute of Health Stroke Scale (NIHSS) and cerebrovascular reserve capacity were recorded half a year later. Results The scores of MMSE and NIHSS in the high-dose group were higher than those in the low-dose group. The cerebrovascular reserve capacity of the high-dose group was significantly improved, and there was significant difference between the two groups. There was a correlation between the improvement of cerebrovascular reserve capacity and cognitive function. Conclusions High dose of atorvastatin could significantly improve the cerebrovascular reserve capacity of patients with mild cognitive impairment after stroke, and promote the recovery of cognitive function and neurological function.

目的 分析中山市博爱医院妊娠合并哮喘急性发作患者相关危险因素。方法 选取2019年7月—2021年2月中山市博爱医院收治100例的妊娠合并哮喘患者作为研究对象,将100例妊娠合并患者分为哮喘急性发作组(n=46)与未发作组(n=54),采用多因素Logistic回归分析进行调查分析。结果 100例患者中发作人数为46例,占46.0%。Logistic回归分析显示孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的危险因素(P<0.05)。发作组剖宫产率发生率、住院时间以及并发症发生率均高于未发作组,差异有统计学意义(P<0.05)。结论 孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的独立危险因素,应对此类患者给予高度重视。

Objective To analyze the risk factors of pregnancy complicated with acute attack of asthma in Zhongshan Bo'ai Hospital.Methods A total of 100 patients with pregnancy complicated with asthma treated in Zhongshan Bo'ai Hospital from July 2019 to February 2021 were selected as the research objects.Patients were divided into acute attack group (n=46) and no attack group (n=54).Multivariate logistic regression analysis was used for investigation and analysis.Results The patient number of attack was 46,accounting for 46.0%. The incidence of cesarean section,length of hospital stay and complications in the attack group were higher than those in the no attack group,and the difference was statistically significant (P<0.05).Conclusions Gestational age,use of asthma drugs,anxiety and IL-17 level were independent risk factors for pregnancy complicated with acute attack of asthma.Great attention should be paid to these patients.

目的 探讨丙酸睾酮注射液联合乌司他丁对脓毒症患者免疫失衡的调节作用。方法 选取我院2019年10月—2020年1月收治的88例脓毒症患者,随机分成观察组和对照组各44例,对照组采用乌司他丁配合常规治疗,观察组在此基础上联合丙酸睾酮注射液对患者治疗,比较治疗1周2组临床疗效差异,观察治疗前及治疗1周,2组炎症因子水平[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)]、睾酮(T)、白蛋白(Alb)水平及疾病危重程度(APACHEⅡ评分)、器官衰竭程度(SOFA评分)变化,分析治疗1周内2组患者药物不良反应发生情况差异。结果 治疗1周,观察组总有效率高于对照组(P＜0.05);2组患者IL-6、IL-1β水平及APACHEⅡ、SOFA评分均降低,且观察组较对照组更低(P＜0.05);2组患者IL-10、T、Alb水平均升高,且观察组较对照组更高(P＜0.05);2组药物不良反应总发生率比较无统计学意义(P>0.05)。结论 丙酸睾酮注射液联合乌司他丁治疗脓毒症可取得良好临床疗效,可有效改善病情及预后,对患者免疫失衡调节有积极意义。

Objective To investigate the regulatory effect of testosterone propionate injection combined with ulinastatin on immune imbalance in patients with sepsis.Methods A total of 88 patients with sepsis treated in our hospital from October 2019 to January 2020 were randomly divided into observation group and control group,with 44 cases each.The control group was treated with ulinastatin combined with routine treatment,while the observation group was treated with testosterone propionate injection additionally.The clinical efficacy difference between the two groups were compared after treating 1 week.The levels of inflammatory factors [interleukin-6 (IL-6),interleukin-10 (IL-10),interleukin-1 β (IL-1β)],testosterone (T),albumin (Alb),the severity of disease (APACHE II score) and the degree of organ failure (SOFA score) in the two groups were observed before and 1 week after treatment.The differences of adverse drug reactions between the two groups within 1 week of treatment were analyzed.Results The total effective rate of the observation group was higher than that of the control group (P＜0.05).IL-6 and IL-1β levels and APACHE II and SOFA scores decreased after treatment,while those of the observation group were lower than the control group (P＜0.05).The levels of IL-10,T and Alb in the two groups were increased,while those in the observation group were higher than the control group (P ＜ 0.05); the total incidence of adverse drug reactions in the two groups was not statistically significant (P>0.05).Conclusions Testosterone propionate injection combined with ulinastatin had good clinical efficacy in the treatment of sepsis,effectively improved the condition and prognosis,and had positive significance in the regulation of immune imbalance.

目的 分析术前血清鳞状细胞癌相关抗原(SCCA)对宫颈鳞癌患者发生盆腔淋巴结转移的预测价值。方法 选取2018年1月—2021年1月于我院肿瘤科治疗的128例宫颈鳞癌患者作为研究对象,根据其是否发生盆腔淋巴结转移将其分为转移组(42例)和非转移组(86例)。对比2组宫颈鳞癌患者一般资料,采用多因素Logistic分析宫颈鳞癌患者发生盆腔淋巴结转移的高危因素,采用ROC曲线评估术前血清SCCA对宫颈鳞癌患者发生盆腔淋巴结转移的预测价值,通过约登指数确定最佳截断值。结果 2组患者一般资料对比,宫颈鳞癌细胞分化程度、宫颈鳞癌临床分期、宫颈鳞癌肿瘤直径大小、是否出现宫旁转移现象、是否出现脉管浸润现象、浸润深度、SCCA水平的差异有统计学意义,P<0.05;多因素Logistic分析显示宫颈鳞癌细胞分化程度、脉管浸润阳性、浸润深度、SCCA水平是宫颈鳞癌患者发生盆腔淋巴结转移的危险因素;ROC曲线分析结果显示,SCCA水平曲线下面积为0.909,最佳截断值为0.597 5 μg/L。结论 术前血清SCCA水平对宫颈鳞癌患者发生盆腔淋巴结转移具有预测价值。

Objective To analyze the predictive value of preoperative serum squamous cell carcinoma antigen (SCCA) on pelvic lymph node metastasis in patients with cervical squamous cell carcinoma.Methods A total of 128 patients with cervical squamous cell carcinoma treated in the oncology department of our hospital from January 2018 to January 2021 were selected as the research objects,and divided into metastatic group (42 cases) and non-metastatic group (86 cases) according to whether pelvic lymph node metastasis occurred.The general data of the two groups of patients with cervical squamous cell carcinoma were compared.Multivariate logistic analysis was used to analyze the risk factors for pelvic lymph node metastasis in patients with cervical squamous cell carcinoma.ROC curve was used to evaluate the predictive value of preoperative serum SCCA for pelvic lymph node metastasis in patients with cervical squamous cell carcinoma,and the optimal cut-off value was determined by Yoden index.Results When comparing the general data of the two groups of patients,the differences in the degree of cervical squamous carcinoma cell differentiation,clinical stage of cervical squamous carcinoma,tumor diameter of cervical squamous carcinoma,whether the phenomenon of parametastasis was present,whether the phenomenon of choroidal infiltration was present,depth of infiltration,and SCCA level were statistically significant,P<0.05; multi-factor logistic analysis showed that the degree of cervical squamous carcinoma cell differentiation,positive vascular invasion,depth of invasion and SCCA level were risk factors for pelvic lymph node metastasis in cervical squamous cell carcinoma patients.The results of ROC curve analysis showed that the area under the curve of SCCA level was 0.909 and the optimal cut-off value was 0.597 5 μg/L.Conclusions Preoperative serum SCCA level had good predictive value for the occurrence of pelvic lymph node metastasis in patients with cervical squamous carcinoma.

目的 探讨复方丹参滴丸联合阿托伐他汀治疗对伴有颈动脉粥样硬化短暂性脑缺血发作患者脑循环动力的影响。方法 将2017年12月—2018年12我院收治入院的98例伴有颈动脉粥样硬化短暂性脑缺血发作患者为研究对象,随机分为观察组(49例,给予复方丹参滴丸联合阿托伐他汀治疗)和对照组(49例,给予阿托伐他汀治疗)。观察对比治疗前及治疗后2组患者每日短暂性脑缺血发作频率及持续时间,血脂水平、血流变指标、粥样硬化斑块及斑块面积。结果 治疗前,两组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比,差异无统计学意义(P>0.05);治疗后,2组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比均有所改善,其中观察组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比优于对照组,差异有统计学意义(P<0.05)。结论 在伴有颈动脉粥样硬化短暂性脑缺血发作患者中采用复方丹参滴丸联合阿托伐他汀治疗效果确切,可有效降低伴有颈动脉粥样硬化的短暂性脑缺血发作患者发作频率及持续时间,同时可有效调节患者血脂水平,改善对脑循环动力学指标,值得临床推广普及。

Objective To investigate the effect of compound Danshen dripping pills combined with atorvastatin on cerebral circulation dynamics in patients with transient ischemic attack accompanied by carotid atherosclerosis. Methods A total of 98 patients with transient ischemic attack with carotid atherosclerosis admitted to our hospital from December 2017 to December 2018 were randomly divided into observation group (49 cases, receiving compound danshen drop pill combined with atorvastatin) and control group (49 cases, receiving atorvastatin), to observe and compare the frequency and duration of transient ischemic attack, blood lipid level, hemorheological indexes, atherosclerotic plaque and plaque area of the two groups before and after treatment. Results Before treatment, there was no significant difference in frequency, duration, blood lipid levels, IMT and plaque area between the two groups (P>0.05). After treatment, 2 groups of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were improved. Compared with observation group of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were better than control group, the differences were statistical significance (P<0.05). Conclusion Patients in associated with carotid atherosclerosis with transient ischemic attack using compound danshen dropping pill with atorvastatin therapy have good effects. This may effectively reduce frequency and duration in patients with transient ischemic attack associated with carotid atherosclerosis, regulate blood lipid levels at the same time, and improve the dynamics of cerebral circulation index. It is worthy of clinical popularization.

目的 乳腺癌是世界范围内最常见的恶性肿瘤之一。目前,人们对乳腺癌的发病机制进行了大量的研究,但对其分子机制的认识尚不清楚。本研究采用生物信息学技术,筛选乳腺癌潜在的关键基因,最终为乳腺癌的诊断、治疗及预后判断提供潜在的生物标记物。方法 从基因表达综合数据库(GEO)下载基因芯片GSE36295、GSE71053和GSE86374,通过GEO2R鉴定差异表达基因(DEGs),并进行功能富集分析。利用STRING构建了蛋白质-蛋白质相互作用网络(PPI),并采用Cytoscape进行了模块分析。结果 共鉴定出95个DEGs,包括62个上调基因和33个下调基因。共鉴定出10个Hub基因:CENPF、KIF2C、TOP2A、NUSAP1、HMMR、MELK、KIF4A、ASPM、CEP55、CCNB1。结论 本研究发现的Hub基因可能对乳腺癌的发展和预后存在一定影响,为乳腺癌的诊断和治疗提供候选靶点。

Objective Breast cancer is one of the most common cancers worldwide. At present, a lot of researches have been carried out on the pathogenesis of breast cancer, but the molecular mechanisms of breast cancer are still not well understood. In this study, bioinformatics technology was used to screen the potential key genes of breast cancer, and ultimately to provide potential biomarkers for the diagnosis, treatment and prognosis of breast cancer. Methods The microarray datasets GSE36295、GSE71053和GSE86374 were downloaded from Gene Expression Omnibus (GEO), and the differentially expressed genes (DEGs) were identified by GEO2R, and the enriched functions and pathways of the DEGs were analyzed. Protein-protein interaction network (PPI) was constructed by using String, and the module analysis was performed using Cytoscape. Results A total of 95 DEGs were identified, consisting of 62 upregulated genes and 33 downregulated genes.Ten hub genes were identified: CENPF,KIF2C,TOP2A,NUSAP1,HMMR,MELK,KIF4A,ASPM,CEP55,CCNB1. Conclusion The hub gene was found in this study may be involved in the development and prognosis of breast cancer. It may provide candidate targets for diagnosis and treatment of breast cancer.