目的 回顾分析我医院近8年混合痔行Milligan-Morgan术式治疗的患者的临床病历资料,探索术后出现胃肠道症状的危险因素。方法 选取我医院2012年1月—2019年6年期间行Milligan-Morgan术式治疗的混合痔患者1 221例,分成术后胃肠道症状组和未出现胃肠道症状组,比较两组间的差异,分析其相关危险因素。结果 1 221例混合痔患者中出现胃肠道症状的为168例,发生率为13.8%(168/1 221);单因素分析结果显示,高血压、全麻麻醉方式是术后出现胃肠道症状的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,高血压、全麻麻醉方式是术后出现胃肠道症状的独立危险因素。结论 混合痔患者行Milligan-Morgan术式治疗出现胃肠道症状率较高;围手术期控制患者血压,以及慎重选择全麻麻醉方式可能有效减少胃肠道症状发生率。

Objective To explored the risk factors of gastrointestinal symptoms after operation by retrospectively analyzing the clinical records of patients with mixed hemorrhoids treated by Milligan-Morgan operation in our hospital in recent 8 years. Methods 1 221 patients with mixed hemorrhoids treated by Milligan-Morgan operation in our hospital from January 2012 to June 2016 were divided into two groups: the group with digestive tract symptoms after operation and the group without digestive tract symptoms. The differences between the two groups were compared and the related risk factors were analyzed. Results Among 1 221 patients with mixed hemorrhoids, 168 had gastrointestinal symptoms, whose incidence was 13.8%(168/1 221). Univariate analysis showed that hypertension and general anesthesia were the related factors of gastrointestinal symptoms after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that hypertension and general anesthesia were the independent risk factors. Conclusion Milligan-Morgan operation for mixed hemorrhoids has a high incidence of digestive tract symptoms. Perioperative blood pressure control and careful selection of general anesthesia may effectively reduce the incidence of digestive tract symptoms.

目的 统计分析中医治疗胎动不安的用药规律,为临床中医治疗胎动不安提供用药参考。方法 严格按照标准筛选中医治疗胎动不安的中药处方,采用 excel表格对处方基本用药信息进行统计,然后再采用 SPSS19.0软件以中药的功效作为评价指标进行分析,以确定处方中用药味数、用药天数、以及中药的使用频次。并对使用频次前30位的药物进行归类,确定药物使用频次高的特征值、贡献率和综合得分。结果 所选取的356例患者中药处方中,平均用药药味数15.7味,平均剂量226.7 g,使用频次最高的前5位药分别为菟丝子、桑寄生、续断、白芍、白术;30味中药通过按照功效可分为5类,所提取的10个主成分能反映系统聚类中的分类结果。结论 对中医治疗胎动不安患者处方进行分析,为中医治疗胎动不安提供了用药参考,对指导临床合理用药有重要指导意义。

Objective To analyze the medication experience in treating fetal irritability and provide medication reference of clinical traditional Chinese medicine in treatment of fetal irritability. Methods The prescription of traditional Chinese medicine treats was screened according to the standard. The information of prescription basic were statisticed with Excel and processed the data by SPSS19.0, to determine the frequency of medicine the number of drugs and medication days. The Chinese medicines used in the top 30 were classified to determine the characteristic of eigenvingue,rate of contribution and synthesis score. Results The top 5 highest frequency medicines were Tusizi, Sanjisheng, Xuduan, Baishao, Baishu; and the average drug taste was 15.7,the average dose was 226.7 g,after analyzing the screened 356 prescriptions. 30 Chinese medicines could be clustered into 5 kinds. The extraction of 10 principal components of principal component scores and comprehensive scores may reflect the classification results of system clustering. Conclusion To analyze the prescriptions of traditional Chinese medicine for fetal irritability, provide the reference for medicine combination in treating different syndromes of fetal irritability. It had the extremely vital significance for guiding the clinical medication.

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 探究甲状腺癌患者对健康知识了解详情和需求,同时提出合理健康教育方案。方法 随机抽取本院2017年11月—2019年5月期间收治的122例甲状腺癌患者为研究对象,通过本院自制的调查问卷对其进行调查,分析和掌握患者对健康知识了解详情和具体需求,同时根据其特点提出合理的健康宣教方式。结果 患者对疾病和生活习惯的联系、定期入院复诊的重要性、临床治疗对疾病的控制详情、具体治疗方案和疗效、疾病临床特征以及疾病详细信息等甲状腺癌相关知识不了解率分别为50.00%、51.64%、72.95%、74.59%、77.87%、8.19%;健康教育内容需求评分较高,需求占比全部高于40%;患者对不同的健康教育形式有着不同的需求,其中需求最高的为护患会议交流,占比98.36%,其次为微信科普知识,占比96.72%,之后依次为播放视频和音频(94.26%)、创建专题讲座(93.44%)、个体指导(91.80%)、电话随访(83.60%)、相同疾病患者经验介绍(80.32%)、宣传栏和宣传册(63.90%)。结论 甲状腺癌患者对健康知识了解较少且需求较大,因此可对患者采取多元化健康知识教育方案,满足不同患者的需求,进而增加患者对疾病的重视程度,有利于患者树立治疗信心、提升其生活质量。

Objective To explore the health knowledge of thyroid cancer patients to understand the details and needs, and put forward a reasonable health education program. Methods 122 patients with thyroid cancer admitted to our hospital from November 2017 to May 2019 were randomly selected as the research objects. Through the questionnaire made by our hospital, we investigated the patients, analyzed and mastered the patients' understanding details and specific needs of health knowledge, and proposed reasonable health education methods according to their characteristics. Results The rates of patients' ignorance about thyroid cancer related knowledge, such as the relationship between disease and lifestyle, the importance of regular admission to hospital, the control details of the disease in clinical treatment, the specific treatment plan and effect, the clinical characteristics of the disease and the detailed information of the disease, were 50.00%, 51.64%, 72.95%, 74.59%, 77.87% and 8.19%, respectively. The score of demand for health education content was high, accounting for more than 40% of the total demand.Patients with different forms of health education had different needs, one of the highest requirements for meeting communication, nurses and patients accounted for 98.36%, followed by WeChat popular science knowledge, accounted for 96.72%, followed by after playing video and audio (94.26%), creating a seminar (93.44%), individual guidance (91.80%), telephone follow-up (83.60%), experience introduction (80.32%),patients with the same disease, publicity column and brochure (63.90%). Conclusion Patients with thyroid cancer have less knowledge of health knowledge and need more health knowledge. Therefore, we may take diversified health knowledge education programs to meet the needs of different patients, and then increase the attention of patients to the disease, which is conducive to the patients to establish treatment confidence and improve their quality of life.

目的 回顾分析我医院近9年产妇行剖宫产术治疗的患者的住院病历资料,探索术后出现切口脂肪液化的危险因素。方法 选取我医院2011年1月—2019年8月期间行剖宫产术治疗的产妇患者1 018例,分成术后切口脂肪液化组和甲级愈合组,比较2组间的差异,分析其相关危险因素。结果 1 018例产妇患者中出现切口脂肪液化的为34例,发生率为3.34%(34/1 018);单因素分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的独立危险因素。结论 产妇患者行剖宫产术治疗出现切口脂肪液化率较高;围手术期控制患者血糖,以及孕期控制体质指数、缩小剖宫产手术切口长度可能有效地减少切口脂肪液化发生率。

Objective To retrospectively analyze the medical records of patients undergoing cesarean section in our hospital in recent 9 years, and explore the risk factors of incision fat liquefaction after operation. Methods 1 018 patients undergoing cesarean section in our hospital from January 2011 to August 2019 were divided into two groups: incision fat liquefaction group and grade A healing group. The differences between the two groups were compared and the risk factors were analyzed. Results Among 1 018 parturients, 34 had incision fat liquefaction, and the incidence was 3.34% (34/1018). Univariate analysis showed that diabetes mellitus, overweight body mass index and incision length of more than 7 cm were risk factors for incision fat liquefaction after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that diabetes mellitus, overweight body mass index and incision length over 7 cm were independent risk factors for incision fat liquefaction. Conclusion The incision fat liquefaction rate is higher in patients undergoing cesarean section. Controlling blood sugar level, body mass index during pregnancy and shortening the length of incision during perioperative period may effectively reduce the incidence of incision fat liquefaction.

目的 了解我院药品不良反应(ADR)发生的规律和特点,为临床合理用药提供参考。方法 收集广州市第一人民医院南沙医院2015年1月1日—2019年12月31日上报国家药品不良反应监测中心的224例ADR,统计分析发生ADR的患者性别、年龄、药品种类、剂型、给药途径、累及系统等情况。结果 224例ADR报告中,女性报告数(51.79%)高于男性(48.21%),50岁以上的病人报告数占48.6%,其中60岁以上属于高发年龄段(30.8%);抗感染药ADR报告数最多(43.3%),其次是心血管系统用药(12.95%),第三是中枢神经系统用药(12.50%);静脉给药ADR报告数最多(57.14%),其次是口服给药(40.18%),剂型因素中,最高为注射液(32.59%),其次为普通片剂(28.57%),第三位粉针剂(24.55%);ADR累及系统中,皮肤及附件损害最多(26.43%),其次是胃肠系统损害(20.70%)和中枢及外周神经系统损害(18.06%);上报来源以药师上报为主(72.77%),护士上报率为0。结论 临床应加强合理用药,尤其抗菌药物使用,减少静脉给药途径,重点关注50岁以上ADR高发人群,加强ADR监测医护宣教,提高ADR上报率和报告质量。

Objective To investigate the occurrence and distribution of adverse drug reaction ADR from 2015 to 2019 in our hospital and provide relevant information for clinical rational usage of medication. Methods 224 ADR reported to National Center were collected from Nansha hospital of Guangzhou First People's Hospital monitoring during 2015~2019.Those ADR were analyzed in terms of gender and age of patients,type of drugs, route of administration,dosage form,etc. Results Among 224 ADR reports,the occurrence rate of ADR in female(51.79%)was higher than male,patients over the age of 50 accounted for 48.6% and age over 60 were at high risk of ADR.The top three of medicine were anti-infectious agent(43.3%),cardiovascular medicine(12.95%)and central nervous system medication(12.50%). Intravenous administration and oral medication accounted for 57.14%,40.18% respectively.For the dosage form factor,the top three were injection (32.59%), ordinary tablet (28.57%) and powder-injection (24.55%).Major systems involved in ADR were lesion of skin and its appendages(26.43%),gastrointestinal system(20.70%),central and peripheral nervous systems(18.06%).Sources of ADR were mainly composed of pharmacist(72.77%)and the nurse reported 0. Conclusion Clinical rational drug use should be strengthen especially antibacterial agents. The intravenous route should be decreased.Patients over the age of 50 deserved special attention. It is necessary to enhance awareness and education of medical workers to improve the reported rate and quality of ADR.

目的 评价贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌的疗效及不良反应。方法 2名评价员通过独立地检索中英文数据库,纳入随机对照研究,其中治疗组为肝动脉灌注贝伐单抗联合肝动脉化疗栓塞组、对照组为单独肝动脉化疗栓塞组,并通过Jadad量表对纳入文献质量进行评分,最后采用Review Manager 5.2软件进行Meta分析。结果 纳入6篇文献,466例病例。结果显示:在疗效方面,治疗组的3、6个月疾病有效率及疾病控制率,12个月的生存率均高于对照组且差异有统计学意义(P<0.05);在安全性方面,两组间关于发热、转氨酶升高、恶心、黑便的发生率之间的比较无统计学意义(P＞0.05)。结论 肝动脉灌注贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌与单独肝动脉化疗栓塞比较,能有效提高肝癌患者近期及远期疗效,且并不增加不良反应发生率。

Objective To evaluate the efficacy and side effects of bevacizumab combined with thanscatheter artierial chemoembolzation in the treatment of primary liver cancer. Methods Two reviewers collected data about clinical trials that the combination of bevacizumab and thanscatheter artierial chemoembolzation for treatment of primary liver cancer from data bases. Jadad Score and Review Manager 5.2 software were respectively used to assess the quality of included studies and analyze the obtained data. Results Six randomized controlled trials involving 466 patients were included in this paper. The results of the meta-analysis showed that compared with thanscatheter artierial chemoembolzation group alone, bevacizumab combined with thanscatheter artierial chemoembolzation improved the response rate and disease control rate, prolonged 12 month survival rate (P<0.05). As for side effects, there were no statistically different of those about fever, level of transaminase, nausea and melena between two groups(P>0.05). Conclusion Compared with simple thanscatheter artierial chemoembolzation group, and Bevacizumab combined with thanscatheter artierial chemoembolzation group, the later may improve short-term and long-term effects, and side effects were under control.

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 探讨影响孕晚期死胎伴胎动减少延迟就诊的临床因素,加强围产期宣教。方法 回顾性分析2017年1月—2019年10月广州市妇女儿童医疗中心住院分娩的孕晚期(孕周≥28周)单胎死胎病例的相关临床资料。结果 在79例死胎中,有59例(74.68%)孕妇感知胎动减少,但只有27人(45.76%)在感知胎动减少后24小时内就诊。妊娠未合并胎儿生长受限可能会导致延迟就诊(P=0.03<0.1)。结论 胎动减少和死胎发生密切相关,但大部分孕妇可能会出现延迟就诊。加强孕期产检,规范孕期宣教,尤其是合并胎儿生长受限等高危妊娠时的孕期严密监测,强调胎动的重要性,在感知胎动减少后强调早期就诊,有助于减少孕晚期死胎风险。

Objective To explore the clinical factors that affect the consultation time of stillbirth after perceptive reduction of fetal movement in the third trimester of pregnancy, and to strengthen the perinatal education. Methods A retrospective analysis of single stillbirth in late pregnancy (gestational weeks≥ 28 weeks) in Guangzhou Women and Children's Medical Center from January 2017 to October 2019 was taken, and the relevant clinical data were summarized and evaluated. Results Out of 79 stillbirth cases, 59 (74.68%) cases had decreased fetal motility. Only 27 pregnant women (45.76%) visited the doctor in 24 hours after they perceived the reduction of fetal movement. Pregnancy without fetal growth restriction may lead to delayed consultation (P=0.03<0.1). Conclusion Perception of decreased fetal movement is closely related to the occurrence of stillbirth, but most pregnant women may have delayed visits. To strengthen the prenatal examination, standardize the propaganda and education during pregnancy, especially the close monitoring of high-risk pregnancy such as fetal growth restriction, emphasize the importance of fetal movement, and emphasize the early consultation after perceiving the reduction of fetal movement, are helpful to reduce the risk of stillbirth in late pregnancy.

目的 系统评价手术与保守治疗无骨折脱位型颈脊髓损伤的疗效。方法 应用计算机检索 PubMed、Cochrane Library、EMbase、OVID、CNKI、维普及万方数据库,纳入关于手术及保守治疗无骨折脱位型颈脊髓损伤疗效比较的随机或非随机对照试验。由2名研究人员独立对文献进行筛选、提取和纳入文献评价,采用 Rev-Man 5.3软件对两种治疗的JOA评分、ASIA运动评分、神经功能恢复率、ASIA分级改善进行Meta分析。结果 ①共纳入13 篇研究,共598例患者,手术和保守治疗组分别371例和227例;②Meta分析显示,与保守治疗相比,手术治疗后的JOA评分更高[MD=3.08,95%CI(2.71,3.45),Z=16.29,P<0.000 01];神经功能恢复率更高[MD=15.87,95%CI(9.28,22.46),Z=4.72,P<0.000 01];ASIA分级改善更明显[OR=2.3,95%CI(1.25,4.15),Z=2.76,P=0.006];在ASIA运动评分方面,两者无差异[MD=5.45,95%CI(-7.56,18.47),Z=0.82,P=0.41]。结论 对于无骨折脱位型颈脊髓损伤的患者,手术治疗更有利于患者神经功能的改善。

Objective To systematically assess the clinical efficacy of surgical treatment versus conservative treatment for CSCIWFD from previously clinical investigations. Methods A systematic search of all the studies published was conducted on the PubMed, Cochrane Library, EMbase, OVID, CNKI, VIP and Wanfang databases. Randomized and non-randomized controlled trials that compared between surgical treatment and conservative treatment for CSCIWFD were identified. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the quality of included studies. Meta-analyses were performed to assess variables including Japanese Orthopaedic Association scores(JOA), Neurological function recovery rate, ASIA impairment scale grade, ASIA motor scores. Results ①A total of 13 articles were included, involving 598 patients, of which 371 and 227 patients received sugical or conservative treatment. ②The results of the meta-analysis indicated that, compared with conservative group, surgical group has higher JOA scores[MD=3.08,95%CI(2.71,3.45),Z=16.29,P<0.000 01], better Neurological function recovery rate[MD=15.87,95%CI(9.28,22.46),Z=4.72,P<0.000 01], better ASIA impairment scale grade improvement[OR=2.3,95%CI(1.25,4.15),Z=2.76,P=0.006], and there were no significant differences in the ASIA motor scores[MD=5.45,95%CI(-7.56,18.47),Z=0.82,P=0.41]. Conclusion These result suggests that surgical treatment can improve the neurological function more effectively for patients with cervical spinal cord injury without fracture and dislocation.