目的 观察应用济川煎加减结合贴穴治疗帕金森病患者便秘的临床疗效。方法 选取帕金森病合并便秘患者64例,随机分为对照组和观察组,各32例。入选患者均进行帕金森病常规治疗,对照组服用莫沙必利;观察组在对照组治疗基础上加服济川煎加减,并选穴敷贴。疗程结束后对两组患者便秘改善程度、生活活动能力、中医证候积分等项目进行比较。结果 观察组患者便秘改善程度、生活活动能力、中医证候改善均优于对照组,两者比较差异有统计学意义(P<0.05)。结论 应用济川煎加减结合贴穴能有效治疗帕金森病患者便秘,并对帕金森病其他症状有正向调节作用,能提高该类患者生存质量。

Objective To investigate the clinical effect of Jichuanjian decoction and acupoint application on the treatment of constipation in Parkinson's disease. Methods 64 patients with constipation in Parkinson's disease were randomly divided into two groups. 32 patients were treated with Mosapride in control group. 32 patients were treated with Jichuanjian decoction and acupoint application in treatment group.The clinical effects were compared in the two groups. Results The clinical effects of the treatment group were better and the differences were statistical significance (P<0.05). Conclusion The treatment of constipation in Parkinson's disease with Jichuanjian decoction and acupoint application had a significant effect.

目的 探讨鼻咽癌个案管理模式,并评价临床中运用的效果。方法 回顾性将2017年8月—2018年4月93例新确诊的鼻咽癌患者作为对照组,按鼻咽癌患者的一般护理常规进行护理。2018年5月—2019年8月新确诊的鼻咽癌患者96例为实验组,实施个案管理比较两种方法的临床运用效果。结果 与对照组比,实验组诊断期完成检查时间和首次住院天数短、既定治疗计划完成率和治疗期间复诊依从性高,Ⅳ度骨髓抑制发生率低,差异均有统计学意义(P<0.05)。结论 鼻咽癌个案管理模式可为患者提供全程、连续性、高品质的护理,提高患者复诊依从性、提高治疗计划完成率,提高医疗护理质量,值得临床推广应用。

Objective To explore the case management mode of nasopharyngeal cancer (NPC) and evaluate the effect of clinical application. Methods 93 patients newly diagnosed NPC from August 2017 to April 2018 were used as the control group,and the general nursing routine was followed. 96 patients newly diagnosed NPC from May 2018 to August 2019 were taken as the experimental group,and accepted case management. Results Compared with the control group,the test time of the experimental group was shorter,the first hospital stay was shorter,the completion rate of treatment was higher,the patient's compliance of follow-up during treatment was better,incidence of grade Ⅳ myelosuppression was lower.The difference was statistically significant (P< 0.05). Conclusion The case management mode of NPC may provide seamless and high-quality nursing for NPC patients,improve the completion rate of treatment,improve the patient's compliance of follow-up and improve the quality of medical care,which is worthy of clinical application.

目的 探讨B超与MRI、宫腔镜联合诊断对宫腔占位性病变的临床意义。方法 选择2017年1月1日— 12月31日我院收治的108例疑似宫腔占位性病变患者为研究对象。所有患者均于宫腔操作前行阴道彩色多普勒超声(以下简称B超)检查、MRI检查及宫腔镜检查。与病理检查结果对比,分别分析其灵敏度、特异度。结果 108例患者中宫腔无病理变化者27例,子宫内膜息肉39例,子宫内膜增生27例,子宫黏膜下肌瘤10例,子宫内膜癌5例。B超、MRI、宫腔镜诊断灵敏度分别为72.84%、71.60%、75.31%,特异度分别为62.96%、85.19%、66.67%。B超+MRI诊断子宫黏膜下肌瘤和子宫内膜癌灵敏度100%,特异度分别为87.76%和99.03%。B超+MRI+宫腔镜诊断子宫内膜增生、子宫黏膜下肌瘤、子宫内膜癌灵敏度均为100%。结论 宫腔占位病变以良性病变居多,B超联合宫腔镜和MRI检查可提高诊断率。对子宫内膜癌高危人群应进行B超与MRI联合检查,宫腔镜定位活检仅在必要时实施。

Objective To explore the clinical significance of B-ultrasound, MRI and hysteroscopy in the diagnosis of uterine space occupying lesions. Methods 108 patients with suspected uterine space occupying lesions admitted to our hospital from January 1 to December 31 2017 were selected as the study objects. All patients were examined by vaginal color Doppler ultrasound, MRI and hysteroscopy before uterine operation. Compared with the results of pathological examination, the sensitivity and specificity were analyzed. Results Among the 108 patients, 27 had no pathological changes in uterine cavity, 39 had endometrial polyps, 27 had endometrial hyperplasia, 10 had submucous myoma, and 5 had endometrial cancer. The sensitivity of B-ultrasound, MRI and hysteroscopy were 72.84%, 71.60% and 75.31% respectively, and the specificity were 62.96%, 85.19% and 66.67% respectively. The sensitivity of B-ultrasound+MRI in the diagnosis of submucous myoma and endometrial carcinoma was 100% and the specificity was 87.76% and 99.03%, respectively. The sensitivity of B-ultrasound+MRI+hysteroscopy in the diagnosis of endometrial hyperplasia, submucous myoma and endometrial carcinoma was 100%. Conclusion Most of the uterine space occupying lesions are benign. B-ultrasound combined with hysteroscopy and MRI may improve the diagnosis rate. The high-risk group of endometrial cancer should be examined by B-ultrasound and MRI, and hysteroscopic biopsy would be performed only when necessary.

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 探讨超声不同方法联合应用对提高卵圆孔未闭检出率的应用价值。方法 收集我院收治的临床疑似卵圆孔未闭的患者88例作为研究对象,进行超声影像组合检查(常规经胸超声心动图检查,经食道超声检查,右心声学造影检查),并对多组超声影像检查结果记录行回顾性统计分析。结果 88例研究对象中常规经胸超声心动图初步筛查发现PFO(+)12例(13.6%),其中合并房间隔膨出瘤2例。经食道超声检查22例,发现PFO(+)20例(90.9%),其中发现来源于肺动静脉瘘2例。全部研究对象均行右心声学造影发现PFO(+)39例(44.3%),分别于静息状态下发现PFO(+)24例,Valsalva动作后发现PFO(+)39例;其中发现合并房间隔膨出瘤形成者4例;合并肺动静脉瘘者3例(其中1例来源于肺静脉)。经食道超声联合右心声学造影检查的14例患者中发现PFO(+)10例(71.4%)。右心声学造影依据微气泡的数量进行半定量分级发现:I级有16例;II级有5例;III级有18例;不同状态下对于RLS的半定量分级差异有统计学意义(χ²=12.729,P=0.02)。结论 超声影像组合可对卵圆孔未闭患者进行半定量评估,能有效补充单一常规超声检查的信息的不足,进而为临床诊治提供客观化依据。

Objective To explore the value of ultrasound combined with different methods in improving the detection rate of patent foramen ovale. Methods 88 cases of clinically suspected patent foramen ovale in our hospital were collected as the research objects to carry out the ultrasonic image group examination (routine transthoracic echocardiography TTE, transesophageal echocardiography TEE, right heart contrast echocardiography), and the results of multiple groups of ultrasonic image examination were recorded for retrospective statistical analysis. Results Among 88 subjects, 12 (13.6%) were found to have PFO (+)by conventional transthoracic echocardiography, 2 of them had atrial septal aneurysm. 20 cases (90.9%) of PFO were found by transesophageal ultrasonography, and two of them were from pulmonary arteriovenous fistula.In all the subjects, 39 cases (44.3%) of PFO were found by right heart sonography, 24 cases were found in resting state, 39 cases were found after Valsalva operation, 4 cases were found with aneurysm of atrial septum, 3 cases with pulmonary arteriovenous fistula (one of them was from pulmonary vein). Among the 14 patients examined by transesophageal ultrasound combined with right cardiac sonography, 10 (71.4%) were found to have PFO(+). According to the number of microbubbles, the right echocardiography showed that there were 16 cases in grade I, 5 cases in grade II, 18 cases in grade III, and there were statistical differences in the semi quantitative classification of RLS in different states (χ²=12.729, P=0.02). Conclusion Ultrasound image histology can be used for semi quantitative evaluation of patients with patent foramen ovale, which can effectively supplement the lack of single conventional ultrasound information, and provide objective basis for clinical diagnosis and treatment.

目的 构建靶向CXCR7基因的CRISPR/Cas9基因编辑系统,并应用于HEK 293T细胞系。方法 设计两对靶向CXCR7基因的sgRNAs,分别插入PX458载体中,并转化DH5α大肠埃希菌。经菌液PCR和测序验证,挑选序列正确的sgRNA-CXCR7-PX458质粒,转染HEK 293T细胞,用流式分选转染阳性细胞,提取其DNA,PCR扩增后测序验证。结果 经测序验证,成功构建了靶向CXCR7基因的CRISPR/Cas9系统,转染HEK 293T细胞后,测序鉴定发现成功编辑CXCR7基因。结论 成功构建了靶向CXCR7的sgRNA-CXCR7-PX458质粒,可在HEK 293T上成功编辑CXCR7基因,为进一步的功能研究奠定基础。

Objective To construct the CRISPR/Cas9 gene editing system targeting C-X-C chemokine receptor 7 (CXCR7) gene and to edit CXCR7 gene in 293T cell line. Methods Two pairs of small guide RNAs (sgRNAs) targeting CXCR7 gene were designed and inserted into PX458 vector, which were transformed into host bacterium Escherichia coliDH5α. The correct sgRNA-CXCR7-PX458 plasmids were selected by PCR and further Sanger sequencing verification. HEK 293T cell line was transfected by DNA of sgRNA-CXCR7-PX458 plasmid. After 72 hours,GFP-positive cells were sorted by flow cytometry. We did DNA extraction of the GFP-positive cells and amplified the CXCR7 gene corresponding fragment by PCR and investigated the CXCR7 gene editing results by Sanger sequencing. Results The CRISPR/Cas9 system targeting CXCR7 gene was successfully constructed. After 293T cells were transfected, the CXCR7 gene was edited in HEK 293T cells successfully. Conclusion The sgRNA-CXCR7-PX458 plasmid targeting CXCR7 gene was successfully constructed. The CRISPR/Cas9 gene editing system targeting CXCR7 gene were used on the HEK 293T cell line, which lays a foundation for further study of BCOR function.

目的 探讨品管圈(Quality Control Circle, QCC)活动对降低造影剂外渗的效果观察。方法 根据QCC的方法和步骤,成立QCC小组,通过比较和分析QCC活动实施前后外渗率的变化,找出导致CT增强扫描前接受高压静脉造影剂注射外渗的主要原因,提出针对性的改进措施并分析其效果。结果 QCC活动实施前外渗率达0.17%,而实施后外渗率为0.07%,差异有统计学意义(P<0.05)。结论 开展QCC活动可降低CT增强扫描前造影剂外渗发生率,值得临床推广应用。

Objective To investigate the effect of quality control circle (QCC)activity on reducing contrast agent extravasation. Methods According to the steps and methods of the quality control circle, a QCC group was set up to compare and analyze the data before and after the implementation of QCC activities to find out the main reason for the extravasation of high-pressure intravenous contrast agent injection before CT enhanced scanning, and put forward targeted improvement measures to analyze its effect. Results The extravasation rate before QCC activity was 0.17%, and the extravasation rate after implementation was 0.07%, the difference was statistically significant (P <0.05). Conclusion Carrying out QCC activities may reduce the incidence of contrast agent extravasation before CT enhanced scanning, which is worthy of clinical application.

目的 探讨医院-社区-家庭一体化管理在精神分裂症患者中的应用效果。方法 选择我院2018年6月—2019年6月期间收治的精神分裂症患者86例,按随机数字表法分为两组,每组43例。对照组采取常规护理管理,研究组实施医院-社区-家庭一体化管理,观察6个月。比较两组精神症状、生活质量及肇事肇祸率。结果 两组管理前阳性与阴性症状量表(PANSS)评分、WHOQOL-100评分比较,差异无统计学意义(P＞0.05);两组管理后PANSS评分均低于管理前,生存质量测定量表简表(QOL-BREF)评分高于管理前,差异有统计学意义(P＜0.05);研究组管理后PANSS评分为(43.23±8.11)分,低于对照组的(49.48±8.26)分,WHOQOL-100评分为(83.69±8.87)分,高于对照组的(77.25±8.54)分,差异有统计学意义(P＜0.05);研究组肇事肇祸率为9.30%,低于对照组的25.58%,差异有统计学意义(P＜0.05)。结论 医院-社区-家庭一体化管理的实施能够减轻精神分裂症患者精神症状,提升生活质量,降低肇事肇祸率。

Objective To explore the applications of hospital community family integrated management on the quality of life and accident rate of schizophrenics. Methods 86 schizophrenics admitted to our hospital from June 2018 to June 2019 were divided into two groups according to the method of random number table, 43 cases in each group. Routine nursing management was adopted in the control group and hospital community family integrated management was implemented in the study group for 6 months. The mental symptoms, quality of life and accident rate were compared between the two groups. ResultsThere was no statistical significance in PANSS score and WHOQOL-100 score between the two groups before management (P>0.05); PANSS score of the two groups after management was lower than that before management, QOL-BREF score was higher than that before management, and the difference was statistically significant (P<0.05); PANSS score of the study group after management was (43.23±8.11), lower than that of the control group (49.48±8.26), WHOQOL-100 score was (83.69±8.87), higher than the control group (77.25±8.54), the difference was statistically significant (P<0.05); the study groupls accident rate was 9.30%, lower than that of the control group 25.58%, the difference was statistically significant (P<0.05). Conclusion The implementation of hospital community family integrated management reduces the mental symptoms of schizophrenics, improve the quality of life, and reduce the accident rate.

目的 探讨数字病理技术及数字病理诊断在基层医院的应用。方法 回顾性分析2018年1月—2019年12月两家医院的病理诊断报告共18 688例。将2018年1月—2018年12月病例纳入A组(n=8 400),将2019年1月—2019年12月病例纳入B组(n=10 288)。采用云康远程病理会诊平台,所有病例依次按编号通过扫描绑定到平台软件的对应病例中,由同一位初诊病理医生和不同的远程病理平台专家分别完成初、复诊。通过三审发布专家团队来评价远程病理诊断初诊及复诊的准确率。结果 A组初诊病理医生正确诊断6 569例,准确率78.20%,复审病理医生正确诊断8 215例,准确率97.80%;B组初诊病理医生正确诊断9 444例,准确率91.80%,复审病理医生正确诊断10 102例,准确率98.19%;两组病理诊断中,B组初诊病理医生诊断正确率高于A组初诊病理医生准确率,差异有统计学意义(P＜0.05);两组的复审病理医生准确率比较,差异无统计学意义(P＞0.05)。结论 日常开展数字病理技术及数字病理诊断可以有效提高基层诊断医生的诊断水平,值得在基层医院广泛和长期应用推广。

Objective To explore the application of digital pathological technology and digital pathological diagnosis in primary hospitals. Methods A total of 18 688 cases of pathological diagnosis reported in two hospitals from January 2018 to December 2019 were retrospectively analyzed. Cases from January to December 2018 were included in group A (n=8 400), and cases from January to December 2019 were included in group B (n=10 288).Yunkang remote pathology consultation platform was adopted. All cases in turn were scanned and bound to the corresponding cases of the platform software by number. The same pathologist and different remote pathological platform experts completed the preliminary and follow-up respectively, to evaluate the accuracy of remote pathological diagnosis at the first and second diagnosis by releasing the expert team in the third audit. Results In group A, the pathologists correctly diagnosed 6 569 cases, with an accuracy rate of 78.20%, The correct diagnosis rate of 8 215 cases was 97.80%,The primary pathologists in group B correctly diagnosed 9 444 cases, with an accuracy rate of 91.80%.The correct diagnosis rate of 10 102 cases was 98.19%,In the two groups of pathological diagnosis, the diagnostic accuracy rate of pathologists in group B was higher than that in group A.The difference was statistically significant (P <0.05).The accuracy of pathologists in the two groups was compared.The difference was not statistically significant (P >0.05). Conclusion Daily development of digital pathological technology and digital pathological diagnosis can effectively improve the diagnosis level of grassroots doctors. It is worthy of extensive and long-term application in primary hospitals.

目的 探索使用血浆中溶血磷脂酸 LPA作为老年糖尿病患者发生缺血性心脑血管病早期预警指标。方法 在公共卫生项目开展的基础上,将老年糖尿病患者随机分为观察组和对照组。对照组实施糖尿病规范管理,观察组在对照组的基础上进行血浆LPA 的水平定期检测,对LPA 明显升高者,予降脂、抗纤溶、抗血小板凝集等干预措施,比较两组间缺血性心脑血管病发生率和病情严重程度。结果 观察组缺血性脑血管发病率高于对照组,差异有统计学意义（P<0.05）。中、重型缺血性脑血管病患者的血浆LPA高于轻型组（P<0.05）,且重型组高于中型组（P<0.05）结论 血浆LPA值可作为老年糖尿病患者发生缺血性心脑血管病的预警因子,值得在基层老年糖尿病患者规范化管理中常规应用。

Objective To explore the early warning index of ischemic cardiocerebrovascular disease in elderly diabetic patients with plasma LPA. Methods On the basis of public health project,elderly diabetic patients were randomly divided into observation group and control group. Control group adopted diabetes management implementation,while observation group adopted periodic testing of the levels of plasma LPA on the basis of the control group,implementing fall fat,resisting fibrinolytic,antiplatelet aggregation and other interventions if LPA significantly increased. We compared the ischemic cardio-cerebrovascular disease incidence and disease severity between the two groups. Results The incidence of cerebral ischemia in the observation group was higher than that in the control group,and the difference was statistically significant （P<0.05）. Medium and heavy plasma LPA is higher than the light of ischemic cerebrovascular disease group （P < 0.05）,and heavy above medium group （P < 0.05） Conclusion The plasma LPA values can be used as early warning factor in elderly patients with diabetes occuring ischemic cardio-cerebrovascular disease and promote its application.