目的 探究词联导航训练法结合针灸、环喉按摩对脑卒中构音功能障碍的疗效。方法 将我院收治的200例脑卒中伴有构音障碍患者按照随机数字表法平均分为干预组与对照组。两组患者均接受临床基础治疗、常规PT、0T、理疗和中医药治疗,在此基础上干预组给予词联导航训练法结合针灸、环喉按摩等综合的康复方案进行康复护理和治疗,观察疗效以及不良反应发生情况。结果 干预组(90%)的临床疗效优于对照组(76%),差异有统计学意义(P＜0.05);生活质量评价干预组高于对照组,差异有统计学意义(P＜0.05);不良反应发生情况干预组(6%)与对照组(7%)接近,差异没有统计学意义(P＞0.05)。结论 词联导航训练法结合针灸、环喉按摩对脑卒中构音功能障碍方法安全、疗效显著,可以提升患者的生活质量。

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 观察及探讨电子纤维喉镜抽吸法结合保守疗法治疗成年人分泌性中耳炎与单纯保守疗法治疗成年人分泌性中耳炎的疗效对比。 方法 86例成年人分泌性中耳炎患者按就诊先后顺序分成电子纤维喉镜抽吸法结合保守疗法治疗组及单纯保守疗法对照组两组,治疗6个月后, 统计分析临床治疗情况。 结果 电子纤维喉镜抽吸法结合保守疗法治疗组的临床疗效明显优于单纯保守疗法对照组 (P<0.05)。结论 电子纤维喉镜抽吸法结合保守疗法是一种高效、副作用小的治疗成年人分泌性中耳炎的方法,明显改善患者的症状、体征,提高疗效,缩短疗程,降低鼓膜穿刺及中耳手术概率。

Objective To observe and explore the difference on the treatment of secretory otitis media between the effect of electronic fiber laryngoscope suction combined with conservative therapy and the effect of the simple conservative therapy only. Methods The 86 adult patients with secretory otitis media were divided into two groups according to the order of treatment, One group used the electronic fiber laryngoscope suction combined with conservative therapy and the other used simple conservative therapy. After 6 months of treatment, the clinical treatment was statistically analyzed. Results The group used the electronic fiber laryngoscope suction combined with conservative therapy has a better effect(P<0.05). Conclusion The treatment of secretory otitis media electronic fiber laryngoscope suction combined with conservative therapy is a high efficiency and less side effect. What more, it improves the patient's symptoms, improves the curative effect and shortens the course of treatment and reduce the probability of tympanic membrane puncture and surgery.

目的 探讨便携式内窥镜视频系统辅助鼻咽喉检查治疗效果。方法 2019年1月1日—2019年12月31日,选取本院眼耳鼻颌面外科院内住院查房、门急诊中实施的168例患者作为研究对象,采用随机法对纳入患者进行分组,各分为84例。实验组采用自主研制的便携式内窥镜视频系统,对照组采用传统的喉镜腔镜系统。比较两组患者检查治疗效果、医务人员使用过程中的满意度和患者检查治疗过程中的满意度并进行效果评价。结果 两组患者鼻咽喉镜腔镜系统检查治疗时间比较,实验组时间为13.4 min;对照组时间为22.9 min;患者对鼻咽喉镜腔镜系统检查治疗的满意度比较主要从检查治疗效果、检查治疗体验效果进行评价,实验组满意度91.67%,对照组满意度86.91%,两组比较差异有统计学意义(χ²=4.695,P=0.030);医务人员对两组鼻咽喉镜腔镜系统检查治疗使用的满意度评价主要从性能参数、检查治疗使用效果等方面进行评价,性能参数主要包括便携性、图像质量、操作方法、运营成本等方面,实验组满意度92%,对照组满意度77%,两组比较差异有统计学意义(χ²=6.834,P=0.009)。结论 便携式内窥镜视频系统操作简单、使用方便,不仅能够满足患者的诊疗需要并减少患者的诊疗时间,而且能够满足医务人员使用过程中的便携性,能够提高医疗质量,非常适合临床使用。

Objective To investigate the therapeutic effect of portable endoscopic video system assisted nasopharynx examination. Methods From January 1, 2019 to December 31, 2019, 168 patients in the department of ophthalmology, otorhino-maxillofacial surgery in our hospital were selected as the research objects. The patients were randomly divided into 84 cases. The experimental group used the self-developed portable endoscope video system, while the control group used the traditional laryngoscope system. The treatment effect, satisfaction of medical staff and satisfaction of patients in the process of examination and treatment were compared between the two groups, and the effect was evaluated. Results Compared to the treatment time of nasopharynx and laryngoscope system between the two groups, the experimental group time was 13.4 min; the control group time was 22.9 min; the patients' satisfaction with nasopharyngoscope system examination and treatment was mainly evaluated from the examination and treatment effect, the experimental group satisfaction was 91.67%, while the control group was 86.91%, the difference was statistically significant (χ²=4.695, P=0.030); medical staffs' satisfaction evaluation on the use of nasopharynx and laryngoscope system in the two groups was mainly evaluated from the performance parameters, examination and treatment effect, and the performance parameters mainly included portability, image quality, operation methods, operating costs and other aspects. The satisfaction of the experimental group was 92%, and that of the control group was 77%. The difference between the two groups was statistically significant (χ²=6.834, P=0.009). Conclusion The portable endoscopic video system is easy to operate use. It can not only meet the needs of patients and reduce the diagnosis and treatment time of patients, but also meet the portability of medical staffs in the process of using, and can improve the quality of medical treatment, which is very suitable for clinical use.

目的 探讨体外受精治疗中第3天(D3)不同质量卵裂期胚胎培养至囊胚的发育潜能,为囊胚培养提供实验室依据。方法 对2015年4月—2019年4月D3移植或冷冻后剩余行囊胚培养的5 510枚胚胎进行了回顾性分析。按D3胚胎质量、卵裂球数目、均一性及碎片率分组,比较囊胚形成率,优质囊胚形成率及可利用囊胚形成率,并分析各因素与可利用囊胚形成的相关性。结果 D3优质胚胎的囊胚形成率,优质囊胚形成率及可利用囊胚形成率与非优质胚胎组相比有统计学差异(P＜0.05);4-6细胞组及＜4细胞组与7-9细胞组相比有统计学差异(P＜0.05),但融合期胚胎(CP)组及＞ 9细胞组与7-9细胞组相比差异无统计学意义;卵裂球大小差异(+)组和(++/+++)组与卵裂球大小均匀(-)相比有统计学差异(P＜0.05); 10%～25%组及碎片＞25%组与碎片≤10%组相比有统计学差异(P＜0.05)。 Logistic分析结果表明,D3胚胎质量、卵裂球数目、均一性及胚胎碎片率与可利用囊胚形成显著相关(P＜0.05)。 结论 D3胚胎质量、卵裂球数目、均一性及胚胎碎片均会影响到囊胚的形成及质量,其中胚胎质量和卵裂球数目对可利用囊胚形成的影响较大。

Objective To explore the developmental potential of day 3(D3) different quality embryos cultured to blastocyst in vitro fertilization treatment, and to provide laboratory basis for blastocyst culture. Methods A total of 5 510 embryos with blastocyst culture remained after D3 transplantation or freezing from April 2015 to April 2019 were analyzed retrospectively. They were divided into groups according to embryo quality, blastomere number, blastomere homogeneity and fragment rate in D3. And the blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate were compared between the groups.The correlation within each factor and available blastocyst formation was analyzed. Results The blastocyst formation rate, high quality blastocyst formation rate and available blastocyst formation rate of D3 high quality embryo group were higher than those of non-high quality embryo group (P<0.05); compared with 7- 9 cell group, 4- 6 cell group and<4 cell group were lower (P<0.05), but there was no significant difference in CP group or >9 cell group. Compared with the normal size of the blastomere (-), the difference in the size of the blastomere (+) group and the (++/+++) group decreased (P<0.05); compared with the fragment ≤ 10%, the difference in the size of the blastomere between the 10%~25% group and the fragment>25% group decreased (P<0.05). The results of logistic analysis suggested that the embryo quality, blastomere number, homogeneity and fragment rate of D3 were correlated with available blastocyst formation (P<0.05). Conclusion D3 embryo quality, blastomere number, homogeneity and embryo fragment may affect the formation and quality of blastocyst, especially the embryo quality and blastomere number.

目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 观察香芹酚的解酒护肝作用。方法 将实验小鼠随机分为实验组(低剂量香芹酚组,中剂量香芹酚组,高剂量香芹酚组),生理盐水对照组和阳性对照组,观察小鼠行为学,醉酒小鼠的醉酒时间和醉酒潜伏期,检测血液中的乙醇浓度和肝组织中的SOD和MDA,计算肝比重。结果 与实验组比较,低,中,高剂量组香芹酚分别能显著延长小鼠的醉酒潜伏期(P<0.05),同时,各剂量的香芹酚组均可使肝组织中丙二醛(MDA)含量降低(P<0.05),肝组织中超氧化物歧化酶(SOD)活性分别增加(P<0.05)。结论 香芹酚具有解酒护肝作用,其作用机理可能与抗氧化活性有关。

Objective To observe the effect of carvacrol on MDA and SOD in acute alcoholic liver injury. Methods The experimental mice were randomly divided into the experimental group (low-dose carvacrol group, medium-dose carvacrol group, high-dose carvacrol group), normal saline control group and positive control group. The behavior of the mice was observed, the time and incubation period of drunkenness of the mice were observed, the concentration of alcohol in blood and SOD and MDA in liver tissues were detected, and the specific gravity of the liver was calculated. Results Compared with the experimental group, carvacrol in the low, medium and high dose groups could prolong the intoxication incubation period of mice (P<0.05), meanwhile, the content of malonaldehyde (MDA) in liver tissues was reduced in the carvacrol group (P<0.05), and the activity of superoxide dismutase (SOD) in liver tissues was increased in the carvacrol group (P<0.05). Conclusion Carvacrol has antialcoholism and liver protecting effects, and its mechanism may be related to antioxidant activity.

目的 本研究旨在探讨颈椎手法治疗对颞下颌关节紊乱症患者的疗效,为其临床应用及推广提供依据。方法 将符合入组条件的40例诊断为颞下颌关节紊乱症的患者随机分为实验组(20例)和对照组(20例)。对照组给予物理治疗,包括超声波及超短波治疗。实验组除与对照组一样的物理治疗外,还给予手法治疗,包括椎旁软组织放松按摩,颈椎复位及枕后肌群抑制技术。两组的治疗均持续2周,每周5次,总共10次。两组患者分别在治疗前和治疗后评估其咬肌的压痛阈值、最大张口度、咀嚼肌(咬肌和颞肌)在静息状态下表面肌电平均电位、咀嚼肌在最大用力状态下表面肌电峰值均值,并计算咀嚼肌不对称性指数、总体活动不对称性指数。结果 组内前后比较:对照组患者治疗后仅部分咀嚼肌的静息电位、最大张口度和咬肌压痛阈值的改变有统计学意义(P<0.05);实验组治疗后所有的指标的改变均有统计学意义(P<0.05)。组间比较:通过比较两组治疗前后的差值,结果显示所有指标改变都有统计学意义(P<0.05)。实验组的静息电位和咀嚼肌不对称性指数下降更多(P<0.05),而最大张口度和咬肌压痛阈值增加得更多(P<0.05)。结论 相比单纯运用理疗的方式,采用颈椎手法治疗联合物理治疗对颞下颌关节紊乱患者,其疗效更加明显。

目的 探讨支气管肺类癌的CT表现,为临床诊断提供更多信息。方法 回顾性地分析我院8例经病理证实的支气管肺类癌患者的CT资料及临床表现,并复习相关文献。结果 8例CT表现均为肺内单发病灶,其中周围型2例,中央型6例,病理证实非典型类癌2例,典型类癌6例;6例边界清楚,且密度多均匀;2例呈分叶状,1例边缘毛糙、伴短毛刺;5例病灶内部见钙化灶,1例病灶内见脂肪成分,1例见少量胸积液;5例肿块表现为“冰山征”,2例表现为支气管腔内结节,1例病灶边缘毗邻支气管分支;6例出现阻塞性肺不张或肺实变;增强扫描5例强化较明显,CT值升高≥30HU,其中2例不典型类癌强化不均匀,2例见可见强化血管影;3例呈轻-中度强化表现。结论 支气管肺类癌的CT表现具有一定特征性,对于临床诊断有一定价值,但其确诊多需要依靠病理检查。

Objective To investigate the CT findings of bronchial carcinoid and to provide more information for clinical diagnosis. Methods The CT findings and clinicaldata were retrospectively analyzed in 8 patientsconfirmed by biopsy. Results All the 8 cases manifested as single round mass on CT images, including 2 peripheral lesions and 6 central lesions. It was proved that 2 atypical tumors and 6 typical tumors. CT findings of these cases consisted of well-defined border and uniform density(6 cases),lobulated contour(2 cases) and rough margin with short burr(1 case). 5 cases contained calcification,1 case contained fat component and 1 case contained a small amount of pleural lesionscould present as an “iceberg sign”(5 cases), intra-bronchial nodule(2 cases) or near the edge of the bronchus(1 case).The obstructive atelectasis or pulmonary consolidation was found in 6 cases. On CT contrast scanning, these lesions presented relatively significant enhancement(5 cases),usually the CT value increased ≥30HU, in which 2 cases of atypical carcinoid were inhomogeneous enhancement, and 2 cases showed enhanced vascular and mild to moderte enhancement(3 cases). Conclusion The CT findings of bronchial carcinoid have certain characteristics, which are certain value for clinical diagnosis, but the final diagnosis mostly depends on pathology.

目的 观察免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、白介素-6(IL-6)和CXC趋化因子13(CXC13)水平影响。方法 选取2017年1月—2020年3月本院收治的60例自身免疫性脑炎患者,采用随机数字表法分为观察组30例与对照组30例。对照组给予甲泼尼龙疗法,观察组在对照组结合免疫球蛋白治疗。两组均以4周后评价。比较两组疗效,治疗前后T淋巴细胞亚群、免疫球蛋白、IL-6、CXC13及简易智能精神状态检查量表(MMSE)变化。结果 观察组总有效率(83.33%)高于对照组(60.00%)(P<0.05)。观察组治疗后CD⁺₃、CD⁺₄和CD⁺₄/CD⁺₈高于对照组(P<0.05)。观察组治疗后血清IgA、IgG和IgM水平低于对照组(P<0.05)。观察组治疗后血清IL-6和CXC13水平低于对照组(P<0.05)。观察组治疗后MMSE评分高于对照组(P<0.05)。结论 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者疗效良好,且可增强机体细胞和体液免疫功能,降低IL-6和CXC13水平。

Objective To observe the effect of immunoglobulin combined with methylprednisolone on T lymphocyte subsets, immunoglobulin, interleukin-6 (IL-6) and CXC chemokine 13 (CXC13) in patients with autoimmune encephalitis. Methods 60 patients with autoimmune encephalitis admitted to our hospital from January 2017 to March 2020 were divided into 30 cases of observation group and 30 cases of control group. The control group was treated with methylprednisolone, and observation group was treated with immunoglobulin compared with the control group. The course of treatment in both groups was 4 weeks. The effects of the two groups were compared. The changes of T lymphocyte subsets, immunoglobulin, IL-6, CXC13 and MMSE before and after treatment were compared. Results Total effective rate (83.33%) of the observation group was higher than that of control group (60.00%) (P<0.05). After treatment, in the observation group, CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ were higher than that of control group (P<0.05); levels of serum IgA, IgG and IgM were lower than that of control group (P<0.05); serum levels of IL-6 and CXC13 were lower than that of control group (P<0.05); MMSE score was higher than that of control group (P<0.05). Conclusion Immunoglobulin combined with methylprednisolone is effective in the treatment of autoimmune encephalitis. It may enhance the cellular and humoral immune function, and reduce the levels of IL-6 and CXC13.