目的 探讨经针刺治疗爆裂性眶壁骨折伴眼球运动障碍的临床疗效及安全性。方法 选取2013年10月—2015年9月在我院接受治疗的70例(70只眼)爆裂性眶壁骨折致眼球 运动障碍患者,按照治疗方式的不同分为常规组和针刺组,每组各35例,其中常规组给予常规药物治疗,针刺组除了接受常规治疗外,依据眶壁骨折部位的不同选取相应临近眼外肌穴进行针刺,每日1次,每次留针30 min,15天为一个疗程,两组患者均持续治疗两个疗程。对比分析两组患者治疗前后的角膜缘移动范围、眼球运动障碍级别以及临床疗效。结果 经过治疗后,两组患者的角膜缘移动范围均较治疗前明显改善,且与常规组患者相比,针刺组患者改善得更显著(P<0.05);经过治疗后,针刺组0级、I级、II级、III级的眼数分别为14、15、3、3只眼,其中0级的眼数明显多于常规组患者,差异有统计学意义(P<0.05);针刺组的治疗总有效率高达91.43%,明显高于常规组的62.86%,差异有统计学意义(P<0.05)。结论 针刺眼外肌穴有助于改善爆裂性眶壁骨折伴眼球运动障碍患者的角膜缘移动范围,促进患者眼外肌功能的恢复而降低眼球运动障碍级别,明显提高治疗总有效率,在临床上值得推广应用。

Objective To explore the clinical effect of eye-acupuncture on eye movement disorders caused by orbital blowout fracture and its security. Methods 70 eyes movement disorder patients with burst orbital wall fracture treated in our hospital from October 2013 to September of 2015 were selected and divided into two groups, each group contains 35 cases. The routine group was given routine drug treatment, beside this, we gave the therapy of eye-acupuncture for 30 minutes to the acupuncture group according to the type to select the corresponding extraocular muscle holes. Both with 15 days was for a course of treatment. After two courses, compared the eye movement disorder level changes and the limbus range of movement of the two groups before and after treatment, we evaluated the efficacy based on efficacy standard. Results After treatment, the corneal limbus range of movement were significantly improved of both groups, and the acupuncture group were better than that of the routine group(P<0.05);after treatment, the eye movement disorder rating of the acupuncture group was as follows: the number of level 0,1,2,3 was 14,15,3,3,respectively, among which the number of level 0 was significantly higher than that of the routine group(P<0.05);The total effective rate of the acupuncture group was 91.43 %, which was significantly higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion Eye-acupuncture may improve the corneal limbus range of movement in patients with eye movement disorders caused by orbital blowout fracture. It could promote the recovery of extraocular muscles function and thus lower the level of eye movement disorders. It significantly improves the total efficiency and is worthy of popularization and application clinically.

目的 分析影响广州青少年自杀行为的因素。方法 选取100例自杀行为青少年为观察组,选100例健康青少年为对照组,对比两组青少年家庭结构、家庭教育方式、自身人格特征等指标。多因素Logistic回归分析其自杀行为危险因素。结果 观察组青少年抑郁量表、焦虑量表、攻击性人格及冲动性人格量表分值均高于对照组高;单亲家庭或父母常年在外、家庭教育方式不当、学校无健康心理教育课、抑郁或焦虑、冲动或攻击性人格、负面事件、消极应对是青少年自杀行为独立危险因素,P均＜0.05。结论 家长及学校应正确引导青少年处事方式,积极面对生活,打消自杀意念。

Objective To analyze the factors influencing the suicide behavior of adolescents in Guangzhou. Methods The 100 cases of adolescent suicide behavior were selected as the observation group, 100 healthy adolescents were selected as control group, compared with two groups of adolescent family structure, family education, personality traits and other indicators. Multivariate logistic regression analysis of risk factors was taken for suicidal behavior. Results In the observation group adolescent depression scale, anxiety scale, attack impulse personality and personality amount scores were higher than those in the control group, single parent family or parents staying outside, improper family education, school health psychological education, depression or anxiety, impulsivity, or aggressive personality, negative events, negative coping were independent risk factors for adolescent suicide, P<0.05. Conclusion Parents and schools should have guide to adolescents, toface life positively, and give up thought of suicide.

目的 探讨临床常用非侵袭性检查指标诊断膀胱出口梗阻(BOO)的准确性及可靠性。方法 回顾性研究2003年11月—2015年11月在广州市第一人民医院就诊并接受压力—流率测定(PFS)的男性LUTS/BPH患者,以侵袭性的PFS为诊断BOO的“金标准”,以前列腺体积(PV)、移行带体积(TZV)、移行带指数(TZI)、前列腺特异性抗原(PSA)、最大尿流率(Qmax)、剩余尿量(PVR)、剩余分数(RF)等非侵袭性检查指标为诊断指标进行诊断试验评价。结果 筛选1319例患者纳入统计分析。以ICS列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR诊断BOO的ROC曲线下面积(AUC)分别为0.803、0.807、0.698、0.775、0.740、0.679、0.641;以Schaefer列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR诊断BOO的AUC分别为0.806、0.814、0.713、0.773、0.721、0.684、0.642。结论 PV、TZV、TZI、PSA、Qmax、RF、PVR等非侵袭性指标对筛查及诊断中老年男性BOO有一定的参考价值及临床意义,其中TZV、PV、PSA、Qmax的诊断准确性较高。

Objective To evaluate and assess the efficacy and validity of the most common and noninvasive parameters in daily clinical practice for detecting bladder outlet obstruction (BOO) in elderly male compared with the golden standard pressure-flow study (PFS). Methods Retrospectively analyze the outpatients and inpatients of male LUTS/BPH from November 2003 to November 2015 in Guangzhou First People's Hospital. Collect the PFS parameters and other noninvasive parameters including PV, TZV, TZI, PSA, Qmax, RF, and PVR. Receiver operating characteristic (ROC) curve was used to evaluate the efficiency of each parameter for detecting BOO. Statistic analyses were performed using SPSS (Version 21). Results The data from 1319 patients were analyzed. According to the ICS-nomogram. The areas under the ROC curve (AUCs) of PV, TZV, TZI, PSA, Qmax, RF, and PVR for detecting BOO were 0.803, 0.807, 0.698, 0.775, 0.740, 0.679, and 0.641, respectively. According to the Schaefer's nomogram, the AUCs of PV, TZV, TZI, PSA, Qmax, RF, and PVR for detecting BOO were 0.806, 0.814, 0.713, 0.773, 0.721, 0.684, and 0.642, respectively. Conclusion PV, TZV, TZI, PSA, Qmax, RF, and PVR would help predicting BOO in elderly male noninvasively, and providing valuable reference and guidance in clinical decision. TZV, PV, PSA and Qmax supply preferable accuracy for detecting BOO, with better sensitivity and specificity.

目的 探讨肌电生物反馈对正常人脑血流动力学的影响及其变化规律。方法 总数30人的健康正常受试者纳入研究,按照表格法随机分为生物反馈实验组和对照组。其中生物反馈组20人,对照组10人。该试验采用肌电生物反馈作为反馈方法,记录两组试验前后双侧大脑前动脉、大脑中动脉和大脑后动脉的平均血流速度和脉动指数。每次生物反馈试验后间隔3天,作为一个生物反馈阶段,总共进行7个阶段。结果 生物反馈组大脑中动脉的平均血流速度在试验前、后高于对照组(P<0.05),而其脉动指数则低于对照组(P<0.05)。生物反馈组在试验前、后大脑中动脉的平均血流速度随着生物反馈次数的增加而增快(P<0.05),而脉动指数则随之而降低(P<0.05)。结论 肌电生物反馈能够增加正常人大脑中动脉的平均血流速度和降低其脉动指数,且随着生物反馈次数的增加而呈现累积效应。

Objective To discuss the effect of electromyographic biofeedback on cerebral hemodynamics in health people. Methods A total of 30 healthy volunteers were enrolled in this study, and randomly divided into biofeedback group (n=20) and control group (n=10). The biofeedback group had been done with electromyographic biofeedback for seven times with 3 days intervals after each test. The data including the mean velocity (Vm) and pulse index (PI) of anterior cerebral artery, middle cerebral artery (MCA) and posterior cerebral artery were collected bilaterally before and after the test using transcranial Doppler in the two groups. Results The values of Vm (P<0.05) were higher and PI (P<0.05) were lower in biofeedback group than those in control group before and after the test. The values of Vm (P<0.05) increased and PI (P<0.05) decreased gradually in biofeedback group from 1st to 7th tests. Conclusion The electromyographic biofeedback can induce to the increasing of velocity of cerebral blood flow and decreasing of PI in MCA, and the additive effect was observed during the 7 tests in biofeedback group.

目的 研究鸟胞内分枝杆菌复合群(MAC)MAV3104基因编码蛋白与药物外排的关系。方法 以MAC标准株基因组为模板,扩增MAV3104基因,构建pMV261-MAV3104c重组质粒;测序正确后,转化重组质粒到大肠杆菌DH5并在MAC标准株中诱导表达, Western Blot鉴定MAV3104表达;按照CLSIM24-A2的操作要求检测MAC标准株对克拉霉素的敏感性及外排泵抑制试验。结果 经基因测序及Western Blot蛋白表达验证重组质粒构建成功;MAV3104过表达能提高鸟分枝杆菌对克拉霉素的MIC,且硫利达嗪能抑制该作用;MAV3104过表达也能提高胞内分枝杆菌对克拉霉素的MIC,但硫利达嗪对其没有抑制效应。结论 MAV3104转运蛋白介导的药物外排在鸟分枝杆菌耐克拉霉素中起重要作用。

Objective To investigate the association of the protein coded by Mycobacterium avium-Mycobacterium intracellulare complex in MAV3104 in drug efflux of Clarithromycin. Methods According to the Mycobacterium avium-Mycobacterium intracellulare complex standard strain, the MAV3104 gene was amplified by PCR and cloned into expression vector pMV261 to generate the recombinant plasmids. After verification by sequence analysis, the recombinant plasmids was transformed into E. coli DH5 andMycoba ctenum avium-Mycobacterium intracellulare complex standard strain. To identify the protein expression by western blotting and investigate the sensitivity of clarithromycin and efflux pump inhibition test in the light of CLSIM24-A2 protocol. Results It was verified by sequence analysis and western blotting that the recombinant plasmids were successfully constructed. Over expression of Mycobacterium avium MAV3104 gene could enhance clarithromycin MIC, which could be inhibited by thioridazine. Over expression of Mycobacterium intracellulare MAV3104 gene also could enhance clarithromycin MIC, but it could not inhibited by thioridazine. Conclusion This study demonstrates that efflux pumps mediated by MAV3104 protein play an important role in Mycobacterium avium resistance to clarithromycin.

目的 探讨优质护理对大面积烧伤患者创面换药时对疼痛及不良情绪的影响。方法 收集我院大面积烧伤的患者,分为研究组和对照组。两组基础护理相同,研究组加用优质护理。对比两组护理前护理4周时焦虑评分,以及两组护理前、护理4周时创面换药时的疼痛评分。结果 ①研究组和对照组护理前焦虑评分结果比较无差异;研究组和对照组护理4周焦虑评分结果比较有差异。②研究组和对照组护理前创面换药时的疼痛评分结果比较无差异;研究组和对照组护理4周创面换药时的疼痛评分结果比较有差异。结论 本次研究认为通过优质护理能够明显提高大面积烧伤患者创面换药时的疼痛程度,对减少住院期间焦虑不良情绪有重要的意义。

目的 调查分析注射剂药品说明书中有关老年人用药描述,为完善和修订注射剂药品说明书提供参考依据。方法 收集某医药公司经营300个品种注射剂的药品说明书,按药理作用、国内外生产厂家和所含成份等统计药品说明书中老年人用药内容的标注情况。结果 在所调查的注射剂药品说明书中,284份(95%)注射剂说明书标注有老年用药项,其中48份(17%) 标注老年人具体用量;236份(83%)标注模糊,标注有“老年人药代动力学”仅39份(占13%);国内外厂家的注射剂在老年人用药标注情况有差异(P<0.01)。结论 注射剂药品说明书在老年人用药方面描述不足,需引起政府和各方面的关注,相关部门应加强对注射剂药品说明书的安全监管,完善说明书的内容,以保证药品说明书的科学性、合理性和有效性。

目的 了解和改善南沙区某制鞋厂甲苯的职业危害情况。方法 采用劳动卫生学调查方法。 结果 车间空气中甲苯浓度督导前为26.00~315.00 mg/m³,督导后浓度降至4.60~46.40 mg/m³;作业工人自觉症状在督导后有不同程度的改善,与督导前的情况相比,两者差异有统计学意义(P<0.01);暴露组白细胞减少情况与对照组间的差异有统计学意义(采用Fisher确切概率法,P<0.01);督导后血红蛋白含量下降得到明显改善,并与对照组基本接近。结论 加强职业卫生监督、定期进行职业危害因素监测和工人健康监护,对于甲苯作业的职业卫生防护具有重要意义。

目的 观察多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗幽门螺杆菌(Hp)感染消化性溃疡的临床疗效和不良反应。方法 选取于2013年7月—2015年7月收治的98例Hp感染消化性溃疡患者,根据不同的治疗方式,随机将其分为治疗组和对照组,每组各49例,治疗组患者给予多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗;对照组给予克拉霉素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗, 两组患者连续服用10天后,均口服泮托拉唑40 mg,每天1次,总疗程为4周。疗程结束4周后,予胃镜复查和Hp检查,观察两组患者的临床疗效、溃疡愈合率、Hp根除率及不良反应。结果 治疗组与对照组患者的临床效果总有效率分别是95.91％、81.63％;治疗组与对照组患者的溃疡愈合率分别是83.67％、61.22％ ;治疗组与对照组患者的Hp根除率分别是89.79％、65.30％;治疗组患者的临床疗效总有效率、溃疡愈合率和Hp根除率均明显优于对照组,差异均有统计学意义(P<0.05),两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗Hp感染消化性溃疡疗效显著、溃疡愈合率高、Hp根除率高、且安全无明显不良反应,值得临床广泛推广使用。

目的 观察慢性荨麻疹特异性免疫治疗(SIT)的早期疗效,同时对患者的不良反应及依从性做相应调查。方法 对206例在我院进行特异性免疫治疗的慢性荨麻疹患者资料进行汇总分析,比较治疗16周及24周两组患者的荨麻疹活动评分(UAS)及症状积分下降指数(SSRI)以判断两组的有效率,同时对脱落患者进行电话访问。结果 特异性免疫治疗24周组与治疗16周组相比RRSI下降明显(P<0.05),有效率较高(P<0.05);206例患者中有62例脱落,脱落率较高(30.1%)。结论 特异性免疫治疗对于慢性荨麻疹的症状改善明显,但脱落率高,治疗24周相比治疗16周效果更佳。