目的 检测抑郁障碍患者血清中IL-2和TNF-α水平,探讨IL-2和TNF-α水平与认知功能情况相关性。方法 采用酶联免疫吸附法(ELISA)检测100例抑郁障碍患者(观察组)和100例健康人(对照组)的血清IL-2、TNF-α的水平,并结合汉密尔顿抑郁量表(HAMD)观察患者抑郁障碍的严重程度,应用Loewenstein 认知评定量表评定患者的认知状态情况进行相关分析。结果 与对照组相比,观察组的IL-2、TNF-α的水平明显更高(P<0.05)。IL-2、TNF-α的水平与HAMD,LOTCA总分呈正相关(P<0.05)。结论 抑郁障碍患者血清中IL-2、TNF-α的水平与抑郁障碍患者的严重程度和认知状态情况呈正相关。

Objective To study the levels of serum IL-2 and TNF-α in depressed patients and theircorrelations with the cognitive function. Methods 100 depressed patients (observation group) and 100 healthy people (control group) were enrolled to this study and we compared their levels of serum IL-2 and TNF-α detected by enzyme-linked immunosorbent (ELISA) from two groups. The correlation analyses of the serum IL-2 and TNF-α levels with the severity of depression of depressed patients observed with Hamilton depression scale (HAMD), and the serum IL-2 and TNF-α levels with the cognitive function evaluated with Loewenstein were conducted. Results The levels of serum IL-2 and TNF-α in the observation group were significantly higher than control group (P<0.05).There were positive correlations between the levels of IL-2 and TNF-α and HAMD scores and between the levels of IL-2 and TNF-α and LOTCA scores (P<0.05). Conclusion The levels of serum IL-2 and TNF-α in the depressed patients were positively correlative with the severity of depression and their cognitive function.

目的 观察肌内效贴技术对桡骨远端骨折内固定术后手功能的影响,并与对照组进行比较。方法 随机选取36例桡骨远端不稳定骨折内固定术后患者,随机分为治疗组与对照组,治疗组18例患者采用肌内效贴扎及腕关节主动活动康复训练,对照组18例采用腕关节主动活动康复训练。所有患者在治疗前及治疗后1周、2周均采用Gartland-Werley进行腕关节功能评价;容积法测量腕关节远端肿胀程度、视觉模拟疼痛评分(visual analog scale,VAS)进行疼痛评价。结果 治疗后1周,后2周治疗组的腕关节功能Gartland-Werley评定,腕关节远端肿胀程度和VAS优于对照组,差异有统计学意义(P＜0.05)。结论 肌内效贴技术对改善桡骨远端骨折术后肿胀,促进患者手功能恢复,改善患肢疼痛方面疗效显著,值得推广。

Objective To observe the effect of Kinesio taping on hand function after internal fixation of distal radius fracture, comparing to the control group. Methods Using randomized controlled methods, 36 cases of unstable distal radius fracture after internal fixation were randomly divided into two groups, 18 cases in the treatment group were treated by Kinesio taping and wrist active rehabilitation training. The control group (18 cases) only got wrist active rehabilitation training. All patients were evaluated before and after treatment in 1 week and 2 weeks, including the function assessment of wrist joint by Gartland-Werley, swelling measurement of distal wrist joint by volumetric method, pain evaluation by visual analogue scale (visual analog scale, VAS). Results In the twice evaluation after treatment, Gartland-Werley assessment of wrist joint, distal swelling degree and VAS of the treatment group were superior to that of the control group, the difference had statistical significance(P<0.05). Conclusion Kinesio taping can improve the distal radius fracture postoperative swelling, promote the recovery of hand function in patients, and improve the curative effect of limb pain significantly. It's worthy of promotion.

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.

目的 评估灯盏花素联合自血穴位注射疗法治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法 对照组使用常规治疗方法,治疗组加用灯盏花素联合自血穴位注射疗法。所有入组患者在入院和出院当天进行圣乔治呼吸问卷(SGRQ)评分和COPD评估测试(CAT)评分,使用统计软件比较两组的SGRQ总评分、CAT评分和住院天数。结果 SGRQ总评分、CAT评分和住院天数有正相关关系;和对照组相比较,治疗组SGRQ总评分在治疗前后没有差异, CAT评分在治疗前后有差异,治疗组的住院天数减少。结论 SGRQ总评分、CAT评分能够反映AECOPD病情,CAT评分更加适合评估AECOPD短期病情变化,灯盏花素联合自血穴位注射疗法治疗AECOPD具有临床疗效。

Objective It was evaluated the clinical effect of the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with Breviscapine combined with self-blood acupoint injection therapy. Methods Routine treatment methods were used in the controlled group. Breviscapine and the self-blood acupoint injection therapy were added into the treatment group. St George's respiratory questionnaire (SGRQ) and chronic obstructive pulmonary disease assessment test (CAT) were done in all enrolled patients. And the total score of SGRQ, the score of CAT and the length of stay in hospital were assessed. Results There were positive relationships between the total score of SGRQ, the score of CAT and the length of stay in hospital.compared with the controlled group, before and after the treatment, significant difference was not observed with the overall score of SGRQ in the treatment group, but was observed with the score of CAT in the treatment group, and stay time in hospital in the treatment group was declined obviously. Conclusion The total score of SGRQ and the score of CAT could reflect the conditions of AECOPD, and the latter was more suitable for the evaluation of the condition change in short period. The clinical effects were obvious in the treatment of AECOPD with Breviscapine combined with self-blood acupoint injection therapy.

目的 调查重症监护病房(ICU)医院感染的常见细菌分布及耐药性变化,为合理使用抗生素和医院感染的预防控制提供相关科学依据。方法 回顾性分析医院2007—2011年ICU收治的381医院感染患者感染菌株分布特点及耐药性情况。结果 ICU医院感染常见菌株主要来源于痰液标本,占78.2%,其次是血液。381 株临床分离菌中共检出革兰阴性杆菌262 株、革兰氏阳性球菌70例和真菌49例,分别占68. 8%、24.9%和占17.4%。革兰阴性杆菌中鲍氏不动杆菌(24.7%)、肺炎克雷伯氏杆菌(10.8%)、铜绿假单胞菌(9.2%)排前三位。其中除碳青霉烯类药物及抑酶制剂,鲍氏不动杆菌对其余抗菌药物耐药率均＞40%。革兰氏阳性球菌以金黄色葡萄球菌为主。对青霉素、庆大霉素、红霉素的耐药率均＞50%。结论 呼吸道仍是ICU最常见的感染部位。病原菌以革兰阴性杆菌为主,且对常用抗菌药物的耐药率逐渐升高,临床应加强抗菌药物规范使用,避免耐药菌株的产生。

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit(ICU)causing nosocomial infections so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The specimen sources and the clinical distribution of the 381 pathogens isolated from 2007 to 2011 were retrospectively analyzed. The drug resistance was observed in ICU that causing nosocomial infections. Results The sputum was the major specimens source in ICU, accounting for 78.2%. Of the 381 pathogens causing nosocomial infections in ICU, the 262 gram-negative bacilli (68.8%), 70 gram-positive cocci (24.9%),and 49 fungi (17.4) were isolated, Among gram-negative bacilli the top three were acinetobacter baumannii (24.7%), klebsiella pneumonia(10.8%),and pseudomonas aeruginosa (9.2%). The drug resisitance rate of baumannii to antibiotics were more than 40%,beside carbapenem and B-Lactamaseinhibitors. The main gram-positive cocci of causing nosocomial infections was saphylococcus aureus in ICU. The drug resisitance rate of S. aureus to penicillin, erythromycin and gentamicin were higher than 50.0%. Conclusion The main distribution area of nosocomial infections was the respiratory tract and the gram-negative bacilli were the common pathogens in ICU. It was benefit to avoid presenting of drug resistant strain, and antibiotics should be reasonably used in clinic.

目的 探讨COOK双球囊导管和欣普贝生引产的优劣性。方法 选择住院分娩的孕妇388例,根据引产方式分为两组,研究组应用COOK双球囊导管,对照组应用欣普贝生。根据宫颈Bishop评分,研究组分为研究组1和研究组2,对照组分为对照组1和对照组2,研究组1和对照组1宫颈Bishop评分小于或等于3分,研究组2和对照组2宫颈Bishop评分大于3分而小于或等于6分。分别对各组促宫颈成熟及引产情况、妊娠结局进行比较。结果 各组放置COOK宫颈双球囊或欣普贝生前后,宫颈Bishop评分有差异,低宫颈Bishop评分组欣普贝生效果更好。研究组与对照组比较,阴道分娩和剖宫产病例差异无统计学意义;急产、产后出血、羊水污染病例差异有统计学意义。研究组新生儿窒息率低于对照组,体温>37.5℃发生率高于对照组,差异无统计学意义。结论 对宫颈条件较差者,建议选用欣普贝生诱导宫颈成熟;COOK双球囊导管引产,作用温和,安全性好,成功率高。

Objective To evaluate the advantage of the COOK double balloon catheter and Propess induced labor. Methods We collected 388 cases with pregnant women. The patients were divided into the research and control groups. The research group applied COOK double balloon catheter while the control group applies Propess. According to cervical Bishop rating, the research team was divided into research group 1 and research group 2. The control group was divided into control group 1 and the control group 2. The cervical Bishop score of the research group 1 and control group 1 was less than or equals 3 points. The cervical Bishop score of the research group 2 and the control group 2 was greater than 3 and less than or equal 6 points. We separately compared the pregnancy outcome for each group to promote cervical mature and induced labor situation. Results The cervical Bishop scores have significant difference before and after COOK cervical double balloon and Propess are positioned between two groups.The effect of low cervical Bishop scores group is better than the high cervical Bishop by propess. The rates of urgent production, postpartum hemorrhage and amniotic fluid pollution reduce significant in the research group. The neonatal asphyxia rate, incidence of temperature > 37.5, vaginal delivery cases and cesarean section cases have not significant differences between the research group and the control group. Conclusion We suggest that patients whose cervical condition is poor should choose Propess induced cervical mature; The COOK double balloon catheter induced labor is safe and has a high success rate.

目的 探讨影响自然周期供精人工授精妊娠的因素。方法 回顾性分析2007年4月—2013年4月期间在广东省计划生育专科医院行自然周期供精人工授精的6161个周期,其中妊娠组1454周期,对照组4707个周期。采用单因素分析及多因素Logistic回归分析女方年龄、不孕年限、子宫内膜厚度、类型及冻融复苏后前向运动精子总数与AID妊娠结局的关系。结果 年龄越大,不孕年限越长,妊娠率越低(P＜0.001); A型子宫内膜妊娠率25.94%较AB型的23.87%及B型的21.54%都高(P=0.001);妊娠组冻融复苏后前向运动精子总数均值(28.95±6.86)×10⁶较对照组的(28.26±6.98)×10⁶高(P=0.001);年龄(OR=1.614,P＜0.001)、不孕年限(OR=1.194,P=0.012)、子宫内膜分型(OR=1.258,P=0.001)影响妊娠率。结论 女方年龄、不孕年限、子宫内膜形态及冻融复苏后前向运动精子总数是影响自然周期供精人工授精妊娠的因素。

Objective To explore the parameters affecting the pregnancy rate from 6161 natural cycles of artificial insemination by donor(AID). Methods Consecutive cases of 6161 natural cycles of AID from April,2009 to April 2013 in Guangdong provincial family planning special hospital were analyzed retrospectively.1454 pregnant cycles were defined as observation group and the other 4707 non pregnant cycles were classified as control group.Related factors in effect of pregnancy rate of AID were analyzed by logistic regression analysis. Results The rate of pregnancy decreased with the increase of women ages and the infertility duration(P＜0.001).And the pregnancy rate of ICI among the women with type A endometrium was the highest among the three types of endometrium(25.94%vs23.87%vs21.54%,P=0.001).The sum of the forward moving sperm after freezing and thawing recovery of observation group is higher than control group(28.95±6.86)×10⁶vs (28.26±6.98)×10⁶.The value of OR of age,infertility duration and types of endometrium were 1.614,1.194 and 1.258,respectively. Conclusion Age of women,infertility duration,types of endometrium as well as the sum of the forward moving sperm after freezing and thawing recovery played an important role in pregnancy rate of natural cycles of AID.

目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.

目的 探讨生长抑素对腹部手术后早期肠内营养支持顺应性的影响。方法 选择在本院接受中等以上腹部手术的住院病人60例,随机分成实验组和对照组各30例,手术后12 h开始给予早期肠内营养支持,连续5 d,实验组按常规使用生长抑素5 d,而对照组未使用生长抑素;比较两组在术后5 d内胃肠道不适的发生与否,胃肠减压的引流量,肠蠕动功能恢复情况,以及术后7 d的血液常规、肝、肾功能及血糖等血液生化指标。结果 与对照组比较,实验组在手术后胃肠道不适的发生,鼻胃管(胃肠减压)引流量,肠蠕动功能恢复时间等差异有统计学意义;术后7 d的血液常规、肝、肾功能及血糖等指标比较差异无统计学意义。结论 生长抑素有助于机体对腹部手术后肠内营养支持的顺应性,并安全可行。

Objective To study the clinical effects of somatostatin on compliance of early enteral nutrition after abdominal surgery. Methods 60 cases who accepted above medium abdominal operations were randomized into two groups including 30 cases of treatment group with somatostatin on the bases of early enteral nutrition and 30 cases of control group with early enteral nutrition, continued for 5 days after abdominal surgery. The promotion of clinical manifestations and signs, gastrointestinal decompression, blood routine examination, liver and renal function, blood glucose and so on were compared between the two groups. Results As for clinical manifestations and signs promotion, there were statistically significance in the alleviation of pain and distension of the abdominal and the average volume gastrointestinal decompression and the time of recovering peristalsis and passing flatus (P<0.05).As for blood routine examination, liver and renal function, blood glucose there were no statistically significance between the two groups. Conclusion Somatostatin can effected on compliance of early enteral nutrition after abdominal surgery.

目的 观察隔药壮灸神阙穴治疗女性黄褐斑的临床疗效及对血清性激素水平的影响。方法 将72例患者随机分为2组,治疗组38例和对照组34例,治疗组予隔药壮灸神阙穴治疗,对照组予口服维生素C、维生素E治疗,10次为1个疗程,第2、4、6疗程末观察疗效,治疗前后测定月经第2～3天血清雌二醇(E2)、孕酮(P)、泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平。结果 第6疗程末治疗组总有效率为83.33％,对照组总有效率30.30%,治疗组疗效优于对照组(P＜0.05),治疗组治疗前后E2、LH下降水平有统计学意义(P＜0.05)。对照组治疗前后E2、P、PRL、FSH、LH、T水平变化不明显(P＞0.05)。治疗后2组E2、LH比较,差异有统计学意义(P＜0.05)。结论 隔药壮灸神阙穴治疗女性黄褐斑临床疗效较好,可能通过调节性激素而起到治疗作用。

Objective To observe the clinical efficacy on female chloasma treated with acupuncture of Zhuang minority medicine at Shengque xue and its influence on sex hormone levels. Methods 72 cases were divided randomly into a treatment group(38 cases) and a control group(34 cases). In treatment group, acupuncture of Zhuang minority medicine at Shengque xue was applied. In control group, oral administration of vitamin C and vitamin E were given. The cases of treatment group were treated ten times as one session. At the end of 2,4,6 treatment session efficacy were analyzed respectively. The levels of serum estradiol(E2), progesterone(P), prolactin(PRL), follicule stimulating hormone(FSH), luteinizing hormone(LH) and testosterone(T) were detected on day 2-3 of menstruation. Results At the end of 6 treatment session the total effective rate was 83.33％ in treatment group and was 30.30% in control group, the efficacy in treatment group were superior to that in control group, with significant difference(P＜0.05). In treatment group, the levels of LH and E2 after treatment were lower as compared with those before treatment(P＜0.05). In control group, there were no obvious changes in E2,P, PRL, FSH, LH and T before and after treatment(P＞0.05). The levels of LH and E2 after treatment were significantly different in comparison of two groups(P＜0.05). Conclusion Acupuncture of Zhuang minority medicine at Shengque xue achieves a definite efficacy on female chloasma in clinic and its pharmacological mechanism may be relevant with its regulation on sex hormone levels for the patients.