目的 目前对于生物反馈发挥治疗作用的机理还未完全研究清楚,该实验借助近似熵(ApEn)这一新型的非线性研究方法,研究在生物反馈过程中心电的变化,从而希望发现生物反馈对心脏功能的潜在影响。方法 总数30人的健康正常受试者纳入研究,其中20人为生物反馈实验组,10人为正常对照组。该实验采用肌电生物反馈作为反馈方法,同时记录心电的变化。实验所得数据采用非线性动力学参数—近似熵(ApEn)进行研究。结果 实验组的平均心率在最后两个生物反馈阶段高于对照组。随着实验进展,实验组的心率标准差逐渐缩小,而心率和心电ApEn明显增高。结论 该实验发现生物反馈能够影响心电生理系统,使得心脏系统变得更加健康,展现出更强的抗应激能力,从而揭示了生物反馈潜在的治疗机理。

Objective The mechanism about biofeedback is not complete clear. Our aim was to study changes of cardiac function (electrophysiology) during biofeedback with the help of approximate entropy (ApEn), and a potential new mechanism about neurofeedback may be detected. Methods A total of 30 healthy volunteers participated in this study which consisted of the neurofeedback group(n=20) and the control group (n=10). We applied electromyogram neurofeedback as the feedback method, and simultaneously recorded electroencephalogram(EEG) and electrocardiogram(ECG). We applied the nonlinear analysis ApEn assess obtained data. Results In the biofeedback group the average of heart rate was higher than that of control group in the last two sessions. As the biofeedback experiment sessions were progressed, the standard deviation of heart rate gradually reduced and the ApEn of ECG increased with statistic significance in the biofeedback group. Conclusion We found that biofeedback can influence cardiac electrophysiological system and make cardiac systems progress healthily and achieve greater ability of anti-stress.

目的 水解乳清蛋白对炎症性肠病大鼠的抗炎作用及机制。方法 将40只雄性大鼠随机分为实验组和对照组,并建立炎症性肠病动物模型,分别喂食添加了水解乳清蛋白及普通蛋白的饲料,喂养4周后处死大鼠,每周检测体重,血清ALB、TNF-α、IL-2、IL-6等。结果 二组间体重及血清白蛋白无区别(P>0.05),实验组与对照组的TNF-α、IL-2及IL-6无区别(P>0.05),从第二周到第四周,实验组的炎症因子水平低于对照组(P<0.05)。结论 水解乳清蛋白具有抗炎作用,能够减少炎症性肠病大鼠动物模型的炎症因子的释放,并改善其营养状况。

Objective To evaluate the anti-inflammatory effects of whey protein on SD rats model of inflammatory bowel disease. Methods 40 SD rats model of inflammatory bowel disease were established and randomly divided into experimental and control groups equally. Experimental and control groups were fed whey protein and ordinary protein respectively. After 4 weeks, TNF-α, IL-2 and IL-6 were detected. Results There were no significant difference between the two groups of weights and the level of ALB. The level of TNF-α, IL-2 and IL-6 between groups were not significantly different in the first week(P>0.05). However, thelevels of TNF-α, IL-2 and IL-6 in experimental group were significantly lower than those of the control group in the follow weeks. Conclusion The whey protein could reduce the production of inflammatory cytokines.

目的 观察Bax抑制因子(Bax-inhibiting peptides,BIP)对肠上皮细胞的保护作用,并探讨其作用机制。方法 建立1日龄新生大鼠的坏死性小肠结肠炎模型。BIP于建模前腹腔内注射,建模后分别检测各组肠组织病理,并分别用流式细胞仪检测各组肠细胞凋亡率,western blot法检测bax下游凋亡蛋白细胞色素C、caspase 9和caspase 3含量。结果 与NEC组及Bax10 μg组比较,bax50 μg和100 μg可减轻肠上皮损伤,减少肠细胞凋亡率,降低bax下游凋亡蛋白细胞色素C、caspase9和caspase3含量。结论 一定剂量的Bax抑制肽可通过降低活性Caspase-3及CytC蛋白释放,保护线粒体膜,抑制肠上皮细胞调亡,发挥对肠上皮细胞的保护作用。

Objective To investigate the protective effects of Bax-inhibiting peptides(BIP) on intestinal epithelial cells and to explore its mechanism. Methods The model of neonatal necrotizing enterocolitis in 1 day neonatal rats were established. Before establishing the model, BIP was intraperitoneal injected to the rats. The pathological of intestinal tissue were detected respectively, the intestinal cell apoptosis rate were detected by flow cytometry, the levels of downstream apoptosis proteins of Bax were detected by Western blotting respectively. Results Compared to NEC and Bax10μg group, bax50μg and 100 μg can significantly reduce the intestinal epithelial damage and intestinal cell apoptosis rate and can decrease the levels of cytochrome C, caspase-9 and caspase-3, downstream apoptosis proteins of Bax,significantly. Conclusion A certain dose of Bax-inhibiting peptides can protect the mitochondrial membrane, inhibit the apoptosis of intestinal epithelial cells by reducing the level of Caspase-3 and CytC and play a protective effect on intestinal epithelial cells.

目的 构建抑癌基因SEMA3B真核表达载体pcDNA3.1-SEMA3B,并检测其对肺癌A549细胞恶性生物学行为的影响。方法 应用PCR扩增SEMA3B全长cDNA片段,构建真核表达载体pcDNA3.1-SEMA3B。克隆PCR、双酶切法、基因测序验证过表达载体构建成功。将pcDNA3.1-SEMA3B真核表达载体和空载体pcDNA3.1分别转染入A549细胞中,应用qRT-PCR、Western blot检测SEMA3B mRNA、蛋白表达水平的变化;MTS法检测细胞增殖;流式细胞仪检测细胞凋亡、细胞周期;克隆形成实验检测细胞集落形成能力。结果 SEMA3B基因扩增片段与预测片段一致,克隆成功,且测序鉴定证实真核表达载体构建成功。转染pcDNA3.1-SEMA3B真核表达载体可上调SEMA3B mRNA、蛋白表达水平,且可抑制A549细胞的增殖,诱导凋细胞亡,细胞被阻滞在G1期,抑制细胞集落形成能力。结论 成功构建了SEMA3B基因真核表达载体,抑癌基因SEMA3B在肺癌恶性生物学进程中可能发挥重要作用。

Objective To construct the eukaryotic expression vector of the cancer suppressor gene, SEMA3B, and research the effects on malignant biological behavior of lung cancer A549 cells. Methods By reverse transcriptase-polymerase chain reaction (RT-PCR), the full length SEMA3B gene was amplified and then was inserted into pcDNA3.1. The recombinant plasmid pcDNA3.1-SEMA3B was confirmed correctly through double enzyme digestion and PCR identification, which was transfected into lung cancer A549 cells by lipid media transfection. The untransfected A549 and A549 transfected with pcDNA3.1 were used as controls. SMEA3B gene was detected by qRT-PCR and western blot. MTS assay, flow cytometry, and colony formation test were performed to evaluate the effect of overexpression of SEMA3B gene on A549 cell proliferation, apoptosis, cell cycle, and colony forming ability. Results The amplied fragment of SEMA3B gene by PCR was consistent with the anticipated result, the SEMA3B gene was cloned successfully. And the recombinant plasmid pcDNA3.1-SMEA3B was constructed successfully through gene sequence identification. After transfection of pcDNA3.1-SEMA3B, SEMA3B mRNA and protein expression levels were raised, and overexpression of SEMA3B gene in A549 cells significantly inhibited the proliferation of A549 cells, induced apoptotic cell death, blocked cell cycle in the G1 phase, and suppressed cell colony-forming ability. Conclusion The recombinant pcDNA3.1-SEMA3B is constructed successfully. SEMA3B gene can significantly inhibit the malignant biological behavior of lung cancer A549 cells.

目的 分析药源性双硫仑样反应医疗损害责任纠纷的规律及特点,为规避用药风险、促进合理用药提供参考。方法 以“双硫仑”为关键词,检索中国裁判文书网,时间截至2025年3月25日,将通过筛选的裁判文书基本情况、双硫仑样反应药物关联情况、症状表现、转归、赔偿情况等信息提取录入Excel表,建立评价数据库。结果 共检索得裁判文书81份,纳入裁判文书18例,涉及医疗机构为三级医院3例、二级医院5例、卫生院/卫生室7例、民营医院2例、诊所1例;性别构成中,男15例,女3例;怀疑引起双硫仑样反应的药物有头孢哌酮、头孢呋辛、替硝唑、头孢噻肟、甲硝唑、左氧氟沙星、头孢曲松钠、头孢替安和头孢米诺;患者饮酒和用药间隔多为1~3 d;症状表现有呼吸困难/呼吸骤停、昏迷/意识丧失/休克、面色紫绀/局部发紫/指甲发紫、抽搐/发抖、出汗、不能说话/说话不清楚等;转归结果中,15例结局为死亡,1例为神经症,1例为一级伤残（植物人）,1例为二级伤残（缺氧缺血性脑病后遗四肢功能障碍）;7例患者死亡案例因未尸检影响了结果鉴定;判决情况中,1例和解,1例未公布三审判决结果,余16例医疗机构承担了10%~70%的医疗赔偿责任,赔偿金额43 092.4~1 616 354元;医方存在的过失主要有未认真采集饮酒史、违反诊疗常规用药、违反合理注意义务、未履行知情告知义务等。结论 药源性双硫仑样反应危害大,误诊率高,发病急骤凶险,基层医疗机构对其鉴别和处置能力亟需提高;应重视饮酒史的采集和记录;合理合规处方抗生素;加强对患者的高度注意义务、知情告知义务等履行;医院药学人员应积极参与安全用药工作,做好用药教育。

      Objective  To analyze the regularity and characteristics of the medical damage liability dispute with drug-induced disulfiram-like reaction, to avoid the risk of medication and provide reference for clinical rational drug use. Methods  China Judgements Online had been searched using the keywords of “disulfiram” from inception to March 25,2025. The evaluation table database was established with the excel table to conduct statistical analysis on the basic information of judgements, drug association, clinical performance,outcome of disease and the compensation. Results A total of 81 cases of judgements documents were retrieved,and 18 cases were enrolled. There were 3 tertiary hospitals, 5 second-class hospitals, 7 health-centers, 2 private hospitals,1 clinic among the medical establishments. Fifteen cases were male and 3 cases were female. The drugs suspected causing disulfiram-like reaction were cefoperazone, cefuroxime, tinidazole, cefotaxime, metronidazole, levofloxacin, ceftriaxone, cefotiam, cefminox. The interval between drinking and medication was usually 1-3 days. The symptoms were as follows：dyspnea/respiratory arrest, coma/loss of consciousness/shock, cyanosis /purple nails, convulsion/trembling, sweatiness, inability to speak/lack of clarity, etc. Fifteen cases ended in death, 1 was neurosis, 1 was first-degree disability (vegetative state), 1 was secondary disability (limb dysfunction after hypoxic encephalopathy). The identification of 7 cases of death was affected by the lack of autopsy. One case was settled and the outcome of the third trial was not announced in another case. The remaining 16 medical institutions took 10%-70% of the medical compensation liability, with the compensation amount ranging from 43 092. 4 yuan to 1 615 354 yuan. The main faults of the medical institutions were undetailed drinking history, irregular medication, breaches of duty of reasonable care, failure to fulfill the obligation of informed notification,etc. Conclusions Drug-induced disulfiram-like reaction has the characteristics of graveness of harm and rapid progress. Primary medical institutions need to improve their identification and disposal capacity urgently. Attention should be paid to collecting and recording of drinking history. Antibiotics should be used in a reasonable and compliant manner. Obligation of high attention to patients, information and other obligations should be fulfilled. Hospital pharmacy staff should ensure drug use safety through participating in drug education actively.

目的 通过构建结构方程模型,分析某三级甲等综合医院腹股沟疝患者住院费用的影响因素,旨在为合理控制腹股沟疝单病种费用提供依据。方法 收集4 328份高州市人民医院2016—2022年主要诊断疾病名称为腹股沟疝且行腹股沟疝手术的患者的病历资料,预分析单个影响因素,采用AMOS28.0拟合构建模型。结果 结构方程模型拟合达到标准。性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝对总费用所产生的总效应数值分别为0.008、-0.044、0.062、0.014、-0.119、0.106、0.236;性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝通过住院时间间接对住院费用产生影响。结论 对住院费用产生的影响因素有性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝、住院时间,建议推行患者预住院模式及日间手术,在正式住院前完成相关检查,优化医疗服务流程,从而合理有效控制单病种住院费用。

Objective By utilizing a structural equation model, to analyze determinants that affect the hospitalization costs for individuals with inguinal hernia at a tertiary-level comprehensive medical center, offering insights for the potential management of costs associated with this specific ailment. Methods This study entailed the compilation of 4 328 patient files from individuals who received surgical treatment for inguinal hernia at a third-level general hospital over the period spanning 2016 to 2022. Preliminary analysis was conducted on isolated variables, followed by the development of a model using AMOS 28. 0 for fit assessment. Results The fitting of structural equation model reached the standard. The total effect values of gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia on the total cost were 0. 008, -0. 044, 0. 062, 0. 014, -0. 119, 0. 106, 0. 236, respectively. Gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia indirectly affected hospitalization expenses through hospitalization days. Conclusions Gender, age, cost, number of hospitalizations, of admission, concomitant diseases, unilateral and bilateral hernia, and length of hospital stay have an impact on hospitalization costs. It is suggested to implement the pre-hospitalization mode and day surgery, complete relevant examinations before formal hospitalization, and optimize the medical service process, so as to reasonably and effectively control the hospitalization cost of single disease.

目的 探讨对注意缺陷多动障碍（ADHD）患儿联合应用维生素D与盐酸托莫西汀的效果及对其行为功能障碍和神经功能损伤的影响。方法 选择于我院接受治疗的105例ADHD患儿,纳入时间为2023年7月—2024年3月,按照计算机分组法分为对照组52例给予盐酸托莫西汀治疗,观察组53例给予维生素D联合盐酸托莫西汀治疗,比较两组临床疗效、神经与行为功能、不良反应。结果 观察组总有效率（96.23%）高于对照组（78.85%）（P<0.05）。治疗后,与对照组比较,观察组神经元特异性烯醇化酶水平与行为、学习、躯体、冲动多动、焦虑及多动指数评分更低（P<0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论 对于ADHD患儿,使用维生素D联合盐酸托莫西汀显示出更为显著的疗效,能有效缓解行为功能障碍,减少神经功能损伤,且具有良好的安全性。

Objective To explore the effect of combined use of vitamin D and atomoxetine hydrochloride on children with attention deficit hyperactivity disorder（ADHD）and its impact on their behavioral dysfunction and neurological damage. Methods A total of 105 children with ADHD treated in the hospital were included from July 2023 to March 2024. They were divided into control group with 52 cases treated with atomoxetine hydrochloride, and observation group with 53 cases treated with vitamin D combined with atomoxetine hydrochloride using a computerized grouping method. The clinical efficacy, neurological function, behavioral function, and adverse reactions were observed in both groups. Results The total effective rate of the observation group（96. 23%）was higher than that of the control group（78. 85%）（P<0. 05）. After treatment, compared with the control group, the levels of neuron-specific enolase in the observation group were significantly lower in terms of behavior, learning, physical fitness, impulsivity hyperactivity, anxiety and hyperactivity index scores（P<0. 05）. The comparison of the incidence of adverse effects between the two groups was not significant（P>0. 05）. Conclusions The combined use of vitamin D and atomoxetine hydrochloride has a more significant therapeutic effect on children with ADHD, which can effectively alleviate behavioral dysfunction, reduce neurological damage, and has good safety.

目的 通过建立急性心力衰竭（AHF）患者服药依从性预测模型,提高AHF患者的服药依从性和临床管理效果。方法 纳入2021年1月—2023年12月在广州市番禺区何贤纪念医院住院治疗的580例AHF患者,通过收集患者的一般人口学资料、疾病相关资料及出院后6个月的服药依从性数据,应用Logistic回归模型分析患者服药依从性的影响因素,并基于影响因素建立预测模型。结果 患者服药依从性总体良好（75%）。依从性良好组与依从性差组的年龄、独居情况、合并基础病、服药种类、疾病了解评分、治疗信心评分和自我控制信心评分比较差异有统计学意义（P<0.05）。Logistic 回归分析显示危险因素包括年龄≥60岁（OR=1.774）、独居（OR=1.871）、合并基础病≥2种（OR=1.719）和服药种类≥7种（OR=1.456）。而疾病了解评分（OR=0.923）、治疗信心评分（OR=0.946）和自我控制信心评分（OR=0.901）是保护因素（P<0.05）。基于上述因素建立的预测模型,通过ROC曲线验证,曲线下面积为0.815（95%CI：0.780~0.850）,提示所构建的模型具有良好的区分度。对该模型的校准度进行评价,P=0.528,提示该预测模型拟合度良好。此外,该预测模型的一致性指数为0.738,说明模型的预测性能良好。绘制的决策曲线中,曲线位于极端线之上,当阈概率取值在9%~59%时,对应的净获益率为0~27%,提示建立的模型具有优秀的临床有效性。结论 AHF患者的服药依从性受到多种因素的影响,包括年龄、居住状态、合并基础病种类及服药种类等。

Objective To establish a predictive model for medication compliance among acute heart failure（AHF）patients in order to enhance their therapeutic compliance and optimize clinical outcomes. Methods A total of 580 AHF inpatients at He Xian Memorial Hospital in Panyu District, Guangzhou between January 2021 and December 2023 were enrolled. Demographic information, disease-specific data,as well as post-discharge medication compliance records within six-month were collected by investigators. Utilizing logistic regression analysis revealed several influential determinants affecting medication compliance which formed the basis for constructing our predictive model. Results Generally,patient compliance was good（75%）. The comparison between the good compliance group and the poor compliance group showed that there were significant differences in age, living alone,combined with underlying diseases, types of medication, disease understanding score, treatment confidence score and self-control confidence score（P<0. 05）. Logistic regression analysis showed that independent risk indicators including individuals aged ≥60 years（odds ratio[OR]=1. 774）, those living alone（OR=1. 871）, presence of two or more underlying diseases（OR=1. 719）, along with consumption of seven or more medications daily（OR=1. 456）. Conversely,disease awareness score（OR=0. 923）, treatment confidence score（OR=0. 946）, and self-control confidence score（OR=0. 901）were identified as independent protective factors. Validation using receiver operating characteristic curves demonstrated robust predictive performance with an area under curve value of 0. 815（95%CI：0. 780-0. 850）, affirming its efficacy. The calibration of the model was evaluated, with a P-value of 0. 528, indicating good fit of the predictive model. Additionally, the concordance index（C-index）of the model was 0. 738, suggesting its excellent predictive performance. The decision curve analysis revealed that the curve was above the extreme lines, with a net benefit rate ranging from 0 to 27% when the threshold probability falls between. Conclusions The medication compliance of AHF patients is influenced by various factors, including age, living arrangement, the number of underlying diseases, and the number of medications taken. Targeted interventions such as enhancing patient education, simplifying treatment regimens, and improving social support can effectively improve the medication compliance of AHF patients. The predictive model established in this study provides a scientific basis for clinicians to develop more precise and effective individualized intervention measures,thereby improving the prognosis and quality of life.

目的 评估重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白（rhTNRF：Fc）治疗难治性慢性痛风性关节炎的临床疗效及安全性。方法 选取2022年1月一2023年12月广州中医药大学顺德医院风湿科门诊收治的46例难治性痛风性关节炎患者,分为观察组和对照组两组,对照组规范使用降尿酸药物治疗,观察组在对照组治疗的基础上联合使用rhTNRF：Fc至少12周,在0、12、24、48周观察两组的血尿酸（sUA）、肿瘤坏死因子-α（TNF-α）、关节肌肉骨骼超声变化、痛风发作例数、肝肾功能等指标。结果 观察组与对照组sUA无明显差别（P>0.05）,TNF-α水平明显下降（P<0.05）,滑膜炎、关节积液影像表现减少（P<0.05）,痛风发作例数明显减少（P<0.05）,观察期间肝肾功能正常,无患者因不良反应退出研究。结论 rhTNRF：Fc对难治性慢性痛风性关节炎安全有效。

Objective To explore the efficacy and safety of recombinant human type II tumor necrosis factor receptor-antibody fusion protein（rhTNRF：Fc）in refractory chronic gouty arthritis. Methods From January 2022 to December 2023, 46 cases of refractory chronic gouty arthritis in the Rheumatology Outpatient Department,Shunde Hospital Guangzhou University of Chinese Medicine were selected and divided into an observation group and a control group. The control group received routine treatment,while the observation group received rhTNRF：Fc treatment additionally for at least 12 weeks, two groups of indicators such as serum urine acid（sUA）, TNF-α, changes in musculoskeletal ultrasound,number of gout attacks,hepatic and renal function at 0, 12, 24, and 48 weeks were observed. Results There was no significant difference in sUA between the observation group and the control group（P>0. 05）, TNF-α significantly decreased（P<0. 05）, synovitis and joint effusion imaging manifestations reduced（P<0. 05）, number of gout attacks decreased（P<0. 05）. During the observation period, liver and kidney function were normal, and no patients withdrew from the study due to adverse reactions. Conclusions Using rhTNRF：Fc is safe and effective in treating refractory chronic gouty arthritis.

目的 通过采用本体感觉神经肌肉刺激技术（PNF）对慢性颈痛患者进行治疗,观察患者颈部肌肉力量是否得到增强,以及颈椎的Cobb角是否得到改善。方法 将符合纳入标准的30例慢性颈痛患者纳入研究对象（PNF组）。研究对象接受为期4周的PNF技术治疗,对比治疗前（基线）和治疗4周后颈部最大等长收缩肌力（MIS）,并比较治疗前后Cobb角。结果 共30例患者完成研究。治疗后颈椎Cobb角明显改善,治疗4周后对比基线Cobb角差异具有统计学意义（t=4.925,P<0.001）。颈椎屈曲和伸展的力量经过4周治疗后都得到明显的改善,颈椎伸展的MIS从（15.8±2.5）lbs增加到（19.3±3.1）lbs,比较基线差异具有统计学意义（t=5.685,P<0.001）。颈椎屈曲的MIS从13.9（10.3,15.6）lbs增加到17.8（15.3,18.8）lbs,治疗4周后对比基线差异具有统计学意义（Z=-4.783,P<0.001）。结论 PNF技术能有效增强颈部肌肉力量,可有效增大颈椎Cobb角,可能为颈椎变直的慢性颈痛患者的治疗带来积极的影响。

Objective To observe whether the strength of the neck muscles and the Cobb angle of the cervical vertebra are improved by proprioceptive neuromuscular facilitation（PNF）in the treatment of patients with chronic neck pain. Methods Thirty patients with chronic neck pain who met the inclusion criteria were included in the study group（PNF group）. They were treated with PNF for four weeks, maximal isometric strength（MIS）and Cobb angle in the neck were compared at before（baseline）and four weeks after treatment. Results A total of 30 participants completed the study. The Cobb angle of cervical spine was significantly improved after treatment,and the Cobb angle before treatment was significantly different from that after four weeks of treatment（t=4. 925, P<0. 001）. The strength of cervical flexion and extension improved significantly after four weeks of treatment,and the MIS of cervical extension increased from（15. 8±2. 5）lbs to（19. 3±3. 1）lbs, which was statistically significant compared to baseline（t=5. 685, P<0. 001）. Cervical flexion MIS increased from 13. 9（10. 3,15. 6）lbs to 17. 8（15. 3,18. 8）lbs,and the difference was statistically significant compared to baseline after four weeks of treatment（Z=-4. 783, P<0. 001）. Conclusions PNF can effectively enhance the strength of neck muscles,and can effectively increase the Cobb angle of cervical spine, which may have a positive impact on the treatment of chronic neck pain patients with cervical straightening.