目的 探究五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧影响的临床效果。方法 选择2018年4月—2019年8月我院收治的人流术后子宫复旧患者240例,随机分成两组,对照组进行常规术后处理,研究组则在常规术后处理的基础上进行五加生化胶囊联合热电复合治疗仪治疗。结果 研究组的术后疼痛症状评分低于对照组(P＜0.05);研究组的平均流血量、持续流血天数以及术后月经复潮天数均少于对照组(P＜0.05);研究组的子宫内膜厚度高于对照组(P＜0.05),且子宫纵径和横径短于对照组(P＜0.05)。结论 五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧进行治疗具有良好效果,值得推广。

Objective To investigate the clinical effect of Wujia biochemical capsule combined with thermoelectric complex therapy instrument on uterine retroplasia after abortion. Methods 240 cases of uterine rehabilitation after abortion from April 2018 to August 2019 were selected and randomly divided into two groups. The control group were performed routine postoperative treatment, while the research group were performed five plus biochemical capsules combined with thermoelectric complex therapy instruments on the basis of routine postoperative treatment. Results The postoperative pain symptom scores were lower than that of control group(P<0.05). The average blood flow, duration of bleeding and post-operative menarche were all less than that of control group(P<0.05). The thickness of endometrium in the study group was higher than that of the control group(P<0.05), and the longitudinal and transverse diameters of the uterus were shorter than those of the control group(P<0.05). Conclusion Wujia biochemical capsule combined with thermoelectric complex therapy instrument has a good effect on the treatment of involution of uterus after abortion and is worth promoting.

目的 检测外周血循环肿瘤细胞(circulating tumor cell, CTC)在原发性肝癌患者中的表达情况,并探讨CTC动态变化及其相对于甲胎蛋白(Alpha fetoprotein AFP)对原发性癌患者术后复发转移的预测作用。方法 收集原发性肝癌患者134例,肝脏良性病变患者72例,检测外周血 CTC 数目,同时检测AFP的表达水平,分析 CTC 与 AFP 的相关性。然后在134名原发性肝癌患者中筛选出成功行肝癌根治术的患者,共86例,检测这86名患者术前、术后外周血CTC和AFP,分析CTC和AFP对原发性肝癌术后复发转移的评估价值。结果 原发性肝癌患者外周血CTC阳性率高于肝脏良性病变患者,差异有统计学意义(P＜0.05);原发性肝癌患者CTC水平与AFP水平、淋巴结转移、肿瘤结节多少有关,与年龄、性别、肿瘤直径、分化程度、肝硬化有无、TNM分期无关;原发性肝癌患者CTC和AFP生存分析显示,原发性肝癌根治术后早期复发转移与CTC和AFP密切相关;CTC较阳性对术后复发转移具有更好的诊断价值,二者联合对复发转移预测价值最高。结论 CTC可以做为一个比传统肿瘤标志物更好的对原发性肝癌术后复发转移进行监测的指标,与肿瘤标志物联合检测预测价值更高。

Objective To detect the expression of peripheral blood circulating tumor cells CTC in patients with primary liver cancer and to explore the dynamic changes of CTC and its predictive effect on postoperative recurrence and metastasis of primary cancer. Methods The number of CTC in peripheral blood was measured in 134 patients with primary liver cancer and 72 patients with benign liver disease, the expression of AFP was detected, and the correlation between CTC and AFP was analyzed. Then 86 patients with primary liver cancer were selected from 134 patients with primary liver cancer who underwent radical hepatectomy. The values of CTC and AFP in evaluating recurrence and metastasis of primary liver cancer before and after operation were analyzed by CTC and AFP, in peripheral blood of these 86 patients. Results The positive rates of CTC in peripheral blood of patients with primary liver cancer were higher than that of patients with benign liver disease(P< 0.05). The levels of CTC in patients with primary liver cancer were related to AFP level, lymph node metastasis and the number of tumor nodules, but not to age, sex, tumor diameter, differentiation degree, liver cirrhosis and TNM stage. The survival analysis of CTC and AFP in patients with primary liver cancer showed that the early recurrence and metastasis of primary liver cancer after radical resection were closely related to the positive rate of CTC and AFP, and the positive rate of CTC was more effective than that of AFP positive in the diagnosis of recurrence and metastasis after operation, and the combination of the two had the highest predictive value for recurrence and metastasis. Conclusion CTC may be used as a better index to monitor postoperative recurrence and metastasis of primary liver cancer than traditional tumor markers. The combined detection prediction value of tumor markers is higher.

目的 评价SAMe-TT₂R₂评分对非瓣膜性房颤使用华法林的患者中的抗凝疗效的评估作用,探讨SAMe-TT₂R₂评分与缺血性卒中事件、出血事件的相关性。方法 以石河子大学医学院第一附属医院2018年1月—2019年1月住院治疗,确诊为非瓣膜性房颤并口服华法林抗凝的患者作为观察对象,进行为期10月的随访。通过患者的国际标准化比值(INR),计算患者的抗凝治疗范围内时间百分比(Time in Therapeutic Range, TTR),并对所有患者进行SAMe-TT₂R₂评分。运用χ²检验、Spearman秩相关、ROC曲线分析评估SAMe-TT₂R₂评分对患者抗凝疗效的预测能力。随访期内收集缺血性卒中和出血事件的发生情况,分析上述事件与SAMe-TT₂R₂评分的相关性。结果 190例患者平均TTR为(46.76±21.99)％,SAMe-TT₂R₂分数与患者的TTR呈负相关(P=0.001),ROC曲线下面积为0.661,P=0.001,约登指数0.203对应的临界值取整数为4分,敏感度和特异度分别为72.6％和47.7％,提示SAMe-TT₂R₂对预测TTR<65％有一定的价值。随访期间共有5例患者发生缺血性卒中事件,25例患者发生不同程度出血事件,11例患者发生全因死亡事件,上述事件在各个SAMe-TT₂R₂分值的发生分布差异无统计学意义(P＞0.05)。结论 在非瓣膜性房颤并使用华法林抗凝治疗的患者中,SAMe-TT₂R₂评分对使用华法林抗凝治疗患者的抗凝有效性具有一定的预测能力,可将SAMe-TT₂R₂评分作为预测华法林抗凝疗效的预测的指标。

Objective To evaluate the anticoagulant effect of SAMe-TT₂R₂ in patients with non-valvular atrial fibrillation treated with warfarin, and to explore the correlation between SAMe-TT₂R₂ and ischemic stroke events and bleeding events. Methods Patients who were diagnosed as non-valvular atrial fibrillation and with oral warfarin were enrolled in the First Affiliated Hospital of Shihezi University School of Medical College in January 2018-January 2019, and for 10 months of follow-up. Collecting patients' International normalization ratio(INR), calculating the Time in therapeutic range(TTR), and the SAMe-TT2 R2 score. And χ² test, Spearman rank correlation and ROC curve analysis were used to evaluate the predictive ability of SAMe-TT2 R2 score on anticoagulant efficacy in patients. Follow-up was conducted to investigate the incidence of ischemic stroke or hemorrhagic events and explore the relationship with the SAMe-TT2 R2 score. Results The mean TTR of 190 patients was 46.76%±21.99%, and the score of SAMe-TT_{2 R2} was negatively correlated with the TTR of the patients(P=0.001), the area under the ROC curve was 0.661, P=0.001, The critical value corresponding was 4 points, and the sensitivity and specificity were 72.6% and 47.7%, respectively suggesting that SAMe-TT₂R₂ had certain value in predicting TTR< 65%. During follow-up, a total of 5 patients had ischemic stroke, 25 patients had different degrees of bleeding, and 11 patients had all-cause death, different SAMe-TT₂R₂ scores showed no statistical significance(P>0.05). Conclusion In patients with non-valvular atrial fibrillation treated with warfarin anticoagulant, the SAMe-TT₂R₂ score has a certain predictive ability for the anticoagulant efficacy of patients treated with warfarin anticoagulant, and the SAMe-TT₂R₂ score could be used as an indicator for predicting the anticoagulant efficacy of warfarin.

目的 观察和评价重症毒蕈中毒(PMP)患者的临床资料,探讨血液灌流(HP)联合血液滤过(HF)与单独血液滤过治疗的疗效比较。方法 收集本院2016年8月—2018年10月救治的32例重症急性毒蕈中毒并发中毒性肝损伤、急性肾衰竭、中毒性心肌炎、消化道出血、中毒性脑病、急性血管内溶血等患者的临床资料,将32例患者分为治疗组和对照组,治疗组14例,采用持续静脉-静脉血液滤过24 h串联灌流2 h;对照组18例,采用单独血液滤过24 h,疗程2～3 d。两组患者内科常规治疗基本相同。结果 14例治疗组在内科常规治疗基础上联合血液灌流+血液滤过,好转率为92.9%(13/14);18例对照组在内科常规治疗基础上单用血液滤过,好转率为61.1%(11/18),两组好转率比较,差异有统计学意义(P<0.05)。治疗组患者黄疸、少尿、黑便、意识障碍等症状减轻,优于对照组;血清AST、ALT、TBil、DBil、PT、APTT水平较治疗前改善,优于对照组,差异有统计学意义(P均<0.05)。结论 毒蕈中毒患者常合并多脏器功能障碍(MODS),及早进行血液灌流联合血液滤过治疗较单独血液滤过能更有效的清除蛋白结合毒素和血清炎症因子,从而减轻内脏器官损害,改善肝、肾和凝血功能,治疗效果显著。

Objective To compare the clinical effect differences between hemoperfusion combined with hemofiltration with simple hemofiltration in treatment of severe mushroom poisoning patients. Methods 32 patients with toxic hepatitis,toxic myocarditis,toxic encephalopathy and acute renal failure due to poisonous mushroom were divided into two groups: treating group(n=14) and control group(n=18).Patients of treating group received continuous veno-venous hemofiltration for 24 hours combined with hemoperfusion for 2 hours.The cases of control group only received hemofiltration for 24 hours. Results After the treatment,the improvement rate in treating group were higher than that in control group(P<0.05).The disturbance of consciousness,jaundice,oliguria,melena in treating group were improved obviously and serum levels of AST、ALT、TBil、DBil、PT、APTT were reduced than those in controls(P<0.05). Conclusion Compared with simple hemofiltration,early hemoperfusion combined with hemofiltration for patients with severe toadstool poisoned can not only remove protein binding toxin and serum inflammatory factors,but also improve liver,kidney and coagulation function.

目的 研究结肠癌组织中转录因子KLF8的表达及下调KLF8的表达对结肠癌细胞的影响。方法 收集结肠癌组织和癌旁正常组织,检测KLF8的蛋白含量;培养结肠癌Lovo细胞株,转染KLF8 siRNA后检测细胞侵袭、迁移以及上皮-间质转化(EMT)。结果 结肠癌组织中KLF8的蛋白含量高于癌旁正常组织;转染KLF8 siRNA的结肠癌细胞组迁移距离低于阴性对照组,且侵袭至transwell微孔膜外侧面的细胞数少于阴性对照组;转染KLF8 siRNA的结肠癌细胞组内E-cadherin的表达升高,Vimentin、N-cadherin的蛋白含量低于阴性对照组。结论 结肠癌组织中KLF8的表达量升高,下调结肠癌细胞中KLF8的表达可抑制结肠癌细胞侵袭、迁移及上皮-间质转化过程。

Objective To study the expression of transcription factor KLF8 in colorectal cancer tissue and its effect of downregulation KLF8 on colorectal cancer cell. Methods Collecting cancer tissues and adjacent normal color tissue and detecting the protein level of KLF8. Culturing the colorectal cancer Lovo cell lines and detecting cell invasion, cell migration and epithelial-mesenchymal transition after transfecting of KLF8 siRNA. Results KLF8 was highly expressed in colorectal cancer tissues compared with adjacent normal colon tissue. After transfection of KLF8 siRNA, the migration distance of colorectal cancer cell and the cell population transferred to the lateral surface of transwell microporous membrane were lower than those of negative control siRNA. E-cadherin of KLF8 siRNA group were higher than those of negative control siRNA group. Vimentin and N-cadherin were lower than those of negative control siRNA group. Conclusion The expression of KLF8 in colorectal cancer tissue is elevated;downregulation of KLF8 expression in colorectal cancer cell lines may inhibit cell invasion, cell migration and epithelial-mesenchymal transition processes.

目的 观察灵芝孢子粉对中重度慢性阻塞性肺疾病(COPD)稳定期患者肺功能、6分钟步行距离及T淋巴细胞亚群的影响。方法 选取稳定期中重度COPD门诊患者19例,服用灵芝孢子粉6个月后观察患者服药前后肺功能的变化及循环血液中CD4⁺、CD8⁺T淋巴细胞的比例变化,症状评分(CAT评分)以及对6 MWT的影响。结果 服用灵芝孢子粉6个月后,中重度COPD患者的六分钟步行距离延长,平均增加19 m(P＜0.01),患者的CAT评分也有改善(P＜0.01),患者肺功能与服药前相比有改善趋势,其中FEV₁较服用前平均增加60 mL(P>0.05),FVC平均增加为130 mL(P<0.01),FEV₁/FVC比例降低0.47(P>0.05);外周血CD4⁺T淋巴细胞比例增加(P<0.01),CD8⁺和CD4⁺/CD8⁺T淋巴细胞亚群比例未见明显变化(P＞0.05)。结论 服用灵芝孢子粉6个月后对肺功能无明显作用,但能改善中重度COPD患者的CAT症状评分,可能与升高CD4⁺T淋巴细胞比例有关。

Objective To observe the effects of Ganoderma lucidum spore powder on lung function, 6-minute walking distance and T lymphocyte subsets in patients with moderate to severe chronic obstructive pulmonary disease(COPD). Methods Nineteen patients with moderate-to-severe COPD outpatients in stable phase were enrolled. After taking Ganoderma lucidum spore powder for 6 months, the changes of lung function and the proportion of CD4⁺ and CD8⁺ T lymphocytes in circulating blood, the symptom score(CAT score) and impact on the 6 MWT were observed. Results After taking Ganoderma lucidum spore powder for 6 months, the six-minute walking distance of patients with moderate to severe COPD was prolonged, with an average increase of 19 meters(P<0.01). The patient's CAT score was also improved(P<0.01). There was an improvement trend in increasing average FEV1 by 60 mL(P>0.05), FVC increased to 130 mL(P<0.01) and the FEV1/FVC ratio decreased by 0.47(P>0.05). The proportion of CD4⁺ T lymphocytes in peripheral blood increased(P<0.01), and the proportion of CD8⁺ and CD4⁺/CD8⁺ T lymphocyte subsets did not reach the significance(P>0.05). Conclusion After taking Ganoderma lucidum spore powder for 6 months, it has no significant effect on lung function, but it may improve the CAT symptom score of patients with moderate to severe COPD, which may be related to the increase of CD4⁺ T lymphocyte ratio.

介绍我院应对新型冠状病毒感染防控工作的护理管理措施,包括发热病区的组建,护理应急队伍的建设,工作流程指引的修订和完善,院感防护措施的严格落实,后勤保障的严密管理等,并进行护理质量控制与持续改进,为其他医院的防控工作提供借鉴。

It introduces nursing management measures of novel coronavirus infection prevention and control in our hospital, including the establishment of fever ward, the construction of nursing emergency team, the revision and improvement of working process guidelines, the strict implementation of hospital sensory protection measures, tight management of logistical support, and quality control and continuous improvement of nursing. It offers experiences for other hospitals.

目的 探讨腰椎间盘手术护理路径对经皮椎管成型下腰椎间盘摘除手术患者腰腿功能康复效果。方法 选择2018年1月—2019年11月住院进行经皮椎管成型下腰椎间盘摘除手术患者60例,按住院时间先后分为对照组和实验组各30例,对照组患者术后按椎间盘摘除手术给患者进行病情观察、腰腿功能康复锻炼、腰围配戴和康复护理知识宣教等护理;实验组患者在实施对照组护理措施基础上按腰椎间盘手术护理路径对患者进行有计划的康复护理知识宣教,按制定的康复护理路径对患者进行个性化康复活动训练指导。术后1周和出院时分别对患者掌握康复护理训练知识、腰椎功能障碍指数(ODI)、服务满意度进行评价。结果 实验组患者在术后首次进行康复训练时间早于对照组,差异有统计学意义(P=0.000 4);掌握康复护理知识得分实验组高于对照组,差异有统计学意义(P=0.002 3);掌握康复训练活动实验组高于对照组,差异有统计学意义(P<0.05);腰椎功能障碍指数(ODI)实验组低于对照组,差异有统计学意义(P<0.05);护理服务满意度实验组高于对照组,结果差异有统计学意义(P<0.05)。结论 椎间盘手术护理路径能促进患者早期进行康复训练,提高患者对腰椎间盘术后康复护理知识和康复训练技能的掌握,降低患者腰椎功能障碍指数,促进术后患者机体功能的康复。

Objective To explore the effect of nursing path of lumbar disc operation on the rehabilitation of lumbar and leg function in patients undergoing percutaneous laminoplasty. Methods From January 2018 to November 2019, 60 patients who were hospitalized for percutaneous laminoplasty were divided into the control group and the experimental group with 30 patients in each group according to the length of stay. The patients in the control group were given nursing care including condition observation, waist and leg function rehabilitation exercise, waist circumference wearing and rehabilitation nursing knowledge propaganda and education after the operation. On the basis of the nursing measures of the control group, patients in the experimental group received the planned rehabilitation nursing knowledge education according to the nursing path of lumbar disc operation, and individualized rehabilitation activity training guidance according to the established rehabilitation nursing path. One week after the operation and at the time of discharge, the patients' mastery of rehabilitation nursing training knowledge, lumbar dysfunction index (ODI) and service satisfaction were evaluated. Results The first time of rehabilitation training in the experimental group was earlier than that in the control group, the results were statistically significant (P=0.000 4); the score of mastering rehabilitation nursing knowledge in the experimental group was higher than that in the control group, the results were statistically significant (P=0.002 3); the experimental group of mastering rehabilitation training activities was higher than that in the control group, the results were statistically significant (P<0.05); lumbar dysfunction index ODI in the experimental group was lower than that in the control group, the results were statistically significant (P<0.05); the satisfaction of nursing service in the experimental group was higher than that in the control group, the results were statistically significant (P<0.05). Conclusion The nursing path of lumbar disc surgery can promote the early rehabilitation training of patients, improve the mastery of postoperative rehabilitation nursing knowledge and rehabilitation training skills of patients, reduce the lumbar dysfunction index of patients, and promote the rehabilitation of patients' body function.

目的 回顾分析我医院近9年产妇行剖宫产术治疗的患者的住院病历资料,探索术后出现切口脂肪液化的危险因素。方法 选取我医院2011年1月—2019年8月期间行剖宫产术治疗的产妇患者1 018例,分成术后切口脂肪液化组和甲级愈合组,比较2组间的差异,分析其相关危险因素。结果 1 018例产妇患者中出现切口脂肪液化的为34例,发生率为3.34%(34/1 018);单因素分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的独立危险因素。结论 产妇患者行剖宫产术治疗出现切口脂肪液化率较高;围手术期控制患者血糖,以及孕期控制体质指数、缩小剖宫产手术切口长度可能有效地减少切口脂肪液化发生率。

Objective To retrospectively analyze the medical records of patients undergoing cesarean section in our hospital in recent 9 years, and explore the risk factors of incision fat liquefaction after operation. Methods 1 018 patients undergoing cesarean section in our hospital from January 2011 to August 2019 were divided into two groups: incision fat liquefaction group and grade A healing group. The differences between the two groups were compared and the risk factors were analyzed. Results Among 1 018 parturients, 34 had incision fat liquefaction, and the incidence was 3.34% (34/1018). Univariate analysis showed that diabetes mellitus, overweight body mass index and incision length of more than 7 cm were risk factors for incision fat liquefaction after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that diabetes mellitus, overweight body mass index and incision length over 7 cm were independent risk factors for incision fat liquefaction. Conclusion The incision fat liquefaction rate is higher in patients undergoing cesarean section. Controlling blood sugar level, body mass index during pregnancy and shortening the length of incision during perioperative period may effectively reduce the incidence of incision fat liquefaction.

目的 探讨近期大咯血对支气管镜诊疗操作相关出血的影响。方法 回顾性分析2015年12月—2019年12月我院支气管镜操作导致出血超过30 mL患者的临床资料,根据近1周是否发生大咯血,分为观察组(大咯血组)和对照组(无大咯血组),比较2组间的出血量以及大出血、血凝块、窒息的发生率。结果 观察组的出血量以及大出血的发生率高于对照组,2组间差异有统计学意义,血凝块、窒息的发生率两组间差异无统计学意义。结论 近期大咯血的患者支气管镜操作发生大出血的风险高。

Objective To explore the effect of short-term massive hemoptysis on the procedure-related bleeding of bronchoscopy. Methods The clinical data of patients with more than 30 mL bleeding caused by bronchoscopy operation in Guangzhou Chest Hospital from December 2015 to December 2019 were analyzed retrospectively. According to whether massive hemoptysis occurred in the past week, the patients were divided into observation group (massive hemoptysis group) and control group (no massive hemoptysis group). The bleeding volume, the incidence of massive hemorrhage, blood clot and asphyxia were compared between the two groups. Results The amount of bleeding and the incidence of massive hemorrhage in the observation group were higher than those in the control group, that there was a statistical significance between the two groups. There was no statistical significance between the two groups in the incidence of blood clots and asphyxia. Conclusion Patients with recent massive hemoptysis have a higher risk of massive haemorrhage due to bronchoscopy.