目的 研究黄连水煎剂对体外建立的金黄色葡萄球菌生物膜(bacterial biofilm,BF)的作用,及黄连水煎剂联合苯唑西林钠对金黄色葡萄球菌作用。方法 由广西医科大学第一附属医院检验科提供金黄色葡萄球菌菌株34134,采用二倍稀释法分别测出黄连水煎剂和苯唑西林钠对金黄色葡萄球菌的最低抑菌浓度(minimum inhibitory concentration MIC),在体外使用腹膜透析管建立金黄色葡萄球菌生物膜模型,加入不同浓度的黄连水煎剂和苯唑西林钠作用3天和7天后,琼脂平板菌落计数法评估细菌粘附腹透管的能力,结晶紫染色法行载体表面BF半定量,银染法快速鉴定BF。结果 黄连水煎剂MIC为16 mg/mL,苯唑西林钠MIC为4 μg/mL,3天BF模型中,1/2MIC黄连水煎剂、1/4MIC黄连水煎剂、1/8MIC黄连水煎剂、1/16MIC黄连水煎剂、1/2MIC苯唑西林钠、1/4MIC苯唑西林钠作用下的金黄色葡萄球菌的菌落计数分别为(39.333 3±3.994 2)×10⁶ CFU/mL、(52.366 7±3.537 8)×10⁶ CFU/mL、(81.266 7±3.341 8)×10⁶ CFU/mL、(90.900 0±2.040 1)×10⁶ CFU/mL、(50.866 7±2.208 6)×10⁶ CFU/mL、(77.666 7±2.880 7)×10⁶ CFU/mL,空白组的菌落计数为(92.033 3±3.890 6)×10⁶ CFU/mL,与空白组相比较,1/2MIC黄连水煎剂,1/4MIC黄连水煎剂、1/8MIC黄连水煎剂、1/2MIC苯唑西林钠、1/4MIC苯唑西林钠的差异有统计学意义(P<0.001),1/16MIC黄连水煎剂与空白组比较,差异无统计学意义(P=0.173)。7天的BF模型中,1/2黄连水煎剂比1/2苯唑西林钠抑制金黄色葡萄球菌生物膜形成的作用更强(P<0.001),结晶紫、银染也得到相似的结果,进一步的研究发现在1/16MIC黄连水煎剂的作用下,加入不同浓度的苯唑西林钠,此时苯唑西林钠的最低抑菌浓度为0.25 μg/mL。结论 黄连水煎剂能抑制金黄色葡萄球菌生物膜的形成,并且在苯唑西林钠联合黄连水煎剂时,能有效地提高苯唑西林钠的疗效,为治疗金黄色葡萄球菌导致的腹膜透析相关性腹膜炎提供新的治疗方案,同时也提高了抗生素的疗效,为临床上减少耐药菌的产生提供了帮助。

Objective To study the effect of Coptis chinensis decoction on bacterial biofilm(BF)in vitro and the effect of Coptis chinensis decoction combined with oxacillin sodium on Staphylococcus aureus. Methods Staphylococcusaureus strain 34 134 was provided by the First Affiliated Hospital of Guangxi Medical University. Using doubling dilution method to measure the minimum inhibitory concentration of Coptis decoction and Oxacillin sodium on Staphylococcus aureus,respectively. In vitro, peritoneal dialysis tube was used to establish Staphylococcus aureus biofilm model after adding different concentrations of Coptis decoction and Oxacillin sodium for 3 days and 7 days, we used Agar plate count method to assess bacterial adhesion on the dialysis tube, crystal violet staining and semi quantitative method to measure the BF of the surface of the carrier and silver staining(light microscopy) rapid identification of BF. Results The MIC of Coptidis decoction was 16 mg/ml, and that of Oxacillin sodium was 4 μg/mL. In the BF model after 3 days, the colony counting of bacteria of 1/2MIC Coptis decoction, 1/4MIC Coptis decoction, 1/8MIC Coptis decoction,1/16MIC Coptis decoction, 1/2MIC Oxacillin sodium,1/4MIC Oxacillin sodium were(39.333 3+3.994 2)×10⁶(52.366 7+3.537 8),CFU/mL×10⁶, CFU/mL×10⁶(81.266 7+3.341 8), CFU/mL(90.900 0+2.040 1)×10⁶,CFU/mL(50.866 7+2.208 6)×10⁶, CFU/mL(77.666 7+2.880 7)×10⁶ CFU/mL, colony counting of blank group was(92.033 3+3.890 6)×10⁶ CFU/mL, respectively. Compared with the blank group, 1/2MIC Coptis decoction, 1/4MIC Coptis decoction,1/8MIC Coptis decoction,1/2MIC Oxacillin sodium,1/4MIC Oxacillin sodium all had differences in statistical significantce(P=0.001), but 1/16MIC Coptis decoction had no statistically significant(P=0.173). In the BF model after 7 days, colony counting bacteria, crystal violet and silver staining showed similar results. Further studies showed that under the effect of 1/16MIC Coptis decoction, the minimum inhibitory concentration of oxacillin sodium was 0.25 μg/mL. Conclusion Coptis decoction could inhibit the formation of Staphylococcus aureus biofilm, and oxacillin sodium combined with Coptidis decoction was effective to improve the curative effect of oxacillin sodium, providing new treatment for peritoneal dialysis related peritonitis that is caused by Staphylococcus aureus improving the efficacy of antibiotics, and providing help for the clinical on reducing the generation of antibiotic resistant bacteria.

目的 初步研究木棉花水提取物抗炎镇痛作用。方法 采用二甲苯和醋酸作为致炎和致痛因子,通过小鼠耳廓肿胀实验、腹腔毛细血管通透性实验与扭体实验,考察灌胃高、中、低剂量的木棉花水提取物的抗炎、镇痛作用。结果 小鼠对于木棉花水提取物的最大耐受量为300 g/kg;木棉花水提取物高剂量(150 g/kg)和中剂量(100 g/kg)均能抑制小鼠耳廓肿胀,降低小鼠腹腔血管通透性;木棉花水提取液各剂量组均能有效地减少小鼠的扭体次数,且作用随剂量增加而增强。结论 木棉花水提取物具有抗炎镇痛作用。

Objective To study the anti-inflammatory and analgesic effect of water extract of Bombax malabaricum DC. Flower. Methods The xylene and acetic acid were used as inflammation and pain factors. The auricle swelling test,intraperitoneal capillary permeability test and writhing experiment were performed to study the anti-inflammatory and analgesic effect with high,medium and low dose of water extract of Bombax malabaricum DC. Flower. Results The maximum tolerated dose of mice for Bombax malabaricum DC. Flower was 300 g/kg. High dose (150 g/kg) and medium dose (100 g/kg) of water extract of Bombax malabaricum DC. Flower could both inhibit mouse auricle swelling and reduce mouse peritoneal vascular permeability. All dosages of the water extract of Bombax malabaricum DC. Flower were effective in reducing the number of writhing in mice,and the effect is strengthened with the increase of dosage. Conclusion Water extract of Bombax malabaricum DC. Flower has anti-inflammatory and analgesic effects.

目的 观察控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响。方法 将我院2016年3月—2017年2月治疗的94例重型颅脑损伤患者作为研究对象,入选者均依据随机数表法分为两组,各47例。对照组实施大骨瓣减压术,观察组实施控制性减压术。观察手术前后两组神经功能、颅内压及预后等。结果 术前2组神经行为认知状态检查表(NCSE)评分、颅内压对比,差异无统计学意义(P＞0.05);术后观察组NCSE评分高于对照组,颅内压低于对照组,差异有统计学意义(P＜0.05);2组预后等级相比,观察组优于对照组,差异有统计学意义(P＜0.05)。结论 将控制性减压术应用于重型颅脑损伤患者中降颅内压效果良好,可恢复受损神经功能,提升患者康复效果,改善预后。

目的 探讨生脉注射液联合环磷腺苷治疗慢性心力衰竭的临床疗效及对其心功能的影响。方法 选择本院2016年3月—2017年4月收治的90例慢性心力衰竭患者,随机将其分为2组,各45例。对照组采用环磷腺苷静脉滴注治疗,在此基础上观察组加用生脉注射液治疗,比较两组临床疗效、心功能及药物不良反应。结果 2个疗程后,观察组总有效率、LVEF、CI及CO水平均较对照组高,差异有统计学意义(P＜0.05);两组治疗期间药物不良反应率相比,差异无统计学意义(P＞0.05)。结论 生脉注射液联合环磷腺苷可提高慢性心力衰竭临床疗效,改善心功能,且用药安全性较高。

目的 探讨布地奈德联合特布他林对中度哮喘患儿血清变态反应及Th相关指标的影响。方法 选择本院2016年3月—2017年4月收治的中度哮喘患儿100例,将其随机分为2组,各50例。对照组采用布地奈德雾化吸入治疗,观察组采用布地奈德联合特布他林雾化吸入治疗,比较两组临床疗效、血清变态反应与Th相关指标、药物不良反应。结果 1周后,观察组治疗总有效率较对照组高,MCP-1、IgE、IL-10及IL-6水平均较对照组低,差异具有统计学意义(P＜0.05);观察组药物不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 布地奈德联合特布他林可提高中度哮喘患儿临床疗效,减轻血清变态反应,改善Th相关指标,且用药安全性较高。

目的 分析睾丸非肿瘤性病变的超声与CT诊断价值。方法 回顾性分析58例经临床病史、超声、CT或病理证实的睾丸非肿瘤性病例,结合临床病史,分析其超声与CT表现,包括炎性(或感染性)病变、外伤性病变、先天性病变及扭转急症。结果 所有病例均行CT检查,睾丸炎症性病变共39例(包括一般性炎症,脓肿和结核),其中19例行超声检查;睾丸外伤8例,隐睾9例,睾丸扭转2例,均行超声检查。睾丸炎症性病变临床表现为患侧或双侧阴囊不同程度的红、肿、痛,或白细胞升高、其他脏器伴发结核,超声表现为睾丸体积不同程度增大,根据炎症坏死程度不同,回声表现为回声均质、回声减低、回声不均质,坏死灶内无血流信号;CT表现为睾丸体积增大,根据炎症性病变的不同可表现为睾丸轻度强化、环形强化,可伴有睾丸鞘膜积液、点状钙化或积气;睾丸外伤均有阴囊外伤史,根据受伤程度表现为白膜下血肿、实质出血、睾丸破裂;隐睾表现为睾丸位置异常或缺如;睾丸扭转表现为睾丸短时间内剧烈疼痛,并进行性加重,超声表现为“镯环征”,CT表现为精索扭转、水肿,睾丸实质水肿。结论 睾丸非肿瘤性病变超声与CT征象均具有特征性,结合患者病史可作出准确诊断。超声检查较为便捷,CT检查可免除受检者接触性疼痛、可对盆腔及腹腔进行更为全面的观察。

Objective: Discussion on diagnosis of testicular non-tumorous lesions by ultrasound and CT.Methods: Rretrospective analysis of 58 testicular non-tumor cases proved by clinical history, Ultrasound, CT or pathologically,combined with the clinical history, and analysis of the Ultrasound and CT features,including inflammatory or infectious disease, traumatic disease, congenital disease and acute torsion.Results: All cases were examined by CT,the testicular inflammatory lesions were 39 cases, 19 of them were examined by ultrasound; testicular trauma 8 cases,cryptorchidism 9 cases, testicular torsion in 2 cases, all of them were examined by ultrasound. The clinical symptom of the inflammatory lesions of the ipsilateral or bilateral scrotum with different degrees of red, swollen, painful, or leukocytosis, other organs associated with TB, Ultrasound showed the testicular volume increased to varying degrees,according to the degree of inflammation and necrosis, the echo showed homogeneous echo, echo reduction, echo heterogeneity, and no blood flow signal in the necrotic area.CT showed an increase in testicular volume, according to the different inflammatory lesions showed mild enhancement of testis, ring enhancement, with a hydrocele, calcification or gas; testicular trauma had scrotal trauma history, according to the severity of injury showed subcapsular hematoma, hemorrhage and rupture of testis; testicular cryptorchidism showed abnormal position or absent; testicular torsion showed testicular short time severe pain, and progressive, Ultrasound showed “bracelet ring sign”, CT showed testicular torsion, edema, testicular parenchyma edema.Conclusion: Ultrasound and CT features of testicular non-tumorous lesions are characteristic, and the accurate diagnosis can be made with the combination of the patient's clinical history. Ultrasound examination is more convenient, CT examination can relieve the patient's contact pain, can be more comprehensive observation of the pelvic and abdominal.

目的 在糖尿病尿失禁女性患者中使用盆底肌功能训练手册,了解该手册对改善糖尿病女性尿失禁的作用。方法 将260例糖尿病尿失禁患者随机分为观察组、对照组,2组均进行常规盆底肌功能训练,每月提醒患者坚持训练,观察组在此基础上发放盆底肌功能训练手册,指导患者及家属填写方法, 每月检查填写记录情况;在治疗前、后评价2组患者尿失禁改善、观察心理健康改善情况。结果 观察组患者在干预后尿失禁改善、心理健康改善优于对照组。盆底肌功能训练手册准确真实反映患者治疗的落实情况,可督促患者落实治疗,从而提高治疗效果,提高患者生活质量。结论 盆底肌功能训练手册对糖尿病尿失禁患者实用性高,尤其对于记忆力下降的糖尿病患者实用性高。

目的 观察脑血管球囊成形支架置入术治疗急性脑梗死的疗效。方法 选取我院和珠江医院2015年1月—2017年7月收治的急性脑梗死患者40例,根据随机数表法分为观察组及对照组,各20例。对照组单纯施以药物治疗,观察组在对照组基础上加以脑血管球囊成形支架置入术治疗,对比两组治疗前后凝血功能指标水平变化情况及疗效。结果 治疗后,观察组APTT、PT、TT、INR水平高于对照组,Fbg水平低于对照组,治疗总有效率高于对照组,差异有统计学意义(P＜0.05)。结论 脑血管球囊成形支架置入术治疗急性脑梗死疗效确切,患者临床症状得到更好更快的改善,可改善患者凝血功能,对急性脑梗死的早期救治有着极为重要的应用价值。

目的 探讨载脂蛋白E基因多态性在COPD患者合并AD中的意义。方法 通过病例资料进行回顾性研究,收集慢性阻塞性肺疾病70例,阿尔茨海默病81例,健康对照人群566例,进行统计分析。结果 “AD组”和“COPD合并AD组”的LDL水平高于“COPD未合并AD组”;“COPD组”的ApoE水平高于“AD组”,且在“COPD组”中,未合并AD者的ApoE水平明显高于合并AD者;“COPD组”的ε3/ε4基因型均少于“AD组”,且“COPD未合并AD组”的ε3/ε4基因型明显少于“COPD合并AD组”;“AD组”及“COPD合并AD组”的ε4等位基因频率多于“COPD组”及“COPD未合并AD组”;“COPD合并AD组”的ε3/ε3基因型少于“健康对照组”,而ε2/ε4基因型则多于“健康对照组”;“COPD组”的ε3/ε4基因型多于“健康体检组”;“COPD合并AD组”的ε3/ε4基因型多于“健康体检组”;“COPD合并AD组”的ε4等位基因频率高于“健康对照组”。结论 ApoE基因多态性不但参与COPD患者认知功能受损甚至合并AD,而且可能通过影响脂质代谢,参与COPD的发生发展;ApoE的ε4等位基因可能是COPD和AD患病的共同危险因素。

目的 分析与比较不同血运重建策略对急性心肌梗死合并多支血管病变患者的疗效,以探讨其临床价值。方法 选取本院在2012年8月—2015年8月期间收治的急性心肌梗死合并多支血管病变患者,对每个患者均成功行PCI后,按随机数字表法分为实验组与对照组,实验组于发病后7～10天行预防性急诊PCI,并对非梗死相关血管病变进行干预;对照组则根据患者的缺血情况对非梗死相关血管病变行急诊PCI。随访2年,并记录2组患者主要心脏不良事件、其它心血管事件以及再次急诊PCI情况。结果 共有450例患者完成2年的随访,实验组患者有226例,对照组患者有224例。2组患者的全因病死率(χ²=7.040,P=0.008)、心脏不良事件(P均>0.05)以及心力衰竭发生率(χ²=1. 527,P=0.217)均无统计学差异。与对照组相比,实验组再发心绞痛(χ²=21.092,P<0.001)、心因性再住院(χ²=22.893,P<0.001)和再次支架治疗(χ²=17.835,P<0.001)的发生率均明显较低,而其相关血管血运重建率较高。且实验组随访2年时,β受体阻滞剂(χ²=7.040,P=0.008)和硝酸酯类药物(χ²=63.889,P<0.001)服用率均明显较高。结论 急性心肌梗死合并多支血管病变患者在成功行急诊干预梗死相关血管后,且预防性干预非梗死相关血管,可使再发心绞痛、再次支架治疗以及心因性再住院的发生率显著降低。

Objective By analyzing and comparing the effects of different revascularization strategies on patients with acute myocardial infarction complicated with multi-vessel disease, to explore its clinical value.Methods Selecting the patients with acute myocardial infarction complicated with multi-vessel disease from August, 2012 to August, 2015 in our hospital (Zhaoqing No.2 People's Hospital), after each patient was successfully treated with PCI, divided them into experimental group and control group by random number table method, the experimental groups were treated with preventive emergency PCI after the onset 7-10 days, and the intervention of non-infarct-related vascular diseases were done;the control groups were treated with emergency PCI for the non-infarct-related vascular diseases according to the patient's lack of blood. Visiting them randomly for 2 years, the main cardiac adverse events, other cardiovascular events and one more emergency PCI situation in the two groups were recorded.Results A total of 450 patients completed two years of follow-up, with 226 patients in the experimental group and 224 patients in the control group. All-cause mortality (χ2=7.040,P=0.008), cardiac adverse events (P> 0.05)and incidence of heart failure (χ2=1. 527,P=0.217) were no statistically significant difference between the two groups. Compared with the control group, the incidence of angina pectoris (χ2=21.092,P<0.001), cardiologic rehospitalization (χ2=22.893,P<0.001)and one more stent treatment (χ2=17.835,P<0.001) of the experimental group was significantly lower, but the revascularization rate was higher of their related blood vessels. And when the experimental group was followed up for 2 years, the taking rate of β-blockers (χ2=7.040,P=0.008) and nitrates (χ2=63.889,P<0.001) was significantly higher.Conclusion After the patients with acute myocardial infarction complicated with multi-vessel disease were successfully treated with emergency PCI to intervene the infarct-related blood vessels, and at the same time the intervention of the non-infarct-related blood vessels were done, the recurrence of angina pectoris, stent treatment and cardiopulmonary rehospitalization was significantly reduced.