目的 研究结肠黑变病(melanosis coli,MC)对结肠息肉的影响。方法 从2014年1月—2017年1月在石河子大学医学院第一附属医院行电子结肠镜的21 708例患者中选取符合条件的522例结肠黑变病患者组成MC组,随机选取569例患者组成非MC组,分析比较2组的一般情况及与结肠息肉的关系,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 结肠黑变病组年龄中位数为64岁(51～73岁),非结肠黑变病组年龄中位数为54岁(47～64岁),2组性别无统计学差异;MC组、非MC组结肠息肉检出率分别为47.8%和40.2%,P=0.013,差异有统计学意义;在病理类型上2组均为炎性息肉检出率最低,腺瘤性息肉检出率最高分别达 58.0%和51.5%,病理类型无统计学差异;在盲肠及降结肠检出率均很低,多发部位、直肠、乙状结肠检出率相对较高,但差异均无统计学意义;结肠息肉大小集中在0~9 mm范围内,2组所占百分比分别高达92.0%和91.3%,≥20 mm息肉检出率均很低,分别为0.40%,0.44%,息肉大小无统计学差异。结论 MC组息肉检出率高于非MC组,差异有统计学意义;2组结肠息肉病理类型、发病部位、息肉大小差异均无统计学意义。

Objective Studying the effect of melanosis coli (MC) on colonic polyps.Methods This is a reospectively review of patients with electronic colonoscopy in our hospital from January 2014 to January 2017. A total of 522 cases of colorectal melanosis (MC) were composed of MC group, and 569 patients were randomly selected to form a non-mc group. The comparison of basic information between the two groups and the relationship of colon polyp and colon cancer was analyzed.Results The median age of the colon melanosis group was 64 years (51~73 years old), and the median age of the non-colonic melanosis group was 54 years (47 to 64 years old), with no statistically significant differences between the two groups.The detection rate of colon polyps in MC group was 47.8%. The detection rate of colon polyps in non-mc group was 40.2%, P= 0.013, and the difference was statistically significant.The two groups of polyps had the lowest detection rate of inflammatory polyps in pathological types, and the detection rate of adenomatous polyps was up to 58.0% and 51.5% respectively, but there was no statistically significant difference between the two groups. In the cecum, the detection rate of the descending colon was low, and the detection rate of multiple sites, rectum and sigmoid colon was relatively high, but the difference was not statistically significant.The size of colon polyps was concentrated in the range of 0~9 mm, and the percentages of the two groups were as high as 92.0% and 91.3% respectively, while the detection rate of the size being more than 20mm was low, that is 0.40% and 0.44%. But there was no statistical difference between the two groups.Conclusion The detection rate of polyps in MC group was higher than that in non-mc group, and the difference was statistically significant.There was no statistically significant difference between the two groups of colon polyps pathology, pathogenesis, and polyp size.

目的 探讨前列地尔联合依帕司他对糖尿病足患者创面肉芽组织肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白介素-6 (interleukin-6,IL-6)及血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的影响。方法 将90例糖尿病足患者随机分为研究组和对照组,每组45例,对照组予常规治疗,研究组在常规治疗基础上给予前列地尔+依帕司他联合治疗。监测两组患者创面愈合率,患肢足背血流动力学及腓总神经传导速度,创面肉芽组织TNF-α、IL-6、VEGF含量及基因表达变化。结果 治疗后第2、4周研究组较对照组创面愈合率升高,差异有统计学意义(P<0.05);治疗后两组患者足背动脉血流动力学及腓总神经传导速度均有改善,而研究组疗效更明显(P<0.05);治疗后研究组患者创面肉芽组织TNF-α、IL-6含量及基因表达较对照组降低,VEGF含量及基因表达则升高(P<0.05)。结论 前列地尔联合依帕司他联合治疗可改善糖尿病足患者足背动脉血流动力学,促进受损神经功能恢复;降低糖尿病足患者创面肉芽组织TNF-α、IL-6表达,减轻免疫损伤;增加VEGF基因表达,促进血管生成,加速创伤愈合。

Objective To investigate the effects of alprostadil combined with epalrestat on the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in granulation tissue in patients with diabetic foot patients.Methods Totally 90 cases with diabetic foot were randomly divided into study group (45 cases)and control group(45 cases). The control group received conventional treatment for 4 weeks and the study group additionally received combination of alprostadil and epalatone for 4 weeks. The curative rate of wound healing, limb dorsal hemodynamics, peroneal nerve conduction velocity and the levels of TNF-α, IL-6 and VEGF in the granulation tissue of the wound were monitored in the two groups.Results The wound healing rate of the study group was significantly higher than that of the control group at the 2nd and 4th week after treatment (P<0.05). After treatment, the hemodynamics and peroneal nerve conduction velocity were improved (P<0.05). The contents and expressions of TNF-α and IL-6 in the granulation tissue of the treatment group were significantly lower than that of the control group, and the content of VEGF and gene expression were significantly increased in the study group (P<0.05).Conclusion The combination therapy of alprostadil and epalrestat may improve the hemodynamics of dorsalis pedis artery in patients with diabetic foot and promote the recovery of damaged nerve function.Also it may reduce the expression of TNF-α and IL-6 in the granulation tissue of diabetic patients and reduce the immune injury. It promotes angiogenesis and accelerates wound healing by increasing VEGF gene expression.

目的 探讨HHIP基因单核苷酸多态性与新疆蒙古族慢性阻塞性肺疾病易感性之间的关系。方法 以259例蒙古族吸烟慢性阻塞性肺疾病患者为病例组,245例蒙古族吸烟健康体检者为对照组,提取外周血标本 DNA,运用Taqman分型技术检测HHIP基因rs13118928、rs13141461位点多态性。结果 HHIP基因rs13118928、rs13141461位点基因型与等位基因在病例组和对照组之间的频率分布,结果显示差异有统计学意义(P<0.05)。rs13118928位点基因型AG、GG,等位基因G在病例组与对照组分布差异有统计学意义(P<0.001),且OR<1,可能降低发生COPD的风险。rs13141461位点基因型TC在病例组与对照组分布差异无统计学意义(P>0.05),rs13141461位点基因型CC, 等位基因C在病例组与对照组分布差异有统计学意义(P<0.05),且OR>1,可能增加发生慢阻肺的风险。rs13118928、rs13141461位点基因型与肺功能 FEV1%预计值比较差异有统计学意义(P<0.05)。结论 HHIP基rs13118928、rs13141461位点多态性可能与新疆蒙古族人群慢阻肺的发生有关。

Objective To explore the relationship between HHIP gene single nucleotide polymorphism and the susceptibility of Mongolian chronic obstructive pulmonary disease.Methods DNAs were extracted from the peripheral blood of 259 patients with COPD (case group) and 245 healthy controls (control group) from Xinjiang Mongolian population. Polymorphisms of HHIP rs13118928 and rs13141461 were determined by the Taqman PCR method.Results The frequency of HHIP rs13118928 and rs13141461 genotypes and alleles in the case group and the control group showed significant difference (P<0.05). HHIP rs13118928 genotype, AG, GG and allele G were significantly different between case group and control group (P<0.001), and OR<1. It could reduce the risk of COPD. There was no significant difference in HHIP rs13141461 genotype TC between the case group and the control group (P>0.05). HHIP rs13141461 genotype CC and allele C were significantly different between the case group and the control group (P<0.05), and OR>1. It may increase the risk of COPD. The difference of HHIP rs13118928, rs13141461 and FEV1% predicted value was statistically significant(P<0.05).Conclusion The polymorphism of HHIP rs13118928 and rs13141461 may be related to the occurrence of COPD in Xinjiang Mongolian population.

目的 针对剖宫产术后瘢痕子宫妊娠早产进行阴道分娩方法的研究,并比较其可行性与安全性。方法 选择 2015年5月—2017年4月在来我科室采用经阴道分娩法进行分娩的瘢痕子宫妊娠早产(28～37周)患者96例为研究对象,设为观察组。同时按照随机分组法选择同时间段来我院就诊的非瘢痕子宫妊娠早产经阴道分娩的患者96例作为对照组A组,瘢痕子宫妊娠早产行剖宫产分娩的患者96例作为对照组B组。对三组患者的产妇分娩情况和新生儿出生后的情况进行比较分析。结果 观察组与对照组A在产住院天数、产程时间、出血量、新生儿窒息发生等产妇术中情况及新生儿情况的比较没有差异(P＞0. 05) 。观察组与对照组B在产后在住院天数、住院花费、出血量等方面进行比较,两组的差异有统计学意义(P＜0.05)。在发生产褥感染、进行输血的病例数、子宫切除例数、新生儿Apgar评分、新生儿并发症等新生儿情况的比较同样没有统计学差异(P＞0.05)。结论 瘢痕子宫妊娠早产患者采用经阴道分娩法进行分娩产后并发症少、新生儿出生后情况较好、母婴妊娠结局良好,是一种可行性好、安全性高的分娩手段。

目的 了解住院老老年心房颤动(atrial fibrillation,AF)患者的临床特征及抗凝现况。方法 收集2015年6月—2017年9月住院老老年(≥80岁)房颤患者的抗凝用药,合并疾病,合并用药等临床信息,统计并分析,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 621例老老年患者根据性别分为男女两组,男354人,女267人,159例患者(25.6%)使用华法林,33例患者(5.31%)使用达比加群,30例患者(4.83%)使用利伐沙班,抗凝总人数为222例(35.75%)。174例患者(28.02%)使用阿司匹林,27例患者(4.35%)使用氯吡格雷,抗血小板总人数为201例(32.37%)。余198例患者(31.89%)未使用任何抗血小板或抗凝药物。结论 老老年房颤患者目前抗凝率低,抗凝药物以华法林为主。

Objective This study investigated the clinical characteristics and antithrombotic status in elderly patients with atrial fibrillation AF. Methods In this study, we collected, analyzed and characterized the data of the patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results 621 cases of elderly patients were divided into two groups according to their gender between men and women, 159 patients (25.6%) take warfarin, 33 patients (5.31%) with dabigatran, 30 patients (4.83%) uses of rivaroxaban, the total number of anticoagulation is 222 (35.75%),174 patients (28.02%) were treated with aspirin, and 27 patients (4.35%) used clopidogrel, and the total number of antiplatelet agents was 201 (32.37%). 198 patients (31.89%) did not use any antiplatelet or anticoagulant drugs. Conclusion patients with atrial fibrillation anticoagulant rate is low, and the anticoagulant is mainly warfarin.

目的 探讨FORCE CT实时迭代ADMIRE重建技术在肝脏CT扫描中的应用价值。方法 临床疑肝病患者50例,行FORCE CT肝脏平扫后,分别采用FBP重建和ADMIRE-1~5级重建,比较6组图像的平均CT值、噪声、SNR、CNR及图像质量的主观评分及诊断效能等。结果 比较6组图像显示,肝实质平均CT值无统计学差异(P>0.05);噪声、SNR、CNR及主观评分间均有差异(P<0.05),ADMIRE-5重建噪声最小、SNR、CNR最大。图像主观评分ADMIRE-1和ADMIRE-5图像评分低于FBP,ADMIRE-2~4高于FBP,绝对评分最高为ADMIRE-3重建,但六种重建图像对病变诊断效能一致。结论 肝脏CT平扫结合FORCE CT 实时迭代ADMIRE重建技术能有效降低图像噪声及提高图像质量,具有潜在降低扫描剂量的作用。

Objective: To discuss the value of ADMIRE reconstruction technique in the liver plain CT scan by the comparison of displays to the liver separately by ADMIRE and traditional FBP reconstructions after DSCT scan. Methods: 48 patients who were clinically doubted to have hepatic lesions were scanned by DSCT in liver, then six groups of images for FBP and ADMIRE 1-5 on the average CT value, noise, signal to noise ratio ( SNR ), contrast to noise ratio (CNR) and subjective scoring on image quality were compared. Results: 6 groups of images were compared,and the average CT value of liver parenchyma has no statistical differences (P>0.05);The differences were statistically significant (P<0.05)on noise, SNR, CNR and subjective scoring,ADMIRE5 reconstruction has the least noise and the largest SNR and CNR.For the images of ADMIRE1 and ADMIRE5, the image subjective scoring is lower than that by FBP; for the images of ADMIRE2 and ADMIRE4, the image subjective scoring is higher than that by FBP; and ADMIRE-3 has the highest score.But for the rate of lesion detection, all the images were the same. Conclusion: ADMIRE reconstruction strength 3 makes the best image quality.ADMIRE reconstruction can decrease noise and improve SNR and CNR,as well as have a potential effect decreasing the scan dose.

目的 通过比较二胎孕妇和初产孕妇心电图变化探讨其对妊娠结局的影响。方法 随机选取300例孕妇,其中150例二胎孕妇为观察组,150例初产孕妇为对照组。观察2组孕妇异常心电图的类型及发生率,分析异常心电图与妊娠结局的关系。结果 初产孕妇组异常心电图35例,心电图异常发生率为23.3%,二胎孕妇组异常心电图50例,心电图异常发生率为33.3%,两组心电图异常发生率差别有统计学意义(P<0.05)。二胎孕妇组窦性心动过速、室性早搏及ST-T改变的发生率显著高于初产孕妇组,差异有统计学意义(P<0.05)。二胎孕妇心电图异常组的剖宫产率和早产率均高于二胎孕妇心电图正常组、初产孕妇心电图正常组,差别有统计学意义(P>0.05)。结论 二胎孕妇易合并心电图异常改变,心电图异常会增加剖宫产和早产的发生率,临床医生在诊治此类患者时应提高警惕。

Objective To observe the relationship between electrocardiogram(ECG) and pregnancy outcomes of the second pregnant women. Methods Pregnant women were divided into two groups by parity history: the second pregnancy group and the Primipara group. The incidence of abnormal electrocardiogram was recorded, then the pregnancy outcome including the delivery mode and the premature birth rate were followed up. Results The incidence of abnormal ECG in the second pregnancy group was significantly higher than that in primipara group(P<0.05) and the incidences of Nodal tachycardia, Premature ventricular contraction, ST-T changes in the group of the second pregnancy were higher than that in the group of Primipara (P<0.05). The incidence of cesarean delivery and premature birth in the second pregnancy group with abnormal ECG group was significantly higher than that in pregnant women with normal ECG group (P<0.05). Conclusion The second pregnant women are more likely to have ECG abnormality, the pregnant women with abnormal ECG are easily suffer from cesarean delivery and premature birth.

目的 探讨不同分化程度前列腺癌患者的直肠超声图像特征,为前列腺癌分化程度的诊断提供依据。方法 纳入我院收治的前列腺癌患者120例,均接受直肠超声检查,根据Gleason评分评估分化程度分成低分化组(n=41)、中分化组(n=39)与高分化组(n=40)。分析不同分化程度患者的结节大小、血流分级、回声、边界是否清晰以及包膜完整性,并对血流频谱进行观察。结果 低分化组的结节≥10 mm、肿瘤组织周围血流分布Ⅱ~Ⅲ级、边界欠清晰、包膜欠完整、高回声占比高于高分化组,且低分化组结节≥10 mm、肿瘤组织周围血流分布Ⅱ~Ⅲ级、高回声占比高于中分化组,中分化组结节≥10 mm、肿瘤组织周围血流分布Ⅱ~Ⅲ级、高回声占比高于低分化组,差异有统计学意义(P<0.05)。结论 不同分化程度前列腺癌患者的直肠超声表现存在差异,随着分化程度越低,肿瘤边界清晰度、包膜完整性越差,血流越丰富。

目的 观察⁹⁹锝-亚甲基二膦酸盐对前列腺癌骨转移患者骨痛、骨质疏松的治疗效果。方法 对76例前列腺癌骨转移患者给予⁹⁹锝-亚甲基二膦酸盐治疗1年(每疗程15 d,每天静滴22 mg,15 d为一个疗程,共12个疗程),比较治疗前及治疗1年后患者骨密度(BMD)值及血清钙、磷、碱性磷酸酶、骨钙素、I型胶原交联羧基末端肽、1,25二羟维生素D3等指标的变化。结果 云克治疗后腰椎(L1-4)及左股骨颈、大转子及小转子骨密度(BMD)值均较治疗前增加(P＜0.05);云克治疗后AKP、ICTP均较治疗前明显下降(P＜0.01)。OC云克治疗后较治疗前增加(P＜0.05)。血钙、血磷、1,25-二羟维生素D3云克治疗后与云克治疗前相比无明显变化,P<0.05。前列腺癌骨转移轻度骨痛组及中度骨痛组治疗1年后骨痛VAS评分明显降低,差异有统计学意义,P＜0.05。重度骨痛组云克治疗前、治疗后VAS评分比较,差异无统计学意义,P<0.05。结论 ⁹⁹锝-亚甲基二膦酸盐在治疗前列腺癌骨转移的骨痛、骨质疏松方面,具有缓解骨痛,促进骨增殖,抑制骨吸收,提高骨密度,防治骨质疏松的作用。

目的 探讨高血压性脑出血在不同时点给药丹参酮ⅡA磺酸钠的疗效分析及对神经保护作用。方法 选取我院2014年10月—2016年10月期间收治的66例高血压性脑出血患者作为研究对象,按照随机数字表的方法分为观察组(n=33)和对照组(n=33),对照组患者于入院后第10天采用丹参酮ⅡA磺酸钠进行治疗,观察组则于入院后第3天采用丹参酮ⅡA磺酸钠进行治疗,分别对2组患者的临床疗效、不良反应、治疗前后的神经功能以及随访一年的脑卒中影响量表(SIS)进行客观比较。结果 经比较,观察组患者的临床总有效率为90.90%,对照组的临床总有效率为69.70%,2组比较,差异有统计学意义(P<0.05);观察组患者的不良反应稍低于对照组,但2组比较差异无统计学意义(P>0.05);此外,观察组患者治疗后的神经功能评分优于对照组和治疗前,差异有统计学意义(P<0.05);在随访一年的时间里发现,观察组患者的SIS量表亦更优于对照组(P<0.05)。结论 早期采用药丹参酮ⅡA磺酸钠治疗高血压性脑出血的临床疗效显著,不良反应相对较小,且在一定程度上发挥了保护患者神经功能的作用,值得推广。

Objective: To investigate the effect of tanshinone II A sulfonate treatment on hypertensive cerebral hemorrhage at different time and the neuroprotective effect. Methods: In our hospital from October 2014 to October 2016 66 cases of hypertensive cerebral hemorrhage patients were enrolled as the research object, according to the random number table method divided into observation group (n=33) and control group (n=33), patients in the control group on the tenth day after admission of sodium tanshinone A sulfonate treatment, The observation group was treated with tanshinone A sodium sulfonate on the third day after admission. The clinical efficacy, adverse reactions, neurological function before and after treatment, and Stroke Scale (SIS) were compared between the two groups. Results: by comparison, the observation group of patients with clinical total efficiency 90.90%, clinical control group in the total efficiency 69.70%, compared with significant difference (P<0.05); to observe the adverse reaction of patients was slightly lower than that of control group, but the difference between the two groups was not statistically significant (P>0.05); in addition, the patients in the observation group the neurological score was significantly better than the control group and before treatment, the difference was significant (P<0.05); Conclusion: the early treatment of sodium tanshinone II A sulfonate in the treatment of hypertensive intracerebral hemorrhage has a significant clinical effect, a relatively small adverse reaction, and to a certain extent, it plays a protective role in patients with neurological function, and is worthy of promotion.