目的 分析不同性别学龄儿童行为问题影响因素,为促进儿童行为健康发展提供指导依据。方法 以儿童保健门诊就诊的学龄儿童200名,男童110例,女童90例,平均年龄为(7±15)a 为调查对象,采用儿童行为量表(CBCL)检测所有调查对象的行为问题。由男/女童父母在专业人员指导下进行问卷调查,对收集的数据使用SPSS 11.0统计软件进行资料分析。结果 本次调查中男、女童年龄差异无统计学意义,男、女童在检出儿童行为问题方面有明显的差异性(P<0.05,P<0.01)具有统计学意义。男童在强迫性、违纪方面明显高于女童,女童在抑郁、社交退缩、体诉方面高于男童。结论 儿童行为问题的发生,受多方面因素影响包括社会环境、家庭环境以及父母的教养方式,应根据男童和女童的不同行为特点,给予有效的干预让孩子的身心发展更趋稳定和健康,从而降低儿童行为问题的发生。

Objective To explore the influence factors of children's behavior problem in school-age children, and to provide the evidence for promoting healthier children's behavior. Methods The objects of our study included 200 school-aged children in health care clinic (110 boys and 90 girls ), the average age is 7(7±15)years, and we used the CBCL questionnaire to assess all the children's behavior problems. The CBCL questionnaire was finished by the parents of the children guided by the specialized investigator. The data was analyzed by the SPSS 11.0 software. Results The score of boys in compulsivity and disobey is significant higher than girls(P<0.05), and the girls have higher score in depression, social flinch and physical demands than boys(P<0.01). There is no significant difference between different genders in the age of the children. Conclusion Behavior problems of children were affected by many kinds of factors including social environment, family environment and parenting styles. We need to conduct appropriate behavior intervention according to the different behavior characteristics between boys and girls, to promote healthier children's behavior and to reduce the behavior problems of children.

目的 探讨不同剂量右美托咪定(Dex)对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性。方法 腰硬联合麻醉下行俯卧位经皮肾镜碎石术患者80例,随机分成4组。D1组、D2组、D3组俯卧位后静脉泵注负荷剂量DEX 0.5 μg/kg,输注的时间为10min,随后分别静脉泵注DEX 0.3 μg/(kg·h)、0.5 μg/(kg·h)、 0.7 μg/(kg·h)至术毕;C组俯卧位后静脉泵注生理盐水10 mL/h至术毕。记录T0～T6共7个时点的HR、MAP、p(O₂)和BIS值;在T0、T3～T6等时点对患者静息Ramesay镇静评分;观察患者不良反应发生情况;询问综合满意度。结果 D2组和D3组的HR、MAP、BIS、Ramesay镇静评分在T3~T6等时点明显慢于C组(P＜0.05);D3组心动过缓和头晕等不良反应的发生率明显高于D1组、D2组和C组(P＜0.05),D2组和D3组术中躁动的发生率明显低于D1组和C组(P＜0.05),D1组、D2组和D3组高血压、寒战和恶心呕吐的发生率明显低于C组(P＜0.05),且综合满意度明显高于C组。结论 DEX本药物用于该类手术的镇静疗效及安全性均优于对比的药物。建议临床使用剂量为DEX负荷剂量0.5 μg/kg,随后以0.5 μg/(kg·h)维持。

目的 分析并探讨应用通窍活血汤配合舒血宁注射液在治疗糖尿病视网膜病变(单纯型)中的临床效果。方法 80例患者(80只眼)按照随机的方式将其列入对照组(40只眼)和治疗组(40只眼)两组,对照组给以调节血糖、饮食控制、运动疗法等常规治疗控制血糖稳定并口服通窍活血汤,治疗组在对照组的基础上,口服通窍活血汤再配合舒血宁注射液离子导入,所有患者均由同一位眼科专科医生分别在治疗前后对所选患者行眼压、视力、眼底镜检查,同时观察其治疗前后血液流变学、血脂变化情况,观察治疗效果。结果 治疗前后血糖、糖化血红蛋白改变无差异,治疗组视力、眼底均较对照组明显改善(P＜0.01),血液流变学,血及血脂各指标的改善较对照组比较有统计学意义(P＜0.01)。结论 通窍活血汤配合舒血宁注射液在单纯型糖尿病视网膜病变中的治疗效果显著,可有明显改善患者的血脂及血液流变学,安全可靠,适合临床长期推广应用,具有较高的社会效益和经济效益,值得临床推广应用。

目的 探讨闭角型青光眼合并白内障采取三联手术治疗的效果。方法 随机抽取我院2013年2月—2015年12月接诊的三联手术治疗的闭角型青光眼合并白内障患者40例(41眼)与同期小梁术后再行超声乳化白内障摘除+人工晶体植入术的闭角型青光眼合并白内障患者40例(41眼)进行回顾性分析,其中前者作为研究组,后者为对照组,均随访半年以上,观察记录两组患者术前与术后最佳矫正视力、术后1周与3个月眼压、术前与术后前房变化、术后滤过泡及并发症情况,并对比分析。结果 两组术前最佳矫正视力比较无明显差异(P>0.05),术后两组均有明显升高(P<0.05),且研究组稍高于对照组(P>0.05);两组术后1周眼压比较无明显差异(P>0.05),术后3个月研究组明显下降(P<0.05),且低于对照组(P<0.05);两组术前前房深度比较无明显差异(P>0.05),术后研究组明显高于对照组(P<0.05);研究组术后功能性滤过泡率稍高于对照组(P>0.05);组间并发症发生率比较无统计学意义(P>0.05)。结论 三联手术治疗闭角型青光眼合并白内障安全性高,可更好地改善视力与眼压,是临床上治疗青光眼合并白内障可靠方法。

目的 了解本地区住院疾病谱的特征,为疾病防治工作及合理配置医疗资源提供参考依据。方法 收集2014年佛山市主要二级以上医院的病案首页资料,根据ICD-10进行分类统计。结果 前五位疾病类型为:肿瘤、循环系统疾病、损伤和中毒、妊娠分娩和产褥期、消化系统疾病,与全国城市医院住院疾病谱不同。结论 佛山市的疾病控制重点有其特点,医院的发展和配置应围绕这些相关学科作为重点。

Objective To investigate the characteristics of the spectrum of diseases of inpatients in the region,which is aimed to provide reference for disease control and allocating medical resources reasonably. Methods Collecting the medical record front pages of inpatients of most secondary or above hospitals in Foshan city in 2014. The diseases identities of the included cases were counted according to ICD-10. Results The top five diseases spectrum were tumor, diseases of the circulatory system, injury, poisoning and certain other consequences of external causes, pregnancy, childbirth and the puerperium, diseases of the digestive system,which was different from that of the urban hospitals of the whole country. Conclusion There is a characteristic about the key emphasis in disease control in Foshan city. We should focus on these related subjects for the hospital development and configuration.

目的 探讨两种不同手法复位治疗向地性眼震水平半规管良性阵发性位置性眩晕的临床效果。方法 选取水平半规管良性阵发性位置性眩晕患者50例,分组进行不同手法复位治疗,短期治疗效果不佳者结合强迫长时间健侧卧位法治疗。结果 初次治疗360-Barbecue复位法组治愈率80%,Gufoni复位法组患者治愈率72%;两组患者结合强迫长时间健侧卧位法,第二天复查治愈率分别为92%和88%,两组比较差异无统计学意义(P>0.05)。结论 两种手法复位均能有效治疗向地性眼震水平半规管良性阵发性位置性眩晕,近期疗效相近,对于无效者结合FPP可增加治愈率。

Objective To study the effects of two different manual reduction of geotropic nystagmus horizontal semicircular canal benign paroxysmal positional vertigo. Methods 50 cases of patients with two different groups, treated with different manual reduction. Patients with short term treatment but ineffective were treated in combination with forced prolonged lateral position FPP. Results The cure rate of initial treatment in the 360-Barbecue manual reduction groups was 80%, the Gufoni manual reduction groups was 72%. As the patients combined with FPP, the cure rate was 92% and 88% respectively in the second day treatment. There was no significant difference between the two groups(P>0.05). Conclusion Both of the different manual reduction may effectively treat HC-BPPV. Their recent curative effect is similar. For ineffective cases may increase the cure rate combined with FPP.

目的 对信息协作平台的社区结直肠癌三级防治及干预体系进行探索与实践。方法 对纳入本次研究的2 492名社区人群进行问卷调查,包括健康人群1 118人,1 374例肿瘤患者。分析健康人群和肿瘤患者关于肿瘤防治知识及途径的认知情况,比较健康人群和肿瘤患者就诊首选医院,了解肿瘤患者就诊流向和行为以及发现患癌的途径。结果 在肿瘤患者中知道癌前病变、早期肿瘤症状、高危人群的比例显著高于健康人群[26.93%(370/1 374)、39.96%(549/1 374)、46.00%(632/1 374)比14.49%(162/1 118)、21.91%(245/1 118)、26.92%(301/1 118)]。健康人群认为肿瘤三级防治网络可行、会参加三级防治网、有必要开展癌症筛查、会参加筛查的比率显著高于肿瘤患者[98.83%(1 105/1 118)、91.95%(1 028/1 118)、98.12%(1 097/1 118)、98.03%(1 096/1 118)比81.95%(1 126/1 374)、79.98%(1 099/1 374)、80.93%(1 112/1 374)、85.95%(1 181/1 374)],差异均有统计学意义(P<0.05)。健康人群把三甲医院视为就诊首选医院的比率显著低于肿瘤患者[32.56%(364/1 118)比86.97%(1 195/1 374)](P<0.05)。肿瘤患者中发现肿瘤及确诊医院、肿瘤复诊、康复医院的选取主要以三甲综合医院为主。在肿瘤患者中因身体不适到医院就诊发现患癌的比率显著高于单位员工体检、自检发现、社区卫生服务中心体检发现的比率。结论 我国目前肿瘤发病率和死亡率正处在快速上升的阶段,利用网络优势,加大肿瘤防治知识的宣传力度,建立社区、区域二级医院、三级医院优势互补的三级肿瘤防控体系,是当前我国肿瘤防治的迫切需求。

Objective To explore and practice the community tertiary prevention and intervention system for colorectal cancer based on information collaboration platform. Methods A questionnaire survey was conducted among 2 492 community residents which were included in this study, including the healthy crowd of 1 118 people, 1 374 cases of tumor patients. The study was to analyze the knowledge of cancer prevention and treatment in healthy people and cancer patients, to contrast the preferred hospital by healthy people and cancer patients, to acquaint the flow direction in seeking medical service, behavior and way to diagnosis cancer of tumor patients. Results In patients with cancer, the understanding proportion of patients with precancerous lesions, early tumor symptoms, and high risk groups was significantly higher than that in healthy people [26.93% (370/1 374), 39.96% (549/1 374), 46.00% (632/1 374) vs 14.49% (162/1 118), 21.91% (245/1 118), 26.92% (301/1 118)]. In healthy people, the proportion of identification of tumor three-grade prevention and control network, willing to participate in the tertiary prevention and control network, necessity to carry out cancer screening, willing to participate in screening was significantly higher than that in patients with cancer [98.83% (1 105/1 118), 91.95% (1 028/1 118), 98.12% (1 097/1 118), 98.03% (1 096/1 118) vs 81.95% (1 126/1 374), 79.98% (1 099/1 374) and 80.93% (1 112/1 374), 85.95% (1 181/1 374)]. There were significantly differences (P<0.05). Healthy people preferred to choose common hospital instead of 3A hospital as the first choice [32.56% (364/1 118) vs 86.97% (1 195/1 374)] (P<0.05). Discovery and diagnosis of cancer, further consultation, and rehabilitation were mainly carried out in 3A hospital. In patients with cancer, the cancer discovery ratio because of physical discomfort for medical attention was significantly higher than that in unit staff physical examination, self-inspection found, and physical examination in community health service center. Conclusion At present, the incidence and mortality of cancer in our country is in a stage of rapid rising. It's an urgent need for cancer prevention and control in China that making use of the advantage of network to improve the propaganda of the knowledge of cancer prevention and control, and establishing complementary advantages of the tertiary cancer prevention and control system by community, regional hospitals, and 3A hospitals.

目的 探讨含双歧杆菌乳杆菌三联活菌新四联疗法对消化性溃疡患者幽门螺杆菌(Helicobacter pylori, Hp)根除治疗中的疗效。方法 将342例Hp阳性的消化性溃疡患者随机分为三个治疗组:A组(三联疗法)、B组(含铋剂四联疗法)及C组(含益生菌四联疗法),疗程均2周。疗程结束4周后复查¹³C-尿素呼气试验评估根除疗效。治疗期间记录患者不良反应发生情况。结果 300例(87.72%)患者按方案完成治疗,A、B及C组治疗完成率分别为85.71%(96/112)、82.50%(99/120)和95.45%(105/110),C组显著高于A及B组(P＜0.05)。在胃溃疡Hp根除率比较中,按意愿(方案)分析,A、B及C组疗法的Hp根除率分别为64.71%(75.86%)、71.43%(85.71%)及84.38%(87.10%),各组间差异无统计学意义(P均>0.05)。在十二指肠球部溃疡Hp根除率比较中,按意愿(ITT)分析,C组(85.90%)明显高于A组(62.82%)及B组(71.79%),差异有统计学意义(χ²=10.893,P=0.001;χ²=4.650,P=0.031);按方案(PP)分析,B组(87.50%)与C组(90.54%)明显高于A组(73.13%),差异有统计学意义(χ²=4.246,P=0.039;χ²=7.304,P=0.007),但B组与C组之间差异无统计学意义(P<0.05)。胃肠道不良反应中,便秘、味觉异常及腹胀的发生率,含益生菌疗法组明显少于另两组,差异有统计学意义(P均<0.05)。结论 含双歧杆菌乳杆菌三联活菌新四联疗法能够显著降低传统三联及四联根除疗法的胃肠道不良反应,提高患者依从性,从而提高消化性溃疡患者Hp的根除率。

Objective To investigate the efficacy of quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria on eradication of Helicobater pylori (Hp) among the patients with peptic ulcer. Methods 342 Hp-infected peptic ulcer patients were randomly divided into three groups:A, B and C. The patients in group A were treated with standard triple therapy. The patients in group B and group C were treated with Colloidal Bismuth Subcitrate and Bifidobacterium and Lactobacillus combined with standard triple therapy, respectively. All patients in three groups were treated for 14 days. In the 4th week after end of treatment, Hp eradication was assessed by ¹³C-urea breath test. Adverse effects during the course of treatment were recorded. Results A total of 300(87.72%) patients completed the treatment. The completion rates in group A, B and C were 85.71%(96/112), 82.50%(99/120) and 95.45%(105/110) respectively, and the completion rate in group C were significantly higher than that in group A and group B(P<0.05). With intention to treat and per-protocol analysis in gastric ulcer, the eradication rates of group A, B and C were 64.71%(75.86%), 71.43%(85.71%)and 84.38%(87.10%) respectively, but there were not significant difference in the three groups(P>0.05). With intention to treat analysis in duodenal ulcer, the Hp eradication rate in group C was 85.90%, which was significantly higher than that in group A (62.82%;χ²=10.893,P=0.001) and in group B (71.79%;χ²=4.650,P=0.031). With per-protocol analysis in duodenal ulcer, the Hp eradication rate was 90.54% in group C and 87.50% in group B. No Obviously difference was found between group B and group C (P<0.05), but both were higher than that in group A(73.13%) (χ²=4.246,P=0.039;χ²=7.304,P=0.007). The incidence of adverse reactions including constipation, taste distortion and bloating in group C were significantly lower than those in the other two groups (P<0.05). Conclusion The quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria can obviously enhance the patient's compliance and decrease the adverse reactions, thereby may increase the Hp eradication rate among the patients with peptic ulcer.

目的 探讨七氟烷复合静脉诱导在脑动脉瘤栓塞术中的临床效果。方法 分析2013年1月—2015年12月在我院接受脑动脉瘤栓塞术80例患者的临床资料,根据随机数字表法分为研究组(n=40)和对照组(n=40),对照组采用全凭静脉诱导插管方法,研究组采用七氟烷复合静脉诱导插管方法,比较两组患者的应用效果。结果 两组患者血流动力学、血浆E及NE、呛咳反应发生率、阿托品及血管活性药物使用率比较,研究组均明显优于对照组(P＜0.05)。结论 七氟烷复合静脉诱导用于脑动脉瘤栓塞术对患者血流动力学和应激反应的影响较小,具有较高的安全性和可靠性,可应用于临床。

Objective To explore the clinical effect of sevoflurane combined with intravenous induction in the treatment of cerebral aneurysm embolization. Methods The clinical data of 80 patients with cerebral aneurysm embolization in our hospital from January 2013 to December 2015 were analyzed and divided into study group (n=40) and control group (n=40) according to the random number table. The control group was treated by intratracheal intubation with total intravenous induction. In the study group, sevoflurane combined intravenous induction with intratracheal intubation was used to compare the effect of the two groups. Results Compared with the control group, the hemodynamics, the plasma E and NE, the incidence of cough reaction, atropine and vasoactive drug use were significantly better than those in the control group (P<0.05). Conclusion Sevoflurane combined with intravenous induction for cerebral aneurysm embolization in patients with less impact on hemodynamics and stress response, with high safety and reliability, can be used clinically.

目的 研究不同剂量重组人干扰素α1b雾化吸入治疗毛细支气管炎的疗效及安全性。方法 选取2016年1月—2016年9月期间我院儿科收治的年龄≤2 a的毛细支气管炎患儿86例,均符合毛细支气管炎诊断标准,随机分为观察一组(29例)、观察二组(29例)和对照组(28例)。所有患儿均给予综合常规治疗,观察一组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+1 μg/(kg·次)重组人干扰素α1b,观察二组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+2 μg/(kg·次)重组人干扰素α1b。比较三组患儿治疗有效率、临床症状改善和不良反应发生情况。结果 观察一组与观察二组在治愈率和总有效率两个方面均显著高于对照组(P<0.05),但观察一组与观察二组治愈率和总有效率比较差异不显著(P>0.05);观察一组和观察二组患儿临床症状和体征持续时间明显少于对照组(P<0.05),但观察一组和观察二组患儿临床症状和体征持续时间无显著差异(P>0.05);三组患儿不良反应发生率差异不显著(P>0.05)。结论 低剂量与高剂量雾化吸入重组干扰素α1b对于小儿毛细支气管炎临床疗效接近,且均无严重不良反应,综合经济效益和社会效益考虑,在临床上推广低剂量雾化吸入重组干扰素α1b治疗小儿毛细支气管炎更具价值。

Objective To study the effects of different doses of recombinant human interferon α1b inhalation efficacy and safety in the treatment of bronchiolitis. Methods 86 cases of children, who were less than 2 years old were selected in department of pediatrics from January 2016 to September 2016. They were randomly divided into for observation group Ⅰ (29 cases), observation group Ⅱ(29 cases) and control group (28 cases). All the patients were treated with conventional therapy. Group Ⅰ with atomization inhalation of salbutamol and 0.02% with saline+1 μg /kg times of recombinant human interferon α1b were observed and the same as in the two groups Ⅱ with atomization inhalation of salbutamol and 0.02% with saline+2 μg /kg recombinant human interferon α1b. The treatment efficiency, the improvement of clinical symptoms and adverse reactions were compared. Results The cure rate and total effective rate of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the cure rate and total effective rate between observation group Ⅰand Ⅱ(P>0.05). The clinical symptoms and signs of the patients of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the clinical symptoms and signs of the patients between observation group Ⅰand Ⅱ(P>0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P>0.05). Conclusion There were no serious adverse reactions in low dose and high dose of atomization inhalation of recombinant interferon α1b for close to the clinical curative effect of children with bronchiolitis. Considering comprehensively economic benefits and social benefits, it is worth of promotion low dose of atomization inhalation of recombinant interferon 1b in the treatment of children with bronchiolitis.