目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

目的 了解非结核分枝杆菌(nontuberculous mycobacteria,NTM)肺病患者免疫功能低下发生率,以及免疫支持的应用状况、探讨免疫支持治疗对患者2月末痰菌阴转及病变吸收的影响,为临床实施免疫干预提供参考依据。方法 分析广州市胸科医院2014年1月—2015年12月确诊的资料完整的381例NTM肺病患者免疫功能情况以及免疫支持的应用状况,观察组(加用免疫调节剂母牛分枝杆菌菌苗)228例与同期对照组(未使用免疫调节剂)153例进行2月末痰菌阴转及病变吸收情况比较。结果 381例患者中,免疫功能低下的发生率为45.67% (174／381);免疫支持率为59.84% (228／381)。细菌学改变:治疗前所有患者痰抗酸杆菌涂片和培养均为阳性。治疗2个月后两组的阴转率分别为67／228(29.38%)、17／153(11.11%),χ²=17.79,P<0.05。 影像学改变:两组的病变吸收有效率分别为62／228(27.19%)、16／153(10.45%),χ²=15.75,P<0.05;空洞吸收有效率分别为61／228(26.75%)、15／153(9.80%),χ² =20.42,P<0.05。结论 非结核分枝杆菌肺病患者存在较高比例的免疫功能低下风险,观察组的痰茵阴转、病灶吸收和空洞闭合的疗效高于对照组。

Objective To explore the immune status of patients with nontuberculous mycobacterial(NTM) pulmonary disease, and the application of immunotherapy. to evaluate the influence of immunotherapy on sputum negative conversion and lesion absorption at the end of two months. provide reference data for immunotherapy. Methods The immune function and immunotherapy of 381 patients diagnosed as NTM pulmonary disease were retrospectively analyzed from January 2014 to December 2015 in Guangzhou Chest Hospital. Curative group (treated with antitubercular agents and immunomodulator mycobacterium vaccae) were compared with control group(treated with antitubercular agents alone) in sputum negative conversion and lesion absorption at the end of two month treatment. Results Of the 381 cases,45.67%(174／381)of the patients were immunocompromised, 59.84% (228／381)received immunotherapy. Bacteriologic changes: Both sputum smear and sputum culture were positive in all patents before treatment. after two months treatment, negative conversion in two groups were 67／228(29.38%),17／153(11.11%),χ²=17.79,P<0.05. 3. Radiological change: The rate of lesion absorption in curative group and control group were respectively 62／228(27.19%),16／153(10.45%),χ²=15.75,P<0.05;The rate of promoting cavity closure were respectively 61／228(26.75%),15／153(9.80%),χ²=20.42,P<0.05. Conclusion The immune function of NTM pulmonary disease had high ratio of being compromised. Curative group showed a significant effect of sputum negative conversion, lesion absorption and promoting cavity closure compared to the control group. Added to chemotherapy, M. vaccae is helpful in the treatment of nevertreated TB patients in terms of improving both Immunotherapy with M. vaccae had a beneficial influence on sputum negative conversion and X-ray appearances.

目的 探索锌剂治疗大鼠慢性细菌性前列腺炎(CBP)的机理及影响。方法 健康成年雄性大鼠100只,随机分为正常对照组(n=20)、CBP模型对照组(n=20)、CBP锌剂治疗组(n=20)、CBP左氧氟沙星治疗组(n=20)及CBP锌剂与左氧氟沙星混合治疗组(n=20)。采用消痔灵及大肠埃希菌制备CBP大鼠模型。CBP锌剂治疗组、CBP左氧氟沙星治疗组及CBP混合治疗组给予相应药物灌胃治疗,正常对照组及CBP模型对照组给予无菌生理盐水灌胃。疗程10 d,分别于2 d、4 d、6 d、8 d、11 d取各组大鼠前列腺,检测细菌数量并分离鉴定细菌性质。于4 d、9 d、14 d、20 d、28 d取各组大鼠前列腺,进行组织病理学检测。结果 CBP各治疗组大鼠前列腺组织的细菌数量与模型对照组相比均明显降低(P﹤0.05)。CBP混合治疗组大鼠前列腺内细菌在治疗8 d后不能检出。4～6 d CBP混合治疗组大鼠前列腺组织的细菌数量与CBP锌剂治疗组相比明显降低(P﹤0.05)。正常对照组大鼠前列腺病理学检查未见明显病理变化;模型对照组大鼠前列腺组织表现为慢性炎症的病理变化;各治疗组大鼠前列腺慢性炎症改变均有不同程度缓解,其中混合治疗组的慢性炎症明显减轻。结论 锌剂具有活化提高前列腺组织细胞抗菌能力的作用,有利于前列腺组织炎性病理损害的缓解以及损伤组织的修复,与敏感抗生素结合治疗CBP具有更显著的治疗效果。

Objective To explore the zinc agent in the treatment of chronic bacterial prostatitis (CBP) rats and the effect. Methods 100 healthy adult male rats, were randomly divided into normal control group (n=20), CBP model group (n=20), CBP zinc treatment group (n=20), CBP levofloxacin treatment group (n=20) and mixed treatment group of CBP zinc and levofloxacin (n=20). Preparation of the CBP rat model was made by Xiaozhiling and E.coli system. CBP zinc treatment group, CBP levofloxacin treatment group and CBP mixed treatment group were given the appropriate drugs for treatment,besides,the normal control group, CBP model control group were given sterile saline. It took 10d. Rats in each group at 2d, 4d, 6d, 8d, 11d were detected, including the number of bacteria and the bacteria isolation and identification properties. The pathological study in 4d, 9d, 14d, 20d, 28d and prostate of rats in each group were detected. Results The prostate tissue of the CBP group rats in the treatment of bacterial number compared with the model control group decreased significantly (P<0.05). CBP mixed treatment of prostate were not detected in bacteria after 8d treatment.4 - 6 days of CBP treatment of prostate tissue in rats of the treatment group compared with the quantity of bacteria and CBP zinc decreased significantly (P<0.05). Normal control group rats pathological prostate pathology examination showed no significant pathological prostate tissue; The model control group rats showed chronic inflammatory pathological changes; The treatment group rat prostate inflammatory changes were alleviated chronic inflammation, which mixed treatment group were significantly reduced. Conclusion Zinc enhances prostate tissue antibacterial ability, is conducive to the inflammation in prostate tissue response and the repair of damaged tissue. Sensitive antibiotics combined with treatment of CBP have a significant therapeutic effect.

目的 分析社区综合干预对小儿反复呼吸道感染的影响,为社区临床治疗小儿反复呼吸道感染性疾病提供理论依据。方法 采用随机抽签方式,从我社区2012年10月—2014年10月期间收治的小儿反复呼吸道感染患儿中,随机抽取60例纳入本项研究,依据就诊单双顺序,分为研究组30例(社区综合干预方式)和对照组30例(常规性治疗和常规措施进行干预),对两组患儿干预结果进行对比分析。结果 研究组治疗总疗效高于对照组(93.33% vs 76.67%),差异有统计学意义(P<0.05)。对比治疗干预过程中疾病发作次数、就诊次数状况,研究组优于对照组,差异有统计学意义(P<0.05)。干预后研究组小儿呼吸道感染致病因素改善情况(除滥用抗生素外)优于对照组,差异有统计学意义(P<0.05)。结论 针对小儿反复呼吸道感染疾病可采用社区综合干预方式,可显著提升治疗有效率,缓解病情,降低反复感染发生率,效果突出,具有广阔应用前景。

目的 对比分析巨幼细胞性贫血和难治性贫血患者骨髓形态的异同及其临床意义。方法 选取我院2010年4月—2016年4月收治的巨幼细胞性贫血(MA)35例,难治性贫血(RA)35例为研究对象。收集两组患者临床检验及检查资料,对比分析其临床表现、骨髓检查结果及血液检查等结果。结果 MA组患者红系病态率、粒系病态率、淋巴样小巨核率及PAS阳性率均明显低于RA组,差异明显(P<0.05);两组患者在发热、出血、消化系反应等临床表现率上相比差异不明显(P>0.05);两组患者血象检查中血红蛋白、血小板、及白细胞含量相似,两组差异不明显(P＞0.05)。结论 巨幼细胞性贫血与难治性贫血临床表现及外周血象相似,RA骨髓形态应重点观察淋巴样小巨核细胞;MA组则应强调红系巨幼变的胞体。

目的 研究鼻内镜下三线减张矫正术治疗鼻中隔偏曲的疗效及安全性。方法 纳入2010年9月—2015年9月我院120例鼻中隔偏曲患者作为研究对象,采用随机数表法分为两组,各60例。观察组行鼻内镜下三线减张鼻中隔偏曲矫正术,对照组行鼻内镜下传统鼻中隔黏膜下切除术。比较两种手术方法对患者鼻塞、头痛、鼻出血等临床症状的改善情况,随访记录两组术后疼痛、鼻阻力及并发症发生情况,评价疗效和安全性。结果 观察组术后鼻塞、头痛及鼻出血症状评分分别为(1.05±0.16)分、(1.3±0.14)分及(1.63±0.14)分,均显著低于对照组和术前水平(P＜0.05)。观察组术后1周、2周及4周各时间点VAS评分和鼻阻力值均显著低于对照组(P＜0.05)。观察组术后鼻中隔血肿和黏膜撕裂发生率均为1.67%,无鼻中隔穿孔和外形改变病例,发生率显著低于对照组,差异有统计学意义(P＜0.05)。结论 鼻内镜下三线减张矫正术能显著改善鼻中隔偏曲患者鼻塞、头痛及鼻出血症状,促进鼻腔通气功能恢复,有效降低术后并发症发生率,安全性高。

目的 探讨慢性阻塞性肺疾病急性期加重期(AECOPD)患者血清降钙素原(PCT)、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平变化及与肺功能的相关性。方法 选择121例COPD急性加重期患者为实验组研究对象,选取同期体检的80例稳定期COPD患者为对照组,比较两组患者血清PCT、IL-6、hs-CRP的差别,并对三者与COPD患者肺功能的相关性进行探讨。结果 实验组患者IL-6、hs-CRP水平显著高于对照组(P＜0.05)。实验组FEV1值、FEV1%显著低于对照组(P＜0.05)。Pearson分析显示,实验组hs-CRP与肺功能指标FEV1%呈负相关关系(r=-1.51,P=0.048)。结论 AECOPD患者的血清炎症因子水平明显高于COPD稳定期患者,血清炎症因子与慢阻肺患者肺功能损伤密切相关。

目的 探讨追踪护理模式对中青年保留神经宫颈癌根治术后膀胱功能恢复的影响效果。方法 按住院先后顺序将82例患者分为对照组40例、实验组42例,对照组给予常规护理,实验组实施追踪护理模式,3个月后对两组患者的尿失禁、尿潴留发生率,膀胱功能恢复情况及尿失禁严重程度进行测评。结果 实验组尿失禁、尿潴留的发生率分别为2%、4% ,膀胱功能Ⅰ级、Ⅱ级达100%,68%患者无尿失禁,与对照组比较差异均有统计学意义(P>0.05)。结论 对中青年保留神经宫颈癌根治术实施追踪护理模式,可提高患者膀胱功能锻炼的有效性,促进膀胱功能的早日恢复,改善其生活质量。

Objective To explore the effect of follow-up nursing on the recovery of bladder function in young and middle-aged patients with cervical cancer after radical operation. Methods 82 patients were divided into control group (n = 40) and experimental group (n=42). The control group was given routine nursing care, experimental group to implement the follow-up nursing model. After 3 months, the incidence of urinary incontinence and urinary retention were observed in the two groups, including bladder function recovery and severity of urinary incontinence. Results The incidence of urinary incontinence and urinary retention in the experimental group were 2% and 4%, respectively. Bladder function level I and II reached 100%. There was no urinary incontinence in 68% patients. Compared with the control group, the difference was statistically significant (P>0.05). Conclusion It may improve the effectiveness of bladder function training, promote the early recovery of bladder function and improve the quality of life of young and middle-aged patients with cervical cancer.

目的 观察尝试采用激素替代疗法(hormonereplace menttherapy,HRT)治疗更年期疾病的干眼症的临床疗效。方法 将80例(160眼)干眼症患者随机分成2组,治疗组40例(80眼)在滴人工泪液的基础上采用激素替代疗法(HRT)口服治疗。对照组40例(80眼)单纯采用人工泪液滴眼液滴双眼。两组同时给予综合护理。3个月后观察疗效。结果 治疗组总有效率82.5%,对照组总有效率60%,两组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论 在人工泪液滴眼液滴双眼的基础上尝试采用激素替代疗法(HRT)治疗更年期疾病的干眼症患者,效果优于单纯应用人工泪液点眼。

Objective To investigate the role of hormone replace menttherapy (HRT) in treating xerophthalmia among patients with climacteric disease. Methods Eighty xerophthalmia patients (160 eyes) were randomly divided into two groups. Forty patients in the treatment group (80 eyes) were treated using combined HRT and artificial drops. Forty patients in the control group (80 eyes) were treated using artificial drops alone. All patients were provided comprehensive nursing. The evaluation of clinical effects was performed after 3 months of treatment. Results The total effective rate of both groups was 82.5% in the treatment group and 60% in the control group, respectively (P<0.05). Conclusion Combined HRT and artificial drops is more effective in treating climacteric disease-related xerophthalmia than using artificial drops only.

目的 探讨康复护理路径早期功能训练对桡骨远端骨折LCP(锁定加压接骨板locking compression plate, LCP)内固定术后患者腕关节功能康复的影响。方法 对2014年5月—2016年6月住院80例桡骨远端骨折LCP 内固定术后患者分为对照组和观察组,每组各40例,对照组按桡骨远端LCP内固定术后护理措施进行护理,观察组患者在此护理基础上,制定术后功能康复护理路径,按功能康复护理路径对术后患者实施早期功能康复训练,随访评价两组患者患肢的组织肿胀、疼痛、骨折复位和腕关节功能康复效果。结果 疼痛评分:对照组在术后第3天~14天疼痛评分均高于观察组(P＜0.005);肿胀程度评分:对照组在术后第3天~7天肿胀程度评分均高于观察组,消肿速度比观察组慢(P＜0.001);腕关节的屈伸活动范围、握力和捏力比较观察组优于对照组(P＜0.001);腕关节复位优良率观察组95%高于对照组87.5%(P＜0.001)。结论 应用康复护理路径对桡骨远端骨折的LCP内固定术后患者进行早期腕关节功能康复训练,能减轻患者疼痛和局部软组织肿胀,减少并发症,提高术后患者康复质量。

Objective To investigate the early functional training of rehabilitation nursing path to the effects of distal radius fracture LCP (locking compression plate LCP) in patients after internal fixation of wrist joint function rehabilitation. Methods From May 2014 to June 2016, 80 patients with distal radius fractures were divided into control group and observation group(n=LCP), each with 40 cases. The control group was treated with nursing care of patients with distal radius LCP internal fixation. On the basis of nursing, the patients in the observation group were given rehabilitation nursing pathway, and the patients were followed up according to the rehabilitation path including evaluation of two groups of patients with fracture limb swelling, pain, fracture reduction and wrist joint function rehabilitation. Results Pain score: in the third days to fourteenth days pain score of the control group was higher than the observation group (P<0.005); Swelling degree score: swelling scores of the control group for the third days to seventh days after were higher than those in the observation group, the swelling reduced slowly (P<0.001); The wrist flexion range, grip and pinch strength compared to the observation group was better than the control group (P<0.001); The good rate of wrist joint reduction in the observation group (95%) was higher than that in the control group[(87.5%) (P<0.001)]. Conclusion The application of rehabilitation nursing path for patients with distal radius fracture after LCP internal fixation for early rehabilitation of wrist function may reduce the pain and local soft tissue swelling, reduce complications and improve the quality of postoperative rehabilitation.