目的 探讨血必净注射液对SAP大鼠TLR4信号通路介导肠黏膜屏障功能障碍的影响。方法 24只SD大鼠随机分成空白组(n=8)、对照组(n=8)和治疗组(n=8)。对照组和治疗组用4.5%牛磺胆酸钠溶液胆胰管逆行注射制备SAP模型,空白组采用等量生理盐水逆行注射。治疗组在造模3 h后经鼠尾静脉注射血必净注射液(3 mL/kg)。三组大鼠造模后观察24 h,然后处死取胰腺和小肠组织送病理检查,采用荧光RT-PCR技术检测TLR4和NF-κB表达水平,采用ELSIA法检测血清TNF-α、IL-6、淀粉酶(AMS)及二胺氧化酶(DAO)水平,比较三组大鼠各项指标。结果 对照组和治疗组小肠组织TLR4和NF-κB表达以及血清TNF-α、IL-6、AMS及DAO水平均高于空白组(P>0.05),治疗组小肠组织TLR4和NF-κB表达以及血清TNF-α、IL-6、AMS及DAO水平低于对照组(P＜0.05)。结论 血必净注射液通过干预SAP大鼠TLR4信号通路,降低小肠组织TLR4和NF-κB的表达,减轻小肠组织的炎症反应,对肠黏膜屏障具有一定的保护作用。

Objective To investigate the effect on intestinal mucosal barrier dysfunction (IBF) of Xuebijing injection mediated by Toll-like receptor 4 (TLR4) signal pathway in rats of severe acute pancreatitis (SAP). Methods 24 Sprague Dawley (SD) rats were randomly divided into Sham group (n=8), control group (n=8) and treatment group (n=8). The SAP model was established by retrograde injection of 4.5% sodium taurocholate into the biliopancreatic duct in control group and treatment group, while control group was injected with the same amount of saline. In treatment group, Xuebijing injection (3 mL/kg) was injected via tail vein after 3h of modeling. All rats were monitored and sacrificed after 24 hours of modeling. Samples of pancreas and intestine were collected for pathologic determination. A fluorescent RT-PCR was used to determine the expression of TLR4 and NF-κB of small intestine. The serum levels of TNF-α, IL-6, amylase (AMS) and diamine oxidase (DAO) were measured by using ELISA. All parameters of three groups were compared. Results The expression of TLR4 and NF-κB of small intestine in control group and treatment group were higher than it in control group (P<0.05), as well as the serum levels of TNF-α, IL-6, AMS and DAO (P<0.05). The expression of TLR4 and NF-κB of small intestine in treatment group were lower than it in control group (P<0.05), as well as the serum levels of TNF-α, IL-6, AMS and DAO (P<0.05). Conclusion Xuebijing injection may not only reduce the expression of TLR4 and NF-κB of small intestine, but also alleviate the inflammation reaction of small intestine by interfering with TLR4 signal pathway, which may have a protective effect on intestinal mucosal barrier in SAP rats.

目的 研究腹腔镜腹膜前疝修补术(TAPP)治疗腹股沟疝的微创性。方法 纳入我院96例腹股沟疝患者为研究对象,按随机数表法分为观察组和对照组各48例,观察组予以TAPP法进行治疗,对照组予以平片无张力修补术(Lichtenstein手术)。比较两组术中出血量、手术时间、术后进食时间、术后下床时间、住院时间及手术费用的差别,分析术后两组疼痛程度,同时观察术后并发症及复发情况。结果 观察组术中出血量少于对照组,术后进食时间、下床时间及住院时间短于对照组,手术时间长于观察组,手术费用高于对照组(P<0.05)。观察组疼痛程度为低于对照组(P<0.05)。随访1年,两组均无患者复发。观察组术后并发症发生率为14.58%低于对照组35.42%(P<0.05)。结论 TAPP治疗腹股沟疝临床疗效高,创伤小,恢复快,可降低术后疼痛感,具有微创性。

目的 探讨非霍奇金淋巴瘤(NHL)合并HBV感染患者化疗过程中肝功能监测的临床意义。方法 以2014年3月—2016年6月我院21例NHL合并HBV感染患者为研究对象,所有患者采用CHOP方案进行化疗,治疗2~6周期。 分别于化疗前后对患者肝功能进行检查,采用荧光定量PCR法进行乙肝病毒DNA复制情况检测;肝功能出现中重度异常患者进一步测定凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fb)等,同时对NHL辅助性标志物进行监测,主要包括β₂微球蛋白(β₂-MG)及乳酸脱氢酶(LDH)。结果 随着化疗进行,患者ALT、GLB、胆红素水平逐渐增高(P<0.05),ALB、PA水平逐渐降低(P<0.05);相比于化疗进行2个周期,进行4～6周化疗者肝功能损害率和重症肝炎发生率均升高,差异有统计学意义(P<0.05)。结论 NHL合并HBV感染患者化疗过程中对肝功能监测,有助于防止重症肝炎发生,并降低病死率,具有重要临床意义。

目的 探讨分阶段延续护理对改善留置输尿管支架管老年农民患者并发症的效果。方法 按时间顺序将106例患者分为对照组52例和观察组54例,对照组给予常规电话随访,观察组实施三个阶段的延续护理。30天后测评患者并发症持续时间和发生率、自我管理能力。结果 观察组腰痛、血尿、膀胱刺激征持续时间缩短,尿路感染、支架管移位和滞留的发生率下降,自我管理能力各维度评分升高,与对照组比较差异均有统计学意义(P＜0.01)。结论 分阶段延续护理能提高留置输尿管支架管老年农民患者的自我管理能力,增强依从性,减少并发症的发生,促进早日康复。

Objective To investigate the effect of staged continuous nursing on complications in elderly agricultural-workerpatients with indwelling ureteral stent. Methods According to the chronological order, 106 patients were divided into control group (52 cases) and observation group (54 cases). The control group received routine telephone follow-up, and the observation group received three stages of continuous care. 30 days later, the complications' duration, incidence and self-management ability were assessed. Results In the observation group, pain, hematuria and bladder irritation were obviously shorten. Urinary tract infection and the incidence of stent displacement and retention were decreased. Scores in all dimensions of self management ability were increased. Comparing with the control group, it had significant difference (P<0.01). Conclusion The phased continuous nursing may improve the self-management ability of the elderly agricultural-worker with indwelling ureteral stents, strengthen the compliance, reduce the occurrence of complications and promote early rehabilitation.

目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P＜0.05),抑郁评分与全国常模相比则无统计学差异(P＞0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。

Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P＜0.05), while there was no statistical difference in depression scores between these two groups (P＞0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.

目的 观察重组牛碱性成纤维细胞生长因子应用于治疗浅Ⅱ度烧伤创面的临床效果。方法 选取90例小面积浅Ⅱ度烧伤患者,随机平均分为2组:应用重组牛碱性成纤维细胞生长因子治疗的患者为治疗组,使用碘伏油纱治疗的患者为对照组,观察创面愈合时间、患者疼痛程度及远期色素沉着、瘢痕增生几率情况。结果 重组牛碱性成纤维细胞生长因子治疗组效果优于对照组,治疗组创面愈合时间(8.56±2.51)d短于对照组(12.42±2.13)d(P﹤0.05),平均愈合时间较提前3~5 d;患者疼痛度减轻[VAS评分分别是:(1.66±0.05)和(3.25±0.12),P﹤0.05];部分患者一年后随访发现治疗组远期色素沉着较轻,疤痕增生几率低。结论 应用重组牛碱性成纤维细胞生长因子治疗小面积浅度烧伤能够缩短创面愈合时间,在有效促进烧伤创面愈合同时,可减轻换药时疼痛,减轻远期色素沉着,降低瘢痕增生率。

Objective To observe effect of the recombinant bovine basic fibroblast growth factor in the treatment of superficial Ⅱ degree burn wounds. Methods Ninety cases of small area of superficial Ⅱ degree burn wounds were randomly divided into 2 groups: recombinant bovine basic fibroblast growth factor group(rb-bFGF) and control group (Iodophor gauze group). The wound healing time,patient pain, long-term hyperpigmentation and scar chance of proliferation were observed. Results The effect of rb-bFGF treatment group was better than that of control group. The healing time of the treatment group was (8.56 ± 2.51)d, it was shorter than that of the control group (12.42±2.13)d(P<0.01). The average healing time was 3~5 days, it was ahead of the control group; Compared to the control group, the rb-bFGF group had less pain (VAS scores were: 1.66±0.05 and 3.25±0.12,P<0.01); Some patients were followed up a year later, we found that the treatment group long-term pigmentation was lighter, scar chance of proliferation was lower. Conclusion Application of rb-bFGF in the treatment of small area of shallow Ⅱ degree of burns may shorten the wound healing time. As effective promotion of burn wound healing, it may reduce the pain when dressing, reduce long-term pigmentation and scarring rate.

目的 探讨中国人群中不同Rh血型表型的RHAG基因序列。方法 用血清学方法检测20例中国人群中不同Rh血型表型[包括了15例Rh(D)阳性样本和5例Rh(D)阴性样本,Rh(D)阳性样本中包含5例RhCcEe抗原弱表达、5例弱D和5例正常Rh(D)阳性样本],依据RHAG基因序列的特异性,设计10对特异性引物扩增20例样本的RHAG基因第1~10外显子,确认条带符合后送公司纯化并测序。结果 20例不同Rh血型表型的样本在统一PCR条件下均扩出RHAG基因1～10外显子,扩增产物测序结果与标准序列对比一致。结论 了解中国人群中RHAG基因的多态性需观察更多有意义的样本。

Objective To explore the RHAG gene sequence of different Rh phenotypes in Chinese population. Methods We detected different Rh phenotypes in 20 cases of Chinese population using serological tests including 15 cases of Rh (D) positive samples and 5 cases of Rh (D) negative samples. Rh (D) positive samples included 5 cases of RhCcEe antigen weak expression, 5 cases of weak D and 5 cases of normal Rh (D) positive samples. According to specific RHAG gene sequence, 10 pairs of specific primers were designed to amplify 10 exon sequences of RHAG gene. Amplification products confirmed by electrophoresis, then the PCR products were purified and sequencing in a company. Results The exon 1~10 of RHAG gene in 20 cases of Chinese population coding region was sequenced, and the results were consistent with the sequence of GenBank standard. Conclusion More significant samples should be observed to study polymorphism of RHAG gene in Chinese population.

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 本研究从细胞生物学角度检测二甲双胍对小鼠胰岛瘤MIN6的影响,并探讨此过程中包含的分子生物学机制。方法 MTT法检测不同浓度二甲双胍(1、2、5、10、20 mmol/L)对MIN6细胞活力的影响,细胞划痕实验检测二甲双胍对MIN6细胞迁移的影响,免疫印记实验检测此过程中细胞凋亡相关蛋白Bcl-2、Bax、caspase3表达的变化,及AMPK和JNK信号通路蛋白磷酸化水平的变化。结果 二甲双胍浓度大于10 mmol/L时可以抑制MIN6细胞的活力(P<0.01),降低其迁移能力(P<0.01),高浓度二甲双胍可以上调细胞内凋亡蛋白Bax(P<0.05)和p-AMPK的表达(P<0.05),降低抗凋亡蛋白Bcl-2的表达,增加caspase3剪切体(P<0.05)。同时,二甲双胍可以降低MIN6细胞内JNK信号通路的磷酸化水平(P<0.05)。结论 高浓度二甲双胍可以抑制MIN6细胞的增殖和迁移,其作用可能与降低了JNK信号的通路活化有关。

Objective This study aims to investigate the effect of metformin on proliferation and migration of MIN6 cells, and to explore the underlying mechanism. Methods The viability of MIN6 cells that were treated with various metformin (1,2,5,10 and 20 mmol/L) was detected by MTT assay. The migration of MIN6 cells was determined by wound-healing assay. Meanwhile, the proteins expression of Bcl-2, Bax, caspase3 and the phosphorylation of AMPK, JNK was detected by western bolt assay. Results The cell viability and the migration of MIN6 cells were decreased when the concentration of metformin above 10 mmol/L(P<0.01). The expression of apoptosis-related protein Bax(P<0.05) and p-AMPK(P<0.05)was up-regulated, anti-apoptosis-related protein Bcl-2 was down-regulated and cleaved caspase3 (P<0.05)was increased after high metformin treatment. At the same time, the phosphorylation of JNK was down-regulated by metformin(P<0.05). Conclusion High concertration of metformin may inhibit the proliferation and migration of MIN6 cells through suppressing the activation of JNK signaling pathway.

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。