目的 探究经鼻间歇正压通气（NIPPV）和经鼻持续正压通气（NCPAP）作为早产儿呼吸窘迫综合征气管插管机械通气拔管后无创呼吸支持过渡的临床效果的差异。方法 纳入2021年1月—2023年6月在广东省吴川市妇幼保健计划生育服务中心治疗的新生儿呼吸窘迫综合征早产儿66例,用随机数字表法将患儿分为NIPPV组（33例）和NCPAP组（33例）。NIPPV组患儿予经鼻间歇正压通气作为过渡期无创呼吸支持,NCPAP组患儿则予以经鼻持续正压通气作为过渡期无创呼吸支持。对比两组患儿治疗前后血气分析结果、脱机失败率、无创呼吸支持时间、无创后吸氧时间、总给氧时间等指标。结果 接受无创呼吸支持12 h后,NIPPV组患儿的PaO₂升至（76.46±1.10）mmHg,高于NCPAP组患儿的（75.51±2.15）mmHg（t=2.249,P=0.028）。此外,NIPPV组患儿的SaO₂升至（96.36±0.52）%,也高于NCPAP组患儿的（96.07±0.59）%（t=2.138,P=0.034）。而NIPPV组患儿的PaCO₂则降至（41.39±0.74）mmHg,较NCPAP组患儿的（41.87±0.95 ）mmHg低（t=-2.230,P=0.025）。NIPPV组无创呼吸支持时间为（3.09±0.52）d,短于NCPAP组的（3.45±0.62）d,且该差异有统计学意义（t=2.584,P=0.012）。同样的,NIPPV组总给氧时间（9.52±0.76）天较NCPAP组的（10.00±0.79）天短,且该差异有统计学意义（t=-2.548,P=0.013）。而两组在脱机失败率、无创呼吸支持后吸氧时间、不良反应发生率等方面比较差异无统计学意义（均P>0.05）。结论 与NCPAP模式相比,早产儿拔管后应用NIPPV模式进行无创呼吸支持取得的临床效果更优。

Objective To explore the difference of clinical effect of nasal intermittent positive pressure ventilation（NIPPV）and nasal continuous positive pressure ventilation（NCPAP）as non-invasive respiratory support mode after extubation in preterm infants with endotracheal intubation．Methods Sixty-six cases of preterm infants with neonatal respiratory distress syndrome treated in our hospital from January 2021 to June 2023 were included．All the subjects were randomly divided into NIPPV group（n=33）and NCPAP group（n=33）．The blood gas analysis results,weaning failure rate,non-invasive respiratory support time,oxygen inhalation time after noninvasive ventilation,total oxygen administration time．were compared between the two groups．Results After 12 hours of noninvasive respiratory support,PaO₂ in the NIPPV group increased to（76.46±1.10）mmHg,which was significantly higher than that（75.51±2.15）mmHg in the NCPAP group（t=2.249,P=0.028）．In addition,SaO₂ in the NIPPV group increased to （96.36±0.52）%,which was also significantly higher than that（96.07±0.59）% in the NCPAP group（t=2.138,P=0.034）．The PaCO₂ in the NIPPV group decreased to （41.39±0.74）mmHg,which was lower than that（41.87±0.95）mmHg in the NCPAP group（t=-2.230,P=0.025）．The duration of non-invasive respiratory support in the NIPPV group（3.09±0.52） days was shorter than that（3.45±0.62）days in the NCPAP group,and the difference was statistically significant（t=2.584,P=0.012）．Similarly,the total duration of oxygen administration in the NIPPV group（9.52±0.76）days was shorter than that（10.00±0.79）days in the NCPAP group,and the difference was statistically significant（t=-2.548,P=0.013）．There were no significant differences in weaning failure rate,oxygen inhalation time after noninvasive respiratory support,and incidence of adverse reactions between the two groups（P>0.05）．Conclusions Compared with NCPAP mode,NIPPV mode for non-invasive respiratory support in preterm infants after extubating has better clinical effect,and it is worthy of clinical application．

目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病（冠心病）患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效（P=0.023）和中医证候积分（P<0.001）均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量（Peak VO₂,P=0.005）、最大摄氧量（VO₂max,P=0.001）、氧脉搏（VO₂/HR,P=0.002）和无氧阈值时最大代谢当量（MET,P=0.001）,以及降低无氧阈值（AT,P<0.001）和二氧化碳通气当量（VE/VCO₂,P=0.020）方面比对照组更明显。两组患者在36项简明健康状态调查表（SF-36）评分的8个维度中评分均有所升高,其中在生理机能（P=0.001）、生理职能（P<0.001）、一般健康状况（P=0.018）、精力（P=0.007）、社会职能（P=0.010）、精神健康（P=0.004）方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义（P>0.05）。两组患者的匹兹堡睡眠质量指数（PSQI）均有所改善,且干预组效果优于对照组（P<0.001）。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO₂、VO₂max、VO₂/HR、MET、AT、VE/VCO₂等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。

Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease（CHD）．Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group．Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment．Results After treatment,both groups showed improvement in the traditional Chinese medicine（TCM）clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index（PSQI）scores;increase in Peak VO₂,VO₂max,VO₂/HR,and metabolic equivalent（MET）;and decrease in AT and VE/VCO₂．However,the treatment group had a more pronounced improvement in the TCM clinical efficacy（P=0.023）,TCM syndrome（P<0.001）,PSQI scores（P<0.001）,and cardiopulmonary exercise testing（CPET）indicators including Peak VO₂（P=0.005）,VO₂max（P=0.001）,VO₂/HR（P=0.002）,MET（P=0.001）,AT（P<0.001）and VE/VCO₂（P=0.020）,compared to their control counterparts． For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning（P=0.001）,role limitations due to physical health（P<0.001）,general health（P=0.018）,vitality（P=0.007）,social functioning（P=0.010）and mental health（P=0.004）,but not in pain or role limitations due to emotional problems．Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO₂、VO₂max、VO₂/HR、MET、AT and VE/VCO₂,and elevate both quality of life and sleep quality among older adults with CHD．

目的 探究腔内微波消融(EMA)联合泡沫硬化剂治疗与腔内射频消融(RFA)联合泡沫硬化剂治疗下肢静脉曲张的临床疗效和并发症情况。方法 回顾性选择收集106例下肢静脉曲张患者的临床资料,其中54例患者(观察组)接受EMA联合泡沫硬化剂治疗,52例患者(对照组)接受RFA联合泡沫硬化剂治疗。比较2组患者相关临床指标及并发症发生情况。结果 观察组手术时间(34.92±2.35)min,对照组手术时间(46.33±2.71)min,观察组手术时间较短,差异有统计学意义(P＜0.05),其余手术参数差异不明显(P＞0.05)。观察组的住院费用(21 063.74±850.47)元,对照组住院费用(23 312.40±1 035.86)元,观察组住院费用较低,有统计学差异(P＜0.05)。2组间并发症发生率、总有效率和总满意度均无显著差异。对比2组患者手术前和手术治疗后1年的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分,组间对比没有统计学差异(P＞0.05);而在患者手术1年之后的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分均呈现出明显的下降趋势(P＜0.05)。结论 微波消融是有效治疗下肢静脉曲张的术式,与射频消融比较,具有同样良好的短期效果;微波消融所需的手术时间较短且费用较低。

Objective To compare the clinical efficacy and complications between endovascular microwave ablation (EMA) combined with foam sclerotherapy and radiofrequency ablation (RFA) combined with foam sclerotherapy in patients with varicose veins of lower extremity. Methods A total of 106 patients with varicose veins of lower extremity were included in the retrospective study.Among them, 54 patients (observation group) were treated with EMA combined with foam sclerotherapy, and 52 patients (control group) were treated with RFA combined with foam sclerotherapy.The related clinical indexes and complications between the two groups were compared. Results The observation group had a shorter procedure time than the control group (34.92±2.35 minutes vs 46.33±2.71 minutes, P＜0.05), and no significant differences were observed in the other procedure parameters.The hospitalization cost was (21063.74±850.47) yuan for the observation group and (23312.40±1035.86) yuan for the control group, and the hospitalization cost of the observation group was lower(P＜0.05).No significant differences were found in the total effective rate,total satisfaction and complication rate between the two groups.Comparison of venous clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scores before and one year after operation between the two groups showed no statistical differences (P＞0.05). While the VCSS and AVVQ scores of the patients showed a significant downward trend one year after operation (P＜0.05). Conclusions Microwave ablation is an effective treatment for varicose veins in the lower extremity, which has the same good short-term effect as radiofrequency ablation. Microwave ablation requires a shorter operation time and less cost.

目的 探讨高速改良涡轮手机拔除下颌阻生第三磨牙的临床疗效。方法 回顾性分析2013年12月—2016年12月于本科室拔除下颌阻生第三磨牙600例临床案例,按拔除方式不同,将其分为高速涡轮手机组和传统凿骨劈冠组,各300例。其中高速涡轮手机组给予高速涡轮手机拔除法拔除下颌第三磨牙,传统凿骨劈冠组给予传统凿骨劈冠拔除法拔除下颌第三磨牙。统计分析两组患者拔出后疗效情况、拔除使用时间、以及拔除后疼痛度及张口受限度情况。结果 高速涡轮手机组患者拔牙优良率明显高于传统凿骨劈冠组,差异有统计学意义(P<0.05),而疗效差发生率明显低于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙时间在30min内人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而在30min以上的人数明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙后疼痛度1级和张口受限度1级人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而术后疼痛度2级、3级和张口受限度2级、3级均明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05)。结论 高速改良涡轮手机拔除下颌阻生第三磨牙具有创口小,伤口愈合较良好,用时短以及能促进患者术后舒适。

目的 观察养血祛瘀方联合血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)类药物对糖尿病肾病不同分期的疗效。方法 134例糖尿病肾病患者采用随机区组设计方案,以初诊时间(月份)作为配伍因素,随机分为治疗组67例和对照组67例,两组均采用常规西医综合基础治疗,对照组给予ACEI或ARB类药物治疗,治疗组在对照组治疗的基础上联用养血祛瘀方治疗,观察60 d,分析两组治疗前后24h尿微量白蛋白、24 h尿蛋白定量、血清C反应蛋白(hs-CRP)的变化。结果 对于糖尿病肾病Ⅲ期患者,治疗组较对照组尿蛋白减少,但差异无统计学意义(P＞0.05),治疗组较对照组hs-CRP水平明显下降(P＜0.05);对于糖尿病肾病Ⅳ期患者,治疗组较对照组尿蛋白减少(P＜0.05),治疗组较对照组hs-CRP水平下降(P＜0.05)。结论 养血祛瘀方联合ACEI或ARB类药物可有效减少糖尿病肾病Ⅳ期患者蛋白尿,降低糖尿病肾病患者hs-CRP水平。

Objective To investigate the efficacy of Yang Xue Qu Yu Fang combined with ARB/ACEI on different stages of diabetic nephropathy. Mehtods 134 patients who suffered from diabetic nephropathy were randomly divided into observation group and control group, each of them had 67 cases. The experiment use randomized block design and choose the time (months) of initial diagnosis as the compatibility factors. Both groups were treated by conventional therapy. The control group was given medicine of ARB/ACEI while the observation group was added Yang Xue Qu Yu Fang on the basis of control group. We observed all the patients for 60 days, to compare the microalbuminuria in urine of 24h, the urinary protein of 24h and the serum high sensitive C-reaction protein (Hs-CRP) between two groups before and after treatment. Results For patients of the 3rd stage of diabetic nephropathy, the albuminuria in observation group decreased obviously, but there was no significant difference between two groups (P>0.05), the serum Hs-CRP in observation group decreased obviously (P<0.05). For patients of the 4rd stage of diabetic nephropathy, the albuminuria in observation group decreased obviously (P<0.05), the serum Hs-CRP in observation group decreased obviously (P<0.05). Conclusion The Yang Xue Qu Yu Fang combined with ARB/ACEI can effectively reduce the albuminuria and can obviously lower the Hs-CRP level in the patients of the 4rd stage of diabetic nephropathy.

       目的    探究经鼻间歇正压通气（NIPPV）和经鼻持续正压通气（NCPAP）作为早产儿呼吸窘迫综合征气管插管机械通气拔管后无创呼吸支持过渡的临床效果的差异。方法   纳入2021年1月—2023年6月在广东省吴川市妇幼保健计划生育服务中心治疗的新生儿呼吸窘迫综合征早产儿66例，用随机数字表法将患儿分为NIPPV组（33例）和NCPAP组（33例）。NIPPV组患儿予经鼻间歇正压通气作为过渡期无创呼吸支持，NCPAP组患儿则予以经鼻持续正压通气作为过渡期无创呼吸支持。对比两组患儿治疗前后血气分析结果、脱机失败率、无创呼吸支持时间、无创后吸氧时间、总给氧时间等指标。结果  接受无创呼吸支持12 h后，NIPPV组患儿的PaO₂升至（76.46±1.10）mmHg，高于NCPAP组患儿的（75.51±2.15）mmHg（t=2.249，P=0.028）。此外，NIPPV组患儿的SaO₂升至（96.36±0.52）%，也高于NCPAP组患儿的（96.07±0.59）%（t=2.138，P=0.034）。而NIPPV组患儿的PaCO₂则降至（41.39±0.74）mmHg，较NCPAP组患儿的（41.87±0.95 ）mmHg低（t=-2.230，P=0.025）。NIPPV组无创呼吸支持时间为（3.09±0.52）d，短于NCPAP组的（3.45±0.62）d，且该差异有统计学意义（t=2.584，P=0.012）。同样的，NIPPV组总给氧时间（9.52±0.76）天较NCPAP组的（10.00±0.79）天短，且该差异有统计学意义（t=-2.548，P=0.013）。而两组在脱机失败率、无创呼吸支持后吸氧时间、不良反应发生率等方面比较差异无统计学意义（均P＞0.05）。结论   与NCPAP模式相比，早产儿拔管后应用NIPPV模式进行无创呼吸支持取得的临床效果更优。

      Objective  To explore the difference of clinical effect of nasal intermittent positive pressure ventilation（NIPPV）and nasal continuous positive pressure ventilation（NCPAP）as non-invasive respiratory support mode after extubation in preterm infants with endotracheal intubation．Methods   Sixty-six cases of preterm infants with neonatal respiratory distress syndrome treated in our hospital from January 2021 to June 2023 were included．All the subjects were randomly divided into NIPPV group（n=33）and NCPAP group（n=33）．The blood gas analysis results，weaning failure rate，non-invasive respiratory support time，oxygen inhalation time after noninvasive ventilation，total oxygen administration time．were compared between the two groups．Results   After 12 hours of noninvasive respiratory support，PaO₂ in the NIPPV group increased to（76.46±1.10）mmHg，which was significantly higher than that（75.51±2.15）mmHg in the NCPAP group（t=2.249，P=0.028）．In addition，SaO₂ in the NIPPV group increased to （96.36±0.52）%，which was also significantly higher than that（96.07±0.59）% in the NCPAP group（t=2.138，P=0.034）．The PaCO₂ in the NIPPV group decreased to （41.39±0.74）mmHg，which was lower than that（41.87±0.95）mmHg in the NCPAP group（t=-2.230，P=0.025）．The  duration of  non-invasive  respiratory  support in the NIPPV group（3.09±0.52） days was shorter than that（3.45±0.62）days in the NCPAP group，and the difference was statistically significant（t=2.584，P=0.012）．Similarly，the total duration of oxygen administration in the NIPPV group（9.52±0.76）days was shorter than that（10.00±0.79）days in the NCPAP group，and the difference was statistically significant（t=-2.548，P=0.013）．There were no significant differences in weaning failure rate，oxygen inhalation time after noninvasive respiratory support，and incidence of adverse reactions between the two groups（P＞0.05）．Conclusions   Compared with NCPAP mode，NIPPV mode for non-invasive respiratory support in preterm infants after extubating has better clinical effect，and it is worthy of clinical application．