目的 探讨妇科门诊宫颈癌高危人群采取阴道镜检查后配合宫颈细胞学检查对宫颈癌筛查价值。方法 选取2016年2月—2017年4月我院妇科门诊就诊合并宫颈癌高危患者387例为研究对象,所有患者均行阴道镜检查和宫颈细胞学检查,以最终病理检查为诊断“金标准”,探究阴道镜、宫颈细胞学检查在宫颈癌中筛查灵敏度、特异度及阳性符合率。结果 387例纳入研究宫颈癌高危患者,经病理诊断后明确诊断为宫颈癌51例,占13.18%。细胞学检查在宫颈癌中筛查灵敏度为72.55%,特异度为90.48%,阳性符合率为88.11%。阴道镜检查在宫颈癌中筛查灵敏度为50.98%,特异度为94.64%,阳性符合率为88.89%。宫颈癌筛查中,细胞学检查灵敏度高于阴道镜检查,特异度低于阴道镜检查(P＜0.05),两者检查阳性符合率比较差异无统计学意义(P＞0.05)。结论 妇科门诊宫颈癌高危患者宫颈筛查中,阴道镜筛查具有较高特异度,细胞学检查具有较高灵敏度,联合检查能提高筛查价值。

目的 研究血浆脂蛋白磷脂酶 A2(Lp-PLA2)在防治急性动脉硬化性脑梗死中的临床价值。方法 选取2014年1月—2015年12月在我院经头颅MRI+MRA及脑血管造影确诊为急性动脉硬化性脑梗死患者80例为病例组,选取同期来我院例行体检头MRI+MRA 正常的健康自愿者40名为对照组。病例组采取脑梗死规范治疗及肢体功能康复锻炼,以酶联免疫法分不同时段测定两组患者血浆Lp-PLA2的浓度,以及评价病例组神经功能缺损程度,经数据分析研究脑梗死患者血浆Lp-PLA2浓度与神经功能缺损程度相关性。结果 急性动脉硬化性脑梗死患者血浆 Lp-PLA2浓度高于健康对照组患者,经统计学分析,P<0.05,并且随着脑梗死时间的推移,Lp-PLA2浓度愈低。NIHSS评分显示,随着脑梗死时间推移,NIHSS评分越来越低,差异有统计学意义(P<0.05)。对比同时期NIHSS评分和患者 Lp-PLA2浓度,NIHSS与Lp-PLA2浓度呈正相关(r=2.376,P<0.01)。结论 血浆Lp-PLA2 浓度升高是脑梗死的危险因素之一,降低血浆 Lp-PLA2 浓度可在脑梗死的早期预防上起到积极作用。

Objective To explore clinical value of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in controlling acute atherosclerosis cerebral infarction. Methods 80 cases of acute atherosclerosis patients diagnosed by head MRI+MRA were selected as cases group, and 40 as normal controls. Cases treated with cerebral infarction specification therapy and lib function rehabilitation exercise. Using enzyme-linked immunoassay points at different times of measuring the concentration of plasma Lp-PLA2 in both groups, evaluating nerve function defect degree of cases, then analysis the correlation of cerebral infarction plasma concentration of Lp-PLA2 and neural function defect degree. Results Acute atherosclerotic cerebral infarction patients plasma concentration of Lp-PLA2 patients was significantly higher than healthy control group, by statistics analysis P<0.05, and with cerebral infarction time went by, the Lp-PLA2 concentration was lower. NIHSS score, with the time of cerebral infarction passed, was lower and lower, the change was statistically significant P<0.05.Compared with NIHSS score and concentration of Lp-PLA2, NIHSS and Lp- PLA2 concentration were positively correlated, r=2.376,P<0.01. Conclusion Plasma Lp-PLA2 is a risk factor for cerebral infarction. Reducing plasma concentration of Lp-PLA2 can play a positive role on the early prevention of cerebral infarction.

目的 探讨血清胱抑素C、尿酸及降钙素原对诊断急性心肌梗死的临床价值。方法 回顾性分析我院134例心肌梗死患者及89名健康人血清胱抑素C、尿酸及降钙素原水平。结果 与健康对照组相比,实验组患者血清Cys-C、UA和PCT均有不同程度的升高,且差异有统计学意义。此外,血清Cys-C和PCT升高的水平与心肌梗死程度有关。结论 血清Cys-C、UA和PCT水平均可以作为AMI的临床指标,并且血清Cys-C和PCT在一定程度反映心肌梗死的严重程度。

       目的   基于最佳矫正视力（BCVA）、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼（AACG）的疗效。方法   回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象，依据1∶1匹配原则，将接受常规小梁切除术的56例患者作为对照组，接受改良小梁切除术的56例患者作为观察组，统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果   术后3个月，观察组视力为（0.63±0.04）logMAR，高于对照组（0.50±0.03）logMAR，眼压为（16.22±2.28）mmHg，低于对照组（19.95±2.31）mmHg（t=19.457、8.600，均P＜0.05）；观察组浅前房发生率为8.93%，低于对照组的26.79%（χ ² =6.087，P=0.014）；观察组角膜水肿状况优于对照组（Z=2.737，P=0.006）；观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%，均低于对照组17.86%、23.21%、32.14%、35.71%（χ ² =8.166、7.292、3.953、9.818，均P＜0.05）。结论   较常规小梁切除术，改良小梁切除术治疗AACG患者，有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生，且安全性较高。

       Objective  To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma（AACG）based on best-corrected visual acuity（BCVA）and degree of corneal edema．Methods  A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects．According to the 1∶1 matching principle，56 patients receiving conventional trabeculectomy were selected as control group，and 56 patients receiving modified trabeculectomy were selected as observation group．Perioperative BCVA，intraocular pressure，postoperative shallow anterior chamber formation，degree of corneal edema and complications were analyzed．Results  At three months postoperatively，visual acuity in the observation group was（0.63±0.04）logMAR，which was higher than that in the control group（0.50±0.03）logMAR，and intraocular pressure was（16.22±2.28）mmHg，which was lower than that in the control group（19.95±2.31）mmHg（t=19.457，8.600，P＜0.05）；the incidence of shallow anterior chamber in the observation group was 8.93%，which was lower than that of the control group（26.79%）（χ ² =6.087，P=0.014）；the corneal edema status in the observation group was better than that of the control group（Z=2.737，P=0.006）；the rates of choroidal detachment，filtering channel obstruction，hyphema，and iris inflammation in the observation group were 1.79%，5.36%，16.07%，and 10.71%，respectively，which were lower than those of the control group（17.86%，23.21%，32.14%，and 35.71%）（χ ² =8.166，7.292，3.953，and 9.818，P＜0.05）．Conclusions  Compared with conventional trabeculectomy，modified trabeculectomy can improve visual acuity，reduce intraocular pressure，relieve corneal edema，and reduce the occurrence of shallow anterior chamber in patients with AACG，with higher safety．