目的 观察⁹⁹锝-亚甲基二膦酸盐对前列腺癌骨转移患者骨痛、骨质疏松的治疗效果。方法 对76例前列腺癌骨转移患者给予⁹⁹锝-亚甲基二膦酸盐治疗1年(每疗程15 d,每天静滴22 mg,15 d为一个疗程,共12个疗程),比较治疗前及治疗1年后患者骨密度(BMD)值及血清钙、磷、碱性磷酸酶、骨钙素、I型胶原交联羧基末端肽、1,25二羟维生素D3等指标的变化。结果 云克治疗后腰椎(L1-4)及左股骨颈、大转子及小转子骨密度(BMD)值均较治疗前增加(P＜0.05);云克治疗后AKP、ICTP均较治疗前明显下降(P＜0.01)。OC云克治疗后较治疗前增加(P＜0.05)。血钙、血磷、1,25-二羟维生素D3云克治疗后与云克治疗前相比无明显变化,P<0.05。前列腺癌骨转移轻度骨痛组及中度骨痛组治疗1年后骨痛VAS评分明显降低,差异有统计学意义,P＜0.05。重度骨痛组云克治疗前、治疗后VAS评分比较,差异无统计学意义,P<0.05。结论 ⁹⁹锝-亚甲基二膦酸盐在治疗前列腺癌骨转移的骨痛、骨质疏松方面,具有缓解骨痛,促进骨增殖,抑制骨吸收,提高骨密度,防治骨质疏松的作用。

目的 探究血必净联合乌司他丁治疗重症急性胰腺炎的疗效及对血清细胞因子水平的影响。方法 选择2016年2月—2017年3月我院收治的重症急性胰腺炎患者88例,随机将其为两组,各44例。对照组采用乌司他丁治疗,在此基础上给予观察组血必净治疗,比较2组临床疗效、血清细胞因子及药物不良反应。结果 观察组总有效率较对照组高,TNF-α、IL-6、hs-CRP水平较对照组低,差异有统计学意义(P＜0.05);观察组不良反应率略低于对照组,但差异无统计学意义(P＞0.05)。结论 血必净联合乌司他丁可提高重症急性胰腺炎临床疗效,减轻炎性反应,且不增加不良反应率,安全性较高。

目的 研究宫腔镜治疗子宫粘连性所致不孕症的临床疗效,为临床相关治疗提供参考。方法 选取我院于2016年11月—2017年11月收治的180例子宫粘连性所致不孕症患者作为观察对象,按照随机数表法平均分成两组。其中观察组90例采用宫腔镜治疗,对照组90例采用传统输卵管通液治疗。对比两组患者治疗前后性激素水平、临床指标及妊娠结局变化。结果 两组间相比,治疗前后 LH、FSH、E2、P等性激素水平无变化,且治疗后观察组与对照组相比,差异均无统计学意义(P>0. 05);两组间相比,治疗后观察组患者的术中出血量、手术时间、住院天数均少于对照组,差异有统计学意义(P<0. 05);两组间相比,治疗后观察组患者的足月分娩率高于对照组,早产率低于对照组,差异有统计学意义(P<0. 05)。结论 宫腔镜治疗子宫粘连性所致不孕症,与传统输卵管通液治疗相比,对性激素水平无影响,但可显著降低患者住院时间及术中出血量,有效提高足月分娩率,值得在临床上推广。

目的 探讨腹腔镜手术与传统开腹手术对右半结肠癌患者免疫功能指标及临床疗效的影响。方法 选取80例右半结肠癌患者,随机分成两组,各40例分别行腹腔镜手术及传统开腹手术,分别比较两组患者手术前后免疫功能指标及相关临床疗效的差异。结果 腹腔镜组及开腹组术后免疫指标CD3⁺、CD4⁺、CD8⁺均出现不同程度下降,但腹腔镜组免疫指标CD3⁺、CD4⁺均优于开腹组(P＜0.05);腹腔镜组术中出血量、术后胃肠排气功能恢复时间、住院时间均优于开腹组(P＜0.05);两组手术时间及淋巴结清扫个数方面无显著差异(P＞0.05)。结论 腹腔镜手术治疗右半结肠癌不仅对患者免疫功能损害较低,还较开腹术具有术中出血量少、术后恢复快等优点,值得临床推广。

目的 探讨醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效。方法 选取我院2014年6月—2016年6月收治的76例脓毒症相关性脑病患者作为研究对象,按照随机数字表法将其分成两组,每组38例。观察组给予醒脑静联合连续肾脏替代疗法治疗,对照组给予连续肾脏替代疗法治疗,比较两组患者的临床疗效,治疗前后格拉斯哥昏迷(Glasgow coma scale,GCS)评分、神经元特异性烯醇化酶(neuron-specifie enolase,NSE)含量、C-反应蛋白(C-reactive protein,CRP)含量及治疗后退热时间、恢复意识时间的长短。结果 观察组总有效率为89.47%,相对于对照组明显上升(P<0.05);观察组治疗后GCS评分较对照组明显升高,NSE含量、CRP含量较对照组明显降低,差异均有统计学意义(P<0.01);观察组治疗后的退热时间、恢复意识时间较对照组明显降低(P<0.01)。结论 醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效显著,可有效缩短退热及恢复意识时间,降低患者痛苦,值得临床推广应用。

Objective To investigate the curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy. Methods 76 cases of sepsis associated encephalopathy in our hospital from June 2014 to June 2016 were selected as the research objects, and they were divided into two groups according to the random number table method, 38 cases in each group. The observation group were treated with Xingnaojing combined with continuous renal replacement therapy. The control group was given continuous renal replacement therapy. The clinical efficacy of two groups were compared before and after treatment about the Glasgow coma (Glasgow coma scale, GCS) score, neuron specific enolase (neuron-specifie enolase, NSE) content, C- reactive protein (C-reactive protein, CRP)content, and the length of the consciousness recovery time and pyretolysis time. Results In the observation group, the total effective rate was 89.47%. Compared with the control group. it increased significantly (P<0.05); After treatment the GCS score in the observation group was significantly higher than the control group, the content of NSE and CRP were significantly lower than the control group, the differences were statistically significant (P<0.01); In the observation group, after treatment the pyretolysis time, consciousness recovery time was significantly lower than the control group(P<0.01). Conclusion The curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy is significant and may effectively shorten the pyretolysis and the recovery of consciousness time, which is worthy of clinical application.

目的 探讨多维铁口服液联合维生素AD滴剂治疗婴幼儿缺铁性贫血的疗效。方法 将首次诊断缺铁性贫血的336例婴幼儿依家长意愿分为2个治疗组(A组和B组)与1个对照组,A组予多维铁口服液联合维生素AD滴剂治疗,B组予多维铁口服液联合维生素D滴剂治疗,对照组饮食调理并补充维生素AD,于治疗4周后(3天内)采末梢血行血细胞分析,比较三组患儿贫血治疗显效率、总有效率差异。结果 治疗4周后,A组显效率为71.70%,总有效率为97.17%;B组显效率为41.05%,总有效率为90.30%;对照组显效率为6.25%,总有效率为32.29%。A组贫血治疗显效率、总有效率高于B组和对照组,差异均有统计学意义(P<0.05)。结论 铁剂联合维生素A制剂可显著提高婴幼儿缺铁性贫血的治疗效果。

Objective To observe the curative effect of multivitamin iron oral solution combined with vitamin AD drops on the treatment of iron deficiency anemia in infants. Methods 336 cases of infants who was found with iron deficiency anemia for the first time were divided into two treatment groups (group A and group B) and one control group in accordance with their parents' will. Group A was treated with multivitamin iron oral solution combined with vitamin AD drops. Group B was treated with multivitamin iron oral solution combined with vitamin D drops. The control group was taken just dietary therapy combined with vitamin AD drops. All subjects were tested blood analysis after 4 weeks of treatment (within 3 days). The differences of the treatment excellence rates and the total effective rates were compared in the three groups. Results After 4 weeks of treatment, the excellence rate in group A was 71.70%. The total effective rate in group A was 97.17%. The excellence rate in group B was 41.05%. The total effective rate in group B was 90.30%. The excellence rate in control group was 6.25%. The total effective rate in control group was 32.29%. The differences of the treatment excellence rates and the total effective rates in group A were significantly higher than those in group B or in the control group. The differences were statistically significant (P<0.05). Conclusion Multivitamin iron combined with vitamin A can significantly improve the curative effect of the treatment of iron deficiency anemia in infants.

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 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 探讨小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响。方法 选取我院2014年5月—2016年5月收治的80例高血压脑出血患者作为研究对象,脑出血量约30～40 mL,根据出血到手术时间不同分为两组,每组40例。从出血到手术时间<6 h者为超早期作为观察组,出血到手术时间处于6~24 h间者为早期作为对照组,比较两组患者治疗后1个月GOS(格拉斯哥预后)优良率,治疗后3周、6周的斯堪的纳维亚(SSS)评分,治疗后3个月、6个月的生存质量评分及治疗后的生存情况、再出血情况。结果 观察组治疗后1个月GOS优良率为77.50%,相对于对照组明显上升(P<0.05);观察组治疗后3周、6周的SSS评分较对照组明显降低(P<0.01);观察组治疗后3个月、6个月的生存质量评分较对照组明显升高(P<0.01);两组治疗后的生存率差异有统计学意义(P<0.05),再出血率差异无统计学意义(P>0.05)。结论 对高血压脑出血患者在超早期行小骨窗显微手术可提高疗效,明显改善患者神经功能,提高生活质量及生存率,值得临床推广。

Objective To investigate the curative effects of microsurgical treatment with small bone flap craniotomy in patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery. Methods To select 80 cases of hypertensive cerebral hemorrhage in our hospital from May 2014 to May 2016 as the research object. The amount of cerebral hemorrhage of the patients was about 30-40 mL. According to the different time of bleeding, they were divided into two groups, 40 cases in each group. The super early period that the time from bleeding to operation was less than 6 h was regarded as the observation group, and the early period that the time from bleeding to operation is during 6~24 h was regarded as the control group. To compare the GOS (Glasgow outcome) excellent rate of patients in two groups in 1 month after treatment, the Scandinavia (SSS) score in 3 weeks and 6 weeks after treatment, and the quality of life score and survival and re-bleeding condition after treatment in 3 months and 6 months. Results Compared with the control group, the GOS excellent rate in the observation group in 1 month after treatment was 77.50% which increased significantly (P<0.05); the SSS score in the observation group in 3 weeks and 6 weeks after treatment was significantly lower than that in the control group (P<0.01); The quality of life score in the observation group in 3 months and 6 months after treatment was significantly higher than that in the control group (P<0.01); There was statistically significant difference in survival rate between the two groups after treatment (P<0.05), and the re-bleeding rate showed no significant difference (P>0.05). Conclusion The curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage is significant, which can improve the patients' neurological function, the life quality and survival rate, thus it is worthy of clinical promotion.

目的 探讨逍遥散治疗首发抑郁症的疗效与5-HT2A受体基因多态性的关联。方法 采用病例对照研究方法,以120例首发抑郁症患者(研究组)和120例正常人(对照组)为研究对象,研究组予逍遥散治疗,疗程8周。于治疗前后采用汉密顿抑郁量表评定。采用高温连接酶检测反应法(LDR)检测5-HT2A受体基因,分析其与抗抑郁药物疗效的关系。结果 5-HT2A受体基因(T102C)T／C基因型、C／C基因型频率及等位基因频率与对照组相比差异无统计学意义(P﹥0.05)。不同基因型的疗效无差异(P﹥0.05)。结论 5-HT2A受体基因(T102C)多态性与逍遥散治疗抑郁症的疗效无关联。