目的 观察百令胶囊辅助缬沙坦治疗IgA肾病效果及对患者肾功能、细胞免疫调节、尿足细胞标志蛋白的影响。方法 选取2019年5月—2021年5月西部战区总医院肾内科收治经肾活检确诊为IgA肾病,筛选治疗方案中尚未使用激素及免疫抑制剂的80例患者,按住院先后顺序随机分为观察组和对照组,每组各40例。对照组给予缬沙坦治疗,观察组给予百令胶囊辅助缬沙坦治疗,治疗12周后,比较2组的疗效、治疗前后肾功能指标[24 h蛋白尿(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、尿红细胞(RBC)计数]、1型/2型辅助性T细胞(Th1/Th2)代表细胞因子[γ-干扰素(IFN-γ)、白介素-4(IL-4)]、尿足细胞标志蛋白[尿足萼糖蛋白(PCX)、尿足细胞B7-1分子(B7-1)]水平。结果 治疗12周后,观察组的治疗总有效率为95.0%,高于对照组的82.5%;观察组的24 h Upro、BUN、SCr、尿RBC计数低于对照组,IFN-γ、Th1/Th2低于对照组、IL-4高于对照组,尿PCX、B7-1水平低于对照组;差异均有统计学意义(P<0.05)。结论 百令胶囊辅助缬沙坦治疗IgA肾病患者,可以提高临床疗效,有效保护患者肾功能,调节其免疫状态,减轻肾损伤。

Objective To observe the effects of Bailing capsules assisting valsartan in the treatment of IgA nephropathy and its influence on renal function, cellular immune regulation and urine prodocytes marker protein. Methods From May 2019 to May 2021, 80 patients with IgA nephropathy confirmed by renal biopsy in the Nephrology Department of Western Theatre Command General Hospital, who had not used hormones or immunosuppressants in the treatment were selected.Patients were divided into observation group and control group according to the order of hospitalization, 40 cases in each group.The control group was given valsartan, and the observation group was given Bailing capsules and valsartan.After 12 weeks of treatment, the efficacy, the levels of renal function indexes [24 h proteinuria (24 h Upro), urea nitrogen (BUN), serum creatinine (SCr), urinary red blood cell (RBC) count], type 1/type 2 helper T cells (Th1/Th2) represent cytokines [interferon-γ (IFN-γ), interleukin-4 (IL-4)], urine prodocytes marker protein [urine podocalyxin (PCX), urinary podocyte B7-1 molecule (B7-1)] before and after treatment were compared between the two groups. Results After treatment, the total effective rate in observation group was higher than that in control group (95.0% vs 82.5%).The 24 h Upro, BUN, SCr levels and urine RBC count in observation group were lower than those in control group, IFN-γ and Th1/Th2 levels were lower than those in control group, the IL-4 level was higher than that in control group, and the levels of urine PCX and B7-1 were lower than those in control group.Those differences were statistically significant (P<0.05). Conclusions Bailing capsules assisting valsartan in the treatment of IgA nephropathy can improve clinical efficacy, effectively protect the renal function of patients, regulate the immune status, and alleviate renal injury.

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 研究白藜芦醇通过抑制T样受体4/核因子-κB(TLR4/NF-κB)通路对呼吸道合胞病毒(RSV)毛细支气管炎小鼠的保护作用。方法 选取30只小鼠随机分为对照组、RSV组、给药组,建立RSV毛细支气管炎小鼠模型,检测小鼠肺组织中TLR4、NF-κB的变化;利用肺组织HE染色、ELISA法检测白藜芦醇给药前后气道炎症病变、IL-6、TNF-α因子水平,Western Blot法及实时定量PCR法检测TLR4、 NF-κB蛋白及基因表达等相关变化。结果 与对照组相比,RSV组小鼠组肺组织中TLR4、NF-κB水平升高,肺组织切片HE染色显示气道炎症细胞浸润加剧,ELISA检测炎性因子IL-6、TNF-α升高;而给药组处理后,肺组织TLR4、NF-κB的表达下调,病理改变减轻,炎性因子IL-6、TNF-α下降。结论 白藜芦醇可通过抑制TLR4/NF-κB通路抑制炎性因子的释放,从而减轻毛细支气管炎小鼠的气道炎症反应。

Objective To study the protective effect of resveratrol on lung tissue of respiratory syncytial virus(RSV) bronchiolitis mice by regulating TLR4/NF-κB pathway. Methods Thirty mice were randomly divided into control group, RSV group and resveratrol group. The mice models of RSV bronchiolitis were established, and the changes of TLR4 and NF-κB levels in lung tissues of mice were detected. HE staining and ELISA were used to detect airway inflammation, IL-6 and TNF-α levels before and after resveratrol administration. TLR4 and NF-κB protein and gene expressions were detected by Western Blot and real-time quantitative PCR. Results Compared with the control group, the levels of TLR4 and NF-κB in the lung tissues of mice with bronchiolitis were significantly increased. Airway inflammatory cell infiltration was aggravated in HE staining of lung tissue sections, and inflammatory factors IL-6 and TNF-α were significantly increased showing by ELISA. The expressions of TLR4 and NF-κB in resveratrol group were down-regulated after treatment. Conclusions Resveratrol can inhibit the release of inflammatory factors by inhibiting the TLR4/NF-κB pathway, play a protective role in mice with bronchiolitis.

目的 探讨加味益气固冲汤在生育期血瘀证崩漏患者治疗中的应用价值及对雌激素水平的影响。方法 按照随机数字表法将2018年11月—2021年1月我院符合诊断标准及选例标准的112例生育期血瘀证崩漏患者分为常规组、实验组,每组56例。常规组予以基础治疗,实验组在常规组基础上采用加味益气固冲汤治疗。比较2组治疗效果、不良反应情况、治疗前后经期出血量、子宫内膜厚度、雌激素水平及血液流变学指标。结果 同常规组总有效率82.14%相比,实验组96.43%较高(P＜0.05);治疗后实验组经期出血量、子宫内膜厚度改善幅度大于常规组(P＜0.05);治疗后实验组黄体生成素、孕酮、卵泡刺激素、雌二醇水平较常规组低(P＜0.05);治疗后实验组红细胞聚集指数、纤维蛋白原、全血低切黏度、血浆黏度均小于常规组(P＜0.05);实验组不良反应总发生率5.36%与常规组10.71%对比,无差异(P＞0.05)。结论 加味益气固冲汤联合西药治疗生育期血瘀证崩漏患者效果显著,调节性激素水平,改善子宫形态,改善血液微循环,缓解经期出血症状。

Objective To explore the application value of Jiawei Yiqi Guchong Decoction in the treatment of patients with blood stasis syndrome of metrorrhagia and metrostaxis and its influence on estrogen level. Methods According to the random number table method, 112 patients with blood stasis syndrome of metrorrhagia and metrostaxis in their reproductive period, who met the diagnostic criteria and case selection criteria in our hospital from November 2018 to January 2021, were divided into conventional group and experimental group, with 56 cases in each group. The conventional group was given basic treatment, and the experimental group was treated with Jiawei Yiqi Guchong Decoction on the basis of the conventional group. The treatment effect, adverse reactions, menstrual bleeding, endometrial thickness, estrogen level and hemorheology indexes before and after treatment were compared between the two groups. Results The total effective rate of experimental group was 96.43%, higher than that of conventional group (82.14%, P<0.05). After treatment, the improvement of menstrual bleeding and endometrial thickness in the experimental group was greater than that in the conventional group (P<0.05). After treatment, the levels of luteinizing hormone, progesterone, follicle stimulating hormone and estradiol in the experimental group were lower than those in the conventional group (P<0.05). After treatment, erythrocyte aggregation index, fibrinogen, whole blood low shear viscosity and plasma viscosity in the experimental group were lower than those in the conventional group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group (5.36%) and the conventional group (10.71%, P>0.05). Conclusions Jiawei Yiqi Guchong Decoction combined with Western medicine had a significant effect on the treatment of patients with blood stasis syndrome of metrorrhagia and metrostaxis in reproductive period, which can regulate the levels of sex hormones, improve the morphology of uterus, blood microcirculation and relieve the symptoms of menstrual bleeding.

目的 探索冰袋冷敷对膝关节前交叉韧带重建术后关节疼痛肿胀和活动度的影响。方法 回顾性分析自2021年1月—2021年7月在我院因前交叉韧带损伤行前交叉韧带重建术的患者资料,将符合标准的71例行单侧前交叉韧带重建术的患者按住院号的单双号分成2组。其中,对照组38名患者,试验组33名患者。对照组38名患者术后不用冰袋冷敷;试验组33名患者术后采用冰袋冷敷。用视觉模拟评分表评估对照组和试验组患者术前、术后的疼痛,并测量患者的膝关节肿胀程度和活动度。结果 对照组和试验组患者术前视觉模拟评分比较,差异无统计学意义(P>0.05),试验组在术后6、24、48、72小时四个不同的时间点时疼痛视觉模拟评分均明显低于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前关节活动度比较,差异无统计学意义(P>0.05),试验组在术后4、5、6、7天四个不同的时间点时关节活动度优于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前膝关节肿胀程度比较,差异无统计学意义(P>0.05),试验组在术后1、2、3天三个不同的时间点时膝关节肿胀程度低于对照组,差异有统计学意义(P<0.001)。结论 冰袋冷敷能够有效减轻前交叉韧带重建术后膝关节疼痛肿胀并改善关节活动度。

Objective To explore the effect of ice pack cold compress on joint pain,swelling and motion after anterior cruciate ligament reconstruction. Methods The data of patients undergoing anterior cruciate ligament reconstruction due to anterior cruciate ligament injury in our hospital from January 2021 to July 2021 were retrospectively analyzed,and 71 patients who received unilateral anterior cruciate ligament reconstruction meeting the standards were divided into two groups according to the odd and even numbers of hospital admission. There were 38 patients in the control group and 33 patients in the experimental group. Thirty-eight patients in the control group did not use ice packs after surgery. Thirty-three patients in experimental group were treated with ice pack after operation. Visual analogue scale was used to evaluate the preoperative and postoperative pain of the control group and experimental group,and the degree of knee swelling and range of motion were measured. Results There was no significant difference in preoperative visual analogue scale between control group and experimental group (P>0.05). The scores of pain in the experimental group were significantly lower than that in the control group at 6,24,48 and 72 hours after surgery,with statistical significance (P<0.001). There was no significant difference in preoperative range of motion between control group and experimental group(P>0.05), the range of motion of the experimental group was significantly better than that of the control group at four different time points of 4,5,6 and 7 days after operation,with statistical significance(P<0.001). There was no significant difference in the degree of preoperative knee joint swelling between the control group and the experimental group(P>0.05),and the degree of knee joint swelling in the experimental group was lower than that in the control group on,1,2 and 3 days after surgery,three different time points, with statistically significant difference(P<0.001). Conclusions Ice pack cold compress can effectively reduce the pain and swelling of the knee joint after anterior cruciate ligament reconstruction and improve the range of motion of the joint.

目的 探索心脏康复干预对房颤合并高血压患者的血脂血压变化、运动耐量、心脏功能、肺功能等指标的影响。方法 选取房颤合并高血压患者96例,随机分为常规治疗组和心脏康复(CR)组,每组各48例患者。常规治疗组给予规范的药物治疗,CR组在规范药物治疗的基础上予运动干预6个月,对比治疗前后2组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)水平,左心房直径(LA)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDd),无氧阈值(AT)、峰值公斤摄氧量(PeakVO₂/kg)、峰值通气量(VEpeak)、每搏输出量(SV)、峰值氧脉搏(PeakO₂pluse),收缩压(SBP)与舒张压(DBP)变化情况,6分钟步行距离(6MWD),以及Borg劳累评估量表评分、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果 2组患者治疗6个月时,TC、TG、LDL-C水平以及SBP、DBP均下降(P<0.05),但2组之间比较,3项血脂指标无统计学差异(P>0.05),而CR组血压显著下降(P<0.05) 。2组患者治疗6个月时,LA、LVEDd减小(P<0.05),而LVEF无变化(P>0.05),CR组LA较常规治疗组缩小(P<0.05)。治疗6个月时,CR组AT、PeakVO₂/kg、VEpeak、SV和PeakO₂plus水平均升高(P<0.05),而常规治疗组的上述相关指标无明显变化(P>0.05)。治疗6个月时,2组患者6分钟步行距离均增加,CR组较常规组增加(P<0.05)。治疗6个月时,CR组Borg劳累评估量表评分、SAS评分及SDS评分均下降,而常规治疗组上述3项评分较治疗前无变化(P>0.05),与常规治疗组比较,CR组上述3项评分降低(P<0.05)。结论 以中等强度运动干预为主导的心脏康复治疗能够降低房颤合并高血压患者的血脂水平、控制血压状态、改善左心房及左心室结构重构,还可以增加该群体的运动耐力及心肺功能、减少消极情绪并提高生活质量。

Objective To evaluate the impact of cardiac rehabilitation on blood lipid level,blood pressure control,exercise endurance,cardiac function, quality of life and lung function in patients with hypertension and atrial fibrillation (AF). Methods This prospective cohort study enrolled 96 patients with AF and hypertension, who were randomly and evenly assigned to the conventional group and the cardiac rehabilitation (CR) group, both treated for at least 6 months. Research indicators included the levels of triglycerides (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C); left atrial diameter (LA), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), anaerobic threshold (AT), peak oxygen uptake volume per kilogram (PeakVO₂/kg), peak ventilation volume (VEpeak), stroke volume (SV), peak oxygen pulse (PeakO₂pluse), changes in blood pressure, 6 minutes walking distance, Borg Fatigue Scale score, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. Results At the 6th month of the treatment, the levels of TG, TC, LDL-C, systolic blood pressure (SBP), diastolic blood pressure (DBP) were significantly reduced (P<0.05) in both groups. However, there was no statistical difference among the three blood lipid indicators between the conventional group and the CR group after treatment (P>0.05). Blood pressure dropped significantly(P<0.05) in both groups, especially in the CR group. Meanwhile, after treatment, LA and LVEDd decreased significantly (P<0.05) in both groups, except LVEF. LA decreased significantly (P<0.05) in CR group, compared with conventional group. In addition, AT, PeakVO₂/kg, VEpeak, SV and PeakO₂pluse levels were significantly elevated (P<0.05) in CR group compared with the conventional group after the treatment. There was no significant difference (P>0.05) in the indicators above in the conventional group. Six minutes walking distance were significantly increased (P<0.05) in both groups at 6th month of treatment, compared with the conventional group, the CR group increased more (P<0.05). Borg Fatigue Scale score, SAS score and SDS score were significantly reduced (P<0.05) in CR group at 6th month of treatment, however, there was no statistical difference (P>0.05) in the conventional group compared with that before treatment. The scores above were significantly reduced (P<0.05) in CR group compared with the conventional group after the treatment. Conclusions Cardiac rehabilitation therapy dominated by moderate-intensity exercise intervention can reduce the blood lipid level of atrial fibrillation and hypertension patients, control the blood pressure, improve the left atrial and left ventricular structure reconstruction, increase the exercise endurance, improve cardiopulmonary function, reduce negative emotions and improve the quality of life.

目的 观察阶梯式呼吸管理策略在改善感染性休克伴急性肺损伤（ALI）患者中的价值。方法 纳入我院2019年1月—2020年12月收治的感染性休克伴ALI患者共146例为研究对象,数字表法随机分为观察组（73例）与对照组（73例）。对照组常规护理方案,观察组阶梯式呼吸管理,对比干预前后患者心肺功能的差异。结果 观察组平均动脉压、PaCO₂水平低于对照组,心脏指数、中心静脉压、血管外肺水指数、PaO₂与氧合指数高于对照组（P<0.05）;观察组复苏成功率与临床总有效率高于对照组,复苏时间与呼吸平稳时间低于对照组（P<0.05）;观察组气管切开率、有创呼吸机使用率及呼吸机相关性肺炎与气道并发症发生率均低于对照组（P<0.05）。结论 感染性休克并急性肺损伤患者建立阶梯化呼吸管理策略能够显著改善患者的心肺功能,提高临床复苏效果,降低相关并发症风险。

Objective To observe the value of stepwise respiratory management strategy in improving patients with septic shock and acute lung injury（ALI）．Methods A total of 146 patients with septic shock and ALI treated in our hospital from January 2019 to December 2020 were included as the research objects．They were randomly divided into observation group（73 cases）and control group（73 cases）by digital table method．The control group received routine nursing plan,and the observation group received stepwise respiratory management．The differences of cardiopulmonary function before and after the intervention were compared．Results The levels of mean arterial pressure,PaCO₂ in the observation group were significantly lower than those in the control group,cardiac index,central venous pressure,extravascular lung water index,PaO₂ and oxygenation index in the observation group were significantly higher than those in the control group（P<0.05）．The success rate of resuscitation and total clinical effective rate in the observation group were significantly higher than those in the control group,and the resuscitation time and respiratory stability time in the observation group were significantly shorter than those in the control group（P<0.05）．The tracheotomy rate,the rate of using invasive ventilator and the incidence of ventilator associated pneumonia and airway complications in the observation group were lower than those in the control group（P<0.05）．Conclusions The establishment of stepwise respiratory management strategy in patients with septic shock and ALI can significantly improve their cardiopulmonary function,improve the effect of clinical resuscitation and reduce the risk of related complications.

目的 从社会组织网络嵌入性的角度,探讨公立医院医务人员工作内外匹配（包括组织匹配和区域匹配）在人际信任与隐性医学知识共享行为之间的中介效应,完善公立医院医务人员隐性医学知识共享机制的研究。方法 采用问卷调查方式对公立医院医务人员进行调查,运用SPSS 17.0软件进行数据分析,采用AMOS 22.0建立公立医院医务人员工作内外匹配在人际信任与隐性医学知识共享行为之间的中介效应回归方程。结果 公立医院医务人员人际信任与隐性医学知识共享行为之间有显著的正相关关系,标准化回归系数为0.446（P <0.001）。加入工作内外匹配变量后,公立医务人员人际信任对隐性医学知识共享行为的标准化回归系数由0.446（P <0.001）降到0.189（P<0.01）。结论 公立医务人员人际信任正向预测隐性医学知识共享行为;组织匹配、区域匹配在公立医务人员人际信任与隐性医学知识共享行为之间具有部分中介效应。

Objective To explore a new path of interpersonal trust impact on knowledge sharing behavior-being from the perspective of job embeddedness．Methods Questionnaire survey was used to investigate the medical staff in public hospitals．SPSS 17.0 software was used to analyze the data．AMOS 22.0 was used to establish the regression equation of intermediary effect between interpersonal trust and tacit medical knowledge sharing behavior of medical staff in public hospitals．Results There was a significant positive correlation between interpersonal trust and tacit medical knowledge sharing behavior．The standardized regression coefficient was 0.446（P <0.001）．When added the fitting to organization and community,the standardized regression coefficient decreased from 0.446（P <0.001）to 0.189（P <0.01）．Conclusions The interpersonal trust of public medical staffs positively predicts the tacit medical knowledge sharing behavior．Organizational matching and regional matching have partial mediating effect between interpersonal trust and tacit medical knowledge sharing behavior of public medical staff.

目的 为寻找治疗盆腔炎性疾病（PID）的有效治疗方案,对比分析头孢哌酮舒巴坦钠+吗啉硝唑、康妇炎胶囊联合头孢哌酮舒巴坦钠及吗啉硝唑两种用药方案治疗PID的效果差异,期望为今后临床中合理选择PID药物治疗方案提供参考依据。方法 选取2019年1月—12月期间在我院接受治疗的104例急性PID患者（湿毒壅盛证）作为研究对象,用随机信封分为参照组、研究组,各52例。予以参照组患者头孢哌酮舒巴坦钠+吗啉硝唑静脉滴注治疗,研究组患者在参照组基础上口服康妇炎胶囊,均持续治疗14 d。观察2组患者近期疗效、炎性因子、盆腔炎性疾病包块、远期复发率（6个月、1年）、远期生活质量,综合评价两种用药方案应用效果。结果 治疗14 d后,研究组总有效率96.00%,高于参照组的80.39%,差异显著（P<0.05）;WBC、CRP、IL-2、TNF-α四项炎性因子水平均低于参照组,差异显著（P<0.05）;腔包块直径、疼痛评分均低于参照组,差异显著（P<0.05）。随访6个月、1年,研究组患者PID复发率分别为4.00%、10.00%,均低于参照组的15.69%、29.41%,差异显著（P<0.05）。结论 以康妇炎胶囊联合头孢哌酮舒巴坦钠及吗啉硝唑治疗PID,能够提升患者的近期治疗效果,改善炎性反应、盆腔炎性疾病包块,降低远期复发风险,改善远期生活质量,而且能够保证用药安全性,具有推广使用价值。

Objective To find an effective treatment for pelvic inflammatory disease（PID）,and to compare and analyze the difference of efficacy of cefoperazone and sulbactam sodium + molinidazole,Kangfuyan capsule combined with cefoperazone and sulbactam sodium + molinidazole in the treatment of PID,in order to provide reference for rational selection of PID drug treatment in future clinical practice．Methods A total of 104 patients with acute PID（excessive wet toxin accumulation syndrome）who received treatment in our hospital from January to December 2019 were selected as the research objects．They were randomly divided into the control group and the research group with 52 cases in each group．Patients in the control group were given intravenous infusion of cefoperazone and sulbactam sodium + morinidazole,and patients in the research group were given Kangfuyan capsule orally on the basis of the control group,all treated for 14 days．The short-term efficacy,inflammatory factors,pelvic inflammatory mass and pain improvement,adverse reactions,long-term recurrence rate（6 months,1 year）,long-term quality of life in two groups were observed,and the application effect of the two drug regimens was comprehensively evaluated．Results After 14 days of treatment,the total effective rate of the research group was 96.00%,which was higher than that of the control group（80.39%）,with significant difference（P<0.05）．After treatment,the levels of WBC,CRP,IL-2 and TNF-α were lower than those of the control group,and the differences were significant（P<0.05）．After treatment,lumen mass diameter and pain score were lower than the control group,the differences were significant（P<0.05）．After 6 months and 1 year follow-up,the PID recurrence rate of the research group was 4.00% and 10.00% respectively,both lower than that of the control group（15.69% and 29.41%）,with significant difference（P<0.05）．Conclusions Using Kangfuyan capsule combined with cefoperazone and sulbactam sodium + molinidazole in the treatment of PID,can improve the patient's recent treatment effect,improve the inflammatory reaction,pelvic inflammation mass, lower long-term risk of recurrence,improve the long-term quality of life,and can ensure medication safety,with promotion value.

目的 观察电子束照射对体外培养的细粒棘球蚴形态结构、死亡率及其p38 mRNA表达的影响。方法 采集自然感染的绵羊肝中的细粒棘球蚴原头蚴,随机分成3组,分别用0 Gy、30 Gy、60 Gy的不同剂量的6 MeV电子束各照射1次,照射后连续培养3 d、14 d,光镜观察虫体的大体变化及死亡率,qRT-PCR法测定p38基因的表达水平。结果 60 Gy组较0 Gy、30 Gy组原头蚴变性坏死数目明显增多,死亡率有差异（P<0.0125）,连续培养天数（3 d、14 d）对虫体死亡率无影响。经电子束照射后,30 Gy、60 Gy组原头蚴p38 mRNA表达水平较0 Gy组升高（P<0.05）。结论 体外培养的原头蚴经电子束照射后大体形态结构发生明显变化、死亡率升高,且与电子束的剂量存在量效关系;p38 mRNA的表达量随着电子束的剂量的增加而升高,p38基因可能参与电子束所致体外杀伤棘球蚴的作用机制。

Objective To observe the effect of 6 MeV electron beam on the morphological structure,mortality rate and expression of p38 mRNA and in Echinococcus granulosus．Methods Einococcus granulosus was collected from natural infected sheep liver and divided into 3 groups randomly,then irradiated by 6 MeV electron beam of 0 Gy,30 Gy and 60 Gy,respectively．After culturing for 3 and 14 days,the gross change and mortality of worms were observed by light microscopy and the expression level of p38 gene was determined by qRT-PCR．Results In 60 Gy group,compared with 0 Gy and 30 Gy group,the gross morphology and structure have changed significantly,the mortality rate was significantly different（P <0.0125）．Days of culture（3 days,14 days）had no obvious effect on mortality,and the p38 mRNA expression levels in 30 Gy and 60 Gy group were significantly higher than 0 Gy group（P <0.05）．Conclusions The gross morphology,structure changes and mortality of Einococcus granulosus increases significantly after electron beam irradiation and has obvious quantitative and effective relationship with the electron beam dose,the p38 gene may be involved in the mechanism of in vitro killing by electron beam.