目的 探讨重组人表皮生长因子滴眼液联合玻璃酸钠治疗白内障术后干眼症的随机对照情况。方法 选取2017年度在本院实施白内障术后发生干眼症患者120例,采取随机分组方法分成观察组、对照组各60例,观察组给予重组人表皮生长因子滴眼液联合玻璃酸钠治疗,对照组给予玻璃酸钠滴眼液治疗,比较两组患者的临床疗效情况。结果 观察组有效率90%高于对照组73.33%,有差异;两组患者治疗前FL、BUT、SIT比较均无差异,P>0.05;治疗后,两组FL、BUT、SIT比较有差异,P<0.05; 两组患者治疗前视力评价比较均无差异,P>0.05;治疗后,两组视力评价比较有差异,P<0.05。结论 给予白内障术后干眼症患者采取重组人表皮生长因子滴眼液联合玻璃酸钠治疗,可提高临床疗效,对于改善相关临床体征、视力指标均具有重要临床价值。

目的 探讨孕妇学校改革创新后,孕妇对孕妇学校授课的效果和满意度及影响因素分析。方法 2016年8月—2017年6月,通过师资授课比赛、课后孕妇满意度、对相关知识知晓率排名相结合方式竞争产生孕妇学校授课师资队伍,随机选取部分听课孕妇作为调查对象。结果 授课后,孕妇对相关知识的知晓得分提高约20分(P＜0.05),孕妇对核心知识点知晓率提高明显(P＜0.05),孕妇对课程讲授效果各方面满意度均在94%以上。对课程不满意的维度主要有授课PPT制作、教学计划、授课形式等,不满意比例分别为19.1%、18.0%和16.3%。对课程不满意组孕妇较满意组孕妇年龄偏大(P＜0.05),其余孕妇基本特征差异无统计学意义。结论 孕妇学校师资改革成效明显,行之有效,值得推广。

Objective To explore the effect of pregnant women's school after reform and innovation. Methods FromAugust 2016 to June 2017, teachers of pregnant women's school were produced by teaching competition and pregnant women's satisfaction and degree of knowledge. Survey objects were randomly selected. Results After teaching, knowledge degree of pregnant women improved about 20 points (P<0.05). The awareness rate of pregnant women on core knowledge points increased (P<0.05). Satisfaction degree of pregnant women on the course was over 94%. The main dimensions of dissatisfaction with the course included PPT production, teaching plan and teaching form. The proportions of dissatisfaction were 19.1%, 18.0% and 16.3% respectively. Unsatisfied women ages were older than satisfied women (P<0.05). Conclusion Reform and innovation is effective, and it is worth promoting.

目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺动脉高压(pulmonary hypertention,PH)的危险因素。方法 回顾2014年1月—2015年1月广州医科大学附属第一医院住院患者55例,经心脏彩色多普勒超声测量肺动脉收缩压(PASP),分为:轻度组(36≤PASP＜50 mmHg),中度组(51≤PASP＜70 mmHg)和重度组(PASP≥70 mmHg),分析比较三组临床特征,危险因素采用单因素及多因素Logistic回归分析。结果 年龄(75.3±11.6)岁,PASP为(52.6±15.1)mmHg。单因素分析中-重度PH与年龄、HCT、PaCO₂、PaO₂、D-二聚体有关;多因素Logistic回归分析确定3项危险因素:HCT[比值比(OR)=51.82,95% CI: 2.34～1149.02],RV(OR=4.53,95% CI: 2.83～7.27),及PaCO₂(OR=1.02,95% CI: 1.00～1.03)。结论 呼吸病相关PH多为轻-中度,高水平的HCT、RV直径及PaCO₂提示PH病情较重。

Objective To analyze the clinical risk factors of pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease(COPD). Methods A total of 55 hospitalized patients from 2014 to 2015 were enrolled in the study and were classified into three groups according to pulmonary artery systolic pressure (PASP) with echocardiography as follows: the mild group (36≤PASP＜50 mmHg), the moderate group (51≤PASP＜70 mmHg) and the severe group (PASP≥70 mmHg). Clinical data were recorded and retrospectively analyzed. Results The average age of all patients was (75.3±11.6)years. Echocardiography showed a mean PASP was 52.6±15.1 mmHg. Age, hematocrit (HCT), partial pressure of carbon dioxide (PaCO₂), the oxygen partial pressure (PaO₂), D-dimer and right ventricular (RV) diameter (>20 mm) were associated with moderate-to-severe PH on an univariate regression analysis, while RV (diameter >20 mm)[odds ratio (OR)=4.53, 95% CI: 2.83～7.27], HCT(OR=51.82, 95% CI: 2.34~1149.02) and PaCO₂ (OR=1.02, 95% CI: 1.00-1.03), to these patients, were independent risk factors using the multiple logistic regression analysis. Conclusion PH related to respiratory diseases is mostly mild-to-moderate. Haemoptysis,high levels of RV diameter, HCT and PaCO₂ suggest a serious condition of patients with PH related to chronic respiratory disease.

目的 探讨鼻咽癌(NPC)放疗致鼻窦炎发生的临床特征、影响因素。方法 回顾性分析2014年1月—2017年6月期间,我院收治的228例NPC患者临床资料,根据患者是否进行放疗,将患者分为非放疗组(106例)和放疗组(122例)。对比分析两组鼻咽癌致鼻窦炎的临床特点,以单因素和多因素Logistic分析鼻咽癌患者放疗后发生鼻窦炎的影响因素。结果 放疗组患者鼻窦炎发生率为81.97%,高于非放疗组患者鼻窦炎发生率54.72%,差异有统计学意义(P＜0.05)。放疗组鼻窦炎累及部位发生率从高到低,依次为后组筛窦、蝶窦、前组筛窦、窦口鼻道复合体、额窦以及上颌窦。放疗组患者鼻窦炎后组筛窦、蝶窦累及率高于非放疗组患者,差异具有统计学意义(P＜0.05)。单因素分析结果显示,放疗后鼻窦炎的发生,与患者年龄是否＞50岁,病程是否＞2年,是否存在鼻腔侵犯,肿瘤分期,是否使用滴鼻剂及是否进行鼻咽冲洗有关,差异有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示,患者病程＞2年,存在鼻腔侵犯以及T3+T4期肿瘤是NPC放疗后鼻窦炎发生的独立危险因素;使用滴鼻剂和鼻咽冲洗是NPC放疗后鼻窦炎发生的保护因素。结论 NPC放疗后具有较高的鼻窦炎发生率,并且主要累及后组筛窦和蝶窦,对于病程＞2年、存在鼻腔侵犯以及T3+T4期肿瘤的患者,应积极采取措施预防鼻窦炎的发生,使用滴鼻剂和鼻咽冲洗是预防NPC放疗后鼻窦炎发生的有效措施。

Objective To investigate the clinical features and influencing factors of nasosinusitis caused by nasopharyngeal carcinoma (NPC) radiotherapy. Methods The clinical data of 228 NPC patients admitted to our hospital from January 2014 to June 2017 were retrospectively analyzed. According to whether the patients were treated with radiotherapy, the patients were divided into non-radiotherapy group (106 cases) and radiotherapy group (122 cases). The clinical characteristics of nasosinusitis were analyzed and compared. Univariate and multivariate logistic analysis was used to analyze the influencing factors of nasosinusitis after radiotherapy in patients with nasopharyngeal carcinoma. Results The incidence of sinusitis was 81.97% in the radiotherapy group, which was higher than that in the non-radiotherapy group (54.72%). The difference was statistical significance (P<0.05). The incidence of sinusitis involvement in the radiotherapy group was in the order of ethmoid sinus, sphenoid sinus, anterior ethmoid sinus, sinus ostium and nasal tract sinus complex, frontal sinus, and maxillary sinus. The incidences of ethmoid sinus and sphenoid sinus in the post-nasal sinusitis group were higher than that in the non-radiotherapy group (P<0.05). Univariate analysis showed that the occurrence of sinusitis after radiotherapy was related to whether the patient's age was > 50 years, whether the disease duration was >2 years, whether there was nasal invasion, tumor staging, whether nasal drops were used, and whether nasopharyngeal irrigation was performed. Multivariate logistic regression analysis showed that patients with a disease course of >2 years had nasal invasion and T3+T4 tumors were independent risk factors for sinusitis after NPC radiotherapy; use of nasal drops and nasopharyngeal washing were protective factors. Conclusion There is a higher incidence of sinusitis after radiotherapy of NPC, and mainly affects the ethmoid sinus and sphenoid sinus in the posterior group. Patients with a disease course of >2 years, with nasal invasion, and T3+T4 tumors should actively take measures to prevent the occurrence of sinusitis. The use of nose drops and nasopharyngeal washing is an effective measure to prevent the occurrence of sinusitis after NPC radiotherapy.

目的 探讨科学的出院后营养管理对肠道术后新生儿体格追赶的效果,分析影响体格追赶的相关因素。方法 通过营养门诊对出院术后婴儿及社区婴儿进行个体化营养喂养指导和营养咨询,比较两组每月体质量、身长及头围,并随访至生后9月龄。两组生后半年生长趋势行重复测量检验。结果 第1月龄时,手术组患儿体质量、身长、头围均落后于对照组婴儿(P<0.001, P=0.004, P=0.008),第2月龄时,手术组患儿体质量、头围仍落后于对照组(P=0.003,P=0.031),第4月龄时,手术组体质量低于对照组(P=0.012),第5～9月龄,两组体格指标均无明显差异。生后半年内两组的生长趋势差异无统计学意义。前半年身长的增长与出生身长、父母文化以及父亲的不良习惯存在负相关关系,头围的增长与住院天数呈明显负相关关系、与出生以及首诊时的体格状况呈正相关关系。结论 合理喂养对新生儿肠道术后体格追赶有利,帮助其接近正常生长曲线。再次手术可能是导致体质量增长下降的主要因素,但未明显影响身长、头围的正常增长。出生时和就诊时的体格状况、父母教育程度和不良习惯以及住院天数均是影响体格追赶的相关因素。

Objective To investigate the effect of scientific nutrition management after discharge on neonatal physical catch-up after intestinal operation, and to analyze the related factors affecting physical catch-up. Methods Individualized nutritional feeding instruction and nutrition consultation were performed on infants and community infants after discharge from hospital through nutrition clinic. The monthly body weight, body length and head circumference were compared between the two groups, and followed up to 9 months old. The growth trend of the two groups in half a year after birth was tested by repeated measurement. Results At the first month of age, the body weight, body length and head circumference of the patients in the operation group were lower than those in the control group (P<0.001, P=0.004, P=0.008). At the second month, the body weight and head circumference of the operation group were still behind those of the control group (P=0.003, P=0.031), and at the fourth month of age, the weight and head circumference of the patients in the operation group were still lower than those in the control group. The body weight of the operation group was lower than that of the control group (P=0.012), and there was no diffence in the physical indexes between the two groups at the age of 5~9 months. There was no statistical significance in growth trend between the two groups within half a year after birth. The growth of body length in the first half of the year had a negative correlation with the length of birth, parents' culture and father's bad habits. The growth of head circumference had a negative correlation with the length of stay in hospital, and had a positive correlation with the physical condition at birth and at first visit. Conclusion Reasonable feeding is beneficial to the physical catch-up of the newborn after intestinal operation and helps them approach the normal growth curve. Reoperation may be the main cause of weight loss, but it does not affect the normal growth of body length and head circumference. The physical condition at birth and medical visit, parents' education level, bad habit and hospitalization days were all related factors of physical catch-up.

目的 为科学合理的测算公立医院人员编制以及编制管理改革提供参考。方法 对各省市公立医院机构编制标准以及相关文献进行系统分析,系统总结编制影响因素以及编制测算方法。结果 公立医院人员编制受多方面因素影响,而现阶段人员编制测算主要以床位数与门诊量为主要考量因素,其他因素为辅。结论 结合我国公立医院人事管理改革方向,在公立医院人员编制管理上,首先需要科学核定医院应配备人员总量,全方位考虑各影响因素,并设定一定的可伸缩区间,使医院可根据实际情况在一定范围内自主选择。

Objective To provide references for public hospital personnel calculation and personnel system reform. Methods The related standards of public hospitals in various provinces and literatures were analyzed systematically to sum up influence factors and calculation methods. Results Public hospital personnel complement is affected by various factors. At this stage that was mainly measured by the number of beds and outpatient service,and supplemented by other factors. Conclusion With the reform of personnel management in public hospitals in our country, in the management of public hospital staff, the first need to scientifically measure the total amount of personnel that hospital should be equipped with considering various factors. And to set an interval, the hospital may make an independent choice according to the actual situation.

目的 了解孕妇妊娠期运动现状及其影响因素,为优化妊娠期运动方案提供依据。方法 采用便利抽样法,使用自编《孕妇妊娠期运动现状及影响因素调查问卷》对广州市某三级甲等妇幼保健院214名孕周＞37周的孕妇进行调查。结果 妊娠期每次运动时长集中在30min~1 h的孕妇占43.0%;91.6%的孕妇选择散步和爬楼梯,仅有8.4%的孕妇接触过孕妇体操和瑜伽等其他运动形式;妊娠合并糖尿病与无合并症孕妇运动量相比,差异无统计学意义(P>0.05);家人朋友为孕妇主要获取妊娠期运动信息来源。认为妊娠期运动不重要、缺乏安全感、家庭及社会支持为妊娠期运动的主要影响因素。结论 孕妇运动量总体处于较低水平,运动形式单一,受认知、心理、生理、社会因素影响;孕妇尤其是患有妊娠合并糖尿病的孕妇对妊娠期运动的重要性和必要性没有给予足够的重视;医护人员对于妊娠期运动的引导作用较弱。

目的 分析不同性别学龄儿童行为问题影响因素,为促进儿童行为健康发展提供指导依据。方法 以儿童保健门诊就诊的学龄儿童200名,男童110例,女童90例,平均年龄为(7±15)a 为调查对象,采用儿童行为量表(CBCL)检测所有调查对象的行为问题。由男/女童父母在专业人员指导下进行问卷调查,对收集的数据使用SPSS 11.0统计软件进行资料分析。结果 本次调查中男、女童年龄差异无统计学意义,男、女童在检出儿童行为问题方面有明显的差异性(P<0.05,P<0.01)具有统计学意义。男童在强迫性、违纪方面明显高于女童,女童在抑郁、社交退缩、体诉方面高于男童。结论 儿童行为问题的发生,受多方面因素影响包括社会环境、家庭环境以及父母的教养方式,应根据男童和女童的不同行为特点,给予有效的干预让孩子的身心发展更趋稳定和健康,从而降低儿童行为问题的发生。

Objective To explore the influence factors of children's behavior problem in school-age children, and to provide the evidence for promoting healthier children's behavior. Methods The objects of our study included 200 school-aged children in health care clinic (110 boys and 90 girls ), the average age is 7(7±15)years, and we used the CBCL questionnaire to assess all the children's behavior problems. The CBCL questionnaire was finished by the parents of the children guided by the specialized investigator. The data was analyzed by the SPSS 11.0 software. Results The score of boys in compulsivity and disobey is significant higher than girls(P<0.05), and the girls have higher score in depression, social flinch and physical demands than boys(P<0.01). There is no significant difference between different genders in the age of the children. Conclusion Behavior problems of children were affected by many kinds of factors including social environment, family environment and parenting styles. We need to conduct appropriate behavior intervention according to the different behavior characteristics between boys and girls, to promote healthier children's behavior and to reduce the behavior problems of children.

目的 探究曲美他嗪对慢性心力衰竭患者血清炎症因子水平及心功能的影响。方法 选择2015年4月—2016年3月我院收治的慢性心力衰竭患者94例,根据随机数表法分为两组,每组47例。对照组实施阿托伐他汀治疗,观察组在此基础上予以曲美他嗪治疗。比较两组患者治疗6个月后血清炎症因子和脑利钠肽(BNP)、心功能以及临床疗效。结果 观察组血清C-反应蛋白(CRP)、BNP、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P＜0.05);观察组左收缩末期内径(LVESD)、左室舒张末期内径(LVEDd)水平较对照组明显降低,而左室射血分数(LVEF)高于对照组,差异有统计学意义(P＜0.05);观察组患者治疗有效率与对照组相比明显提高,差异有统计学意义(P＜0.05)。结论 对慢性心力衰竭患者实施曲美他嗪治疗,能有效提高患者临床疗效,降低患者血清炎症因子,改善心功能,值得临床推广与应用。

Objective To investigate the effect of Trimetazidine on serum inflammatory factors levels and cardiac function in patients with chronic heart failure (CHF). Methods 94 CHF patients admitted into our hospital from April 2015 to March 2016 were divided into two groups randomly, 47 cases in each. Control group took Atorvastatin, and on this basis observation group was given Trimetazidine. The serum inflammatory factors levels, brain natriuretic peptide (BNP), cardiac function and clinical efficacy of two groups after treatment for 6 months were compared. Results The serum C-reactive protein (CRP), BNP, Tumor necrosis factor-α (TNF-α) levels of observation group were lower than control group (P<0.05); The left ventricular end-systolic diameter (LVESD), Left ventricular end-diastolic diameter (LVEDd) levels of observation group significantly decreased compared with control group, but left ventricular ejection fraction (LVEF) was higher than control group (P<0.05); The curative effective rate of observation group significantly increased compared with control group (P<0.05). Conclusion Trimetazidine for treating CHF patients may effectively increase clinical efficacy, decrease serum inflammatory factors and improve cardiac function, which is worthy of clinical promotion and application.

目的 了解农民工对入职体检结果异常的遵医行为状况及影响因素,为临床治疗、护理和健康教育提供相应的依据。方法 对106例在我院行入职体检且结果异常的农民工进行遵医行为的问卷调查,且对影响因素进行分析。结果 遵医行为好的有20例,一般的有38例,差的有48例;年龄、性别、文化程度、职业类型、疾病种类、经济收入对农民工的遵医行为均有影响(P＜0.01)。结论 农民工对入职体检结果异常的遵医行为不容乐观,建议国家或相关省市出台相关政策和法规,为农民工提供相应的健康保障;医疗机构要加大健康教育力度,提高农民工的健康意识和倡导健康行为,降低慢性病的发病率。

Objective To investigate migrant workers' medical compliance after receiving abnormal entry health examination results and relevant factors affecting compliance behavior, providing evidence to clinical treatment, nursing and health education. Methods 106 migrant workers who took part in entry health examination in our hospital and got abnormal results were accepted questionnaires and the relative factors were analyzed. Results 20 migrant workers had good compliance behavior, and 38 workers performed normally while 48 workers did bad. Age, gender, education, type of occupation, type of illness, and income all had influence on compliance behavior (P<0.01). Conclusion The recent condition of migrant workers' medical compliance on abnormal entry health examination results is not good. Therefore the country or province departments should carry out relative laws or policies, providing migrant workers with health support; Medical institutions should promote health education to improve migrant workers' health awareness and health behavior and reduce incidence of chronic diseases.