目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

目的 探讨宫腔积血对于中晚期妊娠结局的影响以及影响的因素。方法 结合477例中晚期宫腔积血孕妇的临床资料分析,根据妊娠结局分为正常妊娠结局组(NP)及不良妊娠结局组(AP)。结果 AP的平均孕周(23.22±6.87周)明显大于NP(16.11±4.76周),两组有明显差异性(P<0.001)。两组首次B超宫腔积血平均体积分别为8.01(2.22~28.67)(NP),13.05(3.54~26.34)mL(AP)(P=0.001),但相邻第二次测量结果两组相差不大(P=0.230)。AP组中胎盘下血肿的比率(53.4%)明显大于NP组(24.2%),而绒毛膜下血肿比率(44.0%)明显小于NP(73.8%),两组有明显差异性(P<0.001)。宫缩也是影响因素之一,在AP组可扪及宫缩的病例(88例55.3%)明显高于NP(38例11.9%),两组有明显差异性(P<0.001)。但在阴道流血率方面两组没有明显差异(P=0.407)。结论 妊娠中晚期宫腔积血可能会导致不良妊娠结局,而首次出现的孕周,急性大量宫腔出血、宫腔积血位置以及是否伴有宫缩都是影响妊娠结局的重要因素。

Objective To study the poor pregnancy outcomes of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors. Methods We analyzed the clinical data of 477 patients who underwent routine examination in our hospital from January 2010 to June 2016 and classified them into normal pregnancy (NP) group and adverse pregnancy (AP) group according to their pregnancy outcomes. Results Gestational age at first detection of hematoma of AP group(23.22±6.87 weeks) was more than NP group (16.11±4.76 weeks)(P<0.001). The volumes of hematoma during the first detection were significantly different between the two groups (P=0.001).The average hematoma volume were 8.01(2.22-28.67)(NP),13.05(3.54-26.34)mL(AP)respectively. However, the hematoma volumes recorded in the second B-ultrasound examination were not significantly different between the two groups (P=0.230). In the AP group, the incidence of retroplacental hematoma (53.4%) was significantly higher than in the NP group (24.2%), while the incidence of subchorionic hematoma (44.0%) was significantly lower than in the NP group (73.8%)(P<0.001). The incidence of palpable contractions in the AP group (62.8%) was significantly higher than in the NP group (12.1%), P<0.001. However, the incidence of vaginal bleeding was similar (P=0.407). Conclusion Intrauterine hematoma in the second and third trimester may lead to adverse pregnancy outcomes. Risk factors for poor pregnancy outcomes are included gestational age at first diagnosis, acute and large intrauterine bleeding, location of hematoma and accompanying contraction.

目的 调查流动人口肺结核患者治疗的健康服务需求的现状及其影响因素。方法 采用随机数字表达法,应用自行设计的调查问卷搜集了2015年9月1日—2016年1月30日在广州市胸科医院登记并确诊接受治疗随访的198例流动人口肺结核患者进行治疗相关健康服务需求情况问卷调查,分析患者的健康服务需求情况及不同特征患者需求进行比较。结果 需求率在前六位分别是健康教育为91.41%(181/198)、重视病情变化为90.40%(179/198)、疾病预防为87.88%(174/198)、与医护沟通为85.86%(170/198)、得到他人理解支持为83.84%(166/198)、心理疏导为80.81%(160/198),是否了解抗结核治疗知识、抗结核治疗与否及治疗分类在部分条目上需求率有统计学差异(P<0.05,P<0.01)。结论 流动人口肺结核患者抗结核治疗健康服务需求内容多样化;抗结核治疗的了解程度、抗结核治疗情况和治疗分类是影响治疗的健康服务需求的重要因素。建议对流动人口肺结核患者尽早提供系统的抗结核治疗的健康管理服务模式,以提升患者治疗的效果。

Objective To investigate current status and influencing factors of health care needs of tuberculosis patients in floating population. Methods Using method of random digits table,we collected 198 tuberculosis patients in floating population,who have registered and received treatment in Guangzhou Chest Hospital between September 1,2015 and January 30,2016. We distributed questionnaires about the health service requirement to patients based on on-site interview, and analyzed needs of patients health service. Needs of patients with different characteristics were compared. We collected their health service requirement. Results The rate of demand accounted for the top six were: health education was 91.41% (181/198), attach importance to the disease change was 90.40% (179/198), 87.88% (174/198)was for disease prevention, and medical communication was 85.86% (170/198), others understand support was for 83.84% (166/198), psychological counseling was for 80.81% (160/198). There was statistically different in knowing of whether the anti tuberculosis treatment knowledge, anti tuberculosis treatment and treatment in some items on demand classification rate (P<0.05, P<0.01). Conclusion Anti tuberculosis treatment needs of extensive health services of tuberculosis patients in floating population. Understanding degree, anti tuberculosis treatment and therapeutic anti tuberculosis are important factors influencing the tuberculosis drug treatment needs. It is recommended that TB patients in floating populationshould be diagnosed as early as possible to provide a systemic health management service mode of anti tuberculosis treatment in order to improve the effect of treatment.

目的 探讨影响本区肺结核发病的危险因素,为肺结核的防控提供参考依据。方法 采用频数匹配病例对照的研究方法,选自2012—2015年间,在本区居住的肺结核患者为病例组,按1∶1病例对照,在本区选择与病例组同性别、年龄相差<2 a的健康居民为对照组,用单因素Logistic分析及对多因素非条件Logistic 回归分析进行统计学分析。结果 肺结核发病的保护因素有文化程度的高低(OR=0.237,P<0.037),居住环境采光(OR=0.393,P<0.013),蔬菜水果类摄入(OR=0.748,P<0.021),蛋奶类摄入(OR=0.704,P<0.027)。肺结核的危险因素有工作环境是否接触粉尘(OR=2.984,P<0.001)是否吸烟(OR=1.537,P<0.020),是否饮酒(OR=1.110,P<0.041),结核病人接触史(OR=11.052,P<0.001),居住环境潮湿(OR=1.117,P<0.001)。最终被选入回归方程的因素为,文化程度、工作环境是否接触粉尘、结核病人接触史、居住环境潮湿、蔬菜水果类摄入,其OR值分别为0.471、8.945、17.652、14.268、0.234。结论 文化程度及蔬菜水果类的摄入为肺结核保护因素,工作环境接触粉尘、接触过结核病人及居住环境潮湿是肺结核的危险因素。

目的 探讨二孩政策后二次妊娠孕妇产前不良情绪及影响因素。方法 选取2016年2月—2017年1月我院收治二次妊娠待产孕妇93例作为研究组,选取同期收治初产妇50例作为对照组,采用汉密顿焦虑量表(HAMA)和抑郁状态采用抑郁自评量表(SDS)评估比较两组产期焦虑、抑郁情绪,同时按照HAMA、SDS评分结果将研究组患者分为A组(合并不良情绪)和B组(未合并不良情绪),采用单因素和多因素Logistic回归分析方法分析影响二次妊娠孕妇产前不良情绪危险因素。结果 研究组HAMA、SDS评分均高于对照组(P＜0.05)。妊娠合并症、不适应医院环境、未参加孕妇学校及胎儿异常均为影响二次妊娠孕妇产前不良情绪危险因素。结论 二孩政策后二次妊娠孕妇产前易合并不良情绪,影响产前不良情绪危险因素较多,产前应针对性进行预防和干预。

目的 探讨断指再植术后血管危象发生情况及危险因素。方法 收集2015年8月—2016年12月我院行断指再植术患者66例临床资料行回顾性分析,根据患者术后是否发生血管危象分为A组(发生血管危象)和B组(未发生血管危象),收集两组患者一般临床资料,采用单因素和多因素Logistic 回归分析影响断指再植术患者术后血管危象发生的危险因素。结果 单因素分析得出,性别、年龄、吸烟史、指别、外伤原因、末端断离及缺血时间在A、B两组间比较有统计学意义(P＜0.05)。多因素分析得出,性别、年龄、吸烟史、指别、外伤类型、末端断离、缺血时间均为影响断指再植术术后血管危象发生危险因素。结论 血管危象为断指再植术常见并发症,影响发生血管危象危险因素较多,临床中应针对性进行预防和干预,以降低断指再植术患者术后血管危象发生率,提高断指存活率。

目的 探讨维持性腹膜透析患者高尿酸血症的临床特点及相关影响因素。方法 收集152名腹膜透析患者,根据血尿酸情况将患者分为高尿酸血症组和正常血尿酸组,分析其临床资料。结果 高尿酸血症112例(73.7%)。高尿酸血症组的血钾、高血压史、血尿素氮、血清肌酐、血磷、iPTH、甘油三脂水平均较正常尿酸组升高(P均＜0.05);而年龄、血钠、血红蛋白、血白蛋白、前白蛋白、血钙、血清铁、总蛋白、hsCRP、空腹血糖、血总胆固醇、血高密度脂蛋白胆固醇、血低密度脂蛋白胆固醇、KT/V、PET无统计学差异(P均＞0.05)。血尿酸水平与血钾、血尿素氮、血磷呈正相关(P＜0.05)。结论 腹膜透析患者高尿酸血症发生率高,血尿酸与血钾、血尿素氮、血磷密切相关,及时纠正高尿酸血症可以改善预后。

Objective To investigate the clinical characteristics and its related influence factors of hyperuricemia in peritoneal dialysis patients. Methods A total of 152 peritoneal dialysis patients were enrolled. Patients were classified into hyperuricemia and normal serum uric acid (SUA)groups. Factors associated with hyperuricemia were analyzed. Results Hyperuricemia occurred in 112 cases(73.7%). There were significant differences in serum potassium, the incidence of hypertension, blood urea nitrogen, serum creatinine, serum phosphorus, parathyroid hormone, triglyceride between hyperuricemia and normal SUA groups(P<0.05). There was no significant difference in age, serum sodium, hemoglobin, serum albumin, prealbumin, serum calcium, serum iron, total protein, high sensitive C-reactive protein, serum glucose, total cholesterol, high density lipoproteins, low density lipoproteins, KT/V and PET(P>0.05). SUA levels was positively correlated with serum potassium, blood urea nitrogen and serum phosphorus(P<0.05). Conclusion Hyperuricemia was common in peritoneal dialysis patients, serum potassium levels is correlated with serum potassium, blood urea nitrogen and serum phosphorus. The timely treatment of hyperuricemia may improve the prognosis of peritoneal dialysis patients.

目的 观察表皮生长因子(EGF)在新生儿坏死性小肠结肠炎(NEC)患儿肠组织中的动态表达情况,探讨EGF在NEC病程中起到的保护作用。方法 选取15例NEC患儿行一期回肠造瘘手术治疗的回肠组织为实验组(NEC组),将以上15例NEC患儿行二期回肠封瘘手术治疗的回肠组织为对照组(封瘘组),采用免疫组织化学技术检测,通过光密度测算软件(IPP)分析回肠组织中的EGF表达。结果 EGF主要表达于肠壁黏膜层,少量表达于黏膜下层、肌层。EGF在NEC组各层表达平均光密度值为:黏膜层(0.241±0.075),黏膜下层(0.213±0.061),肌层(0.1397±0.026),差异有统计学意义(P＜0.05);在封瘘组各层表达情况为:黏膜层(0.211±0.028),黏膜下层(0.119±0.022),肌层(0.097±0.007),差异有统计学意义(P＜0.05)。EGF在NEC组总体表达平均光密度值为(0.198±0.071),明显高于封瘘组(0.146±0.058),差异有统计学意义(P＜0.05)。结论 表皮生长因子(EGF)在新生儿坏死性小肠结肠炎(NEC)肠组织中的表达较封瘘组显著上调,推测EGF可能与NEC炎症相关,可能在NEC炎症过程中起到了一定的保护作用。

Objective We realized that EGF could play an important protective role against NEC. However, the practical condition of the distribution and expression of EGF in intestine of infants with NEC was indefinite. In order to figure out this problem,we carried out this experimentation. Methods The sample were divided into two group.The experimental group(necgroup) were composed of fifteen individual intestinal tissues after the ileostomy were performed on those infants suffered from NEC. The control group(sealing fistula group) were composed of fifteen individual intestinal tissues after the ileal closure fistula were performed on the same infants who were accepted the one-stage ileostomy in the period of NEC and were later accepted the two-stage operation on the condition that their bodies almost recovered from NEC after two to three months gone.Then, we utilized immunohistochemistry to test the distribution and quantities of EGF on those samples of the two group infants. Results The characteristic of EGF expression in intestine of the both group included strong positive expression in mucous layer and less expression in strata submucosum and muscular coat. The average optical density in nec group was mucous layer (0.241±0.075),strata submucosum(0.213±0.026),muscular coat (0.1397±0.022);In the control groupmucous layer (0.211±0.028),strata submucosum (0.119±0.022),muscular coat (0.097±0.007). The expression of EGF in intestinal tissues increased in the period of NEC0.198±0.071 by comparing with the control group (0.146±0.058). Conclusion There may be a correlation between the strong positive expression of EGF in intestinal tissues in the period of NEC and inflammation.By combining the result of this experiment and the research about EGF. We assumed that EGF is one factor of the protective mechanism by which injured intestinal mucous could be recovered and resist inflammation.

目的 了解异鼠李素对LPS刺激下THP-1细胞炎症因子IL-6、MCP-1、TNF-α释放的影响及其抗炎特征。方法 用PI单染色法检测其细胞存活率;用ELISA法检测THP-1细胞炎症因子IL-6、MCP-1、TNF-α释放。结果 不同浓度的LPS均能使炎症因子IL-6释放增高,且24 h及48 h间水平无差异,但随着LPS刺激浓度的增高,细胞的坏死数量也会随之升高;不同浓度的异鼠李素能在不同时间点不同程度地抑制炎症因子MCP-1、TNF-α、IL-6的释放。结论 异鼠李素能抑制LPS刺激下THP-1细胞炎症因子IL-6、TNF-α、MCP-1的释放,并呈浓度依赖性。

Objectives Our study is aim to investigate the influence of the isorhamnetin on the releasing of inflammatory factor cytokines of the THP-1 cells. Methods PI single staining method was used to detect the cell survival rate. ELISA was used to detecte the concentrations of inflammatory cytokines(MCP-1、IL-6、TNF-α). Results The concentration of IL-6 in THP-1 cells were increased after stimulated with LPS and there no difference between the 24 h group and 48 h group. The survival rate of THP-1 cells decreased as the concentration of LPS increased.The isorhamnetin in different concentration could inhibit the secretion of inflammatory cytokines in different time. Conclusion It is found in our study that isorhamnetin may inhibit the secretion of MCP-1, IL-6, TNF-α in THP-1 cells stimulated by LPS in a concentration dependent way.

目的 研究孟鲁斯特治疗哮喘的临床疗效及其对患者Th1/Th2细胞免疫平衡和相关炎症因子水平的影响。方法 选取哮喘患者68例随机分为对照组31例及观察组37例,对照组予以常规糖皮质激素吸入治疗,观察组在此基础上加服孟鲁斯特。用药3个月后流式细胞仪检测两组患者外周血Th1、Th2数量变化,ELISA定量外周血IL-4及IFN-γ含量变化并作临床效果评定。结果 两组患者经治疗后,外周血Th1/Th2比例均升高,IL-4/IFN-γ细胞因子水平下降,但观察组较对照组变化更为明显,差异有统计学意义(P＜0.01)。疗效方面,观察组总有效率94.59%,高于对照组的74.19%,差异具有统计学意义(P＜0.01),同时两组均未见明显不良反应。结论 哮喘患者加用孟鲁斯特具有明显免疫调节功能,使Th1/Th2水平趋于平衡,作为哮喘辅助治疗药物疗效确切。