目的 探讨臭氧水在外科手消毒中的消毒效果和医护人员的舒适度。方法 将参加手术的医务人员80例按时间段分为对照组、低浓度组、高浓度组,于消毒后分别进行手采样培养,并进行分析。结果 消毒后三组在菌落数比较差异有统计学意义(P<0.01);消毒后三组皮肤在发痒、脱屑、干燥评分比较差异有统计学意义(P<0.05);在气味、粘腻感、干燥速度比较差异有统计学意义(P<0.05)。结论 臭氧水用于外科手消毒效果可靠,无刺激气味和粘腻感,医护人员感觉更舒适。
Objective The aim of this study was to explore the disinfection effect of ozone water in surgical hand disinfection and the comfort of medical staffs. Methods 80 medical staffs who participated in surgeries were divided into control group, low-concentration group and high-concentration group according to the time period. After disinfection, hand samples were cultured and analyzed. Results After disinfection, there were statistically significance in colony number (P<0.01), itching, scaling and drying scores (P<0.05), odor, stickiness and drying speed (P<0.05). Conclusion Ozone water for surgical hand disinfection is reliable, no irritating odor and stickiness, and makes medical staffs feel more comfortable.
目的 运用网络药理学方法预测生白术活性成分、作用靶点及生物学意义,探讨其防治便秘的作用机制,并结合导师临床应用取得的疗效进行进一步的验证。方法 借助TCMSP在线数据库查找白术的药效成份并选择其生物利用度(OB)>30%且类药性(DL)>0.18的化合物,并查询每种成分所对应的靶标。通过Gene Cards、OMIM共2个疾病相关靶点的数据库检索便秘相关靶点信息。将二者靶基因相映射获得交集靶点。借助 cytoscape 3.7.1 软件对查询结果进行可视化。所得到的基因通过相互作用数据库(STRING)进行相互作用蛋白查询并构建蛋白质相互作用(PPI)网络。使用R语言对关键靶点行GO和KEGG富集分析,以构建“成分-靶点-信号通路”的网络。结果 共得到白术人源靶蛋白7个,便秘相关的人源基因2 859个。发现其主要通过干预PGR、CHRM3、CHRM1、ACHE、CHRM2五个基因并参与胆碱能突触、钙信号通路、肌动蛋白细胞骨架的调控、神经活性配体-受体相互作用、cAMP信号通路、PI3K-AKT信号通路共6条信号通路以达到防治便秘的效果。结论 应用网络药理学方法分析预测得到重用生白术防治便秘的潜在药效成分、作用靶点及其信号通路,为临床应用提供了理论依据。
Objective To predict the active ingredients, targets and biological significance of Atractylodes macrocephala by network pharmacology, to explore the mechanism of its prevention and treatment of constipation, and to further verify its efficacy in combination with the clinical application of tutors. Methods The constituents of Atractylodes macrocephala were searched by TCMSP database and the compounds with bioavailability (OB) > 30% and drug-like property (DL) > 0.18 were screened, and the corresponding targets of each constituent were queried. Constipation-related target information was retrieved from two disease-related target databases of GeneCards and OMIM, mapping the two target genes to obtain intersecting targets, by visualization of query results with cytoscape 3.7.1. The resulting genes were queried by the interaction database (STRING) and the protein interaction (PPI) network was constructed. GO and KEGG enrichment analysis of key targets was carried out by R language in order to construct the network of “component-target-signal pathway”. Results Seven human target proteins and 2 859 constipation related human genes were obtained from Atractylodes macrocephala. It was found that the effect of prevention and treatment of constipation was mainly achieved by interfering with five genes of PGR, CHRM3, CHRM1, ACHE and CHRM2 and participating in six signaling pathways: cholinergic synapse, calcium signaling pathway, regulation of actin cytoskeleton, neuroactive ligand-receptor interaction, cAMP signaling pathway and PI3K-AKT signaling pathway. Conclusion The potential pharmacodynamic components, targets and signaling pathways of reuse Rhizoma atractylodis macrocephalae in the prevention and treatment of constipation can be predicted by network pharmacological method, which provides a theoretical basis for clinical application.
目的 探讨超声不同方法联合应用对提高卵圆孔未闭检出率的应用价值。方法 收集我院收治的临床疑似卵圆孔未闭的患者88例作为研究对象,进行超声影像组合检查(常规经胸超声心动图检查,经食道超声检查,右心声学造影检查),并对多组超声影像检查结果记录行回顾性统计分析。结果 88例研究对象中常规经胸超声心动图初步筛查发现PFO(+)12例(13.6%),其中合并房间隔膨出瘤2例。经食道超声检查22例,发现PFO(+)20例(90.9%),其中发现来源于肺动静脉瘘2例。全部研究对象均行右心声学造影发现PFO(+)39例(44.3%),分别于静息状态下发现PFO(+)24例,Valsalva动作后发现PFO(+)39例;其中发现合并房间隔膨出瘤形成者4例;合并肺动静脉瘘者3例(其中1例来源于肺静脉)。经食道超声联合右心声学造影检查的14例患者中发现PFO(+)10例(71.4%)。右心声学造影依据微气泡的数量进行半定量分级发现:I级有16例;II级有5例;III级有18例;不同状态下对于RLS的半定量分级差异有统计学意义(χ2=12.729,P=0.02)。结论 超声影像组合可对卵圆孔未闭患者进行半定量评估,能有效补充单一常规超声检查的信息的不足,进而为临床诊治提供客观化依据。
Objective To explore the value of ultrasound combined with different methods in improving the detection rate of patent foramen ovale. Methods 88 cases of clinically suspected patent foramen ovale in our hospital were collected as the research objects to carry out the ultrasonic image group examination (routine transthoracic echocardiography TTE, transesophageal echocardiography TEE, right heart contrast echocardiography), and the results of multiple groups of ultrasonic image examination were recorded for retrospective statistical analysis. Results Among 88 subjects, 12 (13.6%) were found to have PFO (+)by conventional transthoracic echocardiography, 2 of them had atrial septal aneurysm. 20 cases (90.9%) of PFO were found by transesophageal ultrasonography, and two of them were from pulmonary arteriovenous fistula.In all the subjects, 39 cases (44.3%) of PFO were found by right heart sonography, 24 cases were found in resting state, 39 cases were found after Valsalva operation, 4 cases were found with aneurysm of atrial septum, 3 cases with pulmonary arteriovenous fistula (one of them was from pulmonary vein). Among the 14 patients examined by transesophageal ultrasound combined with right cardiac sonography, 10 (71.4%) were found to have PFO(+). According to the number of microbubbles, the right echocardiography showed that there were 16 cases in grade I, 5 cases in grade II, 18 cases in grade III, and there were statistical differences in the semi quantitative classification of RLS in different states (χ2=12.729, P=0.02). Conclusion Ultrasound image histology can be used for semi quantitative evaluation of patients with patent foramen ovale, which can effectively supplement the lack of single conventional ultrasound information, and provide objective basis for clinical diagnosis and treatment.
目的 对下颌角肥大钻凿法截骨整形手术进行生物力学研究,并探索该术式的优化改进。方法 采用有限元方法,建立下颌角钻凿法截骨整形手术及其改良术式的三维有限元模型并进行应力分析、比较。结果 模型-1(钻凿法下颌角截骨整形手术模型)下颌角断裂失效载荷在所有术式中最高,为2426N。其余的改良术式模型(模型-2~7)失效载荷均低于模型-1,分别为2018N、1854N、1447N、1183N、1028N、876N。同时,模型-7与其他模型对比,其应力分布范围最小,关节盘von Mises应力手术侧大于非手术侧,大部分区域为0.52～3.25 MPa之间,最大不超过9.86 MPa。结论 在非均匀钻孔加去下颌角颊侧皮质骨的同时施加最大咬合力和下颌支后缘约束的手术方法最优。
Objective To study the biomechanics of osteotomy surgery for mandibular angle hypertrophy with drilling method and to explore the optimization and improvement of this operation. Methods Using the finite element method, the three-dimensional finite element models of osteotomy surgery for mandibular angle hypertrophy with drilling method as well as its modified operations are established,meanwhile, the stress analysis and comparison are performed. Results Model-1 (mandibular angle osteotomy surgery model by drilling method) had the highest fracture failure load among all surgical methods, which was 2426N. The failure loads of the other modified surgical models (model-2 ~7) were all lower than that of model-1, which were 2018N, 1854N, 1447N, 1183N, 1028N and 876N, respectively. Meanwhile, compared with other models, the stress distribution region of model-7 was the smallest, with the von Mises stress in operating side of the articular disc was greater than that of the non-operating side, and most of the area was between 0.52～3.25MPa and the maximum of 9.86MPa. Conclusion The non-uniform drilling and removal of the buccal cortical bone of the mandibular angle are combined with the maximum occlusal force and the constraint of the posterior margin of the mandibular ramus is the best operation method.
目的 探讨孕中后期中低等强度有氧运动对高龄孕妇产前生活质量和母婴结局的影响。方法 选2017年8月—2018年12月我院接收的560名高龄孕妇作为研究对象,随机分成数量相等的两组。对照组采取常规孕期保健服务和健康教育,观察组则在此基础上增加孕中后期中低等有氧运动的干预,问卷法调查两组孕妇的抑郁情况、睡眠质量、产前生活质量,并比较两组孕妇的母婴结局。结果 χ2检验结果显示,研究组对象平均每周运动次数≥3次及平均每次运动时间≥30 min的比例高于对照组(P=0.001)。研究组对象的EPDS抑郁分值和SRSS睡眠质量分值均低于对照(P=0.006)。研究组对象产前GQOLI-74生活质量问卷中生活质量总得分高于对照组(P=0.000 1)。研究组对象的妊娠糖尿病、妊娠高血压、难产率、巨大儿发生率均低于对照组(P=0.039),但自然分娩率高于对照组(P=0.004)。结论 以瑜伽、慢走或散步为主的中低强度的有氧运动可能有助于提供高龄孕妇的产前生活质量,预防妊娠疾病和不良母婴结局,在临床上具有一定的推广意义。
Objective To study the influences of medium or low strength aerobics during 2nd and 3rd trimester on life quality and pregnant outcome of elderly pregnant women. Methods To select 560 elderly pregnant women in our hospital during August 2017 to December 2018 as the objects of this study. Objects were divided into control group which was given routine pregnant health services and study group which was given medium or low strength aerobicsduring 2nd and 3rd trimester excluding in addition. Questionnaires were used for collecting messages of depression, sleeping, life quality of objects. Pregnant outcome were compared of two groups by Chi-square test in this study. Results The ratio of average aerobics more than 3 times per week and average time more than 30min each time of study group were higher than control group(P=0.001). The scores of EPDS and SRSS of study group were lower than control group(P=0.006). The scores of GQOLI-74 of study group were higher than control group(P=0.000 1). The ratio of pregnant diabetes mellitus, pregnant hypertension, dystocia, fetal macrosomia of study group were lower than control group(P=0.039) but the ratio of eutocia was higher than control group(P=0.004). Conclusion The medium or low strength aerobics such as Yoga, taking a walk may improve pregnant life quality of elderly pregnant women and prevent pregnancy disease and abnormal pregnant outcome that deserved to promote in clinic.
目的 探索2型糖尿病(T2DM)男性患者血尿酸水平与骨密度(BMD)、临床骨折患病率的相关性。方法 选取广州市第一人民医院住院的T2DM男性患者192例,采用双能X线骨密度仪测定各部位BMD,记录年龄、糖尿病病程、BMI,检测血尿酸、空腹血糖、糖化血红蛋白、血脂、碱性磷酸酶等,并分析BMD与其余指标的相关性。结果 骨质疏松组血尿酸、各部位BMD均低于骨量正常组及低骨量组(P＜0.05)。血尿酸与各部位BMD正相关(P＜0.01)。右股骨颈BMD与年龄负相关,与空腹血糖正相关(P＜0.05)。多元Logistic回归分析显示,血尿酸与临床骨折呈负相关。调整年龄、空腹血糖、ALP等混杂因素后,血尿酸水平与临床骨折仍有关联。当进一步调整各部位BMD时,结果无统计学意义。结论 维持正常稍高的血尿酸水平可能有利于减少T2DM男性患者骨质疏松及脆性骨折的发生。
Objective To explore the correlation in serum uric acid level and bone mineral density (BMD) and fracture rate in male patients with type 2 diabetes mellitus (T2DM). Methods 192 cases of male patients with T2DM in Guangzhou First People's Hospital were selected in this study.BMD was measured by bone density machine. The patient's age, diabetes course and BMI were recorded. Fasting blood glucose, glycated hemoglobin (HbA1c), liver and kidney function, blood uric acid, blood lipid, alkaline phosphatase, 25 hydroxyvitamin D3 levels were measured, and the correlation between BMD and other indicators was analyzed. Results The serum uric acid level,lumbar and right femoral neck BMD in the osteoporosis group were lower than those in the normal and low bone mass groups (P<0.05). Serum uric acid was positively correlated with BMD values of lumbar spine and right femoral neck in male patients with type 2 diabetes (P<0.01). BMD value of right femoral neck was negatively correlated with age and positively correlated with fasting blood glucose (P<0.05). Multivariate logistic regression analysis showed a significant negative correlation between serum uric acid and clinical fractures in male patients with type 2 diabetes (model 1). When the model was adjusted for age, fasting blood glucose, ALP and other factors, serum uric acid levels were still associated with clinical fractures (model 2). When the BMD values of the lumbar spine and the right femoral neck were further included (model 3), the results were not statistically significant. Conclusion Slightly higher blood uric acid levels may help to reduce the incidence of OP and fracture rate in male patients with T2DM.
目的 我们探讨2019年6月—2020年1月复发性流产夫妇男性患者精浆弹性蛋白酶同精液参数及DNA碎片率的可能关系。方法 研究对象纳入80例复发性流产的男性患者及25例因女方输卵管因素行IVF-ET正常生育的男性患者。精液标本用来进行精浆弹性蛋白酶、精液常规分析、精子核染色质分析及精子形态学等参数分析。结果 结果表明同正常生育男性相比,复发性流产的弹性蛋白酶是增高(P=0.010)。我们将复发性流产男性患者分为正常组(<600 ng/mL)及异常组(≥600 ng/mL)。结果表明异常组患者的精子前向运动比例(P=0.002)及正常形态百分率(P=0.009)均降低,而精子DNA碎片率(P=0.002)增高。Spearman相关性分析发现精浆弹性蛋白酶同精子前向运动比例(r=-0.43,P<0.001)及正常形态百分率(r=-0.39,P<0.001)负相关,而同精子DNA碎片率(r=0.36,P=0.001)正相关。结论 精浆弹性蛋白酶可能影响复发性流产男性患者的精子活力、形态及DNA碎片率。复发性流产男性患者的生殖道隐性感染值得重视,其相关临床探讨性值得深入研究。
Objective Our study is aim to investigate the possible relationship of seminal elastase, on semen parameters and DNA fragmentation in male patients of recurrent pregnancy loss (RPL) between June 2019 and January 2020. Methods The patients included 80 male patients of RPL couple and 25 male patients from couples with clinical pregnancy through in vitro fertilization due to the female tubal factor. The semen samples were used to determine the seminal elastase, computed assisted semen analysis, sperm dispersion test and sperm morphology analysis. Results Compared to the control group, the levels of seminal elastase was increased in the RPL group. The RPL group was divided into the normal group (Elastase<600 ng/mL) and abnormal group (Elastase ≤ 600 ng/mL).The abnormal group exhibited the lower percentage of progressive sperm (P=0.002) and normal morphology (P=0.009),but higher precentage of DNA fragmentation (P=0.002). Meanwhile, the seminal elastase was positively associated with DNA fragmentation (r=0.36,P=0.001), but was inversely associated with the sperm motility (r=-0.43,P<0.001) and normal morphology (r=-0.39,P<0.001). Conclusion Our study may unveil the possible effects of the seminal elastase on the semen parameters and DNA fragmentation in the male patients of RPL couples. Further studies should put more emphasis on the silent genital tract inflammation of the patients.
目的 应用三维斑点追踪成像(3D-STI)技术评价睡眠呼吸暂停综合征患者左、右心室整体收缩功能。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。用三维斑点追踪成像技术测量各组左心室整体纵向应变(LVGLS)、圆周应变(LVGCS)、径向应变(LVGRS)、面积应变(LVGAS)以及右心室整体纵向应变(RVGLS)、圆周应变(RVGCS)、径向应变(RVGRS),并比较各组间参数的差异。结果 与轻度OSAS组比较,中、重度OSAS组LVGLS、LVGAS降低,差异有统计学意义(P<0.05);与中度OSAS组相比较,重度组LVGLS、LVGCS、LVGRS以及LVGAS均降低,差异有统计学意义(P<0.05);右心室部分应变参数变化早于左心室。结论 应用3D-STI技术能够在患者左心室射血分数(LVEF)发生改变之前发现早期左、右心室功能收缩障碍,为临床早期诊断及干预提供可靠的依据。
Objective To evaluate left and right ventricular systolic function of patients with obstructive sleep apnea syndrome (OSAS) by using three-dimensional speckle tracking imaging(3D-STI). Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index (AHI), the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. The left ventricle global longitudinal strain (LVGLS), left ventricle global circumferential strain (LVGCS), left ventricle global radial strain (LVGRS), left ventricle global area strain (LVGAS) and right ventricle global longitudinal strain (RVGLS), right ventricle global circumferential strain (RVGCS) and right ventricle global radial strain (RVGRS) were measured by three-dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results Compared with mild OSAS group, LVGLS and LVGAS were decreased in moderate and severe OSAS groups, and the difference was statistically significant (P<0.05). Compared with the moderate OSAS group, LVGLS, LVGCS, LVGRS and LVGAS in the severe group all decreased, and the difference was statistically significant (P<0.05). Some of right ventricle strain parameters were earlier than that of left ventricle. Conclusion The application of 3D-STI technology can detect early left and right ventricular dysfunction before left ventricular ejection fraction(LVEF)changes, provide a reliable basis for early clinical diagnosis and intervention.
目的 随着治疗水平和疗效的不断提高,急性白血病患者的生存质量越来越受到广泛的关注,本研究旨在探讨急性白血病(AML)患者化疗后生活质量及其相关因素。方法 采用癌症患者生存质量测定量表(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30)中文版、患者一般状况调查问卷,对268例按照AML患者治疗后1年生活质量进行调查,并将EORTC-QLQ-C30各领域评分与患者的特征进行相关性分析。结果 AML患者年龄、FAB分型、是否恢复工作、ECOG评分、婚姻状态、生存质量评分比较上,差异有统计学意义(P>0.05);不同年龄组AML患者PF、RF、EF、SF、QL、FI评分比较上,差异有统计学意义(P<0.05);不同分型AML患者患者RF、EF、SF、QL、DY、SL、FI评分比较上,差异有统计学意义(P<0.05),恢复工作的AML患者PF、RF、SF、QL评分高于未恢复工作的AML患者,恢复工作的AML患者FA、DY、FI评分则低于未恢复工作的AML患者(P<0.05),结婚AML患者PF、RF、SF、QL评分高于未结婚患者,结婚AML患者FA评分低于未结婚患者(P<0.05);逐步多元回归分析发现,年龄、分型、ECOG评分、婚姻状况与AML生存质量有关。结论 高龄、非M3型、ECOG评分高、未婚是AML生存质量差危险因素,可能作为改善AML患者生活质量预期指标。
Objective With the continuous improvement of treatment level and efficacy, the quality of life of patients with acute myeloid leukemia (AML) has attracted more and more extensive attention. This study aimed to explore the quality of life and related factors of patients with acute leukemia (AML) after chemotherapy. Methods The Chinese version of the quality of life scale for cancer patients(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30, and the general situation questionnaire were was used to investigate quality of life for 268 AML patients one year after treatment.And then the correlation between the EORTC-QLQ-C30 scores in various fields and the characteristics of patients were analyzed. Results There were statistical differences in the scores of age, AML types, work(yes or no),ECOG scores, and marital status in patients (P<0.05).The differences of PF, RF, EF, SF, QL, FI score of AL in different age groups were statistically significant (P<0.05), The PF, RF, EF, SF, QL and FI scores of AML patients in different age groups were statistical different (P<0.05).The scores of PF, RF, SF and QL in AML patients who returned to work were higher than those in AML patients who did not returned to work,while FA, DY and FI scores were the opposite(P<0.05).The PF, RF, SF and QL scores of married AML patients were higher than those of unmarried AML patients,while FA scores were the opposite(P<0.05).Age, classification, ECOG score, marital status were found to be associated with quality of life of AML patients by stepwise multiple regression analysis (P<0.05). Conclusion Old age, non-M3 type, high ECOG score, and unmarried are risk factors for poor quality of life for AML, which may serve as expected indicators for improving the quality of life of patients with acute leukemia.
目的 探讨双侧会阴神经阻滞麻醉配合综合护理在降低单胎初产妇顺产会阴侧切率中的应用效果。方法 选取2019年7月—2019年12月在我院经阴道分娩的顺产初产妇110例为研究对象,按照随机数字表法分成两组,每组各55例,所选产妇对照组产妇给予常规护理模式,给予局部浸润麻,观察组产妇在对照组基础上采用综合护理模式,给予双侧会阴神经阻滞麻醉,比较两组产妇会阴侧切情况、会阴裂伤情况、产程持续时间、VAS评分、新生儿Apgar评分、依从性情况及护理效果等相关指标。结果 和对照组相比,观察组患者会阴侧切发生率少于对照组(P＜0.05),第一、第二产程时间短于对照组(P＜0.05);同对照组相比,观察组产妇在VAS评分、依从性及满意度指标均优于对照组(P＜0.05),而新生儿窒息、产后出血发生情况比较差异无统计学意义(P＞0.05)。结论 双侧会阴神经阻滞麻醉配合综合护理可以有效降低初产妇会阴侧切的发生率,减轻分娩时的疼痛,缩短产程,提高产妇依从性及满意度,具有较高的临床推广价值。
Objective To explore the effect of bilateral perineum nerve block anesthesia combined with comprehensive nursing in reducing the rate of perineum side cutting of primipara. Methods 110 primiparas who delivered vaginally in our hospital from July 2019 to December 2019 were selected as the research objects. According to the random number table method, they were divided into two groups, 55 in each group. The control group was given the routine nursing mode and local infiltration anesthesia. The observation group was given the comprehensive nursing mode and bilateral perineum nerve block anesthesia on the basis of the control group. The perineum side cutting status, perineum laceration, duration of labor, VAS score, Apgar score, compliance and nursing effect of the two groups were compared. Results Compared with the control group, the incidence of perineum side cutting was lower in the observation group than that in the control group (P<0.05).The first and second stages of labor were shorter in the observation group than the control group (P<0.05); compared with the control group, the VAS score, compliance and satisfaction index were better in the observation group than the control group (P<0.05), but there was no significant difference in neonatal asphyxia and postpartum hemorrhage (P>0.05). Conclusion Bilateral perineum nerve block anesthesia combined with comprehensive nursing may effectively reduce the incidence of perineum lateral incision of primipara, reduce the pain during delivery, shorten the labor process, improve the compliance and satisfaction of parturients, and has a high clinical value.
