目的 探讨我院17年间前列腺癌患者的临床特征如发病年龄、前列腺特异性抗原(PSA)、Gleason评分、分期及穿刺阳性率等的变化。方法 采用回顾性分析,对广州市第一人民医院2000—2016年泌尿外科1 231例穿刺活检的患者及564例前列腺癌患者资料进行分析,按患者的诊断时间分为A组(2000—2005年)、B组(2006—2009年)、C组(2010—2012年)、D组(2013—2014年)、E组(2015—2016年),对各组的年龄、PSA、Gleason评分、分期及穿刺活检阳性率进行统计学分析,看各组间的各项指标差异是否有统计学意义。结果 5组年龄均值(73.36,73.74,72.05,73.40,72.96岁)、PSA均值(208.95,190.25,173.19,283.54,148.69 μg/L)及穿刺活检阳性率均值(48%,43%,37%,44%,39%)差异均无统计学意义(P均>0.05)。5组Gleason均值为6.80,6.73,7.12,6.93,7.32,A、B组和E组Gleason评分差异有统计学意义(P均<0.05),其余各组Gleason评分差异均无统计学意义(P均>0.05)。TNM分期转化得分5组均值为5.96,6.80,7.05,7.31,6.83, A和C组、D组、E组差异均有统计学意义(P均<0.05),其余各组TNM分期转化得分差异均无统计学意义(P均>0.05)。结论 17年间前列腺癌患者诊断时的年龄、PSA水平及穿刺活检阳性率没有显著变化。

Objective To investigate changes of inpatients with prostate cancer in the last 17 years such as age of onset, prostate specific antigen (PSA), Gleason score, prostate cancer staging and positive rate of prostate biopsy. Methods A retrospective analysis was conducted in 1 231 cases of biopsy patients of urology and 564 patients with prostate cancer who were hospitalized in the First People's Hospital of Guangzhou from 2000 to 2016. According to the time of diagnose. All the patients were divided into five groups: group A(2000-2005),group B(2006-2009),group C(2010-2012), group D(2013-2014)and group E(2015-2016). The age, PSA, Gleason score, staging and positive rate of prostate biopsy were compared to realize whether the indicators of the differences between groups was statistically significant. Results In five groups, means of age, PSA, Gleason score and prostate biopsy positive rate are respectively 73.36,73.74,72.05,73.40,72.96 years; 208.95,190.25,173.19,283.54,148.69 μg/L;6.80,6.73,7.12,6.93,7.32; 5.96,6.80,7.05,7.31,6.83 and 48%,43%,37%,44%,39%. There was no significant difference in age, PSA and positive rate of prostate biopsy (P>0.05). The Gleason scores of group A and group E, group B and group E were statistically significant (P<0.05), while the other groups had no significant differences in Gleason score (P>0.05). There werestatistical significancein TNM staging score between group A and group C,group D, group E(P <0.05),while the other groups had nostatistical significance (P>0.05). Conclusion There are no change of prostate cancer patients in diagnosis of age, PSA levels and positive rate of prostate biopsy in the past 17 years.

目的 探讨高压氧对FVB小鼠旷场行为的影响。方法 对9只4周龄高压氧组FVB小鼠进行2个疗程共21天高压氧干预;对13只4周龄对照组FVB小鼠不做任何处理,正常饲养。21天后对2组小鼠进行旷场实验,观察高压氧对FVB小鼠旷场行为的影响。结果 高压氧组小鼠在中央区停留时间(3.73±3.69,17.97±6.82,t=-5.564,P=0.000)和运动路程较对照组小鼠减少(189.65±199.32,525.67±244.22,t=-3.298,P=0.040),在外周区停留时间增加(296.07±3.69,281.79±6.79,t=5.597,P=0.000);进入中央区、外周区次数及穿越各区总次数都减少(3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008);2组小鼠总路程和平均速度无差异(8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726)。结论 高压氧改变FVB小鼠的旷场行为的表型,使小鼠趋避性增加,对环境的认知能力及焦虑程度增强,探索性下降。

Objective To explore the effect of hyperbaric oxygenation(HBO)on behaviors of FVB mice in the open field test. Methods 9 mice of four-week-old in the HBO group were treated with hyperbaric oxygenation for a total of 21 days during two courses while 13 control mice of four-week-old did not do any treatment. After 21-day normal breeding, the mice of two groups were tested with open field test. Then, researchers observed the effect of hyperbaric oxygenation on mice behaviors after open field test. Results Compared to 13 control mice, residence time (3.73±3.69,17.97±6.82,t=-5.564,P=0.000) and the range of movement (189.65±199.32,525.67±244.22,t=-3.298,P=0.040)in central region decreased while the residence time in external region increased (296.07±3.69,281.79±6.79,t=5.597,P=0.000). The times of entering the central region and external region and crossing both of the regions decreased (3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008). There was no difference in the total range of movement and the average velocity (8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726). Conclusion Hyperbaric oxygenation may change the behaviors of FVB mice in open field test to enhance its phobotaxis, anxiety degree and the cognitive ability in environment and inhibiting its exploration ability.

目的 探讨幽门螺杆菌(Helicobacter pylori,Hp)感染与儿童过敏性紫癜(Henoch-Schnlein purpura,HSP)的相关性及预后关系,为临床疾病诊治提供一定依据。方法 随机选取2016年12月—2018年2月于我院就诊并经确诊的HSP儿童患者90例为观察组,另选取同期于我院就诊行体检的健康儿童90例为对照组,比较两组患者Hp感染情况。根据Hp感染情况及治疗方式将观察组分为A、B、C三组,其中A组(29例)为Hp(-)组,行常规治疗;B组(31例)为Hp(+)组,行常规治疗;C组(30例)为Hp(+)组,行常规治疗联合抗Hp治疗,比较三组患者治疗疗效。结果 观察组患者Hp感染阳性率高于对照组,差异有统计学意义(P<0.05);合并腹部症状的HSP患者Hp感染阳性率高于不合并腹部症状的HSP患者,差异有统计学意义(P<0.05);B组患者治疗有效率低于A组,C组患者治疗有效率高于B组,差异有统计学意义(P<0.05)。结论 Hp感染可能是HSP发病的原因之一,其腹部症状与Hp密切相关,根除Hp治疗可改善HSP患者预后。

Objective To explore the correlation between helicobacter pylori infection and children allergic purpura disease and its prognosis, and provide some basis for clinical diagnosis and treatment. Methods A total of 90 children with allergic purpura who were treated in our hospital from December 2016 to Feb 2018 were randomly selected as observation group. 90 healthy children who were admitted to our hospital for physical examination during the same period were selected as the control group, and the Hp infection in the two groups was compared. According to Hp infection and treatment, the observation group was divided into three groups: A, B and C, among which group A (29 cases) was Hp (-) group, and routine treatment was performed.Group B (31 cases) were Hp (+) group, and routine treatment was performed. group C (30 cases) were Hp (+) group, and conventional treatment combined with anti-hp treatment were performed. We compared three groups of .curative effects. Results The positive rate of Hp infection in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05).The positive rate of Hp infection in HSP patients with abdominal symptoms was higher than that in HSP patients without abdominal symptoms, and the difference was statistically significant (P<0.05). The effective rate of treatment in group B was significantly lower than that in group A, and the effective rate of treatment in group C was higher than that in group B, and the difference was statistically significant (P<0.05). Conclusion Hp infection may be one of the causes of HSP, and its abdominal symptoms are closely related to Hp, and the eradication of Hp treatment would improve the prognosis of HSP patients.

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 制备以牛血清白蛋白为模型药物的壳聚糖纳米制剂(BAS/CS NPs)及其体内外性质的研究,并通过加入羧化壳聚糖(WCS)来改善聚阳离子制备的纳米粒(CS NPs)的安全性。方法 利用油包水乳化-冻干法制备而得的CS NPs,通过激光粒度分析仪测定纳米粒粒径和电荷,用BCA法测定纳米粒包封率和载药量,并用Caco-2 cells单层膜模型评价BAS/CS NPs的细胞摄取情况和跨膜转运,以Franz扩散池法考察吸收考察BAS/CS NPs的离体各个小肠段黏膜的渗透性能,采用荧光分光光度计测定累积渗透量。结果 所制备的BAS/CS NPs平均粒径 在100～500 nm之间,电荷(-42.32±2.56)mV,包封率为88.37±6.82(%),载药量7.48±0.50(%),细胞毒性和细胞摄取实验表明羧化壳聚糖的BAS/CS NPs能降低细胞的毒性,并发现在十二指肠纳米粒具有促进BSA吸收作用(P<0.05)。结论 BAS/CS NPs是通过打开细胞紧密连接的方式增加BSA在小肠内的吸收。WCS降低BAS/CS NPs的细胞毒性,增强了兔小肠的BSA运输。作用要优于广泛研究的聚阳离子纳米粒体系,为口服蛋白类药物的传递提供了新的渠道。

目的 调查广州市市级(三级)妇幼医院与广州市农村地区区级(二级)妇幼医院护士离职意愿与工作满意度情况。方法 以广州市某三级甲等妇幼医院和4所(花都、南沙、从化、增城)地区二级妇幼医院的3 026名护士为研究对象。应用护士工作满意度量表(MMSS)及离职意愿量表(TIQ)进行问卷调查,并比较分析不同级别妇幼医院护士的离职意愿和工作满意度的差异。结果 相比二级妇幼医院,三级妇幼医院护士的平均年龄较大、学历、职称和奖金均较高、有编制人数所占比例较大,差异有统计学意义(P<0.05)。二、三级妇幼医院护士离职意愿平均得分依次为(2.38±0.682)分、(2.87±0.570)分,工作满意度平均得分依次为(3.34±0.702)分、(3.00±0.482)分。差异均有统计学意义(P<0.05)。结论 相比二级妇幼医院,三级妇幼医院护士离职意愿更强,工作满意度更低,护理管理者可采取有效措施提高护士工作满意度。

Objectives To investigate the current status of nurses' turnover intention and job satisfaction in secondary and tertiary women and children's hospitals in Guangzhou. Methods 3 026 nurses were enrolled in this study, which were from a tertiary hospital in Guangzhou urban area and another 4 secondary hospitals located in rural districts, namely Huadu, Nansha, Conghua, Zengcheng. Systematic sampling was adopted. The Mueller/McCloskey Nurse Job Satisfaction Scale (MMSS) and Turnover IntentionQuestionaire(TIQ)were applied to carry out this investigation. Differences of nurses' turnover intention and job satisfaction between different levels' hospitals were compared and analyzed. Results Compared with those in the secondary hospitals, nurses in the tertiary maternity hospital were at higher average age, had better academic backgrounds with higher professional titles, more bonus and more positions of establishment. The differences all were statistically significant (P<0.05). The average scores of turnover intention for nurses from the secondary and tertiary hospitals were2.38±0.682 and 2.87 ±0.570 respectively. All the differences were statistically significant (P<0.05). Conclusion Compared with those in the secondary maternal and child health hospitals, nurses in the tertiary hospitals were more willing to leave and had lower job satisfaction. Nurse's managers may take effective measurses to increase nurse's satisfaction.

目的 探讨持续负压吸引在微通道经皮肾镜取石术治疗鹿角形肾结石的临床效果。方法 选取2016年1月—2017年12月在我院确诊鹿角形肾结石并行经皮肾镜取石术治疗的病例138例;根据通道大小、有无负压吸引装置分为观察组和对照组,其中观察组66例,采用20F微通道联合持续负压吸引,对照组72例,采用22F标准通道,无负压吸引。比较两组的术中生命体征变化、肾盂内压力以及术后发热的发生率。结果 观察组在术中血压和心率等生命体征变化、肾盂内压力以及术后发热的发生率均低于对照组,差异有统计学意义(P<0.05)。结论 微通道联合负压吸引行经皮肾镜取石术治疗鹿角形肾结石可以有效降低肾盂内压力,有效维持生命体征的稳定,减少术后发热的发生率,提高手术安全性。

Objective To explore the clinical effect of percutaneous nephrolithotomy for treatment of staghorn kidney stonesusingmicro-channel combined with vacuum suction. Methods A total of 138 patientsofstaghorn kidney stones with PCNL in our hospital from January 2016 to December 2017 were included and divided into experimental group and control group according to the size of the channel and the vacuum suction device. Y-type minimally invasive dilatation drainage kit of 20F micro-channelandvacuum suctionwere used in experimental group within 66 patients.A standard channel (22F diameter) without vacuum suction was used in control group within 72 patients. The changes in vital signs, intrapelvic pressureand incidence of postoperative fever were compared between experimental and control groups. Results The vital signs variety of blood pressure and heart rate, intrapelvic pressure and incidence of postoperative fever in experimental group were lower than those in control group(P<0.05). Conclusion Micro-channel combined with vacuum suctioninpercutaneous nephrolithotomy for treatment of staghorn kidney stones could effectively maintenance of stable vital signs, reduce intrapelvic pressure and the incidence ofpostoperative fever, and improve the safety of surgery.

目的 探讨中药熏洗与膝关节自我锻炼管理对改善老年骨性膝关节炎功能康复效果。方法 选择90例在本院就诊的老年骨性关节炎患者,按数字表法分为观察组和对照组各45例,对照组采用膝关节康复护理知识教育、膝部中药熏洗与揉搓按摩等治疗,观察组在此治疗护理上加强对患者进行膝关节功能训炼和自我活动行为管理;随访6周,评价两组患者膝关节肿胀、疼痛、训练依从性、膝关节功能。结果 膝关节疼痛缓解、肿胀消退观察组优于对照组;膝关节功能康复效果观察组优于对照组,活动训练依从性观察组高于对照组。结论 应用中药熏洗与加强患者膝关节自我活动训炼管理,可缓解膝关节疼痛、减轻膝关节肿胀,改善患者膝关节功能,提高患者自我功能训练的依从性和生活质量。

Objective To explore the effect of traditional Chinese medicine fumigation and knee joint exercise management on the rehabilitation of senile osteoarthritis of the knee. Methods 90 cases in our hospital for treatment of senile osteoarthritis were randomly divided into observation group and control group with 45 cases in each group, the control group used the knee joint rehabilitation nursing knowledge education, herbal fumigation and massage knee treatment; the observation group on the treatment and nursingwith strengthening the function of knee joint training and self behavior management for the patients; 6 weeks of follow-up, we have evaluation of two groups of patients with knee joint swelling, pain, and knee joint function training compliance. Results The knee joint pain, swelling, knee joint function rehabilitation effect in the observation group were better than that of control group; training compliance in the observation group was better than that of control group. Conclusion The application of herbal fumigation and strengthen the self training of patients with knee joint activity management, may relieve the pain of knee joint, swelling and improve knee function. Theirtraining compliance and quality of life have been increased.

目的 研究护理干预对慢性阻塞性肺疾病患者抑郁焦虑情绪的效果。方法 选取2015年2月—2017年3月我院收治的慢性阻塞性肺疾病患者84例为观察对象。2015年2月—2016年2月入院患者42例为对照组,遵医嘱给予治疗,同时均予以常规慢性阻塞性肺疾病知识宣教。2016年3月—2017年3月入院患者42例为观察组在对照组基础上予以优质护理干预。分别比较干预前后两组患者抑郁、焦虑及干预前后肺功能变化、患者满意度、生活质量。结果 干预后观察组抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(20.05±5.24)分、(21.57±6.03)分,均低于对照组(28.57±5.29)分、(31.72±6.14)分,差异有统计学意义(P＜0.05)。干预后观察组FEV1水平(2.00±0.33)L,高于对照组的(1.68±0.25)L、观察组FEV1/FVC水平分别为(69.50±7.95)%,高于对照组的(65.18±8.43)%,差异有统计学意义(P＜0.05)。观察组患者满意度为95.24%(40/42),高于对照组的73.81%(31/42),差异有统计学意义(P＜0.05)。观察组患者各项SF-36评分均高于对照组,均P＜0.05差异有统计学意义。结论 优质护理干预可缓解患者负性情绪,改善肺功能,提高满意度及生活质量。

Objective To study effects of nursing intervention in paitents with chronic obstructive pulmonary disease. Methods 84 patients with chronic obstructive pulmonary disease admitted to our hospital from February 2015 to March 2017 were selected as the observation objects. From February 2015 to February 2016, 42 patients admitted to the control group were treated with conventional therapy. From March 2016 to March 2017, 42 patients admitted to the hospital as the observation group were given quality nursing intervention on the basis of the control group. The depression, anxiety, lung function changes, patient satisfaction and quality of life before and after intervention were compared between the two groups before and after intervention. Results After the intervention, the SDS and SAS scores of the observation group were (20.05±5.24), (21.57±6.03), which were lowered than that of the control group (28.57±5.29), (31.72±6.14), the difference was statistical significance (P<0.05). After intervention, the level of FEV1 in the observation group (2+0.33) L was higher than that in the control group (1.68+0.25) L, and the FEV1/FVC level in the observation group was (69.50+7.95)%, which was higher than that in the control group (65.18+8.43)%,the difference was statistical significance (P<0.05). Satisfaction of patients in the observation group was 95.24% (40/42), higher than the control group 73.81% (31/42),the difference was statistical significance (P<0.05). The SF-36 scores of the observation group were higher than those of the control group, P<0.05, the difference was statistical significance. Conclusion High quality nursing intervention may effectively alleviate depression, anxiety and other negative emotions, improve lung function, satisfaction and quality of life.

目的 分析并探讨T细胞斑点技术诊断结核性胸膜炎的临床价值。方法 将2014年5月—2016年5月收治61例的结核性胸膜炎的患者和61例非结核性胸膜炎的患者同时行外周血和胸水的T细胞斑点实验,对各组数据进行统计学处理与分析。结果 结核组血T-SPOT的阳性率为88.52%,高于非结核组的16.39%,(P<0.001),其诊断结核性胸膜炎的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、youden指数分别为88.52％、83.61%、85.71%、86.44%、5.40、0.14、0.72。结核组胸水T-SPOT的阳性率为90.16%,高于非结核组的8.20%,(P<0.001),其诊断结核性胸膜炎的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、youden指数分别为90.16％、91.80%、91.67%、90.32%、11.00、0.11、0.82。联合外周血及胸水T-SPOT检测阳性率为91.80%,特异度为93.44%,阳性似然比为14.00,阴性似然比为0.09,youden指数为:0.85。结论 T细胞斑点实验检测对结核性胸膜炎有较高的临床诊断价值,外周血及胸水T-SPOT联合检测可提高诊断率,可作为结核性胸膜炎快速早期诊断的有效辅助手段。

Objective To analysis the value of T-SPOT.TB in the diagnosis of tuberculous pleurisy. Methods A total of 61 patients with clinically suspected tuberculous pleurisy (group A) and 61 cases of other diseases caused by pleural effusion (group B)admitted from May 2014 to May 2015 from the Guangzhou Chest Hospital had peripheral blood T-SPOT.TB and pleural effusion T-SPOT.TB,for each group of data for statistical processing and analysis. Results The positive rate of T-SPOT in the blood of the group A was 88.52%, which was higher than group B, (P<0.001) (16.39.0%). And the sensitivity, specificity, positive predictive value and negative predictive value, positive likelihood ratio(LR+), and negative likelihood ratio(LR－), Youden index were 88.52%, 83.61%,85.714%, 86.44%, 540, 0.14, 0.72 respectively by peripheral blood T-SPOT.TB in diagnosis of tuberculosis pleurisy. The positive rate of pleural effusion T-SPOT in the group A was 90.16%, which was also higher than group B (P<0.001). The sensitivity, specificity, positive predictive value and negative predictive value, positive likelihood ratio(LR+), and negative likelihood ratio(LR－), Youden index were 90.16％、91.80%、91.67%、90.32%、11.00、0.11、0.82 respectively by pleural effusion T-SPOT.TB in diagnosis of tuberculosis pleurisy. The positive rate of the joint tests of T-SPOT in peripheral blood and in peripheral blood was 91.80%, the specificity was 93.44%, the positive likelihood ratio was 14, the negative likelihood ratio was 0.09, and the youden index was 0.85. Conclusion T-SPOT.TB for the diagnosis of tuberculous pleurisy has a higher clinical value in the diagnosis. The joint tests of T-SPOT in peripheral blood and in pleural effusion may improve the positive rate in the diagnosis of tuberculous pleurisy. The joint tests of T-SPOT in peripheral blood and in pleural effusion have an important reference for diagnosing suspected tuberculous pleurisy quickly, early and accurately.