目的 探索锌剂治疗大鼠慢性细菌性前列腺炎(CBP)的机理及影响。方法 健康成年雄性大鼠100只,随机分为正常对照组(n=20)、CBP模型对照组(n=20)、CBP锌剂治疗组(n=20)、CBP左氧氟沙星治疗组(n=20)及CBP锌剂与左氧氟沙星混合治疗组(n=20)。采用消痔灵及大肠埃希菌制备CBP大鼠模型。CBP锌剂治疗组、CBP左氧氟沙星治疗组及CBP混合治疗组给予相应药物灌胃治疗,正常对照组及CBP模型对照组给予无菌生理盐水灌胃。疗程10 d,分别于2 d、4 d、6 d、8 d、11 d取各组大鼠前列腺,检测细菌数量并分离鉴定细菌性质。于4 d、9 d、14 d、20 d、28 d取各组大鼠前列腺,进行组织病理学检测。结果 CBP各治疗组大鼠前列腺组织的细菌数量与模型对照组相比均明显降低(P﹤0.05)。CBP混合治疗组大鼠前列腺内细菌在治疗8 d后不能检出。4～6 d CBP混合治疗组大鼠前列腺组织的细菌数量与CBP锌剂治疗组相比明显降低(P﹤0.05)。正常对照组大鼠前列腺病理学检查未见明显病理变化;模型对照组大鼠前列腺组织表现为慢性炎症的病理变化;各治疗组大鼠前列腺慢性炎症改变均有不同程度缓解,其中混合治疗组的慢性炎症明显减轻。结论 锌剂具有活化提高前列腺组织细胞抗菌能力的作用,有利于前列腺组织炎性病理损害的缓解以及损伤组织的修复,与敏感抗生素结合治疗CBP具有更显著的治疗效果。

Objective To explore the zinc agent in the treatment of chronic bacterial prostatitis (CBP) rats and the effect. Methods 100 healthy adult male rats, were randomly divided into normal control group (n=20), CBP model group (n=20), CBP zinc treatment group (n=20), CBP levofloxacin treatment group (n=20) and mixed treatment group of CBP zinc and levofloxacin (n=20). Preparation of the CBP rat model was made by Xiaozhiling and E.coli system. CBP zinc treatment group, CBP levofloxacin treatment group and CBP mixed treatment group were given the appropriate drugs for treatment,besides,the normal control group, CBP model control group were given sterile saline. It took 10d. Rats in each group at 2d, 4d, 6d, 8d, 11d were detected, including the number of bacteria and the bacteria isolation and identification properties. The pathological study in 4d, 9d, 14d, 20d, 28d and prostate of rats in each group were detected. Results The prostate tissue of the CBP group rats in the treatment of bacterial number compared with the model control group decreased significantly (P<0.05). CBP mixed treatment of prostate were not detected in bacteria after 8d treatment.4 - 6 days of CBP treatment of prostate tissue in rats of the treatment group compared with the quantity of bacteria and CBP zinc decreased significantly (P<0.05). Normal control group rats pathological prostate pathology examination showed no significant pathological prostate tissue; The model control group rats showed chronic inflammatory pathological changes; The treatment group rat prostate inflammatory changes were alleviated chronic inflammation, which mixed treatment group were significantly reduced. Conclusion Zinc enhances prostate tissue antibacterial ability, is conducive to the inflammation in prostate tissue response and the repair of damaged tissue. Sensitive antibiotics combined with treatment of CBP have a significant therapeutic effect.

目的 了解广东省罗定市中小学教师的职业倦怠情况,为制定政策提供初步依据。方法 采用中文版Maslach职业倦怠量表(C-MBI)对罗定市42所中小学共590名毕业班教师进行评估。结果 受访者的情感衰竭(emotional exhaustion, EE)和知识枯竭(intellectual burnout, IB)因子分显著高于全国常模(P＜0.05),个人成就感降低(reduced personal accomplishment, PA)因子分显著低于全国常模(P＜0.01)。女性受访者的去个性化(depersonalization, DP)、EE和IB因子分均显著高于男性受访者,PA因子分显著低于男性受访者(P均＜0.01)。结论 广东省罗定市中小学毕业班教师的职业倦怠高于全国平均水平,女性教师的职业倦怠感高于男性教师。

Objective To investigate job burnout among primary and secondary teachers in Luoding city and to provide a preliminary basis for policy formulation. Methods We randomly selected 590 graduating class teachers from 42 primary and secondary schools in Luoding. The outcome variable of burnout was measured by the Chinese Maslach Burnout Inventory for primary and secondary school teachers (C-MBI). Results Emotional exhaustion (EE) score and intellectual burnout (IB) score in respondents were both significantly higher than the national norm used as reference (P＜0.05), reduced personal accomplishment (PA) score was significantly lower than the national norm (P＜0.01). The factor scores of DP, EE and IB were obviously higher in female respondents than that those in the male, while the score of PA was obviously lower (all P＜0.01). Conclusion The level of burnout in these teachers is significantly higher than the national average, and the burnout in female teachers is more serious.

目的 探讨超声引导下经皮肺穿刺活检术在艾滋病周围型肺部病变中的应用价值。方法 我院52例经皮肺穿刺活检的病例,术前均采用高效抗逆转录病毒治疗,依据CD4⁺T淋巴细胞确定是否手术,术中规范手术方式,做好防护措施,27例行超声引导穿刺,25例行CT引导穿刺,术后应用抗生素预防机会性感染等。结果 所有患者穿刺成功率100%,超声组肺结核13例,真菌感染67例,细菌感染4例,肺腺样囊性癌2例、卡波西肉瘤1例。CT组肺结核11例,真菌感染7例,细菌感染5例,肺腺样囊性癌1例。术后并发症:超声组5例病灶少量气胸,2例周围少量出血,咯血4例;CT组8例病灶少量气胸,4例周围少量出血,咯血7例。结论 经过术前控制患者计数及预防感染治疗,超声引导下经皮肺穿刺活检术在艾滋病周围型肺部病变中应用更为安全、有效、可行的,值得临床应用及推广。

Objective Objective to investigate the value of ultrasound-guided percutaneous lung biopsy in the diagnosis of peripheral lung lesions in AIDS patients. Methods 52 cases in our hospital of percutaneous pulmonary biopsy cases, preoperative highly active antiretroviral therapy was used, basis of CD4⁺T lymphocytes count determined whether the operation were performed, standard operation mode in the operation. It must to take good protective measures. 27 cases underwent ultrasound guided puncture, 25 cases underwent CT guided puncture and had postoperative application of antibiotics to prevent opportunistic infections. Results The successful rate of puncture was 100% in all patients. Tuberculosis in the ultrasound group was 13 cases, fungal infection was 67 cases, bacterial infection was 4 cases, pulmonary adenoid cystic carcinoma was 2 cases, and Posey's sarcoma was 1 cases. There were 11 cases of pulmonary tuberculosis in CT group, 7 cases in fungal infection, 5 cases in bacterial infection, and 1 cases in adenoid cystic carcinoma of the lung. Postoperative complications included: 5 cases of small pneumothorax in the ultrasound group, a small amount of bleeding around the surrounding, hemoptysis in 4 cases, CT group of patients with 8 cases of a small amount of pneumothorax in the lesions, 4 cases of a small amount of bleeding around the case, 7 cases of hemoptysis. Conclusion After preoperative control count and prevention of infection in patients with treatment, ultrasound guided percutaneous lung biopsy in peripheral pulmonary lesions of AIDS is more safe and effective, worthy of clinical application and promotion.

目的 探讨高黏度骨水泥在治疗骨质疏松性椎体压缩性骨折中的临床疗效分析。方法 随机选取本院2012年1月—2016年1月收治的80例骨质疏松椎体压缩性骨折患者。将患者随机分为对照组和观察组,每组各40例,均采用骨水泥联合经皮椎体后凸成形术治疗,对照组采用低黏度骨水泥,观察组采用高黏度骨水泥。采用视觉模拟量表(VAS)评分比较手术前后患者疼痛情况,Oswestry指数(Oswestry disability index,ODI)评分评估患者腰背部功能。观察并比较两组患者VAS、ODI评分,骨水泥渗漏及相关并发症情况。结果 所有患者均顺利完成手术,术后随访1年以上,期间未发生严重并发症。所有患者VAS评分,ODI评分均明显高于术前。两组均出现骨水泥渗漏及其他并发症,低黏度骨水泥组骨水泥渗漏率为66.7%,明显高于高黏度骨水泥组的33.3%,P<0.05,但均无明显神经功能损伤。结论 高黏度骨水泥在骨质疏松椎体压缩性骨折中的应用能显著改善患者临床疗效,明显降低骨水泥渗漏及并发症的发生率。

Objective To investigate the clinical effect of high viscosity bone cement for treatment of osteoporotic vertebral compression fractures. Methods From Jan. 2012 to Jan. 2016, 80 patients with osteoporosis vertebral fractures were enrolled into this study. They were randomly divided into control group and observation group, with 40 cases in each group. They were all adopted PKP methods for treating, while the observation group got the high viscosity bone cement and the control group got the low one. Clinical outcomes were assessed in terms of back pain visual analogue scale (VAS), Oswestry disability index (ODI) after surgery.The outcomes of back pain VAS score, ODI, venous leakage rate, discoidal leak rate, rate of around vertebral body, rate of contiguous vertebral fracture were compared between two groups. Results All patients were successfully completed surgery. We took postoperative follow-up more than one year, there were severe complications occurred. VAS score, ODI score were significantly higher than that of before operation. Two groups had both bone cement leakage and other complications. Low viscosity bone cement group of bone cement leakage rate was 66.7%, significantly higher than the 33.3% of the high viscosity of bone cement group, P<0.05, but no obvious neurologic injury. Conclusion The high-viscosity bone cement for osteoporotic vertebral fractures provides better clinical outcomes. It may reduce bone cement leak rate and complications.

目的 探讨分析氨茶碱治疗早产儿呼吸暂停的临床疗效及其在治疗过程中所出现的不良事件。方法 选取2014年9—2016年3月广州市第一人民医院新生儿科接受住院治疗的胎龄＜34周,生后2 h内入住新生儿科的早产儿42例。随机分为对照组和氨茶碱组,对照组(20例)给予保暖、吸氧、补充能量、保持呼吸道通畅、物理刺激等对症治疗,不使用氨茶碱及其它改善呼吸的药物;氨茶碱组(22例)患儿除给予对照组治疗措施外,同时给予氨茶碱静脉滴注,首剂负荷量5 mg/kg,在20min内完成,12 h后以2～2.5 mg/kg维持量,每隔12 h一次。观察两组的疗效与不良影响。结果 ①两组患儿性别、出生胎龄、出生体重、产前孕母糖皮质激素的应用、受孕方式、分娩方式、多胎妊娠、5min Apgar评分、机械通气及CPAP辅助通气例数、低-中流量吸氧(箱内或头罩给氧)例数等方面差异均无统计学意义(P均＞0.05)。②与对照组相比,氨茶碱组早产儿呼吸暂停(AOP)发生的次数较少,AOP消失所需时间较短,差异均有统计学意义(P＜0.05)。③不良影响方面,氨茶碱组脑白质发育不良发生率(63.6%,14/22例)显著高于对照组(25%,5/20例),差异有统计学意义(P＜0.05);两组患儿在听力检查异常、喂养不耐受、血糖紊乱、血脂代谢紊乱、血红蛋白下降、电解质紊乱、出院时体重及住院时间等方面均无统计学意义(P均＞0.05)。④氨茶碱组视网膜发育不完全的发生率(40.9%,9/22例)明显高于对照组(15.0%,3/20例),但差异无统计学意义(P＞0.05)。结论 小剂量氨茶碱在防治AOP方面的作用是值得肯定的,但它有可能增加早产儿脑白质发育不良的风险与视网膜发育不完全的风险。

Objective To investigate the clinical efficacy and adverse effects of aminophylline in prevention of apnea of prematurity. Methods Forty-two infants with gestational age ＜34 weeks admitted to department of pediatrics, Guangzhou first people's hospital between Sep. 2014 and Mar. 2016 were randomly divided into 2 groups: control group and aminophylline group. Control group(n=20): 20 infants received warming, oxygen inhalation, supplement energy, maintain airway patency, physical stimulation, such as symptomatic treatment, without aminophylline or any other drugs for improving breathing. Aminophylline group(n=22): In addition to the control group treatment measures, 22 infants received a loading dose of 5 mg/kg of aminophylline and then maintained by a dose of 2mg/kg with intravenous drip q 12 h. Then we compared the efficacy and adverse effects of the two groups. Results ①There was no significant difference in gender, gestational age, birth weight, maternal antenatal glucocorticoid application, pregnancy(including multiple pregnancy) and delivery,5 min Apgar score, oxygen therapy, the application of mechanical ventilation, nasal continuous positive airway pressure, and the low-medium flow oxygen inhalation between the 2 groups(all P＞0.05). ② Compared with the control group, the incidence of apnea in aminophylline group were significant lower, and the time needed for apnea to disappear were significant shorter(all P＞0.05). ③ The incidence of cerebral white matter development dysplasia of aminophylline group(63.6%,14/22 cases) were significant higher than the control group(25%,5/20 cases, P＜0.05). There was no statistically significant difference in hearing loss, feeding intolerance, blood glucose disturbance, blood lipid metabolism disorder, hemoglobin decrease, electrolyte disorder, body weight at discharge, the duration and cost of hospitalization between the 2 groups(all P＞0.05). ④ The incidence of retinal incompleted development of aminophylline group(40.9%, 9/22 cases) were higher than control group(15.0%, 3/20 cases), but there was no statistical significance between the 2 groups(P＞0.05). Conclusion Effects of aminophylline in treating apnea of prematurity is positive, but it is likely to increase the risk of premature brain white matter development dysplasia and the risk of retinal incompleted development.

目的 探讨系统性红斑狼疮(SLE)患者外周血中25-羟基维生素D(25-OH-D)和白介素-17(IL-17)水平的变化及其临床意义。方法 选取40例SLE患者作为研究对象, 20例健康体检人员为健康对照组。运用电化学发光法检测25-OH-D水平,酶联免疫吸附法检测IL-17水平。结果 SLE患者25-OH-D水平明显低于健康对照组(P<0.01),活动期SLE患者25-OH-D水平明显低于缓解期患者(P<0.01)。SLE患者IL-17水平明显升高(P<0.01)。低25-OH-D水平与肾损害(P<0.01)相关,与疾病活动度评分(SLEDAI评分)(r=-0.844,P<0.01)及IL-17水平(r=-0.596,P<0.01)负相关。结论 SLE患者25-OH-D水平降低,低25-OH-D水平与肾损害、病情活动及高IL-17水平相关,25-OH-D可能参与了SLE的炎症进程。

Objective To assess the 25-hydroxyvitamin D (25-OH-D) and interleukin-17(IL-17) status in patients with systemic lupus erythematosus(SLE) and its clinical significance. Methods 40 SLE patients along with 20 matched controls were collected. Chemilumineseent immunoassay (CLIA) was used to detect the levers of serum 25-OH-D. The levels of serum IL-17 were evaluated using enzyme-linked immunosorbent assay (ELISA). Results Serum 25-OH-D level in SLE patients was significantly lower than in healthy controls (P<0.01). Serum 25-OH-D level in active SLE patients was significantly lower than in inactive SLE patients (P<0.01). Lever of IL-17 was significantly higher in SLE patients than in healthy controls (P<0.01). Insufficiency of 25-OH-D was related to renal disorders. Serum 25-OH-D level was negatively correlated with systemic lupus erythematosus disease activity index (SLEDAI) scores(r=-0.844, P<0.01)and serum levels of IL-17(r=-0.596, P<0.01). Conclusion Insufficiency of 25-OH-D is prevalent in SLE patients. It is associated with nephritis, disease activity and high serum levels of IL-17, thus it may play an important part in the inflammatory process in SLE.

目的 通过高通量测序法对多重耐药大肠埃希菌HX43进行耐药分子机制的研究。方法 用Illumina Miseq平台对HX43进行高通量测序,用Edena、RAST、ResFinder、MLST和BLAST等生物信息学工具或数据库进行数据分析,获得耐药基因相关序列数据。结果 HX43对多种临床常用抗生素均不敏感,仅对碳氢霉烯类药物敏感。对高通量测序数据的分析研究发现,该菌存在多种耐药基因,包括β-内酰胺类耐药基因3个(bla_CMY-42、bla_CTX-M-14和bla_OXA-30),氨基糖苷类耐药基因5个(aac(3)-IIa、aadA5、 strA、 strB和aac(6′)-Ib-cr),喹诺酮类耐药基因1个(aac(6′)-Ib-cr),磺胺及甲氧苄啶类耐药基因3个(sul1、sul2和dfrA17),四环素耐药基因1个(tet(B)),氯霉素耐药基因2个(catB3和cmlA1),大环内酯类耐药基因2个(erm(B)和mph(A))。对包含bla_CMY-42的contigs进行分析,发现该基因与ISEcp1插入序列、blc和sugE等基因相关联。质粒分型发现HX43携带5种不相容群的质粒。多位点序列分型(MLST)分析发现HX43属于ST3835,为国内外较少见的序列型。结论 高通量测序技术可准确获得临床菌株抗生素耐药的相关基因信息,为临床抗菌治疗提供重要的实验室数据支持。

Objective To investigate the molecular resistance mechanism of Escherichia coli HX43 by high-throughput sequencing. Methods HX43 was sequenced by the Illumina Miseq platform, and sequencing data were analyzed by the Edena, RAST, ResFinder, MLST and BLAST softwares and databases. Results HX43 was resistant to most common clinical antibiotics except carbapenems. Analysis of data revealed resistance genes to β-lactams (bla_CMY-42, bla_CTX-M-14 and bla_OXA-30), aminoglycosides (aac(3)-IIa, aadA5, strA, strB and aac(6′)-Ib-cr), quinolones (aac(6′)-Ib-cr), trimethoprim/sulfonamides(sul1, sul2 and dfrA17), tetracyclines (tet(B)), chloramphenicol (catB3 and cmlA1), macrolides(erm(B) and mph(A)). Sequence analysis of the contig containing bla_CMY-42 identified correlations of the gene with ISEcp1 insertion sequences, blc and sugE genes. Plasmid typing identified 5 plasmid incompatibility groups in HX43. MLST analysis found that HX43 belonged to ST3835, a relatively rare sequence type in the world. Conclusion Information of resistance genes can be obtained by high-throughput sequencing, which provides important experimental data for clinical antimicrobial treatment.

目的 利用新的分型方法指导现有的微创技术下内固定的选择,提示预后,帮助制定术后康复计划。方法 将200例患者随机分成两组,一组为旧Evans分型组,另一组为改良Evans分型组,通过多层螺旋三维CT重建引导下改良Evans分型,对三个重点区域(股骨内距、头颈部及粗隆外侧入针点部位)的CT成像,利用多平面重组(MPR)、表面遮盖显示(SSD)及容积再现(VR)等多种后处理,分析骨折线走形、局部的微骨折、骨小梁分布、骨皮质厚度的骨折部内环境变化。简化整合到Evans分型中。来实现完善影像分型,有效地指导微创手术。对比两组患者的疗效。结果 新Evans分型组98例患者愈合良好,时间为9~17周,中位数为11.2周。其中伤口感染3例,髋关节内翻畸形3例,骨骨头坏死3例,按照髋关节治疗标准评分,优53例,良31例,可9例,差7例。优良率(包括优和良)为84%。旧Evans分型组80例患者愈合良好,时间为9~18周,中位数为11.8周。其中伤口感染10例,髋关节内翻畸形5例,股骨头坏死8例,按照髋关节治疗标准评分,优48例,良26例,可10例,差16例。优良率(包括优和良)为74%。两组对比,新Evans分型组优良率明显高于旧Evans分型组,差异有统计学意义。P＜0.05。结论 多层螺旋三维CT重建引导下的改良Evans分型对老年脆骨性粗隆间骨折的微创治疗有重要的临床指导意义。

目的 研究鳞癌抗原(SCC-Ag)的表达对宫颈癌手术治疗后临床转归的预测价值。方法 选取我院2014年4月—2015年9月实施宫颈癌手术的患者52例,分别于手术前后分析所有患者的鳞癌抗原表达,对患者进行1年的随访,以发生癌细胞转移、复发或死亡为研究终点,比较预后良好的患者与预后差的患者鳞癌抗原的表达的不同。结果 Ia、Ib1、Ib2、IIa、IIb期宫颈癌患者术后SCC-Ag水平较手术前均显著降低(P＜0.05);纳入本次研究的患者宫颈癌术后复发或转移发生率为15.38%,转归良好的患者为84.62%,预后良好的患者术后SCC-Ag水平(0.91±0.27)ng/mL较发生复发或转移的患者(1.37±0.57)ng/ml显著较较低(P＜0.05)。结论 宫颈癌患者术后血清SCC-Ag水平与肿瘤的应答之间具有关联性,术后SCC-Ag水平高的患者复发与转移发生率显著高于SCC-Ag水平低的患者,鳞癌抗原的表达对宫颈癌手术后患者的转归情况具有预测价值,临床应予以重视。

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.