目的 探讨罗伊适应模式对肺癌患者术后生活质量的影响。方法 将2012年3月—2015年7月来我院就诊的178例肺癌术后患者,随机分为试验组85例和对照组93例;对照组患者按护理常规进行护理,试验组在常规护理基础上给予罗伊适应模式护理干预;出院时分别比较两组患者住院适应性、治疗依从性、病人满意度及患者生活质量评分。结果 试验组住院适应率为87.1%(74例),对照组住院适应率为66.7%(62例),两组差异有显著性(P<0.01);试验组治疗依从性优良率为88.2%(75例)、对照组治疗依从性优良率72.0%(67例),两组差异有显著性(P<0.01);试验组患者满意度为89.4%(76例),高于对照组患者满意度73.1%(68例),两组差异有显著性(P<0.01);试验组生活质量评分,总体健康得分(74.1±8.3)高于对照组(56.7±5.9),且差异有统计学意义(P<0.01)。结论 罗伊适应模式护理干预,可以提高肺癌患者手术后的住院适应性、治疗依从性及病人满意度,显著改善患者生活质量,在临床推广罗伊适应模式护理干预具有现实意义。

Objective To investigate　the effect of Roy adaptation model on quality of life in patients for lung cancer after surgery. Methods 178 cases of　patients with lung cancer after surgery operation　were randomly divided into observation groups(85 cases) and control groups(93 cases). The control group was treated with routine nursing care and the observation group was treated on the basis of routine nursing care plus Roy adaptation model nursing interventions. When the two groups were compared in patients hospitalized and discharged adaptability, treatment compliance, patient satisfaction and patient quality of life score. Results Hospitalization adaptation in the observation group was 87.1%(74 cases) and control group was 66.7%(67 cases). There was statistically significant difference between two groups(P<0.01); Excellent treatment compliance of observation group was 88.2%(75 cases) and control group was 72.0%(67 cases). There was statistically significant difference between two groups(P<0.01); the observation group patient satisfaction were 89.4%(76 cases), it was higher than 73.1%(68 cases) of control group. There was statistically significant difference between two groups(P<0.01); quality of life in general health score(74.1±8.3) in the observation group was higher than that of control group(56.7±5.9),and there was statistically significant difference between two groups(P<0.01). Conclusion Roy adaptation model nursing intervention may improve the adaptability hospitalized the patients with lung cancer after surgery, treatment compliance and the patient satisfaction, and significantly improve the quality of life of patients. It is worthy of promotion clinically.

目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

目的 探讨经针刺治疗爆裂性眶壁骨折伴眼球运动障碍的临床疗效及安全性。方法 选取2013年10月—2015年9月在我院接受治疗的70例(70只眼)爆裂性眶壁骨折致眼球 运动障碍患者,按照治疗方式的不同分为常规组和针刺组,每组各35例,其中常规组给予常规药物治疗,针刺组除了接受常规治疗外,依据眶壁骨折部位的不同选取相应临近眼外肌穴进行针刺,每日1次,每次留针30 min,15天为一个疗程,两组患者均持续治疗两个疗程。对比分析两组患者治疗前后的角膜缘移动范围、眼球运动障碍级别以及临床疗效。结果 经过治疗后,两组患者的角膜缘移动范围均较治疗前明显改善,且与常规组患者相比,针刺组患者改善得更显著(P<0.05);经过治疗后,针刺组0级、I级、II级、III级的眼数分别为14、15、3、3只眼,其中0级的眼数明显多于常规组患者,差异有统计学意义(P<0.05);针刺组的治疗总有效率高达91.43%,明显高于常规组的62.86%,差异有统计学意义(P<0.05)。结论 针刺眼外肌穴有助于改善爆裂性眶壁骨折伴眼球运动障碍患者的角膜缘移动范围,促进患者眼外肌功能的恢复而降低眼球运动障碍级别,明显提高治疗总有效率,在临床上值得推广应用。

Objective To explore the clinical effect of eye-acupuncture on eye movement disorders caused by orbital blowout fracture and its security. Methods 70 eyes movement disorder patients with burst orbital wall fracture treated in our hospital from October 2013 to September of 2015 were selected and divided into two groups, each group contains 35 cases. The routine group was given routine drug treatment, beside this, we gave the therapy of eye-acupuncture for 30 minutes to the acupuncture group according to the type to select the corresponding extraocular muscle holes. Both with 15 days was for a course of treatment. After two courses, compared the eye movement disorder level changes and the limbus range of movement of the two groups before and after treatment, we evaluated the efficacy based on efficacy standard. Results After treatment, the corneal limbus range of movement were significantly improved of both groups, and the acupuncture group were better than that of the routine group(P<0.05);after treatment, the eye movement disorder rating of the acupuncture group was as follows: the number of level 0,1,2,3 was 14,15,3,3,respectively, among which the number of level 0 was significantly higher than that of the routine group(P<0.05);The total effective rate of the acupuncture group was 91.43 %, which was significantly higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion Eye-acupuncture may improve the corneal limbus range of movement in patients with eye movement disorders caused by orbital blowout fracture. It could promote the recovery of extraocular muscles function and thus lower the level of eye movement disorders. It significantly improves the total efficiency and is worthy of popularization and application clinically.

目的 探讨胰腺神经鞘瘤的临床特点和诊治方法。方法 总结并回顾性分析我院肝胆外科收治的胰腺神经鞘瘤患者1例及文献报道的71例患者临床资料。结果 共计72例胰腺神经鞘瘤患者纳入总结和分析。患者平均年龄54岁(范围17～89岁),其中女性40例(56%)。临床表现包括上腹痛、体重减轻,或体检偶然发现胰腺肿物。肿瘤平均大小6.1 cm(1～20 cm)。肿瘤位于胰头部29例(40%)、胰体/尾部32例(44%),沟突部6例(8%)。肿瘤表现为实性肿物27例(38%)、囊性28例(39%)、囊实性10例(14%)。2例通过术前超声内镜下穿刺活检病理确诊,其余均为手术后标本病理诊断证实。手术治疗行胰十二指肠切除术23例、局部剜除术16例、胰体尾切除术15例、胰腺中段切除1例。5例 (7%) 患者术后病理为恶性神经鞘瘤,恶性组肿瘤大小明显大于良性组[(13.8±6.2)cm vs (5.6±4.1)cm,P=0.0004)]。手术切除患者术后随访3～65月,均无肿瘤复发、转移及患者死亡。结论 胰腺神经鞘瘤临床表现缺少特异性,术前诊断困难,肿瘤大小与良恶性具有明显相关性,手术治疗可取得良好效果。

Objective To analyze clinical presentation, diagnosis, treatment options, and outcome of pancreatic schwannoma. Methods A retrospective study of clinical data of a case in our hospital and 71 cases reported in literature with pancreatic schwannoma. Results 72 cases were analysed. The mean age was 54 years (range 17-89 years), with 56 % of patients being female. Mean tumor size was 6.1 cm (range 1-20 cm). Tumor location was the head (29 cases), body and tail (32 cases), and uncinate process (6 cases). 27 cases exhibited solid tumors and 28 cases exhibited cystic tumors. Treatment included pancreaticoduodenectomy (23 cases), distal pancreatectomy (15 cases), enucleation (16 cases). 5 cases (7%) were malignant schwannoma. Tumor size of malignant group was significant larger than benign group (13.8±6.2 cm vs 5.6±4.1 cm,P=0.0004). There was no local recurrence metastasis,or death at the follow-up after operation (range 3-65 months). Conclusion The clinical manifestations of pancreatic schwannoma are lack of specificity and preoperative diagnosis remains difficulty. The tumor size was significantly related to classification of malignant or benign. Pancreatic schwannoma has satisfactory prognosis with surgical treatment.

目的 探讨肌电生物反馈对正常人脑血流动力学的影响及其变化规律。方法 总数30人的健康正常受试者纳入研究,按照表格法随机分为生物反馈实验组和对照组。其中生物反馈组20人,对照组10人。该试验采用肌电生物反馈作为反馈方法,记录两组试验前后双侧大脑前动脉、大脑中动脉和大脑后动脉的平均血流速度和脉动指数。每次生物反馈试验后间隔3天,作为一个生物反馈阶段,总共进行7个阶段。结果 生物反馈组大脑中动脉的平均血流速度在试验前、后高于对照组(P<0.05),而其脉动指数则低于对照组(P<0.05)。生物反馈组在试验前、后大脑中动脉的平均血流速度随着生物反馈次数的增加而增快(P<0.05),而脉动指数则随之而降低(P<0.05)。结论 肌电生物反馈能够增加正常人大脑中动脉的平均血流速度和降低其脉动指数,且随着生物反馈次数的增加而呈现累积效应。

Objective To discuss the effect of electromyographic biofeedback on cerebral hemodynamics in health people. Methods A total of 30 healthy volunteers were enrolled in this study, and randomly divided into biofeedback group (n=20) and control group (n=10). The biofeedback group had been done with electromyographic biofeedback for seven times with 3 days intervals after each test. The data including the mean velocity (Vm) and pulse index (PI) of anterior cerebral artery, middle cerebral artery (MCA) and posterior cerebral artery were collected bilaterally before and after the test using transcranial Doppler in the two groups. Results The values of Vm (P<0.05) were higher and PI (P<0.05) were lower in biofeedback group than those in control group before and after the test. The values of Vm (P<0.05) increased and PI (P<0.05) decreased gradually in biofeedback group from 1st to 7th tests. Conclusion The electromyographic biofeedback can induce to the increasing of velocity of cerebral blood flow and decreasing of PI in MCA, and the additive effect was observed during the 7 tests in biofeedback group.

目的 对不同周龄的KO小鼠与WT小鼠进行悬尾实验进行观察,探讨KO小鼠与WT小鼠的行为差别。方法 采用健康的试验动物180只分两组:①KO组(4、6、8周龄,各周龄30只,雌雄各半,共90只)②WT组(4、6、8周龄,各周龄30只,雌雄各半,共90只);通过悬尾实验观察性别,年龄对不动时间的影响。结果 同龄KO雌性小鼠比雄性小鼠的静止时间差别不大;随着年龄增大,静止时间增长。 同龄同性别的KO鼠比WT鼠的不动时间长。P<0.05;同龄雄性小鼠比雌性小鼠的不动时间短; 随年龄增长各种系小鼠不动时间增长,KO鼠的不动时间比WT鼠长,P<0.05。结论 KO小鼠存在抑郁行为表型。

Objective To observe tail suspension test in Fmr1 gene knockout mice and to explore whether there are differences in mobility of KO and WT mice. Methods 180 test mice were divided into two groups: ① KO group (4,6,8 weeks old, each age group of mice is 30, male and female in half, a total of 90) ② WT group (4,6, 8 weeks old, each group of mice is 30, male and female on half, a total of 90). Through forced swimming test and tail suspension test to observe gender, age effect on immobility time. Results With the same age of the same sex,the KO mice's immobility time was longer than WT mice's. P<0.05. With the same age,the male mice's immobility time was shorter than female mice's. With the age increase, the immobility time of KO mice was longer than WT mice. P<0.05. Conclusion Fmr1 gene knockout mice have anxiety and depressive behavior.

目的 初步探讨黄芩苷防治支气管哮喘的作用机理。方法 用卵蛋白致敏大鼠制备支气管哮喘动物模型,经黄芩苷干预治疗,运用免疫组化法及Western Blot法检测各组大鼠肺组织匀浆中p38 MAPK磷酸化蛋白表达量。结果 两种检测方法均显示,p38 MAPK磷酸化蛋白水平在模型组中有明显的增加,地塞米松组、黄芩苷高剂量组和低剂量组的p38 MAPK磷酸化蛋白水平均低于模型组(P<0.05)。结论 黄芩苷能有效治疗哮喘的作用与抑制哮喘大鼠p38 MAPK信号通路的表达密切相关。

Objective To explore the mechanism of Baicalin in treatment of bronchia asthma. Methods Animal models of bronchia asthma were made in rats sensitized with egg albumen. After the treatment of Baicalin, immunohistochemistry and western-blot methods were used to test expression quantity of phosphorylated p38 protein of lung tissue in all groups of guinea rats. Results Our data confirmed that the level of phosphorylated p38 protein increased significantly in model group, but it decreased in hexadecadrol group, high dose and low dose Baicalin group (P<0.05). Conclusion The effects of Baicalin in asthma model were associated with inhibition of P38 MAPK signal pathways in a dose-dependent manner.

目的 研究鸟胞内分枝杆菌复合群(MAC)MAV3104基因编码蛋白与药物外排的关系。方法 以MAC标准株基因组为模板,扩增MAV3104基因,构建pMV261-MAV3104c重组质粒;测序正确后,转化重组质粒到大肠杆菌DH5并在MAC标准株中诱导表达, Western Blot鉴定MAV3104表达;按照CLSIM24-A2的操作要求检测MAC标准株对克拉霉素的敏感性及外排泵抑制试验。结果 经基因测序及Western Blot蛋白表达验证重组质粒构建成功;MAV3104过表达能提高鸟分枝杆菌对克拉霉素的MIC,且硫利达嗪能抑制该作用;MAV3104过表达也能提高胞内分枝杆菌对克拉霉素的MIC,但硫利达嗪对其没有抑制效应。结论 MAV3104转运蛋白介导的药物外排在鸟分枝杆菌耐克拉霉素中起重要作用。

Objective To investigate the association of the protein coded by Mycobacterium avium-Mycobacterium intracellulare complex in MAV3104 in drug efflux of Clarithromycin. Methods According to the Mycobacterium avium-Mycobacterium intracellulare complex standard strain, the MAV3104 gene was amplified by PCR and cloned into expression vector pMV261 to generate the recombinant plasmids. After verification by sequence analysis, the recombinant plasmids was transformed into E. coli DH5 andMycoba ctenum avium-Mycobacterium intracellulare complex standard strain. To identify the protein expression by western blotting and investigate the sensitivity of clarithromycin and efflux pump inhibition test in the light of CLSIM24-A2 protocol. Results It was verified by sequence analysis and western blotting that the recombinant plasmids were successfully constructed. Over expression of Mycobacterium avium MAV3104 gene could enhance clarithromycin MIC, which could be inhibited by thioridazine. Over expression of Mycobacterium intracellulare MAV3104 gene also could enhance clarithromycin MIC, but it could not inhibited by thioridazine. Conclusion This study demonstrates that efflux pumps mediated by MAV3104 protein play an important role in Mycobacterium avium resistance to clarithromycin.

目的 观察多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗幽门螺杆菌(Hp)感染消化性溃疡的临床疗效和不良反应。方法 选取于2013年7月—2015年7月收治的98例Hp感染消化性溃疡患者,根据不同的治疗方式,随机将其分为治疗组和对照组,每组各49例,治疗组患者给予多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗;对照组给予克拉霉素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗, 两组患者连续服用10天后,均口服泮托拉唑40 mg,每天1次,总疗程为4周。疗程结束4周后,予胃镜复查和Hp检查,观察两组患者的临床疗效、溃疡愈合率、Hp根除率及不良反应。结果 治疗组与对照组患者的临床效果总有效率分别是95.91％、81.63％;治疗组与对照组患者的溃疡愈合率分别是83.67％、61.22％ ;治疗组与对照组患者的Hp根除率分别是89.79％、65.30％;治疗组患者的临床疗效总有效率、溃疡愈合率和Hp根除率均明显优于对照组,差异均有统计学意义(P<0.05),两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 多西环素联合阿莫西林、泮托拉唑、枸橼酸铋钾治疗Hp感染消化性溃疡疗效显著、溃疡愈合率高、Hp根除率高、且安全无明显不良反应,值得临床广泛推广使用。

目的 探讨多措施协作在中药注射剂药物警戒工作的应用效果。方法 2012年1月—2014年12月,采取建立多措施协作,应用于中药注射剂药物警戒工作中。通过对中药注射剂的用药频度(DDDs)、日用金额(DDC)、有效率及引起不良反应(ADR)变化等进行比较分析,以评价中药注射剂使用的安全性和有效性变化情况。结果 2012—2014年,中药注射剂使用有效率从76.5%上升至91.2%,不良反应发生率则由3.12%下降至0.72%,没有重大不良反应事件发生。中药注射剂用药频率DDDs则呈下降趋势,在医院药品总DDC上升的情况下,中药注射剂DDC反而下降。结论 多措施协作有助于建立有效的药物警戒体系,有效地降低了中药注射剂不良反应发生率,提高监测工作数据分析效率和发现药物警戒信号的能力,为中药注射剂的“合理,安全,有效,经济”提供有力的保障。