目的 通过测试获取脑瘫外翻足患儿的足底压力参数特征,为设定步态康复训练方案提供参考。方法 根据纳入和排除标准,选择脑瘫患儿和健康儿童各15人,通过足底压力测试仪测得足底各部位压力分布、区域压力峰值及步态时相百分比,将两组结果进行统计学比较。结果 比较发现在足底接触面积、足底压力值,以及步态时相所占时间长短三方面均有指标存在差异,均有统计学意义(P<0.05)。结论 足底压力测试技术可使临床步态分析更加量化、精确化,为设定更有针对性的康复训练提供依据。

Objective Through the assessment to get the plantar pressure features of cerebral palsy children with talipes valgus, in order to design suitable treatment plan. Methods According to the inclusion criteria and exclusion criteria, we chose 15 cerebral palsy children with talipes valgus in experimental group, and 15 healthy children in control group. Through the test to get the plantar contact area, pressure parameters and the percent of gait phase. the two groups were compared with statistics method. Results There were significant differences between two groups on the plantar contact area, pressure parameters and the percent of gait phase. Conclusion Plantar pressure measurement makes clinic gait analysis more quantized and accurate, it will provide the evidence to plan the suitable treatment plan.

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.

目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.

目的 观察隔药壮灸神阙穴治疗女性黄褐斑的临床疗效及对血清性激素水平的影响。方法 将72例患者随机分为2组,治疗组38例和对照组34例,治疗组予隔药壮灸神阙穴治疗,对照组予口服维生素C、维生素E治疗,10次为1个疗程,第2、4、6疗程末观察疗效,治疗前后测定月经第2～3天血清雌二醇(E2)、孕酮(P)、泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平。结果 第6疗程末治疗组总有效率为83.33％,对照组总有效率30.30%,治疗组疗效优于对照组(P＜0.05),治疗组治疗前后E2、LH下降水平有统计学意义(P＜0.05)。对照组治疗前后E2、P、PRL、FSH、LH、T水平变化不明显(P＞0.05)。治疗后2组E2、LH比较,差异有统计学意义(P＜0.05)。结论 隔药壮灸神阙穴治疗女性黄褐斑临床疗效较好,可能通过调节性激素而起到治疗作用。

Objective To observe the clinical efficacy on female chloasma treated with acupuncture of Zhuang minority medicine at Shengque xue and its influence on sex hormone levels. Methods 72 cases were divided randomly into a treatment group(38 cases) and a control group(34 cases). In treatment group, acupuncture of Zhuang minority medicine at Shengque xue was applied. In control group, oral administration of vitamin C and vitamin E were given. The cases of treatment group were treated ten times as one session. At the end of 2,4,6 treatment session efficacy were analyzed respectively. The levels of serum estradiol(E2), progesterone(P), prolactin(PRL), follicule stimulating hormone(FSH), luteinizing hormone(LH) and testosterone(T) were detected on day 2-3 of menstruation. Results At the end of 6 treatment session the total effective rate was 83.33％ in treatment group and was 30.30% in control group, the efficacy in treatment group were superior to that in control group, with significant difference(P＜0.05). In treatment group, the levels of LH and E2 after treatment were lower as compared with those before treatment(P＜0.05). In control group, there were no obvious changes in E2,P, PRL, FSH, LH and T before and after treatment(P＞0.05). The levels of LH and E2 after treatment were significantly different in comparison of two groups(P＜0.05). Conclusion Acupuncture of Zhuang minority medicine at Shengque xue achieves a definite efficacy on female chloasma in clinic and its pharmacological mechanism may be relevant with its regulation on sex hormone levels for the patients.

目的 探讨体外循环手术前后患者血清HMGB₁、CK、CK-MB、LDH、LD₁、AST水平变化及意义。方法 采用ELISA法检测57例体外循环患者手术前后血清HMGB₁表达水平,采用临床常规方法检测血清中CK、CK-MB、LDH、LD₁、AST水平。对体外循环手术前后血清HMGB1表达水平与CK、CK-MB、LDH、LD₁、AST的水平进行比较与相关分析。结果 体外循环手术患者HMGB₁、CK、CK-MB、LDH、LD₁、AST水平在手术后0.5小时、24小时、48小时、72小时均高于手术前(P<0.05);HMGB₁、CK、CK-MB、LD₁、AST水平在手术后24小时达高峰,LDH水平高峰出现于手术后48小时,其他各指标渐渐下降。体外循环手术阻断时间延长,则HMGB₁、CK、CK-MB、LDH、LD₁、AST水平升高。体外循环手术后患者血清中HMGB₁表达水平与CK、CK-MB、LDH、AST指标呈正相关关系(P<0.05)。结论 体外循环手术后患者血清HMGB₁、CK、CK-MB、LDH、LD₁、AST水平升高,HMGB1参与了心肌的缺血再灌注损伤过程。

Objective To investigate before extracorporeal circulation and after HMGB₁, CK, CK-MB, LDH, LD₁, AST levels and significance in serum of patients. Methods 57 cases before extracorporeal circulation surgery and after, the levels of HMGB₁ were detected by ELISA,while the levels of CK and CK-MB and LDH and LD₁ and AST were detected by using conventional methods of clinical. Difference of HMGB₁ and CK, CK-MB, LDH, LD₁ and AST levels were compared. The relationship were been analyzed on the patients before extracorporeal circulation surgery and after. Results In extracorporeal circulation surgery, HMGB₁, CK, CK-MB, LDH, LD₁, AST levels after surgery in 0.5 hours, 24 hours, 48 hours,72 hours were higher than before surgery (P<0.05); HMGB₁, CK, CK-MB, LD₁, AST levels peaked at 24 hours aftersurgery, LDH levels was peaked at 48 hours after surgery, and then gradually declined. Extracorporeal circulation blocking was prolonged, the levels of HMGB₁ and CK and CK-MB and LDH and LD₁ and AST were elevated. After extracorporeal circulation surgery in serum the levels of HMGB₁ expression and CK,CK-MB,LDH, AST indicators showed a positive correlation(P<0.05). Conclusion The levels of HMGB₁, CK, CK-MB, LDH, LD₁ and AST were elevated after extracorporeal circulation surgery. HMGB₁ was involved in myocardial ischemia and reperfusion injury.

目的 观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法 收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果 脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例 (5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论 肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。

Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time,to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen.RECIST 1.0 was taken to know the result. Results For brain metastasis of the 15 patients, complete response (CR) and partial response(PR) were 1 and 5 patients, respectively. 4 patients were stable disease (SD) and progression disease(PD) in 5 patients. The overall response rate(ORR) was 40% and the disease control rate(DCR) was 66.7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲexpression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin-Ⅲ expression may be associated with the efficacy of this regimen.

目的 探讨心肌细胞RyR2和L型钙通道的基因变异与室性心律失常和心源性猝死的相关性。方法 回顾分析2010年1月—2012年12月在我院就诊的慢性心力衰竭患者622例的临床资料,并选取同一时期体检中心体检的健康人群516例作为对照组,门诊或者电话随访记录慢性心力衰竭患者的死亡为终点,通过候选基因分析可能具有相关功能的4个基因变异,rs41315858(G1885E)、rs3766871(G1886S)、rs790896(G>A)和rs723672(T>C),采用Logestic、Cox回归分析对4个候选基因变异进行相关性研究。结果 入选622例慢性心力衰竭患者和516例对照组,基因分析结果显示RyR2上的基因变异rs376687lA等位基因携带可以增加慢性心力衰竭患者发生室性心律失常的风险性;校正可能与该疾病相关的危险因素后,rs376687lA等位基因携带会增加心源性死亡和心源性猝死的风险,RyR2上的基因变异rs790896A等位基因携带可以降低心源性猝死风险。结论 RyR2上的基因变异rs376687lA是室性心律失常和心源性猝死的遗传学预测因子,而rs790896A等位基因是慢性心力衰竭患者的保护因子,可降低室性心律失常和心源性猝死的风险。

Objective To investigate the myocardial cells RyR2 and L-type calcium channel gene variants with ventricular arrhythmias and sudden cardiac death correlation. Methods Retrospective analysis of patients with chronic heart failure from January 2010 to December 2012 in our hospital including 622 cases of clinical data, and to select 516 cases of healthy people in medical examination center during the same period as a control group.Clinic or telephone follow-up recorded chronic patients with heart failure and sudden death acting as end. We analyzed possible candidate genes, according to four gene variants related functions, rs41315858 (G1885E), rs3766871 (G1886S), rs790896 (G> A) and rs723672 (T> C), by using Logestic, Cox regression analysis of four candidate gene variants for related research. Results 622 cases of chronic heart failure patients were enrolled and 516 patients in the control group. Genetic analysis showed that the gene variant alleles carried rs376687lA RyR2 may increase in patients with chronic heart failure ventricular arrhythmia risk; correction may be associated with the disease after risk factors, rs376687lA allele carries an increased risk of cardiogenic death and sudden cardiac death, and gene mutation alleles carried on rs790896A RyR2 can reduce the risk of sudden cardiac death. Conclusion Gene mutation rs376687lA RyR2 on genetics is predictor of ventricular arrhythmias and sudden cardiac death, and rs790896A allele is protective factor in patients with chronic heart failure which can be reduced ventricular arrhythmias and sudden cardiac death in risk.

KOA是临床上最常见,发病起源于关节软骨的慢性退行性关节疾病。近年来,应用黄芪治疗KOA的报道不断增多,并且开展了大量的机制研究。本文综述了黄芪在KOA治疗中的应用现状及研究进展,同时指出从PPAR-γ信号通路探索黄芪干预KOA的具体分子机制具有积极的理论和实践意义。

目的 观察以湿敷为主的早期综合干预疗法治疗婴幼儿湿疹的效果。方法 按照随机的原则对118例患有湿疹的婴幼儿分为观察组(60例)和对照组(58例)。观察组采取以湿敷为主的早期综合治疗,对照组采取一般家庭干预,两组均跟踪随访,观察湿疹的好转情况,并统计湿疹复发率。结果 观察组60例患者中痊愈38例,占 63.3%;显效20例,占 33.3%;有效2例,占3.3%;无效0例;总有效率100%。痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组58例患者中痊愈20例,占 34.48%;显效14例,占24.14%;有效16例,占27.59%;无效8例,占13.79%;总有效率86.21%。观察组痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组痊愈20例中复发6例,复发率为30%。结论 以湿敷为主的早期综合干预疗法能有效减轻湿疹的症状,可以作为社区治疗婴幼儿湿疹的参考。

Objective To observe the effects of wet compress based early comprehensive intervention therapy in the treatment of infant eczema. Methods 118 cases of infantile eczema within the jurisdiction were randomly divided into observati on group (60 cases)and control group (58 cases). The observation group was given early comprehensive therapy based on wet compress while the control group took general family intervention.Follow-up observations were adopted for both groups to examine the curing of eczema and to collect data for eczema recurrence. Results In the observation group of 60 cases, 38 were cured, accounting for 63.3%; 20 markedly improved (33.3%),2 effective(3.3%) and 0 ineffective; with the total effective rate of 100%.of the 38 cases cured, eczema reappeared in 8 cases after eight weeks of follow-up observation, with the recurrence rate of 21%. In the control group of 58 cases, 20 were cured, accounting for 34.48%; 14markedly improved (24.14%), 16 effective (27.59%),and 8 ineffective (13.79%),with the total effective rate of 86.21%. In the observation group, eczema recurred in 8 of the 38 cured cases after eight weeks of follow-up observation, with the recurrence rate of 21% while in the control group, eczema recurred in 6 cases, with the recurrence rate of 30%. Conclusion Wet compress based early comprehensive intervention therapy can effectively relieve the symptoms of eczema, so it can be effectively used in community treatment of infantile eczema.

目的 了解CHPS患儿经胃镜下幽门肌切开术治疗后幽门部黏膜近期各种并发症的发生情况及对预后的影响。方法 选取2006—2012年我院新生儿科确诊的34例CHPS患儿。以超细胃镜进入十二指肠乳头处,使用电切刀按上行性方向,沿幽门管纵轴切割肥厚狭窄的幽门管黏膜及环形肌以解除幽门部梗阻。术后第1、3、6月复查胃镜。结果 34例CHPS患儿共行胃镜下幽门肌切开术48次,均未发生胃及幽门穿孔、撕裂等严重并发症。24例患儿术后通过胃镜进行了复查,胃镜见幽门部及黏膜改变主要有黏膜充血肿胀、切口未完全愈合、切口疤痕形成、幽门部息肉形成等。结论 经胃镜下幽门肌切开术是一种安全性较高的治疗CHPS的新技术。术后黏膜充血肿胀、切口未完全愈合等幽门部黏膜改变的发生率随时间下降。切口疤痕形成并未影响幽门功能。