目的 社区干预在颈动脉斑块伴脂代谢紊乱人群中的应用。方法 选取我院2012年3月—2014年3月186例颈动脉斑块伴脂代谢患者为研究对象,将患者抽签随机分为观察组与对照组,每组93例。对照组给予基础治疗及运动生活方式指导,观察组给予基础治疗以及强化社区健康管理综合干预,观察并记录两组Crouse积分,总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C )水平及遵医行为。结果 治疗1、2年后观察组颈动脉斑块积分(3.46±2.13)cm、(3.07±2.49)cm低于对照组(4.56±2.26)cm、(4.43±2.51)cm,两组差异有统计学意义(P＜0.05)。观察组治疗1年、2年后TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,两组差异有统计学意义(P＜0.05)。观察组遵医行为优于对照组(P＜0.05)。结论 社区健康管理综合干预能显著提高患者遵医行为,改善生活方式,从而使血脂达到正常水平,延缓颈动脉斑块发展。
Objective To study the application of community intervention in population with carotid plaque complicated with dyslipidemia. Methods 186 cases of patients with carotid plaque complicated with dyslipidemia who were admitted in our hospital from March 2012 to March 2014 were selected as the study objects and were randomly divided into the observation group and the control group according to random sampling method, with 93 cases in each group. The control group was given basic treatment and guidance of exercise lifestyle. The observation group was given basic treatment and strengthened community health management integrated intervention. The crouse integral, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) levels and treatment compliance in the two groups were observed and recorded. Results After 1 and 2 years of treatment, the carotid artery plaque score in the observation group [(3.46±2.13) cm, (3.07±2.49) cm] was lower than that in the control group [(4.56± 2.26) cm, (4.43±2.51) cm](P<0.05). TC, TG and LDL-C levels in the observation group were lower than those in the control group while HDL-C level was higher than that in the control group (P<0.05). The treatment compliance in the observation group was significantly better than that in the control group (P<0.05). Conclusion Community health management integrated intervention can significantly improve the treatment compliance of patientsand their life style, so as to achieve the normal level of blood lipids and carotid plaque will be postponed.
目的 观察康复路径在髋关节置换术后的临床应用效果,探讨其临床应用价值 。方法 将广州市第一人民医院2014年10月—2015年10月收治行髋关节置换术患者100例为研究对象,随机分为对照组与观察组各50例。对照组采取常规围手术期护理,观察组按照康复路径护理,比较两组患者术后并发症、住院时间、费用、患肢功能以及日常生活自理能力。结果 观察组住院时间和住院费用均少于对照组(P<0.01);两组术后并发症发生率、患肢功能评分及日常生活自理能力比较,差异均有统计学意义(P<0.01 )。结论 康复计划护理用于髋关节置换术后效果显著,可明显降低患者术后并发症,缩短住院时间,降低住院费用,有利于促进患者术后功能以及自理能力的恢复。
Objective To observe the effect of clinical application of rehabilitation in the path of a hip replacement, and to explore its clinical application value. Methods October 2014 to October 2015 in Guangzhou First People's Hospitalhip arthroplasty cases werecollected of 100 patients as the research object, randomly divided into control group and observation group with 50 cases in each group. The control group adopted conventional perioperation period nursing care, observation group in accordance with the recovery paths. We compared two groups of patients complications, hospitalization time, expense, limb function and activities of daily living. Results In the observation group, the hospitalization time and cost of hospitalization were significantly less than that of the control group (P<0.01); The incidence of limb function score, ability of daily living and postoperative complications were compared between the two groups, the differences were statistically significant (P<0.01). Conclusion Rehabilitation nursing care plans for after hip replacement effect is significant. It can significantly reduce the postoperative complications, shorten the time of hospitalization, reduce hospitalization expenses, and is beneficial to the recovery of the function of promoting postoperative and self-care ability.
目的 探讨初诊的弥漫大B细胞淋巴瘤(DLBCL)患者外周血Th17细胞的表达与国际预后指标(IPI)之间关系。方法 初诊DLBCL组(n=45)按照国际预后指数(IPI)积分分为4组,采用ELISA和流式细胞术检测各个DLBCL组与正常对照组(n=43)的外周血中IL-17的浓度以及Th17阳性细胞比例,比较各组数值间的差异,并分析IPI的5个指标与IL-17的浓度以及Th17阳性细胞比例的相关性。结果 DLBCL中高危组与高危组的IL-17的浓度以及Th17阳性细胞比例较正常对照组及其他IPI组降低,有显著性差异;DLBCL四组的IL-17的浓度以及Th17阳性细胞比例均低于正常对照组;且可见随着IPI分组的增高,IL-17的浓度以及Th17阳性细胞比例呈降低的趋势;IPI指标中年龄、临床分期、全身状态与Th17细胞的表达有相关性。结论 初诊DLBCL患者外周血Th17细胞的表达与国际预后指标有关系;随着IPI积分的增加,DLBCL患者Th17细胞表达下降;临床上对于年龄60岁以上、临床分期Ⅲ期以上、长期卧床及需别人照顾的患者更要注意监测其外周血Th17细胞的表达情况。
Objective To explore the relationship between the international prognosis indexes(IPI) and the Th17 cells expression in DLBCL patients. Methods DLBCL patients (n=45) were divided into 4 groups according to IPI score, peripheral blood were taken from each person in DLBCL groups and normal group. We used ELISA to test IL-17 and flow cytometry (FCM) to examine the Th17 positive cells. We compared the value of each group, and analyzed the relativity of IPI and Th17 cells' expression. Results Th17 cells' expression level in middle-high risk group and high risk group were higher than that in normal group and other IPI groups; Th17 cells' expression level in DLBCL groups were all lower than that in normal group; Th17 cells decreased while IPI score increased; Age, clinical stage and general body state have the relativity with DLBCL patients' Th17 cells expression level. Conclusion Th17 cells in DLBCL patients has the relativity with prognosis index. In our clinical diagnosis and treatment, we need to pay more attention to those patients who are over 60 years old, or whose clinical stage is above Ⅲ phase, or who need to stay on bed for a long time and need other peoples' help .
目的 探讨尼莫地平对无症状脑梗塞认知功能障碍的改善作用及安全性。方法 将80例无症状脑梗塞患者随机分为治疗组和对照组,每组40例,于治疗前及治疗后3月分别进行蒙特利尔认知量表(MoCA)、简易智能状态量表(MMSE)、画钟测验(CDT)评估,并比较2组的评分结果。结果 尼莫地平治疗后3月MMSE 评分为(26.35±3.26)分,MoCA评分为(25.53±4.31)分,CDT评分为(6.12±2.23)分,较对照组分别为MMSE 评分为(23.12±3.45)分,MoCA评分为(22.21±3.63)分,CDT评分为(4.35±2.61)分有改善,差异均有统计学意义(P<0.05)。80例患者中MoCA评测异常组在视空间与执行能力、延迟记忆、注意力及计算力、抽象思维等分项得分明显低于MoCA评测正常组(P<0.05)。结论 尼莫地平能有效改善无症状脑梗塞患者的认知功能,且安全性较高。
Objective To explore the role of nimodipine in improving cognitive function in silent cerebral infarction patients and its safety. Methods Eighty SCI patients were divided randomly into 2 groups.MMSE、MoCA and CDT scores were assessed before treatement and after 3 month of treatment.The results were compared between the 2 groups. Results MMSE、MoCA and CDT scores of Nimodipine group(26.35±3.26, 25.53±4.31, 6.12±2.23, respectively), improved when compared with the control(23.12±3.45, 22.21±3.63, 4.35±2.61,respectively),and the difference was statistical significance (P<0.05). The patients with abnormal MoCA had lower scores in several cognitive domains (visuospatial and executive abilities, delayed memory, attention and capacity of calculation, abstract thinking (P<0.05) compared with control group. Conclusion Nimodipine could improve effectively the cognitive function in SCI patients and with a higher safety.
目的 对硝苯地平缓释片治疗高血压合并糖尿病的疗效分析。方法 运用随机对照的方法,选择2012年1月—2014年8月在我社区医院就诊的220例高血压合并糖尿病患者,将其分为观察组与对照组,每组各取110例,将全部患者的血糖等各项指标控制在常规范围,观察组服用硝苯地平缓释片,对照组采用常规疗法。一个疗程(8周)进行对比,检测血压、血糖项目,观测临床治疗效果。结果 服用药物后,两组血压均有降低(P<0.05),观察组临床总有效率98.18%,对照组有效率86.36%,观察组比对照组有明显的控制疗效。两组统计数据差异有统计学意义(P<0.05)。结论 硝苯地平缓释片治疗高血压合并糖尿病方面有疗效,无明显的治疗副作用,值得临床推广使用。
目的 探讨中青年医护人员血尿酸(UA)水平与心血管危险因素的关系。方法 利用国人缺血性心血管疾病发病危险的评估方法及简易评估工具“心血管危险积分”评价982名中青年医护人员的心血管危险因素,计算其危险评分积分值,用四分位法根据UA值将研究对象分为四组,比较不同分组间的临床资料,分析UA水平与心血管危险因素的关系。结果 UA水平与心血管危险因素存在正相关(P＜0.01);Ⅲ、Ⅳ组心血管危险积分均高于Ⅰ、Ⅱ组,差异有统计学意义(P＜0.01)。结论 UA增高是心血管疾病的一个重要危险因素,重视高尿酸血症的防治,对预防中青年医护人员的心血管疾病的发生具有重要意义。
Objective To study the relationship between serum uric acid levels and risk factor of cardiovascular disease in young and middle-aged medical staff. Methods Using of risk assessment method and simple assessment tools of cardiovascular risk score of Chinese ischemic cardiovascular disease, the study appraised risk factors of cardiovascular disease about 982 young and middle-aged medical staffs, calculated the risk score integral value. The study divided objects of study into four groups with quartile's method according to serum uric acid levels, compared clinical data between different groups, analyzed the correlation between uric acid level and cardiovascular risk factors. Results Serum uric acid level and cardiovascular risk factors had positive correlation(P<0.01); Ⅲ,Ⅳ group's cardiovascular risk score were higher than Ⅰ, Ⅱ group; the difference had statistics significance(P<0.01). Conclusion Hyperuricemia is an important risk factors in cardiovascular disease. Paying attention to hyperuricemia prevention has important significance to prevention of cardiovascular disease in young and middle-aged medical staff.
目的 检测抑郁障碍患者血清中IL-2和TNF-α水平,探讨IL-2和TNF-α水平与认知功能情况相关性。方法 采用酶联免疫吸附法(ELISA)检测100例抑郁障碍患者(观察组)和100例健康人(对照组)的血清IL-2、TNF-α的水平,并结合汉密尔顿抑郁量表(HAMD)观察患者抑郁障碍的严重程度,应用Loewenstein 认知评定量表评定患者的认知状态情况进行相关分析。结果 与对照组相比,观察组的IL-2、TNF-α的水平明显更高(P<0.05)。IL-2、TNF-α的水平与HAMD,LOTCA总分呈正相关(P<0.05)。结论 抑郁障碍患者血清中IL-2、TNF-α的水平与抑郁障碍患者的严重程度和认知状态情况呈正相关。
Objective To study the levels of serum IL-2 and TNF-α in depressed patients and theircorrelations with the cognitive function. Methods 100 depressed patients (observation group) and 100 healthy people (control group) were enrolled to this study and we compared their levels of serum IL-2 and TNF-α detected by enzyme-linked immunosorbent (ELISA) from two groups. The correlation analyses of the serum IL-2 and TNF-α levels with the severity of depression of depressed patients observed with Hamilton depression scale (HAMD), and the serum IL-2 and TNF-α levels with the cognitive function evaluated with Loewenstein were conducted. Results The levels of serum IL-2 and TNF-α in the observation group were significantly higher than control group (P<0.05).There were positive correlations between the levels of IL-2 and TNF-α and HAMD scores and between the levels of IL-2 and TNF-α and LOTCA scores (P<0.05). Conclusion The levels of serum IL-2 and TNF-α in the depressed patients were positively correlative with the severity of depression and their cognitive function.
目的 探讨影响自然周期供精人工授精妊娠的因素。方法 回顾性分析2007年4月—2013年4月期间在广东省计划生育专科医院行自然周期供精人工授精的6161个周期,其中妊娠组1454周期,对照组4707个周期。采用单因素分析及多因素Logistic回归分析女方年龄、不孕年限、子宫内膜厚度、类型及冻融复苏后前向运动精子总数与AID妊娠结局的关系。结果 年龄越大,不孕年限越长,妊娠率越低(P＜0.001); A型子宫内膜妊娠率25.94%较AB型的23.87%及B型的21.54%都高(P=0.001);妊娠组冻融复苏后前向运动精子总数均值(28.95±6.86)×106较对照组的(28.26±6.98)×106高(P=0.001);年龄(OR=1.614,P＜0.001)、不孕年限(OR=1.194,P=0.012)、子宫内膜分型(OR=1.258,P=0.001)影响妊娠率。结论 女方年龄、不孕年限、子宫内膜形态及冻融复苏后前向运动精子总数是影响自然周期供精人工授精妊娠的因素。
Objective To explore the parameters affecting the pregnancy rate from 6161 natural cycles of artificial insemination by donor(AID). Methods Consecutive cases of 6161 natural cycles of AID from April,2009 to April 2013 in Guangdong provincial family planning special hospital were analyzed retrospectively.1454 pregnant cycles were defined as observation group and the other 4707 non pregnant cycles were classified as control group.Related factors in effect of pregnancy rate of AID were analyzed by logistic regression analysis. Results The rate of pregnancy decreased with the increase of women ages and the infertility duration(P＜0.001).And the pregnancy rate of ICI among the women with type A endometrium was the highest among the three types of endometrium(25.94%vs23.87%vs21.54%,P=0.001).The sum of the forward moving sperm after freezing and thawing recovery of observation group is higher than control group(28.95±6.86)×106vs (28.26±6.98)×106.The value of OR of age,infertility duration and types of endometrium were 1.614,1.194 and 1.258,respectively. Conclusion Age of women,infertility duration,types of endometrium as well as the sum of the forward moving sperm after freezing and thawing recovery played an important role in pregnancy rate of natural cycles of AID.
目的 分析呼吸康复治疗对农村地区慢性阻塞性肺疾病(COPD)稳定期患者BODE评分系统的影响。方法 将我院收治的60例COPD稳定期患者作为研究对象,随机分为对照组与观察组,每组30例。对照组常规治疗,观察组则给予呼吸康复治疗方案。比较两组患者治疗前后BOBE评分系统的变化。结果 治疗后,观察组BMI、FEV1%、MMRC分级、6MWD分别为(22.4±1.1)kg/m2,(68.6±3.6)%,(1.3±0.2)级,(256.3±36.3)m,BODE指数评分降低至(3.4±1.0)分,ADL为(78.2±6.4)分,QOL为(67.8±2.6)分,与对照组相比差异有统计学意义(P<0.05);且观察组炎性因子水平下降幅度高于对照组(P<0.05)。结论 在农村地区COPD稳定期患者的临床治疗中,采用呼吸康复治疗方案,患者BODE评分系统指标改善显著,值得推广。
Objective To analyze the influence of respiratory rehabilitation treatment on BODE coring system of patients with chronic obstructive pulmonary disease (COPD) in stable phase in rural areas. Methods 60 patients with COPD in stable phase admitted into the hospital were selected as the research object and were randomly divided into control group and observation group with 30 cases in each. The control group received conventional treatment while the observation group received respiratory rehabilitation treatment. The changes of BOBE coring system in the two groups before and after the treatment were compared. Results After the treatment, BMI, FEV1% MMRC classification and 6MWD of the observation group were (22.4±1.1) kg/m2, (68.6±3.6)%, (1.3±0.2) and (256.3±36.3) m respectively. The BODE index score decreased to (3.4±1.0), ADL (78.2±6.4), and QOL (67.8 + 2.6).compared with those of the control group, the difference was statistically significant (P< 0.05). And the decline level of inflammatory factors in the observation group was significantly higher than that of the control group (P<0.05). Conclusion In the clinical treatment of patients with COPD in stable phase in rural areas, respiratory rehabilitation treatment were adopted, the improvement of BOBE coring system indexes is significant. It is worthy to be popularized.
目的 探讨NXT629改善肝胆结石形成的相关机制。方法 对C57BL/6J小鼠分别采用常规饮食或成石饮食（LD）喂养，并在LD组小鼠注射PPAR-α拮抗剂NXT629。通过苏木精-伊红染色法染色分析肝脂肪病变，油红O染色检测肝脏脂质的积累，分光光度法检测胆汁或血清中总胆固醇、甘油三酯、磷脂、总胆汁酸、胆固醇饱和指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇指标；qPCR法检测小鼠肝组织中ABCG5/8、CYP7A1、CYP7B1、PPAR-α和ABCB11 mRNA的表达情况。结果 NXT629通过靶向PPAR-α降低LD组小鼠肝脏中的ABCG5、ABCG8、ABCB11 mRNA水平以及增加CYP7A1、CYP7B1 mRNA水平，进而减少LD诱导的肝胆结石形成并改善脂质代谢紊乱。结论 NXT629可能通过影响脂代谢相关基因表达改善肝胆结石。
Objective To explore the mechanism on NXT629 improves hepatolithiasis formation．Methods C57BL/6J mice were fed either a regular diet or a lithogenic diet（LD），with the LD group receiving injections of PPAR-α inhibitor NXT629．Liver steatosis was analyzed via HE staining，hepatic lipid accumulation was detected by Oil Red O staining，and total cholesterol，triglycerides，phospholipids，total bile acids，cholesterol saturation index，low density lipoprotein cholesterol，and high density lipoprotein cholesterol levels in bile or serum were measured using assay kits．RT-qPCR was employed to determine the mRNA expression of ABCG5/8，CYP7A1，CYP7B1，PPAR-α，and ABCB11 in mouse liver tissues．Results The results showed that NXT629 target PPAR-α to down-regulate the mRNA levels of ABCG5，ABCG8，and ABCB11 in the livers of LD-fed mice，while increasing the mRNA levels of CYP7A1 and CYP7B1，thereby reducing LD-induced hepatolithiasis formation and improving lipid metabolism disorders．Conclusions NXT629 can improve cholesterol gallstones by affecting the expression of genes related to lipid metabolism．
