目的 儿童流感相关坏死性脑病(influenza-associated necrotizing encephalopathy,IANE)是一种严重的流感并发症,目前缺乏早期诊断预警指标,本文探讨血生化和脑脊液检测在儿童IANE早期预警中的作用,为IANE早期诊断提供预测参考。 方法 回顾分析2016年1月—2020年12月在我院接受诊治的确诊流感并发神经系统并发症的患儿。40例流感相关性脑病(influenza-associated encephalopathy,IAE)和32例IANE患儿纳入研究。采用受试者工作特征曲线(ROC)分析来确定所选变量的预警价值。 结果 与IAE组相比,IANE组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酐激酶(CK)、乳酸脱氢酶(LDH)、脑脊液乳酸脱氢酶(CSF LDH)、脑脊液蛋白(CSF PRO)均升高,两组差别有统计学意义(P<0.05)。用于区分IAE和IANE的LDH、CSF LDH和CSF PRO的曲线下面积(AUC)分别为0.876、0.853和0.831。LDH>535 U/L预测IANE的敏感度为89.7%,特异度为86.5%。CSF LDH>67 U/L预测IANE的敏感度为82.8%,特异度为73.3%。CSF PRO>0.49 g/L预测IANE的敏感度为73.7%,特异度为76.6%。IANE患儿死亡10例(43.3%),IAE患儿死亡0例(P<0.05)。 结论 IANE组LDH、CSF LDH和CSF PRO明显升高,可作为IANE的早期预警指标。对此类患儿要密切评估,早期预测及干预,减少后遗症及病死率,改善预后。

Objective Influenza-associated necrotizing encephalopathy (IANE) in children is a serious complication of influenza. At present, there is a lack of indicators for early diagnosis and early warning. In this paper, the role of blood biochemical and cerebrospinal fluid detection in early warning of IANE in children is discussed, so as to provide a predictive reference for early diagnosis of IANE. Methods A retrospective analysis was conducted on children diagnosed with influenza and with neurological complications who were treated in our hospital from January 2016 to December 2020. Forty children with influenza-associated encephalopathy (IAE) and 32 children with IANE were included. Receiver operating characteristic curve (ROC) analysis was used to determine the predictive value of the selected variables. Results Compared with IAE group, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine kinase (CK), lactate dehydrogenase (LDH), cerebrospinal fluid lactate dehydrogenase (CSF LDH) and cerebrospinal fluid protein (CSF PRO) were all increased in IANE group, and the differences between the two groups were statistically significant (P<0.05). The area under curve (AUC) of LDH, CSF LDH and CSF PRO used to distinguish IAE from IANE were 0.876, 0.853 and 0.831, respectively. The sensitivity and specificity of LDH>535 U/L for predicting IANE were 89.7% and 86.5% respectively. The sensitivity and specificity of CSF LDH>67 U/L for predicting IANE were 82.8% and 73.3% respectively. The sensitivity and specificity of CSF PRO＞0.49 g/L in predicting IANE were 73.7% and 76.6%. There were 10 deaths of IANE (43.3%) and 0 death of IAE (P<0.05). Conclusion The levels of LDH, CSF LDH and CSF PRO were significantly increased in IANE group, which could be used as early warning indicators for IANE. For such children, close evaluation, early prediction and intervention should be made to reduce sequelae and fatality rate and to improve prognosis.

目的 分析河源市学龄前儿童发生小细胞低色素性贫血的病因。方法 对我院进行健康体检小细胞低色素性贫血儿童287例进行血常规、血清铁蛋白及地中海贫血基因检测。结果 在所研究的287 例小细胞低色素性贫血儿童病例中,分别检出 α地中海贫血 127例,β地中海贫血 48例,α/β复合地中海贫血2例;铁缺乏 83例 (合并地中海贫血20例, 缺铁性贫血45例),不明原因贫血47例。地中海贫血检出率为61.67%,铁缺乏检出率为21.95% 。结论 地中海贫血是河源市学龄前儿童发生小细胞低色素性贫血最主要的原因,其次是铁缺乏,各年龄段儿童以轻度贫血为主,6月~1岁,1~3岁为铁缺乏高发年龄。α地中海贫血基因型以--^SEA/αα最常见,β地中海贫血以βIVS-II-654/β^N最常见,小细胞低色素症在静止型最常见。

Objective To analyze the causes of microcytic hypochromic anemia in preschool children in Heyuan City. Methods A total of 287 cases with microcytic hypochromic anemia were selected in our hospital. The indexes of hematology, serum ferritin were detected and genetic testing for thalassemia was performed. Results Through genetic analysis, 127 of 287 cases of microcytic hypochromic anemia were confirmed with α-thalassaemia,48 cases with β-thalassaemia,2 cases with compound α/β-thalassaemia and 83 cases with iron deficiency (20 thalassemia cases and 45 iron deficiency anemia cases). Thalassaemia detection rate was 61.67%, iron deficiency detection rate was 21.95%. Conclusion Thalassaemia was the main reason of microcytic hypochromic anemia in preschool children in Heyuan City, followed by iron deficiency. The mild anemia was the main type among all age groups, children aged 0.5-3 had higher iron deficiency rate. The main type of α-thalassaemia was --^SEA/αα, the main type of β-thalassaemia was βIVS-II-654/β^N and the main type of microcytic hypochromic was static type.

目的 探究超声-微泡介导的miR-128通过调节PTEN对乳腺癌细胞阿霉素耐药的影响。方法 qPCR检测miR-128在乳腺癌细胞系中的表达,并利用结合微泡的miR-128质粒(质粒+超声+SF6微泡)转染细胞,探究超声-微泡介导的miR-128对乳腺癌细胞阿霉素耐药的影响。CCK8实验检测乳腺癌细胞的活性;qPCR检测过表达miR-128后对PTEN的影响和对乳腺癌细胞阿霉素耐药的影响。结果 miR-128在阿霉素耐药乳腺癌细胞中低表达;过表达miR-128能够增加乳腺癌细胞对阿霉素的敏感性,超声-微泡介导的miR-128进一步增强了乳腺癌细胞对阿霉素的敏感性;miR-128通过调节PTEN从而促进乳腺癌细胞对阿霉素耐药。结论 miR-128过表达可以增强乳腺癌对阿霉素的敏感性,超声-微泡介导的miR-128进一步增强了乳腺癌细胞对阿霉素的敏感性,本研究为乳腺癌阿霉素耐药的治疗提供了新的分子靶标和治疗途径。

Objective To explore the effect of ultrasound-microbubble mediated miR-128 on doxorubicin resistance in breast cancer cells by regulating PTEN. Methods Quantitatine PCR (qPCR) was used to detect the expression of miR-128 in breast cancer cell lines, and the ultrasound-microbubble combined miR-128 plasmid(plasmid+ultrasound+SF6 microbubbles) was used to transfect the cells to explore the effects of ultrasound-microbubble mediated miR-128 on doxorubicin resistance in cancer cells. The CCK8 experiment was used to detect the activity of breast cancer cells; qPCR was used to detect the effect of overexpression of miR-128 on PTEN and the effect on doxorubicin resistance of breast cancer cells. Results miR-128 was under-expressed in doxorubicin-resistant breast cancer cells; overexpression of miR-128 increased the sensitivity of breast cancer cells to doxorubicin,ultrasound-microbubble mediated miR-128 further enhanced breast cancer cells sensitivity to doxorubicin; miR-128 promote resistance to doxorubicin in breast cancer cells by regulating PTEN. Conclusion Overexpression of miR-128 could enhance the sensitivity of breast cancer to doxorubicin. Ultrasound-microbubble mediated miR-128 further enhanced the sensitivity. This study provided a treatment for doxorubicin resistance in breast cancer with new molecular targets and therapeutic approaches.

目的 运用三维斑点追踪成像(3D-STE)技术,检测系统性红斑狼疮(SLE)患者的左室收缩期峰值应变(S)和应变率(Sr)及舒张指数,探讨其评价 SLE 患者左室整体收缩及舒张功能的临床应用价值。方法 选择 30 例 SLE 患者(SLE 组)和 30 例正常人(对照组),分别对其进行二维超声心动图和3D-STI检查,获取心尖四腔、两腔、三腔及心尖长轴二维超声及M型超声切面,测量左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左心室后壁舒张末期厚度(LVPWd)、左心室后壁收缩末期厚度(LVPWs)、左心室射血分数(LVEF)、左心室缩短分数(LVFS)、每搏输出量(SV)、左室舒张末期容积(EDV)、收缩末期容积(ESV)、心输出量(CO)、球形指数(SPI)、左室舒张末期质量(LV EDmass)、左室收缩末期质量(LV ESmass)。应用3D-STI行心肌运动分析, 测量左心室整体纵向、圆周、径向及面积收缩期峰值应变(GLS、GCS、GRS、GAS),经胸采集四维全容积图像,应用公式计算各方向相应的舒张期前1/3点时的应变显像舒张指数(SI-DI),公式为(SI-DI=(A-B)/A×100%)。应用统计学分析上述指标在各组间的差异性及其之间的相关性。结果 SLE 组超声心动图的测量数值(LVEF、 LVFS、SV、EDV、CO、LV EDmass、LV ESmass)较对照组降低,差异有统计学意义(P＜0.05),(LVEDd、LVEDs、IVSd、IVSs、LVPWd、LVPWs、ESV、SPI) 与对照组比较, 差异亦均无统计学意义(P＞0.05)。SLE组左心室 GLS、GCS、GRS、GAS均较对照组减低, 差异均有统计学意义(P<0.05)。GAS诊断SLE的敏感度为93.3%,高于GLS(80%)、GCS(66.7%)、GRS(86.7%),GCS诊断SLE的特异度为(93.3%),高于GLS(86.7%)、GAS(86.7%)和GRS(73.3%);应用公式计算得出,SLE组左心室L-SI-DI、C-SI-DI、R-SI-DI 及A-SI-DI均低于正常对照组,差异均有统计学意义(P<0.05);ROC 曲线显示C-SI-DI敏感度(93.3%)及L-SI-DI敏感度(86.7%)高于R-SI-DI(80.0%)、A-SI-DI(80.0%);A-SI-DI特异度(93.3%)及R-SI-DI特异度(93.3%)高于L-SI-DI(73.3%)、C-SI-DI(73.3%)。结论 SLE 患者左室总体收缩及舒张功能减低,4D-STI超声斑点追踪技术可早期检测 SLE 患者左心室收缩及舒张功能的异常。

Objective To detect left ventricular systolic peak strain(S), strain rate(Sr) and diastolic index in patients with systemic lupus erythematosus(SLE) by three-dimensional speckle tracking imaging(3D-STE), and to evaluate the left ventricular total in SLE patients and clinical application value of systolic and diastolic function. Methods Thirty patients with SLE(SLE group) and 30 normal controls(control group) were enrolled. Two-dimensional echocardiography and 4D-STI were performed to obtain sections of apical four-chamber, two-chamber, three-chamber and apical long axis of ultrasound and m-mode ultrasound. To measure left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), ventricular septal end-diastolic thickness(IVSd), ventricular septal end-systolic thickness(IVSs), left ventricular posterior wall diastolic end-stage thickness(LVPWd), left ventricular posterior wall end-systolic thickness(LVPWs), left ventricular ejection fraction(LVEF), left ventricular shortening fraction(LVFS), stroke volume(SV), left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), cardiac output(CO), spherical index(SPI), left ventricular end-diastolic mass(LV EDmass), left ventricular end-systolic mass(LV ESmass). 4D-STI myocardial motion analysis, the total longitudinal, circumferential, and radial and area systolic peak strains(GLS, GCS, GRS, GAS) of the left ventricle were measured, and the four-dimensional full-volume images were collected through the thoracic, and the formula was used to calculate the first 1/3 of the diastolic phase in each direction. The formula of strain imaging diastolic index(SI-DI) is(SI-DI=(AB)/A×100%). Statistical analysis was used to analyze the differences between the above indicators and the correlation between the groups. Results The measured values of two-dimensional echocardiography(LVEF, LVFS, SV, EDV, CO, LV EDmass, LV ESmass) in the SLE group were lower than those in the control group, and the difference was statistically significant(P＜0.05). In LVEDd, LVEDs, IVSd, IVSs, LVPWd, LVPWs, SPI, there were no significant differences compared with that of control group(P＞0.05). The left ventricular GLS, GCS, GRS, and GAS in the SLE group were lower than those in the control group. The differences were statistically significant(P<0.05). The sensitivity of GAS in the diagnosis of SLE was 93.3%, higher than GLS(80%), GCS(66.7%), and GRS(86.7%). The specificity of GCS for the diagnosis of SLE was(93.3%), higher than GLS(86.7%), GAS(86.7%) and GRS(73.3%). The left ventricle L-SI-DI, C-SI-DI, in the SLE group was calculated by the formula. R-SI-DI and A-SI-DI were lower than the normal control group, the difference was statistically significant(P<0.05);the ROC curve showed C-SI-DI sensitivity(93.3%) and L-SI-DI sensitivity(86.7%) was higher than R-SI-DI(80.0%), A-SI-DI(80.0%);A-SI-DI specificity(93.3%) and R-SI-DI specificity(93.3%) was higher than L-SI-DI(73.3%) and C-SI-DI(73.3%). Conclusion Total left ventricular systolic and diastolic function in patients with SLE are reduced. 4D-STI ultrasound speckle tracking technique can detect left ventricular systolic and diastolic dysfunction in patients with SLE.

目的 探究五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧影响的临床效果。方法 选择2018年4月—2019年8月我院收治的人流术后子宫复旧患者240例,随机分成两组,对照组进行常规术后处理,研究组则在常规术后处理的基础上进行五加生化胶囊联合热电复合治疗仪治疗。结果 研究组的术后疼痛症状评分低于对照组(P＜0.05);研究组的平均流血量、持续流血天数以及术后月经复潮天数均少于对照组(P＜0.05);研究组的子宫内膜厚度高于对照组(P＜0.05),且子宫纵径和横径短于对照组(P＜0.05)。结论 五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧进行治疗具有良好效果,值得推广。

Objective To investigate the clinical effect of Wujia biochemical capsule combined with thermoelectric complex therapy instrument on uterine retroplasia after abortion. Methods 240 cases of uterine rehabilitation after abortion from April 2018 to August 2019 were selected and randomly divided into two groups. The control group were performed routine postoperative treatment, while the research group were performed five plus biochemical capsules combined with thermoelectric complex therapy instruments on the basis of routine postoperative treatment. Results The postoperative pain symptom scores were lower than that of control group(P<0.05). The average blood flow, duration of bleeding and post-operative menarche were all less than that of control group(P<0.05). The thickness of endometrium in the study group was higher than that of the control group(P<0.05), and the longitudinal and transverse diameters of the uterus were shorter than those of the control group(P<0.05). Conclusion Wujia biochemical capsule combined with thermoelectric complex therapy instrument has a good effect on the treatment of involution of uterus after abortion and is worth promoting.

目的 研究过表达miR-29a-3p对IL-22诱导的HaCaT细胞增殖的影响。方法 将HaCaT细胞分为Cell组、IL-22组、IL-22+NC组和IL-22+ miR-29a-3p组,荧光定量PCR检测miR-29a-3p的表达水平,CCK8检测细胞的活力,流式细胞仪检测细胞凋亡及周期。结果 与0 μg/L组相比,25 μg/L组、50 μg/L组和100 μg/L组HaCaT细胞的增殖率在24 h、48 h和72 h均出现升高(F值分别为33.27、36.19、52.29,均P<0.000 1)。与0 μg/L组相比,miR-29a-3p在50 μg/L组和100 μg/L组HaCaT中的表达水平降低(F=129,P<0.000 1),分别降低83%和80%。与IL-22+NC组相比,IL-22+ miR-29a-3p组的增殖率在24 h、48 h和72 h均降低(P值分别为0.002 1、0.001 6、0.023 1),细胞总凋亡率增加(6.67±1.06 vs 30.55±1.86,P=0.000 1),G1期细胞比例增加(P=0.000 1),S期细胞比例降低(P=0.000 1)。结论 IL-22可降低HaCaT中miR-29a-3p的表达量,过表达miR-29a-3p通过促进凋亡和引起细胞G1期阻滞抑制IL-22诱发的HaCaT细胞过度增生。

Objective To investigate the effect of miR-29a-3p overexpression on IL-22-induced proliferation of HaCaT cells. Methods HaCaT cells were divided into four groups, Cell group, IL-22 group, IL-22 +NC group and IL-22+miR-29a-3p group. The expression level of miR-29a-3p was detected by fluorescence quantitative PCR. Cell viability was detected by CCK8. Apoptosis and cell cycle were detected by flow cytometry. Results Compared with the 0 g/L group, the proliferation rate of HaCaT cells in the 25 μg/L group, 50 μg/L group and 100 μg/L group was increased at 24 h, 48 h and 72 h (F value was 33.27, 36.19, 52.29,respectively, all P<0.000 1). Compared with the 0 μg/L group, miR-29a-3p expression level in HaCaT in 50 μg/L and 100 μg/L groups was decreased (F=129, P<0.000 1), with a decrease of 83% and 80%, respectively. Compared with the IL-22+NC group, proliferation rate of IL-22+miR-29a-3p group was decreased at 24 h, 48 h and 72 h (P value was 0.002 1, 0.001 6, 0.023 1, respectively), total apoptosis rate was increased (6.67±1.06 vs 30.55±1.86, P=0.000 1), cell proportion in G1 phase was increased (P=0.000 1), and the cell proportion in S phase was decreased (P=0.000 1). Conclusion Il-22 can reduce miR-29a-3p expression level in HaCaT, and miR-29a-3p overexpression can inhibit the excessive proliferation induced by IL-22 in HaCaT cells by promoting apoptosis and inducing G1 phase arrest.

目的 研究NR3C1(核受体亚科3,C组,成员1)又称糖皮质激素受体(GR)表达量对前列腺癌恶性程度的影响及其与前列腺癌生化复发的相关性。方法 通过组织芯片免疫组化染色检测的方法检验NR3C1在不同恶性程度前列腺癌组织的表达情况,结合Taylor数据库分析NR3C1表达水平与前列腺癌临床病理特征关系,再采用Kaplan-Meier法分析NR3C1对前列腺癌生化复发生存率的影响,最后用Cox回归分析临床病理特征与生化复发的相关性。结果 组织芯片免疫组化结果显示NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.028)。结合Taylor公用数据库分析,NR3C1在前列腺癌组织中的表达低于癌旁组织(P＜0.001),NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.005),NR3C1低表达与PSA复发(P=0.028)和转移(P=0.003)相关。Kaplan-Meier结果提示:NR3C1高表达组患者术后的生化复发生存率更高(P=0.043),总体生存率没有明显区别(P=0.872)。单因素分析结果显示:NR3C1(P=0.002),病理分期(P＜0.001),Gleason评分(P＜0.001),是否转移(P=0.012)是前列腺癌生化复发的影响因素。多因素分析结果显示:高Gleason 评分(P=0.017)和转移(P<0.001)均为生化复发危险因素。结论 NR3C1影响前列腺癌的发病进程,检验NR3C1的表达情况,能预测前列腺癌患者生化复发的概率,可协助判断前列腺癌预后。

Objective We study the role of NR3C1 (nuclear receptor subfamily 3,group C,member 1) in PCa progression,and the correlation between its expression level and the biochemical recurrence of PCa. Methods Immunohistochemistry was used to detect the expression of NR3C1 in PCa tissues of different degrees of malignancy. The associations of NR3C1 expression and clinical pathological features were analyzed using the Taylor dataset. Kaplan-Meier was used to detect the relationship between NR3C1 expression and biochemical recurrence survival rate in PCa. Cox-regressive analysis was used to detect the relationship between clinical pathological features and biochemical recurrence. Results Immunohistochemistry analysis showed the expression of NR3C1 was higher in which its Gleason Score was lower(P=0.028). Base on the Taylor dataset,the expression of NR3C1 was higher in the adjacent benign tissues than that in PCa(P＜0.001). The expression of NR3C1 was higher in which its Gleason Score was lower(P=0.005). Furthermore,low NR3C1 expression was associated with PSA failure(P=0.028) and Metastasis(P=0.003). Kaplan-Meier showed the biochemical recurrence-free time of PCa patients in low NR3C1 expression groups reduced(P=0.043). The overall survival time of PCa patients was not correlated to NR3C1 expression levels(P=0.872). Single factor analysis showed the biochemical recurrence is associated with NR3C1 expression(P=0.002),pathological stage(P＜0.001),Gleason score(P＜0.001), Metastasis status(P=0.012). Multivariate analysis by Cox regression further identified the high Gleason Score(P=0.017) and Metastasis status (P<0.001)were hazards of the biochemical recurrence. Conclusion Our study showed that the expression of NR3C1 critically connected with the process of PCa,which indicated that we can predict the probability of the biochemical recurrence and determine the prognosis of prostate cancer by detecting the expression of NR3C1 in PCa patients.

目的 探讨骨髓间充质干细胞源性微泡(BMSC-MV)修复大鼠早发性卵巢功能不全的自噬机制。方法 大鼠骨髓分离培养骨髓间充质干细胞;超速离心法从骨髓间充质干细胞培养液中分离微泡;腹腔注射顺铂溶液制备早发性卵巢功能不全(POI)模型,制备后3 d尾静脉取血ELISA检测血清雌二醇(E2)及卵泡刺激素(FSH);尾静脉注射BMSC-MV移植治疗POI大鼠模型,移植后28 d尾静脉取血ELISA检测E2、FSH及抗苗勒管激素(AMH),同时取卵巢组织检测自噬相关蛋白LC3及P62。结果 模型对照组及微泡移植组在模型制备后3 d的E2 含量低于正常对照组,FSH 含量高于正常对照组(P<0.001);微泡移植组在移植后28 d的E2、AMH含量高于模型对照组(P<0.001),FSH含量低于模型对照组(P<0.001);微泡移植组的LC3较模型对照组表达升高,而P62表达降低(P<0.001)。结论 BMSC-MV介导自噬修复大鼠早发性卵巢功能不全。

Objective To investigate the autophagy mechanism of bone marrow mesenchymal stem cell-derived microvesicle (BMSC-MV) in repairing premature ovarian dysfunction in rats. Methods The whole bone marrow adherence method was used to isolate,culture and identify BMSCs of SD rats. Microvesicles were isolated from bone marrow mesenchymal stem cell by ultracentrifugation. Premature ovarian insufficiency (POI) model was prepared by intraperitoneal injection of cisplatin solution,and serum estradiol (E2) and follicular stimulating hormone (FSH) were detected by ELISA from tail vein 3 days after preparation. Rat model of POI was treated with BMSC-MV transplantation by tail vein. Blood from tail vein was collected 28 days after transplantation to detect E2,FSH and AMH by ELISA. Meanwhile,ovarian tissues were collected to detect autophagy-related proteins LC3 and P62. Results The E2 content of the model control group and the microvesicle transplantation group was lower than that of the normal control group,and the FSH content was higher than that of the normal control group (P<0.001). The content of E2 and AMH in the microvesicle transplantation group at 28 days after transplantation was higher than that in the model control group (P<0.001),and the content of FSH was lower than that in the model control group (P<0.001). Compared with the model control group,LC3 expression in the microvesicle transplantation group was increased,while P62 expression was decreased (P<0.001). Conclusion BMSC -MV mediate autophagy to repair premature ovarian insufficiency in rats.

目的 探讨运用李可老中医学术思想,从“中气”论治术后肠梗阻的疗效。方法 采用前瞻性临床观察队列研究方法,选择82例术后肠梗阻患者,按照随机化原则平均分为两组:观察组为西医治疗基础上,联合从“中气”论治应用方剂,对照组为单纯西医治疗。结果 观察组的有效率为95.12%,首次排气时间为(12.46±2.75)h,首次排便时间为(31.52±5.38)h,腹痛腹胀完全消失时间为(15.71±3.57)h,平均住院时间为(18.69±3.82)d;对照组的有效率为73.17%,首次排气时间为(36.57±2.75)h,首次排便时间为(62.39±5.73)h,腹痛腹胀完全消失时间为(42.58±8.27)h,平均住院时间为(25.95±5.84)d;有效率对比,观察组高于对照组(P＜0.05),观察组症状改善时间较对照组明显缩短(P＜0.05)。结论 对于术后肠梗阻的治疗,西医联合从“中气”论治疗效优于单纯西医治疗。

Objective To explore the therapeutic effect on postoperative ileus with Li Ke's academic thought of traditional Chinese medicine: by mediating the Qi in the middle energizer(Stomach and Spleen). Methods Using prospective clinical observation cohort study, 82 patients with postoperative ileus were randomly divided into two groups on average: the observation group was treated with Western medicine and Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen). while the control group was treated with Western medicine only. Results The effective rate of the observation group was 95.12%, the average time of first farting of the patients was(12.46±2.75) h, the average time of first defecation was (31.52±5.38)h, the average time of complete disappearance of abdominal pain and abdominal distension was (15.71±3.57) h, and the average hospital stays was (18.69±3.82) d. In the control group, the effective rate was 73.17%, the average time of first farting of the patients was (36.57±2.75)h, the average time of first defecation was (62.39±5.73)h, the average time of complete disappearance of abdominal pain and abdominal distension was (42.58±8.27)h, and the average hospital stays was (25.95±5.84)d. Compared with the control group, the effective rate was higher in the observation group (P <0.05), and the symptom improvement time in the observation group was shorter than that in the control group (P <0.05). Conclusion For the treatment of postoperative ileus, western medicine combined with Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen) is better than Western medicine only.

目的 对首发短暂性脑缺血发作(TIA)及缺血性轻型卒中的患者进行认知功能分析,评估其认知损害程度及常见的认知损害领域,以便制定早期的认知功能康复计划,减少痴呆的发生。方法 纳入起病10天内的首发TIA及缺血性轻型卒中患者,完善MMSE和MoCA评分,把MMSE评分正常者划分为MoCA正常组和MoCA异常者,比较两组的认知功能损害程度及损害领域。结果 纳入142例患者,MMSE正常者113例,其中MoCA正常组83例,MoCA异常组30例。两组的认知功能比较,在视空间/执行功能、命名、注意力、计算、延迟记忆、定向力等方面的差异有统计学意义(P＜0.05),在言语流畅、抽象思维方面的差异无统计学意义(P＞0.05)。结论 TIA/轻型卒中患者存在多方面不同程度的认知功能损害,临床上需重视对该类患者的认知筛查,及时了解患者认知功能的变化,以便给予及时的诊断和治疗。

Objective To analyze the cognitive impairment among the paitents with TIA and minor ischemic stroke for the first attack. Making a recovery plan in early time by eveluating the degree and domains of the cognitive impairment, so as to reduce the prevelance of dimentia. Methods Patients with TIA and minor ischemic stroke for the first attack in 10 days were included. MMSE and MoCA were completed, we sorted out the normal MMSE patients and divided them into MoCA normal group and MoCA abnormal group, compared the cognitive function between the two groups. Results 142 patients were included. Among them 113 patients' MMSE were normal, in which MoCA normal group were with 83 patients and MoCA abnormal group with 30 patients. There were significant differences between them in visuospatial and executive function, naming, attention, caculation, delay memory and orientation(P＜0.05), while no significant difference in language fluency and abstraction(P＞0.05). Conclusion Cognitive impairment of TIA/minor ischemic stroke patients was in different degree, so we should pay more attention to their cognitive function and give them an in-time diagnosis and treatment.