目的 探究高原地区世居居民与常住居民的心脏结构和功能的差异性。方法 选择2022年6月—2023年8月在西藏林芝市人民医院体检的200例世居居民与常住居民作为研究对象,将世居居民和常住居民按照性别分为男女亚组,按照年龄段分为18~31岁、31~40、41~50岁亚组。比较各亚组心脏结构参数、左心功能参数、多普勒超声检测参数差异。结果 与高原常住居民男性和女性比较,世居居民男性和女性的左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标比较差异均无统计学意义（P>0.05）;而主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速增加,两组间比较差异具有统计学意义（P<0.05）。18~31岁、31~40、41~50岁组世居居民和常住居民左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标等指标比较差异均无统计学意义（P>0.05）,但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民,差异具有统计学意义（P<0.05）。结论 高原地区世居居民和常住居民心脏结构参数和左心功能参数无明显差异。但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民。

Objective To explore the ethnic differences in heart structure and function between aborigines and long term residents in the plateau area. Methods A total of 200 aborigines and long term residents who underwent physical examination in our hospital from June 2022 to August 2023 were selected as the study subjects,and the aborigines and long term residents were divided into male and female subgroups,and subgroups aged 18-30 years,31-40 years and 41-50 years．The differences of cardiac structure parameters,left ventricular function parameters and Doppler parameters were compared among subgroups. Results The left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction mitral valve A peak velocity were compared between Aborigines and plateau Long Term Residents,which were no significant difference（P>0.05）．However,the velocity of aortic valve orifice,pulmonary valve orifice and mitral valve E peak velocity increased,and the differences were statistically significant（P<0.05）．There were no significant differences in left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,posterior left ventricular wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,left ventricular diameter,left ventricular diameter,and left ventricular ejection fraction mitral valve A peak velocity indexes in aborigines and long term residents between among aged 18-30 years,31-40 years,41-50 years（P>0.05）,but the differences of aortic valve orifice velocity,pulmonary valve orifice velocity and mitral valve E peak velocity were statistically significant（P<0.05）. Conclusions There were no significant difference in cardiac structure parameters and left heart function parameters between aborigines and long term residents in plateau area．However,the aortic orifice velocity,pulmonary orifice velocity and mitral E-peak velocity of aborigines were higher than those of long term residents．

目的 探讨山莨菪碱联合黄体酮治疗高原地区急性肾绞痛的临床疗效。方法 将2016年9月—2017年6月收治的60例急性肾绞痛患者随机分成2组,试验组和对照组各30人,试验组应用黄体酮注射液40 mg肌肉注射,山莨菪碱10 mg加入质量浓度为50 g/L的葡萄糖注射液250 mL静脉滴注;对照组仅用山莨菪碱10 mg加入质量浓度为50 g/L的葡萄糖注射液250 mL静脉滴注。给药前、后15min、30min、1 h及4 h对患者疼痛采用视觉模拟评分(VAS)评价其疗效,并观察其起效时间和不良反应。结果 治疗组和对照组总有效率分别为 93.3%和70.0%,2组比较差异有统计学意义( P<0.05);2组药物起效时间比较有差异(P<0.05);给药后15min至4 h,试验组VAS评分均低于对照组(P<0.05)。结论 山莨菪碱联合黄体酮治疗高原急性肾绞痛安全有效,联用明显优于只采用山莨菪碱。

Objective To study the effect and efficacy of Anisodamine combined with Progesterone in the treatment of acute renal colic in plateau area. Methods From September 2016 to June 2017, 60 cases of acute renal colic patients were randomly divided into experimental group or control group. Both groups are 30 cases. The test group applied the injection of progesterone injection 40 mg by muscle injection and Anisodamine 10mg to the concentration of 5% of glucose injection in 250 mL by intravenous drip. In the control group, only using 10 mg of Anisodamine was added to the 250 mL intravenous drip of 5% glucose injection. The visual Analogue Scale/Score(VAS) was used to evaluate the efficacy of the patients before dosing, after dosing of 15min, 30min, 1 h and 4 h, and we observed their effective time and adverse reactions. Results The total effective rate of treatment group and control group was 93.3 % and 70.0 % respectively. There was a statistically significant difference between the two groups (P<0.05). The VAS score of the experimental group was lower than that in the control group (P<0.05). Conclusion Anisodamine combined with Progesterone is safe and effective in the treatment of plateau acute renal coli, and is obviously better than only using Anisodamine.

目的 观察动静平衡康复训练对胫骨平台骨折术后患者平衡和行走功能的影响。方法 将2012年7月—2014年12月100例胫骨平台骨折患者,随机分为两组,每组50例。对照组术后展开常规康复训练,观察组实施动静平衡康复训练,观察两组膝关节功能、康复效果以及肌力恢复情况。结果 观察组患者的膝关节功能优良率为98.0%,高于对照组的60.0%,差异有统计学意义(P＜0.05)。观察组患者的Lysholm评分,高于对照组(P＜0.05)。观察组患者的肌力恢复情况,优于对照组(P＜0.05)。结论 基于“动静平衡”理念针对胫骨平台骨折患者实施术后康复指导与训练,有利于促进患者关节功能以及肌力恢复,巩固康复疗效,在训练过程中实现动态平衡,具有积极的临床意义。

Objective To investigate the static and dynamic balance rehabilitation training on the tibial plateau fracture patients balance and walking functions. Methods 100 cases of patients with tibial plateau fractures from July 2012 to December 2014, were randomly divided into two groups, 50 cases of each group. The control group was launched conventional rehabilitation, observation group received static and dynamic balance rehabilitation training. The knee function, rehabilitation and muscle recovery of the two groups were observed and statistically analyzed. Results The knee function excellent rate of observation group was 98.0%, significantly higher than control group 60.0%, there was statistical significance(P＜0.05). Lysholm score of observation group was higher than control group(P＜0.05). Muscle recovery of observation group was better than control group(P＜0.05). Conclusion Based on the “static and dynamic balance” concept for tibial plateau fractures postoperative rehabilitation for patients with guidance and training, and it will be promoting joint function in patients with muscle recovery and consolidate the recovery effect, to achieve dynamic equilibrium in the training process, with positive clinical significance.

      目的   回顾分析高原地区儿童阑尾炎术后早期炎性肠梗阻的临床特征，总结治疗经验。方法   回顾分析青海省妇女儿童医院2019—2023年收治的49例儿童阑尾炎术后早期炎性肠梗阻病例资料。结果   纳入研究的49例患儿，阑尾炎发病时间3～8 d，平均（5.38±1.25）d，术后出现肠梗阻时间3~11 d，平均时间（4.81±1.70）d，其中48例经过保守治疗后梗阻解除，恢复排气、排便，肠功能恢复时间4~13 d，平均（5.93±2.49）d，1例经积极保守治疗后病情进展，最终经手术治愈。49例患儿均顺利治愈出院，住院时间10～26 d，平均（15.69±3.79）d。术后随访1～2年，患儿饮食、排便均无异常。结论   高原地区儿童阑尾炎术后早期粘连性肠梗阻预防是关键，采取保守治疗同样可获得较高的治愈率，若保守治疗无效或病情进展应及时积极采取手术治疗。

       Objective  To review the clinical characteristics of early postoperative inflammatory small bowel obstruction（EPISBO） in children with appendicitis in plateau area and summarize the treatment experience．Methods  The data of 49 cases of appendicitis EPISBO in children admitted to Qinghai Women and Children’s Hospital from 2019 to 2023 were  retrospectively analyzed．Results  The onset time of appendicitis was 3-8 days，with an average of（5.38±1.25）days，and the time of intestinal obstruction was 3-11 days after surgery，with an average of（4.81±1.70）days．After conservative treatment，48 cases were relieved of obstruction，resumed exhaust and defecation，and intestinal function recovered in 4-13 day，average（5.93±2.49）d，1 case had progression after conservative treatment，and was cured by surgery．All the 49 children were successfully cured and discharged．The length of hospital stay was 10-26 days，with an average of（15.69±3.79）days．Postoperative follow-up of 1 to 2 years showed normal eating and bowel movements．Conclusions  The prevention of EPISBO in children with appendicitis in plateau area is the key．Conservative treatment can also achieve a higher cure rate．If conservative treatment is ineffective or the disease progresses，timely surgical treatment should be provided．