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 探索2型糖尿病(T2DM)男性患者血尿酸水平与骨密度(BMD)、临床骨折患病率的相关性。方法 选取广州市第一人民医院住院的T2DM男性患者192例,采用双能X线骨密度仪测定各部位BMD,记录年龄、糖尿病病程、BMI,检测血尿酸、空腹血糖、糖化血红蛋白、血脂、碱性磷酸酶等,并分析BMD与其余指标的相关性。结果 骨质疏松组血尿酸、各部位BMD均低于骨量正常组及低骨量组(P＜0.05)。血尿酸与各部位BMD正相关(P＜0.01)。右股骨颈BMD与年龄负相关,与空腹血糖正相关(P＜0.05)。多元Logistic回归分析显示,血尿酸与临床骨折呈负相关。调整年龄、空腹血糖、ALP等混杂因素后,血尿酸水平与临床骨折仍有关联。当进一步调整各部位BMD时,结果无统计学意义。结论 维持正常稍高的血尿酸水平可能有利于减少T2DM男性患者骨质疏松及脆性骨折的发生。

Objective To explore the correlation in serum uric acid level and bone mineral density (BMD) and fracture rate in male patients with type 2 diabetes mellitus (T2DM). Methods 192 cases of male patients with T2DM in Guangzhou First People's Hospital were selected in this study.BMD was measured by bone density machine. The patient's age, diabetes course and BMI were recorded. Fasting blood glucose, glycated hemoglobin (HbA1c), liver and kidney function, blood uric acid, blood lipid, alkaline phosphatase, 25 hydroxyvitamin D3 levels were measured, and the correlation between BMD and other indicators was analyzed. Results The serum uric acid level,lumbar and right femoral neck BMD in the osteoporosis group were lower than those in the normal and low bone mass groups (P<0.05). Serum uric acid was positively correlated with BMD values of lumbar spine and right femoral neck in male patients with type 2 diabetes (P<0.01). BMD value of right femoral neck was negatively correlated with age and positively correlated with fasting blood glucose (P<0.05). Multivariate logistic regression analysis showed a significant negative correlation between serum uric acid and clinical fractures in male patients with type 2 diabetes (model 1). When the model was adjusted for age, fasting blood glucose, ALP and other factors, serum uric acid levels were still associated with clinical fractures (model 2). When the BMD values of the lumbar spine and the right femoral neck were further included (model 3), the results were not statistically significant. Conclusion Slightly higher blood uric acid levels may help to reduce the incidence of OP and fracture rate in male patients with T2DM.

目的 对比小儿肠套叠的开腹手术与腹腔镜手术治疗的临床价值。方法 选定本院2017年1月—2020年1月收治的50例肠套叠患者,以双盲随机抽样法分组(每组样本容量25例),对照组采纳开腹手术治疗,观察组采纳腹腔镜手术治疗,对比两组手术指标、术中合并疾病探查率、并发症发生率、复套率。结果 观察组手术时间、下床活动时间、胃肠功能恢复时间及住院时间均比对照组短,观察组术中出血量比对照组低,观察组术中合并疾病探查率(68.00%)比对照组(40.00%)高,观察组并发症发生率(0)比对照组(32.00%)低,差异均有统计学意义(P＜0.05)。观察组复套率(0)与对照组(4.00%)比较,P>0.05。结论 腹腔镜手术治疗小儿肠套叠,创伤性较小、住院时间较短、术后炎症反应较轻、并发症发生率较低,且术中对合并疾病的探查率较高,值得借鉴。

Objective To compare the clinical value of laparotomy and laparoscopy in the treatment of intussusception in children. Methods 50 cases of intussusception patients in our hospital from January 2017 to January 2020 were selected and divided into two groups by double-blind random sampling method (25 cases in each group). The control group was treated with open surgery, and the observation group was treated with laparoscopic surgery. The operation indexes, intraoperative detection rate of combined diseases, incidence of complications and recurrence rate were compared between the two groups. Results The operation time, ambulation time, gastrointestinal function recovery time and hospitalization time in the observation group were shorter than those in the control group. The intraoperative blood loss in the observation group was lower than that in the control group. The detection rate of intraoperative diseases in the control group (68.00%) was higher than that in the observation group (40.00%), and the incidence of complications in the observation group (0) was lower than that in the control group 32.00%. The difference was statistically significant (P<0.05). The repetition rate of observation group (0) was higher than that of control group (4.00%), P>0.05. Conclusion Laparoscopic surgery in the treatment of pediatric intussusception has the advantages of less trauma, shorter hospitalization time, less postoperative inflammatory reaction, lower incidence of complications, and higher exploration rate of complications during operation, which is worthy of reference.

目的 探讨制何首乌、巴戟天及二者配伍,对氧化型低密度脂蛋白(ox-LDL)诱导的人脐静脉内皮细胞(HUVEC)损伤的影响,以示临床。方法 建立ox-LDL诱导的HUVEC损伤模型,分别用制何首乌、巴戟天、二者配伍的水煮物干预,检测HUVEC的细胞增殖、相对活率、细胞凋亡率、细胞周期、NFκB mRNA的表达。结果 ①制何首乌、巴戟天均能抑制ox-LDL诱导的HUVEC凋亡,二者配伍的抑制作用强于单味中药制何首乌。②制何首乌、巴戟天均能延长ox-LDL诱导的HUVEC的细胞周期(S+G2)%,制何首乌、巴戟天的延长作用相似,二者配伍的延长作用强于单味中药制何首乌、巴戟天。③制何首乌组、巴戟天组的NFκB mRNA的表达量下降,制何首乌组的抑制作用强于巴戟天组,二者配伍的抑制作用强于单味中药制何首乌、巴戟天。结果 制何首乌、巴戟天均能抑制ox-LDL诱导的HUVEC损伤,二者配伍的作用强于单味中药制何首乌、巴戟天。

Objective To investigate the effects of Polygonum multiflorum praeparata, Morinda officinalis and their compatibility on ox-LDL-induced injury of human umbilical vein endothelial cells(HUVEC). Methods We established an ox-LDL-induced HUVEC injury model, made intervention with Polygonum multiflorumpraeparata, Morinda officinalis and their compatibility, the HUVEC cell proliferation, relative viability, apoptosis, cell cycle, NFκB mRNA were detected. Results ①Both Polygonum multiflorumpraeparata, Morinda officinalis reduced the apoptosis rate of HUVEC, and their compatibility had a stronger effect on reducing the apoptosis rate of HUVEC than single Polygonum multiflorumpraeparata. ②Both Polygonum multiflorumpraeparata, Morinda officinalis increased the HUVEC cell cycle (S+G2)%, the extension between Polygonum multiflorumpraeparata and Morinda officinalis was similar, and their compatibility increased HUVEC cell cycle (S+G2)%, it was stronger than single Polygonum multiflorumpraeparata and single Morinda officinalis. ③Both Polygonum multiflorumpraeparata and Morinda officinalis down-regulated the expression of NFκB mRNA in HUVEC, their compatibility down-regulated HUVEC NFκB mRNA expression,it was stronger than Polygonum multiflorumpraeparata, Morinda officinalis. Conclusion Polygonum multiflorumpraeparata, Morinda officinalis and their compatibility can inhibit ox-LDL-induced HUVEC injury, and their compatibility inhibition is stronger than single Polygonum multiflorumpraeparata, and Morinda officinalis.

新型冠状病毒肺炎是一种新发的急性呼吸道疾病,如何准确、完整、及时的记录好新冠肺炎患者的病历信息,为医学研究提供科学的依据是医院病案管理统计的工作重点。本文结合国家相关的规定和某新冠肺炎定点救治医院疫情防控工作经验,提出针对新冠肺炎病历的管理方案,包含病历的书写、编码、运行管理三方面,配合医院做好疫情防控工作的同时妥善记录好新冠肺炎患者病历信息。

Coronavirus disease 2019 is a new type of acute respiratory disease. Recording accurately, completely and timely the medical records of patients with COVID-19 and providing a scientific basis for medical research are the focus of the medical records management statistics. This paper proposes a management plan including writing, coding, and operation management for COVID-19 medical records, combining with the relevant national regulations and a COVID-19 designated hospital's experiences of epidemic prevention and control. This management plan cooperates with the hospital to do epidemic prevention and control work, and properly recordes the medical records of COVID-19 patients.

目的 探讨流程化(CICARE)沟通模式在中下段尿路结石患者中的应用价值。方法 回顾性分析2018年8月—2019年11月我院80例中下段尿路结石患者,均行输尿管镜下钬激光碎石术,2018年8月—2019年5月的37例患者作为对照组,采用常规沟通流程,2019年6月—2019年11月的43例患者作为研究组,采用CICARE沟通模式。对比两组手术时间、沟通满意度及干预前后手术室注意事项知晓程度、贝克焦虑量表(BAI)、贝克抑郁量表21项版(BDI-21)评分。结果 研究组手术时间较对照组短(P＜0.05);干预后,研究组手术室注意事项知晓程度较对照组高(P＜0.05);干预后,研究组BAI、BDI-21评分较对照组低(P＜0.05);研究组沟通满意度95.35%(41/43)较对照组81.08%(30/37)高(P＜0.05)。结论 CICARE沟通模式应用于中下段尿路结石患者,可提高患者手术室注意事项知晓程度,减轻负性情绪,缩短手术时间,且具有较高沟通满意度。

Objective To explore the application value of CICARE communication model in patients with middle and lower urinary calculi. Methods From August 2018 to November 2019, eighty patients with middle and lower urinary calculi in our hospital were analyzed retrospectively. All patients underwent ureteroscopic holmium laser lithotripsy.Thirty-seven patients from August 2018 to May 2019 served as a control group, using a routine communication process, forty-three patients from June 2019 to November 2019 served as the study group and adopted the CICARE communication model. The two groups were compared in surgical time, communication satisfaction, awareness of operating room precautions before and after intervention, Baker Anxiety Scale (BAI), and Baker Depression Scale 21 item (BDI-21)scores. Results The operation time in the study group was shorter than that in the control group (P＜0.05). After the intervention, the awareness degree of the operating room precautions in the study group was higher than that in the control group (P<0.05). After the intervention, the BAI and BDI-21 scores in the study group were lower than those in the control group (P<0.05). The communication satisfaction of the study group was 95.35% (41/43),higher than the control group of 81.08% (30/37)(P<0.05). Conclusion The application of CICARE communication mode in patients with middle and lower urinary calculi may improve patient's awareness of precautions in the operating room. It may reduce negative emotions, shorten the operation time, and has higher communication satisfaction.

目的 探讨医院-社区-家庭一体化管理在精神分裂症患者中的应用效果。方法 选择我院2018年6月—2019年6月期间收治的精神分裂症患者86例,按随机数字表法分为两组,每组43例。对照组采取常规护理管理,研究组实施医院-社区-家庭一体化管理,观察6个月。比较两组精神症状、生活质量及肇事肇祸率。结果 两组管理前阳性与阴性症状量表(PANSS)评分、WHOQOL-100评分比较,差异无统计学意义(P＞0.05);两组管理后PANSS评分均低于管理前,生存质量测定量表简表(QOL-BREF)评分高于管理前,差异有统计学意义(P＜0.05);研究组管理后PANSS评分为(43.23±8.11)分,低于对照组的(49.48±8.26)分,WHOQOL-100评分为(83.69±8.87)分,高于对照组的(77.25±8.54)分,差异有统计学意义(P＜0.05);研究组肇事肇祸率为9.30%,低于对照组的25.58%,差异有统计学意义(P＜0.05)。结论 医院-社区-家庭一体化管理的实施能够减轻精神分裂症患者精神症状,提升生活质量,降低肇事肇祸率。

Objective To explore the applications of hospital community family integrated management on the quality of life and accident rate of schizophrenics. Methods 86 schizophrenics admitted to our hospital from June 2018 to June 2019 were divided into two groups according to the method of random number table, 43 cases in each group. Routine nursing management was adopted in the control group and hospital community family integrated management was implemented in the study group for 6 months. The mental symptoms, quality of life and accident rate were compared between the two groups. ResultsThere was no statistical significance in PANSS score and WHOQOL-100 score between the two groups before management (P>0.05); PANSS score of the two groups after management was lower than that before management, QOL-BREF score was higher than that before management, and the difference was statistically significant (P<0.05); PANSS score of the study group after management was (43.23±8.11), lower than that of the control group (49.48±8.26), WHOQOL-100 score was (83.69±8.87), higher than the control group (77.25±8.54), the difference was statistically significant (P<0.05); the study groupls accident rate was 9.30%, lower than that of the control group 25.58%, the difference was statistically significant (P<0.05). Conclusion The implementation of hospital community family integrated management reduces the mental symptoms of schizophrenics, improve the quality of life, and reduce the accident rate.

目的 探讨四金石灵膏联合间苯三酚治疗输尿管结石伴肾绞痛的应用价值。方法 随机将76例输尿管结石伴肾绞痛患者分为两组,以接受中药安慰剂联合间苯三酚治疗者为对照组,以接受四金石灵膏联合间苯三酚治疗者为观察组,每组38例。对比两组临床治疗效果,并分析尿液相关指标的变化情况。结果 两组7 d治疗过程中VAS评分及尿Ga水平呈降低趋势、WHOQL-BREF评分及尿OPN水平呈升高趋势(P<0.05),而治疗3 d及7 d后,治疗组VAS评分及尿Ga水平低于对照组、WHOQL-BREF评分及尿OPN水平高于对照组(P<0.05)。同时,治疗7 d后,观察组排石率高于对照组(P<0.05),而观察组排石时间及止痛时间短于对照组(P<0.05)。此外,治疗7 d后,治疗组治疗总有效率高于对照组(P<0.05),而两组间治疗不良反应发生率比较未见差异有统计学意义(P>0.05)。结论 四金石灵膏联合间苯三酚可有效的提高输尿管结石伴肾绞痛的临床治疗效果,具有较为理想的应用价值。

Objective To explore the application value of four-gold-stone-ling confection and phloroglucinol in the treatment of ureteral calculus with renal colic. Methods 76 patients with ureteral calculus with renal colic were randomly divided into two groups, with those receiving traditional Chinese medicine placebo combined with phloroglucinol as the control group, and those receiving four-gold-stone-ling confection combined with phloroglucinol as the observation group,38 cases in each group. The clinical treatment effects of the two groups were compared, and the changes of urine-related indicators were analyzed. Results The VAS score and urine Ga level of the two groups showed a decreasing trend during 7d treatment, and the WHOQL-BREF score and urine OPN level showed an increasing trend(P<0.05). After 3d and 7d treatment, the VAS score and urine Ga level of the treatment group were lower than that of control group, the WHOQL-BREF score and urine OPN level were higher than that of control group(P<0.05). Meanwhile, After 7d of treatment, the rate of stone drainage in the observation group was higher than that of control group(P<0.05), while the time of stone drainage and pain relief in the observation group was shorter than control group(P<0.05). In addition, after 7d treatment, the total effective rate of the treatment group was higher than control group (P<0.05), while the difference of incidence of adverse reactions between the two groups was not significant(P>0.05). Conclusion Four-gold-stone-ling confection combined with phloroglucinol may effectively improve the clinical effect of ureteral calculi with renal colic, and have ideal application value.

目的 比较压力控制通气(PCV)中不同吸气流速对单肺通气(OLV)患者呼吸功能及炎症因子的影响。方法 本研究为2018—2019年对75例单肺通气患者的前瞻性研究。患者在麻醉和单肺通气(OLV)后随机分为吸气流量30 L/min(A组)、50 L/min(B组)或70 L/min(C组)。比较OLV前(T₀)、OLV后30 min(T₁)、60 min(T₂)和120 min(T₃)的呼吸力学、呼吸功能、血流动力学和血气分析,中心静脉血检测分析IL- 6、IL-8、TNF-α和sICAM-1,观察术后3天肺部并发症和ARDS的发生情况。结果 三组一般情况、血流动力学指标差异均无统计学意义(P＞0.05);B组、C组PaCO₂较A组降低(P<0.05);与T₀时比较,T₁-T₃时三组PaO_2、SVO₂均降低(P<0.05);三组PH、SO₂和HB差异均无统计学意义(P>0.05)。与A组比较,B组、C组ΔVT增大(P<0.05);三组Ppeak差异无统计学意义;与A组比较,B组、C组PEEP均增大(P<0.05);与A组比较,T₁-T₃时B组、C组V_D/V_T减少(P>0.05);与T₀比较,T₁-T₃时三组Qs/Qt增加(P<0.05);与A组比较,T₁-T₃时B组、C组Cdyn增大(P<0.05);与T₀相比,T₁-T₃时三组PaO₂/FiO₂降低(P<0.05);与T₀相比,T₁-T₃时三组IL-6、IL-8、TNF-α和sICAM-1的浓度增多(P<0.05),但A组、B组低于C组(P<0.05)。三组患者发生术后肺部并发症和ARDS差异均无统计学意义。结论 在PCV模式下通过增加吸气流速能增加VT,减少死腔率,促进 CO₂的交换,并且改善肺动态顺应性,但并不能很好的改善氧合及肺内分流。吸气流速50 mL/L在较小炎症反应的情况下达到上述改善呼吸功能和呼吸力学,可推荐应用于进行OLV患者。

Objective The effects of different inspiratory velocity PCV on respiratory function and inflammatory factors in patients with one-lung ventilation OLV were compared. Methods This was a prospective study of 75 patients with one-lung ventilation in 2018-2019. The subjects were randomized to the inspiratory velocity 30(group A),50(group B)or 70(group C)L/min after anesthesia and one-lung ventilation OLV. Respiratory mechanics,respiratory function,hemodynamics and blood gas parameters were compared between the three groups pre-OLV(T₀)and after 30 (T₁), 60 (T₂), and 120 (T₃)minutes of OLV.Center venous blood was collected to measure interleukin (IL)-6, IL-8,tumor necrosis factor (TNF)-α,andsoluble intercellular adhesion molecule-1 levels.Observation of pulmonary complications and occurrence of ARDS 3 days after operation were made. Results Hemodynamic and general patient status were similar between the three groups (all P>0.05). PaCO₂was lower in the group B and group C compared with the group A (P<0.05). Compared with T₀, PaO₂ and SVO₂were lower at T₁-T₃of the three groups(P<0.05). PH, SO2 and HB were similar between the three groups (all P>0.05).ΔVT was higher in the group B and group C compared with the group A (P<0.05);Ppeak were similar between the three groups (all P>0.05). PEEP was higher in the group B and group C compared with the group A (P<0.05); V_D/V_T decreased in the group B and group C compared with the group A (P<0.05).Compared with T₀,Qs/Qt increased at T₁-T₃ of the three groups (all P<0.05). Cdyn increased at T₁-T₃ of the group B and group C(all P<0.05). PaO₂/FiO₂ decreased at T₁-T₃ of the three groups(all P<0.05).Compared with T₀, the concentrations of Il-6, Il-8, TNF-α and sICAM-1 increased at T₁-T₃of three groups (P<0.05), and in group A and group B were lower than those in group C (P<0.05).The number of patients who had postoperative pulmonary complications PPCS or acute respiratory distress syndrome(ARDS)were similar between the three groups (all P>0.05). Conclusion In PCV mode, it can increase VT by increasing the inspiratory velocity, reduce the V_D/V_T, promote the exchange of CO₂, and increase the Cdyn, but it cannot improve the oxygenation and Qs/Qt.Inspiratory velocity of 50 mL/L to achieve the above improvement in respiratory function and respiratory mechanics in the case of a smaller inflammatory response. It may be recommended for use in patients undergoing OLV.

目的 探讨细胞毒素-1(Cytotoxin-1,CTX-1)对人卵巢癌SKOV-3细胞增殖凋亡的影响。方法 利用0、4、8、12 μg/mL浓度 CTX-1处理SKOV-3细胞6、12、24 h,MTS法检测细胞活性,8 μg/mL CTX-1处理SKOV-3细胞24、48 h,Hoechst-33258荧光染色观察细胞核染色质形态。取处理 6、12 h 后细胞,利用流式细胞仪检测SKOV-3细胞的凋亡率。结果 4、8、12 μg/mL的CTX-1可抑制SKOV-3细胞活性及增殖,呈时间-剂量依赖。Hoechst-33258染色观察可见细胞染色质呈固缩或碎裂状、染色质着色不均、核形态各异,随时间增加而更趋明显。8 μg/mL CTX-1处理细胞,6 h细胞坏死率为(1.90±0. 27)%,晚期凋亡率为(10.96±1. 56)%,而早期凋亡率为(1.52±0.39)%;12 h细胞坏死率为(10.62±0.96)%,晚期凋亡率(15.07±1.23)%,而早期凋亡率为(1.88±0.17)%,与对照组比较,差异有统计学意义 (P<0.0 1)。结论 CTX-1可以抑制人卵巢癌细胞活性、抑制其体外增殖、诱导其发生凋亡,该作用呈剂量依赖和时间依赖,主要引起细胞晚期凋亡和坏死。

Objective To investigate the effect of cytotoxin-1 (CTX-1)on the proliferation and apoptosis of ovarian cancer SKOV-3 cells. Methods SKOV-3 cells were treated with CTX-1 at concentrations of 0, 4, 8, 12 μg/mL for 6, 12, and 24 hours respectively. Cell viability was measured by MTS method. SKOV-3 cells were treated with 8 μg/mL CTX-1 for 24 and 48 hours, by Hoechst-33258 fluorescence staining to observe the morphology of nuclear chromatin. The apoptotic rate of SKOV-3 cells was detected by flow cytometry after 6 and 12 hours of treatment. Results CTX-1 at 4, 8, and 12 μg/mL inhibited the activity and proliferation of SKOV-3 cells in a time-dose-dependent manner. Hoechst-33258 staining observation showed that the apoptotic cell chromatin was condensed or fragmented chromatin, the chromatin was unevenly colored, and the nuclear morphology was different. It became more obvious with time. 8 μg/mL CTX-1 treated cells, the 6 h cell necrosis rate was (1.90±0.27)%, the late apoptosis rate was (10.96±1.56)%, and the early apoptosis rate was (1.52±0.39)%; 12 hours cell necrosis rate was (10.62±0.96)%, late apoptosis rate was (15.07±1.23)%, and early apoptosis rate was (1.88±0.17)%, compared with the control group, the difference was statistically significant (P<0.01). Conclusion CTX-1 may inhibit the activity of human ovarian cancer cells, inhibit its proliferation in vitro, and induce its apoptosis. The effect is dose-dependent and time-dependent. Mainly it causes late apoptosis and necrosis of cells.