目的 探究甲状腺癌患者对健康知识了解详情和需求,同时提出合理健康教育方案。方法 随机抽取本院2017年11月—2019年5月期间收治的122例甲状腺癌患者为研究对象,通过本院自制的调查问卷对其进行调查,分析和掌握患者对健康知识了解详情和具体需求,同时根据其特点提出合理的健康宣教方式。结果 患者对疾病和生活习惯的联系、定期入院复诊的重要性、临床治疗对疾病的控制详情、具体治疗方案和疗效、疾病临床特征以及疾病详细信息等甲状腺癌相关知识不了解率分别为50.00%、51.64%、72.95%、74.59%、77.87%、8.19%;健康教育内容需求评分较高,需求占比全部高于40%;患者对不同的健康教育形式有着不同的需求,其中需求最高的为护患会议交流,占比98.36%,其次为微信科普知识,占比96.72%,之后依次为播放视频和音频(94.26%)、创建专题讲座(93.44%)、个体指导(91.80%)、电话随访(83.60%)、相同疾病患者经验介绍(80.32%)、宣传栏和宣传册(63.90%)。结论 甲状腺癌患者对健康知识了解较少且需求较大,因此可对患者采取多元化健康知识教育方案,满足不同患者的需求,进而增加患者对疾病的重视程度,有利于患者树立治疗信心、提升其生活质量。

Objective To explore the health knowledge of thyroid cancer patients to understand the details and needs, and put forward a reasonable health education program. Methods 122 patients with thyroid cancer admitted to our hospital from November 2017 to May 2019 were randomly selected as the research objects. Through the questionnaire made by our hospital, we investigated the patients, analyzed and mastered the patients' understanding details and specific needs of health knowledge, and proposed reasonable health education methods according to their characteristics. Results The rates of patients' ignorance about thyroid cancer related knowledge, such as the relationship between disease and lifestyle, the importance of regular admission to hospital, the control details of the disease in clinical treatment, the specific treatment plan and effect, the clinical characteristics of the disease and the detailed information of the disease, were 50.00%, 51.64%, 72.95%, 74.59%, 77.87% and 8.19%, respectively. The score of demand for health education content was high, accounting for more than 40% of the total demand.Patients with different forms of health education had different needs, one of the highest requirements for meeting communication, nurses and patients accounted for 98.36%, followed by WeChat popular science knowledge, accounted for 96.72%, followed by after playing video and audio (94.26%), creating a seminar (93.44%), individual guidance (91.80%), telephone follow-up (83.60%), experience introduction (80.32%),patients with the same disease, publicity column and brochure (63.90%). Conclusion Patients with thyroid cancer have less knowledge of health knowledge and need more health knowledge. Therefore, we may take diversified health knowledge education programs to meet the needs of different patients, and then increase the attention of patients to the disease, which is conducive to the patients to establish treatment confidence and improve their quality of life.

目的 探讨维生素D对维生素D缺乏患者ACCF术后钛网下沉及临床疗效的影响。方法 70例行ACCF术治疗的维生素D缺乏患者,按随机数字表法将患者分为对照组及观察组,每组35例。观察组患者术后即刻及出院后每月给予肌肉注射10万U维生素D₃,持续6个月,对照组患者则给予肌肉注射1 mL生理盐水。比较两组颈椎融合时间、钛网下沉率、术后1年颈椎JOA评分、NDI评分。结果 观察组术后1年颈椎JOA评分、NDI评分均优于对照组(均P＜0.05);观察组钛网下沉率低于对照组,颈椎融合时间短于对照组(均P＜0.05)。结论 补充维生素D可以缩短维生素D缺乏患者的ACCF术后融合时间、减少钛网下沉、改善临床疗效。

Objective To investigate the effect of vitamin D on titanium mesh subsidence and clinical efficacy in patients with vitamin D deficiency after ACCF. Methods Seventy patients with vitamin D deficiency treated by ACCF were divided into control group and observation group according to random number table method, 35 cases in each group. Patients in the observation group were given intramuscular injection of 100 000 U of vitamin D₃ immediately after operation and after discharge for 6 months, while patients in the control group were given intramuscular injection of 1 mL of normal saline. The time of cervical fusion, the subsidence rate of titanium mesh, the JOA score and NDI score of cervical spine 1 year after operation were compared between the two groups. Results The JOA score and NDI score of cervical vertebra in the observation group were better than those in the control group one year after operation(P<0.05);the subsidence rate of titanium mesh in the observation group was lower than that in the control group, and the fusion time of cervical vertebra was shorter than that in the control group(P<0.05). Conclusion Vitamin D supplementation may shorten the fusion time of patients with vitamin D deficiency after ACCF, reduce the sinking of titanium mesh and improve the clinical efficacy.

目的 探讨C反应蛋白(CRP)、降钙素原(PCT)、中性粒细胞计数(NC)及中性粒细胞/淋巴细胞比值(NLR)在肺癌患者化疗后合并细菌感染早期诊断中的意义。方法 收集本院肿瘤科2019年1月—2019年12月肺癌化疗后合并细菌感染患者78例,肺癌化疗后未感染患者64 例,同期健康体检人群39例,采用固相免疫色谱法和速率散射比浊法测定血清中的PCT及CRP 的含量,采用mindray cal8000血细胞分析仪进行血细胞分类计数检查,计算N及NLR。结果 化疗后感染组CRP、PCT、NC及NLR均高于化疗未感染组及健康对照组,差异均有统计学意义(P＜0.01);化疗未感染组与健康对照组CRP、PCT、NC及NLR差异有统计学意义(P＜0.01)。CRP、PCT、NC及NLR联合使用时,其灵敏度为97.507%,而特异度升高为97.15%。细菌感染患者治疗前的PCT、CRP、NC及NLR 与治疗后相比较差异有统计学意义(P<0.05),治疗后低于治疗前。结论 PCT、CRP、NC及NLR联合检测能够提高对肺癌患者化疗后合并细菌感染早期诊断的敏感度和特异度。

Objective To explore the significance of C-reactive protein (CRP), procalcitonin (PCT), neutrophil count (NC) and neutrophil / lymphocyte ratio (NLR) in the early diagnosis of bacterial infection in lung cancer patients after chemotherapy. Methods From January 2019 to December 2019, 78 cases of lung cancer patients with bacterial infection after chemotherapy, 64 cases of uninfected patients after chemotherapy and 39 cases of healthy people in the same period were collected. the contents of PCT and CRP in serum were detected by solid phase immunosorbent assay and rate nephelometry.The NC and NLR were classified and counted by mindray cal8000 hematology analyzer. Results After chemotherapy, CRP, PCT, NC and NLR in the infected group were higher than those in the uninfected group and the healthy control group (P<0.01), while CRP, PCT, NC and NLR in the uninfected group were higher than those in the healthy control group (P<0.01). When CRP, PCT, NC and NLR were used together, the sensitivity was 97.507%, while the specificity increased by 97.15%. The PCT, CRP, NC and NLR of patients with bacterial infection before treatment were lower than those after treatment (P<0.05). Conclusion PCT, CRP, NC and NLR may improve the sensitivity and specificity of early diagnosis of bacterial infection in patients with lung cancer after chemotherapy.

目的 筛选九头狮子草治疗小鼠细菌性阴道炎的有效部位。方法 采用金黄色葡萄球菌、大肠埃希菌菌悬液注入小鼠阴道建立小鼠细菌性阴道炎动物模型,观察九头狮子草各极性部位对细菌性阴道炎的治疗作用。结果 九头狮子草水提液、石油醚提取部位和70%乙醇提取部位对病原菌转阴率和阴道黏膜炎症的治愈程度均有提高,其中,对金黄色葡萄球菌的转阴率分别为60%、50%、40%,对大肠埃希菌的转阴率分别为80%、70%、50%。结论 九头狮子草石油醚提取部位和70%乙醇提取部位为其治疗细菌性阴道炎的有效部位。

Objective To study the active parts of Peristrophe japonica of vaginitis treatment effect. Methods The bacterial vaginitis model was established by injecting the bacteria of Staphylococcus aureus and Escherichia coli into the vagina of the mice and the treatment effect of each extract of Peristrophe japonica was observed. Results Three drug administration groups (including water extract of Peristrophe japonica, ligarine fraction and 70% ethanol fraction) showed marked treatment effect on the vaginitis models. The effect of water extract of Peristrophe japonica group were stronger than that of the ligarine fraction and 70% ethanol fraction groups. The pathogens seroconversion rates in Staphylococcus aureus were orderly as follows: 60%, 50%, 40%. The pathogens seroconversion rates in Escherichia coli were orderly as follows: 80%, 70%, 50%. Conclusion The ligarine fraction and 70% ethanol fraction of Peristrophe japonica might be the active extracts of curing vaginitis.

目的 探讨血必净注射液对ANP大鼠肠道菌群及肠黏膜屏障功能的影响。方法 40只SD大鼠随机分为空白组、假手术组、ANP组和血必净治疗组(每组10只),空白组不作任何处理,假手术组翻动十二指肠后关腹,ANP组和治疗组用4.5%牛磺胆酸钠溶液胆胰管逆行注射建模,治疗组在建模后经鼠尾静脉注射血必净注射液(3 mL/kg)。24 h后处死大鼠并采样,ELISA法测血AMS、CRP、LPS、TNF-α、IL-6、IL-1β、DAO和D-乳酸等指标,粪菌样本行16SrRNA高通量测序分析,实时定量PCR法检测5种细菌数量,病理检测胰腺和回肠组织,比较各组大鼠的指标。结果 ①ANP组大鼠血AMS升高,CRP、LPS、TNF-α、IL-6、IL-1β、DAO、D-乳酸水平以及胰腺、小肠病理评分均高于空白组和假手术组(P<0.001);②治疗组AMS低于ANP组,血必净可降低上述各种血清指标水平和胰腺、小肠病理评分(P<0.001);③肠道菌群微生态分析显示,血必净可改善ANP大鼠粪菌的丰富度和多样性,缩小与空白组、假手术菌种种类的差异,增加厚壁菌门菌量;治疗组乳酸杆菌、双歧杆菌和普拉梭菌的菌量高于ANP组,肠球菌和大肠埃希的菌量低于ANP组(P<0.001)。结论 血必净可增加ANP大鼠肠道菌群的丰富度和多样性,增加有益菌的含量,减少内毒素和促炎因子释放,改善肠黏膜屏障功能。

Objective To investigate the effect of Xuebijing injection on intestinal flora and intestinal mucosal barrier function in ANP rats. Methods 40 SD rats were randomly divided into blank group, sham operation group, ANP group and Xuebijing treatment group (10 in each group). The sham operation group closed the abdomen after turning the duodenum. The ANP model was established by retrograde injection of 4.5% sodium taurocholate solution into the biliopancreatic duct. Xuebijing injection (3mL/kg) was injected into the tail vein of the rats in the treatment group. 24 hours later, the rats were sacrificed and sampled. AMS, CRP, LPS, TNF-, il-6, il-1, DAO and d-lactic acid were measured by ELISA. The fecal bacteria samples were analyzed by 16SrRNA sequencing technique. Real-time quantitative PCR was used to detect the populations of 5 bacteria in fecal sample. The pathology of pancreas and ileum were examined, and the indexes of rats in each group were compared. Results ①In ANP group, AMS was increased, levels of CRP, LPS, TNF-, il-6, il-1, DAO, d-lactic acid, pancreatic and intestinal pathology scores were higher than those in the blank group and the sham group (P<0.001).②In treatment group,AMS was lower than ANP group, and Xuebijing could reduce the levels of the above factors and scores of pancreatic and intestinal pathology (P<0.001).③ The microecological results of intestinal flora showed that Xuebijing treatment could improve the richness and diversity of fecal bacteria, reduce the difference between Xuebijing group and blank group and sham operation group, and increase the quantity of firmicutes. The amount of Lactobacillus, Bifidobacteria and Clostridium prasei in the Xuebijing group was higher than that in ANP group, while the amount of enterococci and Escherichia coli was lower than that in the ANP group (P<0.001). Conclusion Xuebijing can increase the richness and diversity of intestinal flora, increase the content of beneficial bacteria, reduce the release of endotoxin and pro-inflammatory factors, and improve the intestinal mucosal barrier function in ANP rats.

目的 探讨具有不同载脂蛋白E4等位基因(Apolipoprotein E4 alleles,APOE4)阿尔茨海默病患者的神经心理学量表差异。方法 纳入2014年1月—2017年12月广州市第一人民医院收治阿尔茨海默病患者28人,分别予简易精神状态检查量表、阿尔茨海默病评定量表-认知部分、临床医师通过面谈对变化的印象、日常生活活动能力量表、神经精神问卷,并检测量表间相关关系。之后随访18个月,观察量表评测的各功能变化及互相间相关性。检测不同载脂蛋白E4等位基因等阿尔茨海默病相关基因分布及与量表间相关关系。结果 认知评定量表间、认知评定量表与整体评价量表间、以及认知评定量表与日常活动能力评定量表间具有相关性。精神与行为症状量表分数与其他评定量表无明显相关性。随访中各量表分数变化间均无相关性。各基因组间功能变化无显著性差异,载脂蛋白E4等位基因变异主要影响患者的认知功能。等位基因分布与患病年龄,日常活动能力及精神与行为症状无相关性。结论 阿尔茨海默病量表评测的各认知领域间相关性不同,功能变化间无相关关系。载脂蛋白E4等位基因变异主要影响患者的认知功能。

Objective The present study aimed to elucidate the performance of multiple psychological tests among different Apolipoprotein E4 alleles (APOE4) in people with Alzheimer's disease (AD). Methods 28 patients were enrolled from January 2014 to December 2017 in Guangzhou First People'S Hospital. All patients were tested by using Mini-mental State Examination (MMSE), Alzheimer's disease Assessment Scale (ADAS-cog), Clinician's Interview-Based Impression of Change (CIBIC-Plus), Activities of Daily Living (ADL) and the NeuroPsychiatric Inventory (NPI). After 18 months follow-up visit, the change of the tests points were recorded. AD pathogenic genes, including Apolipoprotein E4 allele's variations, were detected in all patients. Then the correlations of APOE4 alleles and multiple psychological tests were analyzed. Results The correlations were confirmed between MMSE and ADAS-cog, MMSE and CIBIC-plus, MMSE and ADL, ADAS-cog and CIBIC-plus, ADAS-cog and ADL. NPI showed no correlation with the others. No correlation was found between changes of multiple psychological tests after 18 months follow-up. APOE4 alleles' variation affected cognitive function mainly. The effects of APOE4 on ADL and NPI showed no statistical significance in AD patients. No correlation was found among patients groups with different APOE4 alleles in all psychological tests and age of onset. Conclusion The correlations were existed among multiple cognitive domains while levels were different. The changes between psychological tests showed no correlations. APOE4 alleles' variation affected cognitive function mainly.

目的 探讨非酒精性脂肪肝患者昼夜节律特点并分析昼夜节律与非酒精性脂肪肝的相关性。方法 选取2017年12月—2018年12月我院门诊部及住院部非酒精性脂肪肝患者60例作为观察组,对照组抽取门诊体检正常人群60例。通过使用本院自制个人一般资料调查表、睡眠节律清晨型与夜晚型量表(MEQ)以及智能手环检测两组纳入对象的昼夜节律(饮食方式、饮食时间、活动节律、体重指数、睡眠节律等)。对比分析两组患者昼夜节律特点并分析其与非酒精性脂肪肝的相关性。结果 非酒精性脂肪肝患者在BMI、睡眠绝对夜晚型、睡眠中度夜晚型、日均运动量小于30 min、睡眠时间紊乱、睡眠时长以及深度睡眠时间等方面与对照组患者比较差异有统计学意义(P＜0.05);以非酒精性脂肪肝为应变量,以昼夜节律为自变量进行回归分析发现性别、年龄、工作性质、BMI、睡眠节律、身体锻炼、睡眠时长、深度睡眠时长与非酒精性脂肪肝呈现正相关且差异有统计学意义(OR＞1,P＜0.01)。结论 非酒精性脂肪肝患者昼夜节律一般存在失眠熬夜、睡眠时间不规律、少运动、身形丰满等特点,引发非酒精性脂肪肝相关因素包括BMI、睡眠节律、运动节律、职业性质、年龄、性别、睡眠质量等,临床上可尝试对非酒精性脂肪肝患者进行昼夜节律干预治疗,改善预后。

Objective To explore the characteristics of circadian rhythm in patients with nonalcoholic fatty liver disease(NAFLD) and to analyze the correlation between circadian rhythm and NAFLD. Methods From December 2017 to December 2018,60 patients with NAFLD in outpatient department and inpatient department of our hospital were selected as observation group,while 60 normal people were selected as control group.The circadian rhythm (dietary pattern,dietary time,activity rhythm,body mass index,sleep rhythm) of the subjects in the two groups were measured by self-made personal data questionnaire,MEQ and smart bracelet.The circadian rhythm characteristics of two groups were compared and the correlation between circadian rhythm and NAFLD was analyzed. Results There were significant differences in BMI,absolute night sleep,moderate night sleep,daily average exercise less than 30 minutes,sleep disturbance,sleep duration and deep sleep time between the patients with NAFLD and the control group (P<0.05). NAFLD was used as dependent variable and circadian rhythm as independent variable. Logistic regression analysis showed that gender,age,nature of work,BMI,sleep rhythm,physical exercise,sleep duration and deep sleep time were positively correlated with fatty liver (OR>1,P<0.01). Conclusion The circadian rhythm of NAFLD patients generally has the characteristics of insomnia,staying up late,irregular sleep time,less exercise and plump figure.The related factors causing NAFLD include BMI,sleep rhythm,motor rhythm,occupational nature,age,gender and sleep quality.In clinic,circadian rhythm intervention therapy may improve the prognosis of patients with NAFLD.

目的 分析毕节地区新型冠状病毒(2019-nCoV)肺炎(novel coronavirus pneumonia,NCP)胸部CT影像学表现,探讨对NCP的临床诊断的价值。方法 回顾性分析毕节市第三人民医院2020年1月14日至2月18日收治的13例NCP患者的流行病学特征及胸部CT影像学特征。结果 13例患者中2例为长期居住在武汉来毕;1例由从上海到湖北宜昌逗留3天返毕;1例直接与武汉当地人接触;3例为与确诊病人的密切接触者;5例是聚集性发病,均与从浙江省台州市返毕确诊病人密切接触;1例无流行病学史。胸部CT影像学以双肺或一侧肺散在斑片状、磨玻璃状高密度影,密度不均,边界不清,肺野外带显著为特征。重型患者短期内肺部CT影像学变化明显。结论 确诊NCP普通型患者胸部CT影像学大多以典型表现为特征;重型NCP患者短时间内可出现实变及肺纤维化。

Objective To analyze the novel coronavirus (2019-nCoV) novel coronavirus pneumonia (NCP) chest CT imaging findings in Bijie area, and to explore the clinical diagnostic value of NCP. Methods The epidemiological characteristics and chest CT features of 13 NCP patients admitted to The Third People's Hospital of Bijie from January 14 to February 18, 2020 were analyzed retrospectively. Results Among the 13 patients, 2 lived in Wuhan for a long time, 1 stayed for 3 days from Shanghai to Yichang, Hubei, and returned home; 1 directly contacted with the local people in Wuhan; 3 closely contacted with the confirmed patients; 5 were clustered diseases, all closely contacted with the confirmed patients returning from Taizhou, Zhejiang province; 1 had no epidemiological history. CT imaging of the chest is characterized by patchy, ground glass high-density shadows scattered in two or one side of the lung, with uneven density, unclear boundary and significant lung field zone. Conclusion Most of the chest CT images of the patients with NCP were characterized by typical manifestations, while consolidation and pulmonary fibrosis were found in the patients with severe NCP in a short period of time.

目的 探究高龄患者植入静脉输液港并发感染相关影响因素分析。方法 随机抽取我院2015年5月—2018年8月期间收入高龄患者总计72例,对并发感染患者数量进行统计,采取Logistic回归方程进行计算,分析高龄患者植入静脉输液港并发感染相关因素。结果 共计纳入植入静脉输液港并发感染患者总计72例,其中并发感染患者为23例,占比31.94%,对比两组一般资料,发现两组患者在穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量上存在差异,数据对比差异有统计学意义(P＜0.05),将上述有差异资料带入Logistic回归方程计算,发现穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量均为导致高龄患者植入静脉输液港并发感染影响因素。结论 对高龄患者而言,植入静脉输液港并发感染各项因素中,包括穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量,患者需加强关注,可控制输液港相关感染。

Objective To explore the influencing factors of infection in elderly patients with intravenous infusion port. Methods 72 elderly patients from May 2015 to August 2018 were randomly selected in our hospital. After counting the number of patients with complicated infection,the relative factors of infection in elderly patients were analyzed by using the Logistic regression equation. Results A total of 72 patients were included in the intravenous infusion port with concurrent infection,of which 23 were accompanied with infection,accounting for 31.94%.By comparing the general data,two groups in puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses had statistically difference(P<0.05). It was found all the above factors were the concomitant factors leading to the implantation of intravenous infusion port in elderly patients by putting the difference data into the Logistic regression equation. Conclusion To control infusion port related infection,the elderly patients should focus more on the infection factors of the implantation in intravenous infusion port which included puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses.

目的 探究Harris-Benedict(HB)公式用于估算机械通气的危重症患者能量代谢的准确性,以及不同BMI分组对其影响。方法 使用间接能量测定法测量患者的静息能量(ICREE),通过HB公式计算其静息能量代谢估算值(HBREE)。将80例患者按BMI分为4组,并通过配对样本t检验对ICREE与HBREE进行比较,Pearson分析用于分析ICREE与HBREE的相关性。结果 共纳入80例机械通气的危重症患者。除肥胖组外的其余各组病人,ICREE均高于HBREE(均P＜0.01),HB公式的准确率为23.75%。ICREE与HBREE相关性差(r=0.331,P＜0.01)。当各组使用校正系数对HB公式进行调整后,ICREE与HBREE差异无统计学意义,准确率提高至38.8%。结论 使用HB公式不能很好地反应危重症患者的实际能量代谢。BMI可能是影响HB公式准确性的重要因素。依据不同BMI分组,使用相应校正系数可提高HB公式的准确性。

Objective To explore the accuracy of the Harris-Benedict (HB) formula used to estimate the energy metabolism in critically ill patients undergoing mechanical ventilation and the effects of different BMI groups on it. Methods Indirect calorimetry was used to measure the resting energy of the patient,and the estimated resting energy metabolism was calculated by the HB formula. 80 patients were divided into four groups according to BMI. ICREE and HBREE were compared by paired sample t test. Pearson analysis was used to analyze the correlation between ICREE and HBREE. Results This study included 80 critically ill patients undergoing mechanical ventilation.Except for the obese group,ICREEE was higher than HBREE in all patients and the remaining groups of patients. The accuracy rate of the HB formula was 23.75%. The correlation between ICREE and HBREE is poor(r=0.331,P＜0.01). There was no statistical difference between ICREEE and HBREE and the accuracy rate increased to 38.8% after the Harris-Benedict equation was adjusted by using the correction factor. Conclusion Using the HB formula can not reflect the actual energy metabolism of critically ill patients well. BMI may be an important factor affecting the accuracy of HB formula. The accuracy of the HB equation can be improved by using different correction factors according to different BMI groupings.