目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.

目的 了解广州地区儿童患者分离的社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)临床分离株的分子特征。方法 收集2009年—2014年我院分离获得的65株CA-MRSA临床分离株,PCR法检测杀白细胞素(PVL)基因阳性菌株,多位点基因序列类型(MLST)测定MRSA菌株的序列类型,多重PCR法对MRSA菌株进行葡萄球菌mec盒式染色体(SCCmec)分型。结果 65株CA-MRSA分离株中PVL基因阳性31株,阳性率47.69%;MLST分型表明以ST5933.84%(22/65)及ST8823.07%(15/65)为主;SCCmec分型中发现3种类型,分别为SCCmecⅡ 32.30%(21/65)、SCCmecⅣ 49.23%(32/65)及SCCmecⅤ 18.46%(12/65),未存在未能分型菌株。结论 广州地区儿童患者分离的CA-MRSA临床分离株的PVL基因阳性率相对较高,SCCmecIV型、V型可形成小范围内的流行,其基因表型存在多种ST分型。

Objective To investigate the molecular characteristic of Community-acquired Methicillin-resistant Staphylococcus aureus(CA-MRSA) isolates from pediatric patients in Guangzhou. Methods 65 non-duplicate strains of Community-acquired Methicillin-susceptible Staphylococcus aureus(CA-MSSA) isolated from our hospital in 2009-2014 were investigated. Panton-valentine leukocidin(PVL) gene was detected by polymerase chain reaction(PCR). The sequence type (ST) of each strain was determined by muhilocus sequence typing (MLST). The genotypes of staphylococcal cassette chromosome mec(SCCmec) of the CA-MRSA isolates were confirmed by multiplex PCR. Results Among 65 isolates of CA-MRSA, the positive rate of PVL genes was 47.69%(31／65). The most common MLST type was ST59 (n=22, 33.84%), followed by ST88 (n=15, 23.07%). Three SCCmec types were found. The most common type was SCCmecIV (49.23%, 32/65), followed by SCCmecⅡ (32.30%, 21/65) and SCCmecV (8.46%, 12/65). Conclusion The PVL gene-positive rate of CA-MRSA isolates in our hospitals is at a relatively high level. SCCmec type IV and SCCmec type V could spread among hospitals and cause a small scale epidemic. Their phenotypes have a variety of ST types.

目的 评估关节松动联合运动疗法对颞下颌关节慢性不可复性盘前移位患者的疗效。方法 采用随机对照方法,将46例慢性不可复性盘前移位患者随机分为联合治疗组(n=24)及对照组(n=22), 对照组仅接受传统治疗(包括超短波、超声波、软组织按摩及健康教育),治疗组在传统治疗的基础上应用关节松动联合运动疗法。在治疗前和治疗后2周采用最大张口度(maximal interincisal opening,MIO)、目测类比法(visual analog scale,VAS)、口腔健康影响程度量表(health impact profile-14,HIP-14)评价疗效。结果 治疗前两组患者一般情况类似。治疗后两组颞下颌关节MIO、VAS、HIP-14得分较治疗前改善(P<0.05),组间比较,治疗组在MIO、VAS、HIP-14评分比对照组改善(P<0.05)。结论 关节松动联合运动疗法治疗颞下颌关节慢性不可复性盘前移位疗效明显,值得推广。

Objective To evaluate the effectiveness of joint mobilization combined with therapeutic exercise in patients with chronic anterior disc displacement without reduction of temporomandibular joints. Methods 46 patients with chronic anterior disc displacement without reduction were randomly divided into two groups. The treatment group of 24 cases received joint mobilization combined with therapeutic exercise and conventional therapy (ultrashort-wave diathermy, ultrasound therapy, soft tissue massage, health education), 22 cases in the control group received conventional treatment.The treatment was administered for 2 weeks. The baseline and endpoint outcome assessment measures were maximal interincisal opening (MIO),visual analogue scale(VAS)score and oral health impact profile (HIP-14). Results After the treatment, significant improvements were observed in the two groups of all the outcome measurements (P<0.05).Maximal interincisal opening, visual analogue scale and oral health impact profile were improved significantly in the treatment group than in the control group (P<0.05). Conclusion Joint mobilization combined with therapeutic exercise can improve the symptoms of chronic anterior disc displacement without reduction.

目的 探讨颈动脉残端压(SP)联合电生理监测在颈动脉内膜切除术(CEA)中的应用价值。方法 回顾性分析19例CEA患者临床资料,通过监测SP、体感诱发电位(SEP)和运动诱发电位(MEP),以确定术中是否放置转流管;比较术前和术后6月美国国立卫生院卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分变化情况。结果 10例患者SP≥50mmHg,SEP和MEP监测无异常,术中未放置转流管;5例患者SP<50 mmHg,SEP波幅下降>50％,MEP监测正常,予以放置转流管;3例患者SP≥50 mmHg,SEP波幅下降>50％,MEP监测正常,予以放置转流管;1例患者SP>50 mmHg,SEP监测正常,MEP波幅下降>50％,未放置转流管。所有患者手术均获得成功,无手术死亡率。患者术后6月NIHSS评分和术前无统计学差异(P>0.05),但术后6月mRS评分较术前下降(P<0.05)。结论 通过术中SP、SEP和MEP联合监测,有助于避免CEA术后缺血性脑卒中的发生,提高CEA手术的安全性。

Objective To investigate the value of stamp pressure(SP), somatosensory and motor evoked potentials(SEP,MEP) monitoring in carotid endarterectomy. Methods 19 patients with carotid endarterectomy were retrospectively analyzed.SP, SEP and MEP were monitored during the operation.National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) were used to evaluate the neurological function before and 6 months after surgery. Results Intraluminal shunting was not performed in 10 patients with normal SP, SEP and MEP.However, intraluminal shunting technique was used in 5 patients (SP<50 mmHg and SEP fluctuation decreased by 50％) and 3 patients (SP≥50 mmHg and SEP fluctuation decreased by 50％).1 patient showed the fluctuation of MEP decreased by 50％, while SP and SEP was normal, no shunting was performed.All patients were successfully operated, and no mortality occurred.The mRS score, not the NIHSS score, revealed statistically difference between preoperation and 6 months after surgery (P<0.05). Conclusion The combination of SP, SEP and MEP monitoring maybe useful for preventing ischemic stroke after carotid endarterectomy, increasing the safety of surgery.

目的 比较脂溶性高杉尖三酯碱(HHRT)与水溶新丝裂霉素C(MMC)和5-氟尿嘧啶(5-Fu)三种药物对人Tenon's囊成纤维细胞(HTFs)增殖率的抑制情况。方法 采用冻存的人眼Tenon's囊成纤维细胞,常规复苏体外培养稳定后,接种于96孔板,分别加入不同浓度HHRT、MMC及5-Fu,继续培养;采用MTT法于加药后24 h、48 h、72 h检测不同浓度HHRT、MMC及5-Fu对体外培养的人眼Tenon囊成纤维细胞增值率的抑制情况。结果 一定浓度的HHRT、MMC及5-Fu,对HTFs的抑制作用呈现不同的剂量和时间依赖性,在药物浓度达到相应程度作用72 h后三者对HTFs的最大抑制率均可达70%以上,且组间对比差异有统计学意义。结论 三种药物均对人眼Tenon's囊成纤维细胞增殖具有明显抑制作用,其最大抑制率均可达70%以上,三种药物对成纤维细胞抗增殖效应的时间浓度依赖性有所差别。

Objective To investigate and compare the inhibitory effects of Mitomycin C(MMC), 5-Fluorouracil(5-Fu) and Homoharringtonine(HHRT) on cultured Human Tenon's fibroblasts(HTFs) proliferation. Methods Fibroblasts were recovered and cultured from cell bank.Fibroblasts were treated with different concentration of MMC, 5-Fu and HHRT for 48h and 72h respectively. The proliferation of fibroblasts was detected using MTT assay. Results Fibroblasts were cultured in MMC, 5-Fu or HHRT demonstrated a dose-dependent and time-dependent inhibition of fibroblasts proliferation.The maximum inhibition rate was found when HTFs were treated with different concentration of MMC, 5-Fu or HHRT for 72h. And the three agents maximum inhibition rates were all more than 70%. The differences of proliferation in control and treated groups was statistically significant(P<0.01). Conclusion The three agents had inhibitory effect on HTFs. And the three agents maximum inhibition rates were all more than 70%. The inhibitory effects of MMC,5-Fu and dexamethasone on fibroblast proliferationwas MMC>HHRT>5-Fu.

本文从康复治疗学专业课程体系、实践教学、学生创新能力和职业素养的培养、考核体系四个方面对康复治疗学本科人才培养模式的构建进行探讨,以期为丰富康复治疗学专业教学实践提供思路。

This paper is to investigate the construction of undergraduate educational talent cultivation mode of rehabilitation therapeutics from the following aspects: Curriculum system, practice teaching, cultivating students' innovative ability and professional quality and the assessment system, aimed to provide a reference for rehabilitation therapeutics teaching practice.

目的 了解佛山市南海区美沙酮治疗门诊重入组维持治疗患者与长期维持治疗患者的治疗依从性。方法 选择佛山市南海区第五人民医院美沙酮治疗门诊自2007年12月—2013年12月30日的全部重入组治疗者作为研究组,同时选择部分长期维持治疗者作为对照组。对全部研究对象通过查阅社区门诊美沙酮维持治疗管理系统及问卷调查获取患者资料。结果 MMT重入组患者与长期维持治疗患者的职业状况、经济来源、居住情况之间的差异有统计学意义(P<0.05);重入组MMT治疗者与对照组相比,无业/待业的比例较大(88.7% vs 73.3%),多数为独居(26.1% vs 5.3%);而对照组MMT治疗者的经济来源大多来自家庭朋友供给(85.3%)。两组患者首次吸毒年龄和吸毒方式的分布之间存在差异(P<0.05)。重入组MMT治疗者与对照组相比,患者的首次吸毒年龄主要集中在20~30岁,占61.4%;重入组患者注射吸毒比例更高。重入组在治者的服药剂量低于对照组;且重入组在治者的服药参与率、尿检参与率均低于对照组,而重入组在治者的尿检阳性率低于对照组。结论 MMT门诊患者中重入组者占较大比例,重入组在治MMT患者的服药依从性较长期维持治疗患者差。

目的 获得广东省保健食品违法广告所针对目标消费人群的现况,为加强保健食品广告的管理提供研究基础。方法 将2009年1月—2014年10月广东省食品药品监督管理局官方网站公布总计40期保健食品违法广告的公告汇总,以目标消费群体的年龄性别作为分析因素,建立统计表进行相关研究分析。结果 2009年1月—2014年10月广东省保健食品违法广告主要是针对中老年人消费人群,并侧重于女性消费群体。结论 针对广东省保健食品违法广告存在问题,相关职能部门应增补保健品广告法规的操作细则,加强部门间协调分工及相互监督,并利用网络媒体平台开展相关保健食品知识宣传工作。

Objective This study the characters of consumers targeted by health food advertisements in Guangdong province. The results will be helpful to enhance the standard management to the advertisements of health food in Guangdong Province. Methods Forty issues announcements of illegal health food advertisements, which published in the official website of Guangdong food and drug administration center from January 2009 to October 2014, were collected and statistically analyzed by the age and gender of the target consumer groups. Results The old people, especially female consumers, were the target consumers of illegal health food advertisements in Guangdong province from January 2009 to October 2014. Conclusion Regulations and rules for the health food advertisements should be developed. And the coordination and supervision among advertizing departments, as well as knowledge to the health food advertisements based on the internet technique, should be strengthened.

目的 探讨群组管理对儿童特应性皮炎患儿生活质量的影响。方法 采用随机数字法将72例患儿分为干预组和对照组各36例,对照组不给予任何干预,干预组实施1个月的群组管理活动。结果 干预后干预组的瘙痒程度显著好转、总疗效率达100%、生活质量评分改善,与对照组比较差异均有统计学意义(P＜0.05)。结论 群组管理是一种有效的管理模式,增强了患儿的自我效能,降低了疾病严重程度,提高了患儿的生活质量。

Objective To explore the influence of group management on quality of life of children with atopic dermatitis. Methods According to random number table, 72 children with atopic dermatitis were randomly divided into the experiment group and the control group. While the control group was not accepted any intervention, the experiment group was accepted one-month group management. Results After the intervention, the pruritus of the intervention group was improved, the total effective rate was 100% and scores of life quality were improved obviously.compared with those in the control group, these changes had statistical significance (P＜0.05). Conclusion Group management is an effective management mode, it improves children's self-efficacy, relieve the seriousness of illness and improve children's quality of life.

目的 评价自我管理小组干预对社区2型糖尿病患者的管理效果。方法 在2013年底选取本区社区卫生服务中心100例患者研究,运用自身对照方法,管理1年后对其自我管理效能、生化指标、空腹血糖、糖化血红蛋白进行比较。结果 管理一年后饮食控制、运动控制、药物依从性、监测依从性、足部护理等指标差异有统计学意义(P<0.05)。空腹血糖、糖化血红蛋白、总胆固醇、尿酸下降,差异有统计学意义(P<0.05)。空腹血糖达标率由12%上升到37%,糖化血红蛋白达标率由10%上升到34%,差异有统计学意义(P<0.05)。结论 自我管理小组干预提高了社区2型糖尿病患者自我管理水平,改善了主要的生化指标,值得社区推广应用。

Objective To evaluate the function of self-management group program on patients with type 2 diabetes in community. Methods Self-management was carried out for one year among 100 patients with type 2 diabetes, the effect of management was analyzed. Results There was statistically significant difference in diet control, motion control, drug compliance, monitoring compliance, and foot care after one year intervention (P<0.05). GLU, HbA1c, CHOL, UA were decreased. The difference was statistically significant (P<0.05). Conclusion Self-management of group intervention is effective in patients with type 2 diabetes, is worthy of further popularization and application.