目的 探讨慢性乙型肝炎病毒（HBV）感染对妊娠期糖尿病（GDM）孕妇的妊娠并发症、孕晚期生殖道B族链球菌（GBS）感染情况以及妊娠结局的影响。方法 选取2020年1月1日—12月31日在广州市妇女儿童医疗中心定期产检、足月、单胎妊娠的GDM孕妇共583例,其中合并HBV感染者（GDM+HBV组）48例,无合并者（GDM组）535例。比较2组的妊娠期并发症、妊娠晚期（妊娠35~37周）生殖道GBS感染情况、妊娠结局以及阴道分娩者的母儿结局。结果 与GDM组患者相比,GDM+HBV组患者出现妊娠期肝内胆汁淤积症、孕晚期生殖道GBS感染者比例较高,孕期出现胎盘早剥者比例较高,阴道分娩过程中出现产时发热、羊水粪染和新生儿入住NICU者比例均较高（均P<0.05）。结论 与无合并慢性HBV感染的GDM患者相比,合并慢性HBV感染的GDM患者在围产期的母儿风险升高。

Objective To investigate the effects of chronic hepatitis B virus（HBV）infection on pregnancy complications,group B streptococcus（GBS）infection in third trimester and pregnancy outcome in pregnant women with gestational diabetes mellitus（GDM）．Methods A retrospective study of 583 pregnant women with GDM,singleton gestation and cephalic presentation delivered at term in Guangzhou Women and Children’s Medical Center was carried out．Including 48 GDM women complicated with chronic HBV infection（GDM+HBV group）and 535 GDM women without HBV infection（GDM group）．Pregnancy complications,GBS infection in third trimester（gestation 35-37 weeks）,pregnancy outcomes,maternal and neonatal outcomes of vaginal delivery were compared between the two groups．Results GDM+HBV group had a higher proportion of intrahepatic cholestasis of pregnancy（ICP）and GBS infection in third trimester than GDM group,and a higher proportion of placental abruption during pregnancy．GDM+HBV group showed a significantly increased proportion in intrapartum fever,meconium-stained amniotic fluid and neonatal intensive care unit admission during vaginal delivery than GDM group（all P<0.05）．Conclusions GDM women with chronic HBV infection are associated with increased maternal and fetal risk during pregnancy and delivery．

糖尿病已成为全球最严重的健康问题之一。需要白内障手术的糖尿病患者也日益增多,虽然糖尿病的眼表并发症很常见,但由于糖尿病患者全身和眼部疾病十分复杂,使得眼前段如角结膜和泪腺的糖尿病并发症往往被忽视。糖尿病患者白内障超声乳化术有引发或加重眼前节疾病的风险,包括干眼病（DED）、角膜上皮糜烂、上皮缺损迁延不愈,甚至威胁视力的角膜溃疡。这些风险里最为常见的是DED,并且可能因白内障超声乳化手术而加重。眼科医生需要在手术前预先评估已存在的DED是否需要术前治疗,并且需要注意在已存在 DED 的情况下,各项术前检查数据测量的准确性会降低,以及尽可能减少对眼表造成损害的各种手术因素;并考虑通过管理减少术后 DED。本综述就评估白内障超声乳化术对合并糖尿病的老年性白内障患者的眼表术中的影响因素进行分析。

Diabetes mellitus(DM)has become one of the most serious health problems in the world. The number of diabetic patients requiring cataract surgery is also increasing. Although ocular surface complications of DM are common,the complexity of systemic and ocular disease in diabetic patients makes diabetic complications in the anterior segment,such as the cornea and lacrimal gland,often be overlooked. Phacoemulsification in diabetic patients carries the risk of triggering or exacerbating ocular segment disease,including dry eye disease,corneal epithelial erosion,persistent epithelial defects and even vision-threatening corneal ulcers. The most common of these risks is dry eye disease,and it can be exacerbated by cataract phacoemulsification. Ophthalmologists need to preemptively assess the need for preoperative treatment of pre-existing dry eye disease(DED),be aware of the reduced accuracy of preoperative data measurements in the presence of DED,and minimize surgical factors that can damage the ocular surface;and consider management to reduce postoperative DED. In this review,we analyze the factors that influence phacoemulsification in ocular surface surgery for senile cataract patients with diabetes.

目的 分析互联网+联合分段式心理干预对结肠癌患者生活质量及希望水平的影响。方法 采用随机数字表法对照试验,于2019年12月—2022年12月选取本院收治的100例结肠癌患者,分为参照组（50例,给予常规心理护理）与试验组（50例,给予互联网+联合分段式心理护理）,比较2组患者在护理前后的精神状态、生活质量、希望水平及护理满意度。结果 护理后,2组患者的简明精神病评定量表（BPRS）评分均降低,且试验组评分优于参照组（P<0.05）;2组患者的简明健康状况调查表（SF-36）各维度评分均升高,并且试验组评分更高（P<0.05）;2组患者的Herth希望量表（HHI）各维度评分均升高,且试验组评分高于参照组（P<0.05）;试验组患者（96.00%）护理满意度高于参照组（80.00%）（P<0.05）。结论 结肠癌患者采用互联网+联合分段式心理干预可改善患者精神状态,提高结肠癌患者生活质量、希望水平。

Objective To analyze the effect of internet combined with segmented psychological intervention on the quality of life and hope level of colon cancer patients. Methods In a randomized controlled trial,100 patients with colon cancer admitted to our hospital from December 2019 to December 2022 were selected as the subjects of this study. According to the nursing methods,they were divided into control group(50 cases,given conventional psychological nursing intervention)and experimental group(50 cases,given internet combined segmented psychological intervention). The mental status,quality of life,hope level and nursing satisfaction of the patients in the two groups were compared. Results After nursing,the score of Brief Psychiatric Rating Scale was decreased in both groups,and the score of experimental group was better(P<0. 05). The scores of all dimensions of the concise Health Survey Questionnaire increased in both groups,and the scores of the experimental group were higher(P<0. 05). The scores of Herth Hope index were increased in both groups,and the scores of experimental group were higher(P<0. 05). The nursing satisfaction of experimental group(96. 00%)was higher than that of control group(80. 00%,P<0. 05). Conclusions The use of internet combined segmental psychological intervention in colon cancer patients can improve the mental state,improve the quality of life and hope level,with promotion value.

目的 探讨精细化管理模式对消毒供应中心风险事件发生率的影响。方法 选取2020年6月—2022年5月为研究阶段,抽取本院消毒供应室1 000件医疗器械作为研究对象,随机分为对照组和研究组,各500件。对照组采用常规管理模式,研究组采用精细化管理模式,对比2组医疗器械不良事件发生率,观察30名工作人员分别在不同管理模式下发生职业风险暴露人数的变化,并进一步比较工作效率的不同。结果 研究组发生数量不等、物品过期、标签错误、型号错误、零部件差错等不良事件发生率均低于对照组（P<0.05）。研究组工作人员利器损伤和血制品污染者发生率低于对照组（P<0.05）,研究组工作人员工作效率评分高于对照组（P<0.05）。结论 精细化管理模式可有效减少消毒供应室医疗器械不良事件,降低工作人员职业暴露风险事件发生率,提高工作人员工作效率,改善管理工作质量。

Objective To explore the influence of refined management mode on the incidence of risk events in disinfection supply center. Methods From June 2020 to May 2022,1 000 pieces of medical devices were selected from the disinfection supply room of our hospital as the research object,and were randomly divided into control group and research group,with 500 pieces in each group. The control group adopted the conventional management mode,while the research group adopted the refined management mode. The incidence of adverse medical device events in the two groups was compared,and the changes in the number of 30 staff exposed to occupational risks under different management modes were observed,and the differences in work efficiency were further compared. Results The incidences of adverse events involving unequal quantities,expired items,mislabeling,modeling errors and parts errors were lower in the study group than in the control group(P<0. 05). The number of sharps injuries and blood product contamination among the staff in the study group was significantly lower than that in the control group(P<0. 05),and the staff efficiency scores of the study group were higher than those of the control group(P<0. 05). Conclusions Refined management mode can effectively reduce the adverse events of medical devices in disinfection supply room,reduce the number of occupational exposure risk events of staff,improve the work efficiency of staff and improve the quality of management.

目的 调查与分析儿童结直肠息肉的临床特征及腹腔镜联合结肠镜下手术对其的治疗效果。方法 选择2019年2月—2021年10月在郑州大学附属儿童医院诊治的98例结直肠息肉患儿,记录患儿的临床特征,根据患儿的手术方法分为腹腔镜组（腹腔镜联合结肠镜下手术治疗,n=40）与结肠镜组（采用结肠镜手术治疗,n=58）,对比不同手术方法的治疗效果、并发症发生率、疼痛视觉模拟评分法（VAS）评分、息肉复发与再手术率。结果 98例患儿中,息肉部位为直肠44例、横直肠38例、其他16例;息肉最大直径（1.65±0.24）cm;息肉单发83例、多发15例。腹腔镜组的围手术期指标比结肠镜组改善（P<0.05）。腹腔镜组术后7 d的感染、出血、肠穿孔、肠梗阻等并发症发生率为5.00%,低于结肠镜组的17.24%（P<0.05）。腹腔镜组术后1个月的总有效率为97.50%,高于结肠镜组的82.76%（P<0.05）。腹腔镜组术后1、3、7 d的疼痛VAS评分低于结肠镜组（P<0.05）。所有患儿术后随访1年,联合的息肉复发率与再次手术率为5.00%、2.50%,均低于结肠镜组的18.97%、13.79%（P<0.05）。结论 儿童结直肠息肉主要位于直肠、横直肠,多为单发,腹腔镜联合结肠镜下手术治疗能促进患儿康复,提高总体治疗效果,也能缓解患儿疼痛,减少并发症的发生,降低随访息肉复发率与再次手术率。

Objective To investigate and analyze the clinical features of children with colorectal polyps and the efficacy of laparoscopic surgery combined with colonoscopy. Methods A total of 98 children with colorectal polyps diagnosed and treated in our hospital from February 2019 to October 2021 were selected as subjects of this study. The clinical characteristics of all children were recorded,and they were divided into the laparoscopic group(laparoscopic surgery combined with colonoscopy,n=40)and the colonoscopy group(colonoscopy,n=58)according to the differences in surgical methods. The therapeutic effect,complication rate,VAS pain score,polyp recurrence and reoperation rate of different surgical methods were compared. Results Among the 98 children,the polyps of 44 cases were in rectum,38 cases in transverse rectum and 16 cases in other sites. The maximum diameter of polyp was(1. 65±0. 24)cm. Polyps were solitary in 83 cases and multiple in 15 cases. The perioperative indexes in the laparoscopic group were significantly improved compared with those in the colonoscopy group(P<0. 05). The incidence of postoperative complications such as infection,bleeding,intestinal perforation and intestinal obstruction was 5. 00% in the laparoscopy group,which was significantly lower than 17. 24% in the colonoscopy group(P<0. 05). The total effective rate of laparoscopic group was 97. 50% one month after operation,which was significantly higher than that of colonoscopy group(82. 76%,P<0. 05). The VAS pain score of the laparoscopic surgery group was significantly lower than that of the colonoscopy group at 1,3 and 7 days after surgery(P<0. 05). After 1 year of follow-up,the combined polyp recurrence rate and reoperation rate were 5. 00% and 2. 50%,which were significantly reduced compared with 18. 97% and 13. 79% in colonoscopy group(P<0. 05). Conclusions The main sites of colorectal polyps in children are rectum and transverse rectum,and most of them are solitary. Laparoscopic and colonoscopic surgery for colorectal polyps in children can promote the recovery of children,improve the overall treatment effect of patients,relieve the pain of children,reduce the occurrence of complications,and reduce the recurrence rate and reoperation rate of follow-up polyps in children.

目的 探析慢性阻塞性肺疾病急性加重（AECOPD）患者在全身糖皮质激素（激素）使用过程中检测呼出气一氧化氮（FeNO）的价值。方法 于2019年1月—2021年12月梅州市人民医院采集病例展开随机对照研究,实施对象为58例AECOPD患者,均检测FeNO水平,根据FeNO水平是否>25 ppb,分组为FeNO高水平组和FeNO低水平组,根据是否接受全身激素治疗分为治疗组和对照组,对照组予以常规治疗,治疗组实行常规+全身激素治疗;检测治疗前后FeNO、肺功能指标水平变化,判定COPD评估测试（CAT）评分,对比组间差异。结果 FeNO高水平组全身激素治疗后（治疗组）FeNO降低（P<0.05）,高水平组常规治疗后（对照组）FeNO前后比较差异无统计学意义（P>0.05）,低水平组中治疗组和对照组治疗前后FeNO比较差异无统计学意义（P>0.05）;FeNO高水平组治疗后第一秒用力呼气容积（FEV₁）、第一秒用力呼气量占用力肺活量比值（FEV₁/FVC）均升高,且治疗组升高程度较对照组更大（均P<0.05）,FeNO低水平组治疗后FEV₁、FEV₁/FVC均升高（均P<0.05）,但治疗组与对照组相比无差异（P>0.05）;FeNO高水平组、低水平组治疗后CAT评分较治疗前均下降（均P<0.05）,FeNO高水平组下降更明显。结论 AECOPD患者实施FeNO测定,其水平变化在一定程度上可反映气道炎症,并预测激素治疗反应,指导合理有效地应用全身激素,避免出现激素过度使用情况。

Objective To explore the value of detecting exhaled nitric oxide(FeNO)during systemic glucocorticoid use in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A randomized controlled study was conducted from January 2019 to December 2021 at the People's Hospital of Meizhou City. The subjects were 58 AECOPD patients,all of whom were tested for FeNO levels. Based on whether the FeNO levels were>25 ppb,they were divided into a high level FeNO group and a low level FeNO group. They were divided into a treatment group and a control group based on whether they received systemic glucocorticoid therapy. The control group received routine treatment,while the treatment group received routine and systemic glucocorticoid therapy. Changes in FeNO and lung function indicators before and after treatment were detected,COPD assessment test(CAT)scores were determined,and differences between groups were compared. Results After systemic glucocorticoid therapy,the high level group of FeNO showed a decrease in FeNO(P<0. 05),while the high level group showed no statistically significant difference in FeNO before and after routine treatment(P>0. 05). The low level group showed no statistically significant difference in FeNO between the treatment group and the control group before and after treatment(P>0. 05). The first second forced expiratory volume(FEV₁)and the ratio of first second forced expiratory volume to forced vital capacity(FEV₁/FVC)in the high level group of FeNO significantly increased after treatment,and the degree of increase in the treatment group was greater than that in the control group(all P<0. 05). The FEV₁ and FEV₁/FVC in low level group of FeNO significantly increased after treatment(all P<0. 05),but the difference between the treatment group and the control group was not significant(P>0. 05). The CAT scores of the high and low levels of FeNO groups decreased after treatment compared to before treatment(all P<0. 05),and the decrease was more significant in the high level FeNO group. Conclusions The implementation of FeNO measurement in AECOPD patients can reflect airway inflammation to a certain extent,predict glucocorticoid treatment response,guide the rational and effective application of systemic glucocorticoid and avoid excessive glucocorticoid use.

目的 探讨特殊健康儿童预防接种评估及不良反应处理。方法 选取2018年1月–2022年12月经预防接种门诊主动筛选的出生日期在2004年6月1日—2022年6月1日的特殊健康儿童,收集临床资料,以此进行预防接种评估建议,随访不良反应。结果 本研究共纳入944例特殊健康儿童,其中精神发育迟滞231例（24.47%）、脑性瘫痪440例（46.61%）、先天愚型115例（12.18%）、癫痫74例（7.83%）、先天性心脏病54例（5.72%）、唐氏综合征30例（3.18%）。其中男、女分别有519例（54.98%）、425例（45.02%）。在特殊健康儿童中,建议可正常接种疫苗918例（97.25%）,建议接种灭活疫苗但避免接种减毒活疫苗8例（0.85%）,建议暂缓接种所有疫苗18例（1.91%）。建议接种疫苗的特殊健康儿童中,已接种疫苗926例（98.09%）,接种灭活疫苗842例（89.19%）,接种减毒活疫苗612例（64.83%）;926例儿童共接种疫苗8 480剂次,其中灭活疫苗6 770剂次、减毒活疫苗1 770剂次;62例儿童进行68剂次疫苗接种后出现不良反应（包括局部反应15例次、全身反应53例次）,总发生率为8.02‰（68/8 480）,其中灭活疫苗、减毒活疫苗发生率分别为6.79‰（46/6770）、1.29%（22/1 710）。所有不良反应案例经处理,除口干1例处理后好转外,其他均达治愈,治愈率达98.53%（67/68）。结论 特殊健康儿童经医学评估后大多可接种疫苗,接种后不良反应发生风险在可控范围内。

Objective To discuss the evaluation of vaccination and treatment of adverse reactions in healthy special children. Methods From January 2018 to December 2022,healthy special children with birth dates from June 1,2004 to June 1,2022 who were screened by the vaccination clinic were selected. Clinical data were collected to conduct vaccination assessment recommendations and follow up adverse reactions. Results A total of 944 healthy special children were included in this study,including 231 cases(24. 47%)of mental retardation,440 cases(46. 61%)of cerebral palsy,115 cases(12. 18%)of congenital foolishness,74 cases(7. 83%)of epilepsy,54 cases(5. 72%)of congenital heart disease and 30 cases(3. 18%)of Down syndrome. There were 519 males(54. 98%)and 425 females(45. 02%). Among the healthy special children,918 cases(97. 25%)were recommended to get vaccinated normally,8 cases(0. 85%)were recommended to be vaccinated with inactivated vaccine but avoid to be vaccinated with attenuated live vaccine,and 18 cases(1. 91%)were recommended to suspend all vaccination. Among the special healthy children recommended for vaccination,926(98. 09%)had been vaccinated,842(89. 19%)had been vaccinated with inactivated vaccine,and 612(64. 83%)had been vaccinated with live attenuated vaccine. A total of 8 480 doses of vaccines were administered to 926 children,including 6 770 doses of inactivated vaccines and 1 770 doses of attenuated live vaccines. Adverse reactions occurred in 62 children after 68 doses of vaccination(including 15 cases of local reactions and 53 cases of systemic reactions),with a total incidence of 8. 02 ‰(68/8480). The incidences of inactivated vaccine and attenuated live vaccine were 6. 79 ‰(46/6 770)and 1. 29%(22/1710),respectively. All cases of adverse reactions were treated and basically cured,with a cure rate of 98. 53%(67/68),except for the case of dry mouth. Conclusions Most of the healthy special children can be vaccinated after medical evaluation,and the risk of adverse reactions after vaccination is controllable.

目的 了解广州市某三甲综合医院2016—2022年住院病例的疾病分布特征,探究新型冠状病毒感染（新冠）疫情对疾病谱的影响,为医院合理配置医疗资源、提高医院医疗水平提供参考。方法 回顾性收集广州市某三甲综合医院2016—2022年间住院病例的病例数据,按照ICD-10国际统计分类标准进行分类,建立Joinpoint回归模型对不同类别疾病构成比的时间变化趋势进行分析。结果 2016—2022年间,前12顺位的疾病种类不变,构成比呈上升趋势的有4种,分别是循环系统疾病、肿瘤、消化系统疾病以及眼和附器疾病,构成比呈下降趋势的有3种,分别是呼吸系统疾病、肌肉骨骼系统和结缔组织疾病以及妊娠、分娩和产褥期。对这7类系统疾病进行不同性别、不同年龄段和不同居住地（广州市内/市外）的亚组分析,结果显示,除眼和附器疾病与妊娠、分娩和产褥期外,其余5种系统疾病在男性和女性中变化趋势比较差异无统计学意义（均P>0.05）。25岁以上人群循环系统疾病、肿瘤和消化系统疾病比例呈上升趋势。45岁以上人群眼和附器疾病的住院比例逐年上升。呼吸系统疾病的下降趋势集中出现在0~5岁和65岁以上人群,肌肉骨骼系统和结缔组织疾病的下降趋势可在45岁以上人群中被观测到,妊娠、分娩和产褥期的下降趋势则可在45岁以下人群中被观测到。总体和市内来源的住院病例的各系统疾病构成比变化趋势均未发现有2019年的连接拐点。但对于居住地在广州市外的病例,有6种系统疾病均存在一个2019年的连接拐点,与2016—2019年相比,2020—2022年增长趋势普遍减弱或者略有降低,但均无统计学意义,2022年市外来源住院病例的多种疾病占比低于2019年。≤24岁年龄组的病例因妊娠、分娩和产褥期住院的比例在2019年以后降低趋势加快,但也无统计学意义,2020—2022年≤24岁人群因妊娠、分娩和产褥期住院的比例低于2019年水平。结论 2016—2022年期间住院病例疾病谱有较大变化,这种变化趋势在不同性别、不同年龄段和居住地间效应存在差异。2020—2022年的新冠疫情流行主要降低了居住地在广州市外的住院病例多个系统疾病的比例以及24岁及以下患者因妊娠、分娩和产褥期住院的比例。

Objective To understand the disease distribution characteristics of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022,to explore the impact of the COVID-19 on the disease spectrum,and to provide reference for hospitals to reasonably allocate medical resources and improve medical level. Methods Inpatient case data of a 3-A-grade general hospital from 2016 to 2022 were retrospectively collected and were classified according to the ICD-10 international statistical classification standard. A Joinpoint regression model was established to analyze the temporal trend of disease composition ratios in different categories. Results From 2016 to 2022,the type of top 12 diseases remained unchanged. There were 4 diseases showing an upward trend in composition,namely circulatory system diseases,tumors,digestive system diseases and eye and accessory organ diseases. There were 3 diseases showing a downward trend in composition,namely respiratory system diseases,musculoskeletal system and connective tissue diseases,as well as pregnancy,childbirth and postpartum period. A subgroup analysis was conducted on these 7 types of systemic diseases by gender,age group and place of residence(within/outside Guangzhou). The results showed that except for eye and accessory organ diseases and pregnancy,childbirth and postpartum period,there was no significant difference in the trend of changes in the other 5 systemic diseases between males and females(all P>0. 05). The upward trend of circulatory system diseases,tumors and digestive system diseases could be observed in people over the age of 25. The hospitalization rate of eye and accessory organ diseases among people over 45 years old was increasing year by year. The downward trend of respiratory diseases was concentrated in people aged 0~5 and over 65 years old,while the downward trend of musculoskeletal and connective tissue diseases could be observed in people aged 45 and above. The downward trend of pregnancy,childbirth and postpartum period could be observed in people under 45 years old. The trend of changes in the proportion of systemic diseases among inpatient cases from both overall and within Guangzhou had not been found to have a joinpoint in 2019. However,for cases residing outside of Guangzhou,there were six systemic diseases that all had a joinpoint in 2019. Compared with the growth trend from 2016 to 2019,the growth trend from 2020 to 2022 generally weakened or showed a slightly downward trend,but none of them were statistically significant. In 2022,the proportion of multiple diseases in hospitalized cases from outside Guangzhou was lower than that in 2019. The proportion of cases in the age group ≤24 years old who are hospitalized due to pregnancy,childbirth and postpartum period has been decreasing rapidly since 2019,but there was no statistical significance. The proportion of cases hospitalized due to pregnancy,childbirth and postpartum period in the population ≤24 years old from 2020 to 2022 was significantly lower than the level in 2019. Conclusions The disease spectrum of inpatients had undergone significant changes between 2016 and 2022,and these trends of changes were different among different genders,age groups and places of residence. The prevalence of the COVID-19 from 2020 to 2022 mainly reduced the proportion of inpatients with multiple systemic diseases living outside Guangzhou,and the proportion of inpatients aged 24 and under hospitalized for pregnancy,childbirth and puerperium.

目的 采用体外试验的方法,研究弱酸性培养对人正常食管内皮细胞（HEEC）活力的影响及潜在的调控机制。方法 细胞培养液的pH值分别设为（6.0~6.5）和（7.0~7.4）。以中性培养组为对照。利用CCK8实验,检测弱酸培养条件下,不同时间点食管内皮细胞活力的变化。采用蛋白免疫印迹法检测p38和磷酸化p38（p-p38）的表达。利用酶联免疫吸附剂测定法检测培养基上清液中IL-1β和IL-8的表达水平,并检测加入p38激酶活性抑制剂SBS 203580后两者浓度的变化。结果 弱酸环境下,细胞活力下降。培养1 h时,弱酸组细胞活力为（96.4±8.0）%,培养3 h和6 h时分别为（88.7±6.2）%和（87.7±7.4）%。细胞中p38的水平与培养基的pH值无关。弱酸培养可以促使细胞内p-p38的含量增加。基线时,弱酸组p-p38的灰度值比值为（0.37±0.02）,在培养2 h和6 h时分别为（0.64±0.09）、（0.84±0.11）,差异显著（P<0.01）。弱酸刺激诱导食管内皮细胞表达更多的IL-8和IL-1β。基线时弱酸组上清液中IL-8和IL-1β的浓度分别为（8.64±1.31）pg/mL,（3.35±0.49）pg/mL。培养6 h后,二者的浓度分别上升至（36.85±2.02）pg/mL和（19.19±1.60）pg/mL,差异显著（P<0.01）。加入SBS 203580后,IL-8和IL-1β的浓度明显下降（P<0.05）。结论 弱酸刺激可以降低食管内皮细胞的活力。p38 MAPK可能通过调控IL-8和IL-1β的表达参与该调节过程。

Objective To study the effect of weak acidic culture on the viability of normal human esophageal endothelial cells(HEEC)and the potential regulatory mechanisms. Methods The pH values of cell culture medium were set at(6. 0-6. 5)and(7. 0-7. 4),respectively. The group in neutral medium was set as control. CCK8 experiment was used to detect the change of cell viability at different time points. The expressions of p38 and phosphorylated p38(p-p38)were detected by Western Blot experiment. Enzyme linked immunosorbent assay was used to detect IL-1β and IL-8 concentration in the medium supernatant before and after adding p38 activity inhibitor(SBS 203580). Results HEEC viability was decreased under weak acidic conditions. After 1 hour of cultivation,the HEEC viability was(96. 4±8. 0)%,after 3 and 6 hours,it decreased to(88. 7±6. 2)% and(87. 7±7. 4)%,respectively. The level of p38 in cells was independent of culture medium pH values. Weak acidic stimulation could promote an increase of p-p38 in HEEC. At baseline,the gray value ratio of p-p38 in the weak acidic group was(0. 37±0. 02),and after 2 and 6 hours of culturing,it increased to(0. 64±0. 09)and(0. 84±0. 11),respectively,which differences were significant(P<0. 01). More IL-8 and IL-1β were expressed after weak acidic stimulation. At baseline,the concentrations of IL-8 and IL-1β in the medium supernatant of weak acidic group were(8. 64±1. 31)pg/mL and(3. 35±0. 49)pg/mL. After 6 hours of culturing,they increased significantly to(36. 85±2. 02)pg/mL and(19. 19±1. 60)pg/mL(P<0. 01),while the concentrations were decreased after adding SBS 203580(P<0. 05). Conclusions The HEEC viability was reduced by weak acidic stimulation,p38 MAPK may participate in the process by regulating the expression of IL-8 and IL-1β.

严重烧伤后患者免疫功能的失调,易导致创面感染、全身炎症反应综合征、脓毒症、感染性休克等并发症,增加患者病死率。免疫细胞功能适度的活化将有助于烧伤患者抵御外界病原体的侵袭、促进创面的愈合,但功能过度激活或者功能低下,则会引发一系列严重的后果。本文旨在归纳严重烧伤后中性粒细胞、单核/巨噬细胞、肥大细胞、NK细胞及T淋巴细胞等免疫细胞的功能变化与炎症反应之间的关系,为完善烧伤患者诊疗、减少并发症、改善预后提供新的思路。

The imbalance of immune function in severely burned patients can easily lead to wound infection,systemic inflammatory response syndrome,sepsis,septic shock and other complications,which increase the mortality of patients. Moderate activation of immune cell function will help burned patients to resist the invasion of external pathogens and promote wound healing,but excessive activation or low function can lead to a series of serious consequences. The purpose of this paper is to summarize the relationship between the functional changes of immune cells such as neutrophils,monocytes/macrophages,mast cells,NK cells,T lymphocytes and inflammatory reaction after severe burns,and to provide new ideas for improving the diagnosis and treatment of burned patients,reducing complications and improving the prognosis.