目的 探究冠心病患者血清同型半胱氨酸(HCY)、血红素加氧酶-1(HO-1)水平与冠状动脉Gensini积分的相关性,并对其进行分析与探讨。方法 随机选取2020年3月—2021年7月于我院心内科行冠脉造影确诊的冠心病患者108例作为观察组和同期于我院行冠脉造影排除冠心病的健康人群33例作为对照组。根据冠心病患者的Gensini积分将其分为低分组(n=42)、中分组(n=35)和高分组(n=31)。对比观察组与对照组2组研究对象血清HCY、HO-1水平差异,冠心病患者的血清HCY、HO-1水平与Gensini积分的相关性通过Pearson相关分析法分析。结果 观察组血清HCY水平高于对照组(P＜0.05);观察组血清HO-1水平低于对照组血清HO-1水平(P＜0.05)。高分组血清HCY水平高于中分组和低分组(P＜0.05);高分组血清HO-1水平低于中分组和低分组(P＜0.05)。血清HCY水平与Gensini积分呈正相关(P＜0.05),血清HO-1水平与Gensini积分呈负相关(P＜0.05)。结论 血清HCY、HO-1水平与冠心病患者Gensini积分密切相关。

Objective To investigate the correlation between serum homocysteine (HCY), heme oxygenase-1 (HO-1) levels and coronary Gensini score in patients with coronary artery disease. Methods One hundred and eight patients with coronary artery disease diagnosed by coronary angiography in the cardiology department of our hospital from March 2020 to July 2021 were randomly included in observation group, while 33 healthy people without coronary artery disease confirmed by coronary angiography in our hospital during the same period as the control group. The 108 patients with coronary artery disease were divided into low (n=42), medium (n=35) and high (n=31) groups by coronary Gensini score. The differences in serum HCY and HO-1 levels between observation group and control group were compared, and the correlation between serum HCY, HO-1 levels and coronary Gensini score was analyzed by Pearson correlation analysis. Results The serum HCY level of the observation group was higher than that of the control group (P<0.05); the serum HO-1 level of the observation group was lower than that of the control group (P<0.05). The serum HCY level in the high group was higher than the middle group and low group (P<0.05); the serum HO-1 level in the high group was lower than the middle group and low group (P<0.05). Serum HCY level was positively correlated with coronary Gensini score (P<0.05), and serum HO-1 level was negatively correlated with coronary Gensini score (P<0.05). Conclusions Serum HCY and HO-1 levels were closely correlated with coronary Gensini score in patients with coronary artery disease.

目的 分析妊娠期肝内胆汁淤积症(ICP)孕妇与正常孕妇围产结局及ICP孕妇不同总胆汁酸水平对围产结局及新生儿的影响,为做好ICP孕妇的妊娠期管理及其新生儿预后评估提供参考依据。方法 以2010年3月—2020年3月在我院分娩的ICP孕妇 249例为观察组,同期分娩的249例正常孕妇为对照组,比较2组围产结局相关指标。结果 观察组羊水污染、新生儿黄疸、新生儿呼吸窘迫综合征发生率均高于对照组,根据总胆汁酸水平分组,重度组早产、羊水污染发生率高于轻度组,以上差异均有统计学意义(P＜0.05)。总胆汁酸水平是ICP孕妇发生早产的危险因素(P＜0.05)。结论 ICP孕妇总胆汁酸水平可用于发生早产的预测,及时干预有利于提高其围产期质量。

Objective To analyze the perinatal outcome of women with intrahepatic cholestasis of pregnancy (ICP) and normal pregnant women and the effects of different levels of total bile acid in ICP women on perinatal outcome and newborn. To provide a reference for the management of pregnancy and prognosis of ICP women. Methods From March 2010 to March 2020, 249 women with ICP delivered in our hospital were included as the observation group, 249 normal pregnant women delivered in the same period as the control group, the perinatal outcomes of the two groups were analyzed and compared. Results The incidences of amniotic fluid contamination, neonatal jaundice and neonatal respiratory distress syndrome in the observation group were higher than that in the control group. Grouping by the total bile acid level, the incidences of premature delivery and amniotic fluid contamination in the severe group were higher than that in the mild group, with statistical significance (P<0.05). Total bile acid level was a risk factor for premature delivery in women with ICP (P<0.05). Conclusions The level of total bile acid in women with ICP can be used to predict the occurrence of premature delivery, and timely intervention is beneficial to improve the perinatal quality of ICP women.

目的 分析人类疱疹病毒(EBV)致传染性单核细胞增多症(IM)患儿病毒量与临床特征的关系。方法 选取我院2016年1月—2021年1月收治的EBV定量阳性的IM患儿128例,按照患儿EBV含量分为低病毒量组(n=64)和高病毒量组(n=64)。比较不同病毒含量组患儿的症状体征、实验室检查及临床特征,并分析具有统计学差异的指标与病毒量之间的相关性。结果 高EBV含量组患儿丙氨酸氨基转移酶、乳酸脱氢酶、血沉、外周血白细胞计数指标水平均高于低EBV含量组(P<0.05)。患儿的退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间均随着EBV含量的增加而延长(P<0.05)。EBV含量与退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间成正相关(r=0.453,0.458,0.402,0.415,P<0.05)。结论 EBV含量越高,IM患儿住院时间及临床指标恢复时间越长,因此临床治疗IM患儿时可以根据EBV含量的高低进行病情评估。

Objective To analyze the relationship between viral load and clinical characteristics in children with infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV). Methods A total of 128 children with IM who tested positive for EBV and admitted to our hospital from January 2016 to January 2021 were selected and divided into low virus group (n=64) and high virus group (n=64) according to their EBV level. The symptoms and signs, laboratory examinations and clinical characteristics of two groups were compared, and the correlation between the statistically different indicators and the amount of virus were analyzed. Results In children with high EBV level, the levels of alanine aminotransferase, lactate dehydrogenase, erythrocyte sedimentation rate, and peripheral blood white blood cell count were higher than low EBV level group (P<0.05). The time of fever, lymph node shrinkage, hepatosplenomegaly to subside, and hospitalization time of the children were all prolonged with the increase of EBV level (P<0.05). The level of EBV was positively correlated with the time to allay fever, the time to shrink the lymph nodes, the time to improve hepatosplenomegaly, and the length of hospital stay (r=0.453, 0.458, 0.402, 0.415,P<0.05). Conclusions The higher EBV level, the longer hospitalization time and recovery time of clinical indicators in children with IM. Therefore, the disease assessment of children with IM can be based on EBV level.

目的 探讨肠道病毒相关性脑炎患儿的临床特点;以期能为临床医师对该病的认识提供一定的帮助。方法 回顾性分析2018年1月—2019年12月广州市妇女儿童医疗中心感染科收治的37例肠道病毒相关性脑炎患儿的临床相关资料。结果 37例患儿男28例,女9例,男女比例3.11:1。主要临床症状体征发热(97.30%)、口腔疱疹和(或)皮疹(54.05%);常见神经系统症状呕吐(56.76%)、头痛(56.76%)、惊厥(29.72%),其中惊厥及呕吐头痛症状≤1岁组与其他年龄组差异有统计学意义;脑脊液检查白细胞升高为主;所有患儿均康复出院且无神经系统后遗症。结论 儿童肠道病毒相关性脑炎近一半患儿临床无咽部疱疹或皮疹表现,1岁以内患儿主要以发热及惊厥为主要表现,大于1岁尤其学龄前期及学龄期患者以发热呕吐伴头疼为主要表现;早期诊治预后良好。

Objective To explore the clinical characteristics of children with enterovirus associated encephalitis, in order to provide some help for clinicians to understand the disease. Methods The clinical data of 37 children with enterovirus related encephalitis treated in the infection department of Guangzhou Women and Children's Medical Center from January 2018 to December 2019 were analyzed retrospectively. Results There were 28 males and 9 females, with a male to female ratio of 3.11:1. The main clinical symptoms and signs were fever (97.30%), oral herpes and/or rash (54.05%); the common nervous system symptoms were vomiting (56.76%), headache (56.76%) and convulsion (29.72%). There were significant differences in convulsion, vomiting and headache symptoms between ≤ 1 year old group and other age groups. The leukocytes level in cerebrospinal fluid was elevated. All children recovered and discharged without neurological sequelae. Conclusions Nearly half of children with enterovirus associated encephalitis had no clinical manifestations of pharyngeal herpes or rash. The main manifestations of children under 1 year old were fever and convulsion. The main manifestations of children over 1 year old, especially preschool and school-age patients, were fever and vomiting with headache. Early diagnosis and treatment had good prognosis.

目的 探究液基细胞学检查联合鳞状上皮细胞癌抗原(SCCA)、癌抗原153(CA153)检测对宫颈癌诊断价值。方法 对子宫颈上皮内瘤变患者54例(内瘤变组)、子宫颈癌患者54例(宫颈癌组)及健康体检者54例(对照组)进行液基细胞学、血清SCCA、血清CA153进行检测,以病理活检诊断为金标准。分析液基细胞学检查、血清中SCCA、血清中CA153对宫颈癌诊断价值,并分析联合液基细胞学检查与血清中SCCA、血清中CA153检测的临床价值。结果 内瘤变组和宫颈癌组血清SCCA、CA153水平均高于对照组,宫颈癌组血清SCCA、CA153水平高于内瘤变组(P均<0.05)。单项检测中,液基细胞学检查阳性率高于SCCA、CA153,联合检测阳性率与其他各单项检测相比明显提高(P<0.05)。结论 宫颈癌患者体内SCCA、CA153水平高,液基细胞学检查联合SCCA、CA153检测对宫颈癌早期阳性检出率高。

Objective To explore the diagnostic value of liquid-based cytology combined with squamous cell carcinoma antigen (SCCA) and cancer antigen 153 (CA153) detection in patients with cervical cancer. Methods Liquid-based cytology, serum SCCA, and serum CA153 were detected on 54 patients with cervical intraepithelial neoplasia (neoplasia group), 54 patients with cervical cancer (cancer group), and 54 healthy subjects (control group). Pathological biopsy diagnosis was used as the gold standard. The diagnostic value of liquid-based cytology, serum SCCA, and serum CA153 in cervical cancer was analyzed, and the clinical value of combining liquid-based cytology with serum SCCA and serum CA153 detection was also analyzed. Results The levels of serum SCCA and CA153 in neoplasia group and cancer group were higher than those in control group, and the serum SCCA and CA153 levels in the cancer group were higher than those in the neoplasia group (P<0.05). In the single detection, the positive rate of liquid-based cytology was higher than that of serum SCCA and CA153, and the positive rate of combined detection was significantly higher than those of the single detection (P<0.05). Conclusions Cervical cancer patients have high levels of serum SCCA and CA153. Liquid-based cytology combined with SCCA and CA153 detection has high positive rate for early cervical cancer.

目的 探讨新冠疫情影响下日间手术制度在乳腺外科住院模式中的应用情况。方法 2021年1月—12月广州市第一人民医院实施日间手术制度,对乳腺外科30张床位实施预约管理,依据患者病情进行日间手术预约,合理安排患者入院。结果 2021年1月—12月我院乳腺外科共入院2 787人/次,手术人数1 497人,其中日间手术720台,占比48.10%。结论 日间手术制度可提升了医院手术服务能力,增加手术量,缩短了平均住院日,为患者提供方便、高效的医疗服务,值得基层医院推广。

目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ²检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。

Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ² test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.

目的 探究与分析化脓性阑尾炎抗生素治疗后不同时机腹腔镜阑尾切除术的疗效及预后。方法 研究于2019年1月—2021年1月进行,我院收治的96例化脓性阑尾炎患者为此研究的参与对象,接受抗生素治疗≤72 h后手术的患者为观察组(n=38),>72 h的患者为对照组(n=38)。对比2组患者的指标。结果 2组的手术时间等相较均无差异(P>0.05);观察组的住院时间及住院费用均短于或少于对照组(P<0.05)。观察组术前中性粒细胞比例及白细胞计数高于对照组(P<0.05);术后2组患者组间无差异(P>0.05)。观察组的腹腔渗液阳性率低于对照组(P<0.05)。2组并发症发生率比较,组间无差异(P<0.05)。结论 化脓性阑尾炎患者经抗生素治疗后续尽早接受手术治疗。

目的 介绍基层妇幼保健院成功开展126例小儿先天性心脏病(先心病)外科治疗经验。方法 2018年9月开始,在基层妇幼保健院设立小儿先心病治疗中心,开展小儿先心病外科治疗。结果 共收治126例小儿先心病患儿进行先心病手术治疗,全部痊愈出院。结论 在有经验的先心病治疗中心的协助下,基层妇幼保健院可以成功开展小儿先心病外科治疗。

目的 利用网络药理学技术,分析黄甲软肝颗粒治疗肝纤维化的作用网络,以及黄甲软肝颗粒治疗肝纤维化的潜在作用机制,并在体内动物实验进行初步验证。方法 采用中药系统药理学分析平台中寻找黄甲软肝颗粒中10味中药相关的化学成分和作用靶点,通过GeneCards等数据库筛选肝纤维化疾病相关的靶标;对药物与疾病靶点相映射得到黄甲软肝颗粒治疗肝纤维化的作用靶点,运用cytoscape将疾病靶点与复方活性成分靶点的交集-交集部分对应的活性成分”构建“C(成分)-T(靶点)”作用网络。将交集靶点利用 DAVID数据库进行GO富集分析和KEGG富集分析,以获得其潜在作用机制。最后,通过黄甲软肝颗粒防治CCl₄导致SD大鼠肝纤维化的体内实验进行初步验证,考察末次给药后大鼠体质量和肝脏指数,采用微板法检测SD大鼠血清中天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平,苏木精-伊红染色观察肝脏病理学变化。结果 预测筛选得到黄甲软肝颗粒共有117个潜在活性成分,266个活性成分对应靶点,161个交集靶点,关键成分有槲皮素、山奈酚、丹参酮IIA、芒柄花黄素等,关键靶点有PTGS2、PTGS1、NCOA1、ACHE、HTR、RXRA、ADRB2、IL1B等。GO 分析共包含 960条富集结果,其中生物过程845 条,分子功能 63条,细胞组成 52 条;KEGG 分析共得出68条通路,与本次研究较相关的通路主要包括TNF信号通路、Toll样受体信号通路、Rap1信号通路、胞质DNA传感途径、ErbB信号通路、VEGF信号通路等。体内动物实验研究表明,黄甲软肝颗粒能显著降低大鼠的肝脏指数和血清ALT、AST,改善肝组织病理学指标。结论 黄甲软肝颗粒可通过多成分、多途径、多靶点协同发挥治疗肝纤维化的作用,本研究为黄甲软肝颗粒治疗肝纤维化疾病的物质基础、作用机制及临床应用的进一步研究奠定基础。

Objective To analyze the effective network of Huangjia Ruangan Granules in treating liver fibrosis and its potential mechanism by using network pharmacology, and preliminary verify by animal in vivo experiments. Methods From the Chinese Medicine System Pharmacology Analysis Platform, we searched for the chemical constituents and targets of 10 Chinese herbs in Huangjia Ruangan Granules, and screened the targets related to liver fibrosis diseases through GeneCards and other databases. The drug and disease target were mapped to the target of Huangjia Ruangan Granules for the treatment of liver fibrosis, and the active component corresponding to the intersection of the disease target and the compound active component target was constructed using cytoscape “C (component)-T (target)” action network. The intersection target was used for GO enrichment analysis and KEGG enrichment analysis with DAVID database to obtain its potential mechanism of action. Finally, through the in vivo experiment of using Huangjia Ruangan Granules to prevent and treat CCl₄ leaded liver fibrosis in SD rats, the rats' body weight and liver index after the last dose were recorded, and the levels of aminotransferase (AST) and alanine aminotransferase (ALT) in the serum of SD rats were detected by the microplate method, hematoxylin-eosin staining were used to observe liver pathological changes. Results Predictive screening showed that Huangjia Ruangan Granules had 117 potential active ingredients, 266 active ingredients corresponded to targets, and 161 intersection targets. The key ingredients was quercetin, kaempferol, tanshinone IIA, formononetin, etc. The key targets were PTGS2, PTGS1 NCOA1, ACHE, HTR, RXRA, ADRB2, IL1B, etc. GO analysis showed a total of 960 enrichment results, including 845 biological processes, 63 molecular functions, and 52 cell compositions; KEGG analysis revealed a total of 68 pathways, the related pathways included TNF signaling pathway, Toll-like receptor signaling pathway, Rap1 signaling pathway, cytoplasmic DNA sensing pathway, ErbB signaling pathway and VEGF signaling pathway, etc. In vivo animal experiments had shown that Huangjia Ruangan Granules could significantly reduce the liver index and serum ALT and AST levels of rats, and improve liver histopathological indicators. Conclusions Huangjia Ruangan Granules treated liver fibrosis through multi-component, multi-pathway and multi-target synergy. This research laid the groundwork for the material basis, mechanism and clinical application of Huangjia Ruangan Granules in treating liver fibrosis diseases.