目的 利用分析各种浓度环氧化酶-2(COX-2)特异度抑制剂塞来昔布对食管癌EC109细胞系的作用,进而对COX-2蛋白表达的影响及对细胞凋亡能力的作用,进一步探讨塞来昔布对食管癌细胞凋亡的作用及机制。方法 使用0 μmol/L、20 μmol/L、60 μmol/L、100 μmol/L四个浓度的塞来昔布处理EC109细胞24 h,酶联免疫吸附剂测定(ELISA)法测定COX-2蛋白表达;流式细胞仪测定EC109细胞凋亡情况。结果 与0 μmol/L塞来昔布组比较,20 μmol/L、60 μmol/L、100 μmol/L塞来昔布组EC109细胞内COX-2蛋白表达不断降低(1.581±0.116;1.226±0.089,0.846±0.076,0.521±0.082)(P<0.05);而细胞凋亡率逐步上升(1.700±0.557,13.400±1.735,18.766±1.301,28.100±1.997)(P<0.05)药物浓度依赖于梯度。结论 塞来昔布是一种COX-2抑制剂,可能以浓度梯度的形式抑制COX-2蛋白的表达,从而促进EC109细胞的凋亡。

Objective The effects of celecoxib, a specific COX-2 inhibitor at various concentrations, on EC109 cell line of esophageal cancer were analyzed, and the effect and mechanism of celecoxib on apoptosis of esophageal carcinoma cells were further studied. Methods EC109 cells were treated with celecoxib at concentrations of 0 μmol/L, 20 μmol/L, 60 μmol/L and 100 μmol/L for 24 h. The protein of COX-2 in EC109 cells was determined by enzyme-linked immunosorbent assay (ELISA). Assay of EC109 cell apoptosis were determined by flow cytometry. Results Compared with the 0μmol/L celecoxib group, the expression of COX-2 protein in EC109 cells of 20μmol/L, 60μmol/L, 100μmol/L celecoxib group gradually decreased(1.581±0.116; 1.226±0.089, 0.846± 0.076, 0.521±0.082) (P<0.05); and the apoptotic rate gradually increased (1.700±0.557; 13.400±1.735, 18.766±1.301, 28.100±1.997) (P<0.05) in a drug concentration gradient-dependent manner. Conclusion The COX-2 inhibitor celecoxib may inhibit the expression of COX-2 protein in a concentration gradient and promote the apoptosis of esophageal cancer EC109 cells.

目的 探讨睫毛蠕形螨感染与睑板腺功能障碍(meibomian gland dysfunction,MGD)发生的相关性,并分析睫毛蠕形螨感染对MGD患者眼表症状跟体征的影响。方法 前瞻性队列研究。选取2018年7月—2019年3月在广州市第一人民医院眼科门诊诊断为MGD患者47例,按照年龄将MGD患者分别纳入MGD＜40岁组(A₁组,28例)和MGD＞60岁组(B₁组,19例)。根据蠕形螨检测结果将MGD患者分别纳入蠕形螨检出阳性组(Ⅰ组,22例)与蠕形螨检出阴性组(Ⅱ组,25例)。同时,选取无MGD正常人或仅患屈光不正、玻璃体混浊的患者共49例,按照年龄将其分别纳入NMGD＜40岁组(A₂组,30例)和NMGD＞60岁组(B₂组,19例)。主要统计受试者眼部症状(眼痒、眼痛、眼干、异物感、视物模糊)发生率、睫毛蠕形螨检出数量及检出率、睑板腺排出能力评分、睑板腺分泌物性状评分及眼表疾病指数(Ocular Surface Disease Index,OSDI)。结果 MGD＜40岁组(A₁组)与NMGD＜40岁组(A₂组)睫毛蠕形螨检出数量分别为(1.14±1.938)、(0.17±0.531)只,差异有统计学意义(P=0.003,＜0.05),睫毛蠕形螨检出阳性率分别为43%、10%,差异有统计学意义(P=0.006,＜0.05);MGD＞60岁组(B₁组)与NMGD＞60岁组(B₂组)睫毛蠕形螨检出数量分别为(1.89±2.331)、(0.68±1.529)只,差异没有统计学意义(P＞0.05),睫毛蠕形螨检出阳性率分别为53%、21%,差异没有统计学意义(P＞0.05); MGD患者睫毛蠕形螨检出阳性组(Ⅰ组)与MGD患者睫毛蠕形螨检出阴性组(Ⅱ组)睑板腺分泌物性状评分分别为(3.00±1.11)、(2.28±1.28),差异有统计学意义(P＝0.047,＜0.05);Ⅰ组OSDI、睑板腺排出能力评分、眼干、眼痛、眼痒、异物感以及视物模糊发生率与Ⅱ组相比,差异均不具有统计学意义(P＞0.05);MGD组文化水平与NMGD组相比,差异没有统计学意义(P=0.382,＞0.05)。结论 首先,在40岁以下人群中,睫毛蠕形螨与MGD形成有一定相关性;而在60岁以上人群中,相较于其他影响因素,睫毛蠕形螨对MGD形成的作用并不显著,表明睫毛蠕形螨对MGD形成的影响主要体现在中青年时期,且随着年龄增长,二者之间的关联性进一步降低。另外,睫毛蠕形螨感染与MGD患者发生眼痛、眼干、眼痒、异物感以及视物模糊这些眼部症状和睑板腺分泌功能受损没有相关性。

Objective To investigate the correlation between eyelash Demodex infection and meibomian gland dysfunction (MGD) and to analyze the effect of eyelash Demodex infection on ocular surface symptoms and signs in patients with MGD. Methods Prospective cohort study. 47 patients with MGD diagnosed in the ophthalmology clinic of Guangzhou First People's Hospital from July 2018 to March 2019 were selected. The MGD patients were assigned to the MGD＜40 years old group (A₁ group, n=28) and MGD＞60 years old Group (B₁ group, n=19) according to the age. According to the Demodex test results, MGD patients were assigned to the Demodex-positive group (I group, n=22) and the Demodex-negative group (II group, n=25). At the same time, 49 patients without MGD or only with ametropia and vitreous opacity were selected and assigned to the NMGD＜40 years old group (A₂ group, n=30) and NMGD＞60 years old group (B₂ group, n=19) according to their age. The incidence of ocular symptoms (itchiness, pain, dryness, foreign body perception, and blurred vision), the number and rate of detection of eyelash Demodex, meibomian gland ejection score, meibomian gland secretion score, and Ocular Surface Disease Index (OSDI) were analyzed. Results The number of eyelash Demodex was (1.14±1.938) in MGD＜40 years old group (A₁ group) and (0.17±0.531) in NMGD＜40 years old group (A₂ group). The difference in the number of eyelash Demodex between these two groups was found to be statistically significant (P=0.003,＜0.05). The positive rate of eyelash Demodex was 43 % in MGD＜40 years old group (A1 group) and 10% in NMGD＜40 years old group (A₂ group). The difference in the positive rate of eyelash Demodex between these two groups was found to be statistically significant (P=0.006,＜0.05). The number of eyelash Demodex in MGD＞60 years old group (B₁ group) was (1.89±2.331) and in NMGD＞60 years old group (B₂ group) was (0.68±1.529). The difference in the number of eyelash Demodex between these two groups was not statistically significant(P>0.05). The positive rate of eyelash Demodex was 53 % in MGD＞60 years old group (A₁ group) and 21% in NMGD＞60 years old group (A₂ group). The difference in the positive rate of eyelash Demodex between these two groups was not statistically significant (P>0.05). The score of the meibomian gland secretion in the MGD with eyelash Demodex group (I Group) was (3.00±1.11) and in the MGD without eyelash Demodex group (II group) was (2.28±1.28). The difference in the score of the meibomian gland secretion between these two groups was found to be statistically significant (P=0.047<0.05). The differences of the OSDI score, the meibomian gland discharge ability score, the incidence rate of dry eye, eye pain, eye itching, foreign body sensation and blurred vision between these two groups were not statistically significant (P>0.05). The difference in the culture level between the MGD group and the NMGD group was not statistically significant (P=0.382, >0.05). Conclusion First, in the population under 40 years old, eyelash Demodex is correlated with MGD. Then in the population over 60 years old, the effect of eyelash Demodex on the formation of MGD compared with other influencing factors is not significant. The results indicated that the effect of eyelash Demodex was mainly reflected in the middle and young age, and the correlation between them was further reduced with the increase of age. In addition, in MGD patients, eyelash Demodex infection was not significantly correlated with the incidence of eye pain, eye dryness, eye itching, foreign body sensation, and blurred vision, as well as the degree of impairment of meibomian gland secretion function.

目的 探究妊娠期糖尿病(GDM)对母婴分娩结局的影响及导致不良分娩结局的相关影响因素。方法 采用现况调查的方法,通过现场问卷调查的形式,收集2017年9月—2017年11月在广州市妇女儿童医疗中心分娩并且在本院孕检的产妇的临床资料。根据是否患有妊娠期糖尿病,把调查对象分为妊娠期糖尿病组与非妊娠期糖尿病组。定量资料采用t检验或秩和检验,定性资料采用卡方检验或非参数检验,采用logistic回归模型分析不良分娩结局的相关影响因素。结果 在882例调查对象中,GDM孕妇共173例(19.6%)。研究结果表明,GDM孕妇与正常孕妇剖宫产率和住院天数差异有统计学意义(P<0.05),GDM组剖宫产率和住院天数增加,GDM产妇胎儿心脏畸形的风险增加(P<0.05)。Logistic回归分析结果提示孕妇孕次≥3次(OR值为0.399,95%CI为0.189~0.840,P=0.016)、产2次(OR值为0.283,95%CI为0.158~0.507,P<0.001)、产3次或以上(OR值为0.241,95%CI为0.112~0.520,P<0.001)、分娩孕周<37周(OR值为0.380,95%CI为0.180~0.804,P=0.011)是孕妇剖宫产的影响因素;分娩孕周<37周(OR值为16.028,95%CI为7.013~36.629,P<0.001)是孕妇住院天数>5天的影响因素。结论 妊娠期糖尿病可增加孕妇剖宫产率、住院天数以及胎儿心脏畸形的发生率;怀孕3次或以上的孕妇采用剖宫产的可能性与怀孕1次的孕妇相比风险降低;分娩2次或以上的孕妇采用剖宫产的可能性与分娩1次的孕妇相比风险降低;分娩孕周<37周的孕妇采用剖宫产的可能性较分娩孕周≥37周孕妇降低;分娩孕周<37周使孕妇住院天数>5天的风险增加升高。

目的 研究喘憋性肺炎合并脓毒症患儿血清降钙素原(PCT)、C反应蛋白(CRP)水平的临床意义。方法 回顾性分析本院80例喘憋性肺炎患儿临床资料,根据是否合并脓毒症将80例患儿分为观察组(合并脓毒症,38例)和对照组(未合并脓毒症,42例)。比较两组患儿血清PCT、CRP水平,根据脓毒症严重程度将观察组患儿分为脓毒症组(14例)、严重脓毒症组(13例)及脓毒症休克组(11例),比较三组患儿血清PCT、CRP水平,记录患儿2周死亡率。分析血清PCT和CRP诊断喘憋性肺炎合并脓毒症患儿的准确性,探讨其判断预后的价值。结果 观察组患儿血清CRP和PCT水平高于对照组,差异均有统计学意义(P<0.05)。脓毒症休克组患儿血清CRP、PCT水平高于脓毒症组和严重脓毒症组,差异有有统计学意义(P<0.05)。严重脓毒症组患儿血清CRP和PCT均高于脓毒症组,差异有统计学意义(P<0.05)。80例患儿中死亡7例,死亡率8.75%,血清CRP与PCT早期诊断喘憋性肺炎患儿合并脓毒症的AUC分别为0.729和0.743(95%CL=0.617~0.841,0.637~0.849,P均<0.001),联合诊断的AUC分别为0.876(95%CL=0.792~0.960,P<0.001)。血清CRP和PCT判断患儿预后的AUC分别为0.794和0.813(95%CL =0.584~1.000,0.000~1.000,P =0.012,0.007),联合检测判断患儿预后的AUC为0.832(95%CL=0.638~1.000,P<0.001)。结论 喘憋性肺炎合并脓毒症患儿血清CRP和PCT均异常升高,监测血清CRP和PCT有助于脓毒症的早期诊断和患儿预后判断。

目的 观察早期经鼻肠内营养(ENEN)对中-重度急性胰腺炎(MSAP+SAP)患者的治疗效果。方法 回顾性分析2014年9月—2019年5月期间,广东药科大学附属第一医院消化内科收治的50例MSAP及SAP患者临床资料,根据患者营养支持治疗方式不同,将患者分为观察组(n=25)和对照组(n=25)。观察组患者采用ENEN治疗,对照组采用肠外肠内营养联合(PNEN)治疗。对比两组患者治疗后血清白蛋白(ALB)、血清前白蛋白(PA)、C-反应蛋白(CRP)、急性生理与慢性健康(APACHE Ⅱ)评分、序贯器官功能衰竭(SOFA)评分及多器官功能障碍综合征(MODS)发生率。结果 经过治疗后,观察组患者ALB水平、PA水平高于对照组,CRP水平低于对照组,差异有统计学意义(P＜0.05)。经过治疗后,观察组患者APACHE Ⅱ评分、SOFA评分低于对照组,差异有统计学意义(P＜0.05)。经过治疗后,观察组患者MODS发生率低于对照组,差异有统计学意义(P＜0.05)。结论 ENEN治疗MSAP及SAP患者可有效改善患者营养状态和健康状况,降低机体炎症反应,减少MODS发生率。

Objective To observe the effect of early nasal enteral nutrition(ENEN) on patients with moderate to severe acute pancreatitis(MSAP+SAP). Methods A retrospective analysis of the clinical data of 58 patients with(MSAP+SAP) admitted to the department of gastroenterology, the First Affiliated Hospital of Guangdong Pharmaceutical University from September 2014 to May 2019, according to the different nutritional support treatment methods, the patients were divided into observation groups(n=25) and control group(n=25). Patients in the observation group were treated with ENEN, and the control group was treated with Parenteral nutrition and enteral nutrition(PNEN). Serum albumin(ALB), serum prealbumin(PA), C-reactive protein(CRP), acute physiology and chronic health evaluation(APACHE II) score, sequential organ failure assessment(SOFA) score, and incidence of multiple organ dysfunction syndrome(MODS) were compared between the two groups. Results After treatment, the ALB and PA level of the observation group were higher than those of the control group, and the CRP level was lower than that of the control group, the difference was statistically significant(P<0.05). After treatment, the APACHE II score and SOFA score of the observation group were lower than those of the control group, and the difference was statistically significant(P<0.05). After treatment, the incidence of MODS in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion ENEN treatment of MSAP and SAP may effectively improve the nutritional status and health of patients, reduce the body's inflammatory response and reduce the incidence of MODS.

目的 应用斑点追踪显像定量评价阻塞性睡眠呼吸暂停综合征患者的左心房功能,并进行对比研究。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。采用二维斑点追踪成像技术测量各组左心房相关应变参数:收缩期应变(Ss),舒张早期应变(Se),舒张晚期应变(Sa),左心房收缩期应变率(SRs),左心房舒张早期应变率(SRe),左心房舒张晚期应变率(SRa),分析并比较各组间参数的差异性。结果 随着疾病严重程度的增加Ss、SRs、Se、SRe呈逐渐减低的趋势,而Sa、SRa先升高后减低,差异有统计学意义(P<0.05)。结论 应用斑点追踪成像技术可在OSAS患者发生左心房重构前检测出心房功能的变化。

Objective The left atrial function of patients with obstructive sleep apnea syndrome was quantitatively evaluated by speckle tracing imaging and compared. Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index(AHI),including the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. Left atrial correlation strain parameters:systolic strain(Ss), early diastolic strain(Se), late diastolic strain(Sa), left atrial systolic strain rate(SRs), early diastolic strain rate(SRe), left atrium left atrium late diastolic strain rate(SRa) were measured by two dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results With the increase of disease severity, Ss, SRs, Se and SRe showed a trend of gradual decrease, while Sa and SRa increased first and then decreased, and the difference was statistically significant(P<0.05). Conclusion Changes in atrial function may be detected in OSAS patients prior to left atrial remodeling using speckle tracking imaging.

目的 探讨广州地区老年住院患者营养状态与日常生活能力(ADL)的相关性。方法 选取2018年7月—2019年6月在广州市第一人民医院住院年龄≥60岁的老年人共275例,收集其一般资料信息,各项临床营养指标(BMI、血清白蛋白、血红蛋白、总胆固醇、甘油三酯)、并运用营养风险筛查2002(NRS2002)评估营养风险、采用Barthel指数评定量表评估日常生活能力;分析老年住院患者营养状态与ADL之间的相关性。结果 在本组研究中,根据NRS2002评分(营养风险:NRS2002≥3;无营养风险NRS2002＜3),营养风险发生率58.9%(162/275);无营养风险发生率41.1%(113/275)。老年住院患者的NRS2002评分与ADL评分呈负相关关系(r=-0.393,P＜0.05);ADL评分与BMI、血清白蛋白、总胆固醇、血红蛋白水平呈正相关关系(P＜0.05)。结论 广州地区老年住院患者NRS2002为日常生活能力的影响因素,通过降低NRS2002评分来减少营养风险可改善老年人的日常生活能力;老年人的营养风险发生率高,应当尽早进行营养干预。

Objective To investigate relationship between nutritional status and activities of daily living(ADL) in elderly inpatients in Guangzhou. Methods Total of 275 people older than 60 were included in this study from Guangzhou First People's Hospital from July 2018 to June 2019. Their nutritional markers(including BMI, plasma albumin, hemoglobin, total cholesterol, triglyceride),the activities of daily living(ADL) were evaluated with Barthel index and the nutrition risk screening 2002(NRS2002)used to assess the nutritional risk status were collected to analyze the relationship between nutrition and ADL. Results In these subjects, based on the NRS2002 scores(nutritional risk that the NRS2002 scores were equal or greater than 3, and the non-nutritional risk that the NRS2002 scores were less than 3),58.9%(162/275) patients were having nutritional risk and 41.1%(113/275) were having non-nutritional risk. In elderly inpatients,NSR2002 were negatively associated with ADL(r=-0.393,P＜0.05). ADL was positively associated with BMI, plasma albumin and hemoglobin level(P<0.05). Conclusion In the old, the NRS2002 is an influencing marker of activities of daily living in Guangzhou. Reducing the nutritional risk by lowering the NRS2002 scores can improve ADL in the elderly. The incidence of nutritional risk is highly prevalent in elderly and early nutritional treatment will be needed.

目的 运用三维斑点追踪成像(3D-STE)技术,检测系统性红斑狼疮(SLE)患者的左室收缩期峰值应变(S)和应变率(Sr)及舒张指数,探讨其评价 SLE 患者左室整体收缩及舒张功能的临床应用价值。方法 选择 30 例 SLE 患者(SLE 组)和 30 例正常人(对照组),分别对其进行二维超声心动图和3D-STI检查,获取心尖四腔、两腔、三腔及心尖长轴二维超声及M型超声切面,测量左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左心室后壁舒张末期厚度(LVPWd)、左心室后壁收缩末期厚度(LVPWs)、左心室射血分数(LVEF)、左心室缩短分数(LVFS)、每搏输出量(SV)、左室舒张末期容积(EDV)、收缩末期容积(ESV)、心输出量(CO)、球形指数(SPI)、左室舒张末期质量(LV EDmass)、左室收缩末期质量(LV ESmass)。应用3D-STI行心肌运动分析, 测量左心室整体纵向、圆周、径向及面积收缩期峰值应变(GLS、GCS、GRS、GAS),经胸采集四维全容积图像,应用公式计算各方向相应的舒张期前1/3点时的应变显像舒张指数(SI-DI),公式为(SI-DI=(A-B)/A×100%)。应用统计学分析上述指标在各组间的差异性及其之间的相关性。结果 SLE 组超声心动图的测量数值(LVEF、 LVFS、SV、EDV、CO、LV EDmass、LV ESmass)较对照组降低,差异有统计学意义(P＜0.05),(LVEDd、LVEDs、IVSd、IVSs、LVPWd、LVPWs、ESV、SPI) 与对照组比较, 差异亦均无统计学意义(P＞0.05)。SLE组左心室 GLS、GCS、GRS、GAS均较对照组减低, 差异均有统计学意义(P<0.05)。GAS诊断SLE的敏感度为93.3%,高于GLS(80%)、GCS(66.7%)、GRS(86.7%),GCS诊断SLE的特异度为(93.3%),高于GLS(86.7%)、GAS(86.7%)和GRS(73.3%);应用公式计算得出,SLE组左心室L-SI-DI、C-SI-DI、R-SI-DI 及A-SI-DI均低于正常对照组,差异均有统计学意义(P<0.05);ROC 曲线显示C-SI-DI敏感度(93.3%)及L-SI-DI敏感度(86.7%)高于R-SI-DI(80.0%)、A-SI-DI(80.0%);A-SI-DI特异度(93.3%)及R-SI-DI特异度(93.3%)高于L-SI-DI(73.3%)、C-SI-DI(73.3%)。结论 SLE 患者左室总体收缩及舒张功能减低,4D-STI超声斑点追踪技术可早期检测 SLE 患者左心室收缩及舒张功能的异常。

Objective To detect left ventricular systolic peak strain(S), strain rate(Sr) and diastolic index in patients with systemic lupus erythematosus(SLE) by three-dimensional speckle tracking imaging(3D-STE), and to evaluate the left ventricular total in SLE patients and clinical application value of systolic and diastolic function. Methods Thirty patients with SLE(SLE group) and 30 normal controls(control group) were enrolled. Two-dimensional echocardiography and 4D-STI were performed to obtain sections of apical four-chamber, two-chamber, three-chamber and apical long axis of ultrasound and m-mode ultrasound. To measure left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), ventricular septal end-diastolic thickness(IVSd), ventricular septal end-systolic thickness(IVSs), left ventricular posterior wall diastolic end-stage thickness(LVPWd), left ventricular posterior wall end-systolic thickness(LVPWs), left ventricular ejection fraction(LVEF), left ventricular shortening fraction(LVFS), stroke volume(SV), left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), cardiac output(CO), spherical index(SPI), left ventricular end-diastolic mass(LV EDmass), left ventricular end-systolic mass(LV ESmass). 4D-STI myocardial motion analysis, the total longitudinal, circumferential, and radial and area systolic peak strains(GLS, GCS, GRS, GAS) of the left ventricle were measured, and the four-dimensional full-volume images were collected through the thoracic, and the formula was used to calculate the first 1/3 of the diastolic phase in each direction. The formula of strain imaging diastolic index(SI-DI) is(SI-DI=(AB)/A×100%). Statistical analysis was used to analyze the differences between the above indicators and the correlation between the groups. Results The measured values of two-dimensional echocardiography(LVEF, LVFS, SV, EDV, CO, LV EDmass, LV ESmass) in the SLE group were lower than those in the control group, and the difference was statistically significant(P＜0.05). In LVEDd, LVEDs, IVSd, IVSs, LVPWd, LVPWs, SPI, there were no significant differences compared with that of control group(P＞0.05). The left ventricular GLS, GCS, GRS, and GAS in the SLE group were lower than those in the control group. The differences were statistically significant(P<0.05). The sensitivity of GAS in the diagnosis of SLE was 93.3%, higher than GLS(80%), GCS(66.7%), and GRS(86.7%). The specificity of GCS for the diagnosis of SLE was(93.3%), higher than GLS(86.7%), GAS(86.7%) and GRS(73.3%). The left ventricle L-SI-DI, C-SI-DI, in the SLE group was calculated by the formula. R-SI-DI and A-SI-DI were lower than the normal control group, the difference was statistically significant(P<0.05);the ROC curve showed C-SI-DI sensitivity(93.3%) and L-SI-DI sensitivity(86.7%) was higher than R-SI-DI(80.0%), A-SI-DI(80.0%);A-SI-DI specificity(93.3%) and R-SI-DI specificity(93.3%) was higher than L-SI-DI(73.3%) and C-SI-DI(73.3%). Conclusion Total left ventricular systolic and diastolic function in patients with SLE are reduced. 4D-STI ultrasound speckle tracking technique can detect left ventricular systolic and diastolic dysfunction in patients with SLE.

目的 探究五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧影响的临床效果。方法 选择2018年4月—2019年8月我院收治的人流术后子宫复旧患者240例,随机分成两组,对照组进行常规术后处理,研究组则在常规术后处理的基础上进行五加生化胶囊联合热电复合治疗仪治疗。结果 研究组的术后疼痛症状评分低于对照组(P＜0.05);研究组的平均流血量、持续流血天数以及术后月经复潮天数均少于对照组(P＜0.05);研究组的子宫内膜厚度高于对照组(P＜0.05),且子宫纵径和横径短于对照组(P＜0.05)。结论 五加生化胶囊联合热电复合治疗仪对人流术后子宫复旧进行治疗具有良好效果,值得推广。

Objective To investigate the clinical effect of Wujia biochemical capsule combined with thermoelectric complex therapy instrument on uterine retroplasia after abortion. Methods 240 cases of uterine rehabilitation after abortion from April 2018 to August 2019 were selected and randomly divided into two groups. The control group were performed routine postoperative treatment, while the research group were performed five plus biochemical capsules combined with thermoelectric complex therapy instruments on the basis of routine postoperative treatment. Results The postoperative pain symptom scores were lower than that of control group(P<0.05). The average blood flow, duration of bleeding and post-operative menarche were all less than that of control group(P<0.05). The thickness of endometrium in the study group was higher than that of the control group(P<0.05), and the longitudinal and transverse diameters of the uterus were shorter than those of the control group(P<0.05). Conclusion Wujia biochemical capsule combined with thermoelectric complex therapy instrument has a good effect on the treatment of involution of uterus after abortion and is worth promoting.

目的 评价SAMe-TT₂R₂评分对非瓣膜性房颤使用华法林的患者中的抗凝疗效的评估作用,探讨SAMe-TT₂R₂评分与缺血性卒中事件、出血事件的相关性。方法 以石河子大学医学院第一附属医院2018年1月—2019年1月住院治疗,确诊为非瓣膜性房颤并口服华法林抗凝的患者作为观察对象,进行为期10月的随访。通过患者的国际标准化比值(INR),计算患者的抗凝治疗范围内时间百分比(Time in Therapeutic Range, TTR),并对所有患者进行SAMe-TT₂R₂评分。运用χ²检验、Spearman秩相关、ROC曲线分析评估SAMe-TT₂R₂评分对患者抗凝疗效的预测能力。随访期内收集缺血性卒中和出血事件的发生情况,分析上述事件与SAMe-TT₂R₂评分的相关性。结果 190例患者平均TTR为(46.76±21.99)％,SAMe-TT₂R₂分数与患者的TTR呈负相关(P=0.001),ROC曲线下面积为0.661,P=0.001,约登指数0.203对应的临界值取整数为4分,敏感度和特异度分别为72.6％和47.7％,提示SAMe-TT₂R₂对预测TTR<65％有一定的价值。随访期间共有5例患者发生缺血性卒中事件,25例患者发生不同程度出血事件,11例患者发生全因死亡事件,上述事件在各个SAMe-TT₂R₂分值的发生分布差异无统计学意义(P＞0.05)。结论 在非瓣膜性房颤并使用华法林抗凝治疗的患者中,SAMe-TT₂R₂评分对使用华法林抗凝治疗患者的抗凝有效性具有一定的预测能力,可将SAMe-TT₂R₂评分作为预测华法林抗凝疗效的预测的指标。

Objective To evaluate the anticoagulant effect of SAMe-TT₂R₂ in patients with non-valvular atrial fibrillation treated with warfarin, and to explore the correlation between SAMe-TT₂R₂ and ischemic stroke events and bleeding events. Methods Patients who were diagnosed as non-valvular atrial fibrillation and with oral warfarin were enrolled in the First Affiliated Hospital of Shihezi University School of Medical College in January 2018-January 2019, and for 10 months of follow-up. Collecting patients' International normalization ratio(INR), calculating the Time in therapeutic range(TTR), and the SAMe-TT2 R2 score. And χ² test, Spearman rank correlation and ROC curve analysis were used to evaluate the predictive ability of SAMe-TT2 R2 score on anticoagulant efficacy in patients. Follow-up was conducted to investigate the incidence of ischemic stroke or hemorrhagic events and explore the relationship with the SAMe-TT2 R2 score. Results The mean TTR of 190 patients was 46.76%±21.99%, and the score of SAMe-TT_{2 R2} was negatively correlated with the TTR of the patients(P=0.001), the area under the ROC curve was 0.661, P=0.001, The critical value corresponding was 4 points, and the sensitivity and specificity were 72.6% and 47.7%, respectively suggesting that SAMe-TT₂R₂ had certain value in predicting TTR< 65%. During follow-up, a total of 5 patients had ischemic stroke, 25 patients had different degrees of bleeding, and 11 patients had all-cause death, different SAMe-TT₂R₂ scores showed no statistical significance(P>0.05). Conclusion In patients with non-valvular atrial fibrillation treated with warfarin anticoagulant, the SAMe-TT₂R₂ score has a certain predictive ability for the anticoagulant efficacy of patients treated with warfarin anticoagulant, and the SAMe-TT₂R₂ score could be used as an indicator for predicting the anticoagulant efficacy of warfarin.