目的 探讨经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的临床应用价值。方法 对本院收治的手术病理结果证实的219例子宫肌瘤,回顾临床资料分组,99例以经阴道三维容积超声成像作为观察组,120例以经阴道二维彩超检查作为对照组。评估经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的诊断符合率。结果 两组子宫肌瘤FIGO分类诊断符合率分别为:观察组97.93%,对照组78.33%;经阴道三维容积超声成像检查诊断符合率显著高于二维彩超,差异有统计学意义。结论 经阴道三维容积超声成像较二维彩超能获得更为丰富的诊断信息,诊断子宫肌瘤FIGO分类较二维彩超优势显著,有利于提高诊断准确率,为指导临床个性化治疗提供可靠的理论依据,值得临床推广应用。

Objective To investigate the clinical value of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of the FIGO classification of hysteromyoma. Methods To retrospectively analysis data of 219 cases hysteromyoma confirmed by the surgical pathological findings in this hospital. 99 cases treated with transvaginal 3D ultrasound were as the observation group, and 120 cases treated with vaginal 2D ultrasound as the control group. To evaluate the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of FIGO classification of hysteromyoma. Results The coincidence rates of FIGO classification of hysteromyoma in the two groups were 97.93% in the observation group and 78.33% in the control group; the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging was higher than that of two-dimensional color Doppler ultrasound, and the difference was statistically significant. Conclusion Transvaginal three-dimensional volumetric ultrasound imaging can obtain richer diagnostic information than two-dimensional color Doppler ultrasound. In the FIGO classification of hysteromyoma, it has significant advantages than two-dimensional color Doppler ultrasound, which is conducive to improving the diagnostic accuracy and providing a reliable theory for guiding clinical personalized treatment. The basis is worthy of clinical promotion and application.

目的 探讨产前超声联合磁共振诊断胎儿部分性胼胝体发育不全的价值。方法 收集产前超声联合磁共振诊断为部分性胼胝体发育不全的胎儿15例,对比出生或引产后的检查结果,分析产前超声特征。结果 产前超声直接征象:胼胝体正中矢状切面相应部位缺失12例(12/15,80.0%)。间接征象:透明隔腔形态异常(80.0%)、侧脑室扩张(73.3%)、大脑纵裂池分离(73.3%)、脑中线丘脑后方囊性包块(26.7%)、侧脑室“泪滴状改变”(26.7%)、胼周动脉走行异常(26.7%),合并颅内或其他系统畸形6例。对比出生或引产后随访结果,诊断准确率:产前超声80.0%,产前磁共振93.3%。结论 超声可以诊断胎儿部分性胼胝体发育不全,更精确的诊断建议结合产前胎儿头颅磁共振检查。

Objective To explore the value of prenatal ultrasound in diagnosis of fetal partial agenesis of corpus callosum. Methods 15 fetuses diagnosed as partial agenesis of corpus callosum by prenatal ultrasound combined with magnetic resonance imaging (MRI) were collected. Results of examination after birth or induction of labor were compared to analyze the characteristics of prenatal ultrasound. Results Direct signs were observed in the prenatal sonographic features: 12 cases (12/15, 80.0%) were missing corresponding parts in the midsagittal section of corpus callosum. Indirect signs: transparent partition morphological abnormalities (80.0%), lateral ventricle expansion (73.3%), separation of longitudinal crack on the brain pool(73.3%), posterior thalamic midline cystic mass (26.7%), “teardrop change” of the lateral ventricle (26.7%), abnormal course of pericallosal artery (26.7%), with intracranial and other system deformity in 6 cases, including multiple anomalies. Compared with the follow-up results after birth or induction of labor, the diagnostic accuracy was 80.0% of prenatal ultrasound and 93.3% of prenatal MRI. Conclusion Ultrasonography may diagnose fetal partial agenesis of corpus callosum properly, and more accurate diagnosis could be finished combining with prenatal fetal cranial MRI.

目的 观察应用济川煎加减结合贴穴治疗帕金森病患者便秘的临床疗效。方法 选取帕金森病合并便秘患者64例,随机分为对照组和观察组,各32例。入选患者均进行帕金森病常规治疗,对照组服用莫沙必利;观察组在对照组治疗基础上加服济川煎加减,并选穴敷贴。疗程结束后对两组患者便秘改善程度、生活活动能力、中医证候积分等项目进行比较。结果 观察组患者便秘改善程度、生活活动能力、中医证候改善均优于对照组,两者比较差异有统计学意义(P<0.05)。结论 应用济川煎加减结合贴穴能有效治疗帕金森病患者便秘,并对帕金森病其他症状有正向调节作用,能提高该类患者生存质量。

Objective To investigate the clinical effect of Jichuanjian decoction and acupoint application on the treatment of constipation in Parkinson's disease. Methods 64 patients with constipation in Parkinson's disease were randomly divided into two groups. 32 patients were treated with Mosapride in control group. 32 patients were treated with Jichuanjian decoction and acupoint application in treatment group.The clinical effects were compared in the two groups. Results The clinical effects of the treatment group were better and the differences were statistical significance (P<0.05). Conclusion The treatment of constipation in Parkinson's disease with Jichuanjian decoction and acupoint application had a significant effect.

目的 初步探究针刺数量对小儿脑瘫肌张力及粗大运动功能的影响。方法 选取我院2017年1月—2019年11月接收的脑瘫患儿78例,以随机数表法分组,常规针刺组39例,采用一般治疗加常规针刺穴位;增穴针刺组39例,在常规针刺组治疗基础上增加13个穴位治疗。对比2组患儿三个疗程后的肌张力及粗大运动功能。结果 治疗三个疗程后,常规针刺组肌张力评分稍低于增穴针刺组,粗大运动功能量表(GMFM-88)评分稍低于增穴针刺组,但差异没有统计学意义(P＞0.05)。结论 针刺疗法可以有效辅助脑瘫患儿治疗,但是增多穴位不一定能明显改善患儿肌张力和粗大运动功能。

Objective To explore the effect of acupuncture quantity on muscle tension and gross motor function in children with cerebral palsy. Methods From January 2017 to November 2019, 78 children with cerebral palsy who were treated in our hospital were collected. 78 children with cerebral palsy were randomly divided into two groups. The conventional acupuncture group (39 cases) were treated with general treatment and conventional acupuncture points. And the more-needle acupuncture group (39 cases) were treated with adding another 13 more acupuncture points. Muscle tension and gross motor function were compared between the two groups after three courses of treatment. Results After three courses of treatment, the muscle tension score of the conventional acupuncture group was slightly lower than that of the more-needle acupuncture group, and the gross motor function scale (GMFM-88) score was slightly lower than that of the more-needle acupuncture group, but the difference was not statistically significant (P>0.05). Conclusion Acupuncture therapy can effectively assist the treatment of children with cerebral palsy, but increasing acupoints may not improve the muscle tension and gross motor function of children with cerebral palsy.

目的 探讨凯格尔(Kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响。方法 选取2018年5月—2019年4月在我院妇产科阴道分娩的足月产妇200例,采用随机数字法分为对照组和观察组,每组各100例,对照组单纯给予Kegel锻炼法,观察组给予Kegel锻炼法结合生物反馈电刺激。干预2～3个月,比较两组患者盆底肌肉功能相关指标改善情况,并比较两组患者生活质量的改变。结果 干预后,观察组患者盆底肌Ⅰ类肌纤维肌力恢复正常率为86.0%(86/100),高于对照组的56.0%(56/100),观察组盆底肌Ⅱ类肌纤维肌力恢复正常率为83.0%(83/100),高于对照组的54.0%(54/100),差异均有统计学意义(P<0.05)。且干预后,观察组下腹不适、尿失禁、排尿异常、排便异常及阴道分泌物异常患者低于对照组(P<0.05),性生活质量评分高于对照组(P<0.05)。结论 Kegel锻炼结合生物反馈电刺激可促进盆底肌力,改善尿失禁、盆腔器官脱垂等盆底异常症状,提高患者生性生活质量。

Objective To explore the effect of Kegel exercise combined with biofeedback electric stimulation on the management of postpartum pelvic floor rehabilitation. Methods A total of 200 full-term pregnant women who delivered vaginally in our hospital from May 2018 to April 2019 were randomly divided into two groups: the control group and the observation group, with 100 cases in each group. The control group was only given Kegel exercise method, and the experimental group was given Kegel exercise method combined with biofeedback electrical stimulation. After 2～3 months of intervention, the improvement of pelvic floor muscle function and quality of life of the two groups were compared. Results After intervention, the recovery rate of pelvic floor muscle type I muscle strength in the observation group was 86.0% (86/100), higher than that in the control group (56/100), and the recovery rate of pelvic floor muscle type II muscle strength in the observation group was 83.0% (83/100), higher than that in the control group (54/100). The difference was statistically significant (P<0.05). After the intervention, the patients situations in the experimental group were lower than those in the control group (P<0.05) including abdominal discomfort, urinary incontinence, abnormal urination, abnormal defecation and abnormal vaginal secretion, and the score of sexual quality of life was higher than that in the control group (P<0.05). Conclusion Kegel exercise combined with biofeedback electrical stimulation may promote pelvic floor muscle strength, improve the symptoms of urinary incontinence, pelvic organ prolapse and other pelvic floor abnormalities, and improve the quality of life of patients.

目的 探讨激光心肌血运重建(Transmyocardial Laser revascularization, TMLR)辅助冠状动脉旁路移植术治疗严重冠心病的临床疗效及 11年随访结果。方法 25例严重冠心病患者行不停跳冠状动脉旁路移植术(off-pump coronary artery bypass, OPCAB)并辅以激光心肌血运重建术(TMLR组),回顾性总结了其术前、术中、术后及 11年随访资料,并与同期进行的 95例单纯不停跳冠状动脉旁路移植术(OPCAB组)病人资料进行比较分析。结果 TMLR组在平均远端吻合口数比 OPCAB组少,而手术时间、术后硝普钠用量比OPCAB组多,其他如术后机械通气时间、ICU停留时间、术后住院天数和术后常见并发症,2组之间均无差异;平均 11年随访资料中,胸闷痛、心衰、新出现 ST-T改变发生率、再发急性心梗、再次 PCI处理、LVEF和血管桥闭塞率,2组间无明显区别;死亡率二者之间也没有区别。结论 TMLR术辅助冠状动脉旁路移植术虽然手术时间比较长,血管活性药物应用较多,但术后康复和 11年随访资料显示与单纯 OPCAB术有相似的结果,说明 TMLR术作为冠状动脉旁路移植术的补充,对那些冠脉血管细小且钙化狭窄严重而不适合冠状动脉旁路移植术的冠心病患者是获益的。

Objective To explore and analyze the clinical effect of off-pump coronary artery bypass (OPCAB) combined transmyocardial laser revascularization(TMLR) of severe coronary artery disease and 11 years follow-up. Methods 25 cases with sever coronary artery disease were treated through OPCAB and TMLR, and the clinical data and 11 years follow-up data were summarized and analyzed retrospectively, compared with the data of the patients treated by only OPCAB. Results There were less mean bypass graft numbers in TMLR group than in OPCAB group. Operation time and the amount of sodium nitroprusside in TMLR group were more than that in OPCAB group. But intubation time, ICU stay time, postoperative stay time and postoperative common complications were not different between two groups. 11 years postoperative follow-up results indicated that chest pain, heart disfunction, ST-T alteration, AMI, PCI treatment again, LVEF and bypass graft occlusion rate were not obviously between two groups. Conclusion TMLR combined OPCAB may result in good outcome and improve long term survival.

目的 研究过表达miR-29a-3p对IL-22诱导的HaCaT细胞增殖的影响。方法 将HaCaT细胞分为Cell组、IL-22组、IL-22+NC组和IL-22+ miR-29a-3p组,荧光定量PCR检测miR-29a-3p的表达水平,CCK8检测细胞的活力,流式细胞仪检测细胞凋亡及周期。结果 与0 μg/L组相比,25 μg/L组、50 μg/L组和100 μg/L组HaCaT细胞的增殖率在24 h、48 h和72 h均出现升高(F值分别为33.27、36.19、52.29,均P<0.000 1)。与0 μg/L组相比,miR-29a-3p在50 μg/L组和100 μg/L组HaCaT中的表达水平降低(F=129,P<0.000 1),分别降低83%和80%。与IL-22+NC组相比,IL-22+ miR-29a-3p组的增殖率在24 h、48 h和72 h均降低(P值分别为0.002 1、0.001 6、0.023 1),细胞总凋亡率增加(6.67±1.06 vs 30.55±1.86,P=0.000 1),G1期细胞比例增加(P=0.000 1),S期细胞比例降低(P=0.000 1)。结论 IL-22可降低HaCaT中miR-29a-3p的表达量,过表达miR-29a-3p通过促进凋亡和引起细胞G1期阻滞抑制IL-22诱发的HaCaT细胞过度增生。

Objective To investigate the effect of miR-29a-3p overexpression on IL-22-induced proliferation of HaCaT cells. Methods HaCaT cells were divided into four groups, Cell group, IL-22 group, IL-22 +NC group and IL-22+miR-29a-3p group. The expression level of miR-29a-3p was detected by fluorescence quantitative PCR. Cell viability was detected by CCK8. Apoptosis and cell cycle were detected by flow cytometry. Results Compared with the 0 g/L group, the proliferation rate of HaCaT cells in the 25 μg/L group, 50 μg/L group and 100 μg/L group was increased at 24 h, 48 h and 72 h (F value was 33.27, 36.19, 52.29,respectively, all P<0.000 1). Compared with the 0 μg/L group, miR-29a-3p expression level in HaCaT in 50 μg/L and 100 μg/L groups was decreased (F=129, P<0.000 1), with a decrease of 83% and 80%, respectively. Compared with the IL-22+NC group, proliferation rate of IL-22+miR-29a-3p group was decreased at 24 h, 48 h and 72 h (P value was 0.002 1, 0.001 6, 0.023 1, respectively), total apoptosis rate was increased (6.67±1.06 vs 30.55±1.86, P=0.000 1), cell proportion in G1 phase was increased (P=0.000 1), and the cell proportion in S phase was decreased (P=0.000 1). Conclusion Il-22 can reduce miR-29a-3p expression level in HaCaT, and miR-29a-3p overexpression can inhibit the excessive proliferation induced by IL-22 in HaCaT cells by promoting apoptosis and inducing G1 phase arrest.

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 探究尿毒症继发性甲状旁腺功能亢进经甲状旁腺切除术治疗效果及安全性分析。方法 选取2017年6月—2019年5月于我院就诊的90例尿毒症继发性甲状旁腺功能亢进患者为研究对象,随机分为对照组与观察组,两组各45例。均采取同一药物治疗,对照组行次全切除治疗,观察组行甲状旁腺全切除术+前臂移植术。对比分析两组治疗效果、血生化指标及并发症。结果 观察组疗效优于对照组(P<0.05);观察组术后1周、1个月钙、iPTH、磷、钙磷乘积及ALP水平均低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 甲状旁腺全切除+前臂移植治疗尿毒症继发性甲状旁腺功能亢进疗效显著,并发症风险低,值得推广。