目的 探究聚乙二醇筛查法在高泌乳血症诊断中的临床意义。方法 选取260例HP患者作为观察组以及80例健康体检者作为对照组。应用雅培I2000全自动化学发光检测仪对两组标本进行PRL浓度测定,并将标本进行PEG筛查法沉淀后再次进行PRL浓度测定,将所得数据进行对比。结果 观察组检出MP67例,检出率25.77%,对照组检出MP3例,检出率3.75%,二者差异有统计学意义(P＜0.05);HP组、MP组和对照组之间PEG沉淀前PRL浓度差异有统计学意义(P＜0.05),沉淀后HP组和MP组以及对照组差异有统计学意义(P＜0.05),MP组和对照组差异无统计学意义(P＞0.05);MP在HP引起的各种临床疾病中检出情况差异无统计学意义(P＞0.05)。结论 应用聚乙二醇筛查法对于排除MPRL对HP诊断的干扰具有可行性,对降低HP的误诊率有着重要的意义。

Objective To explore the clinical signification of polyethylene glycol screening method on the diagnosis of hyperprolactinemiat.Methods We selected 260 patients with hyperprolactinemia as observation group and 80 healthy individuals as control group. The two groups were measured with Abbott laboratories I2000 automatic chemiluminescence detector about the concentration of PRL. Then the groups were measured again after they were precipitated by the polyethylene glycol and the result data were analyzed.Results 78 cases of MP were checked out from the observation group and 3 cases were checked out from the control group. The proportion was 25.77% and 3.75% respectively, and the differences were statistically significant (P＜0.05). The difference of the concentration of PRL before precipitated by PEG among the HP group, the MP group and the control group were statistically significant (P＜0.05). After precipitating, the difference of the concentration of PRL between the HP group and the MP group were statistically significant (P＜0.05), as well as the HP group and the control group. However, there was no difference between the MP group and the control group (P＞0.05). The checking conditions of MP in some diseases caused by HP had no difference(P＞0.05).Conclusion The use of polyethylene glycol screening method is a practicable method to eliminate the interference of MPRL on the diagnosis in HP. It has significance reducing misdiagnosis rate of HP.

目的 了解社区医护人员的心理健康状况,评估心理干预措施效果,找到提高社区医护人员心理健康状况的有效措施。方法 采用《症状自评量表 SCL-90》对社区医护人员的心理健康状况进行基线调查,在干预3、6、9个月时分别进行SCL-90复测,以评估心理干预措施效果;根据《医护人员工作压力测试量表》的调查结果制定有针对性的心理干预措施并适时调整。结果 社区医护人员SCL-90测评总分和躯体化、强迫、人际敏感、焦虑、敌对、恐怖、偏执7个因子得分均高于全国常模水平(P<0.05);经过综合干预,随访期间SCL-90测评总分呈逐步下降趋势,干预6个月时,除人际敏感因子外,SCL-90测评总分及各因子分已趋于正常水平,与全国常模比较差异没有统计学意义(P<0.05)。至9个月时,人际敏感因子得分也恢复至正常水平。结论 社区医护人员心理健康状况低于全国常模水平,进行针对性的综合干预可提高其心理健康水平,实验显示干预时长应不低于6个月。

Objective To understand the mental health status of community health care workers, assess the effect of psychological intervention measures, and find effective measures to improve the mental health status of community health care workers.Methods With the help of Symptom Checklist SCL-90, we firstly carried out baseline survey on community medical staff mental health; then retested that at 3, 6 and 9 months later. Thus, we could assess the effect of psychological intervention. According to the results of the medical staff working pressure test questionnaire, we could develop targeted psychological intervention measures and adopt prompt adjustment.Results Community health care personnel SCL-90 evaluation score and 7 factors scores(physical,forced,interpersonal sensitivity,anxiety,hostility,terror,and paranoia) were higher than the national norm(P<0.05);after comprehensive intervention in the 9 months follow-up,the SCL-90 evaluation score was decreasing gradually.After intervention for 6 months,except for the interpersonal sensitivity factor,SCL-90 total scores and the other factor scores tend to normal levels, to compare the national norm, there was no statistical significance in differences (P<0.05). 9 months later, the scores of interpersonal sensitivity also return to normal levels.Conclusion The mental health status of community health care workers was lower than the national norm,the comprehensive intervention may improve their mental health level, and the experiment showed that the intervention should be no less than 6 months.

目的 探讨低中心静脉压(LCVP)对肝癌肝切除术的影响及意义。方法 选择我院2010年3月—2012年3月期间拟行肝切除术的原发性肝癌患者60例,随机分为LCVP组(30例)和NCVP(30例)。LCVP组术中采用相关技术控制CVP<0.5 kPa;NCVP组术中CVP和血压控制在基础值10%上下范围内。两组的麻醉方法、切口、切肝方法、输血指征均一致。分别记录:心率、血压、CVP值和血常规;手术时间、手术切除肝组织范围、手术期间各阶段出血量、输注血制品的数量;术后第1、3、7天的肝肾功能以及凝血功能,所需补充的外源性白蛋白量;术后并发症的发生率、住院时间和费用。结果 ①2组术前一般临床资料比较均无差异(均P>0 05)。②LCVP组手术时间、手术总出血量、肝离断时出血量、RBC输注量均低于NCVP组(P<0.05);③2组术后肝功能、肾功能指标比较无差异(P>0.05),LCVP组患者术后白蛋白补充量比NCVP组减少(P<0.05);④2组患者术后肝功能衰竭、膈下积液、胆瘘、大量腹水、肺部感染、空气栓塞、死亡的发生率比较,均无差异(P>0.05);⑤LCVP患者住院天数、住院总费用均比NCVP组减少(P<0.05)。结论 术中应用LCVP可减少肝癌肝切除术中出血量,缩短住院时间和住院费用,有利于患者的术后恢复。

Objective To evaluate the effect of LCVP applied during the operation of hepatectomy.Methods Sixty patients underwent hepatectomy were enrolled in the study from March 2010 to March 2012 in our hospital which were randomized into LCVP group and normal CVP (NCVP) group by the sealed envelope method. CVP was kept<0.5 kPa during entire procedure of hepatectomy in LCVP group, and the value of CVP and blood pressure were controlled within 10% of the baseline. The same anesthesia, incision and hepatectomy technique and indications of blood transfusion in LCVP group were undertaken as those in NCVP group. Intraoperative CVP, blood pressure, HR and blood routine were recorded. The time of operation, the amount of bleeding, the extent of removed hepatic tissue, the amount of transfused blood products,liver and renal function index, and coagulation function index were detected on the 1st, 3rd and 7th day after operation. Also the supplement of albumin, the rate of postoperation complications and the length of hospital stay and the expense in hospital were recorded.Results ① The general clinical data of patients were similar in the two group (P>0.05). ② The operation time, total bleeding volume, bleeding volume and RBC infusion volume in LCVP group were significantly lower than those in group NCVP (P<0.05). ③ There were no significant difference of postoperative liver and renal function index between the two groups (P>0.05). But the supplement of albumin in LCVP group after operation was significant less than that in NCVP group (P<0.05). ④ There were no significant difference of the postoperative complication, the length of hospital stay and the expense in hospital between the two groups (P>0.05).Conclusions The application of LCVP in hepatectomy cause less blood loss, shorten the length of hospital stay and decrease the expense in hospital, which is beneficial for the postoperative recovery.

目的 探究全科诊疗过程中健康管理流程再造的效果。方法 选取深圳市龙岗区第二人民医院(东方半岛社区健康服务中心)的病例,即2015年1月—2015年12月的病例作为对照组(使用旧流程);2016年6月—2017年5月的病例作为观察组(使用新流程),对2组相关数据进行回顾性分析整理,观察2组全科诊疗的健康管理情况并实施比较。结果 观察组全科诊疗人次、妇女儿童保健人数、老年保健人数、新增慢病管理人数、家庭医生签约户数、高危人群早期干预人数等同比增长率均高于对照组,2组比较差异有统计学意义(P<0.05)。结论 全科诊疗过程中健康管理流程再造,能够为更多的居民提供优质健康服务,故对于提高全民健康水平具有重要意义,因而值得临床借鉴应用。

Objective To explore the effect of health management process reengineering on the process of general practice.Methods The cases of Shenzhen Longgang District Second People's Hospital from January 2015 to December 2015 were selected as the control group (using the old process), and that from June 2016 to May 2017 were selected as the observation group (using the new process). The clinical data in the two groups were retrospectively analyzed, and the health management of the two groups of general medical was observed and compared.Results The growth rates in the observation group, such as visits of outpatient service, the numbers of women and children health care, the numbers of elderly health care, the numbers of new chronic disease management, the numbers of family doctors signed and the numbers of early intervention of high-risk groups, were higher than that in the control group (P<0.05).Conclusion The health management process reengineering in the process of general practice may provide better health services to more residents, and it is important for improving the health of all people. It is well worth to clinical reference and application.

目的 分析稳定期慢性阻塞性肺疾病患者血浆可溶性尿激酶型纤溶酶原激活因子受体(suPAR)、IL-8和MMP-9的水平,探讨其在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者中的临床意义。方法 入选60例稳定期COPD患者设为观察组,再根据肺功能分为Ⅱ级、Ⅲ级及Ⅳ级亚组;同时选取同期健康体检者70例作为对照组,检测两组的血清suPAR、IL-8和MMP-9水平及肺功能,比较观察组跟对照之间的差异,同时比较Ⅱ级、Ⅲ级、Ⅳ级亚组及对照组之间的差异。结果 观察组血清suPAR、IL-8和MMP-9水平高于对照组;Ⅱ级、Ⅲ级及Ⅳ级各亚组的血清suPAR、IL-8和MMP-9均高于对照组;Ⅲ级及Ⅳ级组高于Ⅱ级组;以上差异均有统计学意义(P<0.05)。但Ⅲ级与Ⅳ级比较无差异(P>0.05)。结论 血清suPAR、IL-8和MMP-9在稳定期COPD患者中水平增高,且反映了其严重程度,有望成为COPD病情评估新指标及未来分子水平治疗的新靶点。

Objective To analyze the serum soluble urokinase-type plasminogen activator receptor, IL-8 and MMP-9 levels in stable chronic obstructive pulmonary disease and explore its clinical significance.Methods 60 patitents with stable COPD were selected as the observation group, and subdivided to subgroups stage Ⅱ, Ⅲ and Ⅳ. Meanwhile, 70 healthy individuals were enrolled as the control group. And then suPAR、IL-8 and MMP-9 levels and pulmonary function were measured in both groups. The differences between both groups as well as all the subgroups were compared.Results The suPAR level of the observation group was higher than that of the control group. Also, compared with the control group, stage Ⅱ, Ⅲ and Ⅳ subgroups showed much higher level of suPAR,IL-8,MMP-9. And it was higher in stageⅢand Ⅳthan in stageⅡ. However, there was no difference between Stage Ⅲ and Ⅳ.Conclusion The suPAR,IL-8 and MMP-9 level are higher in COPD patients and are related to the severity of stages. Therefore, it could be an appropriate biomarker as well as a novel target for future therapy and further evaluation.

目的 通过超声造影成像技术( CEUS)观察颈动脉斑块内新生血管的情况,探讨颈动脉斑块的厚度与新生血管的关系。方法 选择颈动脉粥样硬化患者40例,经常规超声确诊存在斑块,共64个,应用CEUS成像技术检测斑块内新生血管情况。结果 不同厚度的颈动脉斑块的增强强度与斑块厚度成正相关(r=0.897 6,P=0.000 0)。结论 超声造影成像技术可以在常规超声的基础上通过检测斑块内的新生血管,进而判断斑块的性质,提供更多有用的信息进一步评估颈动脉斑块内新生血管增强强度与斑块厚度存在线性正相关性。

Objective To evaluate the neovascularization in carotid plaques by gray-scale harmonic contrast echocardiography (CEUS), and to investigate the relationship between the thickness of carotid artery plaque and the neovascularization.Methods 40 patients with carotid atherosclerosis were selected, and 64 plaques were diagnosed by regular ultrasound. The neovascularization in plaques was detected by CEUS imaging technique.Results The enhanced strength of carotid plaques with different thickness was positively correlated with plaque thickness (r=0.8976,P=0.0000).Conclusion Ultrasound contrast imaging can detect angiogenesis within the plaque based on conventional ultrasound, and then determine the nature of the plaque. More useful information is provided to further evaluate the linear positive correlation between the intensity of neovascularization and the thickness of plaque in carotid plaque.

目的 探讨声触诊组织定量(virtual touch tissue quantification,VTQ)技术在肾上腺肿瘤诊断中的应用价值。方法 对50例患者共50个肾上腺肿瘤及同侧肾皮质进行VTQ检查,获取肾上腺肿瘤及同侧肾皮质剪切波速度(shear wave velocity,SWV)值,比较肾上腺肿瘤与同侧肾皮质及肾上腺肿瘤各类型之间SWV值,全部病例均经手术后病理证实。结果 病理证实恶性肿瘤5个,良性肿瘤45个。良、恶性肿瘤之间SWV值的差异无统计学意义。肿瘤与同侧肾皮质之间SWV值的差异有统计学意义。髓样脂肪瘤、神经鞘瘤、皮质腺瘤、皮质腺癌及嗜铬细胞瘤之间,除皮质腺瘤、皮质腺癌及嗜铬细胞瘤之间SWV值的差异无统计学意义外,其余任两组之间SWV值的差异有统计学意义。结论 VTQ技术可以提供肾上腺肿瘤的硬度及弹性信息,在肾上腺肿瘤的诊断中具有一定应用价值。

Objective To evaluate the application value of virtual touch tissue quantification (VTQ) technique in the diagnosis of adrenal tumors.Methods VTQ was performed in 50 patients with 50 adrenal tumors and ipsilateral renal cortex, to obtain the shear wave velocity(SWV) of adrenal tumors and ipsilateral renal cortex, the comparison between adrenal tumor and ipsilateral renal cortex and adrenal tumors of various types of SWV. All cases were pathologically confirmed after operation.Results 5 malignant tumors and 45 benign tumors were confirmed by pathology. The difference of SWV between benign and malignant tumors was not statistically significant. The difference of SWV between tumor and ipsilateral renal cortex was statistically significant. Among myelolipoma, schwannoma, adrenocortical adenoma, pheochromocytoma and adrenocortical carcinoma in addition to differences in adrenocortical adenoma, pheochromocytoma and adrenocortical carcinoma, SWV value was not statistically significant; it was statistically significant difference between the two groups in any other SWV.Conclusion VTQ technology may provide hardness and elasticity of the adrenal tumors; it has certain application value in the diagnosis of adrenal tumors.

目的 评估AMA-M2、SP100和GP210三种自身抗体在诊断原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)中的应用价值。方法 收集我院近3年就诊患者的AMA-M2、SP100、GP210、ALP和GGT检测数据,其中PBC患者50例,非PBC肝胆疾病或自身免疫病患者226例,正常对照290例。分析这些检测指标对PBC诊断的敏感度和特异度。结果 AMA-M2、SP100和GP210诊断原发性胆汁性肝硬化的敏感度分别为96.00%、36.00%、8.00%,特异度分别为98.26%、97.87%、99.03%。PBC组病人的ALP和GGT检测结果高于非PBC病人组。结论 AMA-M2、SP100和GP210对PBC的临床诊断特异度较高;AMA-M2的敏感度高,但SP100和GP210敏感度低。

Objective To evaluate the diagnostic accuracy of AMA-M2, SP100 and GP210 for the primary biliary cirrhosis (PBC).Methods A total of 50 patients with PBC and 226 patients with other liver diseases or autoimmune diseases were enrolled in this study and 290 healthy individuals were included as normal controls. The data of AMA-M2, SP100, GP210, ALP and GGT were collected and analyzed for sensitivity and specificity in the diagnosis of PBC.Results The sensitivity and specificity of AMA-M2, SP100 and GP210 in the diagnosis of PBC were 96.00%, 36.00%, 8.00% and 98.26%, 97.87%, 99.03%, respectively. Compared to PBC group, the concentrations of ALP and GGT in non-PBC patients and controls were low.Conclusion AMA-M2 is quite accurate with high specificity and sensitivity in the diagnosis of PBC. However, SP100 and GP210 have high sensitivity but low sensitivity.

目的 了解新疆疏附县人民医院心脑血管疾病发病趋势和分析高血压发病相关危险因素,为高血压及其相关的心脑血管疾病的综合防治提供依据。方法 回顾性分析2007—2011年疏附县人民医院住院患者资料,按年份统计慢性非传染性疾病(以下简称慢性病)住院人数情况,并采用Logistic回归分析法分析维吾尔族人群高血压发病的相关危险因素。结果 新疆疏附县人民医院心脑血管疾病住院人数逐年增长,5年增长了约2.7倍,其中因高血压住院人数增长了3.5倍。BMI、血钠水平升高、血脂异常、年龄是维吾尔族人群高血压的危险因素。结论 新疆疏附县人民医院住院患者中以高血压为主的心脑血管疾病逐年增长。当地高血压及其相关的心脑血管疾病的防治采取生活方式干预基础上给予降压、降脂治疗的综合策略是优选。

Objective To investigate the incidence trend of cardio-cerebrovascular disease and the related risk factors about hypertension in Shufu people's hospital of Xinjiang. Moreover, to provide evidence of making prevention and controlling strategies for hypertension and the related cardio-cerebrovascular diseases.Methods A retrospective review was did on case data of the inpatients in Shufu people's hospital during 2007-2011.We counted the number of inpatients of chronic non-communicable diseases(NCDs)by year and collected the information of hypertensive inpatients and non-hypertensive inpatients to analyze the risk factors of hypertension in Uygurs using Logistic regression.Results The number of inpatients with cardio-cerebrovascular disease in Shufu people's hospital was increased by 2.7 times in 5 years, while the number of hypertensive inpatients was increased by 3.5 times. BMI, elevated blood sodium, and dyslipidemia, age are risk factors for hypertension in Uygur population.Conclusion The inpatients with cardio-cerebrovascular disease especially those with hypertension in Shufu people's hospital were increasing in recent 5 years. The strategy of lifestyle intervention combined with antihypertensive as well as lipid-lowering therapy is better to the prevention and treatment of hypertension and the related cardio-cerebrovascular diseases.

目的 探讨A超和IOL Master测量人工晶状体度数的精确性,为白内障手术提供客观的临床数据。方法 选取300例300眼老年性白内障患者,术前采用A 超和IOL Master测量眼轴长度、自动验光仪测量角膜曲率,A超组利用自动验光仪的角膜曲率数据,IOL Master组利用仪器自带的角膜曲率数据,均使用SRK-T公式计算需要植入的人工晶状体度数,观察术后3 m的屈光状态,使用自动验光仪检测患者屈光状态并分析。结果 所有被列入研究的患眼随机分为A超组和IOL Master组, A超组测得的平均眼轴长度为(23.21±0.59)mm,IOL Master组测得的眼轴长度为(23.22±0.59)mm,两组数据对比差异无统计学意义(P>0.05);利用自动验光仪测量的术前平均角膜曲率为(44.01±1.79)D,利用IOL Master测量的术前平均角膜曲率为(44.13±1.62)D,两者比较差异无统计学意义(P＞0.05);A超组和IOL Master组术后的平均绝对屈光误差(mean absolute refractive error,MAE)分别为(0.43±0.26)D、(0.42±0.17)D,两组比较差异无统计学意义(P>0.05)。结论 IOL Master在操作上略优于A超,但在人工晶体度数测量上与A超比较没有发现明显优势,不能完全取代A超,两者结合更能确保人工晶体度数测量的精确性。

Objective By discussing the accuracy of A-scan and IOL Master in intraocular lens power measurement, to offer Objective clinical data for cataract surgery.Methods Three hundred patients(300 eyes)with age-related cataract were included in the study. Before surgery,axial length was measured by A-scan and IOL Master respectively and corneal curvature was measured by auto refractometer. A-scan group used the corneal curvature data of the auto refractometer. IOL Master group used the corneal curvature data from the instrument. Intraocular lens power was calculated according to the SRK-T formula.We observed the refractive state of 3m after operation, detected and analyzed the patient's refractive data by the auto refractometer.Results All patients who were included in the study were randomly divided into A-scan group and IOL Master group.The mean axial length was (23.21±0.59) mm measured by A-scan, the mean axial length was (23.22±0.59) mm measured by IOL Master. There was no significant difference between them (P>0.05). The preoperative mean corneal curvature measured by the auto refractometer was (44.01±1.79)D. The preoperative mean corneal curvature measured by IOL Master was (44.13±1.62)D. There was no statistically significant difference between them (P＞0.05). The mean absolute refractive error ( MAE) in A－scan group was (0.43±0.26)D and in IOL Master group was (0.42±0.17)D. There was no statistically significant difference between them (P＞0. 05).Conclusion IOL Master group operated slightly better than A-scan group, but we did not find a significant advantage in intraocular lens power measurement with A-scan group. IOL Master may not completely replace A-scan. The combination of the two ensures the accuracy of the measurement in intraocular lens power.