目的 了解新生儿先天性心脏病的患病情况,为制定和采取干预措施提供依据。方法 对2015年10月—2016年9月分娩的5 769名新生儿进行心脏彩超检查,根据筛查结果进行统计分析。结果 共筛查出182例新生儿先天性心脏病,患病率3.15%,先天性心脏病新生儿中女婴比例较高,差异边缘显著,早产儿比例较高,差异有统计学意义,产母年龄和正常组分布相近。先天性心脏病类型中室间隔缺损和房间隔缺损的构成比分别排第一位(48.90%)和第二位(38.46%),严重先天性心脏病仅占5.43%。结论 新生儿先心病的发病率较高,采用心脏彩超筛查可尽早发现先心病患儿,同时需做好先心病患儿的随访工作,及时进行干预。
Objective To investigate the prevalence of neonatal congenital heart diseases (CHD) and providing basis for integrating efficient interventions. Methods The color Doppler echocardiography screening were applied to 5 769 newborns from Oct 2015 to Sep 2016, and the data was collected and analyzed. Results 182 cases of neonatal CHD were detected, and the prevalence rate of neonatal CHD was 3.15%. The proportion of girls and premature infants in the newborns with CHD was significantly higher than normal newborns, but the age distribution of their mothers was similar. In the 182 CHD cases, ventricular septal defect(48.90%) and atrial septal defect(38.46%) accounted for the most, while the constituent ratio of severe CHD was only 5.43%. Conclusion The prevalence of neonatal CHD was relatively high, and the color Doppler echocardiography screening could find out neonatal CHD earlier. The follow-up examinations and interventions should be conducted in time.
目的 了解非结核分枝杆菌(nontuberculous mycobacteria,NTM)肺病患者免疫功能低下发生率,以及免疫支持的应用状况、探讨免疫支持治疗对患者2月末痰菌阴转及病变吸收的影响,为临床实施免疫干预提供参考依据。方法 分析广州市胸科医院2014年1月—2015年12月确诊的资料完整的381例NTM肺病患者免疫功能情况以及免疫支持的应用状况,观察组(加用免疫调节剂母牛分枝杆菌菌苗)228例与同期对照组(未使用免疫调节剂)153例进行2月末痰菌阴转及病变吸收情况比较。结果 381例患者中,免疫功能低下的发生率为45.67% (174／381);免疫支持率为59.84% (228／381)。细菌学改变:治疗前所有患者痰抗酸杆菌涂片和培养均为阳性。治疗2个月后两组的阴转率分别为67／228(29.38%)、17／153(11.11%),χ2=17.79,P<0.05。 影像学改变:两组的病变吸收有效率分别为62／228(27.19%)、16／153(10.45%),χ2=15.75,P<0.05;空洞吸收有效率分别为61／228(26.75%)、15／153(9.80%),χ2 =20.42,P<0.05。结论 非结核分枝杆菌肺病患者存在较高比例的免疫功能低下风险,观察组的痰茵阴转、病灶吸收和空洞闭合的疗效高于对照组。
Objective To explore the immune status of patients with nontuberculous mycobacterial(NTM) pulmonary disease, and the application of immunotherapy. to evaluate the influence of immunotherapy on sputum negative conversion and lesion absorption at the end of two months. provide reference data for immunotherapy. Methods The immune function and immunotherapy of 381 patients diagnosed as NTM pulmonary disease were retrospectively analyzed from January 2014 to December 2015 in Guangzhou Chest Hospital. Curative group (treated with antitubercular agents and immunomodulator mycobacterium vaccae) were compared with control group(treated with antitubercular agents alone) in sputum negative conversion and lesion absorption at the end of two month treatment. Results Of the 381 cases,45.67%(174／381)of the patients were immunocompromised, 59.84% (228／381)received immunotherapy. Bacteriologic changes: Both sputum smear and sputum culture were positive in all patents before treatment. after two months treatment, negative conversion in two groups were 67／228(29.38%),17／153(11.11%),χ2=17.79,P<0.05. 3. Radiological change: The rate of lesion absorption in curative group and control group were respectively 62／228(27.19%),16／153(10.45%),χ2=15.75,P<0.05;The rate of promoting cavity closure were respectively 61／228(26.75%),15／153(9.80%),χ2=20.42,P<0.05. Conclusion The immune function of NTM pulmonary disease had high ratio of being compromised. Curative group showed a significant effect of sputum negative conversion, lesion absorption and promoting cavity closure compared to the control group. Added to chemotherapy, M. vaccae is helpful in the treatment of nevertreated TB patients in terms of improving both Immunotherapy with M. vaccae had a beneficial influence on sputum negative conversion and X-ray appearances.
目的 分析2014年482例广州登革热患者的X线胸片特点,探讨X线胸片对登革热患者的临床诊断价值。方法 选取广州市第一人民医院2014年收治的482例登革热患者作为研究对象,观察分析其X线胸片检查结果的特征。结果 登革热患者X线胸片影像学特点以非特异性的肺纹理增多增粗和斑片渗出灶为主要表现,另有胸膜增厚、胸腔积液和间质性改变。结论 X线胸片检查可以经济、便捷地了解登革热患者的肺部改变,为临床诊断和治疗提供帮助。
Objective To analyze the characteristics of chest X-ray in 482 cases of dengue fever in Guangzhou 2014, and to discuss the diagnostic value of chest X-ray in dengue fever patients. Methods 482 patients of dengue fever patients admitted in Guangzhou First People's Hospital were selected as the research object. The characteristics of the chest X-ray were observed and analyzed. Results The characteristics of chest X-ray images included lung markings thickening increased, exudation, and might lead to pleural thickening, effusion and interstitial change. Conclusion Chest X-ray was a convenient examination for dengue fever patients which had an important diagnostic and therapeutic value.
目的 探索锌剂治疗大鼠慢性细菌性前列腺炎(CBP)的机理及影响。方法 健康成年雄性大鼠100只,随机分为正常对照组(n=20)、CBP模型对照组(n=20)、CBP锌剂治疗组(n=20)、CBP左氧氟沙星治疗组(n=20)及CBP锌剂与左氧氟沙星混合治疗组(n=20)。采用消痔灵及大肠埃希菌制备CBP大鼠模型。CBP锌剂治疗组、CBP左氧氟沙星治疗组及CBP混合治疗组给予相应药物灌胃治疗,正常对照组及CBP模型对照组给予无菌生理盐水灌胃。疗程10 d,分别于2 d、4 d、6 d、8 d、11 d取各组大鼠前列腺,检测细菌数量并分离鉴定细菌性质。于4 d、9 d、14 d、20 d、28 d取各组大鼠前列腺,进行组织病理学检测。结果 CBP各治疗组大鼠前列腺组织的细菌数量与模型对照组相比均明显降低(P﹤0.05)。CBP混合治疗组大鼠前列腺内细菌在治疗8 d后不能检出。4～6 d CBP混合治疗组大鼠前列腺组织的细菌数量与CBP锌剂治疗组相比明显降低(P﹤0.05)。正常对照组大鼠前列腺病理学检查未见明显病理变化;模型对照组大鼠前列腺组织表现为慢性炎症的病理变化;各治疗组大鼠前列腺慢性炎症改变均有不同程度缓解,其中混合治疗组的慢性炎症明显减轻。结论 锌剂具有活化提高前列腺组织细胞抗菌能力的作用,有利于前列腺组织炎性病理损害的缓解以及损伤组织的修复,与敏感抗生素结合治疗CBP具有更显著的治疗效果。
Objective To explore the zinc agent in the treatment of chronic bacterial prostatitis (CBP) rats and the effect. Methods 100 healthy adult male rats, were randomly divided into normal control group (n=20), CBP model group (n=20), CBP zinc treatment group (n=20), CBP levofloxacin treatment group (n=20) and mixed treatment group of CBP zinc and levofloxacin (n=20). Preparation of the CBP rat model was made by Xiaozhiling and E.coli system. CBP zinc treatment group, CBP levofloxacin treatment group and CBP mixed treatment group were given the appropriate drugs for treatment,besides,the normal control group, CBP model control group were given sterile saline. It took 10d. Rats in each group at 2d, 4d, 6d, 8d, 11d were detected, including the number of bacteria and the bacteria isolation and identification properties. The pathological study in 4d, 9d, 14d, 20d, 28d and prostate of rats in each group were detected. Results The prostate tissue of the CBP group rats in the treatment of bacterial number compared with the model control group decreased significantly (P<0.05). CBP mixed treatment of prostate were not detected in bacteria after 8d treatment.4 - 6 days of CBP treatment of prostate tissue in rats of the treatment group compared with the quantity of bacteria and CBP zinc decreased significantly (P<0.05). Normal control group rats pathological prostate pathology examination showed no significant pathological prostate tissue; The model control group rats showed chronic inflammatory pathological changes; The treatment group rat prostate inflammatory changes were alleviated chronic inflammation, which mixed treatment group were significantly reduced. Conclusion Zinc enhances prostate tissue antibacterial ability, is conducive to the inflammation in prostate tissue response and the repair of damaged tissue. Sensitive antibiotics combined with treatment of CBP have a significant therapeutic effect.
目的 探讨高黏度骨水泥在治疗骨质疏松性椎体压缩性骨折中的临床疗效分析。方法 随机选取本院2012年1月—2016年1月收治的80例骨质疏松椎体压缩性骨折患者。将患者随机分为对照组和观察组,每组各40例,均采用骨水泥联合经皮椎体后凸成形术治疗,对照组采用低黏度骨水泥,观察组采用高黏度骨水泥。采用视觉模拟量表(VAS)评分比较手术前后患者疼痛情况,Oswestry指数(Oswestry disability index,ODI)评分评估患者腰背部功能。观察并比较两组患者VAS、ODI评分,骨水泥渗漏及相关并发症情况。结果 所有患者均顺利完成手术,术后随访1年以上,期间未发生严重并发症。所有患者VAS评分,ODI评分均明显高于术前。两组均出现骨水泥渗漏及其他并发症,低黏度骨水泥组骨水泥渗漏率为66.7%,明显高于高黏度骨水泥组的33.3%,P<0.05,但均无明显神经功能损伤。结论 高黏度骨水泥在骨质疏松椎体压缩性骨折中的应用能显著改善患者临床疗效,明显降低骨水泥渗漏及并发症的发生率。
Objective To investigate the clinical effect of high viscosity bone cement for treatment of osteoporotic vertebral compression fractures. Methods From Jan. 2012 to Jan. 2016, 80 patients with osteoporosis vertebral fractures were enrolled into this study. They were randomly divided into control group and observation group, with 40 cases in each group. They were all adopted PKP methods for treating, while the observation group got the high viscosity bone cement and the control group got the low one. Clinical outcomes were assessed in terms of back pain visual analogue scale (VAS), Oswestry disability index (ODI) after surgery.The outcomes of back pain VAS score, ODI, venous leakage rate, discoidal leak rate, rate of around vertebral body, rate of contiguous vertebral fracture were compared between two groups. Results All patients were successfully completed surgery. We took postoperative follow-up more than one year, there were severe complications occurred. VAS score, ODI score were significantly higher than that of before operation. Two groups had both bone cement leakage and other complications. Low viscosity bone cement group of bone cement leakage rate was 66.7%, significantly higher than the 33.3% of the high viscosity of bone cement group, P<0.05, but no obvious neurologic injury. Conclusion The high-viscosity bone cement for osteoporotic vertebral fractures provides better clinical outcomes. It may reduce bone cement leak rate and complications.
目的 通过高通量测序法对多重耐药大肠埃希菌HX43进行耐药分子机制的研究。方法 用Illumina Miseq平台对HX43进行高通量测序,用Edena、RAST、ResFinder、MLST和BLAST等生物信息学工具或数据库进行数据分析,获得耐药基因相关序列数据。结果 HX43对多种临床常用抗生素均不敏感,仅对碳氢霉烯类药物敏感。对高通量测序数据的分析研究发现,该菌存在多种耐药基因,包括β-内酰胺类耐药基因3个(blaCMY-42、blaCTX-M-14和blaOXA-30),氨基糖苷类耐药基因5个(aac(3)-IIa、aadA5、 strA、 strB和aac(6′)-Ib-cr),喹诺酮类耐药基因1个(aac(6′)-Ib-cr),磺胺及甲氧苄啶类耐药基因3个(sul1、sul2和dfrA17),四环素耐药基因1个(tet(B)),氯霉素耐药基因2个(catB3和cmlA1),大环内酯类耐药基因2个(erm(B)和mph(A))。对包含blaCMY-42的contigs进行分析,发现该基因与ISEcp1插入序列、blc和sugE等基因相关联。质粒分型发现HX43携带5种不相容群的质粒。多位点序列分型(MLST)分析发现HX43属于ST3835,为国内外较少见的序列型。结论 高通量测序技术可准确获得临床菌株抗生素耐药的相关基因信息,为临床抗菌治疗提供重要的实验室数据支持。
Objective To investigate the molecular resistance mechanism of Escherichia coli HX43 by high-throughput sequencing. Methods HX43 was sequenced by the Illumina Miseq platform, and sequencing data were analyzed by the Edena, RAST, ResFinder, MLST and BLAST softwares and databases. Results HX43 was resistant to most common clinical antibiotics except carbapenems. Analysis of data revealed resistance genes to β-lactams (blaCMY-42, blaCTX-M-14 and blaOXA-30), aminoglycosides (aac(3)-IIa, aadA5, strA, strB and aac(6′)-Ib-cr), quinolones (aac(6′)-Ib-cr), trimethoprim/sulfonamides(sul1, sul2 and dfrA17), tetracyclines (tet(B)), chloramphenicol (catB3 and cmlA1), macrolides(erm(B) and mph(A)). Sequence analysis of the contig containing blaCMY-42 identified correlations of the gene with ISEcp1 insertion sequences, blc and sugE genes. Plasmid typing identified 5 plasmid incompatibility groups in HX43. MLST analysis found that HX43 belonged to ST3835, a relatively rare sequence type in the world. Conclusion Information of resistance genes can be obtained by high-throughput sequencing, which provides important experimental data for clinical antimicrobial treatment.
目的 分析广州市番禺区户籍和流动人口肺结核病发现延误情况,为研究结核病防治基本公共卫生服务均等化策略提供参考依据。方法 根据中国疾病预防信息系统登记的数据,对2013—2016年番禺区登记的肺结核病人进行统计。采用卡方检验的方法,对比分析户籍和流动肺结核病人发现延误的差异。结果 结核病发现延误中,男性患者户籍与流动患者延误天数比较差异有统计学意义(χ2=19.067,P<0.01),户籍患者延误天数30 d以上的比例高于流动患者。户籍与流动患者的医生延误天数比较差异有统计学意义,流动患者的医生延误比例高于户籍患者(χ2=18.001,P<0.01)。结论 广州市番禺区肺结核发现延误主要由户籍病人患者延误和流动病人医生延误所构成,需采取综合性干预措施,减少结核病患者的发现延误,从而进一步体现结核病防治基本公共卫生服务均等化。
目的 探讨小肠出血的诊断策略。方法 回顾性分析我院2010年1月— 2015年6月收治的42例小肠出血病例的诊治经历。结果 42例患者中肿瘤15例(35.7% );血管发育不良和畸形10例(23.8%);炎性肠病9例(21.4%),憩室7例(16.7%),原因不明1例(2.4%)。气钡双重造影阳性率11.8%;B超检查阳性率15%;核素扫描阳性率44.4%;CT检查阳性率46.7%;血管造影阳性率50%,小肠镜检查阳性率58.9%;胶囊内镜阳性率61.5%;术中肠镜检查阳性率88.9%。结论 小肠出血病因多样,检查缺乏特异性;隐性出血者可选择CT或胶囊内镜,结果阳性者进一步可行小肠镜检查或治疗;活动性出血患者选择ECT或DSA,手术探查或术中肠镜是最后选择。
Objective To investigate the diagnosis of small intestinal haemorrhage. Methods The diagnosis and treatment of 42 cases of small intestinal haemorrhage between January 2010 and June 2015 were analyzed retrospectively. Results Among the patients, small bowel tumors were found in 15 cases,angiodysplasia in 10,inflammation disease in 9,diverticulum in 7 and obscure bleeding in 1 each. Positive rate of diagnostic methods was followed:enteroclysis 11.7％,B-ultrasound 15%, ECT 44.5%,CT 46.7％,DSA 50%, device-assisted enteroscopy 58.9％, capsule endoscopy 61.5%,enteroscope examination during operation 88.9%. Conclusion There are various etiological factors and lack of specificity in small intestinal haemorrhage. Capsule endoscopy or CT should be used first if the patient had occult bleeding, positive patients were suggested to taken enteroscopy. ECT and DSA must be applicable for active bleeding or other positive patients. Operation or enteroscope examination during operation could be the last measure.
目的 调查流动人口肺结核患者治疗的健康服务需求的现状及其影响因素。方法 采用随机数字表达法,应用自行设计的调查问卷搜集了2015年9月1日—2016年1月30日在广州市胸科医院登记并确诊接受治疗随访的198例流动人口肺结核患者进行治疗相关健康服务需求情况问卷调查,分析患者的健康服务需求情况及不同特征患者需求进行比较。结果 需求率在前六位分别是健康教育为91.41%(181/198)、重视病情变化为90.40%(179/198)、疾病预防为87.88%(174/198)、与医护沟通为85.86%(170/198)、得到他人理解支持为83.84%(166/198)、心理疏导为80.81%(160/198),是否了解抗结核治疗知识、抗结核治疗与否及治疗分类在部分条目上需求率有统计学差异(P<0.05,P<0.01)。结论 流动人口肺结核患者抗结核治疗健康服务需求内容多样化;抗结核治疗的了解程度、抗结核治疗情况和治疗分类是影响治疗的健康服务需求的重要因素。建议对流动人口肺结核患者尽早提供系统的抗结核治疗的健康管理服务模式,以提升患者治疗的效果。
Objective To investigate current status and influencing factors of health care needs of tuberculosis patients in floating population. Methods Using method of random digits table,we collected 198 tuberculosis patients in floating population,who have registered and received treatment in Guangzhou Chest Hospital between September 1,2015 and January 30,2016. We distributed questionnaires about the health service requirement to patients based on on-site interview, and analyzed needs of patients health service. Needs of patients with different characteristics were compared. We collected their health service requirement. Results The rate of demand accounted for the top six were: health education was 91.41% (181/198), attach importance to the disease change was 90.40% (179/198), 87.88% (174/198)was for disease prevention, and medical communication was 85.86% (170/198), others understand support was for 83.84% (166/198), psychological counseling was for 80.81% (160/198). There was statistically different in knowing of whether the anti tuberculosis treatment knowledge, anti tuberculosis treatment and treatment in some items on demand classification rate (P<0.05, P<0.01). Conclusion Anti tuberculosis treatment needs of extensive health services of tuberculosis patients in floating population. Understanding degree, anti tuberculosis treatment and therapeutic anti tuberculosis are important factors influencing the tuberculosis drug treatment needs. It is recommended that TB patients in floating populationshould be diagnosed as early as possible to provide a systemic health management service mode of anti tuberculosis treatment in order to improve the effect of treatment.
目的 分析广州市离退休干部的体检结果,为疾病的预防和治疗提供依据。方法 以2015年在我院进行体检的离退休干部为对象,对其中有相同体检内容的3 841位的结果进行分析,探讨该人群中阳性体征检出率最高的前15种疾病,以及这些疾病在不同性别人群中的差异,并与2014年检出结果进行对比。结果 总体人群前15种阳性体征检出率疾病中,大部分疾病的检出率在不同性别人群有统计学差异。老年性白内障(总人群检出率67.56%)、高血压病(46.6%)、结节性甲状腺肿(44.18%)位居前三位;与2014年的检测结果相比,老年性白内障、高尿酸血症、胆囊结石这三种疾病的检出率有所下降,而结节性甲状腺肿、痔疮、慢性咽炎、高脂血症、胆囊炎这五种疾病的检出率有所上升(差异均有统计学意义,P<0.05)。结论 离退休人员性别差异罹患各种疾病的几率不同,男性更易罹患老年性白内障、高尿酸血症、牙周炎、牙龈炎、脂肪肝、糖尿病、胆囊炎。女性更易罹患结节性甲状腺肿、痔疮、慢性咽炎、高脂血症。定期健康体检后的进一步健康管理还相当薄弱,健康干预日益迫切需要。
Objective We analyzed the physical examination results of retired cadres,to acquaint the health status of the targeted population and provide the basis for the disease prevention and treatment. Methods Among the retired cadres who conducted healthy examination in the successive two years of 2014 and 2015, we selected 3841 cases of which examination items were the same in these two years. Based on their healthy examination results, we investigated the diseases of which detected rates of positive sign ranked in top 15, including the different appearances between different genders, and made comparisons with that of year 2014. Results Out of the top 15 diseases, senile cataract, hypertension and nodular goiter ranked in top 3. Compared with that of year 2014, a decrease of the detection rate could be seen in three diseases namely senile cataract, hyperuricemia and cholecystolithiasis, but an increase in five diseases namely nodular goiter, hemorrhoids, chronic pharyngitis, hyperlipidemia and cholecystitis. Conclusion Regular examination is an important way to acquaint the health status of retired cadres, and find pathogenesis risk factors timely. The healthy management however is still weak after physical examination.Thus it can be seen that healthy intervention has become increasingly urgent.
