目的 本研究以ICSI后未成熟卵母细胞为研究对象,分析比较卵母细胞不同发育阶段冷冻对其后续效果的影响,评估ICSI后未成熟卵母细胞的利用价值。方法 未成熟卵母细胞直接成熟培养(新鲜组)与玻璃化冷冻后成熟培养(冷冻组)的成熟率,并利用孤雌激活的方法比较卵母细胞的发育潜力。结果 发现新鲜组与冷冻组体外培养卵母细胞成熟率、受精率、卵裂率、优质胚胎率和囊胚率均无差异(P>0.05)。但两组的GV期卵母细胞成熟率低于MI期(P<0.05),且冷冻组的GV期卵母细胞受精率低于MI期(P<0.05)。不过裸卵体外成熟培养效果欠佳,特别是对GV期卵母细胞,体外成熟培养后的卵母细胞发育潜力低下,无囊胚形成。结论 ICSI后未成熟卵母细胞的冷冻对卵母细胞的发育潜力没有明显影响,但体外成熟培养的卵母细胞发育潜力低下,有待进一步提高体外成熟培养技术。

Objective In this study, the immature oocytes after ICSI were used to analyze the effects of freezing on the subsequent development of oocytes at different developmental stages, and to evaluate the utilization value of immature oocytes after ICSI(intracytoplasmic sperm injection). Methods The immature oocytes was directly cultured (fresh group) and matured after vitrification (frozen group), and the development potential of the oocytes was compared by parthenogenetic activation. Results There was no significant difference in the oocyte maturation rate, fertilization rate, embryo cleavage rate, high quality embryo rate and blastocyst rate between the fresh and frozen groups (P>0.05). However, the maturation rate of GV oocytes in the two groups was lower than MI oocytes (P<0.05), and the fertilization rate of GV oocytes in the frozen group was lower than MI oocytes (P<0.05). However, the in vitro maturation of naked oocytes was not effective, especially for GV oocytes, the oocyte development potential after in vitro maturation was low, there was no blastocyst formation. Conclusion The freezing of immature oocytes after ICSI has no significant effect on the development potential, but the development potential of naked oocytes matured in vitro was low, and the in vitro maturation culture technology of naked oocyte needs to be further improved.

目的 探讨中药竹罐结合体感音乐疗法在筋伤腰痛患者中的应用效果。方法 将128例患者按入院顺序分为实验组(68例)和对照组(60例),对照组采用中药竹罐疗法,实验组采用中药竹罐结合体感音乐疗法,4周后对两组患者的疗效、VAS 评分及满意度进行测评。结果 治疗后实验组患者疗效优于对照组(P＜0.01);治疗后实验组、对照组VAS 评分较治疗前降低,但实验组VAS 评分下降更明显(P＜0.01);治疗后实验组、对照组对治疗效果满意度较治疗前提高,而实验组对治疗效果满意度更高(P＜0.01)。结论 筋伤腰痛患者采取中药竹罐结合体感音乐疗法能起到缓解肌肉痉挛,身心放松,活血化瘀,温筋祛寒的作用。

Objective To explore the application effect of traditional Chinese medicine bamboo jar combined with somatosensory music in patients with tendon injury and low back pain. Methods 128 patients were divided into experimental group (68 cases) and control group (60 cases) according to the order of admission. The control group was treated with traditional Chinese medicine bamboo pot therapy. The experimental group was treated with traditional Chinese medicine bamboo pot combined with somatosensory music therapy. After 4 weeks, the curative effect, VAS score and satisfaction of the two groups were evaluated. Results After treatment, the curative effect of the experimental group was better than that of the control group (P<0.01); the VAS score of the experimental group and the control group was lower than that before treatment, but the VAS score of the experimental group was lower (P<0.01); the satisfaction of the experimental group and the control group was higher than that before treatment, while the satisfaction of the experimental group was more satisfactory (P<0.01). Conclusion The traditional Chinese medicine bamboo pot combined with somatosensory music therapy may alleviate muscle spasm, relax body and mind, promote blood circulation and remove blood stasis, warm tendons and dispel cold.

目的 探讨脑动静脉畸形(AVM)破裂出血发生的危险因素。方法 回顾性研究2014年—2018年我院收治的AVM病例42例,根据有无破裂出血,分为出血组和非出血组,对AVM破裂出血发生的相关因素进行统计学分析。结果 通过相关性及逐步回归分析,表明AVM破裂出血的独立危险因素为: 深部静脉引流和低龄患者。结论 对于引流静脉为深部静脉引流类型和低龄的AVM患者,应积极尽早治疗。

Objective To analyze the risk factors related to cerebral arteriovenous malformation(AVM)with hemorrhage. Methods The clinical data of 42 patients with AVM between 2014 and 2018 were respectively studied. According to the presence of rupture, the cases were divided into bleeding group and non-bleeding group. The factors associated with the occurence of AVM rupture were statistically analyzed. Results The correlation and logistic regression analysis suggested that the deep venous drainage and young patients were the independent risk factors for AVM rupture. Conclusion The young patients and the patients with deep venous drainage should be operated as soon as possible to avoid hemorrhage.

目的 研究罗哌卡因阻滞用于胸腹腔镜联合食管癌根治术后镇痛的临床效果。方法 胸腹腔镜联合食管癌根治术患者60例,分为: 观察组(n=30),缝合切口时用0.25%盐酸罗哌卡因10 mL于切口局部浸润;对照组(n=30) 不做局部浸润麻醉处理;记录二组术后2 h、6 h、12 h、24 h、48 h的疼痛视觉模拟评分(VAS)及血浆皮质醇浓度。结果 观察组术后2 h、6 h、12 h VAS评分优于对照组,术后12 h观察组血浆皮质醇浓度低于对照组。结论 罗哌卡因术终阻滞术后12 h内镇痛效果明显。

Objective To evaluate the efficiency of postoperative analgesia with ropivacaine block after thoracoscopic-lapacoscopic esophagectomy (TLE). Methods Totally 60 patients with esophageal cancer underwent TLE were divided into two groups: observation group(n=30)with 0.25% ropivacaine hydrochloride solution 10 mL injection around incision before end of the operation; control group(n=30)without the treatment. The VAS and the plasma Cortisol concentration at 2 h、6 h、12 h、24 h、48 h after surgery were recorded. Results The VAS at 2 h、6 h、12 h after surgery in observation group was higher than that of the control group,but not at 24 h、48 h after surgery. The plasma Cortisol concentration in the observation group was higher than that of in the control at 12 hours postoperatively. Conclusion Ropivacaine block of incision is helpful to have analgesic effect within 12 hours after TLE.

目的 评价Turbohawk定向斑块切除系统联合药物涂层球囊在下肢动脉硬化闭塞症中临床应用价值。方法 对于术前超声以及下肢动脉CTA检查诊断为下肢动脉硬化闭塞症的8例患者,行Turbohawk斑块旋切以及药物涂层球囊治疗,术后行常规抗凝治疗,定期行彩超复查。结果 8例患者下肢动脉均全部再通成功,技术成功率为100%,术后缺血症状明显改善,术后平均踝肱指数为0.78±0.06,高于术前的0.31±0.12(P<0.05)。住院期间无并发症发生,随访3～18个月,患者保肢均获得成功。结论 Turbohawk定向机械旋切系统联合药物涂层球囊治疗下肢动脉硬化闭塞症,具有创伤小、疗效好以及安全性高等优点,值得临床推广使用。

Objective To evaluate clinical application of using Turbohawk atherectomy device in combination with drug-coated balloon in treatment of atreriosclerosis obliterans in lower extremity. Methods Turbohawk atherectomy device and DCB was performed in 8 patiments with atreriosclerosis obliterans in lower extremity. All patients were diagnosed by ultrasound and CTA. Routine anticoagulation drugs were used after the operation. Follow-up was carried out with color Doppler ultrasound. Results Revascularization was gained in 8 patients. The technically successful rate was 100% and ischemic symptoms relieved significantly immediately after the operation. The post-operative ankle brachinal index(ABI) was 0.78±0.06,which was higher than that of before operation(0.31±0.12). No obvious complications occurred after operation. The follow-up range was 3~18 months and limbs were salvaged successfully. Conclusion With minimal invasive, safe and few complications, Turbohawk atherectomy device in combination with drug-coated balloon is proved to be a very effective treatment atreriosclerosis obliterans in lower extremity and it is worth to popularize.

目的 分析儿童危重症乙型流感患者的临床特点,提高临床医师对此危重症的认识水平。方法 对2017年12月—2018年2月广州市妇女儿童医疗中心收治的7例儿童危重症乙型流感患者的临床资料进行回顾性分析。结果 危重患儿好发年龄以幼儿及学龄前期为主。5例表现为呼吸衰竭,1例表现为心源性休克,1例表现为急性坏死性脑病。起病初(3 d内)均未见白细胞减少,白细胞数最高28.1×10⁹/L。白细胞分类以中性粒细胞为主。痰培养出流感嗜血杆菌、肺炎链球菌各1例。3例存在塑型性支气管炎改变。经积极治疗,体温恢复正常最短2 d,最长7 d,平均(4.20±1.79) d。住院时间最短12 d,最长23 d,平均(16.71±3.90)d。结论 乙型流感危重患儿临床表现多样,可累及多个系统器官;呼吸道合并症最多见,可出现塑型性支气管炎改变;及早识别及积极治疗,预后良好。

Objective To analyze the clinical characteristics of the children with severe influenza B and to provide reference for identifying severe cases. Methods Clinical data of 7 children with severe influenza B were retrospectively analyzed. Results The age ranged from 11 months to 7 years old, with an average was (4.13±2.06) years old. Five cases were characterized by respiratory failure, one by cardiogenic shock and one by acute necrotizing encephalopathy. No leukopenia was observed at the beginning of the disease(in 3 days), and the number of white blood cells was as high as 28.1×10⁹/L, White blood cell classification is dominated by neutrophils. haemophilus influenzae and streptococcus pneumoniae were produced by sputum culture in 1 case for each. Three patients had plastic bronchitis changes. After active treatment, the body temperature returned to normal with minimum 2 days, longest 7 days and average (4.20+1.79)days. The length of stay was the shortest 12 days, the longest 23 days, and the average (16.71+3.90) days. Conclusion The clinical manifestations of severe influenza B are diverse and may involve multiple system organs. Respiratory complications were the most common, with plastic bronchitis changes. Early recognition and active treatment had a good prognosis.

目的 应用FRAX^®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX^®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX^®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX^®工具进行骨折风险评估。

Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.

目的 探讨红细胞分布宽度(RDW)与稳定性冠心病的冠脉病变严重程度的关系,评价RDW对稳定性冠心病的预测价值。方法 收集我院2016年11月—2018年11月期间因胸痛住院的患者330例,根据冠脉造影确诊稳定性冠心病组200例,除外冠心病130例为对照组。比较2组RDW水平的差异,分析RDW与冠脉病变严重程度(Gensini评分)的相关性及稳定性冠心病的独立危险因素。结果 稳定性冠心病组RDW水平高于对照组(P<0.05),稳定性冠心病组RDW与 Gensini评分之间存在正相关(r=0.217,P=0.002);多因素logistic回归分析显示RDW(OR=2.950,95%CI: 1.986~4.381,P<0.001)是稳定性冠心病的独立危险因子。结论 RDW与稳定性冠心病的冠脉病变严重程度呈正相关,RDW是稳定性冠心病的独立危险因素,为稳定性冠心病的诊断提供一定预测价值。

Objective To investigate the relationship between the distribution width of red blood cells (RDW) and the severity of coronary artery disease in stable coronary artery disease(SCAD), and to evaluate the predictive value of RDW for SCAD. Methods Patients who were hospitalized for chest pain from November 2016 to November 2018 were enrolled (n=330). According to coronary angiography,200 patients were divided into SCAD group (n=200),except for the SCAD group, the remaining 130 cases were the control group(n=130). The differences of RDW levels between the two groups were compared, and the correlation between RDW and severity of coronary artery disease (Gensini score) and independent risk factors for SCAD were analyzed. Results The RDW level in the SCAD group was higher than that in the control group (P<0.05). There was a positive correlation between the RDW and Gensini scores in the SCAD group (r=0.217,P=0.002). Multivariate logistic regression analysis showed RDW (OR=2.950, 95% CI: 1.986~4.381, P<0.001) is an independent risk factor for SCAD. Conclusion RDW is positively correlated with the severity of coronary artery disease in SCAD. RDW is independent risk factor of SCAD and provides predictive value for the diagnosis of SCAD.

目的 探讨钙调磷酸酶结合蛋白1(calcineurin binding protein 1, Cabin1)在肾小管上皮细胞(renal tubular epithelial cells,RTECs)线粒体损伤中的作用机制。方法 采用siRNA干预体外培养RTECs,敲低Cabin1的表达,继而以电镜观察其对RTECs线粒体形态的影响。结果 在对照组和阴性对照组中Cabin1蛋白在RTECs中有高表达,采用siRNA干预RTECs后,Cabin1蛋白的表达量较对照组和阴性对照组降低50%以上(P＜0.05)。对照组与阴性对照组中,线粒体形态规则,呈圆形或椭圆形,线粒体膜完整,线粒体嵴清晰可见。敲低组中,线粒体肿胀,呈长条形或不规则形,线粒体膜、线粒体嵴结构模糊甚至消失。结论 敲低Cabin1引起RTECs的线粒体形态学异常,提示Cabin1是维持RTECs线粒体正常功能的重要分子。

Objective To investigate the role of calcineurin binding protein 1 (Cabin1) in renal tubular epithelial cells (RTECs) mitochondrial dysfunction. Methods Knocked down Cabin1 in RTECs with siRNA, Western bolt was applied to detect the level of Cabin1 protein. The morphology of mitochondria in RTECs were observed under microscopy. Results In control and negative control groups, Cabin1 protein was obviously expressed in RTECs. After knocked down by siRNA, Cabin1 protein expression was decreased (P＜0.05). In Cabin1 knocked down group, mitochondria changed from large and ellipsoid shape to the small, long and irregulars. Morover, mitochondria were swollen and cristae were remarkably dissolved. Conclusion Knocked down Cabin1 induced RTECs mitochondrial dysfunction, which indicates Cabin1 is a crucial factor regulating mitochondrial function.

目的 探讨Meis1在人子宫内膜细胞中的表达及其受雌、孕激素调控的规律。方法 通过免疫细胞化学和western blot的方法检测雌、孕激素对体外培养的在子宫内膜基质细胞(ESC)及Ishikawa细胞中Meis1的表达及调控。结果 Meis1在ESC和Ishikawa细胞均有表达,且均表达于细胞核中;在ESC中,E2、P4和 E2＋P4三组中Meis1平均蛋白表达水平均高于对照组(P<0.05)。Meis1在E2、P4和 E2＋P4组之间的表达水平亦差异有统计学意义(P<0.05),表达强度E2＋P4组>P4组>E2组;在Ishikawa细胞中,E2、P4和 E2＋P4使Meis1表达增强,表达强度P4组>E2＋P4组>E2组,但与对照组比较无差异(P>0.05),E2、P4和 E2＋P4各组间亦无差异(P>0.05)。结论 转录因子Meis1在ESC和Ishikawa细胞中受到雌、孕激素的调控,可能在子宫内膜容受性分子网络的构建中发挥着重要的作用。

Objective To investegate the expression and regulation discipline of Meis1 in human ESC and Ishikawa cells in vitro by estrogen and progesterone stimuli. Methods Immunocytochemistry and western blot were used to detect the expression and regulation discipline of Meis1 in human normal endometrial cells. Results Meis1 expressed both in endometrial stromal cells (ESC) and in ishikawa cells, and both situ in nucleus. In ESC, the expression of Meis1 was up-regulated by E₂/P₄ and E₂＋P₄, and the up-regulated effect may be superposition by E₂＋P₄, the differences between the groups were statistically difference(P<0.05). In Ishikawa cells, western blot showed that the expression of Meis1 was up-regulated by E₂/P₄ and E₂＋P₄. The differences weren't statistically significant when compared with the control group or between themselves(P>0.05). Conclusion The expression of transcription factor Meis1 is regularly regulated by estrogen and progesterone, which may be a key role during the formation of endometrial receptivity molecular network.