目的 观察平胃散联合耳穴治疗单纯性肥胖的临床疗效及其对血清神经肽Y(Neuropeptide Y,NPY)和瘦素(Leptin,LP)水平的影响。方法 64例单纯性肥胖患者,采用数字表法随机分为治疗组33例和对照组31例。治疗组予口服平胃散免煎颗粒配合耳穴治疗,对照组予口服奥利司他胶囊治疗,疗程4周。观察治疗前后体质量、体质量指数(bodymass index,BMI)、体脂百分比(Fat%,F%)、腰臀比(Waist Hip Ratio,WHR)、NPY、LP的变化。结果 治疗后,治疗组和对照组体质量、BMI、F%、WHR、相关疾病的危险度均下降(P＜0.001)。比较治疗前后体质量、BMI、F%、WHR差值,治疗组下降均比对照组明显(P＜0.01、P＜0.001)。治疗组临床疗效优于对照组(P＜0.05)。治疗组和对照组血清NPY、LP水平均下降(P＜0.001),且治疗组较对照组下降(P＜0.001)。结论 平胃散联合耳穴有较好的减肥作用,其机制可能是通过降低血清中NPY、LP含量。

Objective Clinical observation of Pingwei Powder combined with auricular point therapy in treating simple obesity and the effect on serum NPY and leptin Levels. Methods 64 cases of simple obesity patients were randomized into treatment group(33 cases) and control group(31 cases). The treatment group was given Pingwei Powder combined with auricular point therapy.The control group was given Orlistat capsules. After being treated for 4 weeks, body weight, bodymass index(BMI), fat% (F%), waist hip ratio (WHR),neuropeptide y (NPY) and leptin(LP) were determined. Results After post-treatment in treatment group and control group, body weight, BMI, F%, WHR, the risk of related diseases all decreased (P＜0.001), The body weight, BMI, F%, WHR before and after treatment were lower than those in the control group(P＜0.01, P＜0.001). The clinical efficacy of the treatment group was better than that of the control group(P＜0.05). Serum NPY and LP levels in treatment group and control group were decreased (P＜0.001), and that the treatment group were lower than of the control group (P＜0.001). Conclusion Pingwei Powder combined with auricular point therapy have better in weight loss, which is possibly by way of reducing serum NPY, LP Levels.

目的 探讨应用三维斑点追踪技术(3D-STI)评价冠心病患者左前降支冠状动脉支架置入(PCI)术前、术后左室局部收缩功能。方法 对30例接受左前降支PCl术的患者分别于术前、术后3～5天,术后3个月进行常规及三维超声心动图检查,获得患者左前降支冠状动脉供血的7个心肌节段(即前壁基底段、前间隔基底段、前壁中间段、前间隔中间段、前壁心尖段、前间隔心尖段及心尖帽)的收缩期纵向应变、径向应变、圆周应变及面积应变,分析冠状动脉支架植入术前、后各参数的变化规律。结果 PCI术后3～5天5/7节段纵向应变(前壁基底段、前壁中间段、前间隔基底段、前间隔中间段、前壁心尖段)、3/7节段面积应变(前壁基底段、前壁中间段、前间隔中间段)、3/7节段圆周应变(前壁基底段、前间隔基底段、前壁中间段)及2/7节段径向应变(前间隔基底段、前壁中间段)较术前相应心肌节段升高,差异有统计学意义(P＜0.05),PCI术后3个月左前降支供血各心肌节段纵向、圆周、径向及面积应变较术前、术后3～5天均升高,差异有统计学意义(P＜0.05)。结论 3D-STI能够早期评价冠心病患者左前降支冠状动脉PCI治疗前后左室局部收缩功能的改善,为临床早期评价PCI疗效及后续治疗提供诊断依据。

Objective To evaluate the left ventricular regional systolic function before and after left anterior descending coronary artery stent implantation (PCI) using three-dimensional speckle tracking imaging (3D-STI) in patients with coronary artery disease. Methods 30 patients who received left anterior descending PCl were underwent routine and three-dimensional echocardiography before and after 3~5 days, 3 months to obtain longitudinal strain(LS), radial strain(RS), circumferential strain(CS)and area strain(AS) of the seven myocardial segments(BA,BAS,MA,MAS,AA,AS,A ),which accepted blood from the left anterior descending coronary artery. We analyzed the changes of the parameters before and after the coronary stent implantation. Results The 5/7 segment of the longitudinal strain(BA,MA,BAS,MAS,AA), 3/7 segment of area strain(BA,MA,MAS), 3/7 segment of circumferential strain (BA,BAS,MA)and 2/7 segment of radial strain (BAS,MAS)at 3~5 days after PCI were higher than that before the operation. The difference was statistically significant (P＜ 0.05). The longitudinal, circumferential, radial and area strain of the left anterior descending branch at 3 months after the operation were higher than that before and 3~5 days after the operation. The difference was statistically significant (P＜ 0.05). Conclusion 3D-STI may early evaluate the improvement of left ventricular regional systolic function before and after coronary artery PCI treatment in patients with coronary heart disease, and provide a basis for early clinical evaluation of PCI effect and follow-up treatment.

目的 探讨血碱性磷酸酶水平对维持性透析患者血管钙化与骨质疏松的评估价值。方法 纳入我院186例维持性透析患者,记录相关临床资料并完善实验室检查,以X线片评价血管钙化情况,双能X线吸收法检查骨密度。对上述资料进行双变量相关分析、ROC曲线分析等统计学处理。结果 血碱性磷酸酶水平与股骨颈骨密度负相关,与腹主动脉钙化评分正相关。腹主动脉钙化评分与骨密度负相关。ALP对骨质疏松及严重腹主动脉钙化诊断的ROC曲线下面积分别为0.777及0.701。结论 碱性磷酸酶是评估透析患者血管钙化骨质疏松的良好指标。

Objective To explore evaluation value of alkaline phosphatase in vascular calcification and osteoporosis in maintenance dialysis patients. Methods 186 patients in maintenance dialysis were enrolled in this study. The related clinical data was recorded. The examination of X-ray (lateral abdomens) was done to estimate vascular calcification in patients. Bone mineral density was measured by dual energy X-ray absorptiometry. The results above were analyzed by bivariate correlation analysis and receiver operator characteristic curve. Results By bivariate correlation analysis,serum alkaline phosphatase level was negatively associated with femoral neck bone mineral density, and was positively associated with abdominal aortas calcification scores. Abdominal aortas calcification scores were negatively associated with femoral neck bone mineral density. ROC curve revealed AUCs were respectively 0.777 and 0.701 for serum alkaline phosphatase level in diagnosis of osteoporosis and severe abdominal aortas calcification. Conclusion Alkaline phosphatase may be a good index to evaluate calcification and osteoporosis in maintenance dialysis patients.

目的 探讨高压氧对FVB小鼠旷场行为的影响。方法 对9只4周龄高压氧组FVB小鼠进行2个疗程共21天高压氧干预;对13只4周龄对照组FVB小鼠不做任何处理,正常饲养。21天后对2组小鼠进行旷场实验,观察高压氧对FVB小鼠旷场行为的影响。结果 高压氧组小鼠在中央区停留时间(3.73±3.69,17.97±6.82,t=-5.564,P=0.000)和运动路程较对照组小鼠减少(189.65±199.32,525.67±244.22,t=-3.298,P=0.040),在外周区停留时间增加(296.07±3.69,281.79±6.79,t=5.597,P=0.000);进入中央区、外周区次数及穿越各区总次数都减少(3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008);2组小鼠总路程和平均速度无差异(8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726)。结论 高压氧改变FVB小鼠的旷场行为的表型,使小鼠趋避性增加,对环境的认知能力及焦虑程度增强,探索性下降。

Objective To explore the effect of hyperbaric oxygenation(HBO)on behaviors of FVB mice in the open field test. Methods 9 mice of four-week-old in the HBO group were treated with hyperbaric oxygenation for a total of 21 days during two courses while 13 control mice of four-week-old did not do any treatment. After 21-day normal breeding, the mice of two groups were tested with open field test. Then, researchers observed the effect of hyperbaric oxygenation on mice behaviors after open field test. Results Compared to 13 control mice, residence time (3.73±3.69,17.97±6.82,t=-5.564,P=0.000) and the range of movement (189.65±199.32,525.67±244.22,t=-3.298,P=0.040)in central region decreased while the residence time in external region increased (296.07±3.69,281.79±6.79,t=5.597,P=0.000). The times of entering the central region and external region and crossing both of the regions decreased (3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008). There was no difference in the total range of movement and the average velocity (8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726). Conclusion Hyperbaric oxygenation may change the behaviors of FVB mice in open field test to enhance its phobotaxis, anxiety degree and the cognitive ability in environment and inhibiting its exploration ability.

雄激素性脱发是一种人群中常见的损容性疾病,其发病与多种因素有关,而遗传因素在发病率中具较大的影响。低能量激光疗法(Low-Level Laser Therapy)是近年来用于治疗雄激素性脱发的光疗技术。低能量激光是一种低能量,短波长的激光,因早期研究发现其具有促进毛发生长的作用而被用于研究治疗雄激素性脱发(AGA)。在低功率激光疗法中,通过使用低能量激光照射毛囊,使毛囊炎性反应得以减轻,同时促进细胞新陈代谢,从而使休止期毛囊复苏,达到促进毛发生长的作用。本文通过对低能量激光疗法治疗雄激素性脱发的机制及效果进行论述,并讨论局部治疗、系统治疗等其他方法联合低功率激光在AGA治疗中的研究进展。

Androgenetic alopecia is a common and ashamed disease in the human population. Its incidence is related to a variety of factors, and the gene have a greater impact on the incidence. Low-level laser therapy LLLT is a phototherapy technique for the treatment of androgenetic alopecia in recent years. Low-level laser means low-energy, short-wave length that have been used for research and treatment of androgenetic alopecia because of the early discovery which is promoting hair growth. In LLLT, the laser irradiates hair follicles, so that reduces the folliculitis, while promoting cell metabolism.From this, the dormant hair follicles resume growth. This article discusses the mechanism and effect of low-level laser therapy for the treatment of androgenetic alopecia, and further discusses the advancement of topical treatment, systemic treatment, and other methods which combined with low-level laser in the treatment of AGA.

随着时代的发展,医学模式更具综合性,预防医学专业特性不仅体现其医学范畴,其综合性特点日益突出。因此预防医学专业医学生综合素质及创新能力的培养显得愈发重要。为了提高预防医学学生的综合素质及创新能力,我们从预防医学理论教学及实验教学开展了教学改革探讨。

目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

目的 分析全科医学教学中应用第三方满意度调查,结合学生需求的实践效果。方法 2016年3—12月接收全科医学学生者60例,按照常规方法进行,2017年3—12月全科医学学生62例,教学中应用第三方满意度调查结合学生需求方法,观察教学效果。结果 第二年时,学生期末考试总成绩、病例题成绩、实习报告成绩,课外自学时间、利用网络自学时间、与他人讨论学习时间,教学效果总体评分、课间实习评分均高于第一年,差异有统计学意义(P＜0.05)。结论 全科医学教学中应用第三方满意度调查结合学生需求方法后,可有效的提升教学效果,增强学生的自学能力及自学意识。

Objective To analyze the practical effect of applying the third party satisfaction survey to the needs of the students in the teaching of general medicine. Methods From March 2016 to December 2016, 60 cases of general practice medical students were enrolled. According to the routine method, 62 cases of general medical students from March 2017 to December 2017 were selected. Third party satisfaction survey and student demand method were applied in teaching, and the teaching effect was observed. Results In th second year, students' final exam scores, the total score, case questions internship report scores, extracurricular self-study time, self-study time, learning time, using the network to discuss with othersthe teaching effect of practice during the total score, all above were higher than the first year, there was significant difference (P<0.05). Conclusion The application of third party satisfaction survey combined with students' needs method in general practice teaching may effectively improve teaching effect; enhance students' self-learning ability and self-learning consciousness.

目的 探讨多种教学模式在加强医学生人文素养、沟通意识和沟通能力中的作用。方法 考察多种教学模式培养的临床学生(教学组)和传统模式培养的临床学生(对照组)在人文关怀、沟通技巧、职业素养、医患关系等方面的理论知识和病史询问为主的实践考核情况,并进行对比。结果 多种教学模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(21.03±2.00、20.78±2.11、21.01±2.12、20.91±2.07),病史询问成绩为(16.03±2.13)分,传统模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(20.29±2.26、19.84±2.33、20.24±2.49、20.05±2.32),病史询问成绩(14.89±2.43)分,均较多种模式培养组分数低,两组对比差异均有统计学意义(P<0.05)。结论 在神经病学教学中采用多种教学模式对提高学生沟通能力及人文素养有良好的效果。

目的 探讨品管圈活动在提高神经外科卧床患者便秘预防措施落实率中的的应用效果。方法 成立品管圈,确定以“提高神经外科卧床患者便秘预防措施落实率”为主题,进行现状调查,设定目标,进行要因分析,制定并实施措施,比较品管圈活动前后护士落实便秘预防措施情况。结果 实施品管圈活动后,神经外科卧床患者便秘预防措施落实率从活动前的41.59%上升至活动后85.6%,差异有统计学意义(P＜0.05)。结论 品管圈活动可以有效提高神经外科卧床患者便秘预防措施落实率,降低便秘的发生率,减轻患者痛苦,改善患者生活质量。