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 了解中山市儿童社区获得性肺炎病原学特点及其与年龄、抗生素使用的相关性,为疾病诊断和抗生素合理使用提供参考依据。方法 对中山市妇幼保健院儿科住院部2016年1月—2016年4月收治的小儿社区获得性肺炎临床资料、入院前使用抗生素和病原学检测结果进行回顾性分析。结果 共有155例研究对象纳入研究,细菌检出95株,其中革兰氏阴性菌61株,革兰氏阳性菌34株。流感嗜血杆菌,金黄色葡萄球菌,肺炎链球菌,大肠埃希氏菌,副流感嗜血杆菌的占构成比前五位。支原体和衣原体现症感染率约7.7%～8.4%。RSV检出率达25.8%。年龄在3 a以上、入院前使用过抗生素者,革兰阳性菌检出率较低(P<0.05)。入院前使用过抗生素者,革兰阴性菌检出率较高,且使用4 d及以上者高于使用3 d及以下者(P<0.05)。结论 住院儿童CAP的治疗,应综合考虑病人的年龄、入院前的抗生素使用情况,结合当地CAP 的可能优势病原选择合适的治疗方案。

Objective To explore the etiological characteristics and factors of community-acquired pneumonia(CAP) in children in Zhongshan for providing reference for the diagnosis and rational use of antibiotics for CAP. Methods Retrospective analysis were applied on clinical data and etiology results of CAP in children admitted to the pediatric inpatient department of Maternal and Child Health Hospital in Zhongshan from January to April, 2016. Results 155 children were enrolled. The number of bacteria detected was 95, including 61 Gram-negative bacteria, 34 Gram-positive bacteria. Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Haemophilus parainfluenzae accounted the top five. The recent infection rate of Mycoplasma and Chlamydia were from 7.7% to 8.4%. RSV detection rate was 25.8%.The Children who were over 3 years old, pre-use of antibiotics, associated with lower detection rate of Gram-positive bacteria (P<0.05). The Children who were the pre-use of antibiotics, associated with higher detection rate of Gram-negative bacteria, and the use of four days and more higher than three days or less(P<0.05). Conclusion For the treatment of CAP in children, the patient's age and pre-use history of antibiotics should be considered, combined with local common type of disease pathogens, to select the appropriate treatment.

目的 探讨多维铁口服液联合维生素AD滴剂治疗婴幼儿缺铁性贫血的疗效。方法 将首次诊断缺铁性贫血的336例婴幼儿依家长意愿分为2个治疗组(A组和B组)与1个对照组,A组予多维铁口服液联合维生素AD滴剂治疗,B组予多维铁口服液联合维生素D滴剂治疗,对照组饮食调理并补充维生素AD,于治疗4周后(3天内)采末梢血行血细胞分析,比较三组患儿贫血治疗显效率、总有效率差异。结果 治疗4周后,A组显效率为71.70%,总有效率为97.17%;B组显效率为41.05%,总有效率为90.30%;对照组显效率为6.25%,总有效率为32.29%。A组贫血治疗显效率、总有效率高于B组和对照组,差异均有统计学意义(P<0.05)。结论 铁剂联合维生素A制剂可显著提高婴幼儿缺铁性贫血的治疗效果。

Objective To observe the curative effect of multivitamin iron oral solution combined with vitamin AD drops on the treatment of iron deficiency anemia in infants. Methods 336 cases of infants who was found with iron deficiency anemia for the first time were divided into two treatment groups (group A and group B) and one control group in accordance with their parents' will. Group A was treated with multivitamin iron oral solution combined with vitamin AD drops. Group B was treated with multivitamin iron oral solution combined with vitamin D drops. The control group was taken just dietary therapy combined with vitamin AD drops. All subjects were tested blood analysis after 4 weeks of treatment (within 3 days). The differences of the treatment excellence rates and the total effective rates were compared in the three groups. Results After 4 weeks of treatment, the excellence rate in group A was 71.70%. The total effective rate in group A was 97.17%. The excellence rate in group B was 41.05%. The total effective rate in group B was 90.30%. The excellence rate in control group was 6.25%. The total effective rate in control group was 32.29%. The differences of the treatment excellence rates and the total effective rates in group A were significantly higher than those in group B or in the control group. The differences were statistically significant (P<0.05). Conclusion Multivitamin iron combined with vitamin A can significantly improve the curative effect of the treatment of iron deficiency anemia in infants.

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 探索蟾毒灵对舌鳞状细胞癌Tca8113细胞增殖、凋亡的影响及可能作用机制。方法 以人舌鳞癌Tca8113细胞为研究对象,MTT法检测10、20、40、80、160 nmol/L浓度蟾毒灵体外抑制Tca8113细胞增殖的活性;检测蟾毒灵干预下肿瘤细胞Na⁺-K⁺-ATP酶活性的变化;Western blot发检测Bcl-2、Bax、caspase-3蛋白表达。结果 蟾毒灵有抑制Tca8113细胞的活性,且呈剂量-时间依赖性;在蟾毒灵干预下Tca8113细胞Na⁺-K⁺-ATP酶收到抑制;Western blot结果显示凋亡相关Bax、caspase-3蛋白表达上调,Bcl-2蛋白表达下调。结论 蟾毒灵通过抑制细胞膜Na⁺-K⁺-ATP酶活性,通过调节Bcl-2凋亡通路的相关蛋白,最终激活caspase-3,诱导人舌鳞癌Tca8113细胞凋亡。

Objective To explore the effects of bufalin on proliferation and apoptosis of tongue squamous cell carcinoma Tca8113 cells and its possible mechanism. Methods Tca8113 cells were treated with 10, 20, 40, 80 and 160 nmol/L Tca8113 cells in vitro. MTT assay was used to detect the inhibitory effect of bufalin on the proliferation of Tca8113 cells; And the activity of Na⁺-K⁺-ATPase in tumor cells was detected by the interference of bufalin; The expression of Bcl-2, Bax and caspase-3 protein was detected by Western blot. Results Bufalin inhibited the activity of Tca8113 cells in a dose-and time-dependent manner; Na⁺-K⁺-ATPase in Tca8113 cells was inhibited by bufalin; The results of Western blot showed that the expression of Bax and caspase-3 protein was up-regulated and the expression of Bcl-2 protein was down-regulated. Conclusion Bufalin induced the apoptosis of human tongue squamous cell carcinoma Tca8113 cells by inhibiting the activity of Na⁺-K⁺-ATPase and regulating the related proteins of Bcl-2 apoptosis pathway, finally activating caspase-3.

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 研究NEK2(中心体相关激酶2)在前列腺癌和良性组织中的表达情况及其与前列腺癌预后的相关性。方法 运用qRT-PCR检测NEK2在前列腺癌和癌旁组织的表达差异,通过组织芯片免疫组化染色检测的方法检验NEK2在前列腺癌和癌旁组织的表达情况,最后使用Taylor的数据对NEK2进行生物信息学分析。结果 qRT-PCR检测NEK2在前列腺癌组织的表达显著高于癌旁组织(6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003),组织芯片免疫组化结果显示NEK2在前列腺癌组织的表达显著高于癌旁组织(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001),结合Taylor公用数据库分析,NEK2高表达组患者术后的生化复发生存率减少( χ²=4.33,P=0.037),NEK2高表达组和低表达组在前列腺癌总体生存率上没有明显区别( χ²=0.27,P=0.605)。结论 NEK2参与前列腺癌的发生、发展进程,同前列腺癌发病进程密切相关,通过检测前列腺癌患者NEK2的表达情况,可早期预测生化复发的概率,能够作为判断前列腺癌预后的潜在生物学标志物。

Objective To investigate the expression of NEK2(NIMA-related kinase 2)in prostate cancer as well as benign prostatic hyperplasia,and the involvement of NEK2 in the prognosis of prostate caner(PCa). Methods The different expression of NEK2 in the tissue of prostate cancer and the adjacent benign tissues of prostate were measured by real-time quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) analysis and immunohositochemistry analysis,and then bioinformatically analyzed using the Taylor dataset. Results QRT-PCR showed that NEK2 was highly expressed in PCa than in the adjacent benign tissues (6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003). Immunohositochemistry analysis showed the expression of NEK2 was higher in PCa than in the adjacent benign tissues(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001). Furthermore, the biochemical recurrence-free time of PCa patients in high NEK2 expression groups significantly reduced( χ²=4.33,P=0.037). The overall survival time of PCa patients was not correlated to NEK2 expression levels( χ²=0.27,P=0.605). Conclusion The above findings suggest that NEK2 is associated with production and development of PCa, and also critically connected with the process of PCa,which indicate that we can predict the probability of the biochemical recurrence-free time by detecting the expression of NEK2 in PCa patients,and NEK2 can also become a potential biomarker for PCa prognosis.

目的 分析他汀致肌病的影响因素,使临床更加合理的使用他汀类药物,减少不良反应的发生。方法 对1例口服阿托伐他汀钙片治疗5天后出现双大腿肌肉酸痛伴CK升高患者的病理生理因素、联合用药等情况进行分析,探讨他汀致肌病的相关因素及药学监护要点。结果 临床药师判断他汀导致肌病可能性大,提出治疗建议和监护计划,促进了患者病情好转。结论 他汀类药物导致肌病的影响因素较多,临床药师参与患者的临床治疗过程并加强药学监护,可促进药物治疗的安全性和有效性。

Objective To analyze the influencing factors of myopathy caused by statins, to make the clinical use of statins more rational and reduce the incidence of adverse reactions. Methods The pathophysiologic factors and combined medication of patients with both thigh muscle soreness and CK increase after five days of oral atorvastatin calcium therapy were analyzed. The related factors of statin- induced myopathy and the points of pharmacy care were discussed. Results Clinical pharmacists determined the possibility of statin lead to myopathy, and put forward treatment recommendations and monitoring program to promote the patient's condition improved. Conclusion There are many influencing factors of myopathy caused by statins. Clinical pharmacists participate in the clinical treatment of patients and strengthen the medical care, which can promote the safety and effectiveness of drug treatment.

目的 分析社区综合干预对小儿反复呼吸道感染的影响,为社区临床治疗小儿反复呼吸道感染性疾病提供理论依据。方法 采用随机抽签方式,从我社区2012年10月—2014年10月期间收治的小儿反复呼吸道感染患儿中,随机抽取60例纳入本项研究,依据就诊单双顺序,分为研究组30例(社区综合干预方式)和对照组30例(常规性治疗和常规措施进行干预),对两组患儿干预结果进行对比分析。结果 研究组治疗总疗效高于对照组(93.33% vs 76.67%),差异有统计学意义(P<0.05)。对比治疗干预过程中疾病发作次数、就诊次数状况,研究组优于对照组,差异有统计学意义(P<0.05)。干预后研究组小儿呼吸道感染致病因素改善情况(除滥用抗生素外)优于对照组,差异有统计学意义(P<0.05)。结论 针对小儿反复呼吸道感染疾病可采用社区综合干预方式,可显著提升治疗有效率,缓解病情,降低反复感染发生率,效果突出,具有广阔应用前景。