论著
目的 从炎症反应和肠道屏障两个方面探究五味苦参肠溶胶囊对葡聚糖硫酸钠(DSS)诱导的小鼠结肠炎的治疗作用。方法 6~8周龄雄性BALB/c小鼠被随机分为3组,分别为正常组、急性肠炎模型组和五味苦参组。急性肠炎模型组和五味苦参组小鼠予含有3% DSS的饮用水1周诱导急性结肠炎,其后急性肠炎模型组予PBS灌肠,五味苦参组予五味苦参肠溶胶囊制备为灌肠液灌肠。每天称量小鼠体质量,观察大便性状及血便情况,第8天处死小鼠,取结肠组织检测炎症细胞因子和肠屏障因子。结果 与正常组相比,急性肠炎模型组肠道炎症明显,五味苦参组有效缓解肠道炎症和有利于肠上皮屏障修复。表现为五味苦参灌肠液有效缓解小鼠体质量下降,具有较低的DAI评分,有较好的组织学表现,其结肠组织IL-1β,IL-6和TNF-α的相对表达下降,Occludin和ZO-1的相对表达增加(P<0.05)。结论 五味苦参肠溶胶囊制备的灌肠液可减轻DSS诱导的小鼠急性结肠炎。
Objective To explore the therapeutic effect of five-flavor sophora flavescens enteric-coated capsules(FSEC)on dextran sulphate sodium(DSS)-induced colitis in mice from inflammatory response and intestinal barrier.Methods Male BALB/c mice aged 6-8 weeks were randomly divided into three groups,namely normal group,acute colitis group and FSEC group.The mice in acute colitis group and FSEC group were given drinking water containing 3% DSS for one week to induce acute colitis,and then they were given PBS enema or FSEC enema respectively.The mice were administered daily,including weight loss,the stool properties and bloody feces.The mice were sacrificed on the 8th day,and the colon tissue was collected to detect inflammatory cytokines and intestinal barrier cytokines.Results Compared with the normal group,the intestinal inflammation in the acute colitis group was obvious,however the FSEC effectively relieved intestinal inflammation and facilitated the intestinal epithelial barrier repair.It showed that FSEC enema effectively relieved weight loss and had a lower disease activity index score.In addition,FSEC enema group had better histological appearance.Compared to acute colitis group,the relative expression of IL-1β,IL-6 and TNF-α in colon tissue decreased,and the relative expression of Occludin and ZO-1 significantly increased in FSEC group(P<0.05).Conclusions FSEC enema can alleviate DSS-induced acute colitis in mice.
专家综述
融合基因是指两个独立基因的编码区首尾相连所形成的且置于同一套调控序列控制的产物,研究表明许多癌症的发生与融合基因存在密切的联系。融合基因可作为癌症治疗的靶点,在癌症诊断及治疗领域中融合基因的研究具有重要意义。部分融合基因驱动癌症的机制已被初步揭示,但是有些真实存在的在肿瘤发生发展过程中有重要意义的融合基因由于工具和实验技术限制还未被发现。因此,对融合基因的分析预测研究方法逐渐成为关注的热点之一。本文探讨了目前常用的关于融合基因的分析工具及方法,为融合基因在癌症中的研究提供思路。
Fusion genes are the products of two independent genes whose coding regions are linked and controlled by the same set of regulatory sequences.Studies have shown that many cancers are closely linked to gene fusions.Fusion genes can be used as targets for cancer therapy,and the study of fusion genes is of great importance in cancer diagnosis and treatment.Some of the mechanisms of fusion genes driving cancer have been initially revealed,but there are more fusion genes which are important in the process of tumor development have not been discovered due to the limitation of tools and experimental techniques.Therefore,the analysis and prediction methods of fusion genes are becoming a hot topic of interest.In this paper,we discuss the commonly used analytical tools and methods on fusion genes to provide ideas for the study of fusion genes in cancer.
综述
高压氧治疗是在高于当地压力的环境下,吸入高于当地大气氧浓度的氧来治疗疾病的方法,主要用于缺氧缺血性疾病或与缺氧缺血有关的疾病的治疗。炎症作为机体对刺激的一种防御机制,是感染、损伤、中毒等疾病共同的病理生理基础,在疾病的发生发展中扮演重要角色。高压氧与炎症的关系密切,围绕高压氧与炎症调节相关的研究进行综述,对深入认识高压氧的作用机制具有重要的意义。
Hyperbaric oxygen therapy is the treatment of diseases by inhaling oxygen at a concentration higher than the local atmospheric oxygen concentration in an environment that higher than the local pressure.It is mainly used in the treatment of hypoxic-ischemic diseases or diseases related to hypoxia-ischemia.As a defense mechanism against stimulation,inflammation is the common pathophysiological basis of infection,injury,poisoning and other diseases,which plays an important role in the occurrence and development of diseases.Hyperbaric oxygen is closely related to inflammation.The review on hyperbaric oxygen and inflammation regulation is of great significance to further understand the mechanism of hyperbaric oxygen.
综述
目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。
Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions.Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method.Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation.Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods.The conclusion part of the article proposes directions and challenges for future research.
临床诊疗
目的 以单中心法研究心房颤动患者住院病死率的影响因素。方法 纳入2019年3月—2022年3月于我院住院治疗的338例心房颤动患者作为研究对象,统计住院病死率,并以单因素Logistic回归分析法,分析对患者病死率产生影响的风险因素。结果 统计结果显示,在338例患者中,住院死亡人数为13例,死亡率3.85%;经单因素分析发现,患者的年龄高龄、有慢性肾病病史以及机体贫血均是导致患者住院病死的主要影响因素;脂代谢异常、左房内径稍大、左室射血分数较高则是降低患者住院病死率的重要影响因素。结论 贫血、慢性肾病以及高龄均会提升房颤患者住院期间的病死率,而心功能较强的患者住院死亡率则明显降低,临床治疗期间需高度关注上述因素。
论著
目的 探讨全程健康管理对糖尿病患者的血糖控制应用效果分析。方法 选择在我院门诊接受治疗的200例糖尿病患者作为研究对象,采用随机数表法分为对照组和观察组,各100例。对照组采用常规健康教育对患者进行健康指导,观察组在对照组基础上对患者行全程健康管理干预,建立糖尿病健康教育小组,对患者进行个体化的健康指导。比较2组患者干预后心理评估及空腹血糖、餐后2 h血糖的变化情况。结果 观察组患者予全程健康教育指导后,GAD-7焦虑量表及PHQ-9抑郁量表测试结果、空腹血糖及餐后2 h血糖控制效果优于对照组(P<0.05)。结论 行全程健康管理干预可有效改善糖尿病患者焦虑抑郁情绪,有效改善空腹血糖、餐后2 h血糖,增强患者自我保健意识。
Objective To explore the effect of whole process health management on blood glucose control in patients with diabetes.Methods A total of 200 patients with diabetes who were treated in the outpatient department of our hospital were studied and divided into control group and observation group,with 100 cases respectively.The patients in control group were given routine health guidance.The patients in observation group underwent whole-process health management intervention on the basis of control group,the diabetes health education group was established and individualized health coaching was given.Psychological assessment and fasting blood glucose and 2-hour postprandial blood glucose changes in the 2 groups of patients after the intervention were compared.Results After receiving whole course health education and guidance,the score GAD-7 anxity scale,PHQ-9 depression scale,pre-prandial blood glucose and 2 h postprandial blood glucose in observation group were better than those of control group(P<0.05).Conclusions The whole process of health management intervention can improve anxiety and depression of diabetes patients,lower blood glucose levels before meals and 2 h after meals,enhance patients’ self-awareness.
论著
目的 了解门诊老年患者补充与替代医学(CAM)使用现状及影响因素。方法 采用便利抽样法,选取2020年11月—2021年2月广东省某三甲医院老年科门诊就诊的老年患者作为研究对象,调查方法采用一般资料调查表和CAM使用情况调查表进行横断面调查。应用二元Logistics回归分析探讨门诊老年患者使用CAM的影响因素。结果 参与调查的123例老年患者中,有75例(61.0%)老年患者使用CAM,使用CAM的项目主要为中草药、药膳等中国传统医学项目。支付方式是门诊老年患者是否使用CAM的影响因素,使用医保支付的患者较公费、自费患者更愿意使用CAM(OR=5.054,95%CI:1.452~17.590,P<0.05)。结论 CAM在门诊应用广泛,我们应充分发挥我国传统医学优势,为老年人疾病防治提供更多的思路。政府层面也可进一步提高医保覆盖范围,让更多的患者有经济能力可以接受安全、有效的治疗。
Objective To investigate the current status of complementary and alternative medicine(CAM)use and the influencing factors of elderly patients in outpatient clinic.Methods Using the convenience sampling method,the elderly patients treated in the geriatric outpatient department of a Class A tertiary Hospital in Guangdong from November 2020 to February 2021 were selected.General data and the CAM usage questionnaire were collected.Binary logistics regression analysis was used to explore the factors influencing CAM use in elderly patients.Results Seventy-five(61.0%)of 123 elderly patients used CAM.Chinese herbal medicine and medicinal diet were the most common CAM.Payment method was a factor affecting whether elderly outpatient patients use CAM.Insured patients were more willing to use CAM than self-funded patients(OR=5.054,95%CI:1.452-17.590,P<0.05).Conclusions CAM is widely used in outpatient clinics.We should make full use of our country’s traditional medicine,to provide different thoughts of diseases prevention and treatment in elderly patients.The government can also further enlarge the coverage of health insurance,so that more patients can afford safe and effective treatment.
论著
目的 探讨血清脂联素(ADPN)、糖类抗原125(CA125)及抗苗勒管激素(AMH)水平检测在多囊卵巢综合征(PCOS)中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数(BMI)是否大于28 kg/m2分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义(P<0.05)。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关(P<0.05),ADPN与AMH无关(P>0.05)。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。
Objective To explore the clinical diagnostic value of serum adiponectin(ADPN),carbohydrate antigen 125(CA125)and anti-Mullerian hormone(AMH)levels in polycystic ovary syndrome(PCOS).Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects.All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group.The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index(BMI)whether was greater than 28 kg/m2.A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL.A hundred healthy women of similar age were selected as the healthy control group.The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed.Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group(P<0.05).Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level.There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH.Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased.The three indicators have good diagnostic value in PCOS and are worth promoting.
论著
目的 探讨鳞状上皮细胞抗原(SCCA)、人乳头瘤病毒(HPV)-DNA联合阴道镜检查在宫颈鳞状细胞癌(SCC)筛查中的应用价值。方法 选择2019年1月1日—2021年12月31日在中山市博爱医院就诊并确诊为SCC的妇女作为研究对象,共纳入100例SCC患者(SCC组),同时选择200例经活检确诊为宫颈慢性炎症的患者(宫颈慢性炎症组)作为阴性对照。采用阴道镜观察研究对象的宫颈情况,并采集研究对象的宫颈组织标本进行HPV-DNA检测。采集研究对象的静脉血,采用化学发光免疫法测定研究对象SCCA的水平。以病理检查结果为金标准,分别对HPV-DNA检测、外周血SCCA两者联用以及阴道镜、HPV-DNA检测、外周血SCCA三者联用进行筛查效果的评价。结果 SCC组研究对象的年龄≥40岁者、出血者、性生活开始年龄≤20岁者比例均高于宫颈慢性炎症患者组;而宫颈慢性炎症患者组疼痛的比例高于SCC患者组,差异均有统计学意义(P<0.01)。χ2检验结果显示,SCC组研究对象的SCCA阳性率高于宫颈慢性炎症组(P<0.001)。阴道镜结合SCCA、HPV-DNA检测筛查SCC的灵敏度和特异度均高于单独使用SCCA和HPV-DNA,并取得较好的约登系数(75%)和Kappa值(0.730)。结论 采用阴道镜结合HPV-DNA、SCCA可有效提高SCC疾病的约登系数与Kappa值,其联合诊断的效能高于单独使用阴道镜、HPV-DNA或SCCA诊断SCC。
Objective To study the application value of squamus cell carcinoma antigen(SCCA)and human papillomavirus(HPV)-DNA combined with colposcope in cervical squamous cell carcinoma(SCC)screening.Methods Women diagnosed with SCC who visited Boai Hospital of Zhongshan city from January 1,2019 to December 31,2021 were selected as research subjects,including 100 patients with SCC(SCC group)and 200 patients with chronic cervical inflammation confirmed by biopsy(chronic cervical inflammation group).The cervix of the subjects was observed by colposcope,and cervical tissue samples were collected for HPV-DNA testing.Venous blood of subjects was collected and SCCA levels were determined by chemiluminescence immunoassay.Using pathological examination results as the gold standard,the screening effect of combination HPV-DNA test and peripheral blood SCCA test,combination colposcope,HPV-DNA test and peripheral blood SCCA were evaluated respectively.Results In SCC group,the proportion of age≥40 years old,bleeding,sexual life age ≤20 years old were higher than those in chronic cervical inflammation group,but chronic cervical inflammation group had higher rate of pain than those in SCC group(P<0.01)by Chi-square test.SCCA positive rate in SCC group was higher than that in chronic cervical inflammation group(P<0.001)by Chi-square test.The sensitivity and specificity of colposcope combined with SCCA and HPV-DNA were higher than those of SCCA and HPV-DNA alone,and better Youden’s coefficient(75%)and Kappa value(0.730)were obtained.Conclusions Colposcope combined with HPV-DNA and SCCA can effectively improve the Youden’s coefficient and Kappa value of SCC disease,and its combined diagnosis efficiency was higher than that of colposcope,HPV-DNA and SCCA alone in the diagnosis of SCC,which has high clinical promotion significance.
论著
目的 探究新斯的明拮抗顺阿曲库铵的时机对患者腹腔镜结直肠癌根治术后肌松残留和早期肺功能的影响。方法 选取于2021年2月—2022年9月在我院行结肠癌根治手术的194例患者为研究对象,以随机数字表法将患者分为空白对照组和试验组,然后结合给予新斯的明治疗时所体现的4个成串刺激(TOF)比值将试验组患者分为试验组A(TOF≤0.1)、试验组B(0.10.8)。对比组间肌松残余情况以及肺功能情况。结果 插管前,试验组A患者TOF比值低于其他组(P<0.01),空白对照组患者TOF比值高于其他组(P<0.01);空白对照组分别与试验组A~E在复苏室接受观察的时间比较,差异无统计学意义(P>0.01);试验组A患者肌松恢复指数低于其他组(P<0.01),空白对照组患者肌松恢复指数高于其他组(P<0.01)。插管前、拔管0.5 h以及拔管24 h时,组间1秒用力呼气容积(FEV1)、用力肺活量(FVC)和FEV1/FVC比较差异无统计学意义(P>0.05)。结论 结直肠癌根治术后给予新斯的明,有助于加快肌松恢复,但不会影响复苏室停留时间与肺功能水平。
Objective To investigate the effect of timing of neostigmine antagonizing cisatracurium on residual muscle relaxation and early lung function in patients underwent laparoscopic radical resection of colorectal cancer.Methods February 2021 to September 2022,194 patients who underwent radical colon cancer surgery in our hospital were selected as the research subjects.The patients were randomly divided into a blank control group and an experimental group using a random number table method.Then,combined with the train-of-four(TOF)ratios observed during neostigmine treatment,the experimental group patients were divided into experimental group A(TOF≤0.1),experimental group B(0.10.8).The residual muscle relaxation and lung function between groups were compared.Results Before intubation,the TOF ratio of patients in experimental group A was lower than that of other groups(P<0.01),while the TOF ratio of patients in the blank control group was higher than that of other groups(P<0.01).There was no significant difference in the observation time between the blank control group and the experimental group A~E in the postanesthesia care unit(P>0.01).The muscle relaxation recovery index of patients in experimental group A was lower than that of other groups(P<0.01),while the muscle relaxation recovery index of patients in the blank control group was higher than that of other groups(P<0.01).There were no significant differences in force expiratory volume in one second(FEV1),forced Vital capacity(FVC)and FEV1/FVC between groups before intubation,0.5 h after extubation and 24 h after extubation(P>0.05).Conclusions Administration of neostigmine after radical surgery for colorectal cancer can accelerate muscle relaxation recovery,but it will not affect the residence time of the postanesthesia care unit and lung function levels.