目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法 分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果 所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论 经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。
Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.
目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法 分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果 所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论 经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。
Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.
【摘要】目的：探讨HEART五步沟通模式对突发性耳聋（SSHL）患者心理状态及恢复情况的影响。方法：将2024年3月~2025年9月就诊于本院的110例SSHL患者作为研究对象，经抛币法将入组患者随机列为常规组、试验组，55例为一组。常规组实施常规临床护理，试验组在常规组的护理基础上联合实施HEART五步沟通模式，比较两组患者的心理状态，治疗依从性，护理结束后开展为期3个月短期随访，比较两组患者的听力改善情况及生活质量。结果：护理后，试验组的医院焦虑抑郁量表（HADS）、疾病不确定感（MUIS）评分分别为（8.25±1.39）分、（20.34±5.49）分，均低于常规组[（10.28±2.46）分、（25.52±6.67）分]（t=5.328，4.447；P＜0.05）。护理后，试验组的用药依从性、康复依从性、随访依从性均高于常规组（x2=9.429，11.733，11.282；P＜0.05）。试验组随访1个月、随访3个月时气导1kHz下平均听阈（PTA）及2kHz下PTA分别为（25.62±5.41）dB HL、（18.35±3.69）dB HL、（28.52±5.44）dB HL、（20.18±5.24）dB HL，均低于常规组[（30.67±6.35）dB HL、（21.33±4.25）dB HL、（33.69±6.37）dB HL、（25.49±6.33）dB HL]（t=4.490，3.927，4.577，4.792；P＜0.05）。截至随访结束时，试验组的成人听力障碍量表（HHIA）中社交维度、情绪维度、躯体维度评分均低于常规组（t=3.787，5.562，12.132；P＜0.05）。结论：HEART五步沟通模式可改善SSHL患者的不良心理状态并提升治疗依从性，对促进患者听力水平恢复及生活质量提升均有积极影响
[Abstract]Objective:To explore the impact of the HEART five step communication model on the psychological state and recovery of patients with sudden sensorineural hearing loss (SSHL).Methods:110 patients with SSHL who visited our hospital from March 2024 to September 2025 were selected as the research subjects. The enrolled patients were randomly divided into a control group and an experimental group using a coin toss method, with 55 patients in each group. The routine group received routine clinical nursing care, while the experimental group received the HEART five step communication model in addition to the routine nursing care. The psychological status and treatment compliance of the two groups of patients were compared. After the nursing was completed, a 3-month short-term follow-up was conducted to compare the hearing improvement and quality of life of the two groups of patients.Results:After nursing, the HADS and MUIS scores of the experimental group were (8.25 ± 1.39) points and (20.34 ± 5.49) points, respectively, which were lower than those of the control group [(10.28 ± 2.46) points and (25.52 ± 6.67) points] (t=5.328，4.447; P<0.05). After nursing, the medication compliance, rehabilitation compliance, and follow-up compliance of the experimental group were higher than those of the conventional group (x2=9.429，11.733，11.282; P<0.05). The PTA of the experimental group at 1kHz and 2kHz were (25.62 ± 5.41) dB HL, (18.35 ± 3.69) dB HL, (28.52 ± 5.44) dB HL, and (20.18 ± 5.24) dB HL, respectively, during a 1-month and 3-month follow-up, which were lower than those of the control group [(30.67 ± 6.35) dB HL, (21.33 ± 4.25) dB HL, (33.69 ± 6.37) dB HL, and (25.49 ± 6.33) dB HL] (t=4.490，3.927，4.577，4.792; P<0.05). As of the end of the follow-up, the scores of social, emotional, and physical dimensions in the HHIA of the experimental group were lower than those of the control group (t=3.787，5.562，12.132; P<0.05).Conclusion:The HEART five step communication model can improve the adverse psychological state of SSHL patients and enhance treatment compliance, which has a positive impact on promoting the recovery of patients' hearing level and improving their quality of life.
目的:探讨早期康复治疗对中青年脑卒中患者肢体运动功能恢复等影响。方法：从我院选取中青年脑卒中患者90例作为实验对象，分为实验组和观察组各45例，两组同时接受相同常规治疗并给予早期康复介入，并对其进行患侧上肢和下肢功能评定量表（ Fugl-Meyer, FMMS），以及患者日常生活活动能力（Modified Barthel Index,MBI）评定。实验组给予进一步强化康复运动治疗，以加速提高患者康复速率；2周结束时对实验组和观察组再次进行评估，比较2组患者治疗前后组内和组间治疗疗效。结果：早期康复2周后，实验组FMMS量表上肢评分为(29.82±15.43)分，观察组上肢评分为(21.33±11.98)分，组间存在统计学差异（P=0.005）。实验组FMMS量表下肢评分为(21.18±8.97)分，观察组下肢评分为(15.40±7.40)分，实验组得分高于观察组且两组间存在显著统计学差异（P=0.002）；随访1个月后实验组上下肢功能呈持续改善趋势，且两组间差异具有显著统计学意义。实验组MBI量表评分为(35.56±18.93)分，高于对照组（28.56±14.68）分，但未见统计学意义；1个月后两组间差异具有显著统计学意义（P＜0.001）。结论：研究表明，早期康复治疗对改善中青年脑卒中患者肢体功能和日常生活活动能力具有显著康复效果。
Objective:Exploring the impact of early rehabilitation therapy on the recovery of limb motor function and other aspects in young and middle-aged stroke patients. Methods: Ninety young and middle-aged stroke patients were selected from our hospital as experimental subjects and divided into two groups, namely the experimental group and the observation group, with 45 cases in each group. Both groups received the same conventional treatment and early rehabilitation intervention simultaneously, and were evaluated using the Fugl-Meyer Motor Scale (FMMS) for the affected upper and lower limbs, as well as the Modified Barthel Index (MBI) for activities of daily living. The experimental group received further intensive rehabilitation exercise therapy to accelerate the rehabilitation rate. At the end of 2 weeks, both groups were reassessed, and the therapeutic effects within and between the two groups before and after treatment were compared. Results: After 2 weeks of early rehabilitation, the FMMS upper limb score in the experimental group was (29.36±15.27) points, while that in the observation group was (25.18±11.99) points, with no statistically significant difference observed between the groups. The FMMS lower limb score in the experimental group was (20.93±8.93) points, higher than that in the observation group (15.40±7.40) points, with a significant statistical difference between the two groups (P=0.002). The MBI score in the experimental group was (33.22±15.96) points, higher than that in the control group (28.56±14.68) points, but no statistical significance was observed. Conclusions: Our study indicates that early rehabilitation therapy has certain effects on upper limb function and activities of daily living in patients, particularly demonstrating significant rehabilitation effects in improving lower limb functional recovery in young and middle-aged stroke patients.
目的 探讨膀胱镜在血尿患者膀胱病变诊断中的应用价值，并比较其与超声、CT尿路造影（CTU）、尿液细胞学的诊断效能差异，为临床精准诊疗提供参考。方法 回顾性选取在2020年6月至2025年6月期间本院收治的100例血尿患者作为研究对象，所有患者均 接受膀胱镜检查，以病理检查结果为金标准，分析病变类型分布情况；统计膀胱镜的诊断准确率、灵敏度、特异度；并比较4种检查方法对膀胱肿瘤的检出效能；记录并发症发生情况。结果 100例血尿患者经病理检查确诊：膀胱病变68例，其中膀胱肿瘤23例、膀胱炎26例、膀胱结石12例、膀胱息肉7例；非膀胱源性血尿32例。在膀胱肿瘤检出方面：超声灵敏度34.78%（8/23）、CTU灵敏度47.83%（11/23）、尿液细胞学灵敏度26.09%（6/23），而膀胱镜灵敏度为95.65%（22/23）。肉眼血尿组的膀胱病变检出率和膀胱肿瘤检出率均显著高于镜下血尿组（P<0.05）。经膀胱镜检查诊断：膀胱病变71例，阳性65例，阴性6例；非膀胱病变29例，阴性26例，阳性3例。膀胱镜的灵敏度、特异度和准确度分别为95.59%、81.25%、91.00%；膀胱镜与病理检查的一致性良好（kappa=0.894）。5例患者出现轻微血尿，3例患者出现尿道刺激症状，均在1～2天内自行缓解。无严重感染、膀胱穿孔等严重并发症发生。结论 膀胱镜检查对膀胱病变具有极高的诊断价值，其灵敏度显著优于超声、CTU及尿液细胞学。对于肉眼血尿患者，膀胱镜检查指征明确；对于镜下血尿患者，需结合危险因素综合评估检查必要性，避免过度医疗。
Objective This study explores the application value of cystoscopy in the diagnosis of bladder lesions in patients with hematuria, and compares its diagnostic efficacy with that of ultrasound, CT urography (CTU), and urine cytology, aiming to provide a reference for clinical precise diagnosis. Methods: A total of 100 patients with hematuria admitted to our hospital from June 2020 to June 2025 were retrospectively selected as the research subjects. All patients underwent cystoscopy. Taking the pathological examination results as the gold standard, the distribution of lesion types was analyzed, and the diagnostic accuracy, sensitivity, specificity of cystoscopy. Compare the detection efficacy of the four examination methods for bladder tumors; record the occurrence of complications. Results: Among 100 patients with hematuria, pathological examination confirmed that 68 cases had bladder lesions, including 23 cases of bladder tumors, 26 cases of cystitis, 12 cases of bladder stones, and 7 cases of bladder polyps. There were 32 cases of non-bladder origin hematuria. In terms of bladder tumor detection: the sensitivity of ultrasound was 34.78% (8/23), that of CTU was 47.83% (11/23), that of urine cytology was 26.09% (6/23), and that of cystoscopy was 95.65% (22/23). The detection rates of bladder lesions and bladder tumors in the group with gross hematuria were significantly higher than those in the group with microscopic hematuria (P < 0.05). Diagnosis by cystoscopy: 71 cases of bladder lesions, 65 positive cases and 6 negative cases. There were 29 cases of non-bladder lesions, including 26 negative cases and 3 positive cases. The sensitivity, specificity and accuracy of cystoscopy were 95.59%, 81.25% and 91.00% respectively. The consistency between cystoscopy and pathological examination was good (kappa=0.894). Five patients presented with mild hematuria and three patients had urethral irritation symptoms, all of which relieved spontaneously within 1 to 2 days. No serious complications such as severe infection or bladder perforation occurred. Conclusion: Cystoscopy has extremely high diagnostic value for bladder lesions, with its sensitivity significantly superior to ultrasound, CTU and urine cytology. For patients with gross hematuria, the indication for cystoscopy is clear; for those with microscopic hematuria, the necessity of the examination should be comprehensively evaluated based on risk factors to avoid excessive medical treatment.
目的 探讨长链非编码核糖核酸肺腺癌转移相关转录本 1（LncMALAT1）通过竞争性结合微小RNA-506-3p（miR-506-3p）调控Zeste同源物增强子2（EZH2）影响膀胱癌增殖的机制。方法 收集2023年1月—2024年10月的92例外科手术切除的膀胱癌组织及对应的癌旁组织标本, 利用Western blot和定量实时逆转录聚合酶链式反应（qRT-PCR）方法检测LncMALAT1和EZH2的表达情况。根据患者预后分为不良组（n=34）和良好组（n=58）, 收集患者的性别、年龄、肿瘤直径、血管侵袭情况、TNM分期、远处转移情况等临床指标, 结合临床病理指标分析LncMALAT1和EZH2与膀胱癌患者预后的关系。通过体外实验,包括qRT-PCR、Western blot、平板克隆和EdU实验,验证LncMALAT1对EZH2表达和膀胱癌细胞增殖的影响。利用生物信息学技术预测LncMALAT1与miR-506-3p的相互作用,并通过qRT-PCR验证在膀胱癌细胞中上调LncMALAT1表达后miR-506-3p的表达变化。结果 单因素结果显示, 血管侵袭情况、TNM分期、远处转移情况、LncMALAT1及EZH2表达水平均与膀胱癌患者预后不良有关, 差异有统计学意义（均P<0.05）。分析结果发现LncMALAT1与EZH2在膀胱癌组织中的表达呈正相关。体外实验结果显示, 上调LncMALAT1表达后, EZH2的表达显著上调, 且膀胱癌细胞的增殖能力显著提高（均P<0.05）。qRT-PCR验证表明,上调LncMALAT1表达后,miR-506-3p的表达显著下调（P<0.05）, 提示LncMALAT1通过竞争性结合miR-506-3p调控EZH2,进而影响膀胱癌细胞的增殖进展。结论 LncMALAT1通过竞争性结合miR-506-3p调控EZH2促进膀胱癌增殖功能,进而加快膀胱癌细胞的增殖进展, 可为膀胱癌的治疗提供新的潜在靶点。
Objective To explore the mechanism of long non-coding ribonucleic acid metastasis - associated lung adenocarcinoma transcript 1（LncMALAT1）regulating enhancer of Zeste homolog 2（EZH2）through competitive combination with microRNA-506-3p（miR-506-3p）to affect the proliferation of bladder cancer．Methods A total of 92 pairs of bladder cancer tissues and corresponding adjacent normal tissues were collected from surgical resections between January 2023 and October 2024．The expression levels of LncMALAT1 and EZH2 were detected using Western blot and qRT-PCR．The patients were divided into poor group（n=34）and good group（n=58）according to their prognosis．Clinical data, such as gender, age, tumor diameter, vascular invasion, TNM stage, and distant metastasis were collected, and the relationship between LncMALAT1 and EZH2 and the prognosis of bladder cancer patients was analyzed with clinical pathological indicators．Through in vitro experiments, including qRT-PCR Western blot, plate cloning and EdU experiment were conducted to verify the effect of LncMALAT1 on EZH2 expression and bladder cancer cell proliferation．Bioinformatics technology was used to predict the interaction between LncMALAT1 and miR-506-3p, and qRT-PCR was used to verify the change of miR-506-3p expression after up regulating LncMALAT1 expression in bladder cancer cells．Results The univariate results showed that vascular invasion, TNM stage, distant metastasis, LncMALAT1 and EZH2 expression levels were related to the poor prognosis of bladder cancer patients, and the difference was statistically significant（all P<0.05）．The results showed that the expression of LncMALAT1 and EZH2 in bladder cancer was positively correlated．In vitro experiment results showed that after up regulating LncMALAT1 expression, EZH2 expression was significantly up-regulated, and the proliferation ability of bladder cancer cells was significantly improved（all P<0.05）．QRT-PCR validation showed that the expression of miR-506-3p was significantly down regulated after the expression of LncMALAT1 was up-regulated（P<0.05）, suggesting that LncMALAT1 could regulate EZH2 through competitive combination with miR-506-3p, thereby affecting the proliferation and progression of bladder cancer cells．Conclusions LncMALAT1 can promote the proliferation of bladder cancer cells by competitively combining with miR-506-3p to regulate EZH2, and then accelerate the proliferation of bladder cancer cells, which can provide a new potential target for the treatment of bladder cancer．
