目的 探究百令胶囊联合前列地尔对早期糖尿病肾病患者血液流变学及肾功能影响。方法 选我院2020年1月—2021年1月期间100例糖尿病肾病患者为研究对象,将其以随机数字表法分为对照组、观察组,各50例,分别应用前列地尔治疗、前列地尔+百令胶囊治疗,比较2组治疗前后血液流变学指标、肾功能指标。结果 治疗前2组血浆粘度、全血粘度、红细胞聚集指数水平相近,差异无统计学意义(P＞0.05);治疗后观察组血浆粘度、全血粘度、红细胞聚集指数水平较对照组低,差异有统计学意义(P＜0.05);治疗前2组微量蛋白排泄率(UAER)、血尿素氮(BUN)、血肌酐(Scr)水平相近,差异无统计学意义(P＞0.05);治疗后观察组UAER、BUN、Scr水平较对照组低,差异有统计学意义(P＜0.05);2组治疗期间均未见严重不良反应。结论 对早期糖尿病肾病患者应用百令胶囊+前列地尔治疗,可改善其血液流变学指标及肾功能指标,降低炎症反应程度,治疗安全且疗效理想。

Objective To explore the effect of Bailing capsule combined with alprostadil on hemorheology and renal function in patients with early diabetic nephropathy. Methods A total of 100 patients with diabetic nephropathy in our hospital from January 2020 to January 2021 were randomly divided into control group and observation group, 50 cases in each group.They were treated with alprostadil and alprostadil with Bailing capsule respectively.The indexes of hemorheology and renal function before and after treatment were compared between the two groups. Results Before treatment, the levels of plasma viscosity, whole blood viscosity and erythrocyte aggregation index of the two groups were similar, and the differences were not statistically significant (P > 0.05). After treatment, the levels of plasma viscosity, whole blood viscosity and erythrocyte aggregation index of the observation group were lower than those of the control group, and the differences were statistically significant (P<0.05). Before treatment, the levels of urine albumin excretion ratio, blood urea nitrogen and serum creatinine in the two groups were similar, and the differences were not statistically significant (P > 0.05). After treatment, the levels of urine albumin excretion ratio, blood urea nitrogen and serum creatinine in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). There was no serious adverse reaction in the two groups during the treatment. Conclusion Bailing capsule combined with alprostadil in the treatment of early diabetic nephropathy can improve the indexes of hemorheology and renal function, lower the inflammatory reaction, and the treatment is safe and effective.

目的 分析补阳还五汤加减治疗肾病综合征(NS)的临床疗效。方法 选择本院2019年1月—2021年1月住院治疗的120例NS患者,通过随机数字表法分组,参照组60例患者采纳常规西医治疗,试验组60例患者在参照组基础上予以补阳还五汤治疗,对比2组临床疗效、中医症候积分、肾功能指标、不良反应总发生率。结果 试验组临床总有效率(96.67%)高于参照组(80.00%),试验组治疗后浮肿少尿、腰膝酸软、腹部胀满、头晕乏力积分均低于参照组,差异均有统计学意义(P＜0.05)。治疗后试验组24 h尿蛋白、尿素氮均比参照组低,差异有统计学意义P＜0.05,血肌酐治疗前后差异无统计学意义P>0.05。试验组不良反应总发生率(5.00%)与参照组(6.67%)比较,差异无统计学意义(P>0.05)。结论 补阳还五汤可有效改善NS患者临床症状、肾功能,降低蛋白尿,且不良反应较少,安全性较高,疗效确切。

Objective To analyze the clinical effect of addition or reduction of Buyang Huanwu decoction in the treatment of nephrotic syndrome (NS). Methods A total of 120 NS patients in our hospital from January 2019 to January 2021 were divided into two groups by random digital table method. Sixty patients in the control group were treated by conventional western medicine, 60 patients in the experimental group were treated with Buyang Huanwu decoction on the basis of control group.The clinical efficacy, traditional Chinese medicine syndrome score, renal function index and total incidence of adverse reactions were compared. Results The total clinical effective rate of the experimental group (96.67%) was higher than that of the control group (80.00%). The scores of edema and oliguria, lumbar and knee pain and limpness, abdominal distention and dizziness after treatment in the experimental group were all lower than those in the control group, with statistical significance (P<0.05). After treatment, 24 h urinary protein volume and blood urea nitrogen level in the experimental group were lower than those in the control group, the differences were statistically significant (P<0.05), while there was no statistically significant difference in serum creatinine before and after treatment (P>0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group (5.00%) and the control group (6.67%,P>0.05). Conclusion Buyang Huanwu decoction could effectively improve the clinical symptoms and renal function, reduce proteinuria, and had less adverse reactions, high safety level and accurate curative effect.

目的 探讨组蛋白去乙酰化酶抑制剂曲古霉素对肝癌细胞增殖凋亡是否存在影响,及该抑制作用是否与自噬相关。方法 采用MTT法检测不同浓度曲古霉素作用于肝癌HepG2细胞24 h、48 h、72 h以后肝癌细胞的增殖能力;使用流式细胞术检测不同浓度曲古霉素对HepG2肝癌细胞周期及凋亡的影响;蛋白印迹法(Western blot, WB)检测不同浓度曲古霉素对肝癌HepG2细胞中Beclin1和Bcl-2蛋白的表达;实时荧光定量 PCR(Real-time PCR, RT-PCR)检测不同浓度曲古霉素对肝癌HepG2细胞中Beclin1和Bcl-2 mRNA的表达。结果 曲古霉素对肝癌HepG2细胞具有增殖抑制作用,与对照组相比较,其差异有统计学意义(P＜0.05);通过流式细胞术检测结果显示,曲古霉素作用于肝癌HepG2细胞后,随着浓度的增加,细胞凋亡率显著上升,与对照组相比,差异有统计学意义(P＜0.05);RT-PCR及WB实验观察到,Beclin1蛋白和mMRA的表达随着曲古霉素浓度的增加而逐渐升高,Bcl-2蛋白和mMRA的表达随着曲古霉素作用浓度的增加而逐渐降低,且与对照组相比,其差异均有统计学意义(P＜0.05)。结论 曲古霉素能抑制肝癌细胞的增殖,而且这种作用机制与诱导肝癌细胞凋亡和自噬作用有相关性。

Objective To investigate whether histone deacetylase inhibitor hachimycin has an effect on the proliferation and apoptosis of hepatocellular carcinoma cells and whether the inhibition is related to autophagy. Methods MTT assay was used to detect the proliferation ability of HepG2 cells treated with hachimycin of different concentrations for 24 h, 48 h and 72 h.Flow cytometry was used to detect the effects of different concentrations of hachimycin on HepG2 hepatoma cell cycle and apoptosis.Western blot (WB) assay was used to detect Beclin1 and Bcl-2 expressions in hepatocellular carcinoma HepG2 cells under different hachimycin concentrations.Beclin1 and Bcl-2 mRNA expressions under different hachimycin concentrations in hepatocellular carcinoma HepG2 cells were detected by RT-PCR. Results Hachimycin inhibited the proliferation of HepG2 cells, compared with the control group, the difference was statistically significant (P<0.05). Flow cytometry results showed that the apoptosis rate of hepatocellular carcinoma HepG2 cells was significantly increased with the increase of hachimycin concentration, compared with the control group, the difference was statistically significant (P<0.05). RT-PCR and WB results showed that Beclin1 protein and mMRA expression gradually increased with the increase of hachimycin concentration, while Bcl-2 protein and mMRA expression gradually decreased, compared with the control group, the differences were statistically significant (P<0.05). Conclusion Hachimycin could inhibit the proliferation of hepatocellular carcinoma cells, and its mechanism was related to the induction of apoptosis and autophagy.

目的 分析心力衰竭伴快速心房颤动(简称:心衰伴快速房颤)患者接受胺碘酮急诊抢救治疗的效果及对24 h心室率的影响。方法 将2017年1月—2020年12月急诊接诊且行西地兰治疗的60例心衰伴快速房颤患者作为对照组,将同期急诊接诊且行胺碘酮治疗的60例心衰伴快速房颤患者作为观察组,对组间心功能指标、炎症因子水平、心室率、临床疗效、药物不良反应展开分析。结果 ①组间心功能指标、炎症因子水平在治疗前无差异,P>0.05;观察组心功能指标、炎症因子水平在治疗后优于对照组,P<0.05;②组间心室率在治疗前无差异,P>0.05;观察组治疗后4 h、12 h、24 h心室率均低于对照组,P<0.05;③观察组5例无效(8.33%),对照组14例无效(23.33%),P<0.05;④观察组药物不良反应率(3.33%)与对照组药物不良反应率(5.00%)无差异,P>0.05。结论 在急诊抢救心衰伴快速房颤患者时采用胺碘酮,可以改善患者心功能、炎症反应、心室率,加之无明显不良反应,值得推广。

Objective To analyze the efficacy of emergency treatment with amiodarone and its influence on 24-hour ventricular rate in patients with heart failure and rapid atrial fibrillation. Methods From January 2017 to December 2020, 60 patients with heart failure and rapid atrial fibrillation who received emergency treatment and cedilanide treatment were selected as the control group, and 60 patients with heart failure and rapid atrial fibrillation who received emergency treatment and amiodarone treatment at the same period were selected as the observation group. Results ① There was no significant difference in cardiac function index and inflammatory factors level between the two groups before treatment, P>0.05.The cardiac function index and inflammatory factors level of the observation group were more improved than those of the control group after treatment, P<0.05. ② There was no significant difference in ventricular rate between the two groups before treatment, P>0.05.The ventricular rates of the observation group at 4 h, 12 h and 24 h after treatment were lower than those of the control group, P< 0.05. ③ Treatment for 5 cases (8.33%) in the observation group, 14 cases (23.33%) in the control group were ineffective, P<0.05. ④ There was no significant difference in the adverse drug reaction incidence between the observation group (3.33%) and the control group (5.00%), P>0.05. Conclusion Amiodarone could improve the cardiac function, inflammatory reaction and ventricular rate of patients with heart failure and rapid atrial fibrillation in emergency treatment, and there was no obvious adverse reaction, so it is worthy of promotion.

目的 探讨地西他滨(DAC)联合沙利度胺对骨髓增生异常综合征(MDS)患者的病态造血及疗效的影响。方法 以本院自2014年6月—2020年5月收治的MDS患者为研究总体,行便利抽样法选择60例于收治期间行输血、抗感染及诸如促红生成素 (EPO)+集落刺激因子(CSF)等细胞因子治疗效果不佳的MDS开展研究,按完全区化原则设立对照组及观察组,予以对照组沙利度胺治疗,观察组则于对照组基础上施予地西他滨(DAC)行联合治疗,比较2组疗效、血象相关指标、病态造血改善情况及预后转归。结果 观察组ORR为51.61%,与对照组的26.67%相比更高,差异有统计学意义(P<0.05);经治疗,2组血小板计数(PLT)、血红蛋白(HGB)、中性粒细胞计数(ANC)水平均见一定程度上升,骨髓原始细胞(bls)水平则见下降,观察组PLT、HGB、ANC相较于对照组更高,bls水平则更低(P<0.05);于2020年5月截止随访,随访时间8~96个月,中位随访时间68个月。于治疗及随访中行骨髓形态检查及染色体核型鉴别均表现正常。关于病态造血改善情况,2组T1率比较,差异无统计学意义(P>0.05);观察组国际预后积分系统评分整体优于对照组(P<0.05);2组Ⅰ~Ⅳ级不良反应比较,差异无统计学意义(P>0.05);观察组5年总生存时间率为63.33%,相较于对照组的36.67%更高(P<0.05)。结论 相较于单一沙利度胺治疗,应用地西他滨联合沙利度胺治疗MDS,疗效更为确切,且可改善血象指标,拥有一定T1率,且预后转归表现较好。

Objective To investigate the impact of decitabine (DAC) combined with thalidomide on dyshaematopoiesis and efficacy in patients with myelodysplastic syndrome (MDS). Methods Patients with MDS admitted to our hospital from June 2014 to May 2020 were selected as the research population.Among them, 60 MDS cases were selected by convenience sampling method, which had poor therapeutic effect with treatment of blood transfusion, anti-infection and cytokines treatments such as erythropoietin (EPO)+ colony stimulating factor (CSF). The control group and the observation group were set up according to the principle of complete block, and the control group was treated with thalidomide while the observation group was treated with decitabine (DAC) on the basis of the control group.The efficacy, hemogram-related indicators, improvement of dyshaematopoiesis and prognosis outcomes were compared between the two groups. Results The overall response rate (ORR) of the observation group was higher than that of the control group (51.61%vs 26.67%, P<0.05). After treatment, the levels of platelet (PLT), hemoglobin (HGB) and absolute neutrophil count (ANC) in the two groups were increased to a certain extent while the level of bone marrow blasts(bls) was decreased, and the levels of PLT, HGB and ANC of the observation group were higher than those of the control group while the level of bls was lower (P<0.05). The follow-up deadline was May 2020, and the follow-up time was 8-96 months and the median follow-up time was 68 months.During treatment and follow-up, bone marrow morphology examination and chromosome karyotype identification results were normal.Regarding the improvement of dyshaematopoiesis, the difference in T1 rate between the two groups was not statistically significant (P>0.05). The revised International Prognostic Scoring System prognosis score of the observation group was better than that of the control group (P<0.05). There were no statistically significant differences between the two groups in terms of grade I~IV adverse reactions (P>0.05). The 5-year overall survival rate of the observation group was 63.33%, which was higher than 36.67%of the control group (P<0.05). Conclusion Compared with thalidomide only treatment, the application of decitabine combined with thalidomide in the treatment of MDS had a more accurate efficacy, improved hemogram indicators, and had a certain T1 rate and good prognosis outcomes.

目的 探讨臂丛神经阻滞和关节腔内注射局麻药联合应用在肩关节镜手术中的应用价值。方法 对肩关节镜手术患者100例进行研究,2018年8月—2020年8月入组,根据随机数字表法分组处理,对照组和观察组各为50例,前者用臂丛神经阻滞,后者与关节腔内注射局麻药联合,比较2组麻醉效果、不同阶段疼痛程度、肩关节功能。另对比2组不良反应。结果 观察组麻醉起效时间、苏醒时间和拔管时间分别为(10.72±2.45)min、(8.21±1.32)min和(9.52±1.12)min,与对照组对应指标有差异(P<0.05);2组术前疼痛程度和肩关节功能对比无差异(P>0.05),观察组术后6 h、术后24 h和术后48 h疼痛评分依次为(1.31±0.27)分、(2.87±0.52)分和(3.44±0.42)分,术后6 h、术后12 h、术后24 h和术后48 h镇静评分分别为(2.92±0.32)分、(2.54±0.24)分、(2.38±0.12)分和(2.27±0.15)分,术后1周、1个月和3个月的肩关节功能评分分别为(50.12±4.54)分、(56.18±4.12)分和(73.16±4.78)分,较之于对照组有差异(P<0.05);对照组和观察组出现不良反应的概率分别为18.00%和4.00%(P<0.05)。 结论 在肩关节镜手术中联合应用臂丛神经阻滞联合关节腔内注射局麻药麻醉方式,可提高麻醉效果,术后镇痛和镇静效果明显,也可减少不良反应,对患者肩关节功能改善作用明显,存在广泛应用价值。

目的 使用TCGA数据库,探索DNA甲基化位点对肺腺癌的预后影响。方法 使用TCGA数据库,获取肺腺癌病人癌和癌旁组织甲基化表达数据、基因表达数据及临床数据;将人群分为探索组和验证组,使用LASSO在探索人群中筛选对肺腺癌预后有影响的甲基化位点;受试者工作特征曲线用于评估甲基化位点预测效果,并进一步在验证人群中验证。结果 在TCGA数据库中筛选出158个癌和癌旁组织差异表达且与所在基因mRNA表达显著相关的甲基化位点,经LASSO回归分析,cg19378330与肺腺癌预后相关。甲基化位点水平高于中位数的患者,归入高风险组,甲基化位点水平低于中位数的为低风险组。结果发现与低风险组相比,高风险组的死亡风险比低风险组增加了38%(OR=1.38,95% CI=1.16～2.69)。在探索阶段人群中其曲线下面积为0.80(95% CI=0.73～0.88),灵敏度为86.2%。验证人群中也表现出类似结果。结论 甲基化位点cg19378330与肺腺癌具有较显著的关联性,且可以对肺腺癌的风险进行有效的预测。

Objective Using the TCGA database to explore the prognostic effects of DNA methylation sites on lung adenocarcinoma. Methods TCGA database was used to collecting DNA methylation data, gene expression data and clinical data of lung adenocarcinoma patients. The population were divided into the exploratory group and the validation group. The LASSO regression analysis was used to screen the methylation sites associated with the prognosis of lung adenocarcinoma in the exploratory group. Receiver operating characteristic curve was used to evaluate the prediction effect of the model, and further verified in the validation population. Results A total of 158 methylation sites with differential expression and significant correlation with the mRNA expression of the corresponding gene were screened from the TCGA database. With LASSO regression analysis, the DNA methylation sites associated with prognosis of lung adenocarcinoma were cg19378330. Those patients with levels above the median methylation site were assigned to the high-risk group, while those with levels below the median methylation site were assigned to the low-risk group. Patients' death risk in the high-risk group were 38% higher than those in the low-risk group (OR=1.38, 95%CI=1.16-2.69). The area under the curve was 0.80 (95%CI=0.73-0.88) and the sensitivity was 86.2% in the exploratory stage population.Similar results were seen in the validation population. Conclusions The DNA methylation site cg19378330 was significantly associated withthe prognosisof lung adenocarcinoma, and could effectively predict the risk of lung adenocarcinoma.

目的 观察父亲参与的早期母婴皮肤接触(SSC)对顺产初产妇的新生儿应激反应及生命体征的影响,为进一步优化“新生儿早期基本保健(EENC)”技术的临床实施建议提供实验依据。方法 使用随机数字表选取2017年2月—2021年5月期间,在深圳市福田区妇幼保健院产科分娩的1 986例顺产初产妇及新生儿作为研究对象。其中638例新生儿(共同参与组)实施了父亲参与的早期SSC,467例新生儿(SSC组)实施了早期母婴SSC,881例新生儿(对照组)实施了常规新生儿处理。观察3组新生儿的唾液皮质醇水平、体温和低温发生率、心率以及啼哭时间的差异,探讨父亲参与的早期母婴SSC在临床实施的可行性。结果 ① 3组新生儿出生30 min、60 min、90 min、180 min时,任意2组唾液皮质醇水平比较,差异均有统计学意义(均P<0.01);出生120 min时,共同参与组与对照组、SSC组与对照组比较,差异均有统计学意义(均P<0.01)。② 3组新生儿出生30 min、60 min时,共同参与组与对照组,SSC组与对照组的体温、低温发生率比较,差异均有统计学意义(均P<0.01);出生90 min时,任意2组体温比较,差异均有统计学意义(均P<0.01),共同参与组与对照组,SSC组与对照组的低温发生率比较,差异均有统计学意义(均P<0.01);出生120 min、180 min时,任意2组的体温与低温发生率比较,差异均有统计学意义(均P<0.01)。③ 3组新生儿出生30 min、60 min、90 min时,共同参与组与对照组,SSC组与对照组的心率比较,差异均有统计学意义(均P<0.01)。出生120 min、180 min时,任意2组比较,差异均有统计学意义(均P<0.01)。④ 3组新生儿出生0～30 min、30～60 min、60～90 min时间段,共同参与组与对照组,SSC组与对照组的啼哭时间比较,差异均有统计学意义(均P<0.01)。出生90～120 min、120～180 min时间段:任意2组的啼哭时间比较,差异均有统计学意义(均P<0.01)。结论 早期母婴SSC和父亲参与的早期母婴SSC均能降低顺产初产妇的新生儿唾液皮质醇水平,维持恒定的体温和心率,减少低温发生率和啼哭时间。相比较而言,父亲参与的早期母婴SSC是一种更科学、更有利于降低新生儿应激反应及维护其生命体征的护理模式。

Objective To observe the effect of father's participation in early maternal skin to skin contact (SSC) on primiparas' neonatal stress response and vital signs, so as to provide experimental basis for further optimizing the clinical implementation of “early essential newborn care (EENC)” technology. Methods The random number table was used to select 1 986 primiparas with their newborns who gave birth in Shenzhen Futian District Maternity and Child Healthcare Hospital from February 2017 to may 2021. Among them, 638 newborns (co-participation group) implemented early SSC with father participation, 467 newborns (SSC group) implemented early maternal and infant SSC, 881 newborns (control group) were treated with routine neonatal treatment. To observe the differences of salivary cortisol level, mean body temperature, incidence of hypothermia, heart rate and crying time among the newborns of three groups and to explore the feasibility of early mother and infant SSC with father participation in clinical implementation. Results ①There were significant differences in newborn salivary cortisol levels between any two groups at 30 min, 60 min, 90 min and 180 min after birth (all P<0.01). At 120 min after birth, there were significant differences between the co-participation group and the control group, SSC group and the control group (all P<0.01). ②At 30 min and 60 min after birth, there were significant differences in body temperature and the incidence of hypothermia between the co-participation group and the control group, SSC group and the control group (all P<0.01). At 90 min after birth, there were significant differences in body temperature between any two groups (all P<0.01). There were significant differences in the incidence of hypothermia between the co-participation group and the control group, SSC group and the control group (all P<0.01). There were significant differences in body temperature and the incidence of hypothermia between any two groups at 120 min and 180 min (all P<0.01). ③At 30 min, 60 min and 90 min after birth, there were significant differences in heart rate between the co-participation group and the control group, SSC group and the control group (all P<0.01). At 120 min and 180 min after birth, there were significant differences between any two groups (all P<0.01). ④There were significant differences in the crying time of newborns in the three groups at 0-30 min, 30-60 min and 60-90 min, between the co-participation group and the control group, and between the SSC group and control group (all P<0.01). There were significant differences in crying time between any two groups at 90-120 min and 120-180 min after birth (all P<0.01). Conclusions Early maternal and infant SSC and early maternal and infant SSC participated by father could reduce the salivary cortisol level of primipara newborn, maintain constant body temperature and heart rate,also reduce the incidence of hypothermia and crying time. In comparison, the early maternal and infant SSC with father participation was a more scientific and conducive nursing model to reduce neonatal stress response and maintain their vital signs.

目的 观察中等强度有氧运动联合力量训练对老年高尿酸血症(HUA)尿酸、身体机能及生活质量影响分析。方法 2019年1月—2019年12月在我社区收治的老年HUA患者60例纳入研究,随机数字表法进行分组,选取其中的30例患者实施常规饮食、运动指导为对照组,另30例患者配合中等强度有氧运动联合力量训练为研究组。比较2组患者对干预的依从性,干预前、后的血尿酸水平,身体机能及生活质量评分(WHOQOL-100评分)。结果 2组患者均在干预期内完成训练,依从性优良率比较,差异无统计学意义(P＞0.05)。干预前2组患者的血尿酸水平、身体机能比较,差异无统计学意义(P＞0.05)。干预后2组患者的血尿酸水平、安静心率较干预前降低,研究组低于对照组,而肺活量则较干预前提升,研究组高于对照组,差异有统计学意义(P＜0.05)。干预前2组患者的WHOQOL-100评分比较,差异无统计学意义(P＞0.05),干预后2组WHOQOL-100各项评分较干预前提升,研究组高于对照组,差异有统计学意义(P＜0.05)。结论 在老年HUA患者的相关指导中,运用中等强度有氧运动联合力量训练的运动干预,可较为明显的降低血清血尿酸水平,降低并平稳安静心率,提升肺活量,提升生活质量,效果理想。

Objective To observe the effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia (HUA). Methods Sixty elderly patients with HUA were treated in our center from January 2019 to December 2019. They were randomly divided into two groups, 30 cases in each group. Among them, 30 cases given routine diet and exercise guidance were included in control group, and the other 30 cases given moderate intensity aerobic exercise combined with strength training on the basis of the control group were included in study group. The compliance, blood uric acid level, physical function and quality of life (WHOQOL-100 scores) before and after the intervention were compared between the two groups. Results Two groups of patients completed the training within the expected time, and there was no significant difference in compliance (P＞0.05). Before the intervention, there were no significant differences in blood uric acid level and physical function between the two groups (P＞0.05). After the intervention, the serum uric acid level and resting heart rate of the two groups were lower than those before the intervention, and those of the research group were even lower than the control group, while the vital capacity was higher than that before the intervention, and the research group was higher than the control group, those differences were significant (P＜0.05). Before the intervention, there was no significant difference in WHOQOL-100 score between the two groups (P＞0.05). After the intervention, the scores of WHOQOL-100 in the two groups were higher than those before the intervention, and that in the study group was higher than the control group (P＜0.05). Conclusions In the relevant guidance of elderly patients with hyperuricemia (HUA), the application of moderate intensity aerobic exercise combined with strength training can significantly lower the serum uric acid level, reduce and stabilize the resting heart rate, improve the vital capacity and quality of life, with ideal effect.

目的 探讨超低频经颅磁刺激(ILF-TMS)联合艾司唑仑对失眠症患者睡眠脑电图参数及血清神经营养因子表达的影响。方法 选取2018年8月—2020年4月我院失眠症患者114例,随机数字表法分为研究组(n=57)、对照组(n=57)。对照组予以艾司唑仑联合ILF-TMS假性刺激,研究组予以艾司唑仑联合ILF-TMS真性刺激,均治疗1个月。对比2组疗效与治疗前、治疗1个月后睡眠进程参数(总睡眠时间、入睡时间、睡眠效率、觉醒时间)、睡眠结构(非快速眼动睡眠期、快速动眼睡眠期)、匹兹堡睡眠质量量表(PSQI)评分、失眠严重程度指数量表(ISI)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、血清神经营养因子[胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)]水平。结果 (1)疗效:研究组治疗1个月后总有效率高于对照组(P＜0.05);(2)睡眠进程参数:治疗1个月后研究组总睡眠时间、睡眠效率高于对照组,入睡时间、觉醒时间短于对照组(P＜0.05);(3)睡眠结构:治疗1个月后研究组Ⅲ期、Ⅱ期、非快速眼动睡眠期高于对照组,Ⅰ期睡眠期低于对照组(P＜0.05);(4)PSQI、ISI评分:治疗1个月后研究组PSQI、ISI评分低于对照组(P＜0.05);(5)SAS、SDS评分:治疗1个月后研究组SAS、SDS评分低于对照组(P＜0.05);(6)血清神经营养因子:治疗1个月后研究组血清GDNF、BDNF水平高于对照组(P＜0.05)。结论 ILF-TMS联合艾司唑仑治疗失眠症效果确切,可上调血清神经营养因子表达,改善睡眠脑电图参数,提高睡眠质量,控制焦虑、抑郁症状。

Objective To investigate the effects of infra-low frequency transcranial magnetic stimulation (ILF-TMS) combined with estazolam on sleep EEG parameters and serum neurotrophic factors expression in patients with insomnia. Methods One hundred and fourteen patients with insomnia in our hospital from August 2018 to April 2020 were divided into study group (n=57) and control group (n=57) by random number table method. The control group was treated with estazolam combined with pseudo ILF-TMS stimulation, and the study group was treated with estazolam combined with real ILF-TMS stimulation, all of which were treated for 1 month. Comparing curative effect of two groups before and 1 month after treatment, and sleep process parameters (total sleep time, falling asleep time, sleep efficiency, waking time), the structure of the sleep stages (stage Ⅲ, Ⅱ, Ⅰ, rapid eye movement sleep), Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, serum neurotrophic factors (GDNF, BDNF) levels. Results (1) Efficacy: the total effective rate of the study group was higher than that of the control group after 1 month of treatment (P＜0.05). (2) Sleep process parameters: after 1 month of treatment, the total sleep time and sleep efficiency in the study group were higher than those in the control group, and the falling asleep time and waking time were shorter than those in the control group (P＜0.05). (3) Sleep structure: after 1 month of treatment, compared to the control group, the study group had more in stageⅢ, Ⅱ, rapid eye movement sleep, and less in stage Ⅰsleep(P＜0.05). (4) PSQI and ISI scores: after 1 month of treatment, PSQI and ISI scores of the study group were lower than those of the control group (P＜0.05). (5) SAS and SDS scores: after 1 month of treatment, SAS and SDS scores in the study group were lower than those in the control group (P＜0.05). (6) Serum neurotrophic factors: after 1 month of treatment, serum GDNF and BDNF levels in the study group were higher than those in the control group (P＜0.05). Conclusions ILF-TMS combined with estazolam is an effective treatment of insomnia. It can up-regulate the expression of serum neurotrophic factors, improve the parameters of sleep EEG, improve sleep quality, and control the symptoms of anxiety and depression.