目的 比较一次性包皮切割缝合器与传统包皮环切术和套扎环包皮环切术的临床应用效果。方法 对我院2016年7月—2016年12月内门诊收治的包皮过长和包茎患者,采用不同手术方法治疗,其手术时间、术中疼痛评分(VAS评分)、术后水肿、疼痛持续时间、以及外观满意度等方面进行对比。结果 在手术时间和外观满意度方面一次性包皮切割缝合器明显优于传统包皮环切术;在术中疼痛评分(VAS评分)、疼痛持续时间和术后水肿方面一次性包皮切割缝合器明显优于套扎环包皮环切术。结论 一次性包皮切割缝合器与两种传统常规手术比较,手术更加简单、方便且安全,术后外观满意度高,值得临床推广。

Objective To compare the effects of circumcision between using a novel disposable suture device and traditional or plastibell procedure. Methods The patients from July 2016 to December 2016 that underwent different ways of circumcision were documented. The operation time, VAS score, postoperative edema, the duration of the pain and appearance of satisfaction were collected and analyzed. Results The suture device group had shorter operation time, better appearance of satisfaction than that of traditional group (P<0.05). Besides, the suture device group had lesser VAS score, shorter duration of the pain and less postoperative edema (P<0.05). Conclusion Compared to traditional or plastibell procedure, a novel disposable suture device circumcision represents convenient, efficient and minimal invasive. It is worth promoting clinically.

目的 探讨颈性眩晕应用针刺解结法治疗的临床疗效。方法 选取广东省中医院进修期间2016年3月—2016年9月收治的60例颈性眩晕患者,按照随机数字表法均分为两组。对照组:予以常规针刺治疗;观察组:在此基础上,行针刺解结法治疗。记录比较两组治疗前后基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)等部位的血流速度,改良颈性眩晕症状与功能评估量表(ESCV)总评分,临床疗效。结果 两组治疗后BA、LVA及RVA部位的血流速度,均明显高于治疗前(P<0.05);与对照组治疗后比较,观察组TCD检测参数改善幅度更为显著(P<0.01);与治疗前相比,两组治疗后改良ESCV总评分均显著更高(P<0.01);且观察组改善情况显著优于对照组(P<0.01);观察组总有效率为96.7%较对照组的76.7%相比,明显更高(P<0.05)。结论 颈性眩晕应用针刺解结法治疗更能有效改善脑部血液循环,缓解临床症状,提高生活质量,疗效显著,具有较高临床推广价值。

Objective To analyze the clinical effect of curing cervical vertigo with acupuncture thrawing method. Methods To select 60 patients with cervical vertigo in Cantonese Chinese Medicine Hospital from March 2016 to September 2016 as the research objects. According to the random number table method, they were randomly divided into the control group and the study group. The control group: treated with normal acupuncture; The observation group: plus with acupuncture thrawing method. We recorded and compared the blood flow velocity in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA), the overall score of the improved cervical Evaluation Scale for Cervical Vertigo(ESCV), and the clinical therapeutic effect of the two groups. Results After treatment, the blood flow velocity of the two groups in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA) was obviously higher than before treatment (P<0.05). Compared with the control group, the improvement level of TCD verifying arguments in the observation group was more significant (P<0.01). Compared with before treatment, the overall score of the improved ESCV in the two groups after treatment was significantly higher (P<0.01). And the improved conditions in the observation group were better than in the control group. The total effective rate 96.7% in the observation group was apparently higher than that of 76.7% in the control group (P<0.05). Conclusion Curing cervical vertigo with acupuncture thrawing method may improve the brain blood circulation, relieve clinical symptoms, enhance the living quality, which is a good way with evident clinic efficacy and higher clinical popularization value.

目的 探讨长期吸烟史对高危脑卒中患者口服阿司匹林二级预防效果的影响。方法 将2012年8月—2014年8月医院口服阿司匹林二级预防的高危脑卒中患者115例作为研究对象,根据有无吸烟史分为无吸烟史组(34例)和吸烟史组(81例),其中36例吸烟时间≥20 a(长期吸烟史组)、45例吸烟时间1～19 a(短期吸烟史组)。随访12个月,测定血小板颗粒膜蛋白(GMP-140)、D-二聚体(D-D)、纤维蛋白原(FIB)、组织型纤溶酶原激活物(t-PA)、血小板膜糖蛋白CD61、CD62p,记录1年阿司匹林抵抗和临床终点事件发生率。结果 长期吸烟史组治疗前后GMP-140、D-D、FIB、CD61、CD62p高于短期吸烟史组和无吸烟史组,t-PA低于短期吸烟史组和无吸烟史组,且短期吸烟史组和无吸烟史组组间比较,差异有统计学意义(P＜0.05);长期吸烟组阿司匹林抵抗发生率和临床终点事件发生率分别为33.33%、30.56%,高于无吸烟史组的8.82%、8.82%,差异有统计学意义(P＜0.05),其余组组间比较差异无统计学意义(P＞0.05)。结论 长期吸烟史会使脑卒中患者存在血栓前状态,增加阿司匹林抵抗和临床终点事件的发生几率。

Objective To explore effects of long-term smoking on secondary prevention for oral aspirin in high-risk stroke patients. Methods A total of 115 high-risk stroke patients who orally took aspirin for secondary prevention in our hospital from August 2012 to August 2014 were selected as the study subjects. According to smoking or not, they were divided into non smoking history group (34 cases) and smoking history group (81 cases). Among them, 36 cases whose smoking time was ≥ 20 years were included in the long-term smoking history group, and 45 cases whose smoking time was 1 to 19 years were included in the short-term smoking history group. The patients were followed up for 12 months. The platelet granule membrane protein (GMP-140), D-dimer (D-D), fibrinogen (FIB), tissue plasminogen activator (t-PA), platelet membrane glycoprotein CD61 and CD62p were determined. The incidence rates of 1-year aspirin resistance and clinical outcome events in the three groups were recorded. Results Before and after treatment, GMP-140, D-D, FIB, CD61 and CD62p in long-term smoking history group were higher than those in short-term smoking history group and non smoking history group while T-PA was lower, and there were significant differences between short-term smoking history group and non smoking history group (P<0.05). The incidence rates of aspirin resistance and clinical outcome events in long-term smoking history group (33.33%, 30.56%) were higher than those in non smoking history group (8.82%, 8.82%)(P<0.05), but there was no significant difference among other groups (P>0.05). Conclusion Long-term smoking history will cause prethrombotic state in stroke patients and increase the incidence rates of aspirin resistance and clinical outcome events.

目的 研究雷公藤红素对人阿霉素耐药MCF-7/ADR乳腺癌细胞生长的作用。方法 采用MTT试验检测MCF-7/ADR细胞对阿霉素的耐药情况以及雷公藤红素对MCF-7/ADR细胞生长的影响;采用Annexin V-FITC/PI双染试验分析雷公藤红素对MCF-7/ADR耐药细胞凋亡的诱导作用;应用流式细胞周期分析检测雷公藤红素对MCF-7/ADR耐药细胞周期的影响。结果 MCF-7/ADR细胞对阿霉素耐药指数达14.54;而雷公藤红素能有效抑制阿霉素耐药细胞MCF-7/ADR的生长,并呈现浓度依赖性,作用48 h的IC50是1.04 μmol/L,MCF-7/ADR对雷公藤红素的耐药指数仅为0.87。2 μmol/L雷公藤红素作用8 h后,Annexin V-FITC染色阳性的MCF-7/ADR细胞比例较对照显著升高,差异有统计学意义(P＜0.05)。在1 μmol/L雷公藤红素作用24 h后,G1期细胞比例由对照(59.22±3.78)%升高至(77.44±4.21)%,而S期细胞比例由对照(37.51±2.91)%降至(19.65±2.25)%,差异有统计学意义(P＜0.05)。结论 雷公藤红素能激活MCF-7/ADR细胞凋亡的发生,并诱导MCF-7/ADR发生 G1/S细胞周期阻滞,从而对阿霉素耐药MCF-7/ADR细胞的生长发挥高效抑制作用。

Objective To investigate the effect of celastrol on the growth of adriamycin-resistant MCF-7/ADR breast cancer cells. Methods The resistance situation of MCF-7/ADR cells to adriamycin and the effect of celastrol on the growth of adriamycin-resistant MCF-7/ADR cells were evaluated by MTT assay. The effect of celastrol on apoptosis in MCF-7/ADR breast cancer cells was determined by annexin V-FITC/PI double staining. The effect of celastrol on cell cycle progression was determined by flow cytometry analysis. Results The resistance index of MCF-7/ADR cells to adriamycin was 14.54. After treatment with celastrol for 48 h, MCF-7/ADR cells displayed markedly inhibited growth in a dose-dependent manner, and calculated IC50 was 1.04 μmol/L. Celastrol decreased the resistance index of MCF-7/ADR from 14.54 to 0.87. The numbers of apoptotic MCF-7/ADR cells, as revealed by annexin V binding, significantly increased upon celastrol treatment (P＜0.05). Celastrol treatment caused an increase of cells in G1 phase from (59.22±3.78)% to (77.44±4.21)%, while the percentage of cells in S phase was decreased from(37.51±2.91)% to(19.65±2.25)%(P＜0.05). Conclusion These data demonstrated that celastrol induced apoptosis and G1/S cell cycle arrest in MCF-7/ADR cells and consequently displayed potent cytocidal effect on adriamycin-resistant MCF-7/ADR breast cancer cells.

目的 探讨黄连素联合左氧氟沙星对肺炎克雷伯菌(KPn)抑菌作用。方法 KPn分为敏感株组和耐药株组,采用琼脂二倍稀释法测定黄连素联合左氧氟沙星对KPn的最低抑菌浓度(MIC)、抑制99％接种细菌生长的最低抑菌浓度(MIC99)、防突变浓度(MPC);比浊法测定黄连素联合左氧氟沙星对KPn生长曲线的影响。结果 与单用左氧氟沙星相比,联合黄连素后,敏感株组和耐药株组对左氧氟沙星MIC的下降率分别为33.3%和20%,2组之间无统计学差异(P>0.05)。左氧氟沙星与50 μg/mL黄连素或500 μg/mL黄连素联用后的抗菌能力均较单用左氧氟沙星好,且高浓度黄连素的联合抑菌效果较低浓度更加明显,差异有统计学意义(P<0.05)。与50 μg/mL黄连素联用后,左氧氟沙星SI下降了1/5 ;而与500 μg/mL黄连素联用则下降3/5 。结论 本实验证明了黄连素与左氧氟沙星联用能增加左氧氟沙星对KPn的抗菌作用,可以明显缩小耐药突变选择窗(MSW),且高浓度黄连素联合抗菌作用较低浓度好。

Objective To explore antibacterial effect of berberine(Ber) on K. Pneunmoniae(KPn) combing with levofloxacin(LVX). Methods KPn was divided into sensitive and resistant strains groups.The MIC, MIC99 and MPC of Ber combing with LVX on KPn was determined by the agar dilution method.The growth curve of Ber combing with LVX on KPn was measured by turbidimetry. Results Ber combined with LVX compare with LVX alone, MIC descent rate of sensitive strains group was 33.3%, resistant strains group was 20%, and there were no statistical differences along two groups(P>0.05). Ber combined with LVX could increase antibacterial effect and high concentration was more obvious than the low one, there were statistical differences(P<0.05). Compared with LVX alone,the SI value of 50 μg/mL Ber combined with LVX was decreased 1/5, and the SI value of 500 μg/mL Ber combined with LVX was decreased 3/5. Conclusion Ber combing with LVX could increase bacteriostatic effect on KPn,and reduce MSW significantly; high concentration of berberine was better than low one.

目的 观察紫河车提取物联合顺铂对人脑胶质瘤细胞增殖与凋亡的影响。方法 把正常培养传代后的U251胶质瘤细胞按随机分配的方法分为四组,A组仅加普通培养液,B、C、D组各加紫河车提取物(400 mg/mL)2 mL、顺铂(1 mg/mL)0.01 mL、紫河车提取物(400 mg/mL)2 mL＋顺铂(1 mg/mL)0.01 mL;MTT法观察U251细胞增殖情况,流式细胞仪检测U251细胞凋亡率。结果 培养12、24、36、48、60 h,B、C、D组细胞增殖指数逐渐下降,与A组进行比较,各组P值均小于0.05;其中,将D组与B、C组进行比较,P值小于0.05。将各组培养24 h后上机,测得A、B、C、D各组细胞的凋亡率分别为(0.3±0.2)%,(10.6±1.5)%,(35.9±2.8)%,(52.1±4.1)%。其中,B、C、D各组和A组进行比较,P值均小于0.05;将D组与B、C组两组进行比较,P值也均小于0.05。结论 紫河车提取物联合顺铂可抑制人脑胶质瘤U251细胞增殖,并诱导其凋亡。

Objective To observe the effect of cisplatin combinated with the placental immunoregulating polypeptide (PIP) on proliferation and apoptosis of glioma cells. Methods Randomly we divide the normal handed U251 glioma cells into four groups. We added ordinary nutrient solution to group A, while added activated PIP(400 mg/mL)2 mL to group B, cisplatin (1 mg/ml) 0.01 ml to group C, PIP 400 mg/mL)2 mL and cisplatin (1 mg/mL) 0.01 mL to group D. We surveyed the proliferation rate of gliobma cells by MTT experimental method and analyzed the apoptosis of U251 glioma cells by flow cytometry. Results The index of cell proliferation of group B,C,D declined gradually with the training of 12 h,24 h,36 h,48 h,60 h. Compared B, C,D group with A group, P<0.05,and compared group D with group B and group C, P< 0.05. Put groups culturing of 24 hour on flow cytometer, the glioma cells apoptosis rate of each group was 0.3%±0.2%、10.6%±1.5%、35.9%±2.8%、52.1%±4.1% respectively. Compared group B,C,D with group A, P<0.05,and compared group D with group B and group C, P<0.05. Conclusion Placental immunoregulatingpPolypeptide combined with cisplatin may restrain the proliferation of human glioma cells, meanwhile increase the apoptosis of glioma cells.

目的 探讨川芎嗪对链脲佐菌素(STZ)诱导2型糖尿病大鼠肾病的治疗作用及机制。方法 SD大鼠50只,随机分为正常组和模型组。除正常组外,其余大鼠均给予高脂-高糖饲料喂养4周,再给予链脲佐菌素(40 mg/kg,ip),72 h后测定空腹血糖,将血糖值高于16.67 mmol/L的大鼠随机分成4个组即模型组,二甲双胍阳性组(250 mg/kg),川芎嗪低、高剂量组(80、160 mg/kg),连续给予相应试药8周。其中正常组和模型组的大鼠均给予同等量蒸馏水灌胃。实验结束时,测定大鼠血糖、尿蛋白、血尿素氮和血肌酐含量;免疫组化法测定大鼠肾组织TLR4和caspase3蛋白表达。光镜下观察肾脏病理学变化。结果 与模型组比较,二甲双胍组和川芎嗪高剂量组给药8周后,大鼠动态空腹血糖均能明显降低(P<0.05),大鼠动态尿蛋白显著性降低(P<0.01,P<0.05); 二甲双胍和高剂量组TLR4和caspase3蛋白表达明显低于模型组(P<0.05);肾脏组织病理性损伤明显减轻。结论 川芎嗪对STZ诱导2型糖尿病大鼠肾病具有保护作用,其机制可能与下调TLR4表达作用有关。

Objective To investigate the therapeutic effects and mechanisms of tetramethylpyrazine (TMP) on streptozocin(STZ)-induced-nephropathy in type 2 diabetic rats. Methods 50 SD rats were randomly divided into normal group(n=10) and model group(n=40). The model rats were fed on high fat and sugar diets for 4 weeks, then given STZ(40 mg/kg,ip). After 72 hours, the fasting blood glucose (FBG) was measured. Rats with high FBG above 16.67mmol/L were randomly divided into four groups: model, metformin(Met, 250 mg/kg)and TMP (80 mg/kg, 160 mg/kg) groups for treating 8 weeks, and both the control and model groups were given equals distilled water by intragastric administration. At the end of the experiment, blood glucose, urine protein, blood urea nitrogen and creatinine were measured. The expression of TLR4 and caspase3 protein in kidney tissue of rats was determined by immunohistochemistry. Pathological changes of kidney were observed under light microscope. Results Compared with the model group, metformin and high dose of TMP administered after 8 weeks, rats can significantly reduce the dynamic fasting blood glucose(P<0.05). Urinary protein excretion of total dynamic decreased significantly (P<0.01, P<0.05); the protein expression of TLR4 and caspase3 in the metformin group and high dose group was significantly lower than that in the model group (P<0.05); kidney tissue pathological damage was significantly reduced. Conclusion TMP has a protective effect on STZ induced nephropathy in type 2 diabetic rats, and its mechanism may be related to the down-regulation of TLR4 expression.

目的 采用Meta分析系统定量地评价我国高中生与大学生艾滋病健康教育的干预效果,为在学生群体中开展艾滋病健康教育提供科学依据。方法 以“艾滋病”、“健康教育”、“大学生”和“高中生”为主题词和关键词联合检索PubMed、中国知网和万方数据库的相关文献,各数据库检索时间范围限定在2006年1月—2017年6月。对符合纳入排除标准的文献进行质量评价及摘录所需数据,以健康教育前后艾滋病常识得分作为效应值,运用Revman 5.3软件进行Meta分析。结果 共纳入19篇合格文献。Meta分析结果显示,健康教育对中学生与大学生艾滋病常识得分影响的标准均数差(Standard Mean Difference,SMD)=1.17(95% CI=0.88～1.47)。结论 健康教育对提高我国高中生与大学生艾滋病相关知识的知晓有较好的效果。

目的 探讨高速改良涡轮手机拔除下颌阻生第三磨牙的临床疗效。方法 回顾性分析2013年12月—2016年12月于本科室拔除下颌阻生第三磨牙600例临床案例,按拔除方式不同,将其分为高速涡轮手机组和传统凿骨劈冠组,各300例。其中高速涡轮手机组给予高速涡轮手机拔除法拔除下颌第三磨牙,传统凿骨劈冠组给予传统凿骨劈冠拔除法拔除下颌第三磨牙。统计分析两组患者拔出后疗效情况、拔除使用时间、以及拔除后疼痛度及张口受限度情况。结果 高速涡轮手机组患者拔牙优良率明显高于传统凿骨劈冠组,差异有统计学意义(P<0.05),而疗效差发生率明显低于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙时间在30min内人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而在30min以上的人数明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙后疼痛度1级和张口受限度1级人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而术后疼痛度2级、3级和张口受限度2级、3级均明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05)。结论 高速改良涡轮手机拔除下颌阻生第三磨牙具有创口小,伤口愈合较良好,用时短以及能促进患者术后舒适。

目的 探讨医护合作客观结构化临床考试(OSGE)培训对手术室低年资护士应急能力的影响效果。方法 对36名手术室低年资护士进行医护合作OSGE培训,于培训前和培训后3个月对低年资护士进行手术意外事件应对能力、实际参与应对手术意外事件能力以及对手术配合满意度的测评。结果 培训后低年资护士在医护配合、抢救仪器准备、抢救能力、病情评估、应对能力的得分显著提高,在护士抢救到位时间、抢救仪器到位时间、静脉穿刺成功时间明显缩短,医护对手术配合满意度明显提升,与培训前比较差异均有统计学意义(P＜0.05)。结论 对手术室低年资护士进行医护合作OSGE培训,可提高其对手术意外事件应对能力和实际参与应对手术意外事件能力,提高医护人员对手术配合的满意度,降低手术风险。

Objective To explore the effect of Objective structured clinical examination (OSGE) training on theemergency ability of nurses in the operation room. Methods Medical cooperation OSGE training was taken for 36 junior nurses in operation room. We evaluated their undergo operation contingency ability, participation contingency ability and operation cooperation in 3 months before and after training. Results After the training, the junior nurses in medical care cooperation, rescue ability, equipment preparation, condition assessment, coping ability were significantly higher. Nurses′s in-place time, equipments in place time, puncture time were shortened. Cooperation satisfaction was improved significantly. Compared with that before training, the differences were statistically significant (P<0.05). Conclusion Medical cooperation OSGE training for junior nurses in operation room may improve undergo operation contingency ability, coping contingency ability and operation cooperation, reduce the risk of surgery.