护理研究

基于HEC的健康管理联合早期活动护理干预应用于急性胰腺炎患者的效果

Effect of health management combined with early activity nursing intervention based on HEC on patients with acute pancreatitis

:558-561
 
目的 探讨基于健康意识理论(HEC)的健康管理联合早期活动护理干预应用于急性胰腺炎(AP)患者的效果。方法 将南阳市第一人民医院2020年1月—2023年1月期间收治的80例AP患者作为研究对象,按照随机数字表法分为对照组(n=40)和观察组(n=40)。两组患者均按照AP护理常规进行护理,对照组予早期活动护理干预,观察组予早期活动护理和基于HEC的健康管理,观察两组健康行为能力、健康促进行为和并发症发生情况。结果 干预后,两组患者健康行为能力自评量表得分均高于干预前,且观察组得分高于对照组(P<0.05);两组患者健康促进生活方式量表Ⅱ得分均高于干预前,且观察组得分高于对照组(P<0.05);观察组并发症发生率(5.00%)低于对照组(20.00%)。结论 基于HEC的健康管理联合早期活动护理可以有效改善AP患者的健康行为能力、健康促进行为减少并发症的发生。
Objective To explore the effect of health management combined with early activity nursing intervention based on health as expanding consciousness(HEC)on patients with acute pancreatitis(AP).Methods Eighty patients with AP admitted to the First People’s Hospital of Nanyang City from January 2020 to January 2023 were selected as the study subjects.They were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table method.Both groups of patients received routine AP nursing care.The control group received early activity nursing intervention,while the observation group received early activity nursing and HEC based health management.The health behavior ability,health promotion behavior,and incidence of complications were observed in both groups.Results After the intervention,both groups of patients had higher scores on the Self Rating Health Behavioral Ability Scale than before the intervention,and the observation group had higher scores than the control group(P<0.05).The scores of the Health Promotion Lifestyle Scale II for both groups of patients were higher than before intervention,and the scores of the observation group were higher than those of the control group(P<0.05).The incidence of complications in the observation group(5.00%)was lower than that in the control group(20.00%).Conclusions Health management based on HEC combined with early activity nursing can effectively improve the health behavior ability of AP patients,promote health behavior,and reduce the occurrence of complications.
论著

作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效观察

Observation on the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation on shoulder pain after stroke

:524-529
 
目的 探讨作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效。方法 选取2020年6月—2023年6月在肇庆市第一人民医院治疗的60例脑卒中后肩痛患者为研究对象,随机分为观察组和对照组各30例。其中,观察组进行作业疗法结合经皮神经电刺激;对照组单纯进行作业疗法。记录患者治疗前及治疗4周后的视觉模拟疼痛评分(VAS),改良Barthel指数(MBI)和汉密顿抑郁量表评分(HAMD),并对记录进行检验和t检验。结果 观察组和对照组的治疗效果比较差异有统计学意义(P=0.019),观察组治疗有效率(93.33%)高于对照组(63.33%);治疗前两组患者的VAS(P=0.536)和HAMD(P=0.558)分值比较差异无统计学意义,治疗后其VAS(P=0.049)及HAMD(P=0.023)分值均较治疗前下降,且观察组下降幅度分别为(2.23±1.14)分和(4.47±3.06)分,均高于对照组的(1.27±0.98)和(1.33±1.35),组间比较差异有统计学意义;治疗前两组患者的MBI分值比较差异无统计学意义(P=0.216),治疗后其MBI分值均较治疗前提高,且观察组提高幅度(21.87±10.25)较对照组(12.00±13.58)更显著,组间比较差异有统计学意义(P=0.003)。结论 作业疗法结合经皮神经电刺激可缓解脑卒中肩痛,改善患者日常生活能力和心理精神状态,减少抑郁的发生。
Objective To explore the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation(TENS) on shoulder pain after stroke.Methods Sixty patients with post-stroke shoulder pain who were treated in the First People’s Hospital of Zhaoqing from June 2020 to June 2023 were selected as the study subjects and randomly divided into an observation group and a control group,with 30 cases in each group.Among them,the observation group received occupational therapy combined with TENS,while the control group received occupational therapy alone.This study recorded the Visual Analogue Scale(VAS),modified Barthel Index(MBI),and Hamilton Depression Rating Scale(HAMD)of patients before and after 4 weeks of treatment,and conducted the and t-test analysis.Results The test analysis showed a significant difference in treatment effectiveness between the observation group and the control group(P=0.019),with the observation group having a significantly higher treatment effectiveness rate(93.33%)than the control group(63.33%);t-test analysis showed that there was no statistically significant difference in VAS(P=0.536)and HAMD(P=0.558)indicators between the two groups of patients before treatment.However,after treatment,the VAS(P=0.049)and HAMD(P=0.023)indicators decreased compared to before treatment.The observation group had decreased(2.23±1.14)and(4.47±3.06),respectively,which were significantly higher than the control group’s(1.27±0.98)and(1.33±1.35),and the inter group differences were statistically significant;before treatment,there was no statistically significant difference in MBI indicators between the two groups of patients(P=0.216).After treatment,their MBI indicators increased compared to before treatment,and the observation group(21.87±10.25)showed a more significant improvement compared to the control group(12.00±13.58).The difference between the groups was statistically significant(P=0.003).Conclusions Occupational therapy combined with TENS can significantly alleviate shoulder pain after stroke,improve daily living ability and psychological state of patients,and reduce the occurrence of depression.
论著

伏诺拉生三联疗法治疗幽门螺杆菌的疗效观察

Efficacy of vonoprazan triple therapy for treatment of Helicobacter pylori

:489-493
 
目的 探究伏诺拉生三联疗法根除幽门螺杆菌(Hp)的疗效。方法 入组2022年5月—12月经13C尿素呼气试验确诊的Hp现症感染者200例,分为观察组和对照组,每组100例。观察组方案为阿莫西林、呋喃唑酮、伏诺拉生三联疗法,对照组方案为阿莫西林、呋喃唑酮、艾司奥美拉唑镁、枸橼酸铋钾四联疗法;疗程均为14 d。在治疗停药后1个月复查13C尿素呼气试验判定是否Hp根除成功,并观察药物不良反应发生率。结果 观察组Hp根除率为96.97%,高于对照组的89.80%,差异有统计学意义(P<0.05);观察组不良反应发生率和对照组比较差异无统计学意义(P>0.05)。结论 伏诺拉生、阿莫西林、呋喃唑酮三联疗法的Hp根除率较高且安全性良好,可作为Hp感染的治疗方案之一。
Objective To explore the effect of vonoprazan triple therapy on Helicobacter pylori(Hp).Methods A total of 200 patients with Hp infection confirmed by 13C urea breath test from May-December 2022 were selected and divided into observation group and control group with 100 patients in each group.The observation group was treated with triple therapy of amoxicillin,furazolidone and vonoprazan,while the control group was treated with quadruple therapy of amoxicillin,furazolidone,esomeprazole magnesium and bismuth potassium citrate.The treatment course was 14 days.The 13C urea breath test was reviewed one month after treatment withdrawal to determine whether Hp eradication was successful,and the incidence of adverse drug reactions was observed.Results The eradication rate of Hp in the observation group was 96.97%,higher than 89.80% in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusions The triple therapy of vonoprazan,amoxicillin and furazolidone has a very high eradication rate and good safety,which can be used as one of the treatment options for Hp.
综述

大蒜对糖脂代谢调节作用的研究进展

Garlic and its regulatory effects on glucose and lipid metabolism

:472-477
 
大蒜为百合科葱属植物的地下鳞茎,具有药食两用的价值,其含有大蒜素、二烯丙基硫醚、二烯丙基二硫醚、二烯丙基三硫醚、 硫-烯丙基半胱氨酸等多种生物活性成分,具有抗氧化、抗感染、免疫调节、心血管保护、抗癌等作用。不仅如此,大蒜在糖脂代谢的调节中功效显著,且相关机制日益明晰,主要包括保护胰岛β细胞功能、改善胰岛素抵抗、阻止脂肪细胞生长、抑制脂合成代谢及调节肠道菌群分布等。不同的提取工艺可影响大蒜的功效,其提取手段及药效关系值得进一步研究。
Garlic has values of both medicine and food,with rich allicin,diallyl disulfide(DADS),diallyl trisulfide(DATS)and other garlic sulfur contents,which have been found to have multiple effets such as antioxidant,anti-infection,immunomodulatory,cardiovascular protection,anti-cancer,etc.Moreover,numerous studies have demonstrated that garlic plays an important role in the regulation of glycose and lipid metabolism,and the relevant mechanisms are becoming better understood,including protecting pancreatic β cells,improving insulin resistance,preventing the growth of fat cells,inhibiting lipid anabolism and adjusting the distribution of intestinal microflora.Different extraction processes can affect the efficacy of garlic,and further investigations are needed to elucidate the relationship between effective extraction methods and pharmacodynamic properties.
论著

改良Miccoli手术对单侧甲状腺癌患者机体创伤应激反应的影响

The effect of modified Miccoli operation on the body’s traumatic stress response in patients with unilateral thyroid cancer

:934-939
 
目的 探究改良Miccoli手术治疗单侧甲状腺癌(TC)患者的效果及其对机体创伤应激反应的影响。方法 选取新密市中医院200例单侧TC患者(2021年3月—2023年3月),按随机数字表法分两组。A组100例接受改良Miccoli手术治疗,B组100例接受开放根治术(OT)治疗。对比两组围术期指标、喉返神经损伤发生情况、美学效果、手术前后肿瘤指标[细胞角蛋白19片段抗原(Cyfra21.1)、半乳糖凝集素3(Gal-3)、可溶性白细胞介素-2受体(sIL-2R)]、创伤应激反应指标[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)]水平。结果 A组切口长度为(2.05±0.13)cm,短于B组的(7.11±0.49)cm,住院及手术用时分别为(3.12±0.44)d、(53.48±7.52)min,均短于B组的(5.22±0.81)d、(76.81±11.39)min,术中失血量、引流量分别为(19.24±2.66)mL、(21.47±3.41)mL,均少于B组的(45.08±5.75)mL、(64.82±7.24)mL,组间比较差异有统计学意义(P<0.05);A组喉返神经损伤总发生率为2.00%(2/100),低于B组的12.00%(12/100),组间比较差异有统计学意义(P<0.05);A组美容总满意度为97.00%(97/100),高于B组的73.00%(73/100),差异有统计学意义(P<0.05);A组术后3个月血清Cyfra21.1、Gal-3水平分别为(1.78±0.26)ng/mL、(6.14±1.64)ng/mL,均高于B组的(1.55±0.21)ng/mL、(5.39±1.28)ng/mL,血清sIL-2R水平为(375.36±20.12)μg/mL,低于B组的(427.13±23.18)μg/mL,组间比较差异有统计学意义(P<0.05);A组术后1 d血清NE、E、Cor水平分别为(0.73±0.17)mmol/L、(0.49±0.10)mmol/L、(185.46±22.95)μg/L,均低于B组的(0.96±0.19)mmol/L、(0.81±0.22)mmol/L、(272.53±32.41)μg/L,组间比较差异有统计学意义(P<0.05)。结论 相较于OT治疗单侧TC患者,经改良Miccoli手术治疗更有助于提升美学效果,减少喉返神经损伤,优化围术期指标,抑制肿瘤进展,且机体产生的创伤应激反应更轻微。
Objective To investigate the effect of modified Miccoli surgery on patients with unilateral thyroid cancer(TC)and its impact on the body’s traumatic stress response.Methods The data of 200 patients with unilateral TC in Xinmi City Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were retrospectively collected and divided into two groups according to different surgical protocols.A hundred patients treated with modified Miccoli surgery were classified as group A and 100 patients treated with open radical surgery(OT)were classified as group B.The perioperative indicators,incidence of recurrent laryngeal nerve injury,aesthetic effect,as well as tumor indicators [cytokeratin 19 fragment antigen(Cyfra21.1),galectin-3(Gal-3),soluble interleukin -2 receptor(sIL-2R)] and trauma stress response indicators [norepinephrine(NE),epinephrine(E),and cortisol(Cor)] before and after surgery were compared between the two groups.Results The incision length of group A was(2.05±0.13)cm,which was shorter than that of group B [(7.11±0.49)cm].The duration of hospitalization and operation of group A were(3.12±0.44)d and(53.48±7.52)min,respectively,which were shorter than those of group B [(5.22±0.81)d and(76.81±11.39)min].The intraoperative blood loss and drainage volume were(19.24±2.66)mL and(21.47±3.41)mL,respectively,which were lower than those in group B [(45.08±5.75)mL and(64.82±7.24)mL],and the difference was statistically significant(P<0.05).The total incidence of recurrent laryngeal nerve injury in group A was 2.00%(2/100),lower than that in group B [12.00%(12/100)],and the difference was statistically significant(P<0.05).The total satisfaction of group A was 97.00%(97/100),higher than that of group B [73.00%(73/100)],and the difference was statistically significant(P<0.05).Serum Cyfra21.1 and Gal-3 levels in group A were(1.78±0.26)ng/mL and(6.14±1.64)ng/mL,respectively,higher than those in group B [(1.55±0.21)ng/mL and(5.39±1.28)ng/mL].Serum sIL-2R level was(375.36±20.12)μg/mL,lower than that of group B [(427.13±23.18)μg/mL],and the difference was statistically significant(P<0.05).The serum levels of NE,E and Cor in group A were(0.73±0.17)mmol/L,(0.49±0.10)mmol/L and(185.46±22.95)μg/L,respectively.They were lower than(0.96±0.19)mmol/L,(0.81±0.22)mmol/L and(272.53±32.41)μg/L in group B,and the differences were statistically significant(P<0.05).Conclusions Compared to OT treatment for unilateral TC patients,the modified Miccoli surgery is more helpful in improving aesthetic effects,reducing damage to the recurrent laryngeal nerve,optimizing perioperative indicators,inhibiting tumor progression,and producing less traumatic stress response to the body.
论著

基于儿童早期预警评分的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响

The effect of graded intervention mode based on Pediatric Early Warning Score on the recovery process and respiratory function of children with severe pneumonia

:929-933
 
目的 研究基于儿童早期预警评分(PEWS)的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组(n=50)及对照组(n=50)。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程(相关指标涵盖症状持续时长及住院天数)、呼吸功能(涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量)、并发症发生情况(涵盖呼吸机相关性肺炎、肺大疱及胸膜炎)、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组(均P<0.05)。研究组各项呼吸功能指标水平均高于对照组(均P<0.05)。两组各项并发症发生率对比差异无统计学意义(P>0.05)。研究组患儿家属满意度高于对照组(96.00% vs 82.00%,P<0.05)。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。
Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score(PEWS)on the recovery process and respiratory function of children with severe pneumonia.Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed.Those children were divided into study group(n=50)and control group(n=50)according to the difference of intervention methods.Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group.The two groups were compared with each other in terms of recovery process(including duration of symptoms and length of stay),respiratory function(including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity),complications(including ventilators associated pneumonia,bullosa and pleurisy),and family member satisfaction.Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group(all P<0.05).The levels of respiratory function indexes in study group were higher than those in control group(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The satisfaction of family member in the study group was higher than that in the control group(96.00% vs 82.00%)(P<0.05).Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia.
论著

丙戊酸钠联合奥卡西平治疗癫痫对患者炎性因子及疗效的影响

To investigate the effect of sodium valproate combined with oxcarbazepine on inflammatory factors and efficacy in patients with epilepsy

:923-928
 
目的 探讨丙戊酸钠联合奥卡西平治疗癫痫的疗效及其对患者炎性因子的影响。方法 选择2022年1月—2023年1月医院接收的100例癫痫患者进行研究,电脑随机编号奇偶数分为两组各50例,对照组采取丙戊酸钠治疗,观察组采取丙戊酸钠联合奥卡西平治疗,评价并比较两组治疗效果、神经因子、炎症因子、免疫功能、认知功能及生活质量,观察不良反应发生率。结果 观察组和对照组的治疗有效分别为47例(94.00%)、39例(78.00%),观察组治疗有效率高于对照组(χ2=5.315,P=0.02)。治疗后,观察组的脑源性神经营养因子(195.33±18.29)pg/mL、神经生长因子(594.69±54.45)ng/mL水平高,肿瘤坏死因子-α(4.12±1.07)pg/mL、IL-1β(3.48±0.79)pg/mL、IL-6(53.44±3.63)pg/mL水平比对照组(150.68±15.27)pg/mL、(542.46±45.56)ng/mL、(6.35±1.27)pg/mL、(4.35±0.93)pg/mL、(63.02±3.81)pg/mL低(t=13.250、5.201、9.495、5.041、12.872,P<0.05)。治疗后,观察组的IgM(1.02±0.12)g/L、IgG(10.02±1.22)g/L、IgA(2.10±0.22)g/L比对照组(1.13±0.14)g/L、(11.68±1.57)g/L、(2.65±0.31)g/L更高(t=4.218、5.903、10.230,P<0.05)。治疗后,观察组的蒙特利尔认知量表(27.78±2.15)分、日常生活活动量表(71.88±6.45)分、癫痫患者生活质量评定量表-31(82.65±8.25)分比对照组(25.33±2.01)分、(65.65±5.54)分、(74.05±7.37)分更高(t=5.886、5.181、5.497,P<0.05)。观察组、对照组发生不良反应组间比较差异无统计学意义(χ2=1.010,0.343,1.010,1.010,1.010,P均>0.05)。结论 丙戊酸钠联合奥卡西平治疗癫痫患者可取得良好的疗效,控制癫痫症状,改善神经因子、认知功能,增强免疫功能,控制炎症因子,而且不良反应少,利于生活质量提高。
Objective To investigate the effect of sodium valproate combined with oxcarbazepine in the treatment of epilepsy and its influence on inflammatory factors.Methods From January 2022 to January 2023,100 patients with epilepsy admitted to our hospital were selected and randomly divided into two groups,50 cases in each group.The control group was treated with sodium valproate,and the observation group was treated with sodium valproate combined with oxcarbazepine.The therapeutic effect,neurological factors,inflammatory factors,immune function,cognitive function and quality of life were evaluated and compared between the two groups,and the incidence of adverse reactions was observed.Results The effective rate of the observation group and the control group were 94.00%(47 cases)and 78.00%(39 cases),respectively.The effective rate of the observation group was higher than that of the control group(χ2=5.315,P=0.02).After treatment,the levels of brain-derived neurotrophic factor(195.33±18.29)pg/mL and nerve growth factor(594.69±54.45)ng/mL in the observation group were higher than those in the control group.The levels of tumor necrosis factor-α(4.12±1.07)pg/mL,IL-1β(3.48±0.79)pg/mL,IL-6(53.44±3.63)pg/mL in the control group were(150.68±15.27)pg/mL,(542.46±45.56)ng/mL,(6.35±1.27)pg/mL,(4.35±0.93)pg/mL,(63.02±3.81)pg/mL(t=13.250,5.201,9.495,5.041,12.872,P<0.05). After treatment,the IgM(1.02±0.12)g/L,IgG(10.02±1.22)g/L,IgA(2.10±0.22)g/L were higher than those in the control group(1.13±0.14)g/L,(11.68±1.57)g/L,(2.65±0.31)g/L(t=4.218,5.903,10.230,P<0.05).After treatment,the scores of Montreal Cognitive Scale(27.78±2.15),Activities of Daily Living Scale(71.88±6.45)and Quality of Life in Epilepsy Scale 31(82.65±8.25)in the observation group were higher than those in the control group(25.33±2.01),(65.65±5.54)and(74.05±7.37)(t=5.886,5.181,5.497,P<0.05).There was no significant difference in adverse reactions between the observation group and the control group(χ2=1.010,0.343,1.010,1.010,1.010,all P>0.05).Conclusions Sodium valproate combined with oxcarbazepine in the treatment of patients with epilepsy can achieve good curative effect,control epilepsy symptoms,improve neurological factors,cognitive function,enhance immune function,control inflammatory factors,with less adverse reactions,conducive to improve the quality of life.
论著

危重产妇代理决策者的决策困境及影响因素分析

Analysis of decision-making difficulties and influencing factors of surrogate decision-makers for critically ill puerpera

:907-912
 
目的 了解危重产妇代理决策者的决策困境现状及其影响因素。方法 选择2022年10月—2023年10月许昌市中心医院产科及ICU的262例危重产妇及其代理决策者作为研究对象。应用一般资料问卷、母婴健康素养问卷、决策困境量表、决策参与期待量表进行调查。结果 决策困境量表总分为(39.38±14.58)分,其中信息提供和价值观明确总分为(13.91±7.16)分、社会支持和决策有效性总分为(20.41±8.25)分、不确定性总分为(5.06±1.96)分。多元线性回归分析发现,性别、学历、决策时间和脑卒中防治知识总分对危重产妇代理决策者决策困境均有影响(P<0.05)。结论 危重产妇代理决策者存在决策困境,医护人员需要根据代理决策者的人口学特征、疾病防治知识以及患者疾病特征进行决策辅助,减轻其决策困境,提升决策质量。
Objective To understand the current situation and influencing factors of decision-making difficulties among surrogate decision-makers for critically ill puerpera.Methods A total of 262 critically ill puerpera and their surrogate decision-makers from the obstetrics and ICU of Xuchang Central Hospital from October 2022 to October 2023 were selected.A survey was conducted using the General Information Questionnaire,Maternal and Child Health Literacy Questionnaire,Decision Dilemma Scale,and Decision Participation Expectancy Scale.Results The total score of the Decision Dilemma Scale was(39.38±14.58),with a total score of(13.91±7.16)for information provision and clear values,(20.41±8.25)for social support and decision effectiveness,and(5.06±1.96)for uncertainty.Multiple linear regression analysis found that gender,education level,decision time and total score of stroke prevention and control knowledge all have an impact on the decision-making difficulties of surrogate decision-makers in critically ill puerpera(P<0.05).Conclusions There is a decision-making dilemma for the surrogate decision-makers of critically ill puerpera.Medical staff need to provide decision-making assistance based on the demographic characteristics,disease prevention and control knowledge,and patient disease characteristics of the surrogate decision-makers,in order to alleviate their decision-making difficulties and improve the quality of decision-making.
论著

内托生肌法治疗肉芽肿性乳腺炎溃后期的临床疗效

Clinical efficacy of endotropic muscle-generating therapy in treating late-stage ulcerative granulomatous mastitis

:888-894
 
目的 研究内托生肌法治疗肉芽肿性乳腺炎溃后期的临床疗效。方法 63例符合肉芽肿性乳腺炎溃后期的患者,分为西药组31例和中药组32例。西医药组予常规激素、抗生素等治疗,中药组予内托生肌法,加减组方,两组治疗时间为6个月。比较两组患者的疾病转归、乳房外形评价、临床症状观察评分等指标。结果 中药组6个月治愈率高于西药组,中药组临床治愈18例(56.2%)、痊愈11例(34.4%),相较于西药组临床治愈11例(35.5%)和痊愈9例(29%);治疗后中药组乳房外形评价优于西药组,中药组临床症状评分较低,组间比较差异具有统计学意义。两组患者治疗前后免疫球蛋白IgA、IgG、IgM水平比较差异均未见统计学意义。中药组相较于西药组不良反应更少,患者依从性更高。结论 内托生肌法治疗肉芽肿性乳腺炎溃后期能促进肉芽肿创面愈合,加快肉芽组织新生,改善破溃流脓症状以及在恢复乳房外观方面具有明显的优势。
Objective To study the clinical efficacy of endotropic muscle-generating therapy in treating late-stage ulcerative granulomatous mastitis.Methods Sixty-three eligible patients were included in the western medicine group(31 cases)and the traditional Chinese medicine group(32 cases).The western medicine group received conventional hormones and antibiotics,while the traditional Chinese medicine group received the endotropic muscle-generating method with adjustments.The treatment duration for both groups was six months.Disease regression,breast shape evaluation,clinical symptom observation scores,and other relevant indices of both groups were compared.Results The study found that the six-month cure rate in the traditional Chinese medicine group(56.2% clinically cured,34.4% cured)exceeded that of the western medicine group(35.5% clinically cured,29% cured).Breast appearance evaluation in the traditional Chinese medicine group significantly better that of the western medicine group post-treatment,and clinical symptom scores were lower,demonstrating a statistically significant difference.Before and after treatment,there was no significant difference in the levels of immunoglobulins A,G,and M observed between the two groups.The traditional Chinese medicine group exhibited fewer side effects and higher patient compliance compared to the western medicine group.Conclusions The endotropic muscle-generating method,when employed to treat granulomatous mastitis in the late ulcerative stage,proves effective in promoting granulomatous wound healing,accelerating the generation of new granulation tissue,and improving ulceration and pus flow symptoms.Additionally,it contributes to the restoration of breast appearance.
论著

化疗联合NKG2A抑制剂抗头颈部鳞状细胞癌作用的研究

Effect of chemotherapy combined with NKG2A inhibitor on head and neck squamous cell carcinoma

:860-868
 
目的 研究靶向NKG2A抑制剂抗头颈部鳞状细胞癌(HNSCC)的作用。方法 应用GEO和TCGA数据库分析NKG2A及其配体HLA-E单细胞表达情况、与患者预后以及免疫微环境的相关性。构建HNSCC皮下抑制瘤模型,流式细胞技术检测化学治疗(化疗)对免疫检测点NKG2A表达的影响。动物实验验证NKG2A抑制剂以及NKG2A抑制剂联合多西他赛化疗的抗肿瘤作用。结果 NKG2A(KLRC1)主要表达在NK细胞,少量表达在T淋巴细胞。HNSCC肿瘤高表达NKG2A/HLA-E(P<0.01),与患者不良预后密切相关;肿瘤微环境中NKG2A/HLA-E与多个免疫细胞浸润以及免疫检测点表达密切相关(P<0.01)。动物实验显示化疗能上调T、B淋巴细胞表达免疫检查点NKG2A的表达水平(P<0.01);化疗的基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用(P=0.013)。结论 化疗基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用,为探索HNSCC临床新策略提供实验和理论基础。
Objective To investigate the anti-tumor effects of NKG2A inhibitor on head and neck squamous cell carcinoma(HNSCC).Methods The single-cell expression of NKG2A ,its ligand HLA-E and their correlations with patient prognosis and immune microenvironment were analyzed in GEO and TCGA databases.The subcutaneous tumor model of HNSCC was constructed,and the effects of chemotherapy on the expression of NKG2A on T and B lymphocytes were detected by flow cytometry.Animal experiments were used to confirmed the anti-tumor effects of NKG2A inhibitor and NKG2A inhibitors combined with docetaxel.Results NKG2A(KLRC1)was mainly expressed in NK cells,and a small amount was expressed in T lymphocytes.The high expression of NKG2A/HLA-E in HNSCC tumors(P<0.01)were closely related to poor prognosis.NKG2A/HLA-E in tumor microenvironment were closely related to the infiltration of multiple immune cells and the expression of immune checkpoints(P<0.01).Animal experiments showed that chemotherapy could up-regulate the expression of NKG2A in T and B lymphocytes(P<0.01).Chemotherapy in combination with NKG2A inhibitor could mediate more effective antitumor effects in HNSCC(P=0.013).Conclusions Combined with NKG2A inhibitor on the basis of chemotherapy can mediate more effective anti-tumor effects,and this study may provide experimental and theoretical basis for exploring new clinical strategies of HNSCC.
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