目的 探讨消肿化瘀膏治疗骨性关节炎的临床疗效。方法 选择2017年5月—2022年1月在本院诊治的骨性关节炎患者124例作为研究对象,根据简单分配原则把患者分为消肿化瘀膏组与传统药物组各62例。传统药物组给予传统药物治疗,消肿化瘀膏组给予消肿化瘀膏治疗,判定2组患者治疗总显效率、疼痛评分、关节评分、血清中炎症因子水平变化。结果 消肿化瘀膏组治疗后的总显效率为98.4%,高于传统药物组的83.9%（P<0.05）。治疗后,2组的疼痛评分都低于治疗前（P<0.05）,且消肿化瘀膏组低于传统药物组（P<0.05）。2组治疗后的关节评分都高于治疗前（P<0.05）,且消肿化瘀膏组与传统药物组相比升高（P<0.05）。2组治疗后的血清白介素-1β、白介素-6水平都低于治疗前（P<0.05）,且消肿化瘀膏组较传统药物组降低更多（P<0.05）。结论 消肿化瘀膏治疗骨性关节炎能有效抑制血清炎症因子的表达,缓解疼痛,改善关节功能,提高患者的总体治疗效果。

Objective To explore the clinical efficacy of Xiaozhonghuayu ointment in the treatment of osteoarthritis．Methods From May 2017 to January 2022,124 patients with osteoarthritis who diagnosed and treated in our hospital were selected as the research subjects．According to the simple allocation principle,the patients were divided into the Xiaozhonghuayu ointment group and the traditional medicine group with 62 cases each．The traditional medicine group was treated with traditional medicine,and the Xiaozhonghuayu ointment group was treated with Xiaozhonghuayu ointment．The total therapeutic efficiency,pain score,joint score,and the changes of serum inflammatory factors were compared in the two groups．Results The total efficiency of Xiaozhonghuayu ointment group after treatment were 98.4%,which were higher than 83.9% in the traditional medicine group（P<0.05）．The pain scores in both groups after treatment were lower than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were lower than the traditional medicine group（P<0.05）．The joint scores of the two groups after treatment were higher than those before treatment（P<0.05）,and that in the Xiaozhonghuayu ointment group were higher than the traditional medicine group（P<0.05）．After treatment,the levels of serum interleukin-1β and interleukin-6 in the two groups were significantly lower than those before treatment（P<0.05）,compared with the traditional medicine group,those levels in the Xiaozhonghuayu ointment group also decreased significantly after treatment（P<0.05）．Conclusions Xiaozhonghuayu ointment in the treatment of osteoarthritis can effectively inhibit the expressions of serum inflammatory factors,promote pain relief,improve joint function,and improve the overall therapeutic effect of patients．

目的 探讨桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响,以便临床寻找出更有效的治疗方案,进而改善患者预后。方法 本次研究对象为赣州市人民医院2017年6月—2022年1月收治的82例桥小脑角肿瘤患者,用随机数字表法将其分为对照组（41例）和实验组（41例）。对照组患者给予常规显微手术治疗,实验组患者给予神经内镜辅助常规显微手术治疗,2组患者均于术后观察8周。比较2组患者肿瘤全切率,手术时间、住院时间及住院费用,术前及术后2、4、8周格拉斯哥预后量表（GOS）评分,以及术后8周内并发症发生情况。结果 肿瘤全切率：实验组患者术后8周（90.24%）与对照组（73.17%）相比,处于更高水平;手术时间、住院时间：实验组患者与对照组相比,处于更短水平;GOS评分：术前至术后2周,2组患者评分均呈下降趋势,术后2周至8周,2组患者评分呈升高趋势,其中实验组术后2、4、8周与对照组相比,处于更高水平,差异有统计学意义（P<0.05）;并发症总发生率：术后8周内,实验组患者（4.88%）与对照组（17.07%）相比,差异无统计学意义（P>0.05）。结论 桥小脑角肿瘤微创切除术中应用神经内镜,可有效缓解患者的临床症状,优化手术相关指标,减轻神经功能受损,提高肿瘤全切率,改善预后,且安全性高。

Objective To investigate the effect of neuroendoscope on functional recovery and prognosis of patients with cerebellopontine angle tumor after microinvasive resection,so as to find out more effective treatment and improve the prognosis of patients．Methods The subjects were 82 patients with cerebellopontine angle tumors admitted to Ganzhou People's Hospital from June 2017 to January 2022．They were divided into control group（n = 41）and experimental group（n = 41）by random number table method．Patients in the control group were treated with conventional microsurgery,while patients in the experimental group were treated with neuroendoscope assisted conventional microsurgery．All patients were observed for 8 weeks after operation．The total tumor resection rate,operation time,hospitalization time,hospitalization expense,Glasgow Outcome Scale（GOS）score before and 2,4,8 weeks after operation,and complications within 8 weeks after operation were compared between the two groups．Results Compared with the control group（73.17%）,the patients in the experimental group had a higher resection removal rate of tumor after 8 weeks of operation（90.24%）．Patients in the experimental group had a shorter operation time and hospital stay than those in the control group．From pre-operation to 2 weeks after operation,the GOS scores of patients in both groups showed a downward trend,and from 2 weeks to 8 weeks after operation,the scores of patients in both groups showed an upward trend,and the patients in the experimental group were at a higher level than those in the control group at 2,4,8 weeks after operation,the difference were statistically significant（P < 0.05）．Within 8 weeks after surgery,there was no significant difference in total incidence of complications between the experimental group（4.88%）and the control group（17.07%,P > 0.05）．Conclusions The application of neuroendoscope in the minimally invasive surgery of cerebellopontine angle tumor can effectively relieve the clinical symptoms of patients,optimize the operation-related indexes,reduce the damage of nerve function,increase the total resection rate of tumor,improve the prognosis,and with high safety．

目的 分析精神分裂症患者体内的肌酸激酶（CK）、肌红蛋白（MYO）、β₂微球蛋白（β₂-MG）、细胞间黏附分子（ICAM）水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤（AKI）可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组（同期我院门诊健康体检者）20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β₂-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β₂-MG值高于健康对照组及肾功能正常组,差异具有统计学意义（F=623.534,30.437,636.776,88.283,P<0.05）,精神分裂症AKI 1期组到AKI 3期组CK、MYO、β₂-MG、ICAM数值均比对照组升高（P<0.05）,3组之间如上指标的比较差异有统计学意义（P<0.05）。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β₂-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。

Objective To study the changes of serum creatine kinase（CK）,myoglobin（MYO）,β₂ microglobulin（β₂-MG）,intercellular adhersion molecule（ICAM）with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury（AKI）in patients with schizophrenia．Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls（who underwent physical examination during the same period）were included．At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β₂-MG level in each group．The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed．Results The serum CK,MYO,ICAM and β₂-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant（F=623.534,30.437,636.776,88.283,P<0.05）,and the comparison of the above indexes among the three groups was statistically significant（P<0.05）．Conclusions The abnormal increase of serum CK,MYO,ICAM and β₂-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis．

目的 分析艾司氯胺酮对剖宫产术后镇痛及肾素-血管紧张素-醛固酮系统（RAAS）、产后抑郁情况发生的影响。方法 研究对象为2020年5月—2021年6月在我院行剖宫产的96例孕产妇,根据麻醉药物的不同分为研究组50例和对照组46例,2组孕产妇均给予腰硬联合麻醉行剖宫产术,研究组于手术切皮前5 min静脉注射艾司氯胺酮0.2 mg/kg,对照组静脉注射等量生理盐水。比较2组孕产妇术后疼痛评分（VAS评分）、肾素活性（PRA）、血管紧张素-II（AT-II）、醛固酮（ALD）、爱丁堡产后抑郁量表（EPDS）、不良反应的发生情况。结果 与对照组比较,术后各时间点研究组孕产妇VAS评分均明显较低,差异具有统计学意义（P<0.01）。2组T1、T2、T3各时间点RAAS各指标均明显低于T0时间点（P<0.05）;研究组在T1、T2时间点RAAS各指标均明显低于对照组,差异具有统计学意义（P<0.05）。研究组术后3 d、术后6周EPDS评分均明显低于对照组（P<0.01）。2组不良反应总发生率比较无差异（P>0.05）。结论 艾司氯胺酮用于剖宫产术后镇痛效果显著,对产妇RAAS影响较小,并可缓解产妇抑郁症状,且不良反应发生率较低。

Objective To analyze the effect of esketamine on analgesia and renin angiotensin aldosterone system（RAAS）and the occurrence of postpartum depression after cesarean delivery．Methods The subjects were 96 pregnant women who underwent cesarean section in our hospital from May 2020 to June 2021,they were divided into 50 cases in the study group and 46 cases in the control group．Both groups of pregnant women were given combined spinal epidural anesthesia for cesarean section．The patients in study group were injected with esmketamine 0.2 mg/kg intravenously 5 minutes before skin incision,and those in control group were injected with the same amount of saline intravenously．The postoperative pain scores（VAS score）,plasma renin activity（PRA）,angiotensin-II（AT-II）,aldosterone（ALD）,Edinburgh Postpartum Depression Scale（EPDS）,and the occurrence of adverse effects were compared between the two groups．Results Compared with the control group,maternal VAS scores were significantly lower in the study group at all postoperative time points,and the differences were statistically significant（P<0.01）．The indexes of RAAS were significantly lower in both groups at T1,T2 and T3 time points than at T0 time point（P<0.05）;the indexes of RAAS were significantly lower in the study group at T1 and T2 time points than in the control group,and the differences were statistically significant（P<0.05）．The postoperative EPDS scores in the study group were significantly lower than those in the control group at 3 d and 6 weeks（P<0.01）．There was no difference in the overall incidence of adverse reactions between the two groups（P>0.05）．Conclusions Esketamine is effective for postoperative analgesia after cesarean section,with less effect on maternal RAAS,and can relieve maternal depressive symptoms,and has a low incidence of adverse reactions．

目的 研究核因子-κB激活剂1（Act1）对高糖诱导肾小管上皮细胞炎症反应及细胞外基质表达的调控作用。方法 培养肾小管上皮细胞MK2,设置对照组和高糖组,处理12 h、24 h、48 h、72 h后检测细胞中Act1的mRNA和蛋白表达水平;设置si-NC组（5.5 mmol/L葡萄糖培养基中转染NC siRNA）、si-NC+高糖组（30 mmol/L葡萄糖培养基中转染NC siRNA）、si-Act1+高糖组（30 mmol/L葡萄糖培养基中转染Act1 siRNA）,48 h后检测细胞中Act1、E-钙黏蛋白（E-cadherin）、N-钙黏蛋白（N-cadherin）、I型胶原（Col-I）、III型胶原（Col-III）的mRNA和蛋白表达水平以及培养基中肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）、干扰素-γ（IFN-γ）的含量。结果 高糖组处理12 h、24 h、48 h、72 h时细胞中Act1的mRNA和蛋白表达水平均高于对照组（P<0.05）;si-NC+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均高于si-NC组,细胞中E-cadherin的mRNA和蛋白表达水平均低于si-NC组（P<0.05）;si-Act1+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均低于si-NC+高糖组,细胞中E-cadherin的mRNA和蛋白表达水平均高于si-NC+高糖组（P<0.05）。结论 Act1表达增加对高糖诱导肾小管上皮细胞炎症反应激活和细胞外基质增多具有促进作用。

Objective To study the regulation effect of nuclear factors-κB activator 1（NF-κB activator 1,Act1）on high glucose induced inflammatory response and extracellular matrix expression in renal tubular epithelial cells．Methods Renal tubular epithelial cells MK2 were cultured and control group and high glucose group were set．The mRNA and protein expression of Act1 were detected after treatment for 12,24,48 and 72 hours．MK2 were divided into si-NC group（transfected with NC siRNA in 5.5 mmol/L glucose medium）,si-NC+high glucose group（transfected with NC siRNA in 30 mmol/L glucose medium）and si-Act1+high glucose group（transfected with Act1 siRNA in 30 mmol/L glucose medium）．The mRNA and protein expression of Act1,E-cadherin,N-cadherin,type I collagen（Col-I）,and type III collagen（Col-III）and the contents of tumor necrosis factor-α（TNF-α）,interleukin-1β（IL-1β）,interferon-γ（IFN-γ）in culture medium were detected．Results The mRNA and protein expression levels of Act1 in cells of high glucose group were higher than those of control group at 12 h,24 h,48 h and 72 h（P<0.05）．The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-NC+high glucose group were higher than those of si-NC group,the mRNA and protein expression levels of E-cadherin in cells were lower than those of si-NC group at 48 h（P<0.05）．The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-Act1+high glucose group were lower than those of si-NC+high glucose group,the mRNA and protein expression levels of E-cadherin in cells were higher than those of si-NC+high glucose group at 48 h（P<0.05）．Conclusions The increased expression of Act1 promotes the activation of inflammatory response and the increase of extracellular matrix in renal tubular epithelial cells induced by high glucose．

目的 探讨乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病疗效及对患者肺功能的影响。方法 以2020年4月—2022月4月在本院诊治的84例慢性阻塞性肺疾病患者作为研究对象,根据1∶1简单分配原则把患者分为联合组与对照组各42例。对照组行传统治疗,联合组在对照组治疗的基础上,再给予乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗,联合组与对照组都治疗观察4周。检测患者的疗效、肺功能与血清超敏C反应蛋白（hs-CRP）与降钙素原（PCT）含量变化情况。结果 联合组治疗后的总有效率与对照组相比有提高（P<0.05）。治疗后,联合组与对照组的第一秒用力呼气容积占用力肺活量百分比（FEV₁/FVC）、第一秒用力呼气容积占预计值百分比（FEV₁%）更高（P<0.05）,且联合组与对照组对比有提高（P<0.05）。联合组治疗后的疾病影响、活动能力、症状部分等SGRQ生活质量评分与对照组相比降低（P<0.05）。联合组与对照组治疗后的血清 hs-CRP与 PCT含量低于治疗前（P<0.05）,联合组与对照组相比也降低（P<0.05）。结论 乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病能有效抑制hs-CRP、PCT的表达,能促进改善患者的肺功能,提高治疗效果与生活质量。

Objective To investigate the efficacy of acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of chronic obstructive pulmonary disease（COPD）and its effect on the pulmonary function of patients．Methods From April 2020 to April 2022,a total of 84 patients with COPD diagnosed and treated in our hospital were selected as the research objects,and the patients were divided into the combination group and the control group with 42 cases in each group,according to the 1∶1 simple allocation principle．The control group were given traditional treatment,and the combination group were given acetylcysteine effervescent tablets combined with budigraf aerosol additionally．Both the combined group and the control group were observed for 4 weeks．The efficacy of patients,lung function and serum hypersensitive C-reactive protein（hs-CRP）and procalcitonin（PCT）levels were detected．Results The total effective rates after treatment in the combination group were higher than the control group（P<0.05）．After treatment,The forced expiratory volume in 1 second/forced vital capacity（FEV₁/FVC）,FEV₁% value of the two groups were higher（P<0.05）,and the combination group had greater improvement（P<0.05）．The SGRQ quality of life scores,such as disease impact,activity ability,and symptom in the combination group were lower（P<0.05）．After treatment,the serum high-sensitivity C-reactive protein（hs-CRP）and procalcitonin（PCT）levels in the two groups were significantly lower（P<0.05）,and the combined group decreased more（P<0.05）．Conclusions Acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of COPD can effectively inhibit the expression of hs-CRP,PCT,promote the improvement of lung function,improve the treatment effect and quality of life．

目的 探讨良肢位训练联合风险预控急救应用于重症脑卒中的效果。方法 采用回顾性分析,纳入我院2020年3月—2021年3月期间收治的41例重症脑卒中患者为对照组,救治方式为常规救治联合良肢位训练。同时纳入我院2021年4月—2022年4月期间收治的41例重症脑卒中患者为观察组,救治方式为良肢位训练联合风险预控急救。对比2组抢救情况、抢救效果、运动功能。结果 观察组院外吸氧率（46.34%）、院外插管率（34.15%）均高于对照组（17.07%、9.76%）,转入专科治疗时间、发病至入院时间均短于对照组（P<0.05）;干预3 d后,观察组格拉斯哥昏迷量表分值高于对照组,APACHEⅡ评分分值低于对照组（P<0.05）;观察组Fugl-Meyer运动评估、Berg平衡量表分值均高于对照组,NIHSS量表分值低于对照组（P<0.05）。结论 良肢位训练联合风险预控急救应用于重症脑卒中可有效改善抢救情况、提升抢救效果,从而增强运动功能。

Objective To explore the effect of normal extremity position training combined with risk pre-control emergency treatment in severe stroke．Methods Forty-one severe stroke patients from March 2020 to March 2021 included in the control group were retrospective studied,and the treatment method was conventional treatment combined with normal extremity position training．At the same time,41 severe stroke patients from April 2021 to April 2022 were included in the observation group,which the treatment method was the risk pre-control and emergency treatment．The rescue situation,rescue effect and sports function of the two groups were compared．Results Incidences of oxygen inhalation（46.34%）and intubation（34.15%）outside the hospital in observation group were higher than that in control group（17.07%,9.76%）;specialist treatment,onset to admission time were longer in control group（P<0.05）．Glasgow coma scale score in observation group was higher than that in control group,while APACHE Ⅱ score was lower in observation group（P<0.05）,Fugl-Meyer assessment and Berg Balance Scale score were higher,and NIHSS score was lower than control group（P<0.05）．Conclusions Combination of normal extremity position training and risk pre-control emergency treatment in severe stroke treatment can effectively improve the rescue effect,thus enhance the motor function．

目的 探讨度普利尤单抗对瘙痒性皮肤病的效果及对嗜酸粒细胞（EOS）恢复和生活质量的影响。方法 选取2021年2月—2022年1月期间,我院收治的瘙痒性皮肤病患者96例。根据治疗方式不同分为对照组（48例）和观察组（48例）。对照组给予传统激素治疗,观察组给予度普利尤单抗治疗。比较治疗前后2组血清炎症因子、免疫球蛋白水平情况;比较治疗前后2组症状积分下降指数（SSRI 评分）、神经激肽/速激肽受体1（NK1R）及EOS情况。观察2组疗效情况。采用皮肤病生活质量问卷（DLQI）对2组生活质量进行评价,并观察2组复发率情况。结果 治疗后,2组血清IFN-γ（干扰素-γ）、IL-2（白介素2）、IgA、IgG、IgM、NK1R、EOS水平升高,IL-4、IL-13、IgE水平及SSRI 评分降低,且观察组更明显（P<0.05）。观察组治疗有效率高于对照组（P<0.05）。随访6个月,观察组DLQI评分及复发率低于对照组（P<0.05）。结论 度普利尤单抗可减轻瘙痒性皮肤病患者瘙痒症状,增强机体防御力,促进嗜酸粒细胞恢复,提高其生活质量,值得临床推广应用。

Objective To investigate the effect of Dupilumab on pruritic dermatosis,eosinophil（EOS）recovery and quality of life．Methods From February 2021 to January 2022,96 patients with pruritic dermatosis were selected．According to different treatment methods,they were divided into control group（48 cases）and observation group（48 cases）．The control group was treated with traditional hormone,and the observation group was treated with Dupilumab．The levels of serum inflammatory factors and immunoglobulin in the two groups were compared before and after treatment．The symptom score reduce index（SSRI score）,neurokinin/tachykinin receptor 1（NK1R）and EOS were compared between the two groups before and after treatment．The curative effect of the two groups was observed．The quality of life of the two groups was evaluated with Dermatology Quality of Life Questionnaire（DLQI）,and the recurrence rate of the two groups was observed．Results After treatment,levels of serum IFN-γ,IL-2,IgA,IgG,IgM,NK1R and EOS of two groups increased,while the levels of IL-4,IL-13,IgE and SSRI scores decreased,especially in the observation group（P<0.05）．The effective rate of the observation group was higher than that of the control group（P<0.05）．The DLQI score and recurrence rate in the observation group were lower than those in the control group（P<0.05）in 6 months follow-up．Conclusions Dupilumab can alleviate the itching symptoms of patients with pruritic dermatosis,enhance the body's defense,promote eosinophil recovery,and improve their quality of life,which is worthy of clinical application．

目的 评价银杏二萜内酯葡胺注射液（DGMI）联合依达拉奉右崁对急性缺血性脑卒中（AIS）的治疗效果。方法 回顾性分析我院2021年3月—2022年6月收治的86例AIS患者,根据治疗方法不同,分为单药组和联合组,每组43例,2组均予以DGMI治疗,联合组加用依达拉奉右崁醇。对比2组的治疗效果。结果 治疗后,联合组美国国立卫生研究院卒中量表（NIHSS）评分低于单药组（P<0.05）,简易智能精神状态检查量表（MMSE）和Barthel指数（BI）得分高于单药组（P<0.05）;联合组治疗后脑血流动力学指标（Q_min和V_min）高于单药组（P<0.05）,而全血还原黏度、血浆黏度和血小板聚集指数低于单药组（P<0.05）;联合组治疗后血清丙二醛（MDA）、超敏C-反应蛋白（hsCRP）和白细胞介素-6（IL-6）低于单药组（P<0.05）,而超氧化物歧化酶（SOD）高于单药组（P<0.05）;联合组治疗总有效率88.37%,高于单药组的67.44%（P<0.05）,且2组不良反应总发生率比较差异无统计学意义（P>0.05）。结论 DGMI联合依达拉奉右崁醇可有效提高AIS患者的神经功能、认知功能及日常生活能力,降低血液高凝状态,改善脑部血流,缓解机体氧化应激及炎症反应,且不良反应发生率较低,安全性良好。

Objective To evaluate the clinical efficacy of diterpene ginkgolides meglumine injection（DGMI）combined with edaravone dextracanthol in the treatment of acute ischemic stroke（AIS）．Methods A total of 86 patients with AIS admitted to our hospital from March 2021 to June 2022 were divided into single drug group and combination group according to different treatment methods,with 43 patients in each group．Both groups were treated with DGMI,and the combination group was added with edaravone dextracanthol．The therapeutic effect,neurological function and adverse reactions of the two groups were compared．Results After treatment,compared with the single drug group,the NIH Stroke Scale（NIHSS）score of the combination group was significantly lower（P<0.05）,and the Mini-Mental State Examination（MMSE）and Barthel index（BI）scores were significantly higher（P<0.05）．After treatment,the cerebral hemodynamic indexes（Q_min and V_min）in the combination group were significantly higher（P<0.05）,while the whole blood reducing viscosity,plasma viscosity and platelet aggregation index were significantly lower（P<0.05）．After treatment,compared with the single drug group,the serum malondialdehyde（MDA）,high sensitive C-reactive protein（hsCRP）and interleukin- 6（IL-6）levels in the combination group were significantly lower（P<0.05）,while the level of superoxide dismutase（SOD）was significantly higher（P<0.05）．The total effective rate of the combination group was 88.37%,which was significantly higher than 67.44% of the single drug group（P<0.05）．The incidence of adverse reaction between two groups was not significant（P>0.05）．Conclusions DGMI combined with edaravone dextracanthol can effectively improve the neurological function,cognitive function and daily living ability of patients with AIS,reduce blood hypercoagulability,improve cerebral blood flow,alleviate oxidative stress and inflammatory reaction,improve the therapeutic effect,without increasing the incidence of adverse reactions,which has good safety．

目的 探讨不同分期的子宫内膜异位症（EMs）患者行体外受精-胚胎移植（IVF-ET）助孕结局与成本效果分析。方法 回顾性分析2016年1月—2022年1月Ⅰ~Ⅱ期、Ⅲ~Ⅳ期EMs患者应用卵泡期长方案及同期因“输卵管因素”患者采用黄体期长方案行IVF-ET的助孕结局以及成本费用。结果 EMs各组的启动日LH、E₂以及hCG日E₂水平低于对照组（P<0.05）,Ⅲ~Ⅳ期EMs组的可利用胚胎数、着床率、临床妊娠率、活产率明显低于对照组及Ⅰ~Ⅱ期EMs组（P<0.05）,其流产率偏高,但组间比较差异无统计学差异（P>0.05）。各组间的Gn剂量、Gn天数、hCG日的LH水平、hCG日≥14 mm卵泡数、hCG日子宫内膜厚度、获卵数、受精率、卵裂率比较差异无统计学意义（P>0.05）。成本效果分析提示：各组平均周期总成本无明显差异,Ⅰ~Ⅱ期EMs组患者患者获得一例妊娠所花费的成本与对照组相当,而Ⅲ~Ⅳ期EMs组患者获得一例妊娠所花费的成本最高。结论 对于不同分期的EMs,Ⅰ~Ⅱ期患者应用卵泡期长方案的患者可获得良好的妊娠结局,其妊娠率及成本与传统方案相当,而Ⅲ-Ⅳ期的患者妊娠率偏低,获得妊娠的成本更高,可能与该疾病严重程度及方案选择有关。

Objective To analyze the outcome and cost-effectiveness of invitrofertilization-embryotransfer（IVF-ET）assisted pregnancy in endometriosis（EMs）patients with different stages．Methods The outcomes and costs of patients with stageⅠ-Ⅱ and Ⅲ-Ⅳ EMs treated with follicular phase long protocol and patients treated with luteal phase long protocol due to“tubal factors” during the same time from January 2016 to January 2022 were retrospectively analyzed．Results The levels of LH,E2 on initiation day and the levels of E2 on hCG day in EMs groups were lower than those in control group（P<0.05）,the number of available embryos,implantation rate,clinical pregnancy rate and live birth rate in stage Ⅲ-Ⅳ EMs group were significantly lower than those in control group and stageⅠ-Ⅱ EMs group（P<0.05）,and the abortion rate was higher．But there was no significant difference between groups（P>0.05）．There were no significant differences in the dosage of Gn,duration of Gn,the levels of LH on hCG day,the number of follicles with diamete≥14 mm on hCG day,endometrial thickness on hCG day,number of oocytes retrieved,fertilization rate and cleavage rate among the three groups（P>0.05）．Conclusions For different stages of endometriosis,patients in stageⅠ-Ⅱ who apply the follicular phase long protocol can achieve good pregnancy outcomes,and their pregnancy rate and cost are comparable to the traditional regimen,while patients in stage Ⅲ-Ⅳ have a low pregnancy rate,and the cost of pregnancy is higher,which should be related to the severity of the disease and the choice of regimen.