目的 探讨女性宫内节育器使用年限及类型与生殖道感染的关系,以降低生殖道感染率。方法 2013年1月—2015年1月于我院门诊检查使用宫内节育器360名女性的临床资料进行回顾性分析,研究节育器使用年限、类型、患者年龄、孕次、是否绝经与生殖道感染的关系。结果 带尾丝组患者的生殖道感染率比不带尾丝组高(P<0.05),无尾丝组生殖道感染率与置器年限无关,差异无统计学意义(P>0.05),带尾丝组生殖道感染率与置器年限有关,差异有统计学意义(P<0.05)。生殖道感染率与与女性年龄及妊娠次数无关,与是否绝经有关,未绝经女性的生殖道感染率较高(P<0.05)。结论 带尾丝的宫内节育器的使用可使生殖道感染率增加,使用年限越长,生殖道感染的发生率越高。

Objective To investigate the associations between different time and types of intrauterine device with female reproductive tract infection in order to provide evidence for reducing infection rate. Methods 360 females using intrauterine device were continually recruited during Jan 2013-Jan 2015 in our hospital, and their clinical data was also collected in the same period. The associations between reproductive track infection and clinical characteristics including service time, types, age, gravidity and menopause status were further analyzed. Results We found that the female using intrauterine device with tail wire, as well as with non-menopause had higher infection risk than those did not have(P<0.05). In addition, service time of intrauterine device was significantly associated with infection risk in those patients using intrauterine device with tail wire. However, there was no any remarkable relevance for age and gravidity with risk of reproductive track infection. Conclusion The use of intrauterine device with tail wire, as well as longer service time, could cause the increased risk of reproductive track infection for females.

目的 观察氟伐他汀联合环磷腺苷葡胺治疗慢性肺心病急性加重期的临床疗效。方法 将我院收治的74例慢性肺心病急性加重期病人,使用随机数字表法分为联合用药组与对照组,每组各37例。对照组单独使用环磷腺苷葡胺,联合用药组在对照组的基础上加服氟伐他汀。两组疗程均为7周。观察比较两组患者治疗前后的NO,ET-1,CRP,PaO₂水平以及治疗效果。结果 经7周疗程治疗后,对照组有效率为64.86%,联合用药组94.59%。两组间比较,差异有统计学意义(P<0.05)。两组NO,ET-1,CRP,PaO₂水平比较,联合用药组均优于对照组,差异有统计学意义(P<0.05)。结论 氟伐他汀联合环磷腺苷葡胺治疗慢性肺心病急性加重期的临床疗效更为显著,值得临床推广。

Objective To observe the clinical efficacy of combined treatment of Fluvastatin combined with Meglumine Adenosine Cyclophosphate on acute exacerbation of chronic pulmonary heart disease. Methods 74 patients with acute exacerbation of chronic pulmonary heart disease were randomly divided into combined treatment group and control group. The control group was treated by Meglumine Adenosine Cyclophosphate for 7 weeks.The combined treatment group was treated by Meglumine Adenosine Cyclophosphate and Fluvastatin for 7 weeks. The clinical efficacy and the score of NO,CRP,ET-1,PaO₂ were assessed before and after the treatment. Results After 7 weeks treatment, the total clinical efficacy rate was 64.86% in the control group and 94.59% in the combined treatment group. The differences between them has statistically significant(P<0.05). The score of NO,ET-1,CRP,PaO₂ in combined treatment group were significantly improved compared to control group (P<0.05). Conclusion The clinical efficacy of Fluvastatin combined with Meglumine Adenosine Cyclophosphate on acute exacerbation of chronic pulmonary heart disease is more efficient. It is worth to develop clinically.

目的 探讨内镜下逆行胰胆管造影( ERCP) 治疗胆总管结石患者的临床疗效及其相关并发症。方法 严格筛选纳入从2012年1月—2015年1月在我院行ERCP治疗的胆总管结石患者,归纳评估ERCP手术对胆总管结石治疗的有效性及安全性。结果 359例胆总管结石患者,其中行ERCP治疗共347例,其中9例因一般情况差无法耐受手术或无法配合而未予以实施ERCP治疗,其中3例因术中穿孔转为开放手术治疗。 1次性取净结石者311例(89.6%),结石2次以上(含2次)取净者27例(7.8%),放置胆道支架者9 例(2.6%)。ERCP 术后总胆红素(61.7±103.8) μmol/L; 直接胆红素(34.7±59.6) μmol/L; 谷丙转氨酶(62.8±74.2) U/L; 谷草转氨酶(48.3±61) U/L。术后 2 h血淀粉酶(115±162) U/L,无统计学差异(P＞0.05) ,24 h血淀粉酶(124.7±215.8)U/L,与术前相比差异有统计学意义(P＜0.05) 。术后寒战、发热、腹痛、黄疸等症状均有不同程度的减轻;肝功能术后明显好转(P＜ 0.05);术后平均住院天数4～6 d;出现并发症患者16例,其中急性胰腺炎占6例,急性胆管炎占5例,出血占3例,穿孔占2例,经对症支持治疗后均治愈出院。结论 ERCP 治疗胆总管结石安全、有效,临床疗效显著,是胆胰疾病重要的诊治手段。

Objective To investigate the clinical efficacy and complications of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of common bile duct stones. Methods Cases received ERCP therapy from January 2012 to January 2015 were studied retrospectively,and evaluated the safety and efficacy of therapeutic ERCP in patients with common bile duct calculi. Results 359 Cases of patients with common bile duct stones treated successfully with 347 cases,among them 9 cases unable to implementation of ERCP because of bad surgery tolerance,3 cases of intraoperative perforation to have surgical operation treatment. The stones were removed completely one time in 311 cases(89.6%). More than two times removing net calculi in 27 cases(7.8%). 9 cases were placed biliary stent (2.6%). Postoperative total bilirubin ERCP:61.7 ±103.8 μmol / l; Postoperative bilirubin direct: 34.7±59.6 μmol/l; Postoperative ALT:62.8±74.2 U/L; Postoperative AST: 48.3±61 U/L; Postoperative 2 h blood amylase was 115±162 U/L. It showed no significant difference (P＞0.05).24 h blood amylase was 124.7±215.8 U/L,there was significant difference compared with before operation(P＜0.05). Postoperative chills,fever, pain,jaundice have different degrees of ease. Postoperative liver function was improved significantly(P＜0.05). The postoperative average length of stay in common bile duct stones was 4～ 6 days. Complications occurred in 16 cases,including 6 cases of acute pancreatitis,5 cases of acute cholangitis,3 cases of bleeding,perforation in 2 cases. After treatment they were cured and discharged. Conclusion ERCP is safe,effective in treatment of common bile duct stones. It is an important means in treatment in bile duct diseases

目的 探讨糖尿病自我管理支持对社区2型糖尿病患者生化指标控制的影响。方法 2015年1月1日前已确诊为2型糖尿病患者,随机分为对照组和干预组,对照组303例按照广州市基本公共卫生服务包要求进行定期随访、体检及健康教育,干预组130例进行自我管理支持干预,观察两组生化指标的变化。结果 与对照组比较,自我管理支持组的空腹血糖、总胆固醇、甘油三酯、谷丙转氨酶、尿酸控制效果较好,差异有统计学意义(P<0.05)。结论 自我管理支持对社区2型糖尿病患者生化指标控制的效果良好,值得推广。

Objective To evaluate the control effect of biochemical criterion in patients with type 2 diabetes under diabetes self-management support in community. Methods 130 patients with type 2 diabetes in community from January 2015 to December 2015 accepting the diabetes self-management support were chosen as research group, another 303 diabetic patients without the diabetes self-management support were set as control group, the effect of management was analyzed. Results There was statistically significant difference (P<0.05) in biochemical criterion including blood sugar (BS), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and uric acid (UA). Conclusion Control effect of biochemical criterion was good in the diabetes self- management support for people with type 2 diabetes, which was worth to be popularized.

目的 研究PF诱导化疗联合调强放疗及二维放疗对鼻咽癌近远期疗效影响的回顾性分析。方法 回顾性分析2008年1月—2008年12月中山大学附属肿瘤医院收治的101例鼻咽癌患者治疗情况,按照治疗方案技术分为调强组(n=42)和二维组(n=59)。比较两组患者临床疗效,近期毒副反应及生存情况。结果 放疗结束时调强组患者总缓解率92.86%与二维组77.97%比较差异有统计学意义(P<0.05)。调强组Ⅲ-Ⅳ级胃肠道反应26.19%及黏膜炎14.29%发生率与二维组比较显著较少,差异有统计学意义(P<0.05)。两组患者远期毒副反应及生存率比较无显著差异(P>0.05)。结论 PF诱导化疗联合调强放疗治疗鼻咽癌患者,近远期临床疗效好,毒副反应少。

Objective To study the effects of PF induced chemotherapy combined with intensity modulated radiation therapy and two-dimensional radiotherapy on the short and long term curative effects in nasopharyngeal carcinoma. Methods The treatment condition of 101 cases of patients with nasopharyngeal carcinoma who were treated in the Tumor Hospital Affiliated to San Yat-sen University between January and December 2008 were retrospectively analyzed. According to different treatments, the cases were divided into the intensity modulated group and the two-dimensional group. The clinical curative effects, short-term toxic and side effects and survival status were compared between the two groups. Results At the end of radiotherapy, the total remission rate in the intensity modulated group was 92.86% while in the two-dimensional group was 77.97% (P<0.05). In the intensity modulated group, the incidence rates of grade Ⅲ-Ⅳgastrointestinal tract reactions (26.19%) and mucositis (14.29%) were significantly lower than those in the two-dimensional group (P<0.05). There was no significant difference in long-term side effects and survival rate between the two groups (P>0.05). Conclusion PF induced chemotherapy combined with intensity modulated radiation therapy in the treatment of patients with nasopharyngeal carcinoma has good short and long-term curative effects and few toxic and side effects.

目的 探讨同步放化疗治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法 选取我院2014年收治的晚期NSCLC患者102例,随机分为观察组和对照组,对照组以紫杉醇联合顺铂化疗方案(TP)化疗治疗,观察组加用三维适形放疗同步放化疗治疗,观察两组的临床疗效和不良反应。结果 观察组和对照组患者的总有效率分别为43.14%和21.57% (P<0.05),两组患者的总控制率分别为84.31%和66.67% (P<0.05)。两组患者Ⅲ～Ⅳ级胃肠道反应、白细胞减少、骨髓抑制的发生率差异无统计学意义(P>0.05),观察组比对照组增加了放射性肺炎和放射性食管炎的发生 (P<0.05)。两组患者生活质量比较,差异具有统计学意义(P＜0.05)。结论 同步放化疗治疗晚期NSCLC可以显著提高治疗的总有效率、肿瘤的控制率及生活质量,但也使不良反应增加,选择治疗方案时应根据个体情况综合考虑。

Objective To study the clinical efficacy of concurrent chemoradiotherapy in the treatment of advanced non small cell lung cancer (NSCLC). Methods 102 cases of advanced NSCLC treated in our hospital in 2014 were selected and randomly divided into the observation group and the control group. Patients in control group were treated by chemotherapy with Paclitaxel combined Cisplatin (TP), while those in observation group were treated by concurrent chemoradiotherapy with three- dimensional conformal radiotherapy and TP. The clinical efficacy and adverse reactions of the two groups were observed. Results The total effective rate of the observation group and the control group were 43.14% and 21.57% (P<0.05), respectively. The total control rate of the two groups were 84.31% and 66.67%(P<0.05). In two groups III ~ IV gastrointestinal tract reaction, leukopenia, bone marrow suppression occurrence had no statistical significance(P>0.05). Incidence of radiation pneumonitis and radiation esophagitis increased in observation group(P<0.05). The difference of quality of life between the two groups was statistically significant(P<0.05). Conclusion Concurrent radiotherapy and chemotherapy in the treatment ofadvanced non-small cell lung cancer(NSCLC)can not only significantly improve the treatment, tumor control rate and quality of life, but also make adverse reaction increased. Treatment options should be chosen based on individual circumstances into account

目的 探讨自噬激活剂和自噬抑制剂分别对鼻咽癌细胞CNE2放疗敏感性的影响。方法 利用RNA干扰技术使atg5基因沉默,构建自噬抑制细胞模型后,与雷帕霉素、氯喹分别处理的两组细胞一起,每天以X射线5Gy照射细胞,连续8天观察各组细胞的生长状况,并设置对照组。以MTT法及克隆集落形成法检测其细胞活力,用流式细胞仪分析其细胞周期。结果 与对照组相比,其他三组细胞存活率、克隆形成率、照射后存活率均显著降低(P<0.05);细胞周期检测除对照组外其他三组细胞集中在G0/G1期,其他两个时期比G0/G1期相对较少。结论 自噬抑制剂与激活剂和atg5沉默均能为CNE2放疗增敏,然而自噬激活剂的增敏效果好于其他,为增敏放疗提供实验依据,开辟新的放疗增敏途径。

Objective This study aimed to investigate the autophagy activators and inhibitors effects in nasopharyngeal CNE2 cells radiotherapy sensitization. Methods Atg5 gene silencing by RNA interference technology, two groups of cell autophagy inhibition were built by rapamycin and chloroquine respectively. Then 5Gy x-ray irradiation of cells was taken every day, after 8 days in a row in each group of cell growth and setting a control group. The cell viability was clonaled colony formation by MTT method assay and cell cycle by flow cytometry analysis. Results The three cell group survival rate, colony-forming rate and survival after irradiation were significantly lower (P<0.05) than the control group. Detection of cell cycle in addition to control three other groups concentrated in the G0/G1 period.That of two other periods was relatively fewer than that of the G0/G1 period. Conclusion Autophagy inhibitors, activators and atg5 silence improved the radio-sensitization to CNE2. The autophagy activator group improving the sensitivity was better than the others.This study provided evidence to sensitive radiotherapy, explored a new promising radiosensitization ways.

目的 探讨两种不同治疗方案治疗老年糖尿病合并初治涂阳肺结核患者的临床疗效。方法 将85例老年糖尿病合并初治涂阳肺结核患者分为每日疗法组(n=43)和间歇疗法组(n=42)。比较两组2、3、6个月及疗程结束痰菌转阴率、胸片吸收情况、并发症发生率。结果 两组治疗2个月痰菌转阴率每日疗程组高于间歇疗法组,但两组间无差异,但5、6个月末及疗程结束转阴率每日疗法均高于间歇疗法(P<0.05);治疗后每日疗程组病灶总吸收率(97.62%)高于间歇疗法组(79.07%),且差异有统计学意义(P<0.05);治疗过程中两组出现不良反应情况相比较差异无统计学意义(P>0.05)。结论 使用每日疗法并适当延长强化期及巩固期疗程治疗老年糖尿病合并初治涂阳肺结核的痰菌转阴率及病灶吸收率均优于间歇疗法,且安全性两者无差异,值得临床借鉴。

目的 研究限制会阴切开及会阴不同切口对产妇产后出血、疼痛及性功能的影响。方法 选取我院2012年4月—2013年4月头位自然分娩产妇480例,抽签随机分为三组,每组160例,实施限制会阴切开的为限制组,实施会阴侧切的为侧切组,实施会阴正中切开的为正切组,比较三组产妇产后2 h出血量、产后住院时间、产妇会阴阴道裂伤率、产后疼痛程度和性功能满意程度。结果 产后2 h产妇出血量限制组(203.65±76.68)mL较侧切组(241.41±80.63)mL和正切组(239.15±85.19)mL少(P＜0.05);侧切组(1.64±0.87)d产后住院时间较限制组(1.37±0.64)d较长(P＜0.05);限制组会阴Ⅰ/Ⅱ°裂伤率为86.25%较侧切组1.25%和正切组6.88%较高(P＜0.05);侧切组2.50%和正切组3.13%会阴Ⅲ/Ⅳ°裂伤较限制组0%较高(P＜0.05);女性性功能指数限制组(22.69±2.65)分较侧切组(19.12±2.05)分与正切组(18.96±2.16)分较高(P＜0.05)。结论 实施限制会阴切开的产妇术后出血量少,会阴重度裂伤率低,保证了会阴完整性,产后性功能满意度高,值得临床上应用推广。

目的 探讨功能康复训练与心理干预对全髋关节置换手术患者髋关节功能康复的影响。方法 对2014年3月—2015年12月先后在本院行全髋关节置换手术90例患者,按入院时间分为观察组45例和对照组45例。对照组按全髋关节置换手术功能康复护理要求给予康复护理;观察组在此功能康复护理基础上,同时对患者进行心理评估和相应的心理护理干预;对两组患者在干预前后的心理情况、生活自理能力、髋关节功能和生活质量进行评价。结果 干预前两组患者均有不同程度的焦虑和抑郁反应,不积极的应对方式和自理能力下降;干预后观察组在应对心理反应,降低焦虑和抑郁,主动进行功能锻炼,自理能力和髋关节功能评分均优于对照组。结论 功能康复训练与心理护理干预相结合,对减轻患者心理压力,提高患者心理应对能力、生活自理能力,提高患者生活质量,促进髋关节功能康复有一定的效果。

Objectives To explore the effect of function rehabilitation training and psychological intervention on patients of hip joint function recovery undergoing THA. Methods 90 patients were chosen who were admitted to the hospital from March 2014 to December undergoing THA,2015. These patients were divided into control group and intervention group according to the sequence of admission. The patients in control group were cared by total hip replacement surgery functional rehabilitation; At the same time, the patients in observation group were cared by psychological training. The psychological condition, self-care ability, hip function and quality of life for all patients were evaluated. Results Before the intervention, two groups of patients had some degrees of anxiety and depression, and negative coping style. Their self-care ability were decreased; The response to psychological reaction, reduction for anxiety and depression, initiative exercise, self-care ability and hip function scores of patients in the intervention group were better than that of the control group. Conclusion Combination of rehabilitation training and psychological nursing intervention can relieve the psychological pressure, improve mental health and promote recovery of hip function.