临床诊疗
目的 研究鼓室成形术后慢性中耳炎患者的耳鸣变化情况,并探讨患者术后耳鸣变化情况与术后听力提高的相关关系。方法 记录并分析于我科住院治疗的160例慢性中耳炎患者在术前及鼓室成形术术后6个月的听力变化以及耳鸣症状的改变。结果 有60例患者术前伴有耳鸣,术后23例患者耳鸣治愈;27例治疗有效; 10例治疗无效,则术后耳鸣治疗有效率为83.33%。术后可提高两组患者的气导听力,且耳鸣改善明显组较耳鸣改善不良组提高较为显著(t=0.047,0.005,均P<0.05)。结论 慢性中耳炎患者采用鼓室成形术对耳鸣的治疗有积极影响,术后可提高慢性中耳炎患者的气导听力,进而使耳鸣症状缓解,其中低频气导听力更能缓解耳鸣症状。
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目的 观察康复路径在髋关节置换术后的临床应用效果,探讨其临床应用价值 。方法 将广州市第一人民医院2014年10月—2015年10月收治行髋关节置换术患者100例为研究对象,随机分为对照组与观察组各50例。对照组采取常规围手术期护理,观察组按照康复路径护理,比较两组患者术后并发症、住院时间、费用、患肢功能以及日常生活自理能力。结果 观察组住院时间和住院费用均少于对照组(P<0.01);两组术后并发症发生率、患肢功能评分及日常生活自理能力比较,差异均有统计学意义(P<0.01 )。结论 康复计划护理用于髋关节置换术后效果显著,可明显降低患者术后并发症,缩短住院时间,降低住院费用,有利于促进患者术后功能以及自理能力的恢复。
Objective To observe the effect of clinical application of rehabilitation in the path of a hip replacement, and to explore its clinical application value. Methods October 2014 to October 2015 in Guangzhou First People's Hospitalhip arthroplasty cases werecollected of 100 patients as the research object, randomly divided into control group and observation group with 50 cases in each group. The control group adopted conventional perioperation period nursing care, observation group in accordance with the recovery paths. We compared two groups of patients complications, hospitalization time, expense, limb function and activities of daily living. Results In the observation group, the hospitalization time and cost of hospitalization were significantly less than that of the control group (P<0.01); The incidence of limb function score, ability of daily living and postoperative complications were compared between the two groups, the differences were statistically significant (P<0.01). Conclusion Rehabilitation nursing care plans for after hip replacement effect is significant. It can significantly reduce the postoperative complications, shorten the time of hospitalization, reduce hospitalization expenses, and is beneficial to the recovery of the function of promoting postoperative and self-care ability.
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目的 追踪随访186例甲状腺微小乳头状癌(Papillary Thyroid Microcarcinoma,PMC)患者术后5年及10年的肿瘤复发率、生存率、及术后并发症,探讨不同手术方式对治疗甲状腺微小乳头状癌预后。方法 临床资料为1993—2003年收治的186例甲状腺微小乳头状癌患者,102例行患侧甲状腺大部分切除术(Ⅰ组),84例行患侧甲状腺全切术+峡部切除+对侧甲状腺大部分切除+中央区淋巴结清扫术(Ⅱ组)。结果 Ⅰ组患者术后5年及10年期间肿瘤复发率、生存率与Ⅱ组差别无统计学意义(P﹥0.05),对比I组,Ⅱ组患者术后发生甲状腺及甲状旁腺功能低下的发生率较高,且差别有统计学意义(P﹤0.05)。结论 甲状腺微小乳头状癌预后良好,实行患侧甲状腺大部分切除术对治疗甲状腺微小乳头状癌是安全可行的。
Objective To follow-up 186 cases of papillary thyroid microcarcinoma and analyse their tumor recurrence rate、survival rate and complicationg after 5 and 10 years postoperation, to investigate prognosis of papillary thyroid microcarcinoma from different operation approaches. Methods 186 cases of papillary thyroid microcarcinoma were from 1993 to 2003. All the patients were divided into two groups,102 cases(group Ⅰ) performed with resection of the majority of thyroid gland, and 84 caces(group Ⅱ) performed with total thyroidectomy, thyroidectomy+isthmus thyroidectomy+contralateral thyroid lobectomy+central lymph node ablation. Results The recurrence and survival rates after 5 and 10 years were not significantly different between the two groups, but compared group Ⅰ, the incidences of hypocalcemia and hypothyroidism were higher in group Ⅱ(P<0.05). Conclusion Papillary thyroid microcarcinoma had better prognosis. Resection of the majority of thyroid gland treating papillary thyroid microcarcinoma is safe and feasible.
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目的 观察体重管理对轻型代谢综合征患者的体重指数、血糖、血压、甘油三酯等指标的影响。方法 将40例新诊断的轻型代谢综合征患者随机分成体重管理组和对照组,每组20例。两组患者分别于干预前、干预3月、干预6月检测体重指数、血糖、血压、甘油三脂等治疗,并比较两组患者上述指标。结果 干预6月后,体重管理组的体重指数、甘油三酯均显著性低于对照组,差异有统计学意义(P均<0.05);体重管理组的高密度脂蛋白高于对照组,但无统计学差异。干预6月,体重管理组中血压、血糖达标率高于对照组,差异有统计学意义。结论 体重管理能改善轻型代谢综合征患者的体重指数、血糖、血压、甘油三脂等指标。
Objective To investigate the influence of weight management to body index, blood glucose, blood pressure and triglycerides in mild metabolic syndrome. Methods 40 mild metabolic syndrome patients were randomly divided into weight management group (20 patients) and control group (20 patients). The body index, blood glucose, blood pressure and triglycerides were observed and compared before intervention, 3 months and 6 months after intervention. Results After 6 months intervention, the body index and triglycerides in weight management group were significantly lower than the control group (P<0.05). High density lipoprotein cholesterol in the weight management was higher than the control group, but there was no significant. The success rate of blood glucose and blood pressure were significantly higher than the control group. Conclusion Weight management can significantly improve the body index, blood glucose, blood pressure and triglycerides in patients with mild metabolic syndrome.
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目的 探讨注射用黄芪多糖对宫颈癌化疗患者骨髓抑制的影响。方法 选取2012年11月—2015年10月于我院接受治疗的宫颈癌患者110例,随机分为对照组和观察组,每组各55例,两组患者均接受紫杉醇联合顺铂同步放疗,而观察组患者在此基础上接受每日静脉滴注注射用黄芪多糖治疗,连续应用10天。对比分析两组患者的临床疗效以及治疗前后的血象。结果 经过治疗后,观察组的治疗总有效率为61.81%,明显高于对照组的38.18%,差异有统计学意义(P<0.05);两组患者经过放化疗后其白细胞、红细胞和血小板计数均有不同程度的降低,而与对照组相比,观察组患者下降不明显。结论 注射用黄芪多糖可以减轻宫颈癌放化疗所致的骨髓抑制,对骨髓具有一定的保护作用,在临床治疗宫颈癌的过程中值得推广应用。
Objective To explore the clinical effect of astragalus polysaccharides on protecting marrow suppression of cervical carcinoma after chemotherapy. Methods 110 cases of patients with cervical carcinoma treated in our hospital from November 2012 to October 2015 in our hospital were selected and divided into control group and observation group, each group contains 55 cases. Both groups of patients received radiotherapy and chemotherapy of paclitaxel combined with cisplatin, and the observation group additionally received intravenous injection of astragalus polysaccharides for 10 days, to compare the hemogram before and after treatments between two groups. Results After treatments, the total effective rate of the observation group was 61.81%, significantly higher than that of the control group, the difference was statistically significant (P<0.05); The white blood cell, red blood cell and platelet count reduced in two goups after treatment. Compared with the control group, there was no significant decrease in the observation group. Conclusion Astragalus polysaccharides injection may reduce the marrow suppression induced by radiotherapy and chemotherapy in the treatment of cervical cancer, and it has a protective effect on the bone marrow.
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目的 探讨双歧三联活菌联合补中益气丸治疗腹腔镜胆囊切除术后腹泻患者的临床疗效及安全性。方法 将2014年3月—2015年3月我院收治的68例腹腔镜胆囊切除术后腹泻患者随机分成观察组和对照组(每组34例),观察组患者给予双歧三联活菌联合补中益气丸治疗,对照组患者给予双歧三联活菌治疗,比较两组患者治疗前后的临床症状积分,总体临床疗效以及不良反应。结果 治疗4周后,观察组和对照组患者大便次数、大便性状积分和腹痛/腹部不适积分均明显低于治疗前(P<0.05),同时观察组患者大便次数、大便性状积分和腹痛/腹部不适积分低于对照组患者(P<0.05);观察组和对照组患者临床症状总积分均低于治疗前(P<0.05),且观察组患者临床症状总积分低于对照组患者(P<0.05);观察组患者临床疗效总有效率(91.2%)高于对照组患者临床疗效总有效率为(70.6%)(P=0.03);观察组和对照组患者治疗期间均未出现明显药物不良反应。结论 双歧三联活菌联合补中益气丸治疗腹腔镜胆囊切除术后腹泻能明显改善患者的临床症状,总体疗效较好,不良反应率较低,值得在临床上推广应用。
Objective To investigate the clinical efficacy and safety of bifid triple viable combined with buzhongyiqi pills in treatment of patients with diarrhea after Laparoscopic cholecystectomy. Methods 68 patients with diarrhea after Laparoscopic cholecystectomy in our hospital between March 2014 and March 2015 were randomly divided into observation group and control group with each 34 cases. The patients in observation group were given bifid triple viable and Buzhongyiqi pills therapy and the patients in control group were given bifid triple viable therapy. The clinical symptoms, clinical efficacy and adverse reactions were observed before and after treatment and were compared between two groups. Results After 4 weeks of treatment, the frequency of excrement, scores of excrement consistency and scores of abdominal pain and abdominal unwell in the observation group and the control group were significantly lower than those in relevant groups before treatment (P<0.05) and the frequency of excrement, scores of excrement consistency and scores of abdominal pain and abdominal unwell in observation group were significantly lower than that in the control group (P<0.05). The aggregate score of clinical symptoms in observation group and control group were both significantly lower than that in each group before treatment (P<0.05), and the aggregate score of clinical symptoms in observation group patients was significantly lower than that in the control group patients (P<0.05). The total clinical effective rate in observation group(91.2%)was significantly higher than that in control group(70.6%)(P=0.03). There were no adverse drug reactions in the observation group and the control group during treatment period. Conclusion Bifid triple viable combined with Buzhongyiqi pills in treatment of patients with diarrhea after laparoscopic cholecystectomy could significantly improve clinical symptoms and get good overall effect, which is worthy of clinical application.
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目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均<0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。
Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.
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目的 探讨初诊的弥漫大B细胞淋巴瘤(DLBCL)患者外周血Th17细胞的表达与国际预后指标(IPI)之间关系。方法 初诊DLBCL组(n=45)按照国际预后指数(IPI)积分分为4组,采用ELISA和流式细胞术检测各个DLBCL组与正常对照组(n=43)的外周血中IL-17的浓度以及Th17阳性细胞比例,比较各组数值间的差异,并分析IPI的5个指标与IL-17的浓度以及Th17阳性细胞比例的相关性。结果 DLBCL中高危组与高危组的IL-17的浓度以及Th17阳性细胞比例较正常对照组及其他IPI组降低,有显著性差异;DLBCL四组的IL-17的浓度以及Th17阳性细胞比例均低于正常对照组;且可见随着IPI分组的增高,IL-17的浓度以及Th17阳性细胞比例呈降低的趋势;IPI指标中年龄、临床分期、全身状态与Th17细胞的表达有相关性。结论 初诊DLBCL患者外周血Th17细胞的表达与国际预后指标有关系;随着IPI积分的增加,DLBCL患者Th17细胞表达下降;临床上对于年龄60岁以上、临床分期Ⅲ期以上、长期卧床及需别人照顾的患者更要注意监测其外周血Th17细胞的表达情况。
Objective To explore the relationship between the international prognosis indexes(IPI) and the Th17 cells expression in DLBCL patients. Methods DLBCL patients (n=45) were divided into 4 groups according to IPI score, peripheral blood were taken from each person in DLBCL groups and normal group. We used ELISA to test IL-17 and flow cytometry (FCM) to examine the Th17 positive cells. We compared the value of each group, and analyzed the relativity of IPI and Th17 cells' expression. Results Th17 cells' expression level in middle-high risk group and high risk group were higher than that in normal group and other IPI groups; Th17 cells' expression level in DLBCL groups were all lower than that in normal group; Th17 cells decreased while IPI score increased; Age, clinical stage and general body state have the relativity with DLBCL patients' Th17 cells expression level. Conclusion Th17 cells in DLBCL patients has the relativity with prognosis index. In our clinical diagnosis and treatment, we need to pay more attention to those patients who are over 60 years old, or whose clinical stage is above Ⅲ phase, or who need to stay on bed for a long time and need other peoples' help .
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目的 了解新疆生产建设兵团第三师图木舒克市不同民族Rh血型分布情况及人群Rh血型知识知晓率。方法 2015年6月—2016年2月通过自行设计调查问卷,在全师随机对1325人进行匿名式问卷调查,了解受访者的血型知识知晓率及民族间的差异等信息。结果 有效问卷1259份,调查对象年龄范围18~95岁,平均年龄(56.57±38.34)岁。维吾尔族人Rh阴性血型比例为3.5%(24/677),高于汉族人Rh阴性血型比例0.7%(2/275,P<0.05)。人群整体Rh血型知晓率为53.5%。汉族人Rh血型知识知晓率高于维吾尔族人(P<0.05)。40~49岁年龄组的人群Rh血型知识知晓率较高于其他年龄组(P<0.05)。结论 维吾尔族人群的具有Rh阴性血型的比例高于汉族人,第三师图木舒克市人群的Rh血型知识知晓率偏低,需要进一步在人群中宣传Rh血型知识。
Objective To explore the distribution and awareness rate of Rh blood types for the different nations in Tumushuke City, the location of the third division of Xinjiang Production and Construction Corps. Methods Questionnaire was performed to get the information of distribution and awareness rate of Rh blood types for the different nations during from June of 2015 to February of 2016 in Tumushuke City, and 1325 respondents in total were interviewed. Results There were 1259 respondents with valid questionnaire who aged from 18 to 95 years old, with the average age of (56.57±38.34) years old. The Rh negative rate in Uyghur nationality was 3.5% (24/677), which was significantly higher than that of the Han's 0.7% (2/275, P<0.05). The total awareness rate of all the respondents was 53.5%, and the awareness rate of Han nationality was significantly higher than that of Uyghur ones (P<0.05). The awareness rate of the group who aged from 40 to 49 years old was apparently higher than that of the other age groups (P<0. 05). Conclusion The rate of Rh negative was higher in Uyghur nationality when compared to Han nationality. The awareness rate of Rh blood types is still low in Tumushuke City, where the health education is required.
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目的 研究前列腺癌细胞中miR-221的表达情况及其对癌细胞增殖的影响。方法 运用实时荧光定量PCR(qRT-PCR)检测miR-221在前列腺正常细胞株与前列腺癌细胞株中表达的差异情况,利用细胞转染构建miR-221过表达LNCaP和DU145细胞株,再通过CCK8细胞增殖实验检测细胞增殖情况的变化。结果 qRT-PCR检测细胞株发现miR-221在PC3、LNCaP和DU145三种前列腺癌细胞株中表达量均比前列腺正常细胞株PrEC低 (F=254.197,P<0.001),其中两两比较差异也均有统计学意义。细胞转染技术构建的miR-221过表达LNCaP和DU145细胞株,经qRT-PCR结果显示,miR-221在LNCaP和DU145细胞株中的表达水平明显升高(LNCaP,倍数变化=2.24,t=3.46,P<0.01;Du145,倍数变化=2.24,t=4.29,P<0.01)。细胞增殖实验结果显示,过表达了miR-221的LNCaP(P<0.001)和DU145(P<0.001)细胞生长速度慢于对照组。结论 实验证明miR-221表达过度能减慢前列腺癌细胞的增殖,miR-221有可能成为前列腺肿瘤治疗的生物学标志物。
Objective To investigate miR-221 expression in prostate cancer cells and its influence on prostate cancer cell proliferation. Methods miR-221 expressions in prostate normal cell lines and cancer cell lines were measured by qRT-PCR. Overexpression of the miR-221 in LNCaP and DU145 cell lines used by cell transfection. Effects of the depletion on cell proliferation were assessed in vitro with CCK8. Results qRT-PCR showed miR-221 was lower expressed in PC3, LNCaP and DU145 than in PrEC(F=254.197, P<0.001), in which pairwise comparison also had significant differences. qRT-PCR showed miR-221 expression rose significantly in LNCaP and DU145 cell lines whose miR-221 was overexpression with cell transfection(LNCaP, Fold Change=2.24,t=3.46,P<0.001;Du145, Fold Change=2.24,t=4.29,P<0.001). Cell proliferation assay showed that growth of LNCaP(P<0.001) and DU145(P<0.001) cells whose miR-221 was overexpression was slower than the control group. Conclusion This study demonstrates miR-221 overexpression can inhibited the proliferation of prostate cancer cells for the first time, it also suggests that miR-221 has the potential to serve as a biomarker for PCa therapy.