目的 回顾分析慢性阻塞性肺疾病急性加重期并或不并肺部结核感染在感染及营养方面指标的差异性,明确结核感染对AECOPD的影响。方法 选取2013年7月—2015年6月因急性发作入住我院的COPD患者105例,根据GOLD 2011对COPD的诊断标准及卫生部2008年制定的肺结核诊断标准将其分为无结核组、稳定期组、好转期组及进展期四组。分别在入院时测定患者白细胞计数、中性粒细胞比率、总淋巴细胞计数、淋巴细胞比值、红细胞沉降率、血红蛋白浓度、血清白蛋白及C反应蛋白及体重指数。结果 各组感染指标比较,WBC、CRP两指标差异不显著(P>0.05),而无结核组相较于其他三组,NEUT%更高(F=4.004,P=0.010)、LY%及ESR更低(F/P分别为3.668/0.015和20.197/0.000);各组营养指标比较,合并有肺结核的三组,其Hb、ALB及BMI均比无结核组低,达到统计学差异(P<0.05),而TLC在各组间无差异(F=0.858,P=0.466)。结论 合并有结核感染的AECOPD患者更容易出血贫血(Hb降低)、低蛋白血症(ALB降低)、低体重(BMI降低)、中性粒细胞含量偏低(NEUT%降低)而血沉(ESR)、淋巴细胞比率(LY%)升高的情况,对出现此类情况的AECOPD患者应进行结核感染相关检查。

目的 探讨多措施协作在中药注射剂药物警戒工作的应用效果。方法 2012年1月—2014年12月,采取建立多措施协作,应用于中药注射剂药物警戒工作中。通过对中药注射剂的用药频度(DDDs)、日用金额(DDC)、有效率及引起不良反应(ADR)变化等进行比较分析,以评价中药注射剂使用的安全性和有效性变化情况。结果 2012—2014年,中药注射剂使用有效率从76.5%上升至91.2%,不良反应发生率则由3.12%下降至0.72%,没有重大不良反应事件发生。中药注射剂用药频率DDDs则呈下降趋势,在医院药品总DDC上升的情况下,中药注射剂DDC反而下降。结论 多措施协作有助于建立有效的药物警戒体系,有效地降低了中药注射剂不良反应发生率,提高监测工作数据分析效率和发现药物警戒信号的能力,为中药注射剂的“合理,安全,有效,经济”提供有力的保障。

目的 了解脑卒中患者对社区康复的认知和需求情况。方法 对广州市从化区街口街社区475例脑卒中患者进行问卷调查,调查患者对社区康复认知和需求等相关内容。结果 对脑卒中社区康复知晓者293人,知晓率为61.7%。对社区康复有需求者258人,需求率为54.3%。在对社区康复知晓人群中,文化程度在中学以上、家庭经济≥5000元/月、付费方式为非自费者知晓率较高(P<0.05); 年龄及性别因素无差异(P>0.05)。在对社区康复有需求的人群中,年龄<60岁、男性、文化程度中学以上、家庭经济≥5000元/月、付费方式为非自费者需求率较高(P<0.05)。需求内容最多的是日常活动支持,达100%,需求内容最少的为专业器械支持,仅为26.0%。功能障碍程度越高的脑卒中患者对心理支持、药物支持、专业人员及专业器械支持的需求越高(P<0.05)。结论 脑卒中患者对社区康复的知晓和需要情况一般,仍需多方面的共同努力,促进脑卒中社区康复的开展和发展。

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.

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.

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 .

目的 构建重组pEGFP-C3-HCVc真核表达载体,并建立稳定表达HCVc基因的肝内胆管癌细胞株RBE-core。方法 采用PCR钓取目的基因HCVc,并克隆入pEGFP-C3的多克隆位点,构建pEGFP-C3-HCVc重组质粒。经过双酶切及测序验证后,采用脂质体将pEGFP-C3-HCVc质粒转染到RBE细胞中,经2周G418 (200 μg/mL) 筛选后进行单克隆挑选及扩大培养,建立稳定表达HCVc的胆管癌细胞株RBE-core。采用RT-PCR和Western blot验证HCVc在RBE-core中的表达情况。结果 PCR成功钓取HCVc基因,大小约573 bp,并插入pEGFP-C3载体HindⅢ和BamHⅠ多克隆位点;双酶切及测序证实目的基因HCVc正确连接到pEGFP-C3的多克隆位点。RT-PCR和Western blot分别在573 bp处和34 KD左右检测到相应的阳性条带。结论 成功构建重组质粒pEGFP-C3-HCVc,并在胆管癌细胞RBE中获得稳定表达。

Objective To construct a recombinant plasmid of pEGFP-C3-HCVc containing hepatitis C virus core protein, and establish the HCVc-expressing cell line RBE-core. Methods The HCVc gene was amplified by PCR and cloned into HindⅢ and BamHⅠsite of pEGFP-C3 plasmid. The recombinant plasmid of pEGFP-C3-HCVc was confirmed by sequencing. RBE cells were transfected with the recombinant plasmid by using Lipofectamine 2000, and then performed G418 (200 μg/mL) selection after 2 weeks. The expressing of HCVc gene in RBE cells was confirmed by RT-RCR and western blot. Results The recombinant plasmid of pEGFP-C3-HCVc was successfully constructed. RT-PCR and western blot detected a 573bp and 34KD bland, indicating the stably expressing of HCVc in RBE cells. Conclusion The recombinant plasmid of pEGFP-C3-HCVc is stabled expressing in RBE cells,which provides support for the further study.

目的 调查公众急救培训普及现状及培训需求相关信息,并结合对院前急救工作及急救培训工作等经验的总结与思考,展开对急救培训普及工作的探讨,以指导我国急救培训工作的进一步开展与推广。方法 采用分层随机抽样法,对本市477名市民进行问卷调查。结果 425人(89.1%)认为在18周岁以前就需要掌握基本的急救知识;如无法律保障,原本愿意救援的市民299人中有117人(39.1%)选择放弃施救;最为认同的教学方法是模拟及角色扮演;最希望通过急救培训获得在突发意外灾害事件中正确有效的自救互救能力。结论 普及基本急救知识是城市或区域初级保健的一项重要内容,而目前普及率极低,市民需求迫切,呼吁各级政府及相关的公共服务部门要有计划地多方位、多渠道地组织市民进行内容丰富、形式多样急救培训。

目的 对切开复位与撬拨复位内固定术治疗SandersⅡ型跟骨骨折临床疗效进行比较。方法 回顾分析2014年10月—2016年6月陕西中医药大学附属医院收治的58例SandersⅡ型跟骨骨折患者临床资料,切开组29例,其中男24例、女5例,平均年龄(37.10±3.45)a;闭合组29例,其中男26例、女3例,平均年龄(36.60±3.15)a。采用Maryland及AOFAS评分系统评定临床功能。结果 X线显示两组患者术后Bohler角及Gissane角均恢复,比较差异没有统计学意义(P>0.05)。撬拨复位组术中出血量、住院天数及手术时间均明显少于切开复位组(P<0.05)。撬拨组出现2例针孔感染,换药后感染消失。切开组出现2例切口感染,1例切口裂开,2例刀口皮缘坏死,长期换药后全部好转;1例腓肠神经损伤。两组并发症发生率比较差异有统计学意义(P<0.05)。结论 对于治疗SandersⅡ型跟骨骨折,两组术式均能取得良好疗效,经皮撬拨复位克氏针内固定较切开复位钢板内固定具有时间成本小、创伤小、痛苦少、并发症少等优点。