目的 分析经直肠彩超引导下不同前列腺穿刺方式的阳性率及其相关因素,探讨安全的穿刺方案。方法 回顾性分析接受经直肠彩超引导下前列腺穿刺的701例患者临床资料,所有患者均接受系统性13点穿刺活检,并假设13点穿刺中减少前列腺中线3个穿刺点为10点穿刺术式,加之标准的6点穿刺术式。比较上述穿刺术式的阳性率,分析T-PSA、前列腺体积、PSA体积密度(PSAD)、有无前列腺结节对穿刺阳性率的影响。结果 随前列腺穿刺针数的增加,活检阳性率增高。同一穿刺方式,不同T-PSA组间、不同前列腺体积组、不同PSAD组阳性率有差异。T-PSA>100 ng/mL时,三种穿刺方式的阳性率无差异;T-PSA<100 ng/mL时,6点穿刺法阳性率较低,而10点穿刺、13点穿刺阳性率无差异。前列腺体积>80 mL时,不同穿刺法阳性率有差异。PSAD<0.5 ng/mL²时,10点、13点穿刺阳性率无差异。结论 前列腺穿刺活检阳性率随穿刺针数增多而增加,可根据PSA水平、前列腺体积、PSAD选择个体化穿刺方案。

目的 探讨农村地区糖尿病患者在镇卫生院—村卫生站一体化管理模式下的效果。方法 于2013年10月—2014年9月对花山镇26个村1267名糖尿病患者实行镇卫生院—乡村卫生站一体化管理,镇卫生院定期组织医疗队到村卫生站健康宣教、义诊、体检,村卫生站乡医为本村糖尿病患者开展跟踪随访、血糖监测、用药及饮食运动指导。一年后比较患者的规范管理率、血糖控制率。结果 实施管理后农村糖尿病患者的规范管理率和血糖控制达标率均有提高,尤以血糖控制达标率为明显。结论 对农村社区糖尿病患者实施镇卫生院—村卫生站一体化管理能更好地跟踪监测患者血糖水平,增强患者防病意识,有效提高农村社区糖尿病患者血糖控制率。

目的 探讨光疗对早产儿血浆β-内啡肽含量的影响及与早产儿呼吸暂停的相关性。方法 收集我院住院早产儿92例,检测早产儿光疗前、中、后的血浆β-内啡肽及血清电解质、血糖及pH值,并将光疗过程中出现呼吸暂停者纳入光疗呼吸暂停组28例,无呼吸暂停者纳入光疗非呼吸暂停组44例,并设非光疗无呼吸暂停早产儿为对照组20例,比较组间上述指标的差异。结果 各组早产儿的血清电解质、血糖、血液pH值在光疗前、中、后无变化,差异无统计学意义(P>0.05)。光疗呼吸暂停组的血浆β-内啡肽浓度在光疗前、中、后无变化,差异无统计学意义(P>0.05),光疗呼吸暂停组和非呼吸暂停组之间血浆β-内啡肽的浓度无变化,差异无统计学意义(P>0.05),光疗组与非光疗组β-内啡肽浓度无变化,差异也无统计学意义(P>0.05)。结论 早产儿光疗前后β-内啡肽浓度无变化,呼吸暂停与β-内啡肽含量无相关性。

目的 了解惠州地区无偿献血者中抗-Mur及Mur抗原的频率,为指导临床输血及建立稀有血型红细胞库提供依据。方法 用微板盐水法和凝聚胺法筛查8686名自愿无偿献血者血浆中的抗-Mur,再用微柱凝胶卡方法进一步确认;采用人源抗-Mur血清检测1119名献血者Mur抗原的红细胞表型。结果 无偿献血者血清中抗-Mur频率为0.35%(31/8686),男女间的差异有统计意义(P<0.05),女性高于男性;Mur抗原阳性频率为5.61％(63／1119)。结论 惠州地区无偿献血者中抗-Mur频率较高,而Mur抗原阳性则相对较常见,在输血前检查项目中增加Mur血型抗原抗体检测是非常必要的。

Objective To investigate the frequency of anti-Mur and Mur antigen among blood donors in Huizhou city and provide data for guiding clinical transfusion and establishing red blood cells library of rare blood type. Method Micro-plate brine method and polybrene method are used to screen anti-Mur from 8686 blood donors. DG Gel Coombs cards are used to confirm the result. Human anti-Mur serum is used to screen the phenotypes from other 1119 blood donors. Results The frequency of anti-Mur was 0.35%(31/8686). The differences between men and women had statistical significance (P<0.05), of which women were higher than men. The frequency of Mur antigen positive was 5.61％(63／1119). Conclusion The blood donors in Huizhou showed a high frequency of anti-Mur and a relatively high frequency of Mur antigen, so it is very necessary to add test method of Mur blood group antigen and antibody before the donors carry out the blood transfusion process.

目的 探讨脊髓小脑性共济失调一家系的临床表现、影像学特点和基因型及三者之间的联系。方法 描述一家系5例患者的临床表现,总结其特点,对部分患者行头颅磁共振及基因检测。结果 一家系4代7名成员中共有5例发病,以行走不稳和言语含糊为突出表现,头颅MRI示小脑萎缩,基因检测SCA3相关基因的CAG重复数为65次,确诊为SCA3。结论 SCAs为一组神经系统遗传性疾病,临床以共济失调和构音障碍为突出表现,基因检测可为临床提供准确的分型。

Objective To explore the relation of clinical manifestation, MRI and gene data with the spinocerebellar ataxia. Methods To give a description of the clinical manifestation of the spinocerebellar ataxia patients, summarize the characteristics, and part of them to make the MRI and genetic detection. Results There are 5 patients among 7 numbers of 4 generations in the family.The main clinic features included gait ataxia and ambiguity in speech. Brain MRI showed atrophy on cerebellum. The repeated times of CAG of SCA3 were 65, diagnosed as SCA3 patient. Conclusion SCAs is one group of genetic diseases. The clinical manifestations are ataxia and dysarthria. Molecular genetic detection can be used for SCA subtype diagnosis.

目的 通过比较治疗组服药前、后骨密度及骨代谢指标的变化情况,并将治疗组、对照组分别作对比,观察壮骨颗粒治疗绝经后女性骨量减少及骨质疏松、改善其骨代谢的临床疗效。方法 将研究对象随机分为两组,治疗组服用壮骨颗粒＋迪巧,对照组只服用迪巧。结果 壮骨颗粒组治疗后血清中的PINP、β-Crosslaps及N-MID下降(P＜0.05);与治疗前相比,腰椎(L2-L4)BMD提高(P＜0.05);壮骨颗粒能改善绝经后女性骨代谢及提高骨密度的效果优于迪巧组。结论 壮骨颗粒是治疗绝经后女性骨量减少及骨质疏松、提高骨量、改善骨代谢情况的安全有效药物。

目的 探讨压力管理对改善中年高血压患者生活质量的效果。方法 采用便利抽样法,把首次在我院住院的中年高血压患者115例按时间段分为实验组60例和对照组55例,对照组给予常规护理,实验组采用压力管理干预,分住院期和出院后康复期两阶段进行。使用抑郁自评量表和SF-36量表分别在出院前和出院后1个月进行测评。结果 干预后实验组患者抑郁标准分降低,SF-36量表各维度分及总分升高,与对照组比较差异均有统计学意义(P＜0.05)。结论 对中年高血压患者实施有针对性、整体性、延续性和激励性的压力管理,可提高其生活质量。

Objective To explore the influence of stress management on the improvement of quality of life of middle-aged patients with hypertension. Methods According to convenience sampling, 115 middle-aged patients with hypertension who were the first time admitted to our hospital were divided, on the basis of different periods, into the test group (60 patients) and the control group (55 patients). The control group was accepted normal nursing, while the test group was accepted the stress management intervention that performed during hospitalization and after patients discharged from the hospital. Both groups were assessed, by using self-rating depression scale and SF-36 scale, before discharging from hospital and one month after discharging from hospital. Results After the intervention, the test group experienced reductions in depression standard score and increases in dimension scores and total scores of SF-36 scale.compared with those of the control group, these changes had statistical significant (P＜0.05). Conclusion Selective, integrated, continuous and stimulating stress management can help middle-aged patients with hypertension to improve the quality of life.

目的 探讨急性阑尾炎(acute appendicitis, AA)及急性感染性肠炎(acute infectious enteritis, AIE)患儿的阑尾高频超声影像特点及其显像敏感性。方法 回顾性分析临床确诊为急性阑尾炎患儿120例,急性感染性肠炎患儿160例,并对其行高频超声检查,另设120例正常儿童为对照组。分析高频超声阑尾显示率,阑尾外径,阑尾周围系膜炎性变化以及阑尾的位置等情况。结果 AA组、AIE组、对照组阑尾的显示率分别为96.7%、80.6%、68.3%,差异有统计学意义(P<0.05)。三组超声显示的阑尾外径分别为(8.5±2.2)mm、(4.3±0.8)mm、(3.5±0.7)mm,相互间差异亦均有统计学意义(P<0.05)。AA组所有的阑尾周围系膜炎症改变均可探及,但AIE组的阑尾周围系膜无变化。结论 小儿急性阑尾炎高频超声显像敏感性高,旨在为临床对AA早期诊断、早期治疗提供较准确全面的影像学依据。

Objective Use high-frequency ultrasound to determine the frequency of visualization and image feature of the appendix in children with acute appendicitis (acute appendicitis, AA) and with acute infectious enteritis (acute infectious enteritis, AIE). Methods The ultrasonic features of 120 children with AA, 160 children with AIE, and 120 randomly selected asymptomatic children were analyzed retrospectively. And their visualization rate, outer appendiceal diameter, presence or absence of inflamed periphery appendiceal mesenterium, and location of the appendix were recorded. Results The visualization rates of the appendix were 96.7%, 80.6%, and 68.3% for AA groups, AIE groups, and the control, respectively(P<0.05). The outer appendiceal diameters for the 3 groups were (8.5±2.2)mm, (4.3±0.8)mm, and (3.5±0.7)mm. Difference among the 3 groups was statistically significant also. Periphery appendiceal inflamed mesenterium was detected in all AA cases, but in none of the AIE cases. Conclusion High ultrasound imaging sensitivity of puerile acute appendicitis provided relatively accurate comprehensive imaging basis for clinical early diagnosis and early treatment.

目的 探讨糖化血红蛋白(HbA1c)联合超敏C反应蛋白(hs-CRP)在筛查妊娠期糖尿病(GDM)的临床意义。方法 选择2013年9月1日—2014年8月31日在我院妇产科孕期产前检查及分娩的孕妇,根据糖耐量试验(OGTT)、HbA1c和hs-CRP检查,筛查出92例孕妇为GDM组,并随机抽取OGTT正常的健康孕妇90例为NGT组,25例健康孕龄女性为对照组,分析3组FPG、HbA1c、hs-CRP及OGTT结果。结果 GDM组OGTT、HbA1c、hs-CRP高于NGT组和对照组,差异有统计学意义(P<0.01),NGT组与对照组比较,HbA1c、hs-CRP浓度差异无统计学意义(P>0.05),但3组FPG差异无统计学意义(P>0.05),Pearson相关分析显示,HbA1c与hs-CRP呈正相关(r=0.79,P<0.01)。结论 GDM患者HbA1c、hs-CRP水平升高,HbA1c联合hs-CRP可能成为GDM筛查的良好指标。

Objective To evaluate the feasibility of combination of glycosylated hemoglobin A1c(HbA1c) and high-sensitivity CRP in screening of gestational diabetes mellitus(GDM). Methods According to glucose tolerance test(OGTT),HbA1c and hs-CRP during 24~28 pregnant weeks,92 women with GDM (GDM group) and 90 normal pregnant women (NGT group) were enrolled in this study with another 25 women of child-bearing age as the control group. The results of FBG, OGTT, HbA1c and hs-CRP among three groups were analyzed. Results OGTT, HbA1c and hs-CRP level in GDM group were higher than that in NGT group and control group (P<0.05), but there were no significant differences of the level of FPG of 3 groups(P>0.05).Compare with NGT group and control group, There were no significant differences of the level of HbA1c and hs-CRP(P>0.05). Pearson correlation analysis showed that HbA1c had significant association with hs-CRP(r=0.79, P<0.01). Conclusion HbA1c and hs-CRP level in GDM group were increased, HbA1c combined with hs-CRP could be of some value in screening of GDM.

目的 调查广州市在校大学生AIDS相关知识及对HIV感染者态度现状,为学校更有效地开展大学生AIDS健康教育提供依据。方法 采用目的抽样方法,对广州市某高校 1200名在校大学生进行关于AIDS相关知识、态度的问卷调查。结果 不同年级、生源地,AIDS相关知识差异均有统计学意义(P值均＜0.01);多数学生对HIV感染者持积极态度,但仅5.73%的学生愿意与HIV感染者共餐;2.70%愿意与感染HIV的同学同住一个寝室。网络是大学生获取AIDS相关知识的最主要途径。结论 大学生AIDS相关知识知晓率水平较高,但缺乏系统性和全面性;多数学生对HIV感染者持积极态度,但是一旦与自我卷入较深,即表现出对HIV感染者的回避甚至歧视。高校应加强对大学生AIDS健康教育的系统性、全面性和深刻性,以消除对AIDS的心理恐惧,达到对HIV感染者的零歧视。

Objective To investigate the AIDS related knowledge of the Guangzhou undergraduates and the attitudes on HIV infection status, for the school to provide basis for AIDS health education and to carry out AIDS health education during college students more effectively. Methods 1200 college students in a university in Guangzhou were surveyed by a questionnaire on HIV/AIDS related knowledge and attitudes, using the way of purposive of sampling. Results There was statistical significant difference on the AIDS-related knowledge in the different grades and origin of students (P<0.01). The majority of students has a positive attitude to the HIV-infected, but only 5.73% of them wer willing to share a meal with HIV-infected persons, and 2.70% of them were willing to live with HIV-infected. The network is the most important way to access to HIV/AIDS related knowledge for college students. Conclusion The level awareness during college student on AIDS-related knowledge is high, but lack of systematic and comprehensive. The majority of students had a positive attitude towards the HIV-infetected, however once self-involved, they may avoid even discriminate the HIV-infected individuals. Therefore, the universities should strengthen AIDS health education of college students comprehensively and profoundly, in order to eliminate fear of AIDS, and reached zero discrimination HIV-infected persons in the future.