目的 探讨我院17年间前列腺癌患者的临床特征如发病年龄、前列腺特异性抗原(PSA)、Gleason评分、分期及穿刺阳性率等的变化。方法 采用回顾性分析,对广州市第一人民医院2000—2016年泌尿外科1 231例穿刺活检的患者及564例前列腺癌患者资料进行分析,按患者的诊断时间分为A组(2000—2005年)、B组(2006—2009年)、C组(2010—2012年)、D组(2013—2014年)、E组(2015—2016年),对各组的年龄、PSA、Gleason评分、分期及穿刺活检阳性率进行统计学分析,看各组间的各项指标差异是否有统计学意义。结果 5组年龄均值(73.36,73.74,72.05,73.40,72.96岁)、PSA均值(208.95,190.25,173.19,283.54,148.69 μg/L)及穿刺活检阳性率均值(48%,43%,37%,44%,39%)差异均无统计学意义(P均>0.05)。5组Gleason均值为6.80,6.73,7.12,6.93,7.32,A、B组和E组Gleason评分差异有统计学意义(P均<0.05),其余各组Gleason评分差异均无统计学意义(P均>0.05)。TNM分期转化得分5组均值为5.96,6.80,7.05,7.31,6.83, A和C组、D组、E组差异均有统计学意义(P均<0.05),其余各组TNM分期转化得分差异均无统计学意义(P均>0.05)。结论 17年间前列腺癌患者诊断时的年龄、PSA水平及穿刺活检阳性率没有显著变化。

Objective To investigate changes of inpatients with prostate cancer in the last 17 years such as age of onset, prostate specific antigen (PSA), Gleason score, prostate cancer staging and positive rate of prostate biopsy. Methods A retrospective analysis was conducted in 1 231 cases of biopsy patients of urology and 564 patients with prostate cancer who were hospitalized in the First People's Hospital of Guangzhou from 2000 to 2016. According to the time of diagnose. All the patients were divided into five groups: group A(2000-2005),group B(2006-2009),group C(2010-2012), group D(2013-2014)and group E(2015-2016). The age, PSA, Gleason score, staging and positive rate of prostate biopsy were compared to realize whether the indicators of the differences between groups was statistically significant. Results In five groups, means of age, PSA, Gleason score and prostate biopsy positive rate are respectively 73.36,73.74,72.05,73.40,72.96 years; 208.95,190.25,173.19,283.54,148.69 μg/L;6.80,6.73,7.12,6.93,7.32; 5.96,6.80,7.05,7.31,6.83 and 48%,43%,37%,44%,39%. There was no significant difference in age, PSA and positive rate of prostate biopsy (P>0.05). The Gleason scores of group A and group E, group B and group E were statistically significant (P<0.05), while the other groups had no significant differences in Gleason score (P>0.05). There werestatistical significancein TNM staging score between group A and group C,group D, group E(P <0.05),while the other groups had nostatistical significance (P>0.05). Conclusion There are no change of prostate cancer patients in diagnosis of age, PSA levels and positive rate of prostate biopsy in the past 17 years.

目的 探讨高压氧对FVB小鼠旷场行为的影响。方法 对9只4周龄高压氧组FVB小鼠进行2个疗程共21天高压氧干预;对13只4周龄对照组FVB小鼠不做任何处理,正常饲养。21天后对2组小鼠进行旷场实验,观察高压氧对FVB小鼠旷场行为的影响。结果 高压氧组小鼠在中央区停留时间(3.73±3.69,17.97±6.82,t=-5.564,P=0.000)和运动路程较对照组小鼠减少(189.65±199.32,525.67±244.22,t=-3.298,P=0.040),在外周区停留时间增加(296.07±3.69,281.79±6.79,t=5.597,P=0.000);进入中央区、外周区次数及穿越各区总次数都减少(3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008);2组小鼠总路程和平均速度无差异(8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726)。结论 高压氧改变FVB小鼠的旷场行为的表型,使小鼠趋避性增加,对环境的认知能力及焦虑程度增强,探索性下降。

Objective To explore the effect of hyperbaric oxygenation(HBO)on behaviors of FVB mice in the open field test. Methods 9 mice of four-week-old in the HBO group were treated with hyperbaric oxygenation for a total of 21 days during two courses while 13 control mice of four-week-old did not do any treatment. After 21-day normal breeding, the mice of two groups were tested with open field test. Then, researchers observed the effect of hyperbaric oxygenation on mice behaviors after open field test. Results Compared to 13 control mice, residence time (3.73±3.69,17.97±6.82,t=-5.564,P=0.000) and the range of movement (189.65±199.32,525.67±244.22,t=-3.298,P=0.040)in central region decreased while the residence time in external region increased (296.07±3.69,281.79±6.79,t=5.597,P=0.000). The times of entering the central region and external region and crossing both of the regions decreased (3.11±3.10,8.20±4.80, t=-2.770,P=0.014;3.11±3.10,9.10±4.79,t=-3.264,P=0.005;6.22±6.20,17.30±9.59,t=-3.018,P=0.008). There was no difference in the total range of movement and the average velocity (8766.57±3362.90,8320.47±1692.47, t=0.359,P=0.726;73.05±28.02,69.34±14.10,t=0.359,P=0.726). Conclusion Hyperbaric oxygenation may change the behaviors of FVB mice in open field test to enhance its phobotaxis, anxiety degree and the cognitive ability in environment and inhibiting its exploration ability.

雄激素性脱发是一种人群中常见的损容性疾病,其发病与多种因素有关,而遗传因素在发病率中具较大的影响。低能量激光疗法(Low-Level Laser Therapy)是近年来用于治疗雄激素性脱发的光疗技术。低能量激光是一种低能量,短波长的激光,因早期研究发现其具有促进毛发生长的作用而被用于研究治疗雄激素性脱发(AGA)。在低功率激光疗法中,通过使用低能量激光照射毛囊,使毛囊炎性反应得以减轻,同时促进细胞新陈代谢,从而使休止期毛囊复苏,达到促进毛发生长的作用。本文通过对低能量激光疗法治疗雄激素性脱发的机制及效果进行论述,并讨论局部治疗、系统治疗等其他方法联合低功率激光在AGA治疗中的研究进展。

Androgenetic alopecia is a common and ashamed disease in the human population. Its incidence is related to a variety of factors, and the gene have a greater impact on the incidence. Low-level laser therapy LLLT is a phototherapy technique for the treatment of androgenetic alopecia in recent years. Low-level laser means low-energy, short-wave length that have been used for research and treatment of androgenetic alopecia because of the early discovery which is promoting hair growth. In LLLT, the laser irradiates hair follicles, so that reduces the folliculitis, while promoting cell metabolism.From this, the dormant hair follicles resume growth. This article discusses the mechanism and effect of low-level laser therapy for the treatment of androgenetic alopecia, and further discusses the advancement of topical treatment, systemic treatment, and other methods which combined with low-level laser in the treatment of AGA.

随着时代的发展,医学模式更具综合性,预防医学专业特性不仅体现其医学范畴,其综合性特点日益突出。因此预防医学专业医学生综合素质及创新能力的培养显得愈发重要。为了提高预防医学学生的综合素质及创新能力,我们从预防医学理论教学及实验教学开展了教学改革探讨。

目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

目的 分析全科医学教学中应用第三方满意度调查,结合学生需求的实践效果。方法 2016年3—12月接收全科医学学生者60例,按照常规方法进行,2017年3—12月全科医学学生62例,教学中应用第三方满意度调查结合学生需求方法,观察教学效果。结果 第二年时,学生期末考试总成绩、病例题成绩、实习报告成绩,课外自学时间、利用网络自学时间、与他人讨论学习时间,教学效果总体评分、课间实习评分均高于第一年,差异有统计学意义(P＜0.05)。结论 全科医学教学中应用第三方满意度调查结合学生需求方法后,可有效的提升教学效果,增强学生的自学能力及自学意识。

Objective To analyze the practical effect of applying the third party satisfaction survey to the needs of the students in the teaching of general medicine. Methods From March 2016 to December 2016, 60 cases of general practice medical students were enrolled. According to the routine method, 62 cases of general medical students from March 2017 to December 2017 were selected. Third party satisfaction survey and student demand method were applied in teaching, and the teaching effect was observed. Results In th second year, students' final exam scores, the total score, case questions internship report scores, extracurricular self-study time, self-study time, learning time, using the network to discuss with othersthe teaching effect of practice during the total score, all above were higher than the first year, there was significant difference (P<0.05). Conclusion The application of third party satisfaction survey combined with students' needs method in general practice teaching may effectively improve teaching effect; enhance students' self-learning ability and self-learning consciousness.

目的 探讨多种教学模式在加强医学生人文素养、沟通意识和沟通能力中的作用。方法 考察多种教学模式培养的临床学生(教学组)和传统模式培养的临床学生(对照组)在人文关怀、沟通技巧、职业素养、医患关系等方面的理论知识和病史询问为主的实践考核情况,并进行对比。结果 多种教学模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(21.03±2.00、20.78±2.11、21.01±2.12、20.91±2.07),病史询问成绩为(16.03±2.13)分,传统模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(20.29±2.26、19.84±2.33、20.24±2.49、20.05±2.32),病史询问成绩(14.89±2.43)分,均较多种模式培养组分数低,两组对比差异均有统计学意义(P<0.05)。结论 在神经病学教学中采用多种教学模式对提高学生沟通能力及人文素养有良好的效果。

目的 探讨品管圈活动在提高神经外科卧床患者便秘预防措施落实率中的的应用效果。方法 成立品管圈,确定以“提高神经外科卧床患者便秘预防措施落实率”为主题,进行现状调查,设定目标,进行要因分析,制定并实施措施,比较品管圈活动前后护士落实便秘预防措施情况。结果 实施品管圈活动后,神经外科卧床患者便秘预防措施落实率从活动前的41.59%上升至活动后85.6%,差异有统计学意义(P＜0.05)。结论 品管圈活动可以有效提高神经外科卧床患者便秘预防措施落实率,降低便秘的发生率,减轻患者痛苦,改善患者生活质量。

目的 探讨入院准备中心制度在我院乳腺外科住院预约统筹管理的实践情况。方法 2017年1月—12月广州市第一人民医院入院准备中心对乳腺外科30张床位实施病床集中预约管理,依据患者病情进行预约,合理安排患者入院。结果 2017年1至12月我院乳腺外科共预约入院1225人/次,成功办理预入院1096人/次,约占乳腺外科总入院人数的77.85%。预入院进行手术患者415人/次,其中3日内手术患者为285人/次,预入院三日内手术率为68.67%。结论 预入院制度对乳腺外科病床进行集中预约管理能有效保证床位充分使用,为患者提供方便、有效的医疗服务,值得基层医院推广。

目的 研究脊柱经皮内镜椎间孔入路和椎板间入路治疗腰椎间盘突出的临床应用效果。方法 本次选取的研究对象为2016年1月—2017年12月期间在我院进行治疗的腰椎间盘突出患者,将60例患者根据红蓝球分组法分为两组,30例/组。将实施脊柱经皮内镜椎间孔入路椎间盘切除术的患者纳入PETD组,将采用椎板间入路椎间盘切除术的患者设为PEID组。将两组腰椎间盘突出患者的手术相关指标、治疗优良率、ODI评分、VAS评分进行比对。结果 观察组腰椎间盘突出患者的手术时间、C型臂透视次数同对照组相比存在差异(P＜0.05);术后卧床时间和住院时间、治疗优良率组间对比无统计学意义;两组术后三个月时的ODI评分、VAS评分均较术前更优(P<0.05)。结论 在腰椎间盘突出治疗中脊柱经皮内镜椎间孔入路、椎板间入路的效果相当,临床上需患者的实际情况和解剖特点选择适合的入路方式和手术方法。