目的 分析过敏性疾病儿童过敏原的种类和特点。方法 采用国产欧博克试剂盒(酶联免疫法)对174例过敏性疾病患儿进行食物及吸入性过敏原特异性IgE(SIgE)检测,比较≤3岁和＞3岁两组患儿SIgE阳性率。结果 过敏性疾病患儿SIgE检测阳性率达72.99%(127/174),排名前2位的是:屋尘螨/粉尘螨(39.66%,69/174)、屋尘(26.44%,46/174)。≤3岁组食物性过敏原阳性率33.93%(19/56),吸入性过敏原阳性率44.64%(25/56),＞3岁组食物性过敏原阳性率41.53%(49/118),吸入性过敏原阳性率61.02%(72/118);127例阳性病例中, 96例对≥2种过敏原呈阳性反应, 69例SIgE等级≥3,＞3岁组混合过敏率及高度过敏率高于≤3岁组。结论 广州地区过敏性疾病儿童以吸入性过敏为主,主要过敏原是屋尘螨/粉尘螨、屋尘,随着年龄增长,吸入性过敏原阳性率升高,混合过敏的机率增加。建议对过敏疾病患儿进行过敏原检测,以制定相应环境干预措施及特异性脱敏治疗方案。

Objective To inverstigate the types and characteristics of allergen in children in different age with allergic diseases. Methods The food and inhalant allergen-specifi IgE(SIgE) were detected by the domestic specific IgE Screening ELISA kit in 174 children with allergic diseases,and were compared among children aged ≤3 and ＞3 years. Results 72.99%(127/174) of children with allergic diseases were positive for SIgE,the common allergen were dermatophagoides pteronyssinus/dermatophagoides farina and dust. In the group of ≤3 years old,the positives rate of food allergens was 33.93%(19/56),and the positives rate of aeroallergens was 44.65%(25/56).In the group of >3 years old, the positives rate of food allergens was 41.53%(49/118), the positives rate of aeroallergens was 61.02%(72/118).96 of 127(75.59%) positive cases yielded positive result to more than 2 allergens.69 patients's SIgE levels greater were ≥ 3,the mixed allergic rate and highly allergic rate of the children aged ＞3 years were higher than the children aged ≤3 years. Conclusion The children with allergic diseases in Guangzhou area were allergic mainly to inhalant allergens,especially to dermatophagoides pteronyssinus/dermatophagoides farina and dust.Aeroallergens are becoming the allergens as children grow with ages, and probability of mixture allergy is increasing.

目的 探索复发性卵巢癌放射治疗临床的效果和副作用。方法 采用回顾性分析中山大学肿瘤防治中心放射治疗中心2002年1月—2014年9月收治的复发性卵巢癌采用放射治疗的临床资料和治疗结果。结果 23例患者5年生存率为48.6%,中位生存期为54,局部无瘤生存期中位数为11.9。结论 对于局限性复发性卵巢癌放射治疗有较好的疗效和较少的副作用。

Objective To explore the clinical efficacy and side effects of radiation therapy for recurrent ovarian cancer. Methods We performed a retrospective analysis of clinical data and treatment outcomes from recurrent ovarian cancer patients who received radiation therapy from January 1999 to December 2012 at radiation treatment center of Sun Yat-sen university Cancer Center. Results Among 23 patients, the five-year survival rate was 48.6%, the median survival time was 54, and the local median disease-free survival was 11.9. Conclusion Radiation therapy has better efficacy and less side effects for non-metastatic recurrent ovarian cancer.

目的 检测抑郁障碍患者血清中IL-2和TNF-α水平,探讨IL-2和TNF-α水平与认知功能情况相关性。方法 采用酶联免疫吸附法(ELISA)检测100例抑郁障碍患者(观察组)和100例健康人(对照组)的血清IL-2、TNF-α的水平,并结合汉密尔顿抑郁量表(HAMD)观察患者抑郁障碍的严重程度,应用Loewenstein 认知评定量表评定患者的认知状态情况进行相关分析。结果 与对照组相比,观察组的IL-2、TNF-α的水平明显更高(P<0.05)。IL-2、TNF-α的水平与HAMD,LOTCA总分呈正相关(P<0.05)。结论 抑郁障碍患者血清中IL-2、TNF-α的水平与抑郁障碍患者的严重程度和认知状态情况呈正相关。

Objective To study the levels of serum IL-2 and TNF-α in depressed patients and theircorrelations with the cognitive function. Methods 100 depressed patients (observation group) and 100 healthy people (control group) were enrolled to this study and we compared their levels of serum IL-2 and TNF-α detected by enzyme-linked immunosorbent (ELISA) from two groups. The correlation analyses of the serum IL-2 and TNF-α levels with the severity of depression of depressed patients observed with Hamilton depression scale (HAMD), and the serum IL-2 and TNF-α levels with the cognitive function evaluated with Loewenstein were conducted. Results The levels of serum IL-2 and TNF-α in the observation group were significantly higher than control group (P<0.05).There were positive correlations between the levels of IL-2 and TNF-α and HAMD scores and between the levels of IL-2 and TNF-α and LOTCA scores (P<0.05). Conclusion The levels of serum IL-2 and TNF-α in the depressed patients were positively correlative with the severity of depression and their cognitive function.

目的 观察肌内效贴技术对桡骨远端骨折内固定术后手功能的影响,并与对照组进行比较。方法 随机选取36例桡骨远端不稳定骨折内固定术后患者,随机分为治疗组与对照组,治疗组18例患者采用肌内效贴扎及腕关节主动活动康复训练,对照组18例采用腕关节主动活动康复训练。所有患者在治疗前及治疗后1周、2周均采用Gartland-Werley进行腕关节功能评价;容积法测量腕关节远端肿胀程度、视觉模拟疼痛评分(visual analog scale,VAS)进行疼痛评价。结果 治疗后1周,后2周治疗组的腕关节功能Gartland-Werley评定,腕关节远端肿胀程度和VAS优于对照组,差异有统计学意义(P＜0.05)。结论 肌内效贴技术对改善桡骨远端骨折术后肿胀,促进患者手功能恢复,改善患肢疼痛方面疗效显著,值得推广。

Objective To observe the effect of Kinesio taping on hand function after internal fixation of distal radius fracture, comparing to the control group. Methods Using randomized controlled methods, 36 cases of unstable distal radius fracture after internal fixation were randomly divided into two groups, 18 cases in the treatment group were treated by Kinesio taping and wrist active rehabilitation training. The control group (18 cases) only got wrist active rehabilitation training. All patients were evaluated before and after treatment in 1 week and 2 weeks, including the function assessment of wrist joint by Gartland-Werley, swelling measurement of distal wrist joint by volumetric method, pain evaluation by visual analogue scale (visual analog scale, VAS). Results In the twice evaluation after treatment, Gartland-Werley assessment of wrist joint, distal swelling degree and VAS of the treatment group were superior to that of the control group, the difference had statistical significance(P<0.05). Conclusion Kinesio taping can improve the distal radius fracture postoperative swelling, promote the recovery of hand function in patients, and improve the curative effect of limb pain significantly. It's worthy of promotion.

目的 通过测试获取脑瘫外翻足患儿的足底压力参数特征,为设定步态康复训练方案提供参考。方法 根据纳入和排除标准,选择脑瘫患儿和健康儿童各15人,通过足底压力测试仪测得足底各部位压力分布、区域压力峰值及步态时相百分比,将两组结果进行统计学比较。结果 比较发现在足底接触面积、足底压力值,以及步态时相所占时间长短三方面均有指标存在差异,均有统计学意义(P<0.05)。结论 足底压力测试技术可使临床步态分析更加量化、精确化,为设定更有针对性的康复训练提供依据。

Objective Through the assessment to get the plantar pressure features of cerebral palsy children with talipes valgus, in order to design suitable treatment plan. Methods According to the inclusion criteria and exclusion criteria, we chose 15 cerebral palsy children with talipes valgus in experimental group, and 15 healthy children in control group. Through the test to get the plantar contact area, pressure parameters and the percent of gait phase. the two groups were compared with statistics method. Results There were significant differences between two groups on the plantar contact area, pressure parameters and the percent of gait phase. Conclusion Plantar pressure measurement makes clinic gait analysis more quantized and accurate, it will provide the evidence to plan the suitable treatment plan.

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.

目的 评估灯盏花素联合自血穴位注射疗法治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法 对照组使用常规治疗方法,治疗组加用灯盏花素联合自血穴位注射疗法。所有入组患者在入院和出院当天进行圣乔治呼吸问卷(SGRQ)评分和COPD评估测试(CAT)评分,使用统计软件比较两组的SGRQ总评分、CAT评分和住院天数。结果 SGRQ总评分、CAT评分和住院天数有正相关关系;和对照组相比较,治疗组SGRQ总评分在治疗前后没有差异, CAT评分在治疗前后有差异,治疗组的住院天数减少。结论 SGRQ总评分、CAT评分能够反映AECOPD病情,CAT评分更加适合评估AECOPD短期病情变化,灯盏花素联合自血穴位注射疗法治疗AECOPD具有临床疗效。

Objective It was evaluated the clinical effect of the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with Breviscapine combined with self-blood acupoint injection therapy. Methods Routine treatment methods were used in the controlled group. Breviscapine and the self-blood acupoint injection therapy were added into the treatment group. St George's respiratory questionnaire (SGRQ) and chronic obstructive pulmonary disease assessment test (CAT) were done in all enrolled patients. And the total score of SGRQ, the score of CAT and the length of stay in hospital were assessed. Results There were positive relationships between the total score of SGRQ, the score of CAT and the length of stay in hospital.compared with the controlled group, before and after the treatment, significant difference was not observed with the overall score of SGRQ in the treatment group, but was observed with the score of CAT in the treatment group, and stay time in hospital in the treatment group was declined obviously. Conclusion The total score of SGRQ and the score of CAT could reflect the conditions of AECOPD, and the latter was more suitable for the evaluation of the condition change in short period. The clinical effects were obvious in the treatment of AECOPD with Breviscapine combined with self-blood acupoint injection therapy.

目的 调查重症监护病房(ICU)医院感染的常见细菌分布及耐药性变化,为合理使用抗生素和医院感染的预防控制提供相关科学依据。方法 回顾性分析医院2007—2011年ICU收治的381医院感染患者感染菌株分布特点及耐药性情况。结果 ICU医院感染常见菌株主要来源于痰液标本,占78.2%,其次是血液。381 株临床分离菌中共检出革兰阴性杆菌262 株、革兰氏阳性球菌70例和真菌49例,分别占68. 8%、24.9%和占17.4%。革兰阴性杆菌中鲍氏不动杆菌(24.7%)、肺炎克雷伯氏杆菌(10.8%)、铜绿假单胞菌(9.2%)排前三位。其中除碳青霉烯类药物及抑酶制剂,鲍氏不动杆菌对其余抗菌药物耐药率均＞40%。革兰氏阳性球菌以金黄色葡萄球菌为主。对青霉素、庆大霉素、红霉素的耐药率均＞50%。结论 呼吸道仍是ICU最常见的感染部位。病原菌以革兰阴性杆菌为主,且对常用抗菌药物的耐药率逐渐升高,临床应加强抗菌药物规范使用,避免耐药菌株的产生。

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit(ICU)causing nosocomial infections so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The specimen sources and the clinical distribution of the 381 pathogens isolated from 2007 to 2011 were retrospectively analyzed. The drug resistance was observed in ICU that causing nosocomial infections. Results The sputum was the major specimens source in ICU, accounting for 78.2%. Of the 381 pathogens causing nosocomial infections in ICU, the 262 gram-negative bacilli (68.8%), 70 gram-positive cocci (24.9%),and 49 fungi (17.4) were isolated, Among gram-negative bacilli the top three were acinetobacter baumannii (24.7%), klebsiella pneumonia(10.8%),and pseudomonas aeruginosa (9.2%). The drug resisitance rate of baumannii to antibiotics were more than 40%,beside carbapenem and B-Lactamaseinhibitors. The main gram-positive cocci of causing nosocomial infections was saphylococcus aureus in ICU. The drug resisitance rate of S. aureus to penicillin, erythromycin and gentamicin were higher than 50.0%. Conclusion The main distribution area of nosocomial infections was the respiratory tract and the gram-negative bacilli were the common pathogens in ICU. It was benefit to avoid presenting of drug resistant strain, and antibiotics should be reasonably used in clinic.

目的 探讨COOK双球囊导管和欣普贝生引产的优劣性。方法 选择住院分娩的孕妇388例,根据引产方式分为两组,研究组应用COOK双球囊导管,对照组应用欣普贝生。根据宫颈Bishop评分,研究组分为研究组1和研究组2,对照组分为对照组1和对照组2,研究组1和对照组1宫颈Bishop评分小于或等于3分,研究组2和对照组2宫颈Bishop评分大于3分而小于或等于6分。分别对各组促宫颈成熟及引产情况、妊娠结局进行比较。结果 各组放置COOK宫颈双球囊或欣普贝生前后,宫颈Bishop评分有差异,低宫颈Bishop评分组欣普贝生效果更好。研究组与对照组比较,阴道分娩和剖宫产病例差异无统计学意义;急产、产后出血、羊水污染病例差异有统计学意义。研究组新生儿窒息率低于对照组,体温>37.5℃发生率高于对照组,差异无统计学意义。结论 对宫颈条件较差者,建议选用欣普贝生诱导宫颈成熟;COOK双球囊导管引产,作用温和,安全性好,成功率高。

Objective To evaluate the advantage of the COOK double balloon catheter and Propess induced labor. Methods We collected 388 cases with pregnant women. The patients were divided into the research and control groups. The research group applied COOK double balloon catheter while the control group applies Propess. According to cervical Bishop rating, the research team was divided into research group 1 and research group 2. The control group was divided into control group 1 and the control group 2. The cervical Bishop score of the research group 1 and control group 1 was less than or equals 3 points. The cervical Bishop score of the research group 2 and the control group 2 was greater than 3 and less than or equal 6 points. We separately compared the pregnancy outcome for each group to promote cervical mature and induced labor situation. Results The cervical Bishop scores have significant difference before and after COOK cervical double balloon and Propess are positioned between two groups.The effect of low cervical Bishop scores group is better than the high cervical Bishop by propess. The rates of urgent production, postpartum hemorrhage and amniotic fluid pollution reduce significant in the research group. The neonatal asphyxia rate, incidence of temperature > 37.5, vaginal delivery cases and cesarean section cases have not significant differences between the research group and the control group. Conclusion We suggest that patients whose cervical condition is poor should choose Propess induced cervical mature; The COOK double balloon catheter induced labor is safe and has a high success rate.

目的 探讨影响自然周期供精人工授精妊娠的因素。方法 回顾性分析2007年4月—2013年4月期间在广东省计划生育专科医院行自然周期供精人工授精的6161个周期,其中妊娠组1454周期,对照组4707个周期。采用单因素分析及多因素Logistic回归分析女方年龄、不孕年限、子宫内膜厚度、类型及冻融复苏后前向运动精子总数与AID妊娠结局的关系。结果 年龄越大,不孕年限越长,妊娠率越低(P＜0.001); A型子宫内膜妊娠率25.94%较AB型的23.87%及B型的21.54%都高(P=0.001);妊娠组冻融复苏后前向运动精子总数均值(28.95±6.86)×10⁶较对照组的(28.26±6.98)×10⁶高(P=0.001);年龄(OR=1.614,P＜0.001)、不孕年限(OR=1.194,P=0.012)、子宫内膜分型(OR=1.258,P=0.001)影响妊娠率。结论 女方年龄、不孕年限、子宫内膜形态及冻融复苏后前向运动精子总数是影响自然周期供精人工授精妊娠的因素。

Objective To explore the parameters affecting the pregnancy rate from 6161 natural cycles of artificial insemination by donor(AID). Methods Consecutive cases of 6161 natural cycles of AID from April,2009 to April 2013 in Guangdong provincial family planning special hospital were analyzed retrospectively.1454 pregnant cycles were defined as observation group and the other 4707 non pregnant cycles were classified as control group.Related factors in effect of pregnancy rate of AID were analyzed by logistic regression analysis. Results The rate of pregnancy decreased with the increase of women ages and the infertility duration(P＜0.001).And the pregnancy rate of ICI among the women with type A endometrium was the highest among the three types of endometrium(25.94%vs23.87%vs21.54%,P=0.001).The sum of the forward moving sperm after freezing and thawing recovery of observation group is higher than control group(28.95±6.86)×10⁶vs (28.26±6.98)×10⁶.The value of OR of age,infertility duration and types of endometrium were 1.614,1.194 and 1.258,respectively. Conclusion Age of women,infertility duration,types of endometrium as well as the sum of the forward moving sperm after freezing and thawing recovery played an important role in pregnancy rate of natural cycles of AID.