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目的 探讨全程健康管理对糖尿病患者的血糖控制应用效果分析。方法 选择在我院门诊接受治疗的200例糖尿病患者作为研究对象,采用随机数表法分为对照组和观察组,各100例。对照组采用常规健康教育对患者进行健康指导,观察组在对照组基础上对患者行全程健康管理干预,建立糖尿病健康教育小组,对患者进行个体化的健康指导。比较2组患者干预后心理评估及空腹血糖、餐后2 h血糖的变化情况。结果 观察组患者予全程健康教育指导后,GAD-7焦虑量表及PHQ-9抑郁量表测试结果、空腹血糖及餐后2 h血糖控制效果优于对照组(P<0.05)。结论 行全程健康管理干预可有效改善糖尿病患者焦虑抑郁情绪,有效改善空腹血糖、餐后2 h血糖,增强患者自我保健意识。
Objective To explore the effect of whole process health management on blood glucose control in patients with diabetes.Methods A total of 200 patients with diabetes who were treated in the outpatient department of our hospital were studied and divided into control group and observation group,with 100 cases respectively.The patients in control group were given routine health guidance.The patients in observation group underwent whole-process health management intervention on the basis of control group,the diabetes health education group was established and individualized health coaching was given.Psychological assessment and fasting blood glucose and 2-hour postprandial blood glucose changes in the 2 groups of patients after the intervention were compared.Results After receiving whole course health education and guidance,the score GAD-7 anxity scale,PHQ-9 depression scale,pre-prandial blood glucose and 2 h postprandial blood glucose in observation group were better than those of control group(P<0.05).Conclusions The whole process of health management intervention can improve anxiety and depression of diabetes patients,lower blood glucose levels before meals and 2 h after meals,enhance patients’ self-awareness.
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目的 了解门诊老年患者补充与替代医学(CAM)使用现状及影响因素。方法 采用便利抽样法,选取2020年11月—2021年2月广东省某三甲医院老年科门诊就诊的老年患者作为研究对象,调查方法采用一般资料调查表和CAM使用情况调查表进行横断面调查。应用二元Logistics回归分析探讨门诊老年患者使用CAM的影响因素。结果 参与调查的123例老年患者中,有75例(61.0%)老年患者使用CAM,使用CAM的项目主要为中草药、药膳等中国传统医学项目。支付方式是门诊老年患者是否使用CAM的影响因素,使用医保支付的患者较公费、自费患者更愿意使用CAM(OR=5.054,95%CI:1.452~17.590,P<0.05)。结论 CAM在门诊应用广泛,我们应充分发挥我国传统医学优势,为老年人疾病防治提供更多的思路。政府层面也可进一步提高医保覆盖范围,让更多的患者有经济能力可以接受安全、有效的治疗。
Objective To investigate the current status of complementary and alternative medicine(CAM)use and the influencing factors of elderly patients in outpatient clinic.Methods Using the convenience sampling method,the elderly patients treated in the geriatric outpatient department of a Class A tertiary Hospital in Guangdong from November 2020 to February 2021 were selected.General data and the CAM usage questionnaire were collected.Binary logistics regression analysis was used to explore the factors influencing CAM use in elderly patients.Results Seventy-five(61.0%)of 123 elderly patients used CAM.Chinese herbal medicine and medicinal diet were the most common CAM.Payment method was a factor affecting whether elderly outpatient patients use CAM.Insured patients were more willing to use CAM than self-funded patients(OR=5.054,95%CI:1.452-17.590,P<0.05).Conclusions CAM is widely used in outpatient clinics.We should make full use of our country’s traditional medicine,to provide different thoughts of diseases prevention and treatment in elderly patients.The government can also further enlarge the coverage of health insurance,so that more patients can afford safe and effective treatment.
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目的 探讨血清脂联素(ADPN)、糖类抗原125(CA125)及抗苗勒管激素(AMH)水平检测在多囊卵巢综合征(PCOS)中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数(BMI)是否大于28 kg/m2分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义(P<0.05)。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关(P<0.05),ADPN与AMH无关(P>0.05)。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。
Objective To explore the clinical diagnostic value of serum adiponectin(ADPN),carbohydrate antigen 125(CA125)and anti-Mullerian hormone(AMH)levels in polycystic ovary syndrome(PCOS).Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects.All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group.The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index(BMI)whether was greater than 28 kg/m2.A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL.A hundred healthy women of similar age were selected as the healthy control group.The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed.Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group(P<0.05).Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level.There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH.Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased.The three indicators have good diagnostic value in PCOS and are worth promoting.
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目的 探讨鳞状上皮细胞抗原(SCCA)、人乳头瘤病毒(HPV)-DNA联合阴道镜检查在宫颈鳞状细胞癌(SCC)筛查中的应用价值。方法 选择2019年1月1日—2021年12月31日在中山市博爱医院就诊并确诊为SCC的妇女作为研究对象,共纳入100例SCC患者(SCC组),同时选择200例经活检确诊为宫颈慢性炎症的患者(宫颈慢性炎症组)作为阴性对照。采用阴道镜观察研究对象的宫颈情况,并采集研究对象的宫颈组织标本进行HPV-DNA检测。采集研究对象的静脉血,采用化学发光免疫法测定研究对象SCCA的水平。以病理检查结果为金标准,分别对HPV-DNA检测、外周血SCCA两者联用以及阴道镜、HPV-DNA检测、外周血SCCA三者联用进行筛查效果的评价。结果 SCC组研究对象的年龄≥40岁者、出血者、性生活开始年龄≤20岁者比例均高于宫颈慢性炎症患者组;而宫颈慢性炎症患者组疼痛的比例高于SCC患者组,差异均有统计学意义(P<0.01)。χ2检验结果显示,SCC组研究对象的SCCA阳性率高于宫颈慢性炎症组(P<0.001)。阴道镜结合SCCA、HPV-DNA检测筛查SCC的灵敏度和特异度均高于单独使用SCCA和HPV-DNA,并取得较好的约登系数(75%)和Kappa值(0.730)。结论 采用阴道镜结合HPV-DNA、SCCA可有效提高SCC疾病的约登系数与Kappa值,其联合诊断的效能高于单独使用阴道镜、HPV-DNA或SCCA诊断SCC。
Objective To study the application value of squamus cell carcinoma antigen(SCCA)and human papillomavirus(HPV)-DNA combined with colposcope in cervical squamous cell carcinoma(SCC)screening.Methods Women diagnosed with SCC who visited Boai Hospital of Zhongshan city from January 1,2019 to December 31,2021 were selected as research subjects,including 100 patients with SCC(SCC group)and 200 patients with chronic cervical inflammation confirmed by biopsy(chronic cervical inflammation group).The cervix of the subjects was observed by colposcope,and cervical tissue samples were collected for HPV-DNA testing.Venous blood of subjects was collected and SCCA levels were determined by chemiluminescence immunoassay.Using pathological examination results as the gold standard,the screening effect of combination HPV-DNA test and peripheral blood SCCA test,combination colposcope,HPV-DNA test and peripheral blood SCCA were evaluated respectively.Results In SCC group,the proportion of age≥40 years old,bleeding,sexual life age ≤20 years old were higher than those in chronic cervical inflammation group,but chronic cervical inflammation group had higher rate of pain than those in SCC group(P<0.01)by Chi-square test.SCCA positive rate in SCC group was higher than that in chronic cervical inflammation group(P<0.001)by Chi-square test.The sensitivity and specificity of colposcope combined with SCCA and HPV-DNA were higher than those of SCCA and HPV-DNA alone,and better Youden’s coefficient(75%)and Kappa value(0.730)were obtained.Conclusions Colposcope combined with HPV-DNA and SCCA can effectively improve the Youden’s coefficient and Kappa value of SCC disease,and its combined diagnosis efficiency was higher than that of colposcope,HPV-DNA and SCCA alone in the diagnosis of SCC,which has high clinical promotion significance.
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目的 分析后循环脑梗死(PCCI)患者椎基底动脉狭窄和血清生化指标的相关性。方法 对100例PCCI患者的临床资料进行回顾性分析,依照椎基底动脉狭窄程度将患者分为不稳定斑块组(n=35)、稳定斑块组(n=36)和无斑块组(n=29)。对比3组患者临床一般情况,血清神经细胞因子水平,血清炎症因子水平,并分析PCCI患者椎基底动脉狭窄和血清生化指标的相关性。结果 3组患者再次发病情况与NIHSS评分对比差异有统计学意义,不稳定斑块组高于其他2组(P<0.05),但稳定斑块组与无斑块组比较差异无统计学意义(P>0.05);3组患者脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)水平对比差异有统计学意义,不稳定斑块组BDNF低于稳定斑块组与无斑块组,不稳定斑块组NSE、S100β高于稳定斑块组与无斑块组(P<0.05),但稳定斑块组与无斑块组对比无差异(P>0.05);3组患者血清C反应蛋白(CRP)、白细胞介素-37(IL-37)、肿瘤坏死因子(TNF-α)、血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)、人软骨糖蛋白40(YKL-40)水平对比有差异,不稳定斑块组高于其它2组(P<0.05),但稳定斑块组与无斑块组比较差异无统计学意义(P>0.05);Pearson直线相关分析显示,椎基底动脉狭窄与BDNF呈负相关,与NSE、S100β、CRP、IL-37、TNF-α、VCAM-1、ICAM-1、YKL-40呈正相关(P<0.05);多因素 Logistic 回归分析结果显示,BDNF、NSE、ICAM-1、YKL-40是椎基底动脉狭窄的独立危险因素(P<0.05)。结论 PCCI患者椎基底动脉狭窄程度越严重,再次发病率越高,对患者的神经功能影响越严重。同时血清相关神经细胞因子水平和炎症因子水平与椎基底动脉狭窄严重程度具有明显相关性,其中BDNF、NSE、ICAM-1、YKL-40可作为PCCI患者椎基底动脉狭窄预测的重要指标,因此临床上可以通过监测患者的血清相关生化指标为临床诊断及预后判断提供参考依据。
Objective To investigate the correlation between vertebrobasilar artery stenosis and serum biochemical indexes in patients with posterior circulation cerebral infarction(PCCI).Methods One hundred patients with PCCI admitted to our hospital were selected as the study objects,and the clinical data of all patients were retrospectively analyzed.The patients were divided into unstable plaque group(n=35),stable plaque group(n=36)and no plaque group(n=29)according to the degree of vertebrobasilar artery stenosis.The general clinical conditions,serum levels of neurocytokines and inflammatory factors of the patients were compared,the correlation between vertebrobasilar artery stenosis and serum biochemical indicators in patients with PCCI was analyzed.Results The recurrence and NIHSS score of the 3 groups were significantly different,the unstable plaque group was significantly higher than the other 2 groups(P<0.05),but there was no significant difference between the stable plaque group and the no plaque group(P>0.05).The levels of brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE)and central nerve specific protein(S100β)in the three groups were significantly different.BDNF in unstable plaque group was lower than that in stable plaque group and no plaque group,while NSE and S100β in unstable plaque group were higher than that in stable plaque group and no plaque group(P<0.05).There was no significant difference between stable plaque group and no plaque group(P>0.05).The levels of serum C-reactive protein(CRP),interleukin-37(IL-37),tumor necrosis factor-α(TNF-α),vascular cell adhesion molecule-1(VCAM-1),intercellular adhesion molecule-1(ICAM-1)and human cartilage glycoprotein 40(YKL-40)in 3 groups were significantly different.The unstable plaque group was higher than the other two groups(P<0.05),but there was no significant difference between the stable plaque group and the no plaque group(P>0.05).Pearson Line correlation analysis showed that vertebrobasilar artery stenosis was negatively correlated with BDNF,and positively correlated with NSE,S100β,CRP,IL-37,TNF-α,VCAM-1,ICAM-1,YKL-40(P<0.05).Multivariate Logistic regression analysis showed that BDNF,NSE,ICAM-1 and YKL-40 were independent risk factors for vertebrobasilar artery stenosis(P<0.05).Conclusions The more severe degree of vertebrobasilar artery stenosis in patients with PCCI,the higher recurrence rate and more serious the impact on the neurological function of patients.At the same time,the levels of serum related neurocytokines and inflammatory factors were significantly related to the severity of vertebrobasilar artery stenosis.BDNF,NSE,ICAM-1 and YKL-40 can be used as important indicators to predict the severity of vertebrobasilar artery stenosis in patients with PCCI.Therefore,monitoring the patient’s serum biochemical indicators of angiography can provide reference for clinical diagnosis and prognosis judgment.
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目的 应用锥形束CT比较改良颈肩体热塑膜和传统颈肩体热塑膜体位固定装置在颈胸段食管癌患者放射治疗中的摆位差异,分析两种固定方式对锁骨上下区摆位误差的影响。方法 分析2021年6月—2022年10月在南京医科大学第一附属医院行放射治疗的29例食管癌患者的临床资料。将患者分为改良颈肩体热塑膜组(改良组)和光板颈肩体热塑膜组(对照组),对比分析2组病例不同配准区域的摆位误差。结果 改良组在X(左右)方向的平移误差及Rz(冠状面)方向的旋转误差小于对照组,差异有统计学意义(P<0.05)。改良组锁骨上下区在X(左右)方向的平移误差以及Rx(矢状面)方向的旋转误差小于对照组,差异有统计学意义(P<0.05)。改良组的整体靶区外放范围在X、Y方向上均小于颈肩体组,改良组在锁骨上下区的X方向靶区外放范围也更小。结论 对于颈胸段食管癌需行锁骨上下区放疗的患者,应用改良颈肩体热塑膜可减少平移误差,控制旋转角度,减少靶区外放范围。
Objective To compare the set-up errors between the modified neck-shoulder body thermoplastic film and the traditional neck-shoulder body thermoplastic film fixation device in the radiotherapy of patients with cervical and thoracic esophageal cancer by cone beam CT,and to analyze the influence of the two fixation methods on the positioning error of the upper and lower clavicular region.Methods The clinical data of 29 patients with esophageal cancer who underwent radiotherapy in the First Affiliated Hospital of Nanjing Medical University from June 2021 to October 2022 were analyzed.The patients were divided into two groups:the modified neck-shoulder body thermoplastic film group(the modified group)and the smooth neck-shoulder body thermoplastic film group(the control group),the positioning errors in different regions of the two groups were compared and analyzed.Results The translation error in the X(left and right)direction and the rotation error in the Rz(coronal plane)direction of the modified group were smaller than those of the control group,and the differences were statistically significant(P<0.05).The translation error in the X(left and right)direction and the rotation error in the Rx(sagittal plane)direction of the superior and inferior clavicular region in the modified group were smaller than those in the control group,and the differencs were statistically significant(P<0.05).The overall target area of the modified group was smaller in X and Y directions than that of the neck-shoulder body group,and the target area of the improved group in X direction was also smaller in the upper and lower clavicle area.Conclusions For patients with cervical and thoracic esophageal cancer who need radiotherapy in the upper and lower clavicular region,the application of modified neck shoulder body thermoplastic film can reduce the translation error,control the rotation angle and reduce the external radiation range of the target region.
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目的 探讨腹主动脉瘤腔内修复术后瘤体直径和瘤体体积的转归以及与术后内漏的关系。方法 回顾性分析2015年—2020年在我院行腹主动脉瘤腔内修复术的83例患者的临床及影像学资料。测量术前和术后各随访时间点瘤体最大直径及体积。CT评价术后内漏发生情况。定义瘤体(直径/体积)扩张/回缩及瘤体(直径/体积)稳定。以术前瘤体最大直径大小和术后内漏发生情况将患者分组,比较组间各随访时点的瘤体直径和体积转归情况。结果 患者术后平均随访时间24(10~62)个月。以瘤体直径<50 mm及≥50 mm分组,术后各随访时间点2组间瘤体体积及瘤体直径比较均无统计学差异。以术后有无内漏分组,术后各随访时间点组间比较瘤体体积变化比较差异均有统计学意义(P<0.05),但瘤体直径变化组间比较差异均无统计学意义。结论 主动脉瘤瘤体体积与直径变化并不存在一致性,监测瘤体体积可以发现那些直径变化不明显的瘤体变化;腹主动脉瘤腔内修复术后内漏可能是导致瘤体增大的因素之一。
Objective To evaluate the outcome of aneurysm diameter and volume,and the role of endoleak after endovascular aneurysm repair of abdominal aortic aneurysm.Methods The clinical and imaging data from 83 patients who underwent endovascular repair of abdominal aortic aneurysm in our hospital from 2015 to 2020 were retrospectively analyzed.The maximum aneurysm diameter and volume were measured at the preoperative and postoperative follow-up time points.CT was used to evaluate the incidence of postoperative leakage.The aneurysm(diameter/volume)expansion/shrinkage and aneurysm(diameter/volume)stability were defined.Patients were divided into different groups according to the maximum preoperative aneurysm diameter and the incidence of postoperative endoleak,and the outcomes of aneurysm diameter and volume were compared at established follow-up points.Results The mean follow-up time was 24(10-62)months.There were no statistically significant differences in postoperative aneurysm volume and diameter at follow-up points between the patients with aneurysm diameter <50 mm and patients with aneurysm≥50 mm.There were statistically significant differences in postoperative aneurysm volume between the patients with postoperative endoleak and patients without postoperative endoleak(P<0.05).However,there were no statistically significant differences in postoperative diameter between the two groups.Conclusions The changes of aneurysm volume and diameter were not closely related,and the detection of aneurysm volume can help to find the aneurysm changes with no obvious diameter changes.The postoperative endoleak after endovascular aneurysm repair may be one of the factors leading to aneurysm enlargement.
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目的 评估全身免疫炎症指数(SII)、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在区分急性缺血性卒中(AIS)伴发卵圆孔未闭(PFO)与非伴发PFO患者的价值。方法 回顾性分析100例AIS患者的血液和血清指标,计算SII、NLR和PLR,使用Logistic回归及受试者操作特征(ROC)曲线分析3项指标在鉴别AIS伴发PFO与非伴发PFO中的价值。结果 伴发PFO的AIS患者SII、NLR、PLR高于非伴发PFO的AIS患者,其中以SII最为明显(P均<0.05)。单因素Logistic回归显示,中性粒细胞计数、淋巴细胞计数、PLR、NLR、SII与AIS伴发PFO有关(P<0.05)。ROC曲线分析结果,SII、NLR、PLR鉴别AIS伴PFO与非伴PFO患者,最佳阈值分别为476.4、1.99、115.3,曲线下面积分别为0.777、0.767、0.708。结论 SII、NLR和PLR可作为鉴别AIS患者是否伴发PFO的生物标志物,具有潜在临床应用价值。
Objective To evaluate the value of systemic immune-inflammatory index(SII),neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in distinguishing acute ischemic stroke(AIS)patients with patent foramen ovale(PFO)and without PFO.Methods A retrospective analysis of blood and serum indicators in 100 AIS patients was conducted,and SII,NLR and PLR indices were calculated.Logistic regression and ROC curve analyses were performed.Results SII,NLR and PLR were significantly higher in PFO patients than in non-PFO patients,with SII being the most significant.Univariate logistic regression showed that Neu,Lym,PLR,NLR,and SII variables were significantly associated with AIS combined with PFO(P<0.05).ROC curve analysis revealed that the optimal cut-off values for SII,NLR and PLR in distinguishing AIS patients with PFO from those without PFO were 476.4,1.99 and 115.3,respectively,with area under the curve of 0.777,0.767 and 0.708.Conclusions SII,NLR and PLR can serve as biomarkers for identifying AIS patients with PFO,offering potential clinical application value.
论著
目的 丹酚酸B是传统中药丹参的重要生物活性组分,临床应用广泛。新近发现,丹酚酸B具有防治骨质疏松的作用。本研究拟在前期工作基础上,系统地研究丹酚酸B对去卵巢骨质疏松小鼠的作用,探讨其对小鼠间充质干细胞(MSCs)成骨分化的影响。方法 将18只8周龄SPF级别的C57雌性小鼠分为假手术组、骨质疏松组、丹酚酸B治疗组。骨质疏松组和丹酚酸B治疗组行双侧卵巢摘除术。而假手术组则保持正常的卵巢结构,同时去除局部的脂肪。3组均于术后3日内给予抗生素进行抗感染治疗。4周内,丹酚酸B治疗组给予丹酚酸B 2.5 mg/kg腹腔注射,连续12周,2天1次,其余2组在相同的时间内给予等量生理盐水。16周后,在麻醉状态下将所有小鼠处死。应用MicroCT测量了小鼠右后股骨的骨密度。采用qRT-PCR技术,分析小鼠左后股骨骨髓MSCs中Runx2和Osterix的表达。将小鼠右后股骨进行液氮研磨处理,提取蛋白质,用WB法测定OPG和RANKL的含量。结果 骨质疏松组小鼠股骨骨密度比假手术组低(P<0.05),丹酚酸B治疗组小鼠股骨骨密度比骨质疏松组高,但差异无显著性意义(P<0.05)。骨质疏松组小鼠Runx2和Osterix水平低于假手术组(P<0.05),丹酚酸B治疗组小鼠Runx2和Osterix水平比骨质疏松组高(P<0.05)。骨质疏松组小鼠OPG和RANKL蛋白水平低于假手术组(P<0.05),丹酚酸B组小鼠OPG和RANKL蛋白水平比骨质疏松组高(P<0.05)。结论 绝经后骨质疏松症早期对小鼠的骨质疏松具有一定的影响,但还需要更多的实验来验证本研究的结论。
Objective Salvianolic acid B is an important bioactive component of traditional Chinese medicine Salvia miltiorrhiza and is widely used in clinic.Recently,salvianolic acid B has been found to have the effect of preventing osteoporosis.On the basis of previous work,this study intends to systematically explore the effect of salvianolic acid B on ovariectomized mice with osteoporosis,and its effect on the osteogenic differentiation of mouse mesenchymal stem cells(MSCs).Methods Eighteen eight-week-old SPF C57 female mice were divided into sham operation group,osteoporosis group and salvianolic acid B treatment group(6 mice in each group).The osteoporosis group and salvianolic acid B group underwent bilateral ovariectomy.The sham group maintained normal ovarian structure while removing local fat tissue.All three groups were given antibiotics for anti-infection treatment within 3 days after operation.Within 4 weeks,salvianolic acid B treatment group was given salvianolic acid B 2.5 mg/kg intraperitoneal injection for 12 weeks,once every 2 days,and the other 2 groups were given the same amount of saline at the same time.After 16 weeks,all mice were sacrificed under anesthesia.The bone density of the mouse right posterior femur was measured by MicroCT.The expressions of Runx2 and Osterix in the bone marrow of mouse left posterior femur were analyzed by qRT-PCR.The right posterior femur of mice was ground with liquid nitrogen to extract protein,and the contents of OPG and RANKL were determined by WB.Results The bone mineral density of the femur in the osteoporosis group was lower than that in the sham operation group(P<0.05),and the bone mineral density of the femur in the salvianolic acid B treatment group was higher than that in the osteoporosis group,but the difference was not significant(P<0.05).The levels of Runx2 and Osterix in the osteoporosis group were significantly lower than those in the sham operation group(P<0.05),and the levels of Runx2 and Osterix in the salvianolic acid B treatment group were higher than those in the osteoporosis group(P<0.05).The levels of OPG and RANKL protein in the osteoporosis group were significantly lower than those in the sham operation group(P<0.05),while the levels of OPG and RANKL protein in the salvianolic acid B group were higher than those in the osteoporosis group(P<0.05).Conclusions The early stage of postmenopausal osteoporosis has certain effects on osteoporosis in mice,but more experiments are needed to verify the conclusions of this study.
论著
目的 比较采用一次性使用电子宫腔镜与可重复使用宫腔镜用于门诊宫腔镜检查的有效性与安全性。方法 采用平行随机对照的方法,在3间临床试验研究机构同时进行,一次性使用电子宫腔镜用于宫腔镜检查者82例为试验组,Storz Bettochi检查镜进行检查者82例为对照组。记录2组患者宫腔影像的临床诊断符合率、操作性能评分、不良事件发生率。结果 试验组临床诊断要求符合率98.8%(80/82),对照组临床诊断要求符合率100%(82/82);试验组与对照组宫腔影像的临床诊断要求符合率的差值为-1.22%,试验组和对照组符合率差值的95%可信区间下限为-3.60%,大于非劣效界值-10.00%。试验组与对照组之间的操作性能评分比较差异无统计学意义(P>0.05)。试验组不良事件发生率11.0%(9例,9件),严重不良事件发生率1.2%(1例,1件);对照组中不良事件发生率9.8%(8例,9件),严重不良事件发生率0%(0例,0件);不良事件发生率和严重不良事件发生率的组间比较差异均无统计学意义(P>0.05)。结论 一次性使用电子宫腔镜用于提供患者子宫内图像,整体性能与可重复使用的电子宫腔镜相当,并且安全性好。试验用一次性使用电子宫腔镜的使用性能可满足临床宫腔镜手术的需求,可作为宫腔镜技术的补充手段。
Objective To compare the efficacy and safety of single-use digital hysteroscope and reusable hysteroscope for outpatient hysteroscopy.Methods A parallel randomized control method was used in three clinical trials institutions.Eighty-two cases of outpatient patients who used single-use digital hysteroscope for hysteroscopy were included in experimental group,and 82 cases who underwent hysteroscopy by reusable hysteroscope(Storz Bettochi)were included in control group.The clinical diagnosis coincidence rate,performance score and incidence of adverse events of uterine imaging were recorded in the two groups.Results The coincidence rate of clinical diagnosis in the experimental group was 98.8%(80/82),1.22% lower than the 100%(82/82)in control group.And the difference of lower limit of 95% confidence interval between the experimental group and the control group was-3.60%,which was greater than the non-inferiority margin-10.00%.There was no significant difference in performance scores between the experimental group and the control group(P>0.05).The incidence of adverse events in the experimental group was 11.0%(9 cases,9 events),and serious adverse events incidence was 1.2%(1 case,1 event).In the control group,the incidence of adverse events was 9.8%(8 cases,9 events),and no serious adverse events occurred(0 cases,0 events).There was no significant difference in the incidence of adverse events or serious adverse events between two groups.Conclusions The overall performance of single-use digital hysteroscope for providing intrauterine images,observation and diagnosis is comparable to that of reusable hysteroscope,and the safety is also comparable.The performance of the single-use digital hysteroscope can meet the needs of outpatient hysteroscopy,and it can be an effective supplementary hysteroscopy technology.