目的 分析厄贝沙坦+美托洛尔治疗慢性充血性心力衰竭(congestive heart failure,CHF)的临床效果及对患者心功能影响。方法 选取本院2018年12月—2020年12月住院治疗的200例慢性CHF患者,根据不同的治疗方法分组,参照组100例患者采用厄贝沙坦治疗,治疗组100例患者采用厄贝沙坦+美托洛尔治疗,比较2组临床疗效、心功能指标、血清炎性因子、血清N端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、同型半胱氨酸(homocysteine,Hcy)水平、不良反应发生率。结果 治疗组临床总有效率(97.00%)高于参照组(87.00%),治疗组治疗后左室射血分数(left ventricular ejection fraction,LVEF)高于参照组,治疗组治疗后左室舒张末期内径(left ventricular end diastolic diameter,LVEDd)、左室收缩末期内径(left ventricular end systolic diameter,LVESd)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、NT-proBNP、Hcy水平均低于参照组,差异均具有统计学意义(P＜0.05)。治疗组不良反应发生率(4.00%)与参照组(5.00%)比较,P>0.05。结论 厄贝沙坦+美托洛尔可有效改善慢性CHF患者心功能,减轻炎症反应,抑制NT-proBNP、Hcy释放,且不良反应较少。

Objective To analyze the clinical effect of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure (CHF) and its influence on cardiac function. Methods A total of 200 patients with chronic CHF in our hospital from December 2018 to December 2020 were selected and divided into two groups according to different treatment methods. One handred patients in the control group were treated with irbesartan, and 100 patients in the treatment group were treated with irbesartan + metoprolol. The clinical efficacy, cardiac function indexes, serum inflammatory factors, serum NT-proBNP, Hcy levels and adverse reactions of the two groups were compared. Results The total effective rate of the treatment group (97.00%) was higher than that of the control group (87.00%), LVEF of the treatment group was higher than that of the control group, LVEDd, LVESd, serum TNF-α, hs-CRP, IL-6, NT-proBNP, Hcy levels of the treatment group were lower than those of the control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in the treatment group (4.00%) was higher than that in the control group (5.00%),P>0.05. Conclusion Irbesartan + metoprolol could effectively improve cardiac function, reduce inflammatory reaction, inhibit the release of NT-proBNP and Hcy in patients with chronic CHF, with less adverse reactions.

目的 探讨广州地区儿童2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)感染筛查/疑似病例的流行病学特点、发病特点、可能的原因及防控建议。方法 回顾性分析2020年1月20日—2020年2月29日广州市唯一一家儿童2019-nCoV感染隔离定点医疗单位隔离病房收治住院的符合儿童2019-nCoV感染筛查/疑似病例129例,对其流行病学、发病特点、临床特征、实验室检查及转归、随访等进行总结分析。 结果 男 79例,女 50例,最小1个月,最大13岁,中位数2岁,51例(39.5%)有武汉疫区旅游或居住史,20例(15.5%)有与来自疫区有呼吸道症状人员接触史,17例(13.1%)周边或社区有确诊病例,3例(2.3%)有确诊病人接触史(其中2例为家庭确诊病例密切接触史),38例(29.5%)为临床符合或聚集性发病;临床症状:发热121例(93.8%),咳嗽92例(71.3%),流涕50例(38.8%),32例伴有腹泻、呕吐/腹痛(24.8%),102例(79.0%)白细胞降低或正常,C反应蛋白(C-reactive protein,CRP)＜20 mg/L有103例(79.8%),57例(44.2%)胸片或CT示肺部斑片状影或实变;病原学检查:2019-nCoV实时荧光定量反转录PCR检测结果:所有患儿及陪同家属都有行咽拭子检查,只有21例患儿(16.3%)有行肛拭子检查,仅有1例(0.78%)家庭确诊病例密切接触者肛拭子阳性,但连续多次咽拭子结果阴性,余患者肛拭子和咽拭子及陪同家属咽拭子结果均阴性。其他病原学检查结果61例(47.3%),包括14例RSV阳性,9例流感病毒A,8例人偏肺病毒,6例肠道病毒,6例流感病毒B,6例肺炎支原体,4例副流感病毒1型,1例副流感病毒3型,2例人博卡病毒,3例腺病毒,1例肺炎克雷伯菌,1例人型葡萄球菌,其中1例合并副流感病毒1型及人博卡病毒。跟踪唯一1例确诊患者咽拭子多次检查均阴性,肛拭子持续19天后才转阴,一直无任何症状。其余患者好转出院后第3天、7天及14天进行随访,无异常发现。结论 儿童2019-nCoV感染筛查/疑似病例临床多表现为呼吸道或消化道症状,确诊主要依靠核酸检测,新冠病毒感染确诊率极低,而其将近50%病例能找到除新冠病毒外的其它相关病原体;高危患者为密切接触者,但存在漏诊的可能,肛拭子阳性率或高于咽拭子。

Objective To explore the epidemiological characteristics, onset characteristics, pathogenic mechanism of 2019-nCoV infection in children, and its control and prevention in Guangzhou. Methods From January 20, 2020 to February 29, 2020, a retrospective analysis was carried out on 129 suspected cases of 2019-nCoV infection admitted to the isolation ward of the only medical unit designated for children in Guangzhou. The epidemiology, disease characteristics, clinical characteristics, laboratory examination, outcome and follow-up were summarized and analyzed. Results There were 79 males and 50 females, with a minimum age of 1 month and a maximum age of 13 years. Anong them, 51 cases (39.5%) had a history of tourism or residence in the epidemic area of Wuhan, 20 cases (15.5%) had a history of contact with people with respiratory symptoms from the epidemic area, 17 cases (13.1%) with a confirmed case in the surrounding area or community, 3 cases (2.3%) had a history of contact with a confirmed patient (2 of them were family clustering cases), 38 cases (29.5%) were clinically suspected cases. Clinical symptoms: 121 cases with fever (93.8%), 92 cases with coughing (71.3%), 50 cases with runny nose (38.8%), 32 cases with diarrhea, vomiting or abdominal pain (24.8%). In 102 cases (79.0%), white blood cells were decreased or normal, 103 cases (79.8%) with CRP＜20 mg/L, and 57 cases (44.2%) showed focal infection on chest X-ray or CT scan. Etiological examination: only one case (0.78%) of the family confirmed cases had positive anal swab result, but the throat swab results were negative all the time. The anal swab and throat swab results of other patients and the throat swab results of their accompanying family members were negative. Other pathogens were detected in 61 cases (47.3%), including 14 RSV positive cases, 9 influenza A positive cases, 8 human metapneumovirus positive cases, 6 enterovirus positive cases, 6 influenza B positive cases, 6 Mycoplasma pneumoniae positive cases, 4 parainfluenza virus type 1 positive cases, 1 parainfluenza virus type 3 positive cases, 2 human bocavirus positive cases, 3 adenovirus positive cases, 1 Klebsiella pneumoniae positive cases, 1 Human Staphylococcus positive case, and 1 case with parainfluenza virus type 1 and human bocavirus. The only confirmed patient was followed up while multiple pharyngeal swab results were negative, and the positive anal swab results lasted for 19 days before turning negative and remained asymptomatic. Other patients were followed up on the 3rd, 7th and 14th day after discharge, and no abnormal findings were found. Conclusion Screening/suspected cases of 2019-nCoV infection in children were mostly clinically manifested as respiratory or gastrointestinal symptoms. The diagnosis rate of nucleic acids was extremely low, and there was a possibility of missed diagnosis. Nearly 50% of cases could find other relevant pathogens excluding the 2019-nCoV. The positive rate of anal swab results was higher than that of pharyngeal swab.

目的 本文旨在研究穿心莲内酯对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血清学中的炎症反应因子及肺部功能改变的影响。方法 从我院已出院的患者中挑选2017年6月—2018年6月期间收治的AECOPD患者共80例,其中给予哌拉西林舒巴坦抗感染和雾化吸入布地奈德及复方异丙托溴铵治疗的患者为对照组,对照组的治疗方法基础上给予喜炎平注射液的患者为观察组,各40例。对2组患者接受治疗前后血清学中的基质金属蛋白酶-9 (matrix metalloproteinase-9, MMP-9)、降钙素原 (procalcitonin, PCT)、白介素-6 (interleukin-6, IL-6) 水平和肺功能指标等方面进行比较。结果 2组治疗前血清学MMP-9、PCT、IL-6和肺功能指标第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、用力肺活量(forced vital capacity, FVC)、一秒率(FEV1/FVC)无差异(P＞0.05)。观察组经过治疗后MMP-9为(1995.13±347.281)pg/mL、IL-6为(7.98±3.23)pg/mL,低于对照组的(2159.30±367.477)pg/mL、(10.03±5.45)pg/mL(P＜0.05);观察组治疗后的PCT、FEV1、FVC和FEV1/FVC与对照组相比差异无统计学意义 (P＞0.05)。结论 穿心莲内酯在AECOPD患者中可以减少血清学中炎症因子,值得在临床中推广。

Objective To investigate the effect of andrographolide on levels of serum inflammatory factors and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Eighty patients with AECOPD who were treated in our hospital from June 2017 to June 2018 were selected. Forty patients in the control group were given anti-infection treatment with piperacillin and sulbactam and aerosol inhalation with compound ipratropium bromide and budesonide, while other 40 patients in study group were given andrographolide additionally. The levels of serum matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), interleukin-6 (IL-6) and the pulmonary function indexes of patients in the two groups were observed and compared before and after treatment. Results There were no statistically significant differences in the serum levels of MMP-9, PCT and IL-6 and the pulmonary function indexes forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC of the two groups before treatment (P>0.05). After treatment, in the study group, the MMP-9 and IL-6 levels in serum were (1995.13±347.281)pg/mL and (7.98±3.23)pg/mL respectively, which were significantly lower than that in the control group [(2159.30±367.477) pg/mL and (10.03±5.45) pg/mL (P＜0.05)].Compared with the control group, differences in the PCT, FEV1, FVC and FEV1/FVC in the study group were not statistically significant (P>0.05). Conclusion Andrographolide had significant clinical effect on the treatment of AECOPD, which could reduce the levels of serum inflammatory factors and it is worthy of clinical application.

目的 探讨急性心肌梗死患者细胞色素P450酶基因(cytochrome P450,family 2,subfamily C,polypeptide 19,CYP2C19)多态性与高敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin- 6,IL-6)及临床预后的相关性。方法 选取2019年5月—2020年5月入住我院心血管内科的急性心肌梗死患者182例作为研究对象,研究对象均接受经皮冠脉介入术,采取RT-PCR方法进行外周全血CYP2C19基因多态性的检测,并进行分组。口服阿司匹林300 mg和氯吡格雷300 mg后次日,测定血中hs-CRP和IL-6含量,治疗后12个月内,随访主要心血管不良事件。结果 182例急性心肌梗死患者中,快代谢组(CYP2C19*1/*1)患者最多,为78例(42.8%);中等代谢组(CYP2C19*1/*2、CYP2C19*1/*3),为65例(35.7%);慢代谢型组(CYP2C19*2/*2、CYP2C19*2/*3、CYP2C19*3/*3)最少,为39例(21.5%)。与快代谢组比较,中代谢组及慢代谢组hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05);与中代谢组比较,慢代谢组患者hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05)。CYP2C19基因型与hs-CRP及IL-6呈正相关(r=0.163、0.175,P<0.05)。中代谢组、慢代谢组患者1年内主要心血管不良事件发生率高于快代谢组患者(P<0.05)。结论 CYP2C19基因型与hs-CRP及IL-6具有相关性,CYP2C19基因型为中代谢型和慢代谢型能够激活机体炎症反应,影响急性心肌梗死患者的临床预后。

Objective To explore the correlation of cytochrome P450 gene (CYP2C19) polymorphism with hypersensitive C-reaction protein (hs-CRP), interleukin-6 (IL-6) and prognosis in patients with acute myocardial infarction (AMI). Methods A total of 182 patients with AMI admitted to cardiology department from May 2019 to May 2020 were selected as the research objects, all subjects underwent percutaneous coronary intervention (PCI), and CYP2C19 gene polymorphism in peripheral blood was detected by RT-PCR, which was grouping basis. One day after taking aspirin 300 mg and clopidogrel 300 mg orally, the levels of hs-CRP and IL-6 in patients' plasma were measured. The major adverse cardiovascular events (MACE) were followed up for 12 months after treatment. Results Among 182 patients with AMI, 78 patients (42.8%) were in the fast metabolism group (CYP2C19*1/*1), 65 patients (35.7%) in medium metabolism group (CYP2C19*1/*2, CYP2C19*1/*3), 39 patients (21.5%) in the slow metabolism group (CYP2C19*2/*2, CYP2C19*2/*3, CYP2C19*3/*3).Compared with the fast metabolism group, hs-CRP and IL-6 levels in the medium and slow metabolism group were significantly higher (P<0.05); compared with the medium metabolism group, hs-CRP and IL-6 levels in the slow metabolism group were significantly increased (P<0.05). CYP2C19 genotype was positively correlated with hs-CRP and IL-6 levels (r=0.163, 0.175,P<0.05). The incidences of MACE in the medium and slow metabolism groups were higher than that in the fast metabolism group (P<0.05). Conclusion CYP2C19 genotypes were associated with hs-CRP and IL-6 levels. Medium and slow metabolism types of CYP2C19 gene can activate the inflammatory response and affect the clinical prognosis of patients with AMI.

目的 探讨雾化吸入干扰素-α治疗对儿童疱疹性咽峡炎的治疗效果的影响。方法 本研究纳入2019年1月—2021年1月在清远市妇幼保健院住院治疗的126例疱疹性咽峡炎儿童。所有参与该研究的患儿被随机平均分为2组:对照组(63人)和干预组(63人)。对照组进行常规治疗方案,干预组在对照组基础上雾化吸入干扰素-α治疗。比较2组治疗效果的差异性。结果 干预组患儿平均发热天数(1.86±0.97天)较对照组(2.44±0.89天)低;干预组心肌酶升高比例较对照组低,组间差异有统计学意义(P<0.01)。干预组中显效(50.8%)占主要比例,而对照组中有效(74.6%)占主要比例,并且干预组总有效率(98.4%)高于对照组(96.8%)(P<0.05)。干预组住院天数(5.02±1.85天)较对照组(5.68±1.68天)降低,组间差异有统计学意义(P<0.05)。结论 在常规治疗的基础上加用雾化吸入干扰素-α治疗对提高儿童疱疹性咽峡炎的疗效有促进作用,值得临床推广。

Objective To investigate the effect of nebulized inhalation of interferon-α on the therapeutic effect of herpes angina in children. Methods This study included 126 children with herpetic angina who were hospitalized in Maternal and Child Health Hospital of Qingyuan City from January 2019 to January 2021.All children participating in the study were randomly divided into 2 groups: control group (63 children) and intervention group (63 children). The control group received conventional treatment, and the intervention group was treated with aerosol inhalation of interferon-α on the basis of the control group.The difference of the treatment effect between the two groups were compared. Results The average number of fever days of children in the intervention group (1.86±0.97 days) was lower than that of the control group (2.44±0.89 days); the increase of myocardial enzymes in the intervention group was lower than that of the control group, and the difference was statistically significant (P<0.01). The “obviously effective” (50.8%) in the intervention group accounted for the main proportion, while the “effective” (74.6%) in the control group accounted for the main proportion, and the total effective rate of the intervention group (98.4%) was higher than that of the control group (96.8%,P< 0.05). The length of hospitalization in the intervention group (5.02±1.85 days) was smaller than that of the control group (5.68±1.68 days), and the difference was statistically significant (P<0.05). Conclusion The addition of nebulized interferon-α on the basis of conventional treatment could improve the curative effect of herpetic angina in children, and it is worthy of clinical promotion.

目的 分析疼痛护理对直肠癌癌痛患者不良情绪及爆发性疼痛的影响。方法 选取2020年4月—2020年6月我院收治的68例直肠癌癌痛患者作为研究对象,通过随机分组的方式将患者分为2组,对照组使用常规临床护理模式,观察组使用疼痛护理模式,对比2组患者的癌痛程度、不良情绪及爆发性疼痛的发生率。结果 2组患者在接受不同护理模式后,SF-MPQ评分相较于护理前出现了下降(P＜0.05),其中观察组的评分与对照组比较下降(P＜0.05),但护理前2组比较并无差异(P＞0.05);2组患者在接受不同护理模式后,功能维度评分和总体健康评分相较于护理前出现了上升(P＜0.05),且与对照组比较观察组得分升高(P＜0.05),2组患者在接受不同护理模式后,症状维度评分相较于护理前降低(P＜0.05),且与对照组比较观察组的评分下降(P＜0.05);服药依从率对比结果显示,观察组(94.12%)的依从性优于对照组(61.76%),组间比较有差异(P＜0.05);爆发性疼痛对比结果显示,观察组(8.82%)低于对照组(47.06%),组间比较有差异(P＜0.05)。结论 疼痛护理可以有效应用于直肠癌癌痛患者的护理中,其不仅可以减轻患者的癌痛程度,还有利于调节患者的不良情绪,降低患者的爆发性疼痛发生率,宜广泛应用及推广。

Objective To analyze the influence of pain nursing on the negative mood and explosive pain of patients with rectal cancer pain. Methods A total of 68 patients with colorectal cancer pain in June 2020 were included as research objects, and divided into two groups by randomized grouping.Routine clinical care was applied on the control group, pain nursing was applied on the observation group.The incidence of cancer pain, negative emotions and explosive pain in both groups of patients were compared. Results After applying different care plans, two groups of patients had a significant decrease in the SF-MPQ score (P<0.05), in which the score of the observation group was significantly lower than the control group (P<0.05), however, there were no significant differences before nursing (P>0.05). Two groups of patients were significantly improving in function scoring and the overall health scoring after receiving different care modes (P<0.05), and the observation group was significantly higher than the control group (P<0.05). The symptom dimension scores were significantly lower than before accepting different care modes (P<0.05), and the control group was significantly higher (P<0.05). The comparative results of the medicinal compliance of observation group (94.12%) were better than the control group (61.76%,P<0.05); outbreak pain comparative results showed the observation group (8.82%) was significantly lower than that of the control group (47.06%,P<0.05). Conclusion Pain nursing can be effectively used in the nursing of patients with rectal cancer pain.It can not only reduce the degree of cancer pain, but also help regulate the patient's negative mood and reduce the incidence of explosive pain.It should be widely used and promoted.

目的 探讨超声引导下外周静脉置入中心静脉导管(PICC)老年患者常见并发症的预防与护理措施。方法 回顾性分析本院2019年12月—2021年1月间收治的116例PICC置管老年患者,根据是否实施超声引导下PICC置管并发症专项预防护理(后简称专项护理)将入选患者分配为实施组及对照组各58例,对比2组患者穿刺效果、并发症发生情况,评估2组患者护理前后的心理状态变化情况,调查患者满意度。结果 实施组一次穿刺成功、头端到位率、头端最佳率均高于对照组,平均穿刺次数、操作时间均少于对照组,差异均有统计学意义(P<0.05);实施组各种并发症总发生率为18.97%,对照组为46.55%,2组差异有统计学意义(P<0.05);置管后2组患者焦虑自评量表、抑郁自评量表评分均低于置管前,且实施组均低于对照组,差异均有统计学意义(P<0.05);实施组患者总满意率为96.55%,对照组为77.59%,实施组高于对照组,差异有统计学意义(P<0.05)。结论 专项预防护理措施能够提高老年患者超声引导下外周静脉置入中心导管的穿刺准确性,降低置管相关并发症发生风险,缓解患者心理压力,提高患者满意度。

Objective To explore the preventing and nursing measures of common complications in elderly patients with ultrasound-guided peripherally inserted central catheter (PICC). Methods The data of 116 elderly patients with PICC catheterization in our hospital from December 2019 to January 2021 were retrospectively analyzed.Patients were divided into implementation group and control group (58 cases each) according to whether they received special preventive nursing for complications of ultrasound-guided PICC catheterization (specialized nursing). The catheterization outcomes and complications of the two groups were compared, the changes in the psychological state were evaluated, and satisfaction rate of the patients was investigated. Results The success rate of the first catheterization, the head-end in place, and ideal placement of the head-end in implementation group were higher than those of the control group, the average number of catheterization and operation time were less than those of the control group, and the differences were statistically significant (P<0.05). The total incidence of various complications in the implementation group was 18.97%, while that in the control group was 46.55%, the difference between two groups was statistically significant (P<0.05). The scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale of the two groups after PICC catheterization were lower than those before catheterization, and the implementation group was lower than the control group, the differences were statistically significant (P<0.05). The total satisfaction rate of patients in the implementation group was 96.55%, and that in the control group was 77.59%, which difference was statistically significant (P<0.05). Conclusion Special preventive nursing measures could improve the catheterization accuracy of ultrasound-guided PICC for elderly patients, reduce the risk of catheter-related complications, relieve the psychological pressure of patients, and improve patients’ satisfaction.

目的 探究在胸腰段椎体成形术椎再骨折患者中采用后路椎体次全切治疗的临床疗效,并对其进行探讨与分析。方法 随机选取2019年1月—2021年1月于我院骨科治疗的胸腰段椎体成形术椎再骨折患者58例作为研究对象。给予患者后路椎体次全切治疗,记录患者的手术时间及术中出血量,对比手术前以及手术后6个月患者的VAS疼痛评分、后凸Cobb角、椎体高度、椎管容积率以及美国脊柱损伤协会(ASIA)损伤分级。结果 患者的手术时间为1.4～3.8 h,手术平均时间为(2.45±0.61)h,患者术中出血量为580～1 470 mL,术中平均出血量为(835.48±134.75)mL。手术后6个月患者的VAS疼痛评分低于手术前(P＜0.05);手术后6个月患者的后凸Cobb角小于手术前(P＜0.05);手术后6个月患者的椎体高度和椎管容积率均大于手术前(P＜0.05);患者手术前ASIA损伤分级: A级12例、B级14例、C级16例、D级12例、E级4例;患者手术后6个月ASIA损伤分级:A级5例、B级8例、C级13例、D级15例、E级17例。结论 在胸腰段椎体成形术椎再骨折患者中采用后路椎体次全切治疗可缓解患者的疼痛感,减小后凸Cobb角,增大椎体高度和椎管容积率以及改善患者的ASIA损伤分级。

Objective To investigate the clinical efficacy of posterior subtotal vertebral dissection in patients with vertebral re-fractures of thoracolumbar segmental vertebroplasty. Methods Fifty-eight patients with thoracolumbar segmental vertebroplasty vertebral re-fractures treated in the orthopedic department of our hospital from January 2019 to January 2021 were randomly selected as study subjects.The patients were treated with posterior subtotal vertebral dissection, and the operating time and intraoperative bleeding of the patients were recorded, and the VAS pain score, posterior convex Cobb angle, vertebral body height, spinal canal volume ratio, and American Spinal Injury Association (ASIA) injury classification were compared in patients before and 6 months after surgery. Results The operating time was 1.4-3.8 hours, with a mean of (2.45±0.61) hours, and the intraoperative bleeding was 580-1470 mL, with a mean of (835.48±134.75) mL.The VAS pain scores at 6 months after surgery were lower than those before surgery (P<0.05); the posterior convex Cobb angle at 6 months after surgery was smaller than that before surgery (P<0.05); the vertebral body height and spinal canal volume ratio at 6 months after surgery were greater than those before surgery (P<0.05). Preoperative ASIA injury grading: 12 cases with grade A, 14 cases with grade B, 16 cases with grade C, 12 cases with grade D and 4 cases with grade E; six months after surgery, 5 cases with grade A, 8 cases with grade B, 13 cases with grade C, 15 cases with grade D, and 17 cases with grade E. Conclusion Posterior subtotal vertebral body resection could relieve pain of thoracolumbar vertebroplasty fractures, reduce the posterior convex Cobb angle, increase vertebral body height and spinal canal volume, and improve ASIA injury classification.

目的 分析补阳还五汤加减治疗肾病综合征(NS)的临床疗效。方法 选择本院2019年1月—2021年1月住院治疗的120例NS患者,通过随机数字表法分组,参照组60例患者采纳常规西医治疗,试验组60例患者在参照组基础上予以补阳还五汤治疗,对比2组临床疗效、中医症候积分、肾功能指标、不良反应总发生率。结果 试验组临床总有效率(96.67%)高于参照组(80.00%),试验组治疗后浮肿少尿、腰膝酸软、腹部胀满、头晕乏力积分均低于参照组,差异均有统计学意义(P＜0.05)。治疗后试验组24 h尿蛋白、尿素氮均比参照组低,差异有统计学意义P＜0.05,血肌酐治疗前后差异无统计学意义P>0.05。试验组不良反应总发生率(5.00%)与参照组(6.67%)比较,差异无统计学意义(P>0.05)。结论 补阳还五汤可有效改善NS患者临床症状、肾功能,降低蛋白尿,且不良反应较少,安全性较高,疗效确切。

Objective To analyze the clinical effect of addition or reduction of Buyang Huanwu decoction in the treatment of nephrotic syndrome (NS). Methods A total of 120 NS patients in our hospital from January 2019 to January 2021 were divided into two groups by random digital table method. Sixty patients in the control group were treated by conventional western medicine, 60 patients in the experimental group were treated with Buyang Huanwu decoction on the basis of control group.The clinical efficacy, traditional Chinese medicine syndrome score, renal function index and total incidence of adverse reactions were compared. Results The total clinical effective rate of the experimental group (96.67%) was higher than that of the control group (80.00%). The scores of edema and oliguria, lumbar and knee pain and limpness, abdominal distention and dizziness after treatment in the experimental group were all lower than those in the control group, with statistical significance (P<0.05). After treatment, 24 h urinary protein volume and blood urea nitrogen level in the experimental group were lower than those in the control group, the differences were statistically significant (P<0.05), while there was no statistically significant difference in serum creatinine before and after treatment (P>0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group (5.00%) and the control group (6.67%,P>0.05). Conclusion Buyang Huanwu decoction could effectively improve the clinical symptoms and renal function, reduce proteinuria, and had less adverse reactions, high safety level and accurate curative effect.

目的 探究老年食管鳞癌患者单纯放疗、同步放化疗临床治疗效果。方法 选我院2018年1月—2020年12月期间90例老年食管鳞癌患者为研究对象,依据不同治疗方式将其分为对照组、观察组,各45例,分别接受单纯放疗、同步放化疗治疗,比较2组治疗效果及治疗安全性。结果 观察组治疗总有效率为75.56%,与对照组60.00%相近(P＞0.05);观察组疾病控制率为97.78%,较对照组84.44%高(P＜0.05);观察组放射性肺炎、骨髓抑制发生率为24.44%、77.78%,较对照组6.67%、48.89%高;且观察组放射性肺炎、骨髓抑制、放射性食管炎2级占比分别为17.78%、35.56%、57.78%,均较对照组2.22%、8.89%、24.44%高(P＜0.05)。结论 在老年食管鳞癌患者治疗中,与单纯放疗相比,同步放化疗可提升疾病控制能力,但会增加治疗不良反应,增加不良反应严重程度,因此在临床治疗中,需慎重选择。

Objective To explore the clinical effect of radiotherapy only and concurrent chemoradiotherapy in elderly patients with esophageal squamous cell carcinoma. Methods Ninety cases of elderly patients with esophageal squamous cell carcinoma in our hospital from January 2018 to December 2020 were selected as research objects.According to different treatment methods, they were divided into control group and observation group, 45 cases in each group.They were treated with radiotherapy and concurrent chemoradiotherapy respectively.The treatment effect and safety of the two groups were compared. Results The total effective rate of the observation group was 75.56%, which was close to the control group (60.00%, P>0.05). The disease control rate of the observation group was 97.78%, which was higher than control group (84.44%, P<0.05). The incidence of radiation pneumonia and bone marrow suppression of the observation group were 24.44% and 77.78%, which were higher than that of the control group (6.67%, 48.89%). The proportion of radiation pneumonia, bone marrow suppression, radiation esophagitis grade 2 of the observation group were 17.78%, 35.78% and 57.78% respectively, higher than that of the control group (2.22%, 8.89%, 24.44% respectively, P<0.05). Conclusion Compared with radiotherapy only, concurrent chemoradiotherapy improved the ability of disease control in elderly patients with esophageal squamous cell carcinoma, but it increased the adverse reactions and aggravated the severity of adverse reactions.Therefore, it is necessary to make a careful choice in clinical treatment.