论著
目的 了解农民工对入职体检结果异常的遵医行为状况及影响因素,为临床治疗、护理和健康教育提供相应的依据。方法 对106例在我院行入职体检且结果异常的农民工进行遵医行为的问卷调查,且对影响因素进行分析。结果 遵医行为好的有20例,一般的有38例,差的有48例;年龄、性别、文化程度、职业类型、疾病种类、经济收入对农民工的遵医行为均有影响(P<0.01)。结论 农民工对入职体检结果异常的遵医行为不容乐观,建议国家或相关省市出台相关政策和法规,为农民工提供相应的健康保障;医疗机构要加大健康教育力度,提高农民工的健康意识和倡导健康行为,降低慢性病的发病率。
Objective To investigate migrant workers' medical compliance after receiving abnormal entry health examination results and relevant factors affecting compliance behavior, providing evidence to clinical treatment, nursing and health education. Methods 106 migrant workers who took part in entry health examination in our hospital and got abnormal results were accepted questionnaires and the relative factors were analyzed. Results 20 migrant workers had good compliance behavior, and 38 workers performed normally while 48 workers did bad. Age, gender, education, type of occupation, type of illness, and income all had influence on compliance behavior (P<0.01). Conclusion The recent condition of migrant workers' medical compliance on abnormal entry health examination results is not good. Therefore the country or province departments should carry out relative laws or policies, providing migrant workers with health support; Medical institutions should promote health education to improve migrant workers' health awareness and health behavior and reduce incidence of chronic diseases.
论著
目的 应用Synapsys人体姿势平衡系统对早期帕金森病(Parkinson's disease, PD)患者姿势障碍定量测试评价效果分析。方法 收集我院神经内科2015年7月-2016年7月收治的早期PD患者52例,随机分为试验组和对照组,每组26例。两组患者均给予常规治疗措施,试验组在常规治疗基础上给予康复治疗措施,最后两组均使用Synapsys人体姿势平衡系统和Berg平衡量表对患者进行评估和训练,观察测试结果。结果 干预前动态和静态异常比例组间差异无统计学意义(P>0.05);干预后试验组动态和静态异常分别为34.62%、30.77%,低于对照组的69.23%、73.08%,差异有统计学意义(P<0.05);干预前Berg平衡量表评分组间差异无统计学意义(P>0.05),干预后试验组评分高于对照组,差异有统计学意义(P<0.05);干预后两组Berg平衡量表评分均升高,其中试验组干预前后比较差异有统计学意义(P<0.05)。结论 应用Synapsys人体姿势平衡系统对早期PD患者姿势障碍准确定量测试,以评价康复效果,并且对于康复治疗具有重要作用。
Objective To analyze the clinical effects of quantitative test on early Parkinson's patients who suffering in postural disorders by using synapsys posturography system (SPS). Methods 52 cases of early Parkinson's patients who treated in our department of neurology from July 2015 to July 2016 were collected and divided into experimental and control groups randomly, 26 cases in each group. During the treatment, cases in experimental group and control group received the same conventional treatments. Meanwhile, on the base of conventional treatments, the cases in experimental group also received recovery therapy. Finally, the clinical effects of different treatments in two groups were evaluated by using SPS and Berg balance scale (BBS). Results Before intervention, the dynamic and static abnormal proportion between two groups had no significant difference (P>0.05); However, after the intervention, dynamic and static abnormal proportion in experimental group were 34.62%、30.77%, respectively, which was lower than those in control group (Dynamic: 69.23%; Static:73.08%), and the difference was significant (P<0.05); In addition, the result of BBS showed there was no difference between the experimental group and control group before intervention (P>0.05), while the scores of BBS in experimental group was higher than that in control group after intervention, and the difference was significant (P<0.05); At the same time, the scores of BBS in each group were both increased after the intervention, especially in the experimental group, and the difference in experimental group was significant (P<0.05). Conclusion The quantitative test on early Parkinson's patients who suffering in postural disorders can perform accurately by using synapsys posturography system. And the synapsys posturography system can also evaluate the recovery effects, which is important for the recovery treatment.
论著
目的 探讨醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效。方法 选取我院2014年6月—2016年6月收治的76例脓毒症相关性脑病患者作为研究对象,按照随机数字表法将其分成两组,每组38例。观察组给予醒脑静联合连续肾脏替代疗法治疗,对照组给予连续肾脏替代疗法治疗,比较两组患者的临床疗效,治疗前后格拉斯哥昏迷(Glasgow coma scale,GCS)评分、神经元特异性烯醇化酶(neuron-specifie enolase,NSE)含量、C-反应蛋白(C-reactive protein,CRP)含量及治疗后退热时间、恢复意识时间的长短。结果 观察组总有效率为89.47%,相对于对照组明显上升(P<0.05);观察组治疗后GCS评分较对照组明显升高,NSE含量、CRP含量较对照组明显降低,差异均有统计学意义(P<0.01);观察组治疗后的退热时间、恢复意识时间较对照组明显降低(P<0.01)。结论 醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效显著,可有效缩短退热及恢复意识时间,降低患者痛苦,值得临床推广应用。
Objective To investigate the curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy. Methods 76 cases of sepsis associated encephalopathy in our hospital from June 2014 to June 2016 were selected as the research objects, and they were divided into two groups according to the random number table method, 38 cases in each group. The observation group were treated with Xingnaojing combined with continuous renal replacement therapy. The control group was given continuous renal replacement therapy. The clinical efficacy of two groups were compared before and after treatment about the Glasgow coma (Glasgow coma scale, GCS) score, neuron specific enolase (neuron-specifie enolase, NSE) content, C- reactive protein (C-reactive protein, CRP)content, and the length of the consciousness recovery time and pyretolysis time. Results In the observation group, the total effective rate was 89.47%. Compared with the control group. it increased significantly (P<0.05); After treatment the GCS score in the observation group was significantly higher than the control group, the content of NSE and CRP were significantly lower than the control group, the differences were statistically significant (P<0.01); In the observation group, after treatment the pyretolysis time, consciousness recovery time was significantly lower than the control group(P<0.01). Conclusion The curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy is significant and may effectively shorten the pyretolysis and the recovery of consciousness time, which is worthy of clinical application.
论著
目的 探讨多维铁口服液联合维生素AD滴剂治疗婴幼儿缺铁性贫血的疗效。方法 将首次诊断缺铁性贫血的336例婴幼儿依家长意愿分为2个治疗组(A组和B组)与1个对照组,A组予多维铁口服液联合维生素AD滴剂治疗,B组予多维铁口服液联合维生素D滴剂治疗,对照组饮食调理并补充维生素AD,于治疗4周后(3天内)采末梢血行血细胞分析,比较三组患儿贫血治疗显效率、总有效率差异。结果 治疗4周后,A组显效率为71.70%,总有效率为97.17%;B组显效率为41.05%,总有效率为90.30%;对照组显效率为6.25%,总有效率为32.29%。A组贫血治疗显效率、总有效率高于B组和对照组,差异均有统计学意义(P<0.05)。结论 铁剂联合维生素A制剂可显著提高婴幼儿缺铁性贫血的治疗效果。
Objective To observe the curative effect of multivitamin iron oral solution combined with vitamin AD drops on the treatment of iron deficiency anemia in infants. Methods 336 cases of infants who was found with iron deficiency anemia for the first time were divided into two treatment groups (group A and group B) and one control group in accordance with their parents' will. Group A was treated with multivitamin iron oral solution combined with vitamin AD drops. Group B was treated with multivitamin iron oral solution combined with vitamin D drops. The control group was taken just dietary therapy combined with vitamin AD drops. All subjects were tested blood analysis after 4 weeks of treatment (within 3 days). The differences of the treatment excellence rates and the total effective rates were compared in the three groups. Results After 4 weeks of treatment, the excellence rate in group A was 71.70%. The total effective rate in group A was 97.17%. The excellence rate in group B was 41.05%. The total effective rate in group B was 90.30%. The excellence rate in control group was 6.25%. The total effective rate in control group was 32.29%. The differences of the treatment excellence rates and the total effective rates in group A were significantly higher than those in group B or in the control group. The differences were statistically significant (P<0.05). Conclusion Multivitamin iron combined with vitamin A can significantly improve the curative effect of the treatment of iron deficiency anemia in infants.
论著
目的 了解非结核分枝杆菌(nontuberculous mycobacteria,NTM)肺病患者免疫功能低下发生率,以及免疫支持的应用状况、探讨免疫支持治疗对患者2月末痰菌阴转及病变吸收的影响,为临床实施免疫干预提供参考依据。方法 分析广州市胸科医院2014年1月—2015年12月确诊的资料完整的381例NTM肺病患者免疫功能情况以及免疫支持的应用状况,观察组(加用免疫调节剂母牛分枝杆菌菌苗)228例与同期对照组(未使用免疫调节剂)153例进行2月末痰菌阴转及病变吸收情况比较。结果 381例患者中,免疫功能低下的发生率为45.67% (174/381);免疫支持率为59.84% (228/381)。细菌学改变:治疗前所有患者痰抗酸杆菌涂片和培养均为阳性。治疗2个月后两组的阴转率分别为67/228(29.38%)、17/153(11.11%),χ2=17.79,P<0.05。 影像学改变:两组的病变吸收有效率分别为62/228(27.19%)、16/153(10.45%),χ2=15.75,P<0.05;空洞吸收有效率分别为61/228(26.75%)、15/153(9.80%),χ2 =20.42,P<0.05。结论 非结核分枝杆菌肺病患者存在较高比例的免疫功能低下风险,观察组的痰茵阴转、病灶吸收和空洞闭合的疗效高于对照组。
Objective To explore the immune status of patients with nontuberculous mycobacterial(NTM) pulmonary disease, and the application of immunotherapy. to evaluate the influence of immunotherapy on sputum negative conversion and lesion absorption at the end of two months. provide reference data for immunotherapy. Methods The immune function and immunotherapy of 381 patients diagnosed as NTM pulmonary disease were retrospectively analyzed from January 2014 to December 2015 in Guangzhou Chest Hospital. Curative group (treated with antitubercular agents and immunomodulator mycobacterium vaccae) were compared with control group(treated with antitubercular agents alone) in sputum negative conversion and lesion absorption at the end of two month treatment. Results Of the 381 cases,45.67%(174/381)of the patients were immunocompromised, 59.84% (228/381)received immunotherapy. Bacteriologic changes: Both sputum smear and sputum culture were positive in all patents before treatment. after two months treatment, negative conversion in two groups were 67/228(29.38%),17/153(11.11%),χ2=17.79,P<0.05. 3. Radiological change: The rate of lesion absorption in curative group and control group were respectively 62/228(27.19%),16/153(10.45%),χ2=15.75,P<0.05;The rate of promoting cavity closure were respectively 61/228(26.75%),15/153(9.80%),χ2=20.42,P<0.05. Conclusion The immune function of NTM pulmonary disease had high ratio of being compromised. Curative group showed a significant effect of sputum negative conversion, lesion absorption and promoting cavity closure compared to the control group. Added to chemotherapy, M. vaccae is helpful in the treatment of nevertreated TB patients in terms of improving both Immunotherapy with M. vaccae had a beneficial influence on sputum negative conversion and X-ray appearances.
论著
目的 分析2014年482例广州登革热患者的X线胸片特点,探讨X线胸片对登革热患者的临床诊断价值。方法 选取广州市第一人民医院2014年收治的482例登革热患者作为研究对象,观察分析其X线胸片检查结果的特征。结果 登革热患者X线胸片影像学特点以非特异性的肺纹理增多增粗和斑片渗出灶为主要表现,另有胸膜增厚、胸腔积液和间质性改变。结论 X线胸片检查可以经济、便捷地了解登革热患者的肺部改变,为临床诊断和治疗提供帮助。
Objective To analyze the characteristics of chest X-ray in 482 cases of dengue fever in Guangzhou 2014, and to discuss the diagnostic value of chest X-ray in dengue fever patients. Methods 482 patients of dengue fever patients admitted in Guangzhou First People's Hospital were selected as the research object. The characteristics of the chest X-ray were observed and analyzed. Results The characteristics of chest X-ray images included lung markings thickening increased, exudation, and might lead to pleural thickening, effusion and interstitial change. Conclusion Chest X-ray was a convenient examination for dengue fever patients which had an important diagnostic and therapeutic value.
论著
目的 探索锌剂治疗大鼠慢性细菌性前列腺炎(CBP)的机理及影响。方法 健康成年雄性大鼠100只,随机分为正常对照组(n=20)、CBP模型对照组(n=20)、CBP锌剂治疗组(n=20)、CBP左氧氟沙星治疗组(n=20)及CBP锌剂与左氧氟沙星混合治疗组(n=20)。采用消痔灵及大肠埃希菌制备CBP大鼠模型。CBP锌剂治疗组、CBP左氧氟沙星治疗组及CBP混合治疗组给予相应药物灌胃治疗,正常对照组及CBP模型对照组给予无菌生理盐水灌胃。疗程10 d,分别于2 d、4 d、6 d、8 d、11 d取各组大鼠前列腺,检测细菌数量并分离鉴定细菌性质。于4 d、9 d、14 d、20 d、28 d取各组大鼠前列腺,进行组织病理学检测。结果 CBP各治疗组大鼠前列腺组织的细菌数量与模型对照组相比均明显降低(P﹤0.05)。CBP混合治疗组大鼠前列腺内细菌在治疗8 d后不能检出。4~6 d CBP混合治疗组大鼠前列腺组织的细菌数量与CBP锌剂治疗组相比明显降低(P﹤0.05)。正常对照组大鼠前列腺病理学检查未见明显病理变化;模型对照组大鼠前列腺组织表现为慢性炎症的病理变化;各治疗组大鼠前列腺慢性炎症改变均有不同程度缓解,其中混合治疗组的慢性炎症明显减轻。结论 锌剂具有活化提高前列腺组织细胞抗菌能力的作用,有利于前列腺组织炎性病理损害的缓解以及损伤组织的修复,与敏感抗生素结合治疗CBP具有更显著的治疗效果。
Objective To explore the zinc agent in the treatment of chronic bacterial prostatitis (CBP) rats and the effect. Methods 100 healthy adult male rats, were randomly divided into normal control group (n=20), CBP model group (n=20), CBP zinc treatment group (n=20), CBP levofloxacin treatment group (n=20) and mixed treatment group of CBP zinc and levofloxacin (n=20). Preparation of the CBP rat model was made by Xiaozhiling and E.coli system. CBP zinc treatment group, CBP levofloxacin treatment group and CBP mixed treatment group were given the appropriate drugs for treatment,besides,the normal control group, CBP model control group were given sterile saline. It took 10d. Rats in each group at 2d, 4d, 6d, 8d, 11d were detected, including the number of bacteria and the bacteria isolation and identification properties. The pathological study in 4d, 9d, 14d, 20d, 28d and prostate of rats in each group were detected. Results The prostate tissue of the CBP group rats in the treatment of bacterial number compared with the model control group decreased significantly (P<0.05). CBP mixed treatment of prostate were not detected in bacteria after 8d treatment.4 - 6 days of CBP treatment of prostate tissue in rats of the treatment group compared with the quantity of bacteria and CBP zinc decreased significantly (P<0.05). Normal control group rats pathological prostate pathology examination showed no significant pathological prostate tissue; The model control group rats showed chronic inflammatory pathological changes; The treatment group rat prostate inflammatory changes were alleviated chronic inflammation, which mixed treatment group were significantly reduced. Conclusion Zinc enhances prostate tissue antibacterial ability, is conducive to the inflammation in prostate tissue response and the repair of damaged tissue. Sensitive antibiotics combined with treatment of CBP have a significant therapeutic effect.
论著
目的 研究NEK2(中心体相关激酶2)在前列腺癌和良性组织中的表达情况及其与前列腺癌预后的相关性。方法 运用qRT-PCR检测NEK2在前列腺癌和癌旁组织的表达差异,通过组织芯片免疫组化染色检测的方法检验NEK2在前列腺癌和癌旁组织的表达情况,最后使用Taylor的数据对NEK2进行生物信息学分析。结果 qRT-PCR检测NEK2在前列腺癌组织的表达显著高于癌旁组织(6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003),组织芯片免疫组化结果显示NEK2在前列腺癌组织的表达显著高于癌旁组织(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001),结合Taylor公用数据库分析,NEK2高表达组患者术后的生化复发生存率减少( χ2=4.33,P=0.037),NEK2高表达组和低表达组在前列腺癌总体生存率上没有明显区别( χ2=0.27,P=0.605)。结论 NEK2参与前列腺癌的发生、发展进程,同前列腺癌发病进程密切相关,通过检测前列腺癌患者NEK2的表达情况,可早期预测生化复发的概率,能够作为判断前列腺癌预后的潜在生物学标志物。
Objective To investigate the expression of NEK2(NIMA-related kinase 2)in prostate cancer as well as benign prostatic hyperplasia,and the involvement of NEK2 in the prognosis of prostate caner(PCa). Methods The different expression of NEK2 in the tissue of prostate cancer and the adjacent benign tissues of prostate were measured by real-time quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) analysis and immunohositochemistry analysis,and then bioinformatically analyzed using the Taylor dataset. Results QRT-PCR showed that NEK2 was highly expressed in PCa than in the adjacent benign tissues (6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003). Immunohositochemistry analysis showed the expression of NEK2 was higher in PCa than in the adjacent benign tissues(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001). Furthermore, the biochemical recurrence-free time of PCa patients in high NEK2 expression groups significantly reduced( χ2=4.33,P=0.037). The overall survival time of PCa patients was not correlated to NEK2 expression levels( χ2=0.27,P=0.605). Conclusion The above findings suggest that NEK2 is associated with production and development of PCa, and also critically connected with the process of PCa,which indicate that we can predict the probability of the biochemical recurrence-free time by detecting the expression of NEK2 in PCa patients,and NEK2 can also become a potential biomarker for PCa prognosis.
个案分析
目的 分析他汀致肌病的影响因素,使临床更加合理的使用他汀类药物,减少不良反应的发生。方法 对1例口服阿托伐他汀钙片治疗5天后出现双大腿肌肉酸痛伴CK升高患者的病理生理因素、联合用药等情况进行分析,探讨他汀致肌病的相关因素及药学监护要点。结果 临床药师判断他汀导致肌病可能性大,提出治疗建议和监护计划,促进了患者病情好转。结论 他汀类药物导致肌病的影响因素较多,临床药师参与患者的临床治疗过程并加强药学监护,可促进药物治疗的安全性和有效性。
Objective To analyze the influencing factors of myopathy caused by statins, to make the clinical use of statins more rational and reduce the incidence of adverse reactions. Methods The pathophysiologic factors and combined medication of patients with both thigh muscle soreness and CK increase after five days of oral atorvastatin calcium therapy were analyzed. The related factors of statin- induced myopathy and the points of pharmacy care were discussed. Results Clinical pharmacists determined the possibility of statin lead to myopathy, and put forward treatment recommendations and monitoring program to promote the patient's condition improved. Conclusion There are many influencing factors of myopathy caused by statins. Clinical pharmacists participate in the clinical treatment of patients and strengthen the medical care, which can promote the safety and effectiveness of drug treatment.
全科医学
目的 分析社区综合干预对小儿反复呼吸道感染的影响,为社区临床治疗小儿反复呼吸道感染性疾病提供理论依据。方法 采用随机抽签方式,从我社区2012年10月—2014年10月期间收治的小儿反复呼吸道感染患儿中,随机抽取60例纳入本项研究,依据就诊单双顺序,分为研究组30例(社区综合干预方式)和对照组30例(常规性治疗和常规措施进行干预),对两组患儿干预结果进行对比分析。结果 研究组治疗总疗效高于对照组(93.33% vs 76.67%),差异有统计学意义(P<0.05)。对比治疗干预过程中疾病发作次数、就诊次数状况,研究组优于对照组,差异有统计学意义(P<0.05)。干预后研究组小儿呼吸道感染致病因素改善情况(除滥用抗生素外)优于对照组,差异有统计学意义(P<0.05)。结论 针对小儿反复呼吸道感染疾病可采用社区综合干预方式,可显著提升治疗有效率,缓解病情,降低反复感染发生率,效果突出,具有广阔应用前景。