目的 分析探讨健康驿站新冠病毒肺炎病例感染来源,评估驿站站内感染风险,规范驿站管理,降低感染风险。方法 对驿站2022年2月21日—3月9日全部14例新冠肺炎病例自入境到报告进行全链条风险分析。结果 14例病例为7批次不同时间入住,其中病例1、2、3、4、5、6、7、8、9、10、12、13共12例病例入境后即确诊,病例11入住5天(其共同入境、同住人员病例10,入境后即确诊)确诊、病例14入住10天发病确诊,其余病例均未呈现感染发病时间特异性,未呈现入境后交叉感染时间特异性,未见入住后空间、通风系统、排污系统交集,未见交叉感染情况。结论 该驿站目前报告新冠肺炎病例均有相关旅居史,主要在香港本土感染。13名病例大概率均在香港感染,入境隔离时发病确诊,其中病例1、2、3、4,病例6、7、8,病例10、11是3起呈现家庭聚集性感染发病,病例5、9是独立个案,病例14需要进一步排除,驿站未规范管理会导致误报及进一步扩大站内感染风险。

Objective To investigate and analyze the source of infection of COVID-19 cases in health station, assess the risk of infection, standardize the management and reduce the risk of infection. Methods From February 21 to March 9, 2022, the whole chain risk analysis of all 14 COVID-19 cases from entry to reporting was carried out. Results Fourteen cases were admitted in 7 batches at different times. Except for case 11 who diagnosed at the 5th day (the case of co-entry and co-resident case 10 was diagnosed after entry), and case 14 who diagnosed at the 10th day, the rest of the cases were diagnosed after entry, which did not show infection-onset time specificity, no time specificity of cross-infection after entry, no intersection of space, ventilation system and sewage system after entry, and no cross-infection. Conclusions The COVID-19 cases reported by the station were mainly infected in Hong Kong. Those 13 cases were highly likely infected in Hong Kong, all were diagnosed at the time of entry quarantine, while cases 1~4, cases 6~8, and cases 10~11 were 3 cases of family cluster infection, case 5 and 9 were an independent case, and case 14 needed to be further investigation. Failure to standardize the management of the station will lead to false alarms and further increase the risk of infection in the station.

目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ²检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。

Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ² test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.

慢性肾脏病是一类具有高发病率、高死亡率的慢性疾病群。临床上一般采用血液透析和肾脏移植治疗终末期的慢性肾脏病。研究表明,小分子药物或核酸类药物在慢性肾脏病治疗中极具潜力,但是缺乏特异性导致肾脏纤维化治疗效果有限,亟需开发新的治疗策略。纳米载体因具有良好的理化性质,被广泛应用于生物医学领域。本文综述了近年来纳米载体递送小分子或核酸类药物在慢性肾脏病中的研究进展。

Chronic kidney disease (CKD) is a series of chronic disease groups associated with high morbidity and mortality. Hemodialysis and kidney transplantation are the only choices for end-stage renal disease. According to the literature report, it is shown that small molecule and nucleic acid drugs have great potential in CKD treatments with an unsatisfied therapeutic efficacy because of the lack of specific targeting. Thus, it is necessary to develop a new strategy. Nanocarriers have been widely used in biomedical fields due to their excellent physical and chemical properties. In this review, we have summarized the recent advances in applying functional nanocarriers to deliver the small molecules and nucleic acid drugs in the treatment of CKD.

目的 探究与分析化脓性阑尾炎抗生素治疗后不同时机腹腔镜阑尾切除术的疗效及预后。方法 研究于2019年1月—2021年1月进行,我院收治的96例化脓性阑尾炎患者为此研究的参与对象,接受抗生素治疗≤72 h后手术的患者为观察组(n=38),>72 h的患者为对照组(n=38)。对比2组患者的指标。结果 2组的手术时间等相较均无差异(P>0.05);观察组的住院时间及住院费用均短于或少于对照组(P<0.05)。观察组术前中性粒细胞比例及白细胞计数高于对照组(P<0.05);术后2组患者组间无差异(P>0.05)。观察组的腹腔渗液阳性率低于对照组(P<0.05)。2组并发症发生率比较,组间无差异(P<0.05)。结论 化脓性阑尾炎患者经抗生素治疗后续尽早接受手术治疗。

目的 探讨分析胃肠道套细胞淋巴瘤的临床病理学特点分析及预后情况。方法 选取2019年1月—2021年2月间赣州市人民医院收治的50例胃肠道套细胞淋巴瘤患者为观察组,选取本院同期就诊的50例非胃肠道套细胞淋巴瘤患者为对照组。结果 50例胃肠道套细胞淋巴瘤患者的主要临床表现以腹痛为主占比50.00%;好发于回盲部、回肠、升结肠、直肠、乙状结肠,占比依次为54.00%、42.00%、36.00%、36.00%、28.00%;以多发性黏膜息肉样病变40.00%多见,死亡16例(32.00%)。年龄＞60岁、伴有脾脏肿大的胃肠道套细胞淋巴瘤死亡率更高(P<0.05)。观察组患者浅表淋巴结侵犯的比例明显高于对照组(P<0.05)。结论 胃肠道套细胞淋巴瘤主要表现为腹痛等,多发于结直肠,浅表淋巴结侵犯相对更多,以多发性黏膜息肉样病变多见,年龄＞60岁、伴有脾脏肿大的患者预后相对较差。

目的 介绍基层妇幼保健院成功开展126例小儿先天性心脏病(先心病)外科治疗经验。方法 2018年9月开始,在基层妇幼保健院设立小儿先心病治疗中心,开展小儿先心病外科治疗。结果 共收治126例小儿先心病患儿进行先心病手术治疗,全部痊愈出院。结论 在有经验的先心病治疗中心的协助下,基层妇幼保健院可以成功开展小儿先心病外科治疗。

目的 利用网络药理学技术,分析黄甲软肝颗粒治疗肝纤维化的作用网络,以及黄甲软肝颗粒治疗肝纤维化的潜在作用机制,并在体内动物实验进行初步验证。方法 采用中药系统药理学分析平台中寻找黄甲软肝颗粒中10味中药相关的化学成分和作用靶点,通过GeneCards等数据库筛选肝纤维化疾病相关的靶标;对药物与疾病靶点相映射得到黄甲软肝颗粒治疗肝纤维化的作用靶点,运用cytoscape将疾病靶点与复方活性成分靶点的交集-交集部分对应的活性成分”构建“C(成分)-T(靶点)”作用网络。将交集靶点利用 DAVID数据库进行GO富集分析和KEGG富集分析,以获得其潜在作用机制。最后,通过黄甲软肝颗粒防治CCl₄导致SD大鼠肝纤维化的体内实验进行初步验证,考察末次给药后大鼠体质量和肝脏指数,采用微板法检测SD大鼠血清中天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平,苏木精-伊红染色观察肝脏病理学变化。结果 预测筛选得到黄甲软肝颗粒共有117个潜在活性成分,266个活性成分对应靶点,161个交集靶点,关键成分有槲皮素、山奈酚、丹参酮IIA、芒柄花黄素等,关键靶点有PTGS2、PTGS1、NCOA1、ACHE、HTR、RXRA、ADRB2、IL1B等。GO 分析共包含 960条富集结果,其中生物过程845 条,分子功能 63条,细胞组成 52 条;KEGG 分析共得出68条通路,与本次研究较相关的通路主要包括TNF信号通路、Toll样受体信号通路、Rap1信号通路、胞质DNA传感途径、ErbB信号通路、VEGF信号通路等。体内动物实验研究表明,黄甲软肝颗粒能显著降低大鼠的肝脏指数和血清ALT、AST,改善肝组织病理学指标。结论 黄甲软肝颗粒可通过多成分、多途径、多靶点协同发挥治疗肝纤维化的作用,本研究为黄甲软肝颗粒治疗肝纤维化疾病的物质基础、作用机制及临床应用的进一步研究奠定基础。

Objective To analyze the effective network of Huangjia Ruangan Granules in treating liver fibrosis and its potential mechanism by using network pharmacology, and preliminary verify by animal in vivo experiments. Methods From the Chinese Medicine System Pharmacology Analysis Platform, we searched for the chemical constituents and targets of 10 Chinese herbs in Huangjia Ruangan Granules, and screened the targets related to liver fibrosis diseases through GeneCards and other databases. The drug and disease target were mapped to the target of Huangjia Ruangan Granules for the treatment of liver fibrosis, and the active component corresponding to the intersection of the disease target and the compound active component target was constructed using cytoscape “C (component)-T (target)” action network. The intersection target was used for GO enrichment analysis and KEGG enrichment analysis with DAVID database to obtain its potential mechanism of action. Finally, through the in vivo experiment of using Huangjia Ruangan Granules to prevent and treat CCl₄ leaded liver fibrosis in SD rats, the rats' body weight and liver index after the last dose were recorded, and the levels of aminotransferase (AST) and alanine aminotransferase (ALT) in the serum of SD rats were detected by the microplate method, hematoxylin-eosin staining were used to observe liver pathological changes. Results Predictive screening showed that Huangjia Ruangan Granules had 117 potential active ingredients, 266 active ingredients corresponded to targets, and 161 intersection targets. The key ingredients was quercetin, kaempferol, tanshinone IIA, formononetin, etc. The key targets were PTGS2, PTGS1 NCOA1, ACHE, HTR, RXRA, ADRB2, IL1B, etc. GO analysis showed a total of 960 enrichment results, including 845 biological processes, 63 molecular functions, and 52 cell compositions; KEGG analysis revealed a total of 68 pathways, the related pathways included TNF signaling pathway, Toll-like receptor signaling pathway, Rap1 signaling pathway, cytoplasmic DNA sensing pathway, ErbB signaling pathway and VEGF signaling pathway, etc. In vivo animal experiments had shown that Huangjia Ruangan Granules could significantly reduce the liver index and serum ALT and AST levels of rats, and improve liver histopathological indicators. Conclusions Huangjia Ruangan Granules treated liver fibrosis through multi-component, multi-pathway and multi-target synergy. This research laid the groundwork for the material basis, mechanism and clinical application of Huangjia Ruangan Granules in treating liver fibrosis diseases.

目的 分析ABCC2基因表达水平与肺腺癌预后之间的关联性,并对其影响机制进行初步探索。 方法 采用TCGA数据库和HPA数据库对肺腺癌病人癌组织和癌旁组织基因表达数据进行差异性分析,单因素及多因素COX回归评估ABCC2与肺腺癌预后之间的关联性,GSEA用于探讨与ABCC2显著关联的信号通路。 结果 ABCC2在肺腺癌肿瘤组织中存在过表达现象,Kaplan-Meier生存分析曲线结果显示ABCC2基因过表达使肺腺癌病人的死亡风险显著升高(HR=1.46,95%CI=1.09~1.95; P=0.010)。单因素及多因素COX回归结果显示ABCC2基因过表达是肺腺癌病人不良预后的独立危险因素。GSEA结果显示ABCC2可能通过调节药物代谢从而对肺腺癌的发展进行调控。 结论 ABCC2基因过表达使肺腺癌病人的死亡风险显著升高,ABCC2可能是肺腺癌不良预后的潜在分子生物标志物。

Objective To estimate the association between ABCC2 mRNA expression and the prognosis of lung adenocarcinoma and explore the potential influencing mechanism.Methods Difference analysis was used to evaluate the gene expression in tumor tissues and adjacent normal tissues based on The Cancer Genome Atlas database and Human Protein Atlas database.Multivariate COX regression and Kaplan-Meier analysis were performed to evaluate the association between ABCC2 gene expression and the prognosis of lung adenocarcinoma.Gene-set enrichment analysis (GSEA) was performed to screen differentially enriched pathways associated with the ABCC2 high expression phenotype.Results ABCC2 was overexpressed in lung adenocarcinoma tumor tissues compared with adjacent normal tissues.Kaplan-Meier survival analysis showed a significant relationship between ABCC2 mRNA expression and lung adenocarcinoma prognosis (HR=1.16,95% CI=1.09-1.95; P=0.010).Univariate and multivariate Cox regression analysis showed that ABCC2 mRNA expression was an independent risk factor affecting the survival of patients with lung adenocarcinoma.The results of GSEA suggested that ABCC2 may influence the development of lung adenocarcinoma by regulating the metabolism of targeted drug the treatment.Conclusions ABCC2 overexpression can significantly increase the risk of death in patients with lung adenocarcinoma,ABCC2 may be a potential molecular marker for poor prognosis in lung adenocarcinoma.

目的 分析基于微信平台步行运动训练对慢性充血性心力衰竭(CHF)患者心脏康复水平的影响。方法 本次研究对象来源于梅州市中医医院一内科2020年11月—2021年12月住院的90例CHF患者,根据随机数字表法分组(每组n=45),对比组给予常规药物治疗,观察组在对比组基础上给予基于微信平台步行运动训练治疗,对比两组临床疗效、心脏功能指标、血清NT-proBNP、D-D、6分钟步行距离、日常生活能力评分、明尼苏达心力衰竭生活质量调查表(MLHFQ)评分。结果 观察组临床总有效率(95.56%)高于对比组(66.67%),观察组治疗后左心室舒张末期内径、左心室收缩末期内径均低于对比组,观察组治疗后左室射血分数高于对比组,观察组治疗后血清NT-proBNP、D-D均低于对比组,观察组治疗后6分钟步行距离、日常生活能力评分均高于对比组,观察组治疗后MLHFQ评分低于对比组,P＜0.05(差异均具有统计学意义)。结论 基于微信平台步行运动训练可有效改善CHF患者心功能,抑制NT-proBNP、D-D高表达,提高日常生活能力、生存质量。

Objective To analyze the effect of walking training through Wechat on cardiac rehabilitation of chronic congestive heart failure (CHF) patients. Methods A total of 90 patients with CHF hospitalized in the First Internal Medicine Department of Meizhou Traditional Chinese Medicine Hospital from November 2020 to December 2021 were enrolled in this study. They were divided into two groups according to the random number table method (45 patients in each group).The control group was given routine drug treatment,and the observation group was given walking training through Wechat on the basis of control group. The clinical efficacy,cardiac function indexes,serum NT-proBNP,D-D levels,6-minute walking distance,ability of daily life (ADL) score and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between two groups. Results The total clinical effective rate of the observation group (95.56%) was higher than that of the control group (66.67%),the LVEDd and LVESd of the observation group were lower than those of the control group after treatment,the LVEF of the observation group was higher than that of the control group after treatment,the serum NT-proBNP and D-D levels of the observation group were lower than those of the control group after treatment,the 6-minute walking distance and ADL score of the observation group were higher than those of the control group after treatment,and the MLHFQ score of the observation group was lower than that of the control group after treatment,P<0.05 (the difference was statistically significant).Conclusions Walking training by Wechat could effectively improve the cardiac function of CHF patients,inhibit the high expression of NT proBNP and D-D,and improve the ability of daily living and quality of life.

目的 探究质控预警系统在重症患儿连续性血液净化治疗的应用效果。方法 随机选取于2020年1月—2021年12月在我院进行连续性血液净化治疗的共80例重症患儿作为本次研究对象,将80例患儿随机分成研究组和对照组,对照组进行常规护理,研究组则在常规护理的基础上行预警系统质量控制,对比2组患儿连续性血液净化治疗时长及报警频次、2组患儿在不同治疗时间段内滤器凝血发生率、2组非计划下机发生情况及2组患儿家属的护理满意度。结果 研究组平均报警频次为(8.60±3.35),低于对照组(16.52±7.41)的报警频次。而研究组的治疗时长(32.54±6.73 h)较对照组(21.38±5.61 h)延长,研究组患儿在进行连续性血液净化治疗的过程中,在8小时至24小时之间及大于24小时滤器的凝血发生率低于对照组,研究组和对照组护理满意度分别为92.50%和75.00%,对比差异显著。结论 在对重症患儿进行连续性血液净化治疗过程中应用质控预警系统具有较高的临床使用价值,不仅可以有效降低报警频次及滤器凝血发生率,而且对延长治疗时间有显著的促进作用,值得在今后的治疗过程中大力推广。

Objective To explore the application effect of quality control early warning system in continuous blood purification treatment of critically ill children.Methods A total of 80 critically ill children who underwent continuous blood purification treatment in our hospital from January 2020 to December 2021 were randomly selected as the research object, and were randomly divided into observation group and control group.The control group received routine nursing,and the observation group received early warning system quality control on the basis of routine nursing.The duration and alarm frequency of continuous blood purification treatment,the incidence of filter coagulation in different treatment periods,the occurrence of unplanned quitting and nursing satisfaction of the two groups were compared.Results The average alarm frequency of the observation group was (8.60±3.35),which was significantly lower than that of the control group (16.52±7.41).However,the treatment duration of the observation group (32.54±6.73 h) was significantly longer than that of the control group (21.38±5.61 h).During continuous blood purification treatment,the incidence of blood coagulation in the observation group was lower than that of the control group,and the nursing satisfaction of the observation group and the control group were 92.50% and 75.00% respectively,with significant differences.Conclusions The application of quality control early warning system in the continuous blood purification treatment of critically ill children has a high clinical value,which can not only effectively reduce the alarm frequency and the incidence of filter coagulation,but also significantly prolong the treatment time,and it is worth promoting in the future treatment process.