目的 分析院际转运紫绀型先天性心脏病患儿中的流行病学特征,评价院际转运在患儿救治过程中的作用及效果。方法 回顾性分析2016年1月—2019年12月我院院际转运的145例紫绀型先天性心脏病患儿的性别、年龄、体质量、生命体征、转运期间检测指标、支持治疗等资料。结果 145例紫绀型先天性心脏病男105例,女40例,73.1%(106/145)的转诊患儿是新生儿,59.3%(86/145)的转诊患儿来自三级医院,55.9%(81/145)的转诊患儿转诊距离在200 km以上,仅有10.3%(15/145)的转诊患儿转诊距离在50 km以内。转诊过程中44.1%(64/145)的患儿给予呼吸机辅助通气,33.1%(48/145)的患儿给予吸氧处理,仅22.1%(32/145)的患儿无需呼吸支持,所有患儿安全转运到接诊医院,入院后138例接受外科手术治疗手术康复,7例放弃治疗。结论 安全、有效的院际转运紫绀型先天性心脏病是救治的关键环节,为紫绀型先天性心脏病的救治提供前提。

Objective To analyzed the epidemiological characteristics of interhospital transport of cyanotic congenital heart disease in children and evaluate the effect of interhospital transport on treatment. Methods 145 children with cyanotic congenital heart disease from January 2016 to December 2019 transported in our hospital were analyzed retrospectively. Epidemiological data such as sex, age, weight, vital signs, detection indexes during transport and supportive treatment were collected. Results Among 145 children with cyanotic type of congenital heart disease there were 105 male, 40 female. 73.1% (106/145) children were newborn, 59.3% (86/145) children were from tertiary hospitals, 55.9% (81/145) children were transported over 200 km, only 10.3% (15/145) children were within 50 km. 44.1% (64/145) were given assisted ventilation during transporting, 33.1% (48/145) children were given oxygen treatment, only 22.1% (32/145) of the children did not need respiratory support. All children were transferred to the receiving hospital successfully. After admission, 138 of them received surgical treatment successfully, and 7 of them gave up treatment. Conclusion Safe and effective interhospital transport is the key to treating cyanotic congenital heart disease, which provides the basis for the treatment of cyanotic congenital heart disease.

目的 探讨四君寿胎汤对地中海贫血孕妇贫血状况的改善效果,以期指导地中海贫血孕妇的中药治疗。方法 选择2019年5月—2020年10月期间我院诊治的200例地中海贫血孕妇,根据随机数字表法将其分为两组,观察组与对照组,各100例,观察组患者给予四君寿胎汤,1剂/d,连续治疗3个月,对照组患者给与安慰剂,1剂/d,连续治疗3个月;治疗前、治疗3个月后,比较两组血液检测指标[血红蛋白(HGB)、红细胞(RBC)、红细胞比容(HCT)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)]、中医症候积分、肝肾指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Cre)、尿素(ure)、总胆汁酸(TBA)],记录两组孕妇妊娠结局、新生儿情况并比较。结果 治疗前,两组HGB、RBC、HCT、MCV、MCH比较,差异无统计学意义(P＞0.05);治疗3个月后,两组均升高,且观察组高于对照组(P＜0.05);治疗前,两组食少纳呆、体倦乏力、食后或午后腹胀、大便异常症候积分比较,差异无统计学意义(P＞0.05);治疗结束后,两组症候积分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P＜0.05);治疗前后,两组ALT、AST、TBA、Cre、Ure差异无统计学意义(P＞0.05)。两组胎儿宫内窘迫、宫内生长受限发生率、产妇产后出血率比较,观察组较对照组发生率低,但差异无统计学意义(P＞0.05)。观察组早产发生率较对照组明显下降,差异有统计学意义(P＜0.05);观察组孕妇分娩孕周大于对照组,剖宫产率低于对照组,差异有统计学意义(P＜0.05);两组新生儿窒息率、转PICU率比较,差异无统计学意义(P＞0.05);观察组新生儿出生体重、HGB高于对照组(P＜0.05)。结论 四君寿胎可以改善地中海贫血孕妇的整体贫血状况,对肝肾功能无不良影响,中医证候得到改善,且有利于减少早产发生风险,降低剖宫产率,改善新生儿情况。

Objective To investigate effect of Sijun Shoutai decoction in improving anemia status of pregnant women with thalassemia, and to guide the Chinese medicine treatment of thalassemia in pregnant women in the future. Methods Two hundred pregnant women with thalassemia who were diagnosed in the hospital from May 2019 to October 2020 were divided into observation group and control group randomly, with 100 cases in each group. The observation group was treated with Sijun Shoutai decoction,1 dose/d, with continuous treatment for 3 months. The control group was given placebo,1 dose/d, with continuous treatment for 3 months. The indicators of blood test [hemoglobin (HGB), red blood cell (RBC), hematocrit value (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH)], TCM symptom scores, hepatic and renal indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cre), urea (Ure), total bile acid (TBA)] were compared between the two groups before and after treatment for 3 months. The maternal pregnancy outcome and neonatal condition in the two groups were recorded and compared. Results There were no statistical difference in the HGB, RBC, HCT, MCV and MCH between the two groups before treatment (P>0.05); after 3 months the indicators above of two groups increased, and those in observation group were higher than those in control group (P<0.05). There were no statistical differences in the symptom scores of poor appetite, fatigue, abdominal distension after eating or after noon and fecal abnormalities between the two groups before treatment (P<0.05). The levels of ALT, AST and TBA in the two groups decreased after treatment for 3 months, while the Cre and Ure increased, but the differences were not statistically significant (P>0.05). There were no statistical differences in the rates of intrauterine fetal distress, intrauterine growth restriction, and postpartum hemorrhage between the two groups (P>0.05), though the results of observation group were lower than control group.The rate of premature birth was lower than that of control group(P<0.05) ; the gestational week of observation group was more than control group, and the cesarean section rate of observation group was lower than that of control group (P<0.05). There were no statistical differences in the rates of neonatal asphyxia and transfering to PICU between the two groups (P>0.05); the neonatal birth weight and HGB in observation group were higher than those in control group (P<0.05). Conclusion Sijun Shoutai decoction in the treatment of pregnant women with thalassemia can improve anemia status, with no adverse effect on liver or kidney function, improve TCM syndrome, reduce the risk of premature birth,reduce the rate of cesarean,and improve the neonatal condition.

目的 分析芳香化酶(CYP19)基因多态性与子宫内膜异位症(endometriosis,EMs)术后复发的关系。方法 回顾性分析2019年2月—2020年2月于我院接受手术的110例EMs患者临床资料,按照术后12个月是否复发分为未复发组(62例)、复发组(48例),通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术测定两组CYP19基因115T/C、240A/G、1531C/T位点的单核苷酸多态性(single nucletide polymorphism,SNP),并分析不同位点对应VAS评分、r-AFS评分的差异。结果 复发组CYP19基因115T/C、1531C/T位点不同基因型及等位基因频率与未复发组相比,差异均无统计学意义(P＞0.05);复发组CYP19基因240A/G位点AG基因型频率比未复发组高(P＜0.05),AA基因型频率比未复发组低(P＜0.05);两组240A/G位点等位基因频率相比,差异有统计学意义(P＜0.05);CYP19基因240A/G位点AG 型VAS评分、r-AFS评分＞GG型＞AA型,差异有统计学意义(P＜0.05);CYP19基因115T/C、1531C/T位点不同基因型的VAS评分、r-AFS评分相比,差异均无统计学意义(P＞0.05)。结论 CYP19基因240A/G位点多态性与EMs术后复发、疼痛程度及病情密切相关,且携带G等位基因的基因型(AG+GG)可能是术后复发的风险因素。

Objective To analyze the relationship between aromatase (CYP19) gene polymorphism and recurrence of endometriosis (EMs) after surgery. Methods The clinical data of 110 patients with EMs who underwent the operation in our hospital from February 2019 to February 2020 were analyzed retrospectively. The patients were divided into non-relapsing group (62 cases) and relapsing group (48 cases) by 12 months followed-up outcomes. The single nucleotide polymorphism (SNP) of 115T/C, 240A/G and 1531C/T sites of CYP19 gene were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the differences of VAS and r-AFS scores between the two groups were analyzed. Results The genotypes and allele frequencies of 115T/C and 1531C/T of CYP19 gene in relapsing group were not significantly different from those in non-relapsing group (P>0.05). The AG genotype frequency of 240A/G site of CYP19 gene in relapsing group was higher than that in non-relapsing group (P<0.05), while the AA genotype frequency was significantly lower than that in non-relapsing group (P<0.05). There were significant differences in the allele frequencies of 240A/G site (P<0.05). The scores of VAS and r-AFS of AG＞GG＞AA, with significant differences (P<0.05). There were no significant differences in the VAS and r-AFS scores of CYP19 gene at 115T/C and 1531C/T site (P>0.05). Conclusion The 240A/G polymorphism of the CYP19 gene is closely related to postoperative recurrence, pain degree and condition of EMs, and the genotypes carrying the G allele (AG+GG) may be the risk factor of postoperative recurrence.

目的 探讨SNCG蛋白在卵巢癌组织中的表达情况及临床意义,明确SNCG在人卵巢癌中的表达情况及其恶性程度的关系,为临床卵巢癌的诊断、治疗及预后提供理论依据。方法 收集2010年1月—2015年1月石河子大学医学院第一附属医院收治的具有完整临床病理资料和石蜡切片的119例卵巢癌以及50例正常卵巢患者,用免疫组化方法检测组织中SNCG的表达情况,并分析SNCG的表达与卵巢癌患者临床病理特征及预后的关系。结果 SNCG在卵巢癌组织中的表达高于正常卵巢组织(χ²=73.575,P＜0.001);SNCG的表达与卵巢癌患者的肿瘤分期、分化程度、淋巴结转移、达到满意减瘤术、CA125以及HE4水平相关,差异均有统计学意义(P＜0.05);与卵巢癌肿瘤的原发部位、腹水、复发及化疗耐药无关,差异无统计学意义(P＞0.05);SNCG的过表达与HGSOC患者的PFS、OS相关,差异有统计学意义(P＜0.05);多变量Cox比例风险模型分析显示SNCG是HGSOC患者的独立预后因素,与PFS(HR=2.107,95%CI:1.014～3.795,P=0.034)、OS(HR=1.238,95%CI:0.716～1.928,P=0.047)相关。结论 SNCG在卵巢癌中高表达,与患者肿瘤分期、分化程度、淋巴结转移、达到满意减瘤术、CA125以及HE4水平有关,与卵巢癌患者的复发与化疗耐药无关,SNCG蛋白的过表达可作为HGSOC患者的独立预后因素,指导临床诊治。

Objective To detect the expression of SNCG in ovarian cancer tissue and its clinical significance, to clarify the relationship between the expression of SNCG in human ovarian cancer and the degree of malignancy, so as to provide theoretical basis for the diagnosis, treatment and prognosis of clinical ovarian cancer. Methods From January 2010 to January 2015 in First Affiliated Hospital of Medical College of Shihezi University,119 patients with ovarian cancer and 50 patients with normal ovarian which had complete clinical data and paraffin section were selected. Immunohistochemical method was used to detect ovarian SNCG expression, and the expression of SNCG relationship with clinical pathological characteristics and prognosis of patients with ovarian cancer was analyzed. Results The expression of SNCG in ovarian cancer tissue was significantly higher than that in normal ovarian tissue (χ²=73.575,P＜0.001). SNCG expression was correlated with tumor stage, degree of differentiation, lymph node metastasis, satisfying tumor reduction, CA125 and HE4 levels in ovarian cancer patients, and the differences were statistically significant (P＜0.05). It was not correlated with the tumor primary site, ascites, recurrence of ovarian tumor and chemotherapy resistance, and the differences were not statistically significant (P＞0.05).The overexpression of SNCG was correlated with PFS and OS in HGSOC patients, and the differences were statistically significant (P＜0.05). Analysis of multivariate Cox proportional risk model showed that SNCG was an independent prognostic factor in patients with HGSOC, related to PFS (HR=2.107,95%CI: 1.014-3.795,P=0.034) and OS (HR=1.238,95%CI: 0.716-1.928,P=0.047). Conclusion The high expression of SNCG in ovarian cancer is related to tumor stage, degree of differentiation, lymph node metastasis, satisfying tumor reduction, CA125 and HE4 expressions, but it is not related to the recurrence of ovarian cancer or chemotherapy resistance. The overexpression of SNCG protein can be used as an independent prognostic factor in patients with HGSOC for clinical diagnosis and treatment guidance.

目的 探讨Sysmex-2100全自动血液分析仪检测β-地中海贫血(β-地贫)患儿血小板参数显示不全的原因。方法 收集2017年4月—2020年4月期间本院确诊β-地贫患儿301人,其中重型病例204例,非重型97例。对301例患儿均采用希森美康Sysmex-2100血细胞分析仪进行血细胞分析,标本制作血涂片充分干燥后经瑞氏-吉姆萨染色,由主管技师及以上检验人员进行人工镜检。结果 301例β-地贫患儿血细胞分析结果出现血小板参数不显示者102例,占33.89％;其中有小红细胞、红细胞碎片、血小板聚集97例(95.10％);血小板直方图异常93例(91.18％)。重型β-地贫患儿血小板参数显示不全者75例,非重型β-地贫患儿血小板参数显示不全者27例,两组间血小板参数显示不全比例差异无统计学意义(P= 0.126)。血小板参数全显示病例的平均红细胞体积高于血小板参数显示不全病例,差异有统计学意义(P< 0.0001)。结论 小细胞低色素性红细胞及红细胞碎片化是β-地贫患儿血小板参数显示不全的主要原因,通过血小板直方图正常与否可大致判断血小板参数的可信度,采用PLT-O通道检测及涂片镜检查找原因,可提高结果的准确性。

目的 描述下肢深静脉血栓(deep vein thrombosis,DVT)患者抗凝药服药知识、信念与依从性的现状并探讨三者间的相关性,为提高下肢DVT患者服药依从性提供依据。方法 采取方便抽样的方法,抽取2019年7月—2020年5月广州市某三甲医院随诊的下肢DVT患者100例。采用一般资料调查表、抗凝药服药知识问卷、中文版服药信念特异性问卷、中文修订版8条目Morisky服药依从性量表进行问卷调查。结果 下肢DVT患者的抗凝药服药知识平均得分为(0.72±0.11)分,处于良好水平;服药信念得分为(2.06±4.34)分,处于中等水平;服药依从性得分为(6.52±1.08)分,处于中等水平;服药知识与服药信念呈正相关(r=0.301,P<0.01),与服药依从性呈正相关(r=0.232,P<0.05);患者的服药信念与服药依从性呈正相关(r=0.373,P<0.01)。结论 提高下肢DVT患者抗凝知识水平可以提高患者的服药信念和服药依从性,提高患者的服药信念可以提高患者的服药依从性。

目的 分析首发精神分裂症患者前驱期症状,并对精神病未治疗时间对疾病治疗效果的影响进行探讨。方法 对我院精神心理科2018年2月—2020年2月间收治的96例精神分裂症患者进行研究,分析患者前驱期症状,根据《精神分裂症首发症状评定量表 (SOS)》将这96例患者分成长精神病未治疗时间组和短精神病未治疗时间组,即对照组和观察组,两组各为48例,两组均用单一型抗精神病药物治疗,于治疗6个月后对比患者疾病严重程度、认知功能和神经认知功能。结果 首发精神分裂症患者前驱期症状主要有:情感不当或受限;行为举止离奇古怪;社会交往进行不顺利;对照组和观察组患者阳性症状、阴性症状、一般精神病理和阳性和阴性综合征量表评分对比无差异(P＞0.05);两组分类完成数比较,差异无统计学意义(P＞0.05),观察组总测验次数为(74.20±3.96)次,随机错误次数为(26.72±2.18)次,持续错误次数(16.54±1.98)次,P300潜伏期为(280.24±30.72)ms,低于对照组(28.16±2.24)次、(28.16±2.24)次。(18,36±3.12)次和(300.12±32.56)ms,正确次数为(30.12±2.56)次,P300波幅为(8.44±1.86)μV,高于对照组的(28.44±2.72)次和(7.32±1.54)μV,数据对比存在统计学差异(P＜0.05)。结论 首发精神分裂症患者前驱期症状以情感受限、行为和社交受限为主要表现,精神病未治疗时间对患者认知功能影响较为明显,需尽早开展治疗工作,以改善预后。

目的 分析急性胰腺炎患者给予罗格列酮联合乌司他丁治疗的疗效。方法 采用分层随机法将我院于2019年1月—2020年12月收治的94例急性胰腺炎患者分为对照组和观察组,对照组(n=47)单纯给予乌司他丁治疗,观察组(n=47)给予罗格列酮联合乌司他丁治疗,对比两组患者疗效、病情恢复时间、炎症因子、肝功能指标。结果 两组患者治疗前C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-17(interleukin-17,IL-17)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)水平差异无统计学意义(P＞0.05),治疗后观察组治疗总有效率较对照组高,且首次排气时间、腹胀消失时间、肠鸣音消失时间、淀粉酶恢复时间更短,CRP、IL-6、IL-17、ALT、AST水平更低,数据差异有统计学意义(P＜0.05)。结论 急性胰腺炎患者给予罗格列酮联合乌司他丁治疗可改善症状,促进康复,减轻炎性损伤,保护肝功能,是兼具疗效与安全性的治疗方法。

目的 探讨经子宫后路子宫修补术联合血管阻断治疗前置胎盘的临床效果,旨在为临床治疗提供参考依据。方法 回顾性分析2018年2月—2020年2月本院收治的86例前置胎盘患者临床资料,依据治疗方式不同分为实验组(n=50)与对照组(n=36),两组患者均开展子宫修补术,对照组增加低位腹主动脉球囊阻断术,实验组增加血管阻断治疗。对比两组患者非产科因素并发症率、围术期相关指标及新生儿结局。结果 实验组非产科因素并发症率低于对照组,差异有统计学意义(P＜0.05);两组患者手术时间、住院时间、术中出血量、血浆输入量比较,差异无统计学意义(P＞0.05);两组新生儿Apgar评分、窒息率及体质量比较,差异无统计学意义(P＞0.05)。结论 前置胎盘患者在子宫后路子宫修补术基础上开展血管阻断进行干预,与低位腹主动脉球囊阻断术治疗效果差异性较小,但血管阻断治疗可避免X线对机体产生辐射,进而降低非产科因素并发症率,不良反应小,安全性较高,值得临床推广。

目的 本研究探讨补肾养骨口服液对强直性脊柱炎的疗效及其安全性。方法 本研究为随机对照试验,研究了补肾养骨口服液+塞来昔布胶囊对比单纯用塞来昔布胶囊治疗强直性脊柱炎的效果,观察指标有腰臀痛程度、僵硬持续时间、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)、ASAS 20改善标准,观察时间点为第1和第12周。在整个研究过程中,通过血液、肝脏和肾功能测试来监测安全性,并记录不良反应。结果 有60名患者参加了此次试验。①两组治疗均有效:补肾养骨口服液+塞来昔布胶囊组30例(80.3%),塞来昔布组30例(60.8%),两组的ASAS 20都达到改善标准;但补肾养骨口服液+塞来昔布胶囊组效果好于塞来昔布组(P＜0.05)。②两组监测指标(腰臀痛程度、僵硬持续时间、ESR、CRP)对比,治疗后改善显著,而且补肾养骨口服液+塞来昔布胶囊组比塞来昔布组改善更明显。③两组治疗前后血常规、肝肾功能未见异常,但补肾养骨口服液+塞来昔布胶囊组不良反应发生率12.5%,而塞来昔布组为52.5%,两组差异具有统计学意义(P＜0.05)。结论 本研究说明了补肾养骨口服液在治疗强直性脊柱炎中具有疗效,且较安全。