目的 探讨用捏脊联合中药外洗治疗脾胃气虚型儿童功能性消化不良的效果。方法 随机选取脾胃气虚型功能性消化不良的儿童120例,分为联合组、捏脊组、外洗组、对照组4个组,每组30例,分别采用捏脊、中药外洗、捏脊联合中药外洗、吗丁啉进行治疗,两周后观察4组治疗效果及唾液淀粉酶活性比值、D-木糖排泄率的变化,进行分析。结果 联合组的有效率优于捏脊组、外洗组、对照组,差异有统计学意义(P<0.05)。治疗后联合组的唾液淀粉酶活性比值比捏脊组、外洗组、对照组提高,差异有统计学意义(P<0.05)。治疗后D-木糖排泄率均较治疗前有增加,两两比较,联合组与对照组比较差异有统计学意义(P<0.05)。结论 捏脊联合中药外洗可改善脾胃气虚型儿童功能性消化不良,疗效良好,其机理同改善唾液淀粉酶活性有关。

目的 观察阵发性房颤(PAF)环肺静脉电隔离术(CPVI术)治疗对左心房结构和功能的影响。方法 对63例PAF患者行CPVI术,超声心动图测定术前及术后3天、6个月时左心房内径(LAD)、左心房面积(LAA) 、左心房最大容积(LAVmax)、收缩期前容积(LAVp)、最小容积(LAVmin),测量二尖瓣血流频谱A峰流速(VA)、左心房被动射血分数(LAPEF)、主动射血分数(LAAEF)、扩张指数 (LaexpI)。结果 63例患者中54例于术后6个月时仍维持窦性心律,维持窦性心律者 LAD、LAA、LAVmax、LAVp、LAVmin对比术前减小 (P<0.05); VA、LAAEF术后3天降低(P<0.05),6个月对比术前无变化(P>0.05); LaexpI、LAPEF术后3天及6个月时均无改变(P>0.05)。结论 阵发性房颤环肺静脉电隔离术后左心房结构逆重构,早期辅泵功能下降,6个月时左心房功能未受影响。

目的 回顾性分析支气管肺泡细胞癌(bronchioloalveolar carcinoma,BAC)临床特点,提高早期BAC的确诊率,减少误诊。方法 对2013年—2014年间在我院确诊的BAC病例5例的临床资料进行回顾性分析。结果 5例患者中男4例,女1例,年龄在50～73岁之间,在社区医院均曾误诊为肺炎,所有患者均在我院经支气管镜肺活检后确诊为BAC。结论 BAC是一种较为特殊的肺癌,临床上症状无特异性,极易误诊为普通肺炎。由于BAC预后差,误诊后果严重,对初诊为普通肺炎的患者经常规抗感染治疗后临床症状及影像学表现改善不明显时,应及时进行各项检查、明确诊断,以便有效改善患者预后。

Objective To elevate the clinical diagnosis of BAC (bronchioloalveolar carcinoma) so as to reduce misdiagnosis by using retrospective analyses. Methods Retrospective analyses were used to study the five BAC patients, who were diagnosed in our hospital from 2013 to 2014. Results 4 of 5 male, and 1 female, age between 50 and 73, were diagnosed as pneumonia. All of them were made a definite diagnosis as BAC after performing transbronchial lung biopsy. Conclusion BAC is an exceptional lung adenocarcinoma and there is no specific clinic symptom. BAC was easily misdiagnosed as common lung pneumonia. There will be serious consequences after misdiagnosis of BAC due to its poor prognosis. Those patients who were misdiagnosed as common lung disease, but there was no obvious improvement after accepting long anti-infective therapy and there was negatively detection of pathogenic bacteria in them, are needed to perform all other clinical examination to clarify a diagnosis, and to further improve the prognosis of the patients.

目的 统计医院眼科门诊病人前15位疾病的构成变化及不同年龄段间差异。方法 对2008年—2011年眼科门诊病人诊断及治疗信息作横断面研究,分析逐年门诊量变化及疾病谱的变化。结果 4年来门诊共接诊患者22356人次,初诊病人20915例。4年初诊患者分别为1476、3795、7177、8467人次。其中男12088例(59.9%),女8087例(40.1%),平均年龄 33.75岁。未成年人占20.23%,中青年占72.33%,老人占7.44%。前15位的疾病构成4年间有一定的波动,但结膜炎、角膜异物及屈光不正所占比例较高。三个年龄组构成最高的疾病分别为屈光不正、结膜炎、白内障。结论 该院眼科门诊4年来就诊人数增加5倍有余。患者中青年、未成年患者比例高、老年患者比例低,男性比例高于女性。角膜异物等外伤性疾病较多,不同年龄段疾病谱各有特点。

Objective Describe the distribution of diagnoses at the ophthalmic clinic of a tertiary hospital in the first four years since its inception. And also analyse the patterns of diagnoses of different age. Methods Cross-sectional study was administered on all new patients seen by ophthalmologists at Nansha Central Hospital from 2008 to 2011. Results 59.90% (12088 cases) were male and 40.10% (8087 cases) were female. Juveniles, adults and the elders accounts for 20.33%, 72.33%, and 7.44% of all visitors respectively. The most common conditions were conjunctivitis (27.00%), refractive error (9.87%) and corneal foreign bodies (9.07%). There were more diagnoses of refractive error (32.26%, P<0.01) among the juveniles, while the elders had higher percentage of cataract diagnoses (27.81%, P<0.01). Conclusion The number of new patients visiting the ophthalmic clinic had increased six-fold over the four years. The proportion of younger patients was much higher than that of older ones and the male to female ratio was high.compared to the results of literature, the marked characteristic of the disease distribution was the high rate of ocular traumatic diseases. The most common diagnoses varied with age.

目的 探索协助式农疗对慢性精神分裂症患者社会功能的影响。方法 选取住院5年以上的慢性精神分裂症患者64例,随机分为研究组32例和对照组32例,实施室外农艺园艺方面的职业康复训练,并实行协助式管理新模式,康复训练前与训练后的第1、3、6月末分别采用护士用住院病人观察量表(NOSIE)对患者进行评价。结果 患者通过协助式农疗后,NOSIE总积极分、社会能力、社会兴趣、个人整洁等得分有明显提高,有统计学意义;总消极分激惹、精神病表现、迟缓、抑郁出现降低,有统计学意义。结论 慢性精神病患者在工作人员协助下参加农艺和园艺技术培训治疗,其症状和社会功能有较显著的改善。

Objective To explore the impact of assisted farming and gardening therapy on social function of patients with chronic schizophrenia. Methods 64 patients with chronic schizophrenia were randomly and equally divided into research group and control group, with 32 cases implemented outdoor farming and gardening vocational rehabilitation training in new management mode. Observe scale evaluation (NOSIE) was applied to assess the patients at the time before the training, one month after the training, three month after the training, and six month after the training. Results Patients received assisted farming therapy scored higher in total positive points, social ability, social interest, individual tidy. The difference was statistically significant. The scores of total negative points irritability, mental performance, slow, depression had reduced with statistical significance. Conclusion Assisted farming and gardening therapy can relieve patients' symptoms and improve patients' function.

目的 观察动静平衡康复训练对胫骨平台骨折术后患者平衡和行走功能的影响。方法 将2012年7月—2014年12月100例胫骨平台骨折患者,随机分为两组,每组50例。对照组术后展开常规康复训练,观察组实施动静平衡康复训练,观察两组膝关节功能、康复效果以及肌力恢复情况。结果 观察组患者的膝关节功能优良率为98.0%,高于对照组的60.0%,差异有统计学意义(P＜0.05)。观察组患者的Lysholm评分,高于对照组(P＜0.05)。观察组患者的肌力恢复情况,优于对照组(P＜0.05)。结论 基于“动静平衡”理念针对胫骨平台骨折患者实施术后康复指导与训练,有利于促进患者关节功能以及肌力恢复,巩固康复疗效,在训练过程中实现动态平衡,具有积极的临床意义。

Objective To investigate the static and dynamic balance rehabilitation training on the tibial plateau fracture patients balance and walking functions. Methods 100 cases of patients with tibial plateau fractures from July 2012 to December 2014, were randomly divided into two groups, 50 cases of each group. The control group was launched conventional rehabilitation, observation group received static and dynamic balance rehabilitation training. The knee function, rehabilitation and muscle recovery of the two groups were observed and statistically analyzed. Results The knee function excellent rate of observation group was 98.0%, significantly higher than control group 60.0%, there was statistical significance(P＜0.05). Lysholm score of observation group was higher than control group(P＜0.05). Muscle recovery of observation group was better than control group(P＜0.05). Conclusion Based on the “static and dynamic balance” concept for tibial plateau fractures postoperative rehabilitation for patients with guidance and training, and it will be promoting joint function in patients with muscle recovery and consolidate the recovery effect, to achieve dynamic equilibrium in the training process, with positive clinical significance.

目的 研究乳管镜在乳头溢液的诊断中的应用价值。方法 回顾性分析2010年2月－2014年3月采用乳管镜检查的123例乳头溢液患者的临床资料。结果 乳管镜检查发现乳腺导管癌8例,导管内乳头状瘤33例,乳头状瘤病32例,导管扩张及炎症35例。术后病理检查证实乳腺导管癌5例,导管内乳头状瘤35例,乳头状瘤病30例,导管扩张及炎症33例。结论 乳管镜可作为诊治乳头溢液的首选措施,其所起到的作用是超声、钼靶及乳管造影所不及的。

Objective To study the clinical application value of the fiberoptic ductoscopy(FDS) on the diagnosis of nipple discharge. Methods A retrospective analysis of 123 patients with nipple discharge undergoing FDS from February 2010 to March 2014. Results After fiberoptic ductoscopy examination,it was found there were 8 cases of breast cancer,33 cases of intra-duct papilloma,35 cases of papillomatosis,35 cases of dilatation and inflammation. However there were 5 cases of breast cancer,35 cases of intra-duct papilloma,30 cases of papillomatosis, and 33 cases of dilatation and inflammation were comfirmed through postoperative pathological examination. Conclusion Fiberoptic ductoscopy is more effective than B-ultrasonography and Mo-traget mammography, so it can be the preferred method of diagnosis and treatment for nipple discharge.

目的 探讨FLT3及C-kit基因突变在急性髓细胞白血病(AML)中的临床意义。方法 回顾性分析南方医院2010年1月—2013年12月期间初诊AML患者的临床资料,PCR分析FLT3及C-kit基因突变情况。结果 248例初诊AML患者中, FLT3-ITD突变率为16.9%,TKD突变率为3.2%,C-kit8号外显子突变率为1%,17号外显子突变率为5.2%;FLT3-ITD突变更倾向发生于正常染色体核型的AML患者;FLT3突变阳性组及C-kit突变阳性组患者的外周血白细胞数高于基因突变阴性组,染色体核型正常患者的无病生存时间较阴性组缩短(P<0.05)。但是对血红蛋白、血小板及完全缓解率(CR率)并无影响(P>0.05)。结论 FLT3及C-kit突变的AML患者有较差的临床预后。

Objective This study was to investigate the prognostic value of FLT3 and C-kit gene mutations in patients with acute myeloid leukemia (AML). Methods We retrospect and analyzed the data of the 248patients with newly diagnosed AML from January 2013 to December 2010. FLT3 and C-kit gene mutations was detected by Polymerase chain reaction (PCR). Results Among these 248 subjects, the FLT3-ITD mutation rate was 16.9%, FLT3-TKD was 3.2%, C-kit 8 exon mutation rate was 1% and 17exon mutationwas 5.2%. FLT3-ITD mutation likely occurred in AML patients with normal karyotype. The patients with FLT3-ITD mutation or C-kit mutation had significantly higher PWBC and shorter DFS than patients without gene mutations (P< 0.05), but there was no significantly differences in sex, age, Hb, PLT and CR rate of the first course induction chemotherapy among groups (P>0.05). Conclusion Among patients with AML,FLT3-ITD and C-kit mutations were associated with worse prognosis.

目的 探讨新生儿早发型B族链球菌(GBS)败血症的临床特点,提高对本病的认识。方法 选取我院2010—2012年我院新生儿重症监护病房(NICU)收治的新生儿资料,回顾性分析GBS的临床表现、实验室检查、治疗和转归。结果 早发型GBS败血症8例,占住院患儿的6.28‰,均为足月儿,生后24小时内发病,以气促、发绀等呼吸系统症状为主,其中4例出现感染性休克表现;实验室检查提示血常规WBC:2.07~14.1×10⁹/L,＜5×10⁹/L 5例,中性粒细胞绝对值0.54~8.32×10⁹/L。胸部X线提示:肺部纹理粗乱,渗出增多。1例需机械通气辅助呼吸。青霉素联合头孢三代或万古霉素治疗有效,重症感染者需加强支持治疗。结论 应重视新生儿早发型无乳链球菌败血症早期呼吸系统症状,尽早诊断和治疗,降低病死率。

Objective To investigate the clinical features of early-on set neonatal Group B Streptococcal (GBS)septicemia in order to guide the clinical diagnosis and treatment. Methods Retrospectively analysing the clinical presentation, laboratory examination, treatment and prognosis of the 8 cases of all newborns from 2010 to 2012 in our hospital. Results The incidence of neonatal early-on set Group B Streptococcal septicemia was 6.28‰.8 cases were full-term infants in this study.Respiratory symptoms such as anhelation and cyanosis were first signs of early-on set Group B streptococcal septicemia within 24 hours after birth; 4 cases of septic shock. Results of laboratory tests included WBC:2.07~14.1×10⁹/L, in which 5 cases were ＜5×10⁹/L, N 0.54~8.32×10⁹/L. Chest X-ray: lung texture showed coarse and disorderly, leakage was increased. One case needed respiratory support with mechanical ventilation. Intravenous treatment of neonatal GBS with penicillin combined with Vancomycin was effective. Patients of serve infections should be provided supportive care. Conclusion Patients of serve early symptom of respiratory system should be paid attention. Early diagnosis and treatment should be as soon as possible to reduce fatalities.

目的 探讨儿童登革热(DF)合并肝功能损害的临床特征。方法 对2014年8—12月我院感染科收治住院的78例儿童DF的临床资料进行回顾性分析。结果 并发肝功能损害36例(46.15%),其中血清丙氨酸转氨酶(ALT)升高24例(30.77%),血清天冬氨酸转氨酶(AST)升高33例(42.31%);27例(75%)ALT/AST病程2周内恢复正常,9例于1月复查恢复正常。仅有1例总胆红素(TBIL)升高80.8 μmol/L,直接胆红素升高为主,1周后恢复正常。肝功能损害组较无肝功能损害组在外周血白细胞水平、血小板水平差异有统计学意义(P<0.05)。结论 儿童DF并肝功能损害较普遍,以轻度损害为主。与年龄、性别、皮疹、外周血白细胞、血小板有相关性。

Objective To approach the clinical characteristics of children dengue fever combined liver function damage. Methods Clinical data of 78 cases of children dengue fever in our hospital were retrospectively analyzed from August to December in 2014. Results 36 cases (46.15%) complicated with liver function damage. Among them 24 cases (30.77%) of serum alanine aminotransferase (ALT) increased, 33 cases (42.31%) of serum aspartate aminotransferase (AST) increased; 27 cases (75%)ALT/AST returned to normal within 2 weeks, 9 cases were recovered to normal in 1 month. Only 1 cases of total bilirubin (TBIL) increased to 80.8 mol/L, recovered after 1 week. Liver injury group and non liver injury group of peripheral blood leukocytes, platelets level comparison was statistically significant (P<0.05). Conclusion Children dengue fever combined liver function damage was common, mainly mild. There was correlation with age, gender, skin rash, peripheral blood leukocytes and platelets.