目的 探讨复方甘草酸苷联合卡泊三醇乳膏治疗寻常型银屑病的效果观察。方法 选取辽健集团阜新矿总医院2019年12月—2022年12月收治的96例寻常型银屑病患者,分为联合组与对照组,每组48例。对照组使用卡泊三醇乳膏治疗,联合组在对照组基础上联用复方甘草酸苷治疗,对比临床疗效,以皮质含量、经表皮水分流失（TEWL）、角质层水含量变化评价患者的皮肤屏障功能,并对比两组患者治疗前后T细胞相关炎症因子表达水平。结果 联合组治疗总有效率较对照组高[93.75% vs 77.08%,χ²=5.352,P=0.021];治疗后两组皮质含量、角质层水含量升高,联合组高于对照组,TEWL降低,联合组低于对照组[皮质含量：（73.59±7.24）μg/cm² vs（110.12±13.64）μg/cm²,t=16.389,P<0.001;角质层水含量：（25.28±3.25）% vs（16.24±2.14）%,t=16.095,P<0.001;TEWL：（8.06±1.44）g/（h·m²）vs（11.71±2.68）g/（h·m²）,t=8.312,P<0.001];治疗后两组患者白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、γ干扰素（IFN-γ）表达水平均降低,且联合组低于对照组[IL-2：（22.25±3.32）vs（26.62±3.24）pg/mL,t=6.661,P<0.001;IL-6：（80.46±5.11）vs（112.62±12.16）pg/mL,t=16.892,P<0.001;IFN-γ：（68.62±10.73）vs（51.26±6.37）ng/L,t=9.639,P<0.001]。结论 复方甘草酸苷联合卡泊三醇乳膏可改善寻常型银屑病皮肤屏障功能,降低炎症因子,改善Th1/Th2细胞因子失衡情况。

Objective To investigate the effect of compound glycyrrhizin and caspotriol cream in psoriasis vulgaris. Methods The 96 psoriasis patients admitted to Fuxin Mine General Hospital from December 2019 to December 2022 were selected and divided into combined group and control group,with 48 patients in each group．The control group was treated with caspotriol cream,the combined group treated with compound glycyrrhizin treatment,the clinical efficacy was compared,and the skin barrier function of patients was evaluated by cortical content,transepidermal water loss（TEWL）,and changes in stratum corneum water content．The expression levels of T cell related inflammatory factors before and after treatment were compared between the two groups. Results The overall effective treatment rate in the combined group was higher than in the control group[93.75% vs 77.08%,χ²=5.352,P=0.021]．After treatment,cortical and stratum corneum water levels increased in both groups,with the combined group being higher than the control group．TEWL decreased and the combined group was lower than the control group[cortical content：（73.59±7.24）μg/cm² vs（110.12±13.64）μg/cm²,t=16.389,P<0.001;water content in the stratum corneum：（25.28±3.25）% vs（16.24±2.14）%,t=16.095,P<0.001;TEWL：（8.06±1.44）g/（h·m²）vs（11.71±2.68）g/（h·m²）,t=8.312,P<0.001]．After treatment,two groups of patients were treated with interleukin-2（IL-2）,interleukin-6（IL-6） and interferon（IFN）-γ,and the combined group was lower than the control group[IL-2：（22.25±3.32）pg/mL vs（26.62±3.24）pg/mL,t=6.661,P<0.001;IL-6：（80.46±5.11）pg/mL vs（112.62±12.16）pg/mL,t=16.892,P<0.001;IFN-γ：（68.62±10.73）ng/L vs（51.26±6.37）ng/L,t=9.639,P<0.001]. Conclusions The combination of compound glycyrrhizin and carpotriol cream can improve the skin barrier function of psoriasis vulgaris,reduce inflammatory factors,and improve the imbalance of Th1/Th2 cytokines．

目的 探讨血浆置换联合泼尼松（PDN）联合环磷酰胺（CTX）治疗抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎（DM）伴肺间质纤维化（ILD）患者疗效及安全性。方法 回顾性分析2014年6月—2023年6月普洱市人民医院诊断的MDA5阳性DM伴ILD患者40例,其中治疗组20例,采用血浆置换联合PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗;另20例设为对照组,采用PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗,分别于治疗后3月、6月检测一氧化碳弥散量（DLCO）、第1秒用力呼气量（FEV₁）,血清铁蛋白（SF）、C-反应蛋白（CRP）、涎液化糖链抗原（KL-6）、MDA5转阴率行疗效评估。结果 在治疗3个月和6个月时,两组患者的DLCO、FEV1、SF、CRP、KL-6、MDA5转阴率等指标的完全缓解率不一致。其中,3个月时,治疗组上述指标的完全缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为15%、20%、20%、15%、0%、0%。两组患者在治疗3个月的DLCO、FEV1、SF、CRP、KL-6水平和MDA5转阴数均有所不同。其中治疗组的DLCO、KL-6、CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,治疗组SF水平较对照组降低（P<0.05）,两组治疗6个月时,治疗组上述指标缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为20%、25%、20%、20%、20%、5%。两组患者在DLCO、FEV₁、SF、CRP、KL-6水平以及MDA5转阴数和死亡例数方面比较差异均有统计学意义,其中治疗组的DLCO、KL-6和CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,SF水平治疗组较对照组降低（P<0.05）。结论 在MDA5抗体阳性DM伴ILD患者治疗中,给予血浆置换联合PDN、CTX治疗,可以提高疗效,降低病死率。

Objective To explore the effect of plasmapheresis combined with prednisone（PDN）plus cytoxan（CTX）on patients with anti-melanoma differentiation-associated gene 5（MDA 5）antibody-positive dermatomyositis（DM）with interstitial lung disease（ILD）. Methods The data of 40 patients with MDA 5 positive DM and ILD diagnosed in the People's Hospital of Pu'er City from June 2014 to June 2023 were retrospectively was analyzed．Twenty patients of the treatment group were treated with plasmapheresis combined with PDN 1mg / kg once daily,which was reduced by 10% per week after 4 weeks．The other 20 patients of the control group were treated with PDN 1mg / kg once daily,which was reduced after 4 weeks by 10% per week,and CTX 1g once per month．diffusing capacity of the lungs for carbon monoxide（DLCO）,forced expiratory volume in the first second（FEV₁）,serum ferritin（SF）,C-reactive protein（CRP）,Krebs Von den Lungen-6（KL-6）and MDA5 negative conversion rate were measured at 3 and 6 months after treatment,respectively. Results At 3 and 6 months of treatment,complete remission rates of DLCO,FEV₁,SF,CRP,KL-6,MDA 5 conversion and other indicators were inconsistent．Among them,at 3 months,the complete response rate of the above indicators in the treatment group was successively：95%,85%,90%,90%,90% and 85%．The control group was 15%,20%,20%,15%,and 0%,0%．Statistical analysis showed that the levels of DLCO,FEV₁,SF,CRP,KL-6 and MDA 5 significantly varied at 3 months of treatment．Pairwise comparison of LSD found that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower than the control group（P<0.01）,the FEV₁ level in the treatment group was significantly higher（P<0.01）,and the SF level in the treatment group was significantly lower（P<0.05）．After 6 month of treatment,the complete response rate of the above indicators in the treatment group were 95%,85%,90%,90%,90% and 85%,and the complete response rate of the above indicators in the control group was 20%,25%,20%,20%,20% and 5%．Statistical analysis showed the levels of DLCO,FEV₁,SF,CRP,KL-6 for the amount of MDA 5 and the number of deaths between two groups were significantly different．Further pairwise comparison of LSD showed that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower compared with the control group（P<0.01）,the FEV₁ level was significantly increased compared with the control group（P<0.01）,and the SF treatment group was significantly decreased compared with the control group（P<0.05）. Conclusions In the treatment of patients with MDA 5 antibody positive DM with ILD,the treatment of plasmapheresis combined with PDN and CTX can significantly improve the efficacy and reduce the mortality rate．

目的 探索干预因素对4~12岁孤独症谱系障碍（ASD）患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法 选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表（SRS）对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况（性别、共患病情况、干预时长、上学情况等）。结果 202例ASD患儿中,男性患儿162例（80.2%）,女性40例（19.8%）,性别对社交反应的影响比较差异无统计学意义（t=2.969,P>0.05）。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义（F=6.920,P<0.05）。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义（F=3.823,P<0.05）,但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义（P>0.05）。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义（F=4.477,P<0.05）,但干预<1年与未干预患儿相比,两者差异无统计学意义（P>0.05）。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。

Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder（ASD）aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected．The social behavior of the children was evaluated using the Social Response Scale（SRS）,and the parents were surveyed using a self-made general situation questionnaire．The survey content included the basic information of the children（gender,comorbidity,intervention duration,and school attendance,etc．）. Results Among the 202 cases of ASD,162 were male（80.2%）and 40 were female（19.8%）．There was no statistically significant difference in the impact of gender on social response（t=2.969,P>0.05）．In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder（F=6.920,P<0.05）．In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school（F=3.823,P<0.05）,but there was no statistically significant difference between children enrolled in special schools and those who did not attend school（P>0.05）．In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant（F=4.477,P<0.05）．However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant（P>0.05）. Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response．Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment．

目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者（均行无痛胃肠镜检查）为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义（t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05）;重复测量方差分析结果显示,分组因素间收缩压（SBP）（F=30.019,P<0.001）、心率（HR）（F=282.057,P<0.001）、SpO₂（F=64.518,P<0.001）、;时间因素SBP（F=21.780,P<0.001）、HR（F=345.118,P<0.001）、SpO₂（F=41.762,P<0.001）;分组与时间交互时间因素SBP（F=12.941,P<0.001）、HR（F=193.295,P<0.001）、SpO₂（F=13.546,P<0.001）,差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO₂、较B组低。;A组患者围术期不良反应发生率（20.00%）低于B组患者（56.67%）（χ²=25.593,P<0.001）。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。

Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients（all underwent painless gastroscopy）admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects．They were randomly divided into groups using a random number table method．Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol．Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups．There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients（t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05）．The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP（F=30.019,P<0.001）,HR（F=282.057,P<0.001）,SpO₂（F=64.518,P<0.001）,time factors SBP（F=21.780,P<0.001）,HR（F=345．118,P<0.001）,SpO₂（F=41.762,P<0.001）,and interaction factors SBP（F=12.941,P<0.001）,HR（F=193.295,P<0.001）,and SpO₂（F=13.546,P<0.001）．The line chart visually shows that the SBP,HR,SpO₂ of Group A patients were lower than those of Group B．The incidence of perioperative adverse reactions in Group A patients（20.00%）was lower than that in Group B patients（56.67%）（χ²=25.593,P<0.001）. Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions．

目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%（χ²=3.887,P<0.05）,观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为（3.09±1.25）（4.17±2.24）（3.95±1.53）（4.05±1.77）d,均低于对照组（5.14±2.43）（7.03±3.23）（6.40±2.62）（6.32±1.81）d（t=5.143、4.988、5.536、6.147,P<0.05）,观察组的 C 反应性蛋白（C-reactive protein,CRP）、白细胞介素-6（Interleukin-6,IL-6）以及Toll样受体4（Toll-like receptor 4,TLR-4）水平分别为（3.64±0.87）mg/L、（54.59±10.65）ng/mL、（7.94±1.57）%,均低于对照组（7.51±1.43）mg/L、（87.66±11.17）ng/mL、（12.11±2.48）%（t=15.850、14.690、9.740,P<0.05）,观察组的气道压力、动脉血二氧化碳分压（partial pressure of carbon dioxide in artery,PaCO₂）水平分别为（6.92±3.60）cmH₂O、（43.19±6.29）mmHg,低于对照组（8.68±2.98）cmH₂O、（55.43±5.95）mmHg,观察组动脉氧分压（Partial arterial oxygen pressure,PaO₂）（86.06±5.31）mmHg、血氧饱和度（oxyhemoglobin saturation,SpO₂）（98.03±6.63）%高于对照组（68.04±5.19）mmHg、（90.22±5.51）%要高（t=2.582、9.692、16.638、6.221,P<0.05）,观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义（χ²=2.849,P>0.05）。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。

Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group．The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration．The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group（χ²=3．887,P<0.05）．The relief time of fever,pulmonary rale,cough and sputum in observation group was（3.09±1.25）d,（4.17±2.24）d,（3.95±1.53）d,and（4.05±1.77）d,respectively,which were significantly lower than the control group[（5.14±2.43）d,（7.03±3.23）d,（6.40±2.62）d and（6.32±1.81）d]（t=5.143,4.988,5.536,6.147,P<0.05）．The levels of CRP,IL-6 and TLR-4 in the observation group were（3.64±0.87）mg/L,（54.59±10.65）ng/mL and（7.94±1.57）%,respectively．They were significantly lower than（7.51±1.43）mg/L,（87.66±11.17）ng/mL and（12.11±2.48）% in the control group（t=15.850,14.690,9.740,P<0.05）．The airway pressure and PaCO₂ levels of the observation group were（6.92±3.60）cmH₂O and（43.19±6.29）mmHg,respectively,which were significantly lower than those of the control group[（8.68±2.98）cmH₂O and（55.43±5.95）mmHg]．The levels of PaO₂[（86.06±5.31）mmHg] and SpO₂[（98.03±6.63）%] in the observation group were higher than those in the control group[（68.04±5.19）mmHg and（90.22±5.51）%],and there were statistically significant differences（t=2.582,9.692,16.638,6.221,P<0.05）．The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference（χ²=2.849,P>0.05）. Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients．

目的 分析早产儿发生新生儿坏死性小肠结肠炎（NEC）的临床特点及危险因素。方法 选取2021年3月—2023年3月在濮阳市人民医院出生的早产儿160例,根据有无NEC分为NEC组（40例）和非NEC组（120例）,总结和比较两组患儿的临床资料,分析早产儿NEC的危险因素。结果 NEC组早产儿的发病时间主要集中在出生后的3~21 d,平均发病时间为（12.84±3.5）d。主要临床症状包括肉眼便血23例（57.5%）、腹胀31例（77.5%）、呕吐18例（45.0%）、呼吸暂停7例（17.5%）、肠穿孔9例（22.5%）。Logistic回归分析发现,败血症、输血、呼吸窘迫综合征及新生儿窒息是早产儿发生NEC的危险因素（P<0.05）,而预防应用益生菌以及母乳喂养是NEC的保护因素（P<0.05）。结论 NEC的主要临床表现包括肉眼便血、腹胀、呕吐、呼吸暂停、肠穿孔等;患儿出现NEC与败血症、输血、呼吸窘迫综合征及新生儿窒息等因素相关;母乳喂养和益生菌的应用是其保护因素。

Objective To analyze the clinical characteristics and risk factors of necrotizing enterocolitis（NEC）in premature infants. Methods A total of 160 premature infants born in Puyang People's Hospital from March 2021 to March 2023 were selected and divided into NEC group（40 cases）and non-NEC group（120 cases）according to the presence or absence of NEC．The clinical data were obtained and compared between the two groups．The clinical data of two groups were compared,and the related risk factors of NEC in premature infants were analyzed and summarized. Results The onset time of NEC premature infants is mainly between 3-21 days after birth,with an average onset time of（12.84±3.5）days．The main clinical symptoms included 23 cases（57.5%）of bloody stool,31 cases（77.5%）of abdominal distension,18 cases（45.0%）of vomiting,7 cases（17.5%）of apnea,and 9 cases（22.5%）of intestinal perforation．Logistic regression analysis found that sepsis,blood transfusion,respiratory distress syndrome,and neonatal asphyxia were risk factors for NEC in premature infants（P<0.05）,while prophylactic use of probiotics and breastfeeding were protective factors for NEC（P<0.05）. Conclusions The main clinical manifestations of NEC include bloody stool,abdominal distension,vomiting,apnea,intestinal perforation,etc．NEC in infants is related to sepsis,blood transfusion,respiratory distress syndrome and neonatal asphyxia．Breastfeeding and the application of probiotics are its protective factors．

目的 探究高原地区世居居民与常住居民的心脏结构和功能的差异性。方法 选择2022年6月—2023年8月在西藏林芝市人民医院体检的200例世居居民与常住居民作为研究对象,将世居居民和常住居民按照性别分为男女亚组,按照年龄段分为18~31岁、31~40、41~50岁亚组。比较各亚组心脏结构参数、左心功能参数、多普勒超声检测参数差异。结果 与高原常住居民男性和女性比较,世居居民男性和女性的左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标比较差异均无统计学意义（P>0.05）;而主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速增加,两组间比较差异具有统计学意义（P<0.05）。18~31岁、31~40、41~50岁组世居居民和常住居民左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标等指标比较差异均无统计学意义（P>0.05）,但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民,差异具有统计学意义（P<0.05）。结论 高原地区世居居民和常住居民心脏结构参数和左心功能参数无明显差异。但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民。

Objective To explore the ethnic differences in heart structure and function between aborigines and long term residents in the plateau area. Methods A total of 200 aborigines and long term residents who underwent physical examination in our hospital from June 2022 to August 2023 were selected as the study subjects,and the aborigines and long term residents were divided into male and female subgroups,and subgroups aged 18-30 years,31-40 years and 41-50 years．The differences of cardiac structure parameters,left ventricular function parameters and Doppler parameters were compared among subgroups. Results The left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction mitral valve A peak velocity were compared between Aborigines and plateau Long Term Residents,which were no significant difference（P>0.05）．However,the velocity of aortic valve orifice,pulmonary valve orifice and mitral valve E peak velocity increased,and the differences were statistically significant（P<0.05）．There were no significant differences in left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,posterior left ventricular wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,left ventricular diameter,left ventricular diameter,and left ventricular ejection fraction mitral valve A peak velocity indexes in aborigines and long term residents between among aged 18-30 years,31-40 years,41-50 years（P>0.05）,but the differences of aortic valve orifice velocity,pulmonary valve orifice velocity and mitral valve E peak velocity were statistically significant（P<0.05）. Conclusions There were no significant difference in cardiac structure parameters and left heart function parameters between aborigines and long term residents in plateau area．However,the aortic orifice velocity,pulmonary orifice velocity and mitral E-peak velocity of aborigines were higher than those of long term residents．

目的 探讨依奇珠单抗对中重度斑块型银屑病的治疗效果。方法 选取厦门大学附属第一医院2022年1月—2023年8月收治的75例中重度斑块型银屑病患者,应用抽签法进行分组,分为试验组（n=35）与对照组（n=40）。对照组采取常规外用药物治疗,试验组采取依奇珠单抗治疗。对比两组临床疗效,治疗前后外周血调节性T细胞（Treg）和辅助性T细胞17（Th17/Treg）细胞水平变化,并对所有患者进行6个月门诊复查随访,对比复发率及不良反应。结果 试验组总有效率88.57%,高于对照组的67.50%（χ²=4.730,P=0.028）;治疗后两组患者Treg细胞升高,试验组（5.59±1.24）%高于对照组（4.12±1.13）%,对比差异有统计学意义（t=5.371,P<0.001）,Th17细胞、Th17/Treg细胞降低,试验组[（1.06±0.14）%、0.19±0.05]低于对照组[（1.71±0.28）%、0.42±0.14],对比差异有统计学意义（t=12.434、9.212,P<0.001）;试验组停药后6个月复发率低于对照组（5.71% vs 27.50%,χ²=6.180,P=0.013）;试验组不良反应发生率略高于对照组,组间对比差异无统计学意义（14.29% vs 5.00%,χ²=1.900,P=0.168）。结论 依奇珠单抗治疗中重度斑块型银屑病疗效显著,可调节Th17/Treg平衡,降低停药后复发率,且安全性较高。

Objective To explore the therapeutic effect of Ixekizumab on moderate to severe plaque psoriasis. Methods Seventy-five patients with moderate to severe plaque psoriasis who were admitted to the First Affiliated Hospital of Xiamen University from January 2022 to August 2023 were selected and allocated by lottery into an experimental group（n=35）and a control group（n=40）．The control group received routine external medication while the experimental group received Ixekizumab treatment．The clinical efficacy of two groups,changes in Th17/Treg cell values before and after treatment were compared,and a 6-month outpatient follow-up for all patients was conducted to compare recurrence rates and incidence of adverse reactions. Results The total response rate in the experimental group was 88.57%,which was higher than the 67.50% in the control group（χ²=4.730,P=0.028）．After treatment,the level of Treg cell in the two groups was significantly higher,and the level of Treg cell experimental in the group was higher than that in the control group[（5.59±1.24）% vs （4.12±1.13）%,t=5.371,P<0.001]．After treatment,the level of Th17 and Th17/Treg cell in the two groups were lower,and the level of Th17 cell and Th17/Treg in the experimental group[（1.06±0.14）%,0.19±0.05] were significantly lower than those in the control group[（1.71±0.28）%,0.42±0.14],which was statistically significant（t=12.434、9.212,P<0.001）．The relapse rate at 6 months after drug withdrawal in the experimental group was significantly lower than that in the control group（5.71% vs 27.50,χ²=6.180,P=0.013）．The incidence of adverse reactions in the experimental group was higher than that in the control group,but with no statistical significance（14.29% vs 5.00%,χ²=1.900,P=0.168）. Conclusions Ixekizumab has a significant therapeutic effect on moderate to severe plaque psoriasis．It can regulate the Th17/Treg balance and reduce the recurrence rate after discontinuation,and with high safety．

目的 初步探讨无创产前基因检测（NIPT）筛查胎儿患猫叫综合征临床性能。方法 收集2018年4月—2019年3月行NIPT提示胎儿患猫叫综合征高风险的孕妇,并收集其羊水细胞培养染色体核型分析或微阵列芯片检测结果,分析NIPT与羊水产前诊断结果的符合率。结果 NIPT提示猫叫综合征病例11例,孕妇均接受了羊水穿刺,染色体核型分析或微阵列芯片检测出胎儿染色体异常6例,符合率为54.5%。结论 NIPT对胎儿猫叫综合征的筛查具有临床价值,当提示高风险时必须行有创性产前诊断。

Objective To investigate the value of non-invasive prenatal testing（NIPT）for the screening of fetal Cri du Chat Syndrome（CdCS）. Methods Pregnant women who accepted NIPT with the results with high risk of fetal CdCS were selected in the study from April 2018 to March 2019．They were also accepted prenatal genetic counseling and the chromosome karyotype analysis or CMA detection of amniotic fluid cell culture．The coincidence rate of NIPT with chromosome karyotype and microarray analysis results were conducted. Results There were 11 cases with high risk of fetal CdCS in NIPT．All of them had received amniocentesis chromosome karyotype or microarray analysis,6（54.5%）cases were confirmed. Conclusions NIPT has some clinical value in screening fetal CdCS from maternal blood．Therefore,it was suggested to perform the invasive chromosomal karyotyping and CMA for high risk of fetal CdCS．

前人总结的用药禁忌十八反未必是绝对禁忌,笔者从广东省名中医陈国成主任独创星夏止痛膏外治中得到反药“乌头-半夏”的配伍启示。本文简要叙述反药配伍的源流及应用,重点对陈国成使用乌头配半夏外用的经验及思路进行论述,认为乌头与半夏配伍可通过多种方式减毒增效,为临床安全使用该配伍药物提供新的思路。

The eighteen antagonisms summarized by predecessors may not be absolute contraindications．The author obtained the inspiration of the antagonism medicinals “aconite-pinellia” from the external treatment of Xingxia painkiller ointment created by Chen Guocheng．The present paper provides a concise overview of the origin and application of anti-drug compatibility,with a specific focus on Chen Guocheng's expertise and insights regarding the external use of aconite combined with pinellia．It is postulated that diverse approaches can be employed to modulate the compatibility between aconite and pinellia,thereby offering novel perspectives for ensuring the safe utilization of this drug combination in clinical practice．