目的 分析PBK在前列腺癌中的表达及临床意义。方法 利用前列腺癌的组织芯片,包含98例前列腺癌及81例对照癌旁组织作为研究对象,免疫组化方法检测PBK的表达情况,并运用统计学方法分析免疫组化芯片及Taylor数据库中PBK表达与前列腺癌临床病理特征之间的关系。结果 PBK在前列腺癌中表达明显升高(P=0.001);且在Gleason高评分组的表达比低评分组表达升高(P=0.001)。Taylor数据库得到相似结果,且运用Kaplan-Meier分析发现PBK与无生化复发生存率显著相关(P=0.007),最后采用Cox回归模型进行多因素综合分析发现在影响前列腺癌预后的队列中,PBK高表达(P=0.041)与Gleason评分、病理分期都是前列腺癌生化复发的独立预测指标。结论 PBK的表达与前列腺癌密切相关,可作为临床诊断及治疗的分子标志物。

Objective To investigate the expression and clinical significance of PBK in prostate cancer. Methods Using tissue microarrays of prostate cancer, which including 98 cases of prostate cancer and 81 cases of normal tissue adjacent to cancer as the research object, the expression of PBK was detected by immunohistochemistry, and statistical analysis was used to analyze the relationship between the expression of PBK and the clinicopathological features of prostate cancer in the microarray and Taylor database. Results The expression of PBK in prostate cancer was significantly higher (P=0.001), and the expression increased in the group of high Gleason score (P=0.001). The Taylor database obtained similar results, and Kaplan-Meier analysis showed that PBK was significantly correlated with the biochemical recurrence free survival (P=0.007). Finally, Cox regression model was used to analyze the prognostic factors of prostate cancer. Result shows that, the high expression of PBK (P=0.041), Gleason score and pathological stage were independent predictors of biochemical recurrence of prostate cancer. Conclusion The expression of PBK is closely related to prostate cancer, and can be used as a molecular marker for clinical diagnosis and treatment.

目的 探索长链非编码RNA LINC00672在肺癌组织中的表达及其与患者预后的关系。方法 采用实时荧光定量PCR技术检测LINC00672在75对肺癌组织和癌旁正常组织中的表达,分析其在癌组织中的表达水平与肺癌患者临床分期和预后的关联。结果 LINC00672在肺癌组织中的表达显著低于癌旁正常组织(P=0.026),LINC00672高表达与低表达相比能显著降低肺癌患者的死亡率(死亡风险比=0.46;95%置信区间=0.23~0.95;P=0.036),延长患者中位生存期(34个月 vs 18个月,P=0.027)。并且,LINC00672与肺癌预后的关联在低年龄组(<60 a)、吸烟者和非饮酒者中更为显著。进一步相乘交互作用分析显示LINCOO672与饮酒在肺癌死亡风险上具有显著的交互效应(P=0.049)。然而,LINC00672的表达水平在不同分期、T、N、M患者来源的肺癌组织中的表达无显著性差异。结论 LINC00672与肺癌发生发展存在关联,可用于预测肺癌患者的预后。

Objective To explore the expression status of long non-coding RNA LINC00672 in lung cancer tissues and its correlation with survival of lung cancer. Methods We applied the real-time PCR method to measure the expression level of LINC00672 in 53 pairs of lung cancer tissues and adjacent lung normal tissues, and analyzed the correlation between its expression and survival of lung cancer. Results LINC00672 was significantly down-regulated in lung cancer tissues than their adjacent lung normal tissues (P=0.026). Compared to those with low expression level of LINC00672, patients with high expression level of LINC00672 exerted a significant long median survival time than those with low expression level (34 vs 18 months, P=0.027). High LINC00672 expression also contributed to low mortality rate than low LINC00672 expression (hazard ratio=0.46, 95% confidence interval =0.23-0.95, P=0.036). Meanwhile, the correlation was more evident in those low age groups (< 60 years), smokers and non-drinkers. There was also a significant interaction between LINC00672 and drinking on affecting death risk of lung cancer. However, no significant association was observed between LINC00672 expression and clinical stages as well as T, N, M status. Conclusion LINC00672 is correlated with development of lung cancer, which may be a valuable biomarker to predict lung cancer prognosis.

目的 探讨川芎嗪对链脲佐菌素(STZ)诱导2型糖尿病大鼠肾病的治疗作用及机制。方法 SD大鼠50只,随机分为正常组和模型组。除正常组外,其余大鼠均给予高脂-高糖饲料喂养4周,再给予链脲佐菌素(40 mg/kg,ip),72 h后测定空腹血糖,将血糖值高于16.67 mmol/L的大鼠随机分成4个组即模型组,二甲双胍阳性组(250 mg/kg),川芎嗪低、高剂量组(80、160 mg/kg),连续给予相应试药8周。其中正常组和模型组的大鼠均给予同等量蒸馏水灌胃。实验结束时,测定大鼠血糖、尿蛋白、血尿素氮和血肌酐含量;免疫组化法测定大鼠肾组织TLR4和caspase3蛋白表达。光镜下观察肾脏病理学变化。结果 与模型组比较,二甲双胍组和川芎嗪高剂量组给药8周后,大鼠动态空腹血糖均能明显降低(P<0.05),大鼠动态尿蛋白显著性降低(P<0.01,P<0.05); 二甲双胍和高剂量组TLR4和caspase3蛋白表达明显低于模型组(P<0.05);肾脏组织病理性损伤明显减轻。结论 川芎嗪对STZ诱导2型糖尿病大鼠肾病具有保护作用,其机制可能与下调TLR4表达作用有关。

Objective To investigate the therapeutic effects and mechanisms of tetramethylpyrazine (TMP) on streptozocin(STZ)-induced-nephropathy in type 2 diabetic rats. Methods 50 SD rats were randomly divided into normal group(n=10) and model group(n=40). The model rats were fed on high fat and sugar diets for 4 weeks, then given STZ(40 mg/kg,ip). After 72 hours, the fasting blood glucose (FBG) was measured. Rats with high FBG above 16.67mmol/L were randomly divided into four groups: model, metformin(Met, 250 mg/kg)and TMP (80 mg/kg, 160 mg/kg) groups for treating 8 weeks, and both the control and model groups were given equals distilled water by intragastric administration. At the end of the experiment, blood glucose, urine protein, blood urea nitrogen and creatinine were measured. The expression of TLR4 and caspase3 protein in kidney tissue of rats was determined by immunohistochemistry. Pathological changes of kidney were observed under light microscope. Results Compared with the model group, metformin and high dose of TMP administered after 8 weeks, rats can significantly reduce the dynamic fasting blood glucose(P<0.05). Urinary protein excretion of total dynamic decreased significantly (P<0.01, P<0.05); the protein expression of TLR4 and caspase3 in the metformin group and high dose group was significantly lower than that in the model group (P<0.05); kidney tissue pathological damage was significantly reduced. Conclusion TMP has a protective effect on STZ induced nephropathy in type 2 diabetic rats, and its mechanism may be related to the down-regulation of TLR4 expression.

目的 观察乳腺癌组织中沉默信息调节因子(SIRT1)的表达并探讨其临床意义。方法 选取70例乳腺癌组织和20例乳腺纤维腺瘤组织,应用免疫组化法观察SIRI1在两组中的表达,并分析其与临床病理参数、预后之间的关系。结果 SIRT1在乳腺癌组织中和乳腺纤维腺瘤组织中的阳性表达分别为:62.9%(44/70)、35%(7/20),P＜0.05;SIRT1的表达与乳腺癌的病理分期及淋巴结转移有关,P＜0.05;SIRT1表达阳性和阴性患者2年无疾病进展生存率分别为40.6%和73.7%,P＜0.05。结论 乳腺癌组织中SIRT1的阳性表达率较高,并与乳腺癌的发生、发展、侵袭、转移、预后有关。

Objective To investigate the sirtuin (SIRT1) expression in breast cancer and its relationship with clinicopathological parameters in breast tissue. Methods We used immunohistochemical staining (Envision two-step) to detect the expression of 70 cases of breast cancer and 20 cases of breast fibroadenoma of SIRT1. Results The positive expression of sirt1 in breast cancer and breast fibroadenoma tissues were 62.9 % (44/70) and 35 % (7/20),P<0.05. The expression of sirt1 was correlated with the pathological stage and lymph node metastasis of breast cancer, P<0.05. The 2-year survival rates of sirt1 positive and negative patients were 40.6 % and 73.7 %, respectively, P<0.05. Conclusion The positive expression rate of sirt1 in breast cancer is higher, and is related to the occurrence, development, invasion, metastasis and prognosis of breast cancer.

目的 观察芳香烃受体(AhR)及Th17相关细胞因子在类风湿关节炎中的表达水平及其对疾病的预测价值。方法 选择2014年1月—2015年12月于我院就诊的RA患者60例作为观察组,选取同期于我院进行健康体检的正常人60例作为对照组,采用酶联免疫吸附法检测血清中 IL-17、IL-23及AhR的表达水平,并分析其与疾病活动度的关系。结果 RA患者血清IL-17、IL-23及AhR水平高于对照组(P＜0.05)。而根据病情严重程度,RA 非早期组IL-17、IL-23及AhR水平较早期组增高(P＜0.05)。血清 IL-17 水平与除CRP以外的病情活动度指标均呈正相关关系(P＜0.05)。IL-23 水平与SJC、TJC、HAQ 、DAS28 评分呈正相关关系(P＜0.05),但其他指标无明显相关性(P>0.05)。RA患者PBMC中AhR的表达水平与各项临床指标无相关性(P>0.05)。IL-17和IL-23水平与Sharp评分呈正相关关系(r=0.895,P＜0.01;r=0.708,P＜0.01)。AhR的表达与血清IL-17和IL-23水平呈正相关(r=0.415,P＜0.01)。经荧光定量PCR检测结果显示,RA患者AhR及其下游因子CYP1A1、IL-17、FOXP3 mRNA的表达水平高于对照组(P＜0.05)。且RA 非早期组AhR及其下游因子CYP1A1、IL-17、FOXP3 mRNA的表达水平较早期组增高(P＜0.05)。经相关关系检测,RA患者AhR及其下游因子CYP1A1、IL-17、FOXP3 mRNA的表达水平与Sharp评分呈正相关关系(r=0.715,P＜0.01;r=0.734,P＜0.01;r=0.812,P＜0.01;r=0.755,P＜0.01)。结论 Th17相关细胞因子IL-17和IL-23在RA病理生理过程中发挥重要作用,其表达增高,提示关节炎症处于活跃状态,骨质破坏较重,可作为评估RA病情的重要指标。RA患者体内AhR蛋白及其相关下游信号通路均呈高表达状态,AhR通路在RA患者的发病过程中可能发挥关键作用。

Objective To observe the expression level of aroma receptor (AhR) and Th17 related cytokines in rheumatoid arthritis and its predictive value to disease. Methods Sixty patients with RA who were treated in our hospital from January 2014 to December 2015 were selected as the observation group. Sixty healthy subjects were randomly selected as the control group. IL-17, IL-23 and AhR levels in serum were detected by enzyme-linked immunosorbent and the relationship between IL-17, IL-23 and disease activity were analyzed. Results IL-17, IL-23 and AhR levels in serum of RA patients were significantly higher than those in controls (P<0.05). However, the levels of IL-17, IL-23 and AhR levels were significantly higher in the non- early RA group than in the early group (P<0.05), depending on the severity of the disease. There was a positive correlation between serum IL-17 level and disease activity index except CRP (P<0.05). IL-23 level was positively correlated with SJC, TJC, HAQ and DAS28 scores (P<0.05), but no significant correlation was found between other indexes (P>0.05). The expression level of AhR in PBMC of RA patients was not correlated with clinical indexes (P>0.05). IL-17 and IL-23 levels were positively correlated with Sharp score (r=0.895, P<0.01; r=0.708, P<0.01). The expression of AhR was positively correlated with serum IL-17 and IL-23 levels (r=0.415, P<0.01). The expression of AhR and its downstream factors CYP1A1, IL-17 and FOXP3 mRNA in RA patients were significantly higher than those in the control group (P<0.05) by fluorescence quantitative PCR. The expression of AhR and its downstream factors CYP1A1, IL-17 and FOXP3 mRNA in RA group were significantly higher than those in early group (P<0.05). The expression level of AhR and its downstream factors CYP1A1, IL-17 and FOXP3 mRNA in RA patients were positively correlated with Sharp scores (r=0.715, P<0.01; r=0.734, P<0.01; r=0.812, P<0.01; r=0.755, P<0.01). Conclusion The Th17-related cytokines IL-17 and IL-23 play an important role in the pathophysiology of RA, and the expression of Th17-associated cytokines is increased, suggesting that arthritis is active and bone destruction is serious. The AhR protein and its associated downstream signaling pathways are highly expressed in RA patients, and the AhR pathway may play a key role in the pathogenesis of RA patients.

目的 观察紫河车提取物联合顺铂对人脑胶质瘤细胞增殖与凋亡的影响。方法 把正常培养传代后的U251胶质瘤细胞按随机分配的方法分为四组,A组仅加普通培养液,B、C、D组各加紫河车提取物(400 mg/mL)2 mL、顺铂(1 mg/mL)0.01 mL、紫河车提取物(400 mg/mL)2 mL＋顺铂(1 mg/mL)0.01 mL;MTT法观察U251细胞增殖情况,流式细胞仪检测U251细胞凋亡率。结果 培养12、24、36、48、60 h,B、C、D组细胞增殖指数逐渐下降,与A组进行比较,各组P值均小于0.05;其中,将D组与B、C组进行比较,P值小于0.05。将各组培养24 h后上机,测得A、B、C、D各组细胞的凋亡率分别为(0.3±0.2)%,(10.6±1.5)%,(35.9±2.8)%,(52.1±4.1)%。其中,B、C、D各组和A组进行比较,P值均小于0.05;将D组与B、C组两组进行比较,P值也均小于0.05。结论 紫河车提取物联合顺铂可抑制人脑胶质瘤U251细胞增殖,并诱导其凋亡。

Objective To observe the effect of cisplatin combinated with the placental immunoregulating polypeptide (PIP) on proliferation and apoptosis of glioma cells. Methods Randomly we divide the normal handed U251 glioma cells into four groups. We added ordinary nutrient solution to group A, while added activated PIP(400 mg/mL)2 mL to group B, cisplatin (1 mg/ml) 0.01 ml to group C, PIP 400 mg/mL)2 mL and cisplatin (1 mg/mL) 0.01 mL to group D. We surveyed the proliferation rate of gliobma cells by MTT experimental method and analyzed the apoptosis of U251 glioma cells by flow cytometry. Results The index of cell proliferation of group B,C,D declined gradually with the training of 12 h,24 h,36 h,48 h,60 h. Compared B, C,D group with A group, P<0.05,and compared group D with group B and group C, P< 0.05. Put groups culturing of 24 hour on flow cytometer, the glioma cells apoptosis rate of each group was 0.3%±0.2%、10.6%±1.5%、35.9%±2.8%、52.1%±4.1% respectively. Compared group B,C,D with group A, P<0.05,and compared group D with group B and group C, P<0.05. Conclusion Placental immunoregulatingpPolypeptide combined with cisplatin may restrain the proliferation of human glioma cells, meanwhile increase the apoptosis of glioma cells.

目的 探讨原发性肉碱缺乏症的诊断与治疗方案,对2例原发性肉碱缺乏症患儿及其家系行SLC22A5基因检测,确定基因突变位点,为家系提供遗传疾病的咨询。方法 用串联质谱技术对1例疑似患儿进行游离肉碱及多种酰基肉碱检测,对游离肉碱降低的患儿行SLC22A5基因突变检测,确诊PCD,对其姐姐行上述检查。对2例确诊PCD患儿补充左旋肉碱治疗,随访11个月。并对其家系行SLC22A5基因检测。结果 2例确诊PCD患儿,1例为临床患儿,另1例为其姐姐,无明显临床表现。2例患儿均检测到基因突变。2例患儿血游离肉碱水平低于参考值,伴多种酰基肉碱显著降低,均给予补充左旋肉碱治疗,1例治疗2月后症状改善,另1例未曾未发病,血游离肉碱及其他酰基肉碱水平上升至正常。2例患儿SLC22A5 c.760C>T,(p.Arg254X)纯合,致病突变;患儿父母亲SLC22A5基因的c.760C位点检测,发现:均携带c.760C>T,(p.Arg254X)杂合突变。结论 应用串联质谱技术检测血游离肉碱、多种酰基肉碱水平及SLA22A5基因突变检测诊断了2例PCD,均补充左旋肉碱取得较好疗效。SLC22A5基因c.760C>T,(p.Arg254X)突变是本家系中患有PCD的致病突变,用错义突变和剪切改变的分析手段对SLC22A5基因的外显子编码区进行直接测序可为PCD家系提供遗传咨询。

Objective To explore the diagnosis and treatment of primary carnitine deficiency. To identify potential mutation of SLC22A5 gene in two children affected with primary carnitine deficiency and provide genetic counseling. Methods We measured the free camitine(Co)and acylcamitine levels in a suspected clinical inherited metabolic diseases by tandem mass spectrometry. The SLC22A5 gene mutations were tested to the children with low Co level and the diagnosis was made. Then, We measured the free camitine(Co)and acylcamitine levels and SLC22A5 gene mutations in her sister. The children with PCD were treated with carnitine and followed up for 11 months. The SLC22A5 gene was detected in their family. Results In two children affected with PCD, 1 case was clinical children, another case of their sister was no obvious clinical manifestations. Mutations were found in all of them.The average C0 level in patients was lower than the reference value,along with decreased level of different acylcamitines. Two cases were treated with earnitine. Their clinical symptoms reduced 2 months later. Another case had not been sick. The CO level and different acylcamitines level in the blood rose to normal. A homozygous mutation C. 760C>T (P. Arg254X)of the SLC22A5 gene was detected in the two cases.Heterozygous mutation C. 760C>T (P.Arg254X) was also found in other family members. Conclusion Two patients were diagnosed with PCD by the test levels of free carnitine and acylcarnitines in blood with tandem mass spectrometry,and gene mutation test. L-carnitine supplement had a good effect in treatment of the PCD patients.C.760C> T (P.Arg254X) mutations of the SLC22A5 gene is the deleterious mutations for PCD families, The analysis method of the wrong mutagenesis and shear changes which is used to directly sequence the exons codes of the SLC22A5 gene can provide genetic counseling for PCD families.

目的 探讨黄连素联合左氧氟沙星对肺炎克雷伯菌(KPn)抑菌作用。方法 KPn分为敏感株组和耐药株组,采用琼脂二倍稀释法测定黄连素联合左氧氟沙星对KPn的最低抑菌浓度(MIC)、抑制99％接种细菌生长的最低抑菌浓度(MIC99)、防突变浓度(MPC);比浊法测定黄连素联合左氧氟沙星对KPn生长曲线的影响。结果 与单用左氧氟沙星相比,联合黄连素后,敏感株组和耐药株组对左氧氟沙星MIC的下降率分别为33.3%和20%,2组之间无统计学差异(P>0.05)。左氧氟沙星与50 μg/mL黄连素或500 μg/mL黄连素联用后的抗菌能力均较单用左氧氟沙星好,且高浓度黄连素的联合抑菌效果较低浓度更加明显,差异有统计学意义(P<0.05)。与50 μg/mL黄连素联用后,左氧氟沙星SI下降了1/5 ;而与500 μg/mL黄连素联用则下降3/5 。结论 本实验证明了黄连素与左氧氟沙星联用能增加左氧氟沙星对KPn的抗菌作用,可以明显缩小耐药突变选择窗(MSW),且高浓度黄连素联合抗菌作用较低浓度好。

Objective To explore antibacterial effect of berberine(Ber) on K. Pneunmoniae(KPn) combing with levofloxacin(LVX). Methods KPn was divided into sensitive and resistant strains groups.The MIC, MIC99 and MPC of Ber combing with LVX on KPn was determined by the agar dilution method.The growth curve of Ber combing with LVX on KPn was measured by turbidimetry. Results Ber combined with LVX compare with LVX alone, MIC descent rate of sensitive strains group was 33.3%, resistant strains group was 20%, and there were no statistical differences along two groups(P>0.05). Ber combined with LVX could increase antibacterial effect and high concentration was more obvious than the low one, there were statistical differences(P<0.05). Compared with LVX alone,the SI value of 50 μg/mL Ber combined with LVX was decreased 1/5, and the SI value of 500 μg/mL Ber combined with LVX was decreased 3/5. Conclusion Ber combing with LVX could increase bacteriostatic effect on KPn,and reduce MSW significantly; high concentration of berberine was better than low one.

目的 利用大肠杆菌原核表达系统优化表达纯化肠道病毒71型(EV71)VP3结构蛋白,为后续单克隆抗体制备及检测试剂盒研发提供前期基础。方法 采用PCR方法扩增EV71病毒VP3基因,将其插入表达载体pET28a(+),构建pET28a-VP3重组质粒,转化大肠杆菌BL21(DE3)菌株,分别在25 ℃、37 ℃下经IPTG诱导表达,重组表达的蛋白产物经凝胶电泳初步分析,比较不同温度诱导表达的蛋白产物。结果 成功构建pET28a-VP3重组质粒,不同温度下诱导表达的蛋白产物在30.5 kDa左右位置均出现目的条带;37 ℃下诱导表达的蛋白超声破碎并离心后,目的蛋白基本位于沉淀中,而25 ℃诱导表达的蛋白产物有少量目的蛋白溶解于上清液中。结论 在25 ℃或37 ℃下均能利用大肠杆菌原核表达系统有效表达EV71病毒VP3蛋白;37 ℃诱导时蛋白可融性表达低,目的蛋白获取效率较高。

Objective To express VP3 capsid protein of enterovirus 71 by using Escherichia coli prokaryotic expression system. Methods VP3 gene was amplified by PCR before inserted into pET28a(+) plasmid. Then the plasmid pET28a-VP3 was transformed and expressed in the Escherichia coli BL21 strain at 25 ℃ or 37 ℃. Finally the protein was analyzed by SDS-PAGE gel electrophoresis. Results The pET28a-VP3 plasmid was successfully constructed, and the EV71 VP3 protein was expressed. Supernatant of the production after ultrasonication and centrifugation got a little VP3 protein. Conclusion The EV71 VP3 protein was expressed. Expression at 25 ℃ may lead to the dissolution of the recombinant protein.

目的 研究雷公藤红素对人阿霉素耐药MCF-7/ADR乳腺癌细胞生长的作用。方法 采用MTT试验检测MCF-7/ADR细胞对阿霉素的耐药情况以及雷公藤红素对MCF-7/ADR细胞生长的影响;采用Annexin V-FITC/PI双染试验分析雷公藤红素对MCF-7/ADR耐药细胞凋亡的诱导作用;应用流式细胞周期分析检测雷公藤红素对MCF-7/ADR耐药细胞周期的影响。结果 MCF-7/ADR细胞对阿霉素耐药指数达14.54;而雷公藤红素能有效抑制阿霉素耐药细胞MCF-7/ADR的生长,并呈现浓度依赖性,作用48 h的IC50是1.04 μmol/L,MCF-7/ADR对雷公藤红素的耐药指数仅为0.87。2 μmol/L雷公藤红素作用8 h后,Annexin V-FITC染色阳性的MCF-7/ADR细胞比例较对照显著升高,差异有统计学意义(P＜0.05)。在1 μmol/L雷公藤红素作用24 h后,G1期细胞比例由对照(59.22±3.78)%升高至(77.44±4.21)%,而S期细胞比例由对照(37.51±2.91)%降至(19.65±2.25)%,差异有统计学意义(P＜0.05)。结论 雷公藤红素能激活MCF-7/ADR细胞凋亡的发生,并诱导MCF-7/ADR发生 G1/S细胞周期阻滞,从而对阿霉素耐药MCF-7/ADR细胞的生长发挥高效抑制作用。

Objective To investigate the effect of celastrol on the growth of adriamycin-resistant MCF-7/ADR breast cancer cells. Methods The resistance situation of MCF-7/ADR cells to adriamycin and the effect of celastrol on the growth of adriamycin-resistant MCF-7/ADR cells were evaluated by MTT assay. The effect of celastrol on apoptosis in MCF-7/ADR breast cancer cells was determined by annexin V-FITC/PI double staining. The effect of celastrol on cell cycle progression was determined by flow cytometry analysis. Results The resistance index of MCF-7/ADR cells to adriamycin was 14.54. After treatment with celastrol for 48 h, MCF-7/ADR cells displayed markedly inhibited growth in a dose-dependent manner, and calculated IC50 was 1.04 μmol/L. Celastrol decreased the resistance index of MCF-7/ADR from 14.54 to 0.87. The numbers of apoptotic MCF-7/ADR cells, as revealed by annexin V binding, significantly increased upon celastrol treatment (P＜0.05). Celastrol treatment caused an increase of cells in G1 phase from (59.22±3.78)% to (77.44±4.21)%, while the percentage of cells in S phase was decreased from(37.51±2.91)% to(19.65±2.25)%(P＜0.05). Conclusion These data demonstrated that celastrol induced apoptosis and G1/S cell cycle arrest in MCF-7/ADR cells and consequently displayed potent cytocidal effect on adriamycin-resistant MCF-7/ADR breast cancer cells.

目的 探讨DPP-4抑制剂西格列汀对成人隐匿性自身免疫性糖尿病(LADA)早期患者胰岛β细胞功能的影响。方法 把14例新诊断为LADA患者随机分为两组,胰岛素治疗100 mg/d西格列汀(A组,n=7)或无西格列汀(B组,n=7)共治疗9个月。结果 9个月后两组之间的血糖和糖化血红蛋白水平无差异。9个月后A组空腹C肽(FCP),餐后C肽(CP),和ΔCP(ΔCP=2 h CP-FCP)水平与基线相比无明显差别(P＞0.05),B组FCP,2 h的CP和ΔCP进行比较基线显著下降(P<0.05)。A组2 h CP水平明显高于B组(P<0.05)。结论 胰岛素与西格列汀联用较单用胰岛素治疗成人隐匿性自身免疫糖尿病早期患者似乎能更好保护胰岛β细胞功能,西格列汀或可延长LADA非胰岛素依赖期的时间。

Objective The Objective of the study was to investigate the effects of the DPP-4 inhibitor on β-cell function in patients with recent-onset latent autoimmune diabetes in adults LADA. Methods Fourteen recently diagnosed LADA patients were randomized into two groups, A and B, to receive insulin therapy with 100 mg/d sitagliptin (group A, n=7) or without sitagliptin (group B, n=7) for 9 months. Results There were no differences in the clinical baseline data between the two groups. During the 9 months of follow-up, there were no significant differences in glucose and glycosylated hemoglobin levels between the two groups. At 9 months, there were not different in group A including fasting C-peptide (FCP), 2-hour postprandial C-peptide (CP), and ΔCP(ΔCP=2 h CP-FCP) levels (P>0.05). Compared with baseline, whereas in group B the levels of FCP, 2-hour CP and ΔCP were significantly decreased compared with baseline (P<0.05). Levels of 2-hour CP were higher in group A, it was higher than group B at 9 months (P<0.05). Conclusion LADA patients treated with sitagliptin and insulin was more likely maintain β-cell function by comparison with insulin alone. Sitagliptin administration in patients with LADA might prolong the insulin-free period.

目的 探讨代谢综合征(metabolic syndrome, MS)(指包括高血压,糖尿病,高脂血症和腹型肥胖的一组综合征)在中国南方老年病人的患病率、及其与心血管事件和痴呆关系。方法 本研究为一个中国南方老年人代谢综合征的横断面研究。我们采集了患者的病史、人口学和生化资料。对比生化资料、心血管事件、痴呆等疾病在MS组和非MS组中的差异,并使用Logistic回归分析来寻找MS的独立影响因子。结果 本研究共纳入206例患者。其中有92(44.66%)例患者符合代谢综合征的诊断标准。女性在MS组中35例(38.04%)明显高于在非MS组中28例(24.56%)。整体年龄(86.74± 6.10),在MS组(86.37±5.74)和非MS组(87.04±6.38)对比中无统计学意义。生化资料对比中,白细胞[(7.46±2.38) vs (6.46±2.35),P=0.003]和血肌酐[94.50(68.50, 129.33) vs 78.00(64.50, 99.75),P=0.004]在MS组中较高。Logistics单因素回归分析及多因素回顾分析提示白细胞、血肌酐和女性为MS的独立风险因子。心肌梗塞(35例,38.04%和心绞痛(28例, 24.56%)在MS组中明显高于非MS组中心肌梗塞(10例,8.77%)和心绞痛(39例,34.21%),两组比较有统计学意义,Logistics回归分析发现MS是心肌梗塞和心绞痛的独立影响因子;但是心衰和中风在两组对比中无统计学差别。痴呆(包括老年性痴呆和血管性痴呆)在MS组中明显低于非MS组:26例(28.26%)vs 50例(43.86%),提示MS可能对痴呆有预防作用。结论 MS在中国南方老年患者中普遍存在,女性、白细胞、血肌酐为MS的独立影响因子;MS是心肌梗塞和心绞痛的独立影响因子;MS中痴呆明显低于非MS组,可能对痴呆有预防保护性作用。

Objective To study the prevalence and correlation between the metabolic syndrome MS (including hypertension, diabetes, hyperlipidemia and obesity) with cardiovascular and dementia in the elderly people of south China. Methods This cross-sectional research studied metabolic syndrome of the elderly in south China. We collected the demographics and chemotic data and compared them in MS and non-MS group. And Logistic regression was used to analyze the independent factor of MS and the relationship between MS and the cardiovascular disease and dementia. Results This study included 206 patients and 92 (44.66%) of them were diagnosed as MS. 35 patients (38.04%) in MS group were female and 28 female cases (24.56%) in non-MS group. The mean age of the sample was (86.74±6.10) and the comparison between the MS group (86.37±5.74) and non-MS group (87.04±6.38) was not significantly different. White blood cell (WBC) (7.46±2.38 vs 6.46±2.35,P=0.003) and serum creatinine (Scr) was significantly [94.50(68.50,129.33) vs 78.00(64.50, 99.75),P=0.004]in MS group versus in non-MS group. Single factor and Multinomial logistic regression found WBC, serum creatinine and female gender were the independent risk factors of MS. Myocardial infarction (35, 38.04%) and angina (28, 24.56%) were significantly higher in MS group than that in non-MS group (10, 8.77%) and (39, 34.21%), respectively, with P<0.05. Logistic regression found MS was an independent risk factor of myocardial infarction and angina but not in heart failure and stroke. Dementia (including Alzheimer disease and vascular dementia) was found lower in MS group (26, 28.26%) than that in non-MS group (50, 43.86%), the difference was significant and this means MS could be protective for dementia. Conclusion MS is prevalent in the elderly of south China. Female gender, WBC and Scr were independent factors of MS; MS was the independent risk factor of myocardial infarction and angina; dementia was significantly lower in MS group, implying MS could be protective to dementia.

目的 通过对婴幼儿泌尿系感染并发脓毒症的临床特点、病原菌情况及相关因素的分析,探讨其早期诊断和及时治疗的措施。方法 选取83例我科收治的确诊泌尿系感染合并脓毒症的婴幼儿作为研究对象,回顾性分析其临床表现、实验室检查及治疗预后情况。结果 所选婴幼儿均确诊泌尿系感染合并脓毒症,以男性患儿多见,全身中毒症状重,6月以下多以严重脓毒症、脓毒性休克为首诊表现,尿路刺激症状不明显。有明显细菌感染生物标记物的改变。细菌学培养共检出细菌22株,大肠埃希菌占54.55% (12/22),对头孢吡肟较为敏感,对亚胺培南、美罗培南全部敏感;屎肠球菌占22.73%(5/22),对万古霉素、利奈唑胺、替考拉宁敏感。结论 在婴幼儿常见的感染部位中,泌尿系感染容易被忽略。而小于6月的患儿更易并发严重脓毒症、脓毒症休克等危重症。因此,以脓毒症为首诊表现的婴幼儿应特别警惕泌尿系感染,尽可能早期明确感染部位,防止漏诊。首诊1小时内给予广谱抗生素治疗,可降低婴幼儿脓毒症的病死率,改善患儿预后。

Objective By analyzing the clinical features, laboratory tests, pathogenic bacteria culture and the treatments of infants and toddlers with urinary tract infection UTI accompanied with sepsis, we aim to guide the further clinical treatments and prevention. Methods We selected 83 cases from January 1, 2014 to December 31, 2016 in our hospital as the research objects which were accepted the diagnosis and treatments of urinary tract infection complicated with sepsis. Its clinical manifestations, laboratory tests, bacteriology examination and treatment prognosis were retrospectively analyzed. Results Among the selected infants and toddlers diagnosed with urinary tract infection complicated with sepsis, male patients were more common. Symptoms of systemic poisoning were observed in the majority especially in the children aging under 6 months, with severe sepsis and septic shock as the first manifestation, while conventional symptoms were not obvious. Biological markers of bacterial infection were significantly changed. In bacterial culture, 22 strains of bacteria were detected, Escherichia coli accounted for 54.55% (12/22), were almost sensitive to cefepime, and all sensitive to imipenem and meropenem; Enterococcus following accounted for 22.73% (5/22), could be more sensitive to vancomycin, linezolid, teicoplanin. Conclusion Urinary tract infection is common in under 3 years old babies. Patients aging under 6 months are more likely to be complicated with severe sepsis and septic shock. Therefore, we should be especially vigilant of the UTI among the babies whose first manifestations appear to be sepsis only. It is important to find out the site of infection as early as possible, in order to prevent misdiagnosis. It is also critical to use broad-spectrum antimicrobial therapy within 1 hour when severe sepsis is diagnosed in order to reduce the mortality of sepsis in infants and improve the prognosis.

目的 探讨长期吸烟史对高危脑卒中患者口服阿司匹林二级预防效果的影响。方法 将2012年8月—2014年8月医院口服阿司匹林二级预防的高危脑卒中患者115例作为研究对象,根据有无吸烟史分为无吸烟史组(34例)和吸烟史组(81例),其中36例吸烟时间≥20 a(长期吸烟史组)、45例吸烟时间1～19 a(短期吸烟史组)。随访12个月,测定血小板颗粒膜蛋白(GMP-140)、D-二聚体(D-D)、纤维蛋白原(FIB)、组织型纤溶酶原激活物(t-PA)、血小板膜糖蛋白CD61、CD62p,记录1年阿司匹林抵抗和临床终点事件发生率。结果 长期吸烟史组治疗前后GMP-140、D-D、FIB、CD61、CD62p高于短期吸烟史组和无吸烟史组,t-PA低于短期吸烟史组和无吸烟史组,且短期吸烟史组和无吸烟史组组间比较,差异有统计学意义(P＜0.05);长期吸烟组阿司匹林抵抗发生率和临床终点事件发生率分别为33.33%、30.56%,高于无吸烟史组的8.82%、8.82%,差异有统计学意义(P＜0.05),其余组组间比较差异无统计学意义(P＞0.05)。结论 长期吸烟史会使脑卒中患者存在血栓前状态,增加阿司匹林抵抗和临床终点事件的发生几率。

Objective To explore effects of long-term smoking on secondary prevention for oral aspirin in high-risk stroke patients. Methods A total of 115 high-risk stroke patients who orally took aspirin for secondary prevention in our hospital from August 2012 to August 2014 were selected as the study subjects. According to smoking or not, they were divided into non smoking history group (34 cases) and smoking history group (81 cases). Among them, 36 cases whose smoking time was ≥ 20 years were included in the long-term smoking history group, and 45 cases whose smoking time was 1 to 19 years were included in the short-term smoking history group. The patients were followed up for 12 months. The platelet granule membrane protein (GMP-140), D-dimer (D-D), fibrinogen (FIB), tissue plasminogen activator (t-PA), platelet membrane glycoprotein CD61 and CD62p were determined. The incidence rates of 1-year aspirin resistance and clinical outcome events in the three groups were recorded. Results Before and after treatment, GMP-140, D-D, FIB, CD61 and CD62p in long-term smoking history group were higher than those in short-term smoking history group and non smoking history group while T-PA was lower, and there were significant differences between short-term smoking history group and non smoking history group (P<0.05). The incidence rates of aspirin resistance and clinical outcome events in long-term smoking history group (33.33%, 30.56%) were higher than those in non smoking history group (8.82%, 8.82%)(P<0.05), but there was no significant difference among other groups (P>0.05). Conclusion Long-term smoking history will cause prethrombotic state in stroke patients and increase the incidence rates of aspirin resistance and clinical outcome events.

目的 探讨颈性眩晕应用针刺解结法治疗的临床疗效。方法 选取广东省中医院进修期间2016年3月—2016年9月收治的60例颈性眩晕患者,按照随机数字表法均分为两组。对照组:予以常规针刺治疗;观察组:在此基础上,行针刺解结法治疗。记录比较两组治疗前后基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)等部位的血流速度,改良颈性眩晕症状与功能评估量表(ESCV)总评分,临床疗效。结果 两组治疗后BA、LVA及RVA部位的血流速度,均明显高于治疗前(P<0.05);与对照组治疗后比较,观察组TCD检测参数改善幅度更为显著(P<0.01);与治疗前相比,两组治疗后改良ESCV总评分均显著更高(P<0.01);且观察组改善情况显著优于对照组(P<0.01);观察组总有效率为96.7%较对照组的76.7%相比,明显更高(P<0.05)。结论 颈性眩晕应用针刺解结法治疗更能有效改善脑部血液循环,缓解临床症状,提高生活质量,疗效显著,具有较高临床推广价值。

Objective To analyze the clinical effect of curing cervical vertigo with acupuncture thrawing method. Methods To select 60 patients with cervical vertigo in Cantonese Chinese Medicine Hospital from March 2016 to September 2016 as the research objects. According to the random number table method, they were randomly divided into the control group and the study group. The control group: treated with normal acupuncture; The observation group: plus with acupuncture thrawing method. We recorded and compared the blood flow velocity in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA), the overall score of the improved cervical Evaluation Scale for Cervical Vertigo(ESCV), and the clinical therapeutic effect of the two groups. Results After treatment, the blood flow velocity of the two groups in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA) was obviously higher than before treatment (P<0.05). Compared with the control group, the improvement level of TCD verifying arguments in the observation group was more significant (P<0.01). Compared with before treatment, the overall score of the improved ESCV in the two groups after treatment was significantly higher (P<0.01). And the improved conditions in the observation group were better than in the control group. The total effective rate 96.7% in the observation group was apparently higher than that of 76.7% in the control group (P<0.05). Conclusion Curing cervical vertigo with acupuncture thrawing method may improve the brain blood circulation, relieve clinical symptoms, enhance the living quality, which is a good way with evident clinic efficacy and higher clinical popularization value.

目的 研究全髋关节置换术对于股骨颈骨折老年患者的适用性。方法 回顾性分析本院2012年1月—2014年1月间收治的89例股骨颈骨折老年患者,根据不同治疗术式将患者分为两组,将其中采取人工全髋关节置换术治疗的56例患者纳入全髋组,以将其中采取半髋关节置换术治疗的33例患者纳入半髋组,对比两组患者的手术情况,随访一年评估疗效并统计功能恢复时间以及并发症发生情况。结果 半髋组各项手术情况观察指标均优于全髋组,P<0.05;治疗后随访一年,全髋组总有效为96.43%,半髋组总有效率为93.94%,全髋组疗效优于对照组,P<0.05;全髋组并发症发生率为3.57%,半髋组并发症发生率为18.18%,全髋组并发症发生率优于半髋组,P<0.01。结论 全髋关节置换术治疗股骨颈骨折老年患者适用性高于半髋关节置换术,可考虑作为老年患者的首选术式加以推广。

Objective To study the applicability of total hip arthroplasty in elderly patients with femoral neck fracture. Methods A retrospective analysis of 89 cases of elderly patients with femoral neck fracture in our hospital was made from January 2012 to January 2014, according to different surgical methods. The patients were divided into two groups, among them 56 cases of total hip arthroplasty were in the total hip group, and 33 cases of hip replacement were in the semi hip arthroplasty group. To compare the surgery condition, one year of follow-up evaluation of occurrence curative effect was made and added up the function recovery time and complications in the two groups. Results The surgical observation indicators in the semi arthroplasty group were better than the total hip group, P<0.05; follow-up one year after the treatment, the total effective rate of the total hip group was 96.43%, that in the semi hip arthroplasty group was 93.94%, thus the curative effect of the total hip group was better than the control group, P<0.05; The incidence of complications of the total hip arthroplasty group was 3.57%, that in the semi hip arthroplasty group was 18.18%, thus the incidence of complications of the total hip group was better than the semi hip group, P<0.01. Conclusion The adaptability of the total hip arthroplasty in the treatment of elderly patients with femoral neck fractures is better than the semi hip replacement surgery, and it may be considered as the first choice for the elderly patients to promote.

目的 探讨爪形肋骨接骨板内固定治疗多发肋骨骨折的临床价值及意义。方法 收集2015年6月—2016年12月收治多发肋骨骨折40例,其中手术内固定20例,保守治疗组20例,比较分析两组临床治疗情况。结果 所有患者均痊愈出院,手术内固定组比保守治疗组疼痛明显减轻,胸管留置时间、下床自主活动时间及住院时间短,并发症发生率低,胸廓畸形矫正更满意,差异有统计学意义(P＜0.05)。结论 爪形肋骨接骨板内固定术治疗多发肋骨骨折固定效果满意,手术操作简单、创伤小,术后并发症少,恢复快,值得临床推广应用。

Objective To investigate the clinical value and significance of rib jaw-shaped bone plate in the treatment of multiple rib fractures. Methods 40 patients with multi-rib fractures were selected from June 2015 to November 2016. 20 cases were performed of rib jaw-shaped bone plate in the surgical treatment,20 cases of conservative treatment. The clinical treatment conditions of two groups were compared. Results Patients in both groups were all cured. Pain perception, hospital stay time, retain time of thoracic duct and independent ambulation time in surgery group were obviously reduced comparing with conservative treatment group as well as the surgical complications. There was a significant differences(P＜0.05). Conclusion Rib jaw-shaped bone plate for the treatment of multiple rib fractures has satisfactory results.Its advantages are as follows:simple and quick operative technique,minimal invasive surgery,less complications, fast recovery. It is worthy of clinical application.

目的 比较一次性包皮切割缝合器与传统包皮环切术和套扎环包皮环切术的临床应用效果。方法 对我院2016年7月—2016年12月内门诊收治的包皮过长和包茎患者,采用不同手术方法治疗,其手术时间、术中疼痛评分(VAS评分)、术后水肿、疼痛持续时间、以及外观满意度等方面进行对比。结果 在手术时间和外观满意度方面一次性包皮切割缝合器明显优于传统包皮环切术;在术中疼痛评分(VAS评分)、疼痛持续时间和术后水肿方面一次性包皮切割缝合器明显优于套扎环包皮环切术。结论 一次性包皮切割缝合器与两种传统常规手术比较,手术更加简单、方便且安全,术后外观满意度高,值得临床推广。

Objective To compare the effects of circumcision between using a novel disposable suture device and traditional or plastibell procedure. Methods The patients from July 2016 to December 2016 that underwent different ways of circumcision were documented. The operation time, VAS score, postoperative edema, the duration of the pain and appearance of satisfaction were collected and analyzed. Results The suture device group had shorter operation time, better appearance of satisfaction than that of traditional group (P<0.05). Besides, the suture device group had lesser VAS score, shorter duration of the pain and less postoperative edema (P<0.05). Conclusion Compared to traditional or plastibell procedure, a novel disposable suture device circumcision represents convenient, efficient and minimal invasive. It is worth promoting clinically.

目的 分析广州市离退休干部的体检结果,为疾病的预防和治疗提供依据。方法 以2015年在我院进行体检的离退休干部为对象,对其中有相同体检内容的3 841位的结果进行分析,探讨该人群中阳性体征检出率最高的前15种疾病,以及这些疾病在不同性别人群中的差异,并与2014年检出结果进行对比。结果 总体人群前15种阳性体征检出率疾病中,大部分疾病的检出率在不同性别人群有统计学差异。老年性白内障(总人群检出率67.56%)、高血压病(46.6%)、结节性甲状腺肿(44.18%)位居前三位;与2014年的检测结果相比,老年性白内障、高尿酸血症、胆囊结石这三种疾病的检出率有所下降,而结节性甲状腺肿、痔疮、慢性咽炎、高脂血症、胆囊炎这五种疾病的检出率有所上升(差异均有统计学意义,P<0.05)。结论 离退休人员性别差异罹患各种疾病的几率不同,男性更易罹患老年性白内障、高尿酸血症、牙周炎、牙龈炎、脂肪肝、糖尿病、胆囊炎。女性更易罹患结节性甲状腺肿、痔疮、慢性咽炎、高脂血症。定期健康体检后的进一步健康管理还相当薄弱,健康干预日益迫切需要。

Objective We analyzed the physical examination results of retired cadres,to acquaint the health status of the targeted population and provide the basis for the disease prevention and treatment. Methods Among the retired cadres who conducted healthy examination in the successive two years of 2014 and 2015, we selected 3841 cases of which examination items were the same in these two years. Based on their healthy examination results, we investigated the diseases of which detected rates of positive sign ranked in top 15, including the different appearances between different genders, and made comparisons with that of year 2014. Results Out of the top 15 diseases, senile cataract, hypertension and nodular goiter ranked in top 3. Compared with that of year 2014, a decrease of the detection rate could be seen in three diseases namely senile cataract, hyperuricemia and cholecystolithiasis, but an increase in five diseases namely nodular goiter, hemorrhoids, chronic pharyngitis, hyperlipidemia and cholecystitis. Conclusion Regular examination is an important way to acquaint the health status of retired cadres, and find pathogenesis risk factors timely. The healthy management however is still weak after physical examination.Thus it can be seen that healthy intervention has become increasingly urgent.

目的 调查流动人口肺结核患者治疗的健康服务需求的现状及其影响因素。方法 采用随机数字表达法,应用自行设计的调查问卷搜集了2015年9月1日—2016年1月30日在广州市胸科医院登记并确诊接受治疗随访的198例流动人口肺结核患者进行治疗相关健康服务需求情况问卷调查,分析患者的健康服务需求情况及不同特征患者需求进行比较。结果 需求率在前六位分别是健康教育为91.41%(181/198)、重视病情变化为90.40%(179/198)、疾病预防为87.88%(174/198)、与医护沟通为85.86%(170/198)、得到他人理解支持为83.84%(166/198)、心理疏导为80.81%(160/198),是否了解抗结核治疗知识、抗结核治疗与否及治疗分类在部分条目上需求率有统计学差异(P<0.05,P<0.01)。结论 流动人口肺结核患者抗结核治疗健康服务需求内容多样化;抗结核治疗的了解程度、抗结核治疗情况和治疗分类是影响治疗的健康服务需求的重要因素。建议对流动人口肺结核患者尽早提供系统的抗结核治疗的健康管理服务模式,以提升患者治疗的效果。

Objective To investigate current status and influencing factors of health care needs of tuberculosis patients in floating population. Methods Using method of random digits table,we collected 198 tuberculosis patients in floating population,who have registered and received treatment in Guangzhou Chest Hospital between September 1,2015 and January 30,2016. We distributed questionnaires about the health service requirement to patients based on on-site interview, and analyzed needs of patients health service. Needs of patients with different characteristics were compared. We collected their health service requirement. Results The rate of demand accounted for the top six were: health education was 91.41% (181/198), attach importance to the disease change was 90.40% (179/198), 87.88% (174/198)was for disease prevention, and medical communication was 85.86% (170/198), others understand support was for 83.84% (166/198), psychological counseling was for 80.81% (160/198). There was statistically different in knowing of whether the anti tuberculosis treatment knowledge, anti tuberculosis treatment and treatment in some items on demand classification rate (P<0.05, P<0.01). Conclusion Anti tuberculosis treatment needs of extensive health services of tuberculosis patients in floating population. Understanding degree, anti tuberculosis treatment and therapeutic anti tuberculosis are important factors influencing the tuberculosis drug treatment needs. It is recommended that TB patients in floating populationshould be diagnosed as early as possible to provide a systemic health management service mode of anti tuberculosis treatment in order to improve the effect of treatment.

目的 探讨小肠出血的诊断策略。方法 回顾性分析我院2010年1月— 2015年6月收治的42例小肠出血病例的诊治经历。结果 42例患者中肿瘤15例(35.7% );血管发育不良和畸形10例(23.8%);炎性肠病9例(21.4%),憩室7例(16.7%),原因不明1例(2.4%)。气钡双重造影阳性率11.8%;B超检查阳性率15%;核素扫描阳性率44.4%;CT检查阳性率46.7%;血管造影阳性率50%,小肠镜检查阳性率58.9%;胶囊内镜阳性率61.5%;术中肠镜检查阳性率88.9%。结论 小肠出血病因多样,检查缺乏特异性;隐性出血者可选择CT或胶囊内镜,结果阳性者进一步可行小肠镜检查或治疗;活动性出血患者选择ECT或DSA,手术探查或术中肠镜是最后选择。

Objective To investigate the diagnosis of small intestinal haemorrhage. Methods The diagnosis and treatment of 42 cases of small intestinal haemorrhage between January 2010 and June 2015 were analyzed retrospectively. Results Among the patients, small bowel tumors were found in 15 cases,angiodysplasia in 10,inflammation disease in 9,diverticulum in 7 and obscure bleeding in 1 each. Positive rate of diagnostic methods was followed:enteroclysis 11.7％,B-ultrasound 15%, ECT 44.5%,CT 46.7％,DSA 50%, device-assisted enteroscopy 58.9％, capsule endoscopy 61.5%,enteroscope examination during operation 88.9%. Conclusion There are various etiological factors and lack of specificity in small intestinal haemorrhage. Capsule endoscopy or CT should be used first if the patient had occult bleeding, positive patients were suggested to taken enteroscopy. ECT and DSA must be applicable for active bleeding or other positive patients. Operation or enteroscope examination during operation could be the last measure.

目的 探讨快速康复外科理念对降低子宫全切术后患者下肢深静脉血栓形成的应用效果。方法 采用方便抽样的方法,将185例子宫全切术后患者分为观察组(95例)和对照组(90例)。观察组实施快速康复外科护理路径,对照组实施常规护理路径。结果 两组患者术后的下肢深静脉血栓发生率、D-二聚体水平、日常生活活动能力评分的比较差异均有统计学意义(P<0.05);观察组下肢深静脉血栓形成的发生率和D-二聚体水平低于对照组(P<0. 01),观察组日常生活活动能力评分低于对照组(P<0.05)。结论 快速康复外科理念应用于子宫全切术后患者,可降低患者下肢深静脉血栓的发生率,提高患者自理能力,使患者尽快恢复健康水平。

Objective To explore the effect of fast-track surgery on the treatment of lower extremity deep venous thrombosis in patients after total hysterectomy. Methods A total of 185 patients with hysterectomy were divided into observation group(n=95) and control group (n=90) randomly. The observation group implemented a rapid rehabilitation surgical care path, and the control group implemented routine nursing path. Results There were significant differences in the incidence of deep venous thrombosis, D-dimer level and daily living activity score between the two groups (P<0.05). The incidence of deep venous thrombosis and the level of D-dimer in the lower extremity of the observation group were significantly lower than those in the control group (P<0.01). The score of the daily living activity was lower in the observation group than that of control group (P<0.05). Conclusion Fast-track surgery for patients after total hysterectomy could reduce the incidence of postoperative deep venous thrombosis and improve the self-care abilities of patients, so that patients may return to health as soon as possible.

目的 探讨配偶参与式护理对腹腔镜保留盆腔自主神经子宫切除术年轻患者功能恢复的影响效果。方法 按时间先后将96例患者分为实验组50例和对照组46例,对照组按常规护理,实验组采用先培训配偶,然后让配偶与护士共同对患者实施整体护理,6个月后测试患者膀胱和性功能恢复情况。结果 实验组术后7天膀胱功能恢复41例,尿管留置时间为(10.8±2.1),术后6个月FSFI评分为(29.11±3.65),均优于对照组,两组比较差异均有统计学意义(P＜0.05)。结论 配偶参与式护理可使腹腔镜保留盆腔自主神经子宫切除术年轻患者得到更多专业的照顾,利于术后膀胱功能和性功能的恢复。

Objective To evaluate the influence of spouse participatory nursing on functional recovery of young patients who experienced laparoscopic nerve-sparing radical hysterectomy. Methods 96 patients were divided into the experiment group (50 patients) and the control group (46 patients) according to the timeline. The control group accepted normal nursing while the experiment group accepted the method that the spouse was provided with training first and then nurses provided overall nursing to the patient along with the spouse. Six months later, patients' recovery of bladder and sexual function were assessed. Results In the experimental group, 41 patients' bladder function recovered in seven days after the surgery, and the catheter retention time was(10.8±2.1); the FSFI score was (29.11±3.65)in six months after the surgery, and the score was better than that in the control group. The differences between both groups had statistical significance (P<0.05). Conclusion Spouse participatory nursing can provide more professional care to young patients who experienced laparoscopic nerve-sparing radical hysterectomy, therefore help to recover bladder and sexual function.

目的 探讨早期康复护理干预对胸腰椎骨折内固定术后患者的临床护理效果。方法 2014年6月—2016年12月,将94例胸腰椎骨折内固定术后患者按数字随机法,分为实验组51例和对照组43例,分别实进行早期康复护理和常规性护理。比较两组患者胸腰背部功能状况、胸腰背部疼痛情况、术后抑郁水平,以及护理满意度等相关指标,以评价早期康复护理的效果。结果 94例患者均获得3个月随访。与对照组比较,实验组患者平均住院天数减少4.1 d,差异有统计学意义(P<0.05);平均住院费用也有所下降;实验组和对照组总并发症发生率分别为7.84%和20.9%,两组间比较差异有统计学意义;实验组的护理工作满意度高达90.20%,高于对照组的67.44%,差异具有统计学意义(P<0.05)。术后3个月随访时,Oswestry功能障碍评分实验组为(14.74±3.25),低于对照组的(20.04±5.32)(P<0.05); SDS评分实验组的为42.35±3.68,低于对照组的(47.28±3.49)(P<0.05);胸腰背痛VAS评分实验组的为(1.07±0.67),低于对照组的(2.62±1.86)(P<0.05)。结论 早期康复护理干预是促进胸腰椎骨折内固定术后患者快速康复的有效方法,提高患者对护理工作的满意度,值得推广应用。

Objective To evaluate and compare the outcomes of early rehabilitation nursing and routine nursing care for patients with thoracolumbar bursting fracture after internal fixation. Methods From June 2014 to December 2016, this study enrolled ninety-four subjects who were randomly divided into observe group with fifty-one cases and control group with forty-three cases according to the digital random method. Patients in the control group were treated with routine nursing care, and early rehabilitation nursing care were used in the observe group. The physical function of thoracolumbar spine, psychological condition, pain of thoracolumbar spine, nursing satisfaction and soon. were compared between the two groups. Results The average days of hospital stay in the observation group was 4.10 days, it was less than that of control group, and the difference was statistically significant(P<0.05). Average hospital costs were also declined. The total complication rate were 7.84% in observe group and 20.9% in control group, there was significant difference between the two groups (P<0.05). The nursing satisfaction was 90.20% in observe group, which was higher than 67.44% in that in control group (P<0.05). When follow-up three months after operation, the ODI score in experiment group was(14.74±3.25), which was lower than that (20.04±5.32)in control group (P<0.05). The SDS score in experiment group was (42.35±3.68), which was lower than that (47.28±3.49)in control group(P<0.05). And the VAS score in experiment group was (1.07±0.67), which was lower than that(2.62 ±1.86)in control group (P<0.05). Conclusion Early rehabilitation nursing care is effective to the rapid functional recovery for patients with thoracolumbar bursting fracture after internal fixation, and improves the nursing satisfaction.

目的 探讨血清铁蛋白及超敏C反应蛋白联合检测对急性脑出血患者的临床意义。方法 2012年1月—2015年12月,自发性脑出血的患者77例,男42例,女35例;年龄45～82 a,平均年龄(67.19±10.17)a。根据Rankin 评分将患者分成两组,A组,MRS≤2分,预后良好; B组,MRS＞2分,预后差;另选取同期健康体检者35例作为健康对照组,即C组。分别于入院时、发病后第3天、7天、14天时,采静脉血化验血常规、Hs-CRP及SF;于入院时和发病后第3天时,进行头颅CT检查。采用美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS) 分别于入院及随访12个月时,对两组患者神经功能损伤及恢复情况进行评估。结果 77例脑出血患者在发病12个月随访时, 53例患者MRS≤2分,预后良好;24例患者MRS＞2分,预后较差。于入院时、发病后第3天、7天、14天,脑出血患者的Hs-CRP及SF水平均显著高于健康体检人员,差异具有统计学意义(P<0.05);在各时间点脑出血患者中的预后较差组Hs-CRP及SF水平均不同程度高于预后良好组;但在入院发病后第3天则显著高于预后良好组,差异具有统计学意义(P<0.05),同时,脑出血患者中的预后较差组脑水肿量及水肿系数均显著高于预后良好组,差异具有统计学意义(P<0.05)。影响脑出血预后的独立危险因素包括NIHSS评分(P=0.012),Hs-CRP(P=0.027)和SF水平(P=0.041)。结论 Hs-CRP及SF水平在一定程度上可作为脑出血预后的重要评估指标。

Objective To investigate the clinical significance of combined detection of serum ferritin and high sensitive C reactive protein in patients with acute cerebral hemorrhage. Methods From January 2012 to December 2013, 77 cases with cerebral hemorrhage male 42, female 35; aged 45 to 82 year old, average age (67.19±10.17)years old. According to MRS(Modified Rankin Scale) score criteria, patients were divided into good prognosis group(group A) with MRS ≤2, and poor prognosis group (group B)with MRS ＞2. Another 35 cases of healthy physical examination were selected as the healthy control group(group C). RT(Routine blood test), Serum Ferritin(SF)and Hs-CRP were tested at the time of admission, the third, the seventh and the fourteenth day from onset of the disease respectively. Head CT were done at the time of admission, the third day from onset of the disease respectively. Neurological assessment were scored according to the NIHSS criteria(National Institutes of Health Stroke Scale) for the patients in the two groups at the time of admission and 12 months of follow up. Results 77 cases of cerebral hemorrhage were followed up for 12 months, 53 cases with MRS ≤2, the prognosis was good; And 24 cases with MRS >2, the prognosis was poor. The levels of Hs-CRP and SF were all higher in patients with cerebral hemorrhage than that in healthy control group (P<0.05) at the time of admission, the third day,seventh and fourteen day from onset of the disease respectively. The levels of Hs-CRP and SF were higher in group B than that in control group at the time of admission, the third day, the seventh day and the fourteenth day from onset of the disease respectively, but only at the time of admission, three days from onset of the disease, the difference was statistically significant (P<0.05). At the same time, the brain edema and edema index in the group B were higher than those in group A. The independent risk factors influencing the prognosis of cerebral hemorrhage were NIHSS score (P=0.012), Hs-CRP(P=0.027) and SF(P=0.041). Conclusion Hs-CRP and SF may be important indicators of the prognosis for cerebral hemorrhage in a certain degree.

目的 研究鳞癌抗原(SCC-Ag)的表达对宫颈癌手术治疗后临床转归的预测价值。方法 选取我院2014年4月—2015年9月实施宫颈癌手术的患者52例,分别于手术前后分析所有患者的鳞癌抗原表达,对患者进行1年的随访,以发生癌细胞转移、复发或死亡为研究终点,比较预后良好的患者与预后差的患者鳞癌抗原的表达的不同。结果 Ia、Ib1、Ib2、IIa、IIb期宫颈癌患者术后SCC-Ag水平较手术前均显著降低(P＜0.05);纳入本次研究的患者宫颈癌术后复发或转移发生率为15.38%,转归良好的患者为84.62%,预后良好的患者术后SCC-Ag水平(0.91±0.27)ng/mL较发生复发或转移的患者(1.37±0.57)ng/ml显著较较低(P＜0.05)。结论 宫颈癌患者术后血清SCC-Ag水平与肿瘤的应答之间具有关联性,术后SCC-Ag水平高的患者复发与转移发生率显著高于SCC-Ag水平低的患者,鳞癌抗原的表达对宫颈癌手术后患者的转归情况具有预测价值,临床应予以重视。

目的 分析广州市番禺区户籍和流动人口肺结核病发现延误情况,为研究结核病防治基本公共卫生服务均等化策略提供参考依据。方法 根据中国疾病预防信息系统登记的数据,对2013—2016年番禺区登记的肺结核病人进行统计。采用卡方检验的方法,对比分析户籍和流动肺结核病人发现延误的差异。结果 结核病发现延误中,男性患者户籍与流动患者延误天数比较差异有统计学意义(χ²=19.067,P<0.01),户籍患者延误天数30 d以上的比例高于流动患者。户籍与流动患者的医生延误天数比较差异有统计学意义,流动患者的医生延误比例高于户籍患者(χ²=18.001,P<0.01)。结论 广州市番禺区肺结核发现延误主要由户籍病人患者延误和流动病人医生延误所构成,需采取综合性干预措施,减少结核病患者的发现延误,从而进一步体现结核病防治基本公共卫生服务均等化。

目的 了解南沙新区三级医院门诊患者健康教育需求情况,为制定医院健康教育策略提供科学依据。方法 采用随机抽样的方法,利用自制调查问卷对287名门诊患者进行健康教育需求调查。结果 青年期患者、大专以上文化程度患者健康教育需求率高,需求的健康教育内容最高的为传染病防治健康教育,需求的健康教育方式依次为医患交流、护患交流、微信公众号或网站宣传。结论 南沙新区三级医院门诊患者健康教育需求较高,应根据门诊患者的不同特点,制定有针对性措施进行健康教育,以提高其健康素养水平。

目的 了解某市不同性别在职高级干部营养“知识-态度-行为”(KAP)现状及其健康状况,为开展健康教育工作提供理论依据。方法 采用整群抽样方法抽取228名在职高级干部作为调查对象,采用自行设计的问卷调查营养KAP,根据统一健康体检数据,分析两者之间的相关性。结果 某市在职高级干部男性干部与女性干部在营养知识、营养行为得分两者间有显著差异P＜0.05。营养态度得分两组间无差异P＞0.01。体检结果男性干部总体异常及脂肪肝、高脂血症和高尿酸血症发病率均显著高于女性干部,差异有统计学意义(P＜0.05)。健康状况得分8.27±1.57分(满分10分),与营养KAP得分有明显正相关关系(r＝0.481,P＜0.01)。结论 某市不同性别在职高级干部营养知识水平有待提高,营养态度良好,饮食行为不够合理,应采用多种方式进行营养健康指导,增强自我保健意识,提高整体健康水平。

目的 利用新的分型方法指导现有的微创技术下内固定的选择,提示预后,帮助制定术后康复计划。方法 将200例患者随机分成两组,一组为旧Evans分型组,另一组为改良Evans分型组,通过多层螺旋三维CT重建引导下改良Evans分型,对三个重点区域(股骨内距、头颈部及粗隆外侧入针点部位)的CT成像,利用多平面重组(MPR)、表面遮盖显示(SSD)及容积再现(VR)等多种后处理,分析骨折线走形、局部的微骨折、骨小梁分布、骨皮质厚度的骨折部内环境变化。简化整合到Evans分型中。来实现完善影像分型,有效地指导微创手术。对比两组患者的疗效。结果 新Evans分型组98例患者愈合良好,时间为9~17周,中位数为11.2周。其中伤口感染3例,髋关节内翻畸形3例,骨骨头坏死3例,按照髋关节治疗标准评分,优53例,良31例,可9例,差7例。优良率(包括优和良)为84%。旧Evans分型组80例患者愈合良好,时间为9~18周,中位数为11.8周。其中伤口感染10例,髋关节内翻畸形5例,股骨头坏死8例,按照髋关节治疗标准评分,优48例,良26例,可10例,差16例。优良率(包括优和良)为74%。两组对比,新Evans分型组优良率明显高于旧Evans分型组,差异有统计学意义。P＜0.05。结论 多层螺旋三维CT重建引导下的改良Evans分型对老年脆骨性粗隆间骨折的微创治疗有重要的临床指导意义。