目的 研究NEK2(中心体相关激酶2)在前列腺癌和良性组织中的表达情况及其与前列腺癌预后的相关性。方法 运用qRT-PCR检测NEK2在前列腺癌和癌旁组织的表达差异,通过组织芯片免疫组化染色检测的方法检验NEK2在前列腺癌和癌旁组织的表达情况,最后使用Taylor的数据对NEK2进行生物信息学分析。结果 qRT-PCR检测NEK2在前列腺癌组织的表达显著高于癌旁组织(6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003),组织芯片免疫组化结果显示NEK2在前列腺癌组织的表达显著高于癌旁组织(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001),结合Taylor公用数据库分析,NEK2高表达组患者术后的生化复发生存率减少( χ²=4.33,P=0.037),NEK2高表达组和低表达组在前列腺癌总体生存率上没有明显区别( χ²=0.27,P=0.605)。结论 NEK2参与前列腺癌的发生、发展进程,同前列腺癌发病进程密切相关,通过检测前列腺癌患者NEK2的表达情况,可早期预测生化复发的概率,能够作为判断前列腺癌预后的潜在生物学标志物。

Objective To investigate the expression of NEK2(NIMA-related kinase 2)in prostate cancer as well as benign prostatic hyperplasia,and the involvement of NEK2 in the prognosis of prostate caner(PCa). Methods The different expression of NEK2 in the tissue of prostate cancer and the adjacent benign tissues of prostate were measured by real-time quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) analysis and immunohositochemistry analysis,and then bioinformatically analyzed using the Taylor dataset. Results QRT-PCR showed that NEK2 was highly expressed in PCa than in the adjacent benign tissues (6.93±0.15 vs 5.38±0.4,t=6.25,P=0.003). Immunohositochemistry analysis showed the expression of NEK2 was higher in PCa than in the adjacent benign tissues(5.84±0.56 vs 4.27±0.49,t=5.38, P<0.001). Furthermore, the biochemical recurrence-free time of PCa patients in high NEK2 expression groups significantly reduced( χ²=4.33,P=0.037). The overall survival time of PCa patients was not correlated to NEK2 expression levels( χ²=0.27,P=0.605). Conclusion The above findings suggest that NEK2 is associated with production and development of PCa, and also critically connected with the process of PCa,which indicate that we can predict the probability of the biochemical recurrence-free time by detecting the expression of NEK2 in PCa patients,and NEK2 can also become a potential biomarker for PCa prognosis.

目的 探索锌剂治疗大鼠慢性细菌性前列腺炎(CBP)的机理及影响。方法 健康成年雄性大鼠100只,随机分为正常对照组(n=20)、CBP模型对照组(n=20)、CBP锌剂治疗组(n=20)、CBP左氧氟沙星治疗组(n=20)及CBP锌剂与左氧氟沙星混合治疗组(n=20)。采用消痔灵及大肠埃希菌制备CBP大鼠模型。CBP锌剂治疗组、CBP左氧氟沙星治疗组及CBP混合治疗组给予相应药物灌胃治疗,正常对照组及CBP模型对照组给予无菌生理盐水灌胃。疗程10 d,分别于2 d、4 d、6 d、8 d、11 d取各组大鼠前列腺,检测细菌数量并分离鉴定细菌性质。于4 d、9 d、14 d、20 d、28 d取各组大鼠前列腺,进行组织病理学检测。结果 CBP各治疗组大鼠前列腺组织的细菌数量与模型对照组相比均明显降低(P﹤0.05)。CBP混合治疗组大鼠前列腺内细菌在治疗8 d后不能检出。4～6 d CBP混合治疗组大鼠前列腺组织的细菌数量与CBP锌剂治疗组相比明显降低(P﹤0.05)。正常对照组大鼠前列腺病理学检查未见明显病理变化;模型对照组大鼠前列腺组织表现为慢性炎症的病理变化;各治疗组大鼠前列腺慢性炎症改变均有不同程度缓解,其中混合治疗组的慢性炎症明显减轻。结论 锌剂具有活化提高前列腺组织细胞抗菌能力的作用,有利于前列腺组织炎性病理损害的缓解以及损伤组织的修复,与敏感抗生素结合治疗CBP具有更显著的治疗效果。

Objective To explore the zinc agent in the treatment of chronic bacterial prostatitis (CBP) rats and the effect. Methods 100 healthy adult male rats, were randomly divided into normal control group (n=20), CBP model group (n=20), CBP zinc treatment group (n=20), CBP levofloxacin treatment group (n=20) and mixed treatment group of CBP zinc and levofloxacin (n=20). Preparation of the CBP rat model was made by Xiaozhiling and E.coli system. CBP zinc treatment group, CBP levofloxacin treatment group and CBP mixed treatment group were given the appropriate drugs for treatment,besides,the normal control group, CBP model control group were given sterile saline. It took 10d. Rats in each group at 2d, 4d, 6d, 8d, 11d were detected, including the number of bacteria and the bacteria isolation and identification properties. The pathological study in 4d, 9d, 14d, 20d, 28d and prostate of rats in each group were detected. Results The prostate tissue of the CBP group rats in the treatment of bacterial number compared with the model control group decreased significantly (P<0.05). CBP mixed treatment of prostate were not detected in bacteria after 8d treatment.4 - 6 days of CBP treatment of prostate tissue in rats of the treatment group compared with the quantity of bacteria and CBP zinc decreased significantly (P<0.05). Normal control group rats pathological prostate pathology examination showed no significant pathological prostate tissue; The model control group rats showed chronic inflammatory pathological changes; The treatment group rat prostate inflammatory changes were alleviated chronic inflammation, which mixed treatment group were significantly reduced. Conclusion Zinc enhances prostate tissue antibacterial ability, is conducive to the inflammation in prostate tissue response and the repair of damaged tissue. Sensitive antibiotics combined with treatment of CBP have a significant therapeutic effect.

目的 探索蟾毒灵对舌鳞状细胞癌Tca8113细胞增殖、凋亡的影响及可能作用机制。方法 以人舌鳞癌Tca8113细胞为研究对象,MTT法检测10、20、40、80、160 nmol/L浓度蟾毒灵体外抑制Tca8113细胞增殖的活性;检测蟾毒灵干预下肿瘤细胞Na⁺-K⁺-ATP酶活性的变化;Western blot发检测Bcl-2、Bax、caspase-3蛋白表达。结果 蟾毒灵有抑制Tca8113细胞的活性,且呈剂量-时间依赖性;在蟾毒灵干预下Tca8113细胞Na⁺-K⁺-ATP酶收到抑制;Western blot结果显示凋亡相关Bax、caspase-3蛋白表达上调,Bcl-2蛋白表达下调。结论 蟾毒灵通过抑制细胞膜Na⁺-K⁺-ATP酶活性,通过调节Bcl-2凋亡通路的相关蛋白,最终激活caspase-3,诱导人舌鳞癌Tca8113细胞凋亡。

Objective To explore the effects of bufalin on proliferation and apoptosis of tongue squamous cell carcinoma Tca8113 cells and its possible mechanism. Methods Tca8113 cells were treated with 10, 20, 40, 80 and 160 nmol/L Tca8113 cells in vitro. MTT assay was used to detect the inhibitory effect of bufalin on the proliferation of Tca8113 cells; And the activity of Na⁺-K⁺-ATPase in tumor cells was detected by the interference of bufalin; The expression of Bcl-2, Bax and caspase-3 protein was detected by Western blot. Results Bufalin inhibited the activity of Tca8113 cells in a dose-and time-dependent manner; Na⁺-K⁺-ATPase in Tca8113 cells was inhibited by bufalin; The results of Western blot showed that the expression of Bax and caspase-3 protein was up-regulated and the expression of Bcl-2 protein was down-regulated. Conclusion Bufalin induced the apoptosis of human tongue squamous cell carcinoma Tca8113 cells by inhibiting the activity of Na⁺-K⁺-ATPase and regulating the related proteins of Bcl-2 apoptosis pathway, finally activating caspase-3.

目的 分析2014年482例广州登革热患者的X线胸片特点,探讨X线胸片对登革热患者的临床诊断价值。方法 选取广州市第一人民医院2014年收治的482例登革热患者作为研究对象,观察分析其X线胸片检查结果的特征。结果 登革热患者X线胸片影像学特点以非特异性的肺纹理增多增粗和斑片渗出灶为主要表现,另有胸膜增厚、胸腔积液和间质性改变。结论 X线胸片检查可以经济、便捷地了解登革热患者的肺部改变,为临床诊断和治疗提供帮助。

Objective To analyze the characteristics of chest X-ray in 482 cases of dengue fever in Guangzhou 2014, and to discuss the diagnostic value of chest X-ray in dengue fever patients. Methods 482 patients of dengue fever patients admitted in Guangzhou First People's Hospital were selected as the research object. The characteristics of the chest X-ray were observed and analyzed. Results The characteristics of chest X-ray images included lung markings thickening increased, exudation, and might lead to pleural thickening, effusion and interstitial change. Conclusion Chest X-ray was a convenient examination for dengue fever patients which had an important diagnostic and therapeutic value.

目的 了解非结核分枝杆菌(nontuberculous mycobacteria,NTM)肺病患者免疫功能低下发生率,以及免疫支持的应用状况、探讨免疫支持治疗对患者2月末痰菌阴转及病变吸收的影响,为临床实施免疫干预提供参考依据。方法 分析广州市胸科医院2014年1月—2015年12月确诊的资料完整的381例NTM肺病患者免疫功能情况以及免疫支持的应用状况,观察组(加用免疫调节剂母牛分枝杆菌菌苗)228例与同期对照组(未使用免疫调节剂)153例进行2月末痰菌阴转及病变吸收情况比较。结果 381例患者中,免疫功能低下的发生率为45.67% (174／381);免疫支持率为59.84% (228／381)。细菌学改变:治疗前所有患者痰抗酸杆菌涂片和培养均为阳性。治疗2个月后两组的阴转率分别为67／228(29.38%)、17／153(11.11%),χ²=17.79,P<0.05。 影像学改变:两组的病变吸收有效率分别为62／228(27.19%)、16／153(10.45%),χ²=15.75,P<0.05;空洞吸收有效率分别为61／228(26.75%)、15／153(9.80%),χ² =20.42,P<0.05。结论 非结核分枝杆菌肺病患者存在较高比例的免疫功能低下风险,观察组的痰茵阴转、病灶吸收和空洞闭合的疗效高于对照组。

Objective To explore the immune status of patients with nontuberculous mycobacterial(NTM) pulmonary disease, and the application of immunotherapy. to evaluate the influence of immunotherapy on sputum negative conversion and lesion absorption at the end of two months. provide reference data for immunotherapy. Methods The immune function and immunotherapy of 381 patients diagnosed as NTM pulmonary disease were retrospectively analyzed from January 2014 to December 2015 in Guangzhou Chest Hospital. Curative group (treated with antitubercular agents and immunomodulator mycobacterium vaccae) were compared with control group(treated with antitubercular agents alone) in sputum negative conversion and lesion absorption at the end of two month treatment. Results Of the 381 cases,45.67%(174／381)of the patients were immunocompromised, 59.84% (228／381)received immunotherapy. Bacteriologic changes: Both sputum smear and sputum culture were positive in all patents before treatment. after two months treatment, negative conversion in two groups were 67／228(29.38%),17／153(11.11%),χ²=17.79,P<0.05. 3. Radiological change: The rate of lesion absorption in curative group and control group were respectively 62／228(27.19%),16／153(10.45%),χ²=15.75,P<0.05;The rate of promoting cavity closure were respectively 61／228(26.75%),15／153(9.80%),χ²=20.42,P<0.05. Conclusion The immune function of NTM pulmonary disease had high ratio of being compromised. Curative group showed a significant effect of sputum negative conversion, lesion absorption and promoting cavity closure compared to the control group. Added to chemotherapy, M. vaccae is helpful in the treatment of nevertreated TB patients in terms of improving both Immunotherapy with M. vaccae had a beneficial influence on sputum negative conversion and X-ray appearances.

目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

目的 探讨多维铁口服液联合维生素AD滴剂治疗婴幼儿缺铁性贫血的疗效。方法 将首次诊断缺铁性贫血的336例婴幼儿依家长意愿分为2个治疗组(A组和B组)与1个对照组,A组予多维铁口服液联合维生素AD滴剂治疗,B组予多维铁口服液联合维生素D滴剂治疗,对照组饮食调理并补充维生素AD,于治疗4周后(3天内)采末梢血行血细胞分析,比较三组患儿贫血治疗显效率、总有效率差异。结果 治疗4周后,A组显效率为71.70%,总有效率为97.17%;B组显效率为41.05%,总有效率为90.30%;对照组显效率为6.25%,总有效率为32.29%。A组贫血治疗显效率、总有效率高于B组和对照组,差异均有统计学意义(P<0.05)。结论 铁剂联合维生素A制剂可显著提高婴幼儿缺铁性贫血的治疗效果。

Objective To observe the curative effect of multivitamin iron oral solution combined with vitamin AD drops on the treatment of iron deficiency anemia in infants. Methods 336 cases of infants who was found with iron deficiency anemia for the first time were divided into two treatment groups (group A and group B) and one control group in accordance with their parents' will. Group A was treated with multivitamin iron oral solution combined with vitamin AD drops. Group B was treated with multivitamin iron oral solution combined with vitamin D drops. The control group was taken just dietary therapy combined with vitamin AD drops. All subjects were tested blood analysis after 4 weeks of treatment (within 3 days). The differences of the treatment excellence rates and the total effective rates were compared in the three groups. Results After 4 weeks of treatment, the excellence rate in group A was 71.70%. The total effective rate in group A was 97.17%. The excellence rate in group B was 41.05%. The total effective rate in group B was 90.30%. The excellence rate in control group was 6.25%. The total effective rate in control group was 32.29%. The differences of the treatment excellence rates and the total effective rates in group A were significantly higher than those in group B or in the control group. The differences were statistically significant (P<0.05). Conclusion Multivitamin iron combined with vitamin A can significantly improve the curative effect of the treatment of iron deficiency anemia in infants.

目的 了解中山市儿童社区获得性肺炎病原学特点及其与年龄、抗生素使用的相关性,为疾病诊断和抗生素合理使用提供参考依据。方法 对中山市妇幼保健院儿科住院部2016年1月—2016年4月收治的小儿社区获得性肺炎临床资料、入院前使用抗生素和病原学检测结果进行回顾性分析。结果 共有155例研究对象纳入研究,细菌检出95株,其中革兰氏阴性菌61株,革兰氏阳性菌34株。流感嗜血杆菌,金黄色葡萄球菌,肺炎链球菌,大肠埃希氏菌,副流感嗜血杆菌的占构成比前五位。支原体和衣原体现症感染率约7.7%～8.4%。RSV检出率达25.8%。年龄在3 a以上、入院前使用过抗生素者,革兰阳性菌检出率较低(P<0.05)。入院前使用过抗生素者,革兰阴性菌检出率较高,且使用4 d及以上者高于使用3 d及以下者(P<0.05)。结论 住院儿童CAP的治疗,应综合考虑病人的年龄、入院前的抗生素使用情况,结合当地CAP 的可能优势病原选择合适的治疗方案。

Objective To explore the etiological characteristics and factors of community-acquired pneumonia(CAP) in children in Zhongshan for providing reference for the diagnosis and rational use of antibiotics for CAP. Methods Retrospective analysis were applied on clinical data and etiology results of CAP in children admitted to the pediatric inpatient department of Maternal and Child Health Hospital in Zhongshan from January to April, 2016. Results 155 children were enrolled. The number of bacteria detected was 95, including 61 Gram-negative bacteria, 34 Gram-positive bacteria. Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Haemophilus parainfluenzae accounted the top five. The recent infection rate of Mycoplasma and Chlamydia were from 7.7% to 8.4%. RSV detection rate was 25.8%.The Children who were over 3 years old, pre-use of antibiotics, associated with lower detection rate of Gram-positive bacteria (P<0.05). The Children who were the pre-use of antibiotics, associated with higher detection rate of Gram-negative bacteria, and the use of four days and more higher than three days or less(P<0.05). Conclusion For the treatment of CAP in children, the patient's age and pre-use history of antibiotics should be considered, combined with local common type of disease pathogens, to select the appropriate treatment.

目的 了解新生儿先天性心脏病的患病情况,为制定和采取干预措施提供依据。方法 对2015年10月—2016年9月分娩的5 769名新生儿进行心脏彩超检查,根据筛查结果进行统计分析。结果 共筛查出182例新生儿先天性心脏病,患病率3.15%,先天性心脏病新生儿中女婴比例较高,差异边缘显著,早产儿比例较高,差异有统计学意义,产母年龄和正常组分布相近。先天性心脏病类型中室间隔缺损和房间隔缺损的构成比分别排第一位(48.90%)和第二位(38.46%),严重先天性心脏病仅占5.43%。结论 新生儿先心病的发病率较高,采用心脏彩超筛查可尽早发现先心病患儿,同时需做好先心病患儿的随访工作,及时进行干预。

Objective To investigate the prevalence of neonatal congenital heart diseases (CHD) and providing basis for integrating efficient interventions. Methods The color Doppler echocardiography screening were applied to 5 769 newborns from Oct 2015 to Sep 2016, and the data was collected and analyzed. Results 182 cases of neonatal CHD were detected, and the prevalence rate of neonatal CHD was 3.15%. The proportion of girls and premature infants in the newborns with CHD was significantly higher than normal newborns, but the age distribution of their mothers was similar. In the 182 CHD cases, ventricular septal defect(48.90%) and atrial septal defect(38.46%) accounted for the most, while the constituent ratio of severe CHD was only 5.43%. Conclusion The prevalence of neonatal CHD was relatively high, and the color Doppler echocardiography screening could find out neonatal CHD earlier. The follow-up examinations and interventions should be conducted in time.

目的 探讨孕期生殖道菌群变化特征及其与不良妊娠结局的相关性。方法 选取2015年1月—2015年9月期间在我院妇产科门诊进行常规产科检查的90例孕妇为研究对象,根据孕期分为孕早期组28例(孕周＜14周),孕中期组29例(孕周14～28周),孕晚期组33例(29～42周)。采集阴道分泌物或宫颈分泌物,对生殖道菌群进行检测。比较三组生殖道菌群分布情况。根据细菌检测结果分为阳性组与阴性组,分别为44例、46例。观察两组不良妊娠结局发生情况,分析生殖道菌群变化特征及其与不良妊娠结局的相关性。结果 90例孕妇中,细菌检测阳性44例,占48.89%,依次为解脲脲原体20例(45.45%)、假丝酵母菌属9例(20.45%)、肠杆菌属8例(18.18%)、葡萄球菌属3例(6.82%)、阴道加德纳菌属2例(4.55%)与衣原体2例(4.55%);孕早期、孕中期、孕晚期孕妇生殖道菌群分布情况相比,差异无统计学意义(P＞0.05);细菌检测阳性者胎膜早破、产褥感染、新生儿感染、早产发生率高于细菌检测阴性者,差异有统计学意义(P＜0.05);不同菌属类型者不良妊娠结局相比,差异无统计学意义(P＞0.05)。结论 孕期生殖道菌群以解脲脲原体、假丝酵母菌属、肠杆菌属为主,细菌检测阳性者不良妊娠结局发生率高,而不同菌属类型与不良妊娠结局无关。

Objective To investigate the correlation between change characteristics of pregnant genital tract flora and adverse pregnancy outcomes. Methods 90 pregnant women received routine obstetric examination in our obstetrics and gynecology of hospital from January 2015 to September 2015 were selected as research object. According to duration of pregnancy, they were divided into 28 cases of early pregnancy group (gestational weeks<14 weeks), 29 cases of middle pregnancy group (14~28 weeks) and 33 cases of late pregnancy group (29~42 weeks). The vaginal or cervical secretions were collected, and genital tract flora was detected. The genital tract flora distribution of three groups were compared. According to bacteria detection results, patients were divided into 44 cases of positive group and 46 cases of negative group. The adverse pregnancy outcomes of two groups were observed, and the correlation between change characteristics of pregnant genital tract flora and adverse pregnancy outcomes was analyzed. Results Among 90 pregnant women, there were 44 cases of positive bacteria (48.89%), which included 20 cases of ureaplasma urealyticum(45.45%), 9 cases of Candida (20.45%), 8 cases of enterobacter (18.18%), 3 cases of staphylococcus (6.82%), 2 cases of vaginal gardnerella (4.55%) and 2 cases of chlamydia (4.55%); There was no statistical difference in the genital tract flora distribution among early, middle, late pregnancy group (P>0.05); The incidence of premature rupture of membrane, puerperal infection, neonatal infection and premature birth in patients with positive bacteria was higher than that in patients with negative bacteria (P<0.05); There was no statistical difference in the adverse pregnancy outcomes in patients with different types of bacterial genus (P>0.05). Conclusion Pregnant genital tract flora are mainly ureaplasma urealyticum, candida and enterobacter, and the incidence of adverse pregnancy outcomes in patients with positive bacteria is higher, but different types of bacterial genus has no correlation with adverse pregnancy outcomes.

目的 探讨醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效。方法 选取我院2014年6月—2016年6月收治的76例脓毒症相关性脑病患者作为研究对象,按照随机数字表法将其分成两组,每组38例。观察组给予醒脑静联合连续肾脏替代疗法治疗,对照组给予连续肾脏替代疗法治疗,比较两组患者的临床疗效,治疗前后格拉斯哥昏迷(Glasgow coma scale,GCS)评分、神经元特异性烯醇化酶(neuron-specifie enolase,NSE)含量、C-反应蛋白(C-reactive protein,CRP)含量及治疗后退热时间、恢复意识时间的长短。结果 观察组总有效率为89.47%,相对于对照组明显上升(P<0.05);观察组治疗后GCS评分较对照组明显升高,NSE含量、CRP含量较对照组明显降低,差异均有统计学意义(P<0.01);观察组治疗后的退热时间、恢复意识时间较对照组明显降低(P<0.01)。结论 醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效显著,可有效缩短退热及恢复意识时间,降低患者痛苦,值得临床推广应用。

Objective To investigate the curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy. Methods 76 cases of sepsis associated encephalopathy in our hospital from June 2014 to June 2016 were selected as the research objects, and they were divided into two groups according to the random number table method, 38 cases in each group. The observation group were treated with Xingnaojing combined with continuous renal replacement therapy. The control group was given continuous renal replacement therapy. The clinical efficacy of two groups were compared before and after treatment about the Glasgow coma (Glasgow coma scale, GCS) score, neuron specific enolase (neuron-specifie enolase, NSE) content, C- reactive protein (C-reactive protein, CRP)content, and the length of the consciousness recovery time and pyretolysis time. Results In the observation group, the total effective rate was 89.47%. Compared with the control group. it increased significantly (P<0.05); After treatment the GCS score in the observation group was significantly higher than the control group, the content of NSE and CRP were significantly lower than the control group, the differences were statistically significant (P<0.01); In the observation group, after treatment the pyretolysis time, consciousness recovery time was significantly lower than the control group(P<0.01). Conclusion The curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy is significant and may effectively shorten the pyretolysis and the recovery of consciousness time, which is worthy of clinical application.

目的 观察分析急性左心衰竭患者应用不同剂量硝酸甘油对血浆中氨基末端B型脑钠肽(NT-proBNP)的影响。方法 选取我院120例急性左心衰竭患者作为研究对象,采用随机数字表法进行分组,其中对照组给予小剂量硝酸甘油,观察组患者采取大剂量硝酸甘油,观察并比较两组患者用药后NT-proBNP的变化情况及临床疗效。结果 经不同剂量药物治疗后,观察组总有效率(96.67%)明显高于对照组(68.33%),差异有统计学意义( χ²=16.681,P＜0.05);用药前,两组患者NT-proBNP水平相近,差异无统计学意义(t=0.384,P＞0.05);用药后6 h、12 h及24 h,观察组患者NT-proBNP指标水平有明显降低,较对照组改善明显,差异有统计学意义(t=17.470、13.988、13.900,P＜0.05)。结论 在常规治疗基础上,应用硝酸甘油微泵注入,采用大剂量硝酸甘油给药治疗急性左心衰竭,可在短时间内降低患者NT-proBNP指标水平,缓解患者症状,临床效果显著。

Objective To observe and analyze the influence and significance of different doses of nitroglycerin on plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute left ventricular failure. Methods One hundred and twenty patients with acute left heart failure were randomly assigned into control group and observation group. Patients in the control group were treated with low dose of nitroglycerin, while patients in the observation group were given high dose of nitroglycerin. NT-proBNP and clinical efficacy in the two groups were observed and compared after treatment. Results After different doses of drug treatment, the overall response rate in the observation group (96.67%) was significantly higher than that in the control group (68.33%), with statistically significant difference (χ²=16.68, P<0.05). Before treatment, NT-proBNP levels were similar, without statistically significant difference (t=0.384, P>0.05). At 6, 12 and 24 hours after treatment, NT-proBNP level was obviously decreased, which was improved than the control group, there were statistically significant differences (t=17.470, 13.988, 13.900, P<0.05). Conclusion Conventional treatment combined high-dose nitroglycerin micro-injection may reduce NT-proBNP indicator levels, relieve symptoms, and have significant clinical effect in patients with acute left heart failure.

目的 探讨急性心衰(AHF)患者NTpro-BNP,cTnI,hs-CRP的变化及其临床意义。方法 分别选取342例AHF患者和30例同期健康查体者作为观察组和对照组。统计2组NTpro-BNP,cTnI,hs-CRP及LVEF水平及随访期间死亡率。分析患者NTpro-BNP,cTnI,hs-CRP与其LVEF的关系及其联合预测患者死亡率的价值。结果 观察组NTpro-BNP,cTnI,hs-CRP均较对照组升高,LVEF则较对照组降低;与T₀比较,患者T₂、T₃、T₄的NTpro-BNP,cTnI,hs-CRP均降低,LVEF则升高;心衰较严重患者其NTpro-BNP,cTnI,hs-CRP较高,LVEF则较低(P<0.05)。观察组存活患者NTpro-BNP,cTnI,hs-CRP较低,LVEF则较高(P<0.05)。AHF患者NTpro-BNP,cTnI,hs-CRP与其LVEF均呈负相关且预测预后的价值良好。结论 AHF患者NTpro-BNP,cTnI,hs-CRP与其心功能相关且其联合预测预后的价值较高,可能作为AHF患者心功能及患者预后评估的参考指标。

Objective To study the NTpro-BNP, cTnI and hs-CRP changes of patients with acute heart failure(AHF)and its clinical significance. Methods 342 patients with AHF and 30 healthy persons were selected as observation group and control group. NTpro-BNP, cTnI, hs-CRP and LVEF level of two groups and mortality during the follow-up period were analyzed. Relationship between NTpro-BNP, cTnI, hs-CRP and LVEF, and value of them unitedly predicting mortality of patients were analyzed. Results NTpro-BNP, cTnI, hs-CRP of observation group were higher than that of the control group while LVEF was lower than that of the control group; Compared with T₀, NTpro-BNP, cTnI, hs-CRP of observation group in T₂, T₃, T₄ were reduced while LVEF increased; Patients with more serious heart failure had higher NTpro-BNP, cTnI, hs-CRP and lower LVEF (P<0.05). NTpro-BNP, cTnI, hs- CRP of survived patients in observation group were lower while LVEF was higher(P<0.05). NTpro-BNP,cTnI and hs-CRP of AHF patients were negative correlated with LVEF and value of them predicting good prognosis. Conclusion NTpro-BNP, cTnI, hs-CRP of AHF patients are related to its heart function and the value of them unitedly predicting prognosis is good, thus they may used cardiac function and prognosis evaluation reference index of AHF patient.

目的 应用Synapsys人体姿势平衡系统对早期帕金森病(Parkinson's disease, PD)患者姿势障碍定量测试评价效果分析。方法 收集我院神经内科2015年7月-2016年7月收治的早期PD患者52例,随机分为试验组和对照组,每组26例。两组患者均给予常规治疗措施,试验组在常规治疗基础上给予康复治疗措施,最后两组均使用Synapsys人体姿势平衡系统和Berg平衡量表对患者进行评估和训练,观察测试结果。结果 干预前动态和静态异常比例组间差异无统计学意义(P>0.05);干预后试验组动态和静态异常分别为34.62%、30.77%,低于对照组的69.23%、73.08%,差异有统计学意义(P<0.05);干预前Berg平衡量表评分组间差异无统计学意义(P>0.05),干预后试验组评分高于对照组,差异有统计学意义(P<0.05);干预后两组Berg平衡量表评分均升高,其中试验组干预前后比较差异有统计学意义(P<0.05)。结论 应用Synapsys人体姿势平衡系统对早期PD患者姿势障碍准确定量测试,以评价康复效果,并且对于康复治疗具有重要作用。

Objective To analyze the clinical effects of quantitative test on early Parkinson's patients who suffering in postural disorders by using synapsys posturography system (SPS). Methods 52 cases of early Parkinson's patients who treated in our department of neurology from July 2015 to July 2016 were collected and divided into experimental and control groups randomly, 26 cases in each group. During the treatment, cases in experimental group and control group received the same conventional treatments. Meanwhile, on the base of conventional treatments, the cases in experimental group also received recovery therapy. Finally, the clinical effects of different treatments in two groups were evaluated by using SPS and Berg balance scale (BBS). Results Before intervention, the dynamic and static abnormal proportion between two groups had no significant difference (P>0.05); However, after the intervention, dynamic and static abnormal proportion in experimental group were 34.62%、30.77%, respectively, which was lower than those in control group (Dynamic: 69.23%; Static:73.08%), and the difference was significant (P<0.05); In addition, the result of BBS showed there was no difference between the experimental group and control group before intervention (P>0.05), while the scores of BBS in experimental group was higher than that in control group after intervention, and the difference was significant (P<0.05); At the same time, the scores of BBS in each group were both increased after the intervention, especially in the experimental group, and the difference in experimental group was significant (P<0.05). Conclusion The quantitative test on early Parkinson's patients who suffering in postural disorders can perform accurately by using synapsys posturography system. And the synapsys posturography system can also evaluate the recovery effects, which is important for the recovery treatment.

目的 观察轻性精神疾病患者对不同躯体疾病患者病情的影响,为临床轻性精神疾病合并躯体疾病患者的诊治提供参考。方法 选择我院门诊于2015年3月—2016年3月期间诊治的124例轻性精神疾病合并躯体疾病患者作为研究对象,设为观察组。选择同期诊治的124例不伴有精神疾病的躯体疾病患者设为对照组。两组患者分别根据患者实际情况采用精神疾病和合并躯体疾病临床诊疗指南进行治疗,并按照孙传兴编著的临床疾病诊断依据治愈好转标准(第二版)判断治疗预后。比较两组患者中不同躯体疾病患者的治愈率、好转率、复发率。结果 对照组和观察组患者的年龄、性别、文化背景、躯体疾病类型比较差异无统计学意义(P>0.05)。两组患者经过临床规范治疗后,观察组患者不同躯体疾病治愈率和好转率与对照组相同躯体疾病患者比较,差异无统计学意义(P>0.05),但观察组患者所有类型躯体疾病患者的复发率均明显高于对照组同类躯体疾病患者,组间比较差异有统计学意义(P<0.05)。治疗结束后至随访期间,观察组患者完全遵医率明显低于对照组,组间比较差异有统计学意义(P＜0.05)。结论 轻性精神疾病患者的躯体疾病病情进展和单纯躯体疾病患者之间存在差异,临床医护人员在诊治轻性精神疾病合并躯体疾病患者时,应重视精神疾病对躯体疾病的影响,酌情调整治疗方案,确保患者预后良好。

Objective To observe the effect of mild mental illness on the condition of patients with physical diseases, to provide reference for clinical diagnosis and treatment. Methods We selected 124 cases of patients with mild mental illness combined with physical diseases in our hospital from March 2015 to March 2016 as the research objects, and set up as the observation group. 124 patients with physical diseases but without mental illness were selected as the control group. Based on the actual situation of patients in the two groups, clinical guidelines of mental disorders and physical diseases were adopted to the treatment, and according to the clinical disease diagnosis based on cure and improvement standard edited by Sun Chuanxing (Second Edition), we judged the prognosis conditions. And then the cure rate, improvement rate and recurrence rate were compared between the two groups of patients with physical diseases. Results There were no significant differences in age, sex, culture background, and physical disease types in the control group and the observation group (P>0.05). After the clinical standard treatment, compared with patients with the same physical diseases in the control groups, it had no statistically differences in cure rate and improvement rate of the patients with different physical diseases (P>0.05), but all types of physical disease recurrence rate of patients in the observation group was significantly higher than that of the control group, there was statistically difference between the two groups(P<0.05). After the end of treatment to the follow-up period, the rate of patients' completely following the medical treatment in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P< 0.05). Conclusion There is progressive difference between patients with mild mental illness combined with physical diseases and patients with only physical diseases. When the clinical medical personnel are faced with the diagnosis and treatment of patients with mild mental illness combined with physical diseases, they should pay attention to the impact of mental illness on the physical diseases, and adjust the treatment plan appropriately in order to ensure a good prognosis of patients.

目的 分析研究不同类型脑梗死患者睡眠结构及其与抑郁的相关性,为脑梗死患者睡眠障碍及抑郁的治疗提供新的思路及理论支持。方法 抽取我院2012年4月—2015年5月接收的124例脑梗死患者进行分组研究,根据脑梗死不同发生部位将患者分为四组,分别为小脑梗死组30例、皮层梗死组33例、脑干梗死组29例及皮层下梗死组32例,对比观察四组患者睡眠结构及睡眠参数和睡眠障碍、HAMD评分的相关性。结果 四组患者睡眠结构相比存在明显差异,脑干梗死组和皮层下梗死组觉醒时间远多于小脑梗死组和皮层梗死组,小脑梗死组NREM 1+2期、NREM期明显短于皮层梗死组、脑干梗死组及皮层下梗死组,小脑梗死组REM期、NREM 3+4期明显大于皮层梗死组、脑干梗死组及皮层下梗死组,各项数据对比差异均有统计学意义(P＜0.05);HAMD评分、PSQI评分和NREM1+2期、觉醒指数呈正相关关系(P＜0.05,r＞0);与REM期和NREM 3+4期呈负相关关系(P＜0.05,r＜0)。结论 皮层下梗死睡眠结构紊乱发生率更高,并且睡眠结构的变化和脑梗死后抑郁评分、睡眠障碍评分具有一定关系。

Objective To study the correlation between sleep structure and depression in patients with different types of cerebral infarction,to provide new ideas and theoretical support for the treatment of sleep disorders and depression in patients with cerebral infarction. Methods 124 patients with cerebral infarction in our hospital from April 2012 to May 2015 were selected. They were divided into four groups according to the different parts of the cerebral infarction, respectively, 30 cases of cerebellar infarction group, 33 cases of cortical infarction group, 29 cases of brainstem infarction group and 32 cases of subcortical infarction group. The correlation of sleep structure and sleep parameters, sleep disorder and HAMD score of the four groups were observed and compared. Results There was a significant difference in sleep structure between the four groups. Brainstem infarction group and subcortical infarction group awakening time was far more than that of cerebellar infarction group and cortex infarction group.Cerebellar infarction group NREM 1+2, NREM period was significantly shorter in cortical infarction, brain stem infarction group and subcortical infarction group. Cerebellar infarction group of REM and NREM stage 3+4 were significantly greater than that of cortical infarction death group, brain stem infarction group and cerebral cortex infarction group. The differences were statistically significant(P<0.05);HAMD score, PSQI score and NREM1+2 period, arousal index was positively correlated (P<0.05, r> 0); And REM phase and 3+4 NREM phase was negatively correlated (P<0.05, r< 0). Conclusion Subcortical infarction sleep structure disorder incidence is higher, and the sleep structure changes and infarction depression score, sleep disorder score has a certain relationship.

目的 了解农民工对入职体检结果异常的遵医行为状况及影响因素,为临床治疗、护理和健康教育提供相应的依据。方法 对106例在我院行入职体检且结果异常的农民工进行遵医行为的问卷调查,且对影响因素进行分析。结果 遵医行为好的有20例,一般的有38例,差的有48例;年龄、性别、文化程度、职业类型、疾病种类、经济收入对农民工的遵医行为均有影响(P＜0.01)。结论 农民工对入职体检结果异常的遵医行为不容乐观,建议国家或相关省市出台相关政策和法规,为农民工提供相应的健康保障;医疗机构要加大健康教育力度,提高农民工的健康意识和倡导健康行为,降低慢性病的发病率。

Objective To investigate migrant workers' medical compliance after receiving abnormal entry health examination results and relevant factors affecting compliance behavior, providing evidence to clinical treatment, nursing and health education. Methods 106 migrant workers who took part in entry health examination in our hospital and got abnormal results were accepted questionnaires and the relative factors were analyzed. Results 20 migrant workers had good compliance behavior, and 38 workers performed normally while 48 workers did bad. Age, gender, education, type of occupation, type of illness, and income all had influence on compliance behavior (P<0.01). Conclusion The recent condition of migrant workers' medical compliance on abnormal entry health examination results is not good. Therefore the country or province departments should carry out relative laws or policies, providing migrant workers with health support; Medical institutions should promote health education to improve migrant workers' health awareness and health behavior and reduce incidence of chronic diseases.

目的 探讨标准化沟通模式在重症孕产妇院前转运前评估与交接环节中的应用效果。方法 设计转运前标准化沟通信息登记表,用以标准化转运前评估与交接环节,护士按照登记表中的项目逐条交接,对方未交代的项目护士进行主动评估,并将结果登记并汇报接诊医生。结果 运用标准化沟通模式后,有效缩短了转诊的通话时间和抵院后的处理时间,护士评估信息的错漏率由13.84%降低至4.23%,交接不清导致的不良事件发生率由7.41%降至1.21%,并在改善母婴结局等方面均取得较好效果。结论 SBAR 沟通模式在重症孕产妇孕前转运的评估和交接环节中保证了重要信息的准确传递,为重症孕产妇的救治争取宝贵时间,值得临床上推广应用。

Objective To explore the application effects of SBAR (situation, background, assessment and recommendation) communication mode in the transfer of critically ill obstetric women. Methods A transfer from based on SBAR communication mode was designed and used to assess the psychological status and illness condition of critically ill obstetric women. Results After the application of SBAR communication transfer model, the communication time and hospital action time were both shortened and the occurrence of transfer problems decreased,while the pregnancy outcomes were improved (P＜0.05). Conclusion Applying SBAR communication mode in the transfer of critically ill obstetric women is helpful to reduce the transfer time and the occurrence of transfer problems,and improve the quality of patient handover.

目的 运用灵龟八法配合面瘫针治疗Bell麻痹患者,探讨该法治疗Bell麻痹的有效性及其机理。方法 随机分组的4组Bell麻痹患者,A组:灵龟八法配合面瘫针组、B组:面瘫针组、C组:常规针刺组、D组:西药组。治疗≤2个疗程,每个疗程4周,治疗前及发病2,4,8周后进行House-Brackmann面神经分级与症状积分、瞬目反射(BR)、肌电图(EMG)、神经电图(ENoG)及红外热像测定。结果 根据House-Brackmann面神经分级与症状积分评定疗效,4组有效率比较A组疗效最好,疗程最短(P＜0.05)。各项神经电生理检查及红外热像结果在治疗后变化中A组变化差异均最显著(P＜0.05)。结论 灵龟八法配合面瘫针治疗Bell麻痹在疗效及疗程方面均有较大的优势。且该疗法取穴简便、安全,使患者易以接受,值得临床推广。

Objective Through the clinical observation of Jin's 3-needle with eight methods of Intelligent Turtle(Traditional Chinese Medicine) in the treatment of Bell's palsy,to explore the impact mechanism of this method in the treatment of Bell's palsy. Methods Patients with Bell's palsy were randomly divided into study groups. 30 cases were in Jin's 3-needle with eight methods of Intelligent Turtle treatment group (Group A); 30 cases were in the Jin's 3-needle treatment group (Group B); 30 cases were in the routine acupuncture group(Group C);30 cases were in the oral medicine group (Group D). The course of the treatment took 4 weeks. Before the treatment and in 2,4,8 weeks after the diseases onset in each group, House-Brackmann facial nerve grading and symptom score,BR,EMG,ENoG and infrared thermography were observed and compared. Results Each group of treatment was effective in House-Brackmann facial nerve grading and symptom score(P＜0.05). However, Group A were better than the other three groups.The results of electrophysiological examination and infrared thermal imaging were statistically significant after treatment(P＜0.05). The difference was the most significant in group A. Conclusion Jin's 3-needle with eight methods of Intelligent Turtle treatment has a great advantage in curative effect and shortens the course of treatment. The method is simple and safe. It is worthy to be widely used in clinical practice.

目的 分析、探讨正常压力性脑积水发病机制、临床特点、手术指征及疗效。方法 回顾性分析我院自2005年1月—2015年1月采用侧脑室-腹腔分流术治疗53例正常压力性脑积水患者临床资料。结果 随访0.5~3年,总有效率为79.2%,无效率为20.8%,不良反应发生率为5.6%,不同临床特点患者的疗效有显著性差异(P＜0.05)。结论 提高对正常压力性脑积水认识,尽早确诊,选用合适压力的分流管,及时行脑室-腹腔分流术,注意防治并发症,以提高手术疗效。

Objective To explore the pathogenesis, clinical features, operation indication as well as therapeutic effect of hydrocephalus with normal pressure. Methods 53 patients underwent the ventriculo-peritoneal shunt from our hospital from Jan 2005 to Jan 2015 were retrospectively studied. Results Follow-up period was 0.5 to 3 years. Total efficacy rate was 79.2%; The failure rate was 20.8%; The incidence rate of adverse reaction was 5.6%. There were significance statistically for therapeutic effect between different groups(P＜0.05). Conclusion It is important to strengthen the awareness and diagnosis for hydrocephalus with the normal pressure. The suitable shunt duct and the ventriculo-peritoneal shunt in time will decrease complications and improve surgical therapeutic effect.

目的 探讨行动导向法在原位新膀胱患者康复中的应用效果。方法 选取36例新膀胱术后回归社区的患者,自出院当天起按“提出任务、计划制订、计划实施、自我反馈”4个完整的行动进行健康教育,6个月后评价患者尿失禁或尿潴留的发生率、新膀胱控尿效果、健康知识知晓率。结果 干预后患者尿失禁的发生率为2.78%、尿潴留为8.33%,新膀胱控尿效果和健康知识知晓率均为100%,与干预前比较差异均有统计学意义(P<0.05 )。结论 行动导向法对原位新膀胱患者进行健康教育,有利于提高患者学习积极性和依从性,促进理想自主排尿早日恢复。

Objective To explore the effect of action oriented method in the rehabilitation of patients with orthotopic neobladder. Methods Select 36 cases of patients who return to the community after the new bladder surgery, from the day of discharge, according to“ the objective, plan making, plan implementation, self feedback” these 4 complete actions to implement health education. After 6 months the evaluation for the patients with urinary incontinence or urinary retention including the incidence of new bladder continence, awareness of health knowledge were taken. Results The incidence of urinary incontinence was 2.78% and urinary retention was about 8.33%. The awareness rate of urinary continence and health knowledge was 100%, and the difference was statistically significant (P<0.05). Conclusion It is helpful to improve the learning interesting and compliance of the patients with bladder cancer, and to promote the early recovery of the ideal autonomous urination.

目的 探究曲美他嗪对慢性心力衰竭患者血清炎症因子水平及心功能的影响。方法 选择2015年4月—2016年3月我院收治的慢性心力衰竭患者94例,根据随机数表法分为两组,每组47例。对照组实施阿托伐他汀治疗,观察组在此基础上予以曲美他嗪治疗。比较两组患者治疗6个月后血清炎症因子和脑利钠肽(BNP)、心功能以及临床疗效。结果 观察组血清C-反应蛋白(CRP)、BNP、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P＜0.05);观察组左收缩末期内径(LVESD)、左室舒张末期内径(LVEDd)水平较对照组明显降低,而左室射血分数(LVEF)高于对照组,差异有统计学意义(P＜0.05);观察组患者治疗有效率与对照组相比明显提高,差异有统计学意义(P＜0.05)。结论 对慢性心力衰竭患者实施曲美他嗪治疗,能有效提高患者临床疗效,降低患者血清炎症因子,改善心功能,值得临床推广与应用。

Objective To investigate the effect of Trimetazidine on serum inflammatory factors levels and cardiac function in patients with chronic heart failure (CHF). Methods 94 CHF patients admitted into our hospital from April 2015 to March 2016 were divided into two groups randomly, 47 cases in each. Control group took Atorvastatin, and on this basis observation group was given Trimetazidine. The serum inflammatory factors levels, brain natriuretic peptide (BNP), cardiac function and clinical efficacy of two groups after treatment for 6 months were compared. Results The serum C-reactive protein (CRP), BNP, Tumor necrosis factor-α (TNF-α) levels of observation group were lower than control group (P<0.05); The left ventricular end-systolic diameter (LVESD), Left ventricular end-diastolic diameter (LVEDd) levels of observation group significantly decreased compared with control group, but left ventricular ejection fraction (LVEF) was higher than control group (P<0.05); The curative effective rate of observation group significantly increased compared with control group (P<0.05). Conclusion Trimetazidine for treating CHF patients may effectively increase clinical efficacy, decrease serum inflammatory factors and improve cardiac function, which is worthy of clinical promotion and application.

目的 调查分析中山市某三甲医院抗菌药物不良反应的发生和分布情况,为临床合理应用抗菌药物提供相关信息。方法 以中山市某三甲医院2013—2015年上报国家药品不良反应监测系统的528例抗菌药物的不良反应为考察对象,按照给药途径、不良反应严重程度、年龄、性别、药物种类、不良反应累及的系统-器官、不良反应发生时间进行分类、整理、归纳和总结。结果 累及系统-器官涉及皮肤及其附件、血液系统、神经系统、消化系统、泌尿系统等。其中皮肤及其附件损害、神经系统、胃肠道反应容易发现,消化系统、血液系统、泌尿系统、肝胆系统的反应具有隐匿性。结论 临床在使用抗菌药物时,既要关注其抗菌效应,也要高度警惕其不良反应的危害性。避免无指征用药,合理选用抗菌药物,科学地开展ADR 监测工作,确保临床安全、有效、合理用药。

Objective To investigate occurrence and distribution of adverse drug reaction ADR of antibiotic drugs in a hospital of Zhongshan, in order to provide relevant information for clinical rational use of antibacterial drugs. Methods We classified and analyzed 528 cases of adverse drug reaction of antibiotic drugs which was reported to National center for ADR Monitoring during 2013～2015, according to the administration route、the severity of ADRs、age、sex、types of drugs、the organs systems involved by ADRs, the time of ADRs occurrence. Results Adverse drug reaction of antibiotic drugs involved in skin and its appendix、hematological system、nervous system、digestion system、urinary system and so on. Among them skin and its appendix、nervous system and gastrointestinal reactions were easy to acquire, others were obscure and difficult to find. Conclusion When the clinical use of antibacterial drugs, should not only focus on its antibacterial effect, also need to keep high vigilance against the dangers of its adverse reactions. To ensure the clinical safety, effective and rational drug use, we need to avoid no indication of medicine, take rational use of antibiotic drugs,scientifically to carry out the ADR monitoring.

目的 探讨吸烟对稳定期COPD患者炎症反应和肺功能的影响。方法 选取2013年8月—2016年9月我院门诊收治的稳定期COPD患者70例为研究对象,其中吸烟35例(X1组)、不吸烟35例(X2组),另选取同期入院的不吸烟健康志愿者35例纳入健康组,采用酶联免疫吸附试验(ELISA)测定血清白介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,以肺功能检测仪测定三组一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1％),并采用自拟症状评分表及简明健康调查简表(SF-36)评价呼吸困难程度及生活质量。结果 X1组IL-6、IL-8及TNF-α依次为(135.27±1.24)pg/mL、(189.45±1.14)pg/mL、(39.39±1.14)pg/mL,明显高于X2组、健康组(P均<0.05);X1组FEV1(0.75±0.14)L、FEV1/FVC(3.65±1.87)％、FEV1％(3.45±0.12)％低于X2组、健康组(P均<0.05);X1组症状积分(10.17±1.02)分较X2组、健康对照组高(P<0.05),而其SF-36评分(54.27±1.46)分明显低于X2及健康组(P<0.05);X2组上述指标与健康组比较亦有统计学意义(P均<0.05)。结论 吸烟可明显增加稳定期COPD患者IL-6、IL-8、TNF-α等炎症因子水平,同时降低肺功能,临床应采取措施进行有效干预,防止患者病情恶化。

目的 探讨血管介入治疗糖尿病足的疗效以及术后血管再狭窄的影响因素。方法 选取2013年2月—2015年3月在我院接受治疗的糖尿病足患者96例,采用随机数表法将患者分为观察组和对照组两个各48例,观察组患者给予血管微创手术介入治疗,对照组患者给予常规治疗,比较两组患者治疗后的临床疗效、住院费用、住院天数、Wagner分级以及患者观察组患者术后血管再狭窄的影响因素。结果 治疗后,观察组患者的总有效率为93.75%高于对照组72.91%,两组比较差异有统计学意义(P<0.05);将观察组患者术后发生发生血管再狭窄的22例患者作为A组,未出现血管再狭窄的26例患者作为B组。A、B两组患者病程、TG、LDL-C、MDA含量、HbA以及BMI比较差异无统计学意义(P>0.05);术后,A组患者的TC明显高于B组,两组比较差异有统计学意义(P<0.05),由此可见,TC是导致患者术后出现血管再狭窄的危险因素;观察组患者的住院费用以及住院天数低于对照组,两组比较差异显著(P<0.05)。结论 采用血管介入治疗糖尿病足患者疗效显著,高TC是患者术后血管再次发生狭窄的影响因素。

目的 观察甲氨蝶呤(MTX)联合激素、羟氯喹治疗轻、中度活动性系统性红斑狼疮(SLE)的实验室结果分析及临床应用价值。方法 选择我院收治的系统性红斑狼疮患者60例,随机分成研究组(n=30)与对照组(n=30),对照组给予糖皮质激素0.5～1.0 mg/(kg·d)及羟氯喹治疗,研究组给予口服MTX片剂每周一次7.5～15 mg联合糖皮质激素及羟氯喹(用法同对照组),比较分析两组患者的实验室检查结果差异。结果 与治疗前相比,研究组患者的ANA、抗ds-DNA滴度及ESR、CRP的下降都明显优于对照组(P＜0.05);研究组患者的ALT、AST、BUN、SCr及血象(WBC、Hb、PLT)指标也明显优于对照组(P＜0.05);研究组患者补体(C3、C4) 也明显高于对照组(P＜0.05)。结论 加用MTX治疗SLE有效,安全性良好,且联合治疗能更好地控制疾病,减少复发,防止及延缓重要脏器的损害。缓解患者的临床症状,为SLE患者提供一个安全、有效的治疗方案。

目的 探讨机采血小板献血者流失原因,为建立一支稳固的机采血小板献血者队伍提供参考。方法 选择2009年1月1日—2012年12月31日河源市中心血站首次机采血小板献血者共382例为研究对象,根据其首次机采血小板献血后3年内是否再次参加机采血小板献血分为实验组和对照组,分别对研究对象进行电话回访调查。结果 3年内未再次参加血小板献血流失者118例,总流失率为30.89%;不同献血动机组流失率差异有统计学意义 (χ²= 18.552,P=0.000),其中动机不明确组流失率(52.49%)最高,寻求社会荣誉组流失率(15.79%)最低。发生过献血反应组(63.64%)流失率显著高于未发生献血反应组流失率(26.63%),两组间差异有统计学意义(χ²=8.501,P=0.004);对献血过程不满意组流失率(39.77%)显著高于满意组流失率(28.23%),两组间差异有统计学意义(χ²=16.413,P=0.000);认为机采时间过长组机采血小板献血者流失率(49.40%)显著高于不认为机采时间过长组流失率为(25.75%),两组间差异有统计学意义(χ²=17.014,P=0.000)。健康状况(体检结果)不合格组流失率(43.84%)显著高于合格组流失率(27.83%),两组间差异有统计学意义(χ²=9.022,P=0.030)。媒体(或网络)负面的宣传与献血者是否方便对机采血小板献血者流失率的影响不显著(χ²=1.579,P=0.209;χ²=2.130,P=0.144)。结论 机采血小板献血者流失主要与献血动机、献血过程感受以及自身健康等因素有关。

目的 探讨腹腔镜手术与传统开腹手术对右半结肠癌患者免疫功能指标及临床疗效的影响。方法 选取80例右半结肠癌患者,随机分成两组,各40例分别行腹腔镜手术及传统开腹手术,分别比较两组患者手术前后免疫功能指标及相关临床疗效的差异。结果 腹腔镜组及开腹组术后免疫指标CD3⁺、CD4⁺、CD8⁺均出现不同程度下降,但腹腔镜组免疫指标CD3⁺、CD4⁺均优于开腹组(P＜0.05);腹腔镜组术中出血量、术后胃肠排气功能恢复时间、住院时间均优于开腹组(P＜0.05);两组手术时间及淋巴结清扫个数方面无显著差异(P＞0.05)。结论 腹腔镜手术治疗右半结肠癌不仅对患者免疫功能损害较低,还较开腹术具有术中出血量少、术后恢复快等优点,值得临床推广。

目的 探讨产后出血(PPH)应用一次性囊式宫颈扩张器治疗的临床效果。方法 选取我院2001年1月—2016年12月收治的50例PPH产妇,按就诊先后顺序进行分组,2001年1月—2015年12月就诊的25例为对照组(予以宫腔填塞纱布治疗);2016年1月—2016年12月就诊的25例为观察组(给予一次性囊式宫颈扩张器治疗),并按照分娩方式不同分为阴道分娩组(15例),剖宫产组(10例)。记录比较观察组和对照组的治疗与预后情况;阴道分娩组与剖宫产组的治疗情况。结果 与对照组比较,观察组在操作时间、填塞物留置时间及起效时间方面,均显著更优(P<0.01);两组放置后12 h出血量、显效率相比,差异无统计学意义(P>0.05);观察组子宫切除、子宫动脉结扎及产褥感染等发生率均低于对照组,但差异均无统计学意义(P>0.05);阴道分娩组的起效时间、留置时间、T2时间段阴道总流血量、显效率及产褥感染率,较剖宫产组比较,差异均无统计学意义(P>0.05),阴道分娩组T1时间段阴道总流血量显著低于剖宫产组(P<0.01)。结论 PPH产妇应用一次性囊式宫颈扩张器治疗操作简便,更有利于缩短操作时间,改善预后,效果切实,且对于阴道分娩与剖宫产产妇的疗效相当,适用于基层医院,具有较高临床推广价值。

瘦素是维持人体能量代谢平衡的蛋白质,在人体中主要由白色脂肪组织分泌,通过与瘦素受体结合发挥作用。近年来有许多与瘦素相关的研究证明高血压患者及代谢综合征患者的血清瘦素水平较健康人群明显升高。两种疾病均可出现心室肥厚,蛋白尿,动脉粥样硬化等表现,说明二者存在共同的靶器官。瘦素代谢异常可出现瘦素抵抗并通过影响肾素-血管紧张素-醛固酮系统(renin angiotensin aldosterone system, RAAS)及炎症细胞因子来损伤靶器官。本文旨在总结瘦素在高血压及代谢综合征中的作用机制,并探讨瘦素对高血压合并代谢综合征靶器官损伤作用的研究进展。

Leptin is a protein that maintains the balance of energy metabolism in human body. It is mainly secreted by white adipose tissue in human body. In recent years, many studies have shown that the serum leptin level in patients with hypertension complicated with metabolic syndrome is significantly higher than that of healthy people. Both of the diseases can lead to left ventricular hypertrophy, proteinuria, atherosclerosis and other manifestations. The abnormal metabolism of leptin may contribute to leptin resistance which damages target organs by affecting the angiotensin aldosterone system and inflammatory cytokines. The aim of this article is to summarize the mechanism of leptin in hypertension and metabolic syndrome, and to explore its effect on the target organ damage in patients with hypertension complicated with metabolic syndrome.

目的 研究中山市南部镇区医院人员关于继续医学教育的政策知悉程度、参加继续医学教育的途径、障碍因素及动机,为完善继续医学教育管理工作提供决策依据。方法 采用简单随机抽样的方法,选取中山市南部镇区医院200名医务人员,采用问卷调查方法,了解中山市南部镇区医务人员继续教育的参与情况,接受继续教育的主要途径与障碍。结果 24～40岁年龄段、初级职称人员知悉程度较高,而40～48岁年龄段、中高职称人员参与程度较高;晋升和发展是主要参与动机,时间和空间因素是主要参与障碍。结论 医院应根据不同层次专业技术人员继续教育的需要开展继续教育,并创造有利条件,克服时间上和空间上的障碍,更好地使继续教育的效果转化为知识结构的不断优化。

目的 调查我院处方错误的数量和分类,保障门诊患者用药的安全性、有效性和经济性。方法 采用回顾性分析方法,对我院2016年1月—6月的门诊电子处方统计,对不合理处方及时电话沟通和改正,并将错误处方登记入册分析。结果 其中登记入册的错误处方占总处方数的0.24%,主要包括药物用法用量不合理、给药途径不当、药物相互作用不合理、禁忌证用药、重复用药、电脑输入剂量或单位错误等。结论 我院门诊电子处方仍存在一定的不合理现象,临床药师通过处方审核进行干预,并与医院管理和医师有机结合,努力开展药学监护,提高我院处方质量,促进合理用药,共同保证患者用药正确,有效,安全,经济,合理,降低医疗纠纷的发生。

目的 分析于剖宫产产妇围手术期实施针对性护理对其切口感染率及不良情绪的影响。方法 选取2015年6月—2016年4月于我院择期行剖宫产术的102例产妇,通过随机数表法分为观察组与对照组,各51例。给予对照组常规护理,在此基础上观察组给予针对性护理干预。对比两组术后恢复情况、护理前后疼痛评分(VAS)、抑郁评分(SDS)及焦虑评分(SAS)变化情况,并统计两组并发症发生率、护理满意度。结果 观察组肛门排气时间、切口愈合时间、24 h睡眠时间、住院时间、下床活动时间均少于对照组,差异有统计学意义(P＜0.05);护理前两组SAS评分、SDS评分、VAS评分间无明显差异(P＞0.05),经护理干预,观察组SAS评分、SDS评分、VAS评分低于对照组,差异有统计学意义(P＜0.05);两组切口感染率、并发症发生率(1.96%、7.84%)低于对照组(15.69%、31.37%),差异有统计学意义(P＜0.05);两组护理满意度对比,观察组(98.04%)高于对照组(82.35%),差异有统计学意义(P＜0.05)。结论 给予剖宫产围术期产妇针对性护理疗效确切,可缓解不良情绪,减轻疼痛感,促使机体功能及早康复,减少切口感染与并发症发生。