目的 探讨胃癌组织中刺猬信号通路(Hedgehog signaling pathway, Hh)中的音猬因子(Sonic hedgehog, Shh)和胶质瘤相关癌基因同源物-1(Glioma-associated oncogene homolog -1, Gli-1)与金属基质蛋白酶-2(Matrix metalloproteinase-2, MMP-2)的表达和临床意义。方法 采用免疫组织化学方法检测40例人胃癌组织、人胃息肉组织和40例正常胃黏膜组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2蛋白的表达。结果 胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的阳性表达率分别为62.5%、67.5%、72.5%,高于胃息肉组织(阳性表达率分别为27.5%、37.5%、32.5%)和正常胃黏膜组织(阳性表达率分别为22.5%、17.5%、12.5%)(P<0.05);以上三者的表达与患者性别、年龄、组织学类型无关(P>0.05);而与分化程度、浸润深度、淋巴结转移相关(P<0.05);音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2表达呈正相关。结论 刺猬信号通路可能通过某些机制可上调金属基质蛋白酶-2的表达,从而增强胃癌的侵袭性。联合检测胃癌组织中音猬因子、胶质瘤相关癌基因同源物-1、金属基质蛋白酶-2的表达水平在一定程度上可以作为胃癌预后的客观参考指标。

Objective To investigate the expression and clinical significance of Sonic hedgehog(Shh), Glioma-associated oncogene homolog -1(Gli-1) and Matrix metalloproteinase-2(MMP-2) in gastric cancer.Shh and Gli-1 are the molecules of Hedgehog(Hh) signaling pathway. MMP-2 is the member of matrix metalloproteinase family. Methods The expression of Shh,Gli-1 and MMP-2 proteins was examined by immunohistochemistry in the human gastric cancer tissues and the human gastric polyp and the normal gastric mucosa tissues of 40 cases. Results The positive expression rates of Shh,Gli-1 and MMP-2 in gastric cancer were 62.5%,67.5% and 72.5% respectively, which were significantly higher than those in the gastric polyp tissues (the positive expression rates were 27.5%,37.5% and 32.5% respectively) and normal gastric mucosa tissues (the positive expression rates were 22.5%,17.5% and 12.5% respectively),P<0.05.The expression of Shh,Gli-1 and MMP-2 was not correlated with the sex,age or histological type(P>0.05),but was correlated with depth of invasion,differentiation level and lymphonode metastasis in gastric cancer(P<0.05). The expression of Shh and Gli-1 was positive correlated with MMP-2. Conclusion Hedgehog(Hh)signaling pathway may have great effects on enhancing the invasive ability of gastric cancer by upregulating MMP-2 protein through some unknown mechanisms.The combined detection of the expression level of Shh,Gli-1 and MMP-2 in gastric cancer tissues might be used as an Objective references for assessing the prognosis of gastric cancer.

目的 探讨Bcl-2、COX-2在宫颈癌新辅助化疗前后表达的意义, 以及新辅助化疗(NACT)对宫颈癌的近期临床疗效。方法 对32例宫颈癌患者,采集NACT治疗前后的宫颈癌组织标本,采用免疫组织化学SP法检测组织中的Bcl-2及COX-2表达。结果 ①经NACT后,治疗总有效率(CR+PR)为75%,无效率(PD+SD)为25%。②宫颈癌组织中Bcl-2、COX-2的表达均出现明显下降,差异均有统计学意义(P<0.05);临床有效组中Bcl-2、COX-2的表达在NACT后出现显著下降(P<0.05),无效组中Bcl-2、COX-2的表达在NACT前后无明显统计学意义(P>0.05)。结论 Bcl-2、COX-2的表达情况对评价宫颈癌患者新辅助化疗效具有肯定的临床意义,宫颈癌行NACT后近期疗效良好。

Objective To investigate the expression of Bcl-2 and COX-2 in cervical cancer before and after neoadjuvant chemotherapy; To evaluate the efficacy of neoadjuvant chemotherapy(NACT) for cervical cancer in the recent clinical effects. Methods To select 32 cases of patients with cervical cancer, collect the cervical cancer tissues before and after NACT, immunohistochemical SP method was used to detect the expression of Bcl-2and COX-2 in the tissues. Results After neoadjuvant chemotherapy, total effective rate (CR+PR) was 75%(24/32), inefficient rate(PD+SD) was 25%(8/32). The expression of Bcl-2 and COX-2 of cervical cancer patients who had neoadjuvant chemotherapy (NACT), before and after, had great differences. The difference had statistical significance (P<0.05); The expression of Bcl-2 and COX-2 were significantly lower after neoadjuvant chemotherapy in clinical effective group(P<0.05), there is no statistical significance in clinical non-effective group(P>0.05). Conclusion The expression of Bcl-2 and COX-2 of cervical cancer patients has certain clinical significance in evaluating the effect of neoadjuvant chemotherapy in cervical cancer patients. Recent curative effect after NACT in the cervical cancer patients is good.

目的 探讨微泡增强的超声空化增加睾丸组织的药物浓度的可行性。方法 18只雄性8月龄性成熟新西兰兔随机分为空白对照组(C)、单纯微泡组(MB)、治疗超声组(TUS)、超声联合微泡辐照组(MEUS)4组,每组各9个。MB组给予静注微泡造影剂 0.1 mL/kg ;TUS组给予超声辐照5min;MEUS组给予静注微泡造影剂0.1 mL/kg的同时超声辐照5min;每组在治疗前5min均经耳缘静脉注射2%伊文思蓝(EB)2.5 mL/kg;治疗后1 h取各组睾丸组织制备组织匀浆测量 EB 浓度。结果 MEUS组兔睾丸组织内 EB 浓度高于其他各组(P<0.05),差异有统计学意义。结论 微泡增强的超声空化可以明显提高睾丸组织内EB浓度。

Objective To investigate feasibility of microbubbles enhanced ultrasound (MEUS) on the concentration of Evans blue (EB) in rabbit,stestis. Methods Eighteen sexually mature male New Zealand rabbits were divided into four groups randomly. Pulsed ultrasound irradiation and intravenous microbubbles injection were both applied in the microbubbles enhanced ultrasound group (MEUS), pulsed ultrasound irradiation and intravenous microbubbles injection were individually applied in the therapeutic ultrasound group (TUS) and the simple microbubbles group (MB). Injection of EB was applied in each group five minutes before the treatment.Concentration of EB in testis tissue was measured homogenated. Results The concentration of Evans blue(EB) in rabbit's testis in MEUS group was statistically higher than the other groups (P<0.05). Conclusion Microbubbles enhanced ultrasound (MEUS) can increase the concentration of Evans blue (EB) in rabbit's testis.

目的 探讨雷公藤甲素防治大鼠青光眼术后滤过泡纤维化的可行性。方法 选取Wistar大鼠100只分为两组,对照组和观察组各50例。采用房水释放联合激光房角光凝法建立青光眼大鼠模型,然后所有大鼠均进行青光眼手术。手术后,观察组大鼠使用雷公藤甲素预防治疗青光眼术后滤过泡纤维化,对照组大鼠使用5-氟尿嘧啶预防治疗青光眼术后滤过泡纤维化。观察比较防治滤过泡纤维化效果。结果 观察组大鼠的眼压在手术后第1天与对照组相比无差异(P＞0.05),在第6天、14天低于对照组(P＜0.05),观察组大鼠滤过泡面积在手术后第1天、6天、14天均小于对照组大鼠(P＜0.05);观察组大鼠的治疗后滤过泡分型Ⅰ型和Ⅱ型均优于对照组,Ⅲ型和Ⅳ型均低于对照组(P＜0.05);观察组术后不良反应发生率为12.16%,低于对照组22.86%(P＞0.05)。结论 雷公藤甲素防治大鼠青光眼术后滤过泡纤维化效果明显,且安全性较高,值得临床广泛运用推广。

Objective To investigate the feasibility of triptolide in prevention and cure rats glaucoma surgery fibrosis. Methods 100 cases of Wistar rats were divided into two groups, with 50 cases in the control group and the observation group.Glaucoma rat model were built by aqueous release combined with laser photocoagulation, and all rats underwent glaucoma surgery. After surgery, the rats in the observation group were observed their triptolide preventive treatment in glaucoma surgery fibrosis, the control rats were observed their 5-fluorouracil preventive treatment in glaucoma surgery fibrosis.The effects of prevention and treatment of bleb fibrosis were compared. Results The intraocular pressure of rats in observation group in the first day after surgery compared with the control group has no significant difference (P>0.05), on the 6th、 14th day it was lower than the control group rats(P<0.05). Filtration area in the observation group on first, 6th day, 14th days after surgery, was less than the control rats(P<0.05); In the observation group, the type Ⅰ and type Ⅱ of filtering bleb were better than those of the control group, the type Ⅲ and type Ⅳ were lower than those of the control group (P<0.05);The adverse reaction rate was 12.16% in observation group, it was lower than the control group 22.86% (P<0.05). Conclusion Triptolide in prevention and cure of rats glaucoma surgery fibrosis is obvious, and high security. It is worthy of promotion.

目的 探讨健康成人颈段气管的体外高频超声影像特点,为开展体外超声在检测颈段气管病变应用作前期研究。方法 应用体外高频超声观察120例健康成人颈段气管结构的声像表现,并对气管环T1-T4的内外横径、气管环厚度、相邻气管环间距进行测量和统计学分析。结果 120例志愿者均获得了颈段气管前、侧壁声像图,以及气管环T1-T4内外横径、气管环厚度、相邻气管环间距测值。结论 体外高频超声可以清晰显示气管形态和细微支撑结构,并进行部分径线测量,有望成为评估颈段气管病变的一种有价值的辅助手段。

Objective We investigated features of the healthy adult cervical tracheas in order to studying cervical tracheal lesions by extracorporeal high-frequency ultrasound EHFUS. Methods EHFUS examination of the trachea was performed in 120 asymptomatic adult volunteers. We observed imaging features of the healthy adult cervical tracheas, and measured TRID, TRED, TRTh and TRAS to analysis. Results The cervical tracheal anterior and side wall ultrasonograms, and measurements were obtained in all subjects. Conclusion The cervical tracheal shape and the fine structure of support can be seen in EHFUS, and partly of diameter measurements were obtained. Thus EHFUS may be a valuable assistant method to assess cervical tracheal lesions of support structure.

目的 探讨在待产孕妇中应用中医药辨证护理对促进气血虚弱型足月妊娠孕妇宫颈成熟的临产前护理策略及临床效果。方法 选取中医辨证为气血虚弱型的足月妊娠单胎头位初产妇180例,随机分为对照组即催产素组及常规护理组60例,中医药辨证护理组即在对照组的基础上入院后即给予中药口服加辨证护理60例,空白组即期待观察组及常规护理组60例。观察三组治疗前后宫颈Bishop评分,阴道及宫颈分泌物FFN(胎儿纤连蛋白)定性测定,分娩结局及对母胎的影响。结果 中医药辨证护理组在临产率、阴道分娩率及宫颈评分、FFN测定等方面较对照组及空白组均有差异,P<0.05。结论 对于气血虚弱型足月妊娠在入院后开展中医药辨证护理对临产前宫颈成熟有辅助作用,对于提高顺产率,降低高危分娩促进母儿健康有积极作用,值得推广。

Objective To explore the prenatal care strategy of applying Chinese medicine dialectical care to promoting cervical ripening of full-term pregnant women with qi-blood deficiency and its clinical effect. Methods We chose 180 first-time, full-term pregnant women with single fetus cephalic presentation who were diagnosed as with qi-blood deficiency and then randomly divided them into three groups, 60 in control group with oxytocin and usual care; 60 in group of Chinese medicine dialectical care, which provided oral use of Chinese medicine and dialectical care after those women being admitted to hospital; 60 in blank group with usual observation and care. We did Bishop assessment of neck of uterus before and after treatment in these three groups, conducted qualitative test in FFN (Fetal Fibronectin), the secreta from vagina and neck of uterus, and observed delivery outcome as well as the influence to mother and child. Results Compared with control group and blank group, the group ofChinese medicine dialectical care was outstanding in terms of labor rate, vaginal delivery rate, and FFN test(P<0.05). Conclusion Chinese medicine dialectical care boosts cervical ripening of full-term pregnant women with qi-blood deficiency. It is helpful to increase natural labor rate, reduce high-risk delivery, and promote health of mother and child. Therefore it is worth to be popularized.

目的 比较腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后发生尿失禁(postprostatectomy incontinence,PPI)与没有发生PPI的患者在尿动力学上的差异,为临床诊疗提供尿动力学依据。方法 对87例LRP术后的患者按术后是否并发PPI分成两组,行尿动力学检查后进行比较分析。结果 PPI组患者术中保留一侧或双侧神经血管束的比例少于非PPI组,且最大尿道闭合压(maximum urethral closure pressure,MUCP)、最大膀胱容量(maximum cystometric capacity,MCC)、排尿时膀胱开口压力和最大逼尿肌压均较非PPI组低。而腹压漏尿点压试验阳性与临床上是否漏尿并不完全相符。多变量回归分析表明,术中保留神经血管束、MUCP和MCC是PPI的相关因素。结论 PPI与LRP术中保留神经血管束、MUCP和MCC独立相关。尿动力学检查能为更精准有效指导临床治疗提供依据。

Objective To compare the urodynamic parameters in men with and without postprostatectomy incontinence(PPI) after laparoscopic radical prostatectomy(LRP). Methods 87 patients of prostatic carcinoma after LRP were divided into two groups according to have PPI or not. After urodynamic study, the data were collected to find the difference. Results Overall, the proportion of preservation of unilateral or bilateral neurovascular bundles(NVBs) during LRP was lower in PPI group than that in non-PPI group. Besides, the patients in PPI group had lower maximum urethral closure pressure (P=0.04), maximum cystometric capacity (P=0.04), detrusor pressure during opening (P=0.02)and maximum detrusor pressure (P<0.001), as compared with those in non-PPI group. In the multivariate logistic regression, the preservation of unilateral or bilateral NVBs, MUCP and MCC were identified as the related factor with PPI. Conclusion PPI is significantly associated with the preservation of unilateral or bilateral NVBs, MUCP and MCC. Urodynamic test can be used to make the treatment for PPI. It will be more accurate and effective in clinical practice.

目的 研究老年慢性阻塞性肺病(COPD)患者血清IL-33水平与其病程分期的相关性。方法 选择60例老年COPD患者作为观察组,按病程分期分为稳定期组和急性加重组,另选择15例非COPD老年患者作为对照组;分别检测血清IL-33水平。结果 各组组间比较结果显示,AECOPD组和COPD稳定期组的血清IL-33水平均高于对照组(P<0.05),其中,AECOPD组的比COPD稳定期组的更高(P<0.05)。结论 血清IL-33水平在老年COPD患者中增高,急性加重期更明显,提示IL-33在老年人COPD发生、发展中可能起重要作用。

Objective To have relevant research between serum IL-33 level and the stage of disease in elderly patients with chronic obstructive pulmonary disease(COPD). Methods 60 elderly patients with COPD were selected as the observation group, who were divided into stable COPD group and AECOPD group. The other 15 patients with non-COPD were selected as the control group. The serum IL-33 levels were detected respectively. Results The comparison results between the groups showed that the serum IL-33 levels in the AECOPD group and the stable COPD group were higher than those in the control group(P<0.05), which was higher in the AECOPD group than in the COPD group(P<0.05). Conclusion Serum IL-33 levels were increased in elderly patients with COPD, the increase in acute exacerbation was more obvious, suggesting that IL-33 may play an important role in the occurrence and development of COPD in the elderly.

目的 探讨胸腰椎爆裂性骨折(TLBF)应用经伤椎椎弓根钉固定结合经椎弓根植骨治疗的临床效果。方法 选取我院2013年7月—2016年7月收治的28例TLBF患者,均行经伤椎椎弓根钉固定结合经椎弓根植骨治疗。详细记录所有患者术中出血量、手术时间及住院时间等围术期情况;比较28例患者手术前后影像学指标、腰背部疼痛视觉模拟评分法(VAS)评分及Frankel分级;随访期间并发症情况。结果 与术前相比,28例患者术后1个月、3个月时的椎体前后缘高度、Cobb角及VAS评分,均更优(P<0.01);经Ridit分析知,28例患者术后6个月时Frankel分级显著优于术前(P<0.01);术后随访6个月期间内,未见内固定松动、断裂等情况,且并未发生因椎弓根植骨而引起的神经症状。结论 TLBF应用经伤椎椎弓根钉固定结合经椎弓根植骨治疗能有效复原与保持脊柱生物力学稳定性,矫正后凸畸形,减少患者术后痛苦与并发症,改善神经功能,安全可靠,具有较高临床推广价值。

Objective To investigate the effects of the pedicle screw fixation combined with pedicle bone graft in treatment of thoracolumbar burst fracture(TLBF). Methods Selected 28 patients with TLBF treated in our hospital from July, 2013 to July, 2016, all of whom were treated with the pedicle screw fixation combined with pedicle screw fixation in the treatment of vertebral pedicle screw fixation. Recorded all patients' detailed situations on preoperative period of bleeding volume, operation time and length of stays. Compared 28 patients' imaging parameters, back pain visual analogue scale (VAS) score and Frankel classification before and after operation. And to observe the complications during follow-up as well. Results Compared with the pre-operation, 28 patients' anterior and posterior margin height, Cobb angle and VAS score were significantly better (P<0.01) than that of one month and three months after the operation. According to the Ridit analysis, six months after the operation, 28 patients' Frankel classification was better than that of pre-operation (P<0.01). No internal fixation loosening or breakage was found during the follow-up period of 6 months, and there was no nerve symptoms caused by pedicle screw fixation. Conclusion The pedicle screw fixation combined with pedicle screw fixation in treatment of thoracolumbar burst fracture(TLBF) can effectively restore and maintain the biomechanical stability of the spine, correct kyphosis, reduce postoperative pain and complications, improve nerve function and be safe and reliable,have higher clinical value.

目的 探究在合并桥本甲状腺炎的甲状腺乳头状癌治疗过程中,应用不同手术方式对其进行治疗后的效果。方法 选取2015年04月—2016年05月在我院进行手术治疗的87例单侧甲状腺乳头状癌合并桥本甲状腺炎患者,并将所有患者按照不同的手术方式分为两组,分别命为观察组、对照组。观察组44例患者选择患侧甲状腺腺叶+峡部切除的术式,对照组43例患者选择全甲状腺切除的术式。对比两组应用不同术式治疗后的甲状旁腺功能及甲状腺功能的变化,术中出血量、切口长度及手术时间。结果 观察组的甲状旁腺功能低下率(0.00%)、甲状腺功能低下率(2.27%)以及切口长度 (4.00±1.10)cm、术中出血量(33.60±8.30)mL、手术时间(130.73±34.67)min均低于对照组的甲状旁腺功能低下率(11.63%)、甲状腺功能低下率(97.67%)以及切口长度 (9.70±2.33)cm、术中出血量(76.70±23.90)mL、手术时间(160.94±39.70)min,差异有统计学意义(P＜0.05)。结论 合并桥本甲状腺炎的甲状腺乳头状癌患者采用患侧甲状腺腺叶+峡部切除术的治疗效果显著,可有效降低甲状旁腺及甲状腺功能低下几率的发生,改善术中出血量、切口长度及手术时间相关指标。

Objective To explore clinical efficacy of different surgical methods in treatment of papillary thyroid cancinoma combined Hashimoto's thyroiditis. Methods Eighty-seven patients of unilateral papillary thyroid carcinoma in patients with Hashimoto's thyroiditis who were treated in our hospital between April 2015 and May 2016 were divided into two groups according to surgical treatment methods, namely observation group and control group. Forty-four patients in the observation group received ipsilateral thyroid lobe + isthmus resection, while forty-three patients in the control group were given total thyroidectomy. Changes of parathyroid and thyroid functions, intraoperative blood loss, length of incision and operation time after different surgical procedures were compared. Results The hypoparathyroidism rate (0.00%), hypothyroidism rate (2.27%), and incision length (4.00±1.10)cm, blood loss (33.60±8.30)mL, operation time (130.73±34.67)min in the observation group were lower than those in the control group (11.63%), (97.67%), (9.70±2.33)cm, (76.70±23.90)mL, (160.94±39.70) min, the difference was statistically significant (P<0.05). Conclusion Ipsilateral thyroid lobe and isthmus resection shows obvious effect in treatment of papillary thyroid carcinoma with Hashimoto's thyroiditis, effectively reduces the incidence of parathyroid and thyroid dysfunction, improves intraoperative blood loss, length of incision and operation time.

目的 探讨加味骨洗方外治法用于治疗类风湿关节炎的疗效以及类风湿因子等临床指标的变化。方法 选取100例类风湿关节炎患者,随机分为治疗组和对照组各50例。治疗组给予加味骨洗方及TDP特定电磁疗灯导入的外治,对照组给予TDP特定电磁疗灯磁疗。结果 在缓解症状和恢复功能方面治疗组总有效率为84%,对照组总有效率为58%,治疗组各临床指标与对照组相比均有差异(P<0.05)。结论 加味骨洗方治疗类风湿关节炎疗效显著,能有效降低类风湿因子等炎性指标,值得临床推广。

Objective To discuss curative effects of rheumatoid arthritis treatment and clinical indicators transformation including rheumatoid factor by additional Guxi prescription external therapy. Methods We selected 100 patients who were suffered from rheumatoid arthritis, divided randomly into two groups. 50 patients for the treatment group and another 50 for the control group. The treatment group was treated by the additional Guxi prescription external therapy. While the control group was treated by the infrared magnetic therapy. Results The effective proportion of the treatment group was 84%, while the control group total was 58% in the aspect of relieve the symptoms and recovery of functions. Besides, all clinical indicators of the treatment group were inferior to the control group(P<0.05). Conclusion There are effects for treating rheumatoid arthritis by utilizing additional Guxi prescription external therapy. This therapy which can effectively reduce the inflammatory indexes of the rheumatoid factor is worth promoting clinically.

目的 探讨尼莫地平对无症状脑梗塞认知功能障碍的改善作用及安全性。方法 将80例无症状脑梗塞患者随机分为治疗组和对照组,每组40例,于治疗前及治疗后3月分别进行蒙特利尔认知量表(MoCA)、简易智能状态量表(MMSE)、画钟测验(CDT)评估,并比较2组的评分结果。结果 尼莫地平治疗后3月MMSE 评分为(26.35±3.26)分,MoCA评分为(25.53±4.31)分,CDT评分为(6.12±2.23)分,较对照组分别为MMSE 评分为(23.12±3.45)分,MoCA评分为(22.21±3.63)分,CDT评分为(4.35±2.61)分有改善,差异均有统计学意义(P<0.05)。80例患者中MoCA评测异常组在视空间与执行能力、延迟记忆、注意力及计算力、抽象思维等分项得分明显低于MoCA评测正常组(P<0.05)。结论 尼莫地平能有效改善无症状脑梗塞患者的认知功能,且安全性较高。

Objective To explore the role of nimodipine in improving cognitive function in silent cerebral infarction patients and its safety. Methods Eighty SCI patients were divided randomly into 2 groups.MMSE、MoCA and CDT scores were assessed before treatement and after 3 month of treatment.The results were compared between the 2 groups. Results MMSE、MoCA and CDT scores of Nimodipine group(26.35±3.26, 25.53±4.31, 6.12±2.23, respectively), improved when compared with the control(23.12±3.45, 22.21±3.63, 4.35±2.61,respectively),and the difference was statistical significance (P<0.05). The patients with abnormal MoCA had lower scores in several cognitive domains (visuospatial and executive abilities, delayed memory, attention and capacity of calculation, abstract thinking (P<0.05) compared with control group. Conclusion Nimodipine could improve effectively the cognitive function in SCI patients and with a higher safety.

目的 探讨胸部良性疾病非计划二次手术的原因,降低非计划二次手术率,研究防止措施。方法 回顾性分析2006年5月—2016年5月间胸部良性疾病患者行外科手术治疗的临床资料574例,其中16例术后因各种原因行非计划二次手术,总结胸部良性疾病外科治疗后非计划二次手术的临床特点、治疗经过及原因,对可能的影响因素进行单因素分析和多因素分析。结果 本组患者行非计划二次手术,无死亡病例,二次手术手术时间为30～215(135.6±47.4) min。术中出血量50～650 (313.6±93.1)mL。术后住院时间7～30(15.7±6.8)d。二次手术原因包括术后出血 (10例)、术后肺持续漏气(4例)、切口感染(2例)。单因素分析首次手术疾病分类,首次手术时间,首次手术方式与胸部良性疾病非计划二次手术相关性有统计学意义(P<0.05),多因素分析结果显示首次手术疾病分类,首次手术时间,首次手术方式是胸部良性疾病非计划二次手术的独立危险因素(P<0.05)。结论 根据胸部良性疾病的不同疾病类别来估计和预防可能出现的并发症,特别是胸部炎症性病变,术前充分准备、术中仔细操作、术后并发症的早期积极处理,能降低胸部良性疾病非计划二次手术的发生率。

Objective To investigate the causes of benign thoracic disease unplanned reoperation,improve the level of diagnosis and treatment and reduce the rate of unplanned reoperation. Methods From May 2006 to May 2016,594 cases of benign thoracic disease were performed thoracic surgery,including 16 patients underwent the unplanned reoperation due to various reasons. The clinical characteristics, therapy course and results of benign thoracic disease unplanned reoperation were analyzed retrospectively. Results The patients underwent the unplanned reoperation were no deaths. The operative time 30～215(135.6±47.4)min, intraoperative blood loss 50～650 (313.6±93.1)mL,postoperation hospitalization duration 7～30(15.7±6.8)d. The causes of benign thoracic disease unplanned reoperation were as follows: postoperative bleeding (10 cases), prolonged air leaks (4 cases),incision infection (2 cases). Univariate analysis showed first-time classification of diseases, operative time and operation method were statistically significant (P<0.05), Multivariate Logistic regression analysis revealed first-time classification of diseases, operative time and operation method were independent factors associated with benign thoracic disease unplanned reoperation. Conclusion According to the different classification of benign thoracic disease to estimate and prevent possible complications, we need to have sufficient preoperative preparation, intraoperative careful operation. Early active processing can be taken in postoperative complications.It can reduce the incidence of unplanned reoperation in benign thoracic disease,especially the chest inflammatory diseases.

目的 探讨皮罗氏序列征伴先天性心脏病的临床特点。方法 我院2011年1月—2015年12月共收治141例皮罗氏序列征的患儿,将患儿分成单纯皮罗氏序列征组、皮罗氏序列征伴腭裂组及皮罗氏序列征伴听力损伤组,对3组患儿均行心电图及彩色多普勒超声心动图检查,对检查结果进行分析。结果 141例皮罗氏序列征患儿中共检出先天性心脏病19例,总发生率为13.47%,其中单纯皮罗氏序列征组患儿先天性心脏病的发生率为12.82%,伴腭裂组和伴听力损伤组患儿先天性心脏病的发生率分别为13.56%、25%。主要的先天性心脏病为:房间隔缺损(ASD)、室间隔缺损(VSD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS)。通过统计学分析,3组患儿先天性心脏病的发生率差异无显著性。结论 先天性心脏病在皮罗氏序列征患儿中发生率较高,心电图及彩色多普勒超声心动图检查能清楚准确地诊断各类型的先天性心脏病,可用于皮罗氏序列征患儿常规检查,做出早期诊断、治疗,可以改善患儿的预后。

Objective To explore the clinical characteristics of congenital heart diseases in patients with Pierre-Robin sequence. Methods From January 2011 to December 2015, Guangzhou Women and Children's Medical Center has treated 141 patients with Pierre-Robin sequence. They were divided into 3 groups: Pierre-Robin sequence group, Pierre-Robin sequence and cleft palate group, and Pierre-Robin sequence and hearing impairment group. Electrocardiogram and colour Doppler echocardiogram was performed in each group and the results were analysed with statistics. Results 19 patients were found to have congenital heart diseases in 141 patients, the occurrence rate was 13.47%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence was 12.82%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and cleft palate was 13.56%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and hearing impairment was 25%. Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA),and pulmonary valve stenosis (PS) were the most common lesions. Through statistical analysis, the occurrence rate of congenital heart diseases has no significant difference among the three groups of patients. Conclusion The occurrence rate of congenital heart diseases in patients with Pierre-Robin sequence is high. Electrocardiogram and colour Doppler echocardiogram are the useful and reliable tool in diagnosing congenital heart diseases in patients with Pierre-Robin sequence.

目的 研究音乐疗法对新生儿喂养不耐受的保护作用,以及对胃动素和胃泌素水平的影响。方法 将2013年3月—2015年6月在我院新生儿科住院治疗的40例喂养不耐受新生患儿随机分为音乐治疗组和常规治疗组,治疗干预后,比较两组的喂养不耐受情况以及GAS和MOT水平。结果 音乐治疗组腹胀缓解时间、吸吮吞咽功能建立时间、达足量喂养时间、静脉营养应用时间明显的短于常规治疗组,体重增加量明显的高于常规治疗组(P＜0.05);治疗后,音乐治疗组的GAS和MOT水平明显的高于常规治疗组(P＜0.05)。结论 音乐疗法可以促进新生儿喂养不耐受症状改善,提高患儿血清GAS和血浆MOT水平,促进其生长发育。

Objective To study music therapy for neonatal feeding intolerance protection, and the effects of levels of gastrin and motilin. Methods From March 2013 to June 2015 in newborn Department of Pediatrics in our hospital 40 cases feeding tolerance of newborns were randomly divided into music therapy group and routine treatment group, after treatment, compared feeding tolerance and GAS and MOT level in the two groups. Results Abdominal distension relieving time, sucking and swallowing function establishment time, full enteral feeding time, use of the parenteral nutrition in the music therapy group was fewer than the conventional therapy group. Weight gain was higher than that in the conventional treatment (P<0.05). After the treatment, GAS and MOT levels in the music therapy group were higher than conventional treatment group, the difference is statistical significant (P<0.05). Conclusion Music therapy may promote neonatal feeding intolerance symptoms and improve patients serum GAS and plasma MOT levels, promote their growth and development.

目的 研究并探讨产前优生筛查对出生缺陷的干预作用。方法 于2013年1月—2015年12月,选取69 183例孕产妇的临床资料进行回顾性研究,胎儿总数为69 262例,所有孕产妇在妊娠期均进行产前优生筛查,对产前筛查结果进行分析,统计胎儿异常例数,采取相应的产前干预措施,并对未检出胎儿异常的孕产妇进行跟踪随访,观察其妊娠结局,统计出生缺陷儿娩出例数及产前筛查漏检率。结果 69 262例胎儿中,共有7 470例胎儿检出异常,其胎儿异常率为10.79%,其中2013年检出1 910例,2014年检出2 569例,2015年检出2 991例,其检出率分别为9.15%、10.70%、12.17%,最终经产前诊断检查确定为出生缺陷的胎儿共98例,均采用引产术以终止妊娠。对未检出异常的61 792例胎儿进行跟踪随访后发现,其中17例胎儿在孕期流产,有9例出生缺陷儿娩出,其出生缺陷发生率为0.1 457‰,其产前筛查漏检率为0.1 456‰。结论 在产前对孕产妇进行产前优生筛查,并根据产前筛查结果进行相应的干预,可有效检出异常胎儿,及时终止异常妊娠,有利于减少缺陷儿的出生,促进优生优育。

Objective To study and discuss intervention effects of prenatal eugenic screening in birth defects. Methods From January 2013 to December 2015, we did retrospective study on the clinical data of 69 183 cases of pregnant in which there were 69 262 fetal cases, made prenatal eugenic screening for all pregnant women. Prenatal screening results were analyzed, fetal abnormal cases were calculated. We took appropriate prenatal intervention measures, and followed up pregnant women who had no detection of fetal abnormal. We observed the pregnancy outcome, and calculated the defected childbirth cases and prenatal screening miss rates. Results 69 262 cases of fetus, a total of 7 470 cases of fetal abnormalities were detected. The fetal abnormality rate was 10.79%, of which 1 910 cases were in 2013, 2 569 cases in 2014, 2 991 cases in 2015. The detection rates respectively were 9.15%, 10.70%, 12.17%. 98 cases were determined as fetal birth defects by the final prenatal diagnosis examination, in which all adopted induction of labor to terminate pregnancy. 61 792 cases who were not detected anomalies were followed up in which 17 cases of fetus were found and had abortion during pregnancy, and 9 cases of fetal birth defects were delivered . The incidence of birth defects was 0.1 457 ‰, the prenatal screening miss rate was 0.1 456 ‰. Conclusion Pregnant women were made prenatal eugenic screening and according to the result of prenatal screening we took corresponding intervention, which is effective detect abnormal fetus. We may have timely termination of abnormal pregnancy,and reduce birth defects. It may promote human eugenics.

目的 研究探讨重症监护病房(ICU)病原菌的分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法 回顾性分析2015年ICU住院患者送检细菌分离培养及药敏试验结果。结果 ICU共送检标本1 326份,分离出病原菌554株,其中革兰阴性病原菌462株(83.4%),革兰阳性病原菌48株(8.7%),真菌44株(7.9%)。革兰阴性杆菌前5位依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、粘质沙雷菌和大肠埃希菌,且多耐药菌株比例较高。革兰阳性病原菌以金黄色葡萄球菌为主,32株(66.7%),MRSA检出率78.3%(25/32)。结论 加强重症监护病房的细菌及药敏监测,根据病原菌药敏结果指导临床合理使用抗菌药物,控制耐药菌株的产生,预防及控制院内感染及感染暴发。

Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in intensive care unit(ICU) and provide scientific evidence for clinically reasonable use of antibiotics. Methods Specimens from hospitalized intensive care unit patients in 2015 were obtained for routine bacterial isolation and culture. Results A total of 554 bacterial strains were isolated from 1326 specimens, in which Gram-negative bacilli accounted for 462 stains (83.4%),Gram-positive cocci accounted for 48 stains (8.7%),and fungi accounted for 44 stains (7.9%). Gram-negative bacilli of the top five were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae, Serratia marcescens and Escherichia coli,and the rate of multiple resistant bacteria was relatively high.Staphylococcus aureus were the main Gram-positive cocci, including MRSA accounted for 78.3%(25/32). Conclusion The monitoring of ICU clinical pathogens and their resistance should be strengthened. It is a great significance to use antibiotics rationally according to the results of susceptibility testing, in order to control the occurrence of resistant bacteria , prevent and control hospital infection and infection outbreak.

目的 了解近五年某地市级综合医院传染病病例疫情情况,分析其流行病学特征,为探索医院传染病预防控制工作提供科学依据。方法 采用描述性流行病学方法和Excel 2007软件对传染病疫情报告资料进行分析。结果 2010—2014年法定报告的传染病发病例数基本呈持续上升趋势。2010—2014年共报告传染病11 673例次,发病数居前5位的传染病依次为手足口病、乙型肝炎、梅毒、生殖道沙眼衣原体感染、肺结核,分别占21.17%、12.44%、12.16%、8.51%和7.52%;总死亡数为21例,病死率为1.799‰。5年来,不同传染病发病数呈现出不同的变化趋势。结论 及时掌握当地传染病的发病情况,加强对常见传染病的防控力度,提高病原检测力度,做好传染病的筛查工作,防止传染病在医院内传播。

Objective To analyze the characteristic features of notifiable diseases in a general hospital from 2010 to 2014, and provide basis information for notifiable diseases' prevention and control. Methods Using descriptive epidemiological methods and microsoft Excel 2007, the report data of notifiable diseases was statistically analyzed. Results The number of notifiable diseases increased during 2010 to 2014. 11 673 cases of notifiable diseases were reported in the hospital at the same time.The top five reported cases of notifiable diseases were hand-foot-and-mouth disease(HFMD),hepatitis B virus, syphilis, chlamydia trachomatis infection and tuberculosis, account for 21.17%,12.44%,12.16%,8.51% and 7.52% accordingly. Moreover, there are total 21 death cases have been reported and case fatality rate was 1.799‰.Different infectious diseases showed different trend variation during the above mentioned period. Conclusion We should understand and grasp the local incidence of infectious disease, strengthen the prevention and control, improve the pathogen detection, make an effort on screening, and prevent the spread of infectious diseases in the hospital.

目的 通过对我院健康体检人群眼科体检的数据分析,探讨眼科健康管理对眼部疾病防治的重要性。方法 分析2015年1月—12月眼科体检人群的数量、来源、性别、年龄。分析各类眼部疾病的检出率及不同年龄、性别的分布情况。结果 眼科疾病主要为屈光不正、结膜炎、白内障、眼底动脉硬化、黄斑变性等。屈光不正多以青壮年为主,结膜炎在中老年人群中检出率较高,白内障及眼底疾病的检出率在中老年人群中随年龄的增加而增加。结论 对于常见病和隐匿性疾病的防治,眼科体检具有较好的指导意义。

Objective Through the data analysis of eye common diseases in our hospital physical examination population to discuss the importance of eye health management for eye common disease prevention and control. Methods To analyze the quantities, source, gender and age of the eye examination population from Jan to Dec 2015.To analyze relevance ratio of all kinds of eye common disease and the distribution of different age and gender. Results Ophthalmic diseases included mainly ametropia, conjunctivitis, cataracts,fundus arteriosclerosis,macular degeneration and so on. Ametropia mainly happened at young adults, conjunctivitis detection rate was higher in the elderly crowd. The detection rate of cataract and retinal diseases in the elderly crowd increased with their ages. Conclusion For the prevention and treatment of common diseases and latent glomerular diseases, ophthalmic examination has a good guiding significance.

目的 研究并分析优质护理对消化性溃疡患者的临床疗效以及护理满意度的影响。方法 入选2014年8月—2015年10月收治的184例消化性溃疡患者作为研究对象, 根据电脑随机数字将患者随机分为研究组和对照组,各92例。对照组男50例,女42例,年龄18～60 a,平均年龄(43.7±2.1)a,病程2～10 a,平均(5.2±0.4)a,研究组男48例,女44例,年龄20～59 a,平均(42.3±3.6)a,病程2～10 a,平均(5.2±0.4)a。患者入院后均给予消化性溃疡常规基础治疗(四联疗法),在此基础上给予对照组患者常规护理,研究组患者优质护理,对比两组患者的临床疗效和护理满意度。结果 经研究观察对比,研究组消化性溃疡患者的临床疗效明显优于对照组,研究组消化性溃疡患者的总有效率为95.65%,对照组为79.35%,两组数据对比差异有统计学意义(P＜0.05)。研究组患者治疗后烧心、上腹痛、嗳气等症状减轻明显较对照组显著,所需时间更短,胃镜检查显示研究组患者经优质护理处理后溃疡愈合时间明显缩短,愈合明显优于对照组,上述对比差异有统计学意义(P＜0.05)。研究组护理满意度为96.74%,对照组护理满意度仅83.69%,研究组高于对照组,差异有统计学意义(P＜0.05)。结论 优质护理能够明显缩短溃疡愈合时间,促进患者痊愈,提高消化性溃疡患者的疗效和护理满意度,值得临床推广和应用。

Objective To study and analyze the effect of high quality nursing on curative effect of patients with peptic ulcer and nursing satisfaction. Methods 98 cases of peptic ulcer patients income for treatment from August 2014 to October 2015 were selected as study subjects. The patients were randomly divided into study group and control group, 49 cases in each group. The control group included male 28 case,female 21 case,aged 18～60 years old, average age (43.7±2.1) years, disease duration of(2～10)years, average(5.2±0.4) years.Study group included male 24 cases, female 25 cases, aged 20～59 years old, average age (42.3±3.6) years, disease duration of (2～10) years, average (5.2±0.4) years. After the patient was admitted to hospital, they were treated with digestive ulcer routine treatment (quadruple therapy). On this basis,patients in the control group were given routine nursing care, the study group patients with high quality nursing, compared with the two groups of patients with clinical efficacy and nursing satisfaction. Results Study group patients with peptic ulcer clinical, curative effect was obviously superior to the control group. The study group patients with peptic ulcer, total efficiency was 95.91%, It was 79.59% in the control group, the difference between the data of two groupshad statistical significance (P<0.05). Study group nursing satisfaction was 97.96%, the control group was only81.63%. The study group was significantly higher than the control group, the difference was statistically significant (P<0.05). Quality care may significantly shorten the average length of stay in patients, the difference was statistically significant (P<0.05). Conclusion High quality nursing may significantly shorten the average length of stay in patients with peptic ulcer, improve the curative effect of peptic ulcer patients and nursing satisfaction. It is worthy of clinical popularization and application.

目的 探讨生血宁片对缺铁性贫血孕妇的治疗效果。方法 选取90个缺铁性贫血孕妇为研究对象,随机分为A、B、C三组,每组30人,从孕28周开始治疗,A组服用多糖铁复合物,B组口服生血宁片,C组采用营养科建议的补铁食疗菜谱,一直治疗至分娩前,治疗前后各检测血常规,血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白浓度(MCHC)对比治疗效果。结果 服药前各组孕妇的血Hb、RBC、HCT、MCV、MCH无统计学差异,A、B组服药后Hb、RBC、HCT、MCV、MCH均高于服药前,且结果有统计学意义(P＜0.05),C组食疗前、后Hb、RBC、HCT、MCV、MCH无统计学差异,A、B、C三组之间Hb、RBC、HCT、MCV、MCH对比结果为,A、B组之间Hb、RBC、HCT、MCV、MCH差异无统计学意义(P＞0.05),但均高于C组,差异有统计学意义(P＜0.05)。结论 生血宁对孕晚期缺铁性贫血的孕妇有治疗作用,且效果与多糖铁复合物相当。

Objective To investigate the therapeutic effect of Shengxuening tablets on iron deficiency anemia in pregnant women. Methods Selected A total of 90 pregnant women with iron deficiency anemia as the research objects, randomly divided into A, B, C three groups. Each group of 30 people was treated since 28 weeks of pregnancy. Group A was treated with polysaccharide iron complex, group B with Shengxuening tablets, group C with the nutritionist recommended iron diet recipes. They have been treated till delivery. Before and after treatment, blood routine examination, the value of Hb,RBC,HCT,MCV,MCH had contrast treatment. Results There was no significant difference of serum Hb,RBC,HCT,MCV,MCH in the pregnant women before treatment. After treatment, Hb,RBC,HCT,MCV,MCH of group A, B were higher than before, and the results were statistically significant(P＜0.05). Before therapy of group C, there was no significant difference, in the three groups, results of Hb,RBC,HCT,MCV,MCH, there was no statistical difference between group A, B (P＞0.05), but both were higher than group C, the difference was statistically significant(P＜0.05). Conclusion There was therapeutic effect of Shengxuening in late pregnant women with iron deficiency anemia, and it is equal to the effect of Polysaccharide iron complex treatment.

目的 观察自拟中药方内服外洗结合冲击波治疗足底筋膜炎的临床疗效。方法 收集在我院门诊就诊的符合条件足底筋膜炎患者50例,采用自拟四物四藤汤内服外洗结合冲击波治疗,运用VAS评分法及疼痛减轻百分数评定治疗前与治疗后1周、2周、1月的疗效比较。结果 治疗前后VAS评分比较(P<0.05),组间比较有统计学意义,且前两周效果更明显,总有效率为94.00%,患者满意度为96.00%。结论 本治疗方法对足底筋膜炎是有明显疗效的,可以在临床上进一步推广验证。

Objective To observe clinical curative effect of TCM oral use and external wash combined with application of shock wave in the treatment of plantar fasciitis. Methods To collect 50 cases of patients with plantar fasciitis in our hospital clinic,use Siwusiteng medical herbal decoction combined with shock wave treatments, elevate VAS score and the percentage of pain relief before and after treatment at 1 week, 2 weeks, and 1 month. Results VAS score before and after treatment was statistically significant(P<0.05), and the effect of the first two weeks is more obvious. The total effective rate was 94.00%,patient satisfaction was 96.00%. Conclusion This treatment has obvious curative effect on plantar fasciitis, and it could be further promoted in clinical verification.

目的 探讨替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病的临床疗效及安全性。方法 前瞻性选取本院2012年4月—2015年10月收治的80例急性冠脉综合征合并妊娠糖尿病患者,按随机数字表法分为对照组、实验组,每组40例,实验组采用替罗非班辅助低分子肝素治疗,对照组使用单独低分子肝素治疗方案,比较两组治疗后血浆蛋白-A(PAPP-A)以及超敏C反应蛋白(hs-CRP)水平;比较两组内出血情况以及血小板计数的变化。结果 两组治疗后PAPP-A以及hs-CRP水平均有所下降,实验组下降幅度高于对照组,对比差异有统计学意义(P＜0.05);两组内出血发生率分别为10.0%、40.0%,均无严重出血情况发生,实验组轻度出血3例,中度出血1例,对照组轻度出血10例,中度出血6例,实验组轻中度出血率低于对照组(P＜0.05);两组治疗前血小板计数对比差异无统计学意义(P＞0.05),治疗后实验组血小板计数下降明显,对照组血小板计数无明显变化,两组不同时间点血小板计数差异无统计学意义(P＞0.05)。结论 替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病患者具有一定的效果,且用药安全性较高。

目的 对比观察罗哌卡因及布比卡因应用于患有妊娠期高血压的产妇行剖宫产时腰麻联合硬膜外麻醉的临床效果。方法 将103例择期行剖宫产手术的妊娠期高血压患者随机分为罗哌卡因组51例及布比卡因组52例分别采用对应药物进行麻醉,研究两组阻滞效果、心血管系统变化情况及不良反应发生情况。结果 两组间麻醉镇痛效果及优良率比较,差异没有统计学意义(P>0.05)。罗哌卡因组感觉及运动阻滞起效时间较布比卡因组长,运动阻滞恢复时间较布比卡因组短(P<0.05)。心血管系统变化情况比较,麻醉5min、10min时两组收缩压及平均动脉压均降低,但布比卡因组波动更大,两组间比较差异显著(P<0.05),心率及血氧饱和度比较无差异(P>0.05)。罗哌卡因组不良反应出现时间较布比卡因组晚,同时其不良反应发生率较布比卡因组低(χ²=4.1599,P<0.05)。结论 罗哌卡因及布比卡因在阻滞时间上略有差异,麻醉镇痛效果相当,但鉴于妊高症产妇本身心血管系统存在基础问题,运用罗哌卡因对心血管系统的影响较小,安全性更高,更值得推荐使用。

目的 对切开复位与撬拨复位内固定术治疗SandersⅡ型跟骨骨折临床疗效进行比较。方法 回顾分析2014年10月—2016年6月陕西中医药大学附属医院收治的58例SandersⅡ型跟骨骨折患者临床资料,切开组29例,其中男24例、女5例,平均年龄(37.10±3.45)a;闭合组29例,其中男26例、女3例,平均年龄(36.60±3.15)a。采用Maryland及AOFAS评分系统评定临床功能。结果 X线显示两组患者术后Bohler角及Gissane角均恢复,比较差异没有统计学意义(P>0.05)。撬拨复位组术中出血量、住院天数及手术时间均明显少于切开复位组(P<0.05)。撬拨组出现2例针孔感染,换药后感染消失。切开组出现2例切口感染,1例切口裂开,2例刀口皮缘坏死,长期换药后全部好转;1例腓肠神经损伤。两组并发症发生率比较差异有统计学意义(P<0.05)。结论 对于治疗SandersⅡ型跟骨骨折,两组术式均能取得良好疗效,经皮撬拨复位克氏针内固定较切开复位钢板内固定具有时间成本小、创伤小、痛苦少、并发症少等优点。

目的 了解河源市无偿献血人群中丙型肝炎病毒(HCV)感染情况及HCV感染合并乙型肝炎病毒(HBV)、人类免疫缺陷病毒(HIV)以及梅毒螺旋体(TP)感染的情况,为当地预防和控制输血传播性疾病提供实验室依据。方法 选择2010年1月1日—2015年12月31日河源市中心血站无偿献血者71 618例,采用酶联免疫吸附试验(ELISA)方法检测其血浆抗-HCV、乙型肝炎表面抗原(HBsAg)、抗-TP及HIV(Ag/Ab),统计分析抗HCV阳性无偿献血者合并感染HBV、HIV和TP的情况。结果 71 618例无偿献血者标本中抗-HCV、HBsAg 、抗-TP及HIV(Ag/Ab) 阳性率分别为0.56％(402例)、1.48％(1 062例)、1.14％(821例)、0.09％(61例);初次献血者抗-HCV、HBsAg 、抗-TP及HIV(Ag/Ab)阳性率均高于多次献血者(P＜0.05);402例抗-HCV阳性无偿献血者中合并HBsAg、抗-TP、HIV(Ag/Ab) 阳性率分别为1.74%(7例)、4.98%(20例)、0.25%(1例)。结论 抗-HCV阳性献血者合并TP感染率显著高于抗-HCV阴性无偿献血者, HCV合并HBV、HIV感染率低。

目的 探讨自我效能干预对于手术室护士的压力能够起到的调节效果。方法 通过对66名手术室护士的压力来源进行总结,并根据压力来源渠道分别进行自我效能护理干预一个月,并进行自我效能感以及工作倦怠方面对比评定,应用自我效能量表(USES量表)、工作倦怠量表( MBI量表)进行测算,将结果进行归纳总结。结果 经过自我效能护理干预的手术室护士的自我效能感评分显著提高,经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前:手术室护士自我效能感以非常低的为主,占54.55%;干预后以非常高的为主,所占比例为48.48%;经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前主要以中重度的工作倦怠护士为主,重度43例、中度21例;干预后主要以轻度和无倦怠的护士为主(P＜0.05)。结论 通过自我效能护理干预可以显著提高手术室护士的自我效能感、减少工作倦怠情绪,提高工作效率。

目的 探讨早期干预对早产儿运动水平及技能的影响。方法 2013年3月—2014年3月在惠州市出生的283例有早产背景的高危儿,按照家长意愿分为两组,早产儿干预组143例及早产儿对照组140例。选择同时期出生的145例正常足月新生儿作为正常对照组。早产儿干预组根据评估结果制定干预训练方案,并按照评估—干预—评估的模式调整干预方案,早产儿对照组和正常对照组按健康检查的顺序进行体检并给予相关指导。在月龄3、6、9、12、18月时对三组婴儿行AIMS评估和神经系统相关检查。结果 早产儿干预组的运动发育水平明显高于早产儿对照组(P<0.01),神经系统异常率低于早产儿对照组(P<0.01),而早产儿干预组的神经系统异常率高于正常对照组(P<0.05)。但运动发育水平与正常对照组相比差异无统计学意义(P>0.05)。结论 早期干预能提升早产儿运动发育水平,改善运动技能,减少神经系统异常发生率,提高早产儿生存质量。

目的 探讨血清胱抑素C、尿酸及降钙素原对诊断急性心肌梗死的临床价值。方法 回顾性分析我院134例心肌梗死患者及89名健康人血清胱抑素C、尿酸及降钙素原水平。结果 与健康对照组相比,实验组患者血清Cys-C、UA和PCT均有不同程度的升高,且差异有统计学意义。此外,血清Cys-C和PCT升高的水平与心肌梗死程度有关。结论 血清Cys-C、UA和PCT水平均可以作为AMI的临床指标,并且血清Cys-C和PCT在一定程度反映心肌梗死的严重程度。

目的 观察家庭病床的癌症患者临终关怀对患者和家属的生活质量的影响,为提升癌症患者和家属生活质量提供参考。方法 我院于2014年3月—2016年3月对50例癌症晚期家庭病床患者实施临终关怀治疗,设为观察组,另选择同期在我院住院治疗但未接受我院临终关怀治疗的50名癌症晚期患者作为对照组,比较两组患者入组后1月、3月的疼痛评分、接受死亡率及患者照护家属的生活质量评分变化。结果 两组患者年龄、性别、癌症类型、分期、入组前疼痛评分、对死亡接受率比较差异无统计学意义(P>0.05)。观察组和对照组患者入组后1月、3月疼痛评分比较,观察组明显低于对照组患者,组间比较差异有统计学意义(P＜0.05);观察组患者1个月后死亡接受率明显高于对照组,组间差异有统计学意义(P＜0.05);观察组患者照护家属入组1月、3月后的生活质量评分明显高于对照组患者照护家属,组间比较差异有统计学意义(P＜0.05)。结论 对家庭病床的癌症患者实施临终关怀,可有效减轻患者临床症状痛苦,提高患者死亡接受率,给予患者精神抚慰和心理支持,维持患者临终尊严,提高患者照护家属的生活质量,具有较高的临床价值,值得进一步推广应用。

目的 观察健康促进诊疗管理模式对社区慢性病的干预效果。方法 选取社区的慢性病患者268例,对他们实施慢性病健康促进诊疗管理,主要的方向有健康干预、诊疗管理、随访管理等。结果 干预后患者的体质指数、血压、血糖、血脂的达标率、健康知识、用药依从率等都比干预前有所提升。组间比较差异具有统计学意义(P＜0.05)。干预治疗后患者的满意度为87.3%,治疗有效率为85.8%,显著高于干预治疗前的70.1%和59.0%。结论 对社区慢性病患者采取健康促进诊疗管理模式进行干预,能够提高社区慢性病的综合防治效果,对提高患者的生活质量具有一定的促进作用。

目的 对社区妇科慢性盆腔炎患者对疾病相关知识的认知情况进行调查,探讨健康宣教对策,提高慢性盆腔炎患者的自我保健意识。方法 对我中心2015年5月—2016年5月收治的100例社区慢性盆腔炎患者采用自制调查表进行盆腔炎疾病相关知识认知情况调查,按照合格与否将患者分为合格组和不合格组,对两组的措施患者的一般资料进行分析,总结影响慢性盆腔炎患者疾病认知的因素,探讨慢性盆腔炎患者健康宣教。结果 100例患者中对疾病认知合格者45例,不合格者55例,合格与不合格患者间在年龄、文化程度、居住地、家庭经济状况方面比较差异有统计学意义,说明这些因素是影响患者对疾病认知水平的相关因素(P＜0.05)。疾病认知相关知识项目中,疾病的定义、高危因素、疾病危害认知不合格率明显高于其它相关知识的不合格率,比较差异有统计学意义(P＜0.05)。结论 慢性盆腔炎临床常见,对患者的远期危害大,针对性健康宣教提高患者对疾病的防范意识,提高患者的自我保健意识,降低疾病对患者健康的不良影响。

目的 调查公众急救培训普及现状及培训需求相关信息,并结合对院前急救工作及急救培训工作等经验的总结与思考,展开对急救培训普及工作的探讨,以指导我国急救培训工作的进一步开展与推广。方法 采用分层随机抽样法,对本市477名市民进行问卷调查。结果 425人(89.1%)认为在18周岁以前就需要掌握基本的急救知识;如无法律保障,原本愿意救援的市民299人中有117人(39.1%)选择放弃施救;最为认同的教学方法是模拟及角色扮演;最希望通过急救培训获得在突发意外灾害事件中正确有效的自救互救能力。结论 普及基本急救知识是城市或区域初级保健的一项重要内容,而目前普及率极低,市民需求迫切,呼吁各级政府及相关的公共服务部门要有计划地多方位、多渠道地组织市民进行内容丰富、形式多样急救培训。

心肌梗死模型在心肌梗死病理发生机制、新药研发研究中占有重要地位。目前冠状动脉结扎法制作大鼠心肌梗死模型,模型稳定,操作简单,造价便宜,效果可靠,为最主要的心肌梗死造模方法,制作方法及具体操作中存在各自的优势和不足,影响着模型的进一步推广,有待继续进行改进和深入研究。