阿托伐他汀对老年脑梗死伴高血脂患者颈动脉粥样硬化斑块的影响

Objective To investigate the effect of atorvastatin on arteriosclerosis plaque of carotid artery in elder patients with cerebral infarction and hypercholesterolemia. Methods With self-comparsion of before and after treatment,50 subjects with arteriosclerosis plaque of carotid artery were given atorvastatin 10 mg,qn for 12 months. After treatment 6 and 12 months, arteriosclerosis plaque of carotid artery、 intima-media thickness and peak index were measured in all patients. Results After 6 and 12 months adminstration of atorvastatin, TC、TG、LDL-C were all reduced (P<0.05), and HDL-C was elevated (P<0.01) in all patients.The initial diameter of carotid was significantly enlarged in 12 months (P<0.01). The size of plaque decreased (P<0.01) in 12 months after atorvastatin therapy than before(P<0.01). Conclusion The effect of atorvastatin is certain and it can stabilize the plaque of carotid artery.     

Anti-virus efficacy of cyclosporine in renal transplant recipients with hepatitis C virus-RNA positive

BACKGROUND:The selection of immunosuppressants and anti-hepatitis C virus drug is currently the focus for the hepatitis C virus-positive patients after receiving renal transplantation. OBJECTIVE:To investigate the anti-virus replication effect of cyclosporine in hepatitis C virus-RNA positive renal transplant recipients in addition to its anti-rejection effect. METHODS:Eleven hepatitis C virus-RNA positive renal transplant recipients were enrol ed and treated with cyclosporine, prednisone and mizoribine. Hepatitis C virus-RNA level, hemoglobin, liver functions and renal functions were evaluated before treatment and at 6 and 12 months after treatment. RESULTS AND CONCLUSION:The median of hepatitis C virus-RNA in 11 patients before treatment, and at 6 and 12 months after treatment were 1.22×107 copies/mL,1.11×104 copies/mL and 4.19×106 copies/mL respectively. At 6 months after treatment,8 cases of hepatitis C virus-RNA were negative (hepatitis C virus-RNA<500 copies/mL), and the total response of hepatitis C virus-RNA was 73%, and the sustained virological response was 55%(6/11) at the final fol ow-up. There was no significant difference of alanine transaminase, serum creatinine and serum uric acid levels before and after treatment (P>0.05), and the hemoglobin level was increased after treatment. During the fol ow-up, acute rejection only occurred in one patient and was control ed within 3 days after methylprednisolone pulse therapy. Cyclosporine-based treatment would be a better choice for renal transplant recipients combined with hepatitis C virus infection for both the anti-virus replication and anti-rejection effect.     

阿托伐他汀对老年人颈动脉粥样斑块和血脂的影响

Objective To observe the influence of atorvastatin on the arteria carotis atheromatous plaque and blood lipid in old people. Methods 57 hospitalized patients who had cerebral infarction or transient ischemic attack(TIA) were examined for atheromatous plaque by the color Doppler. They were administered atorvastatin 20 mg/d for three months. The changes of diameter of arteria carotis, rate of flow and size of plaque were measured be-fore and after treatment. Results The diameter of arteria carotis was expanded [left ( 0.99 ± 0. 11 ) era, right (0.98 ± 0.08 ) cm vs left (0.94 ± 0.09 ) cm, right ( 0.95 ± 0.07 ) cm, P < 0.05], the hemorrheology was improved, the size of plaque was diminished[left(0.57±0.20)cm2, right (0.54± 0.18 )cm2 vs left (0.86±0. 17 ) cm2 and right (0.82 ±0. 16 )cm2, P < 0. 05], TC, TG, LDL-C were lowered and HDL-C was elevated with statistical signifi-cance ( P < 0. 05). Conclusions The atorvastatin has positive therapeutical effect in diminishing the size of plaque, adjusting blood lipid and improving hemorrheology.     

Clinical effect of combined application of Maizhiling tablets and salmon calcitonin after artificial femoral head replacement in elderly patients with femoral neck fracture

Objective To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation. Methods Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation. Results VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant (t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation (P<0.01). In the control group, there was significant difference between 14 days and 3 months (P<0.01), and between 3 months and 6 months (P<0.01); 6 months after operation, the difference was statistically significant (P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation (P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation (P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age(OR=1.318, 95%CI1.002-1.732, P=0.048) and treatment method (OR=29.168, 95%CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery (OR=0.624, 95%CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation. © 2021, Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

高糖危象患者血清瘦素和氧化应激的关系

Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.     

韶关市农村留守儿童孤独感状况调查

目的了解广东省韶关市农村地区留守儿童孤独感现状及其影响因素。方法对韶关市某地区两所农村小学3～6年级学生中的489名留守儿童采用儿童孤独量表和自编调查表进行问卷调查。结果17．6％留守儿童存在孤独感，不同性别孤独感发生率无差异性，不同年龄及不同年级间孤独感发生率差异均有极显著性（P〈0.01）；随年级增加，孤独感发生率呈下降趋势（X^2趋势=5．970，P〈0.05）。留守儿童孤独感与健康状况、学习成绩、学习困难程度、父母教育方式、父母间关系和老师教育方式等因素显著相关（P〈0.01～0．05）。结论农村地区留守儿童中存在一定程度的孤独感问题，老师和家长应以正确的态度和方法对待留守儿童，以减少其孤独感的发生。     

产科新生儿不同部位经皮测黄报警预值的可靠性观察

目的对比观察产科新生儿不同部位经皮胆红素（TCB）报警预值的可靠性。方法132例产科新生儿采取随机数字分组法分为正常产组和剖宫产组各66例,新生儿均于产后第4天同一时间点应用KJ8000经皮测黄仪分别测量额、胸、腹、额胸、额胸腹TCB值,TCB〉12．9mg／dl者,取得亲属同意抽取静脉血检测血清胆红素（SB）,对比分析不同部位TCB及其与sB值的差异。结果两组分别有17例或21例达到TCB报警预值。两组TCB或sB相同方法及相同部位比较,差异无统计学意义（P〉0．05）;两组TCB不同部位对比,额部值最低、胸部值最高,且与其他部位同组对比差异均有统计学意义（P〈0．01）;两组sB值对比差异无统计学意义（t=1．53,P〉0．05）,与不同部位TCB对比均以胸部数值差异无统计学意义（P〉0．05）,而与其他部位TCB两组差异均有统计学意义（P〈0．01）。结论正常产与剖宫产新生儿术后sB对比差异无意义;TCB动态监测以胸部结果更接近SB。     

肇庆市居民颈椎病流行病学调查

目的 :调查肇庆市居民颈椎病发病情况及相关问题。方法 :通过分层随机抽样选择该市区18～70岁居民5000人为研究对象 ,入户或至单位询问调查。结果 :该市居民颈椎病发病率为8.11% ,男女差异无显著性 ,随着年龄的增长 ,发病率逐渐增加。经多因素分析 :体位姿势不正确、情绪紧张、潮湿、疲劳是发病的主要诱因。结论 :该病严重影响肇庆市居民的健康 ,做好防治应从早做起 ,综合防治。     

中国人四肢瘫日常生活能力评定量表的信度研究

目的研究四肢瘫日常生活能力评定量表评测四肢瘫患者的重测信度及观察者间信度。方法由1位评定者应用四肢瘫日常生活能力评定量表对20例四肢瘫患者进行评定,评定后1周内再次对该患者进行评定;另1位评定者在第1位评定者初次评定后2 d内对该患者进行评定。结果第1位评定者两次评定总分的组内相关系数为0.994(P<0.01);第1位评定者与第2位评定者评定总分的组内相关系数为0.971(P<0.01)。结论四肢瘫日常生活能力评定量表具有良好的重测信度及观察者间信度。     

Determination of loss of quality of life

Physiatrists are a valuable resource in legal settings, where assessment of functional capacity to perform work and of future medical needs must be determined. Physiatrists help determine what future medical care is needed to restore and maintain an individual at the maximum level of life function. This article focuses on the use of a quality of life (QOL) rehabilitation model, rather than a medical model, for enhancing functional performance, modifying environments, and facilitating patient coping. We discuss use of the QOL model to describe and influence a patient's physical, psychological, cognitive, vocational/economic, and social/leisure domains.     

护理干预对提高中风患者生活质量的效果观察

目的探讨提高中风患者生活质量的护理方法。方法将50例中风患者随机分为对照组23例和实验组27例,对照组给予针灸内科常规护理,实验组在此基础上给予心理护理和康复训练。结果两组患者治疗护理后日常生活活动(ADL)能力和贝克抑郁量表(BDI)评分均有好转,但实验组疗效明显优于对照组(P<0.05)。结论实施针对性心理护理和康复训练可明显提高中风患者的治疗效果。     

胰腺癌治疗的Cochrane系统评价证据

目的评价胰腺癌治疗的Cochrane系统评价证据,以及纳入系统评价的临床随机对照试验（RCT）的方法学质量。方法检索Cochrane Library数据库（2009年第4期）中有关胰腺癌治疗的系统评价,并运用RewMan5.0.21对所纳入研究的偏倚进行评估。结果共检索到胆道支架置入术姑息治疗梗阻型胰腺癌的系统评价、放化疗治疗不能手术的进展期胰腺癌的系统评价共2篇系统评价,共纳入79个RCT。依照Cochrane协作网推荐的质量评价方法,对所纳入RCT的偏倚进行评估,表明均存在不同程度的偏倚,方法学质量普遍较低。结论 Cochrane系统评价是公认的最高质量的研究证据,但目前缺少足够强度的证据来支持胆道支架置入术姑息治疗梗阻型胰腺癌的疗效。其他治疗手段的疗效如胰腺癌围手术期的营养支持治疗等还需要通过进一步的完成系统评价来评估。建议推行临床试验透明化,实施临床试验注册制度以及按照CONSORT声明严格规范RCT的报告,以便于总结胰腺癌治疗的临床证据。