4.5~5.5岁聋儿与正常儿童语音清晰度的比较

目的研究同年龄段聋儿与正常儿童的语音发音特征及差异。方法选用《聋儿听力语言康复评估题库》,采用三级人员评估方法,分别对4.5～5.5岁的听障组(20例聋儿)和健听组(20名正常儿童)进行声母和韵母清晰度测试。结果与结论声母清晰度测试显示,聋儿发音清晰度最高的声母为/b.m.d.l.j/,其次为/h.f.r.p.t.n.g.x/,最后为/zh.z.k.c.sh.q.s.ch/;正常儿童发音清晰度最高的声母为/b.p.f.g.m.d.h/,其次为/k.j.x.t.r.l/,最后为/q.zh.ch.sh.n.z.s.c/。韵母清晰度测试显示,两组发音清晰度最高的韵母为单韵母,其次为复韵母,最后为鼻韵母,听障组儿童的三类韵母平均清晰度均明显小于健听组儿童(P<0.01)。     

《中医药临床杂志》常用参考文献的著录格式

1期刊序号主要责任者.文献题名.刊名,出版年份,卷号（期号）：起止页码2专著序号主要责任者.文献题名.出版地：出版者,出版年.起止页码3论文集序号主要责任者.文献题名.论文集名.出版地：出版者,出版年.起止页码4专利文献序号专利所有者.专利题名.专利国别：专利号,发布日期5国际、国家标准序号标准代号,标准名称.出版地：出版者,出版年6报纸文章序号主要责任者.文献题名.报纸名,出版日期（版次）     

厚朴及6种混乱品种的鉴别

厚朴为木兰科植物厚朴Magnolia officinalis Rehd.et Wils.或凹叶厚朴Magnolia officinalis Rehd.ef Wils.Var.biloba Rehd.et Wils.的干燥干皮、根皮及枝皮.具有燥湿消痰、下气除满功效.用于湿滞伤中,脘痞吐泻,食积气滞,腹胀便秘,痰饮喘咳.     

红细胞比容对急性心肌梗死患者预后的影响

Objective To examine the relationship between hematocrit and risk of long term mortality among patients with acute myocardial infarction. Methods A total of 274 patients with acute myocardial infarction were recruited and divided into two groups by death after long term follow-up, the relationship between hematocrit and mortality was evaluated through the methods of independent t-test,chi-square test and multivariate regression analysis. Results The mean age was 69. 79 ± 7.45 years, with 73. 0% of male. The average of followup was 44. 4± 10. 7 months, with mortality of 38.7% . Comparison of baseline data showed that NYHA classification, smoking history, hemoglobin, hematocrit, mean red cell volume, glomerular filtration rate, ejection fraction,left ventricular diastolic diameter and right ventricular diameter was significantly different between the two groups( Ps ＜ 0. 05), Multivariable logistic analysis showed that hematocrit ,glomerular filtration rate, ejection fraction and smoking history were independently predicted factors, with OR of 0. 904 (95% CI: 0. 832 - 0. 982,P =0. 016) ,0. 983 (95% CI: 0. 969 -0. 996,P =0. 014) ,0. 932 (95% CI: 0. 887 -0. 979,P =0. 005) and 3. 230 (95% CI: 1.468 - 7. 106, P = 0. 004), respectively. The power of hematocrit to predict mortality was examined by ROC curves, the area under the curve was 0. 669(P ＜ 0. 001,95% CI: 0. 603 - 0. 736) Conclusion Hematocrit is a significant independent predictor for long term death among patients with acute myocardial infarction.     

脓毒症早期血清白细胞介素-18和10在疾病严重程度及预后评估中的价值研究

Objective To observe the dynamic changes in levels of serum interleukins (IL-18, IL-10)in the early stage of sepsis, and to appraise their values in the evaluation of severity and prognosis of sepsis.Methods Prospective randomized controlled study was conducted. Thirty-eight patients with sepsis who stayed longer than 72 hours in intensive care unit (ICU) from December 2009 to August 2010 were enrolled as sepsis group. At the same time, 20 patients without sepsis served as control group. The patients were classified as survival (n=12) or death group (n = 26) according to 28-day survival. The clinical laboratory examination data were recorded at 24, 48, 72 hours after admission to the ICU, and venous blood was obtained at the same time. The IL-18, IL-10 levels were determined by enzyme-linked immunosorbent assay (ELISA). Results The vital signs, blood routine, liver function, renal function, coagulation function,arterial blood gas, and electrolyte showed no significant difference between sepsis group and control group 24, 48, 72 hours after admission, the levels of IL-18 were lowered, IL-10 elevated, the IL-18/IL-10 ratio was lowered in the sepsis group, and all of them were higher than control group at each time point. The levels of IL-18, IL-10 in death group of patients with sepsis were all higher than those of survival group at 24, 48, and 72 hours [IL-18 (ng/L): 108. 36± 18. 54 vs. 91. 66±21. 49, 92.13±28. 92 vs. 54.16±31.76,91. 78 ± 17. 33 vs. 76. 04 ±22.09; IL-10 (ng/L): 99. 42 ± 12.10 vs. 77. 20 ±9. 47, 103. 39 ± 17. 24 vs.67.88±18.90, 118. 99 ±11. 20 vs. 99. 20± 12. 46, P＜0. 05 or P＜0. 01]. IL-18/IL-10 ratios were all lowered in both non-survivors and survivors with sepsis at 24, 48, 72 hours, while the differences were not statistically significant (1. 09±0. 19 vs. 1. 20±0. 32, 0. 92±0. 18 vs. 0. 98±0. 29, 0. 78±0.15 vs. 0. 77±0. 23, all P＞0. 05). Conclusion The levels of serum IL-18, IL-10 were all elevated in the early stage of patients with sepsis, and in non-survivors they were higher than those of survivors. With the progress of the illness, IL-18 showed a lowering tendency, while IL-10 showed an elevation. The levels of serum IL-18 and IL-10 may be valuable in evaluating the severity of sepsis and prognosis of patients with sepsis.     

骨科长期卧床病人预防便秘的护理

骨科病人由于多种因素的影响,极易引起便秘,对原发疾病的恢复造成不利的影响.经过临床观察,骨科病人发生便秘的原因有:1.创伤疾病的初始原因或手术.2.长期卧床病人,肠蠕动减弱.3.营养缺乏,饮食结构不合理.4.忽视便意.5.精神因素.便秘的发生,给病人的进食、睡眠及康复带来不利的影响.为此,我院骨科对可能发生便秘的病人采取措施进行预防护理,取得了满意效果.     

高糖诱导人脐静脉内皮细胞衰老过程中活性氧与二甲基精氨酸二甲胺水解酶-非对称性二甲基精氨酸系统的变化

Objective To investigate the changes in reactive oxygen species (ROS) and dimethylarginine dimethylaminohydrolase-asymmetric dimethylarginine (DDAH-ADMA) system in the process of endothelial cell senescence after exposure to high glucose. Methods The human umbilical vein endothelial cells (HUVECs) were cultured with different concentrations of glucose, e.g. 5. 5 mmol/L (normal level),and high levels as 11. 0, 22. 0 and 33. 0 mmol/L. for 48 hours, respectively. Subsequently, SA-β-gal staining was used to evaluate senescence of cells. Telomerase activity was detected by polymerase chain reactionenzyme linked immunosorbent assay (PCR-ELISA). The intracellular ROS level was measured by flow cytometry. The ADMA concentration and DDAH activity were determined with high-performance liquid chromatography. Results Compared with normal glucose concentration group, after the endothelial cells were treated with high glucose concentration (11. 0 - 33. 0 mmol/L) for 48 hours, the number of SA-β-gal positive cells was increased significantly [(7.00±1. 73)%, (12. 67±2. 03)%, (16. 00±2. 26)% vs. (4. 00±1.33)%, P＞0.05, P＜0.05, P＜0.05] and the telomerase activity was inhibited dramatically [(91. 32±4.01)%, (78. 44±3. 78)%, (56. 04±3. 35)% vs. 100%, all P＜0. 05]. The ROS level (mfi) was increased in all high glucose groups (159. 84±27. 52, 188. 99±18. 77, 244. 56±20. 96 vs. 117.11±18. 76, P＜0. 05 or P＜0. 01). At the same time, the ADMA (μmol/L) production was increased (0. 78±0. 14, 0. 88±0.18,1. 08±0.15 vs. 0. 70±0. 12, P＞0. 05, P＜0. 05, P＜0. 05), and DDAH activity was decreased [(91. 32±4.01)%, (78.44±3.78)%, (56. 04± 3. 35)% vs. 100%, all P＜0.05]. Conclusion High glucose can accelerate endothelial cells senescence in dose-dependent manner and the underlying mechanism may be related to an increased oxidative stress and change in DDAH-ADMA system.     

中药临床应用备要之二十二

贝母 贝母有川贝母、浙贝母之分,二者均为百合科植物的鳞茎.明代以前的本草统称贝母,明代以后分别记述.川贝母味苦、甘,性微寒.归肺、心经.功能清热润肺,化痰止咳.浙贝母又称大贝母,味苦,性寒.归肺、心经.功能清热散结,化痰止咳.临床应掌握二者的主要功能,并正确区别其药性.     

围生期心肌病发病相关因素的研究

Objective To explore the risk factors of peripartum cardiomyopathy (PPCM). Methods A total of 82 PPCM and 100 normal delivery females were randomly recruited in the current study. Echocardiographic, cTNI,high sensitive C-reaction protein(hs-CRP) ,NT-proBNP were measured. Fifty-two patients were followed up for a mean of 6 months. Results The PPCM patients (29. 5 ± 6. 4) yrs were older than the controls (25. 2 ± 5. 8) yrs (P<0.01) . Compared to the controls, the PPCM patients showed higher blood pressure (146.9/98. 8 mm Hg v. s. 130. 2/80. 1 mm Hg, P < 0. 01) , higher proportion of cesarean section (65. 9% v. s. 51. 0% , P < 0. 05) and complicated infection(75. 6% v. s. 10. 0% ,P <0. 01). The level of leucocyte(11.0 × 109/L) ,cTNI(0. 17 μg/L), hs-CRP(28. 2 mg/L)and NT-proBNP(650. 1 ng/L) were significantly higher in the PPCM patients compared with control(8. 8 × 109/L,0. 06μg/L,6. 2 mg/L and 110. 5 ng/L,P <0. 01). Hs-CRP was positively related with NT-proBNP(r = 0. 67, P < 0. 01). After average of 6 months of treatment, left ventricular ejection fraction enhanced from 32. 2% to 50. 6%. NT-proBNP significantly declined from 650. 1 ng/L to 225.6 ng/L(P <0. 01). Multiple linear regression analysis showed that diastolic pressure (P < 0. 05), LVED (P < 0. 05) and hs-CRP (P < 0. 05) were the independent predictors for declined NT-proBNP. Conclusions Inflammatory plays an important role in the development of peripartum cardiomyopathy.     

瑞舒伐他汀联合氯吡格雷对急性脑梗死患者血脂水平、血液流变学及神经功能的效果分析

目的分析瑞舒伐他汀联合氯吡格雷对急性脑梗死患者血脂水平、血液流变学及神经功能的影响效果。方法前瞻性选取空军第九八六医院2017年3月至2018年11月收治的168例急性脑梗死患者作为研究对象。随机分为两组,观察组84例,使用瑞舒伐他汀联合氯吡格雷进行治疗;对照组84例,使用氯吡格雷进行治疗。观察并记录两组患者治疗前后的血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDLC)、全血低切黏度、全血高切黏度、纤维蛋白原(FIB)、血细胞比容、NIHSS评分及Barthel指数等指标,以及临床疗效。结果两组患者治疗后的TC、TG、HDL-C较治疗前明显下降(观察组:6. 92±1. 01 mmol/L vs. 4. 31±0. 78 mmol/L,3. 30±0. 82 mmol/L vs. 1. 24±0. 28 mmol/L,4. 60±0. 86 mmol/L vs. 2. 43±0. 48 mmol/L;对照组:6. 84±1. 10 mmol/L vs. 5. 10±0. 88 mmol/L,3. 24±0. 76 mmol/L vs. 1. 56±0. 36 mmol/L,4. 68±0. 94 mmol/L vs. 3. 11±0. 56 mmol/L),LDL-C水平较治疗前明显升高(0. 76±0. 15 mmol/L vs. 1. 84±0. 38 mmol/L; 0. 72±0. 11 mmol/L vs. 1. 38±0. 30mmol/L),差异均有显著统计学意义(P 0. 05),且治疗后观察组患者的TC、TG、HDL-C较对照组下降更明显,LDLC水平升高更明显(P 0. 05);两组患者治疗后的全血低切黏度、全血高切黏度、FIB、血细胞比容较治疗前下降(观察组:21. 38±4. 26 mPa·s vs. 15. 72±3. 15 mPa·s,5. 40±0. 95 mPa·s vs. 4. 16±0. 81 mPa·s,4. 05±0. 72 g/L vs. 3. 26±0. 52 g/L,0. 46±0. 05%vs. 0. 43±0. 03%;对照组:21. 63±4. 33 mPa·s vs. 18. 83±3. 81 mPa·s,5. 35±0. 91 mPa·s vs. 4. 79±0. 86 mPa·s,3. 98±0. 79 g/L vs. 3. 62±0. 60 g/L,0. 49±0. 06%vs. 0. 47±0. 03%),差异有统计学意义(P 0. 05),且观察组患者治疗后的各指标较治疗前下降更明显(P 0. 05);两组患者治疗后的NIHSS评分较治疗前明显下降(21. 14±4. 46分vs. 14. 47±2. 95分; 20. 67±4. 30分vs. 17. 25±3. 71分),Barthel指数明显升高(25. 03±4. 96分vs. 39. 26±8. 18,25. 38±5. 17分vs. 33. 75±6. 81分),差异有统计学意义(P 0. 05),且观察组治疗后的NIHSS评分及Barthel指数较对照组变化更明显(P 0. 05);观察组患者总有效率为88. 1%,高于对照组患者总有效率75. 0%,差异有统计学意义(P 0. 05)。结论瑞舒伐他汀联合氯吡格雷能有效改善急性脑梗死患者的血脂水平、血液流变学指标及神经功能,值得临床推广应用。     

豚鼠变应性鼻炎模型鼻黏膜超微结构的改变

目的:探讨豚鼠变应性鼻炎模型鼻黏膜出现的超微结构病理变化.方法:用橄榄油将甲苯-2,4-二异氰酸酯配成浓度为10%溶液作为致敏剂,滴鼻,建立豚鼠变应性鼻炎模型8例.另8例正常豚鼠作对照.致敏结束、模型成功后,取两组鼻黏膜进行透射电镜观察.结果:透射电镜见①对照组:鼻黏膜上皮细胞结构完整.表面有纤毛,排列整齐,纤毛内微管排列规则、清晰.胞质内细胞器丰富,偶见嗜酸性粒细胞.偶见表面活性物质板层体.②模型组:黏膜上皮破损.杯状细胞破损.纤毛微管结构紊乱,出现复合、短纤毛.微绒毛消失.细胞体积缩小.电子密度增加.核变形、固缩.细胞器退变、空泡化.见大量嗜酸性粒细胞,并见其胞膜破裂,伪足形成,脱颗粒及空泡形成.肥大细胞较多,可见巨噬细胞及浆细胞.血管扩张.浆液腺体旺盛增生.这种形态学的改变与变应性鼻炎的临床表现大致吻合.结论:变应性鼻炎鼻黏膜出现形态学的改变,基本病理是上皮损害,血管扩张和毛细血管内皮细胞连接扩大,组织水肿,浆液腺体增生.嗜酸性粒细胞、肥大细胞等浸润、脱颗粒.     

围生期心肌病发病相关因素的研究

Objective To explore the risk factors of peripartum cardiomyopathy (PPCM). Methods A total of 82 PPCM and 100 normal delivery females were randomly recruited in the current study. Echocardiographic, cTNI,high sensitive C-reaction protein(hs-CRP) ,NT-proBNP were measured. Fifty-two patients were followed up for a mean of 6 months. Results The PPCM patients (29. 5 ± 6. 4) yrs were older than the controls (25. 2 ± 5. 8) yrs (P<0.01) . Compared to the controls, the PPCM patients showed higher blood pressure (146.9/98. 8 mm Hg v. s. 130. 2/80. 1 mm Hg, P < 0. 01) , higher proportion of cesarean section (65. 9% v. s. 51. 0% , P < 0. 05) and complicated infection(75. 6% v. s. 10. 0% ,P <0. 01). The level of leucocyte(11.0 × 109/L) ,cTNI(0. 17 μg/L), hs-CRP(28. 2 mg/L)and NT-proBNP(650. 1 ng/L) were significantly higher in the PPCM patients compared with control(8. 8 × 109/L,0. 06μg/L,6. 2 mg/L and 110. 5 ng/L,P <0. 01). Hs-CRP was positively related with NT-proBNP(r = 0. 67, P < 0. 01). After average of 6 months of treatment, left ventricular ejection fraction enhanced from 32. 2% to 50. 6%. NT-proBNP significantly declined from 650. 1 ng/L to 225.6 ng/L(P <0. 01). Multiple linear regression analysis showed that diastolic pressure (P < 0. 05), LVED (P < 0. 05) and hs-CRP (P < 0. 05) were the independent predictors for declined NT-proBNP. Conclusions Inflammatory plays an important role in the development of peripartum cardiomyopathy.     

胃癌根治术后不同吻合方式对贲门癌患者胃肠功能及血清瘦素和铁蛋白水平的影响

目的 探讨胃癌根治术后不同吻合方式对贲门癌患者胃肠功能及血清瘦素、铁蛋白水平的影响。方法选择2016年8月至2018年8月青海省第五人民医院收治的94例贲门癌患者进行前瞻性研究,随机数字表法分为两组:A组和B组,每组各47例。两组均行胃癌根治术,A组患者采取空肠食管Roux-en-Y吻合术,B组患者采取食管残胃后壁吻合术。比较两组患者的胃肠功能(肛门排气时间、拔胃管时间、进食时间),并发症发生情况,血清瘦素、铁蛋白水平,术后胃肠道症状评分(GSRS),主观综合营养评估法(SGA)评分,胃癌患者生活质量问卷(QLQ-ST022)评分。结果 A组患者的肛门排气时间(145. 61±25. 67) h、拔胃管时间(81. 27±10. 36) h、进食时间(98. 25±10. 17) h均短于B组的(160. 33±28. 74) h、(130. 52±11. 88) h、(119. 77±8. 44) h,并发症发生率(10. 64%)低于B组(27. 66%),差异具有统计学意义(t=11. 163、21. 420、2. 619,χ2=4. 398,P 0. 05)。术后3个月,A组患者的血清铁蛋白水平[(196. 71±15. 58)μg/L]高于B组[(155. 35±14. 46)μg/L],差异具有统计学意义(t=13. 340,P 0. 05);血清瘦素水平[(4. 22±1. 78)μg/L]低于B组[(5. 81±1. 56)μg/L],差异具有统计学意义(t=4. 606,P 0. 05);两组患者的GSRS评分比较,差异无统计学意义(P0. 05)。术后3个月,A组患者的SGA评分(7. 04±2. 11)分低于B组的(10. 56±2. 84)分,差异具有统计学意义(t=6. 821,P 0. 05);两组患者的GSRS评分比较,差异无统计学意义(P 0. 05)。术后3个月,A组患者的胃部疼痛、饮食受限、身体外观评分分别为(4. 33±0. 56)分、(4. 59±0. 77)分、(1. 22±0. 39)分,低于B组的(6. 05±0. 81)分、(6. 11±0. 64)分、(2. 01±0. 55)分,差异具有统计学意义(t=11. 975、10. 408、8. 033,P 0. 05)。结论 与食管残胃后壁吻合术相比,胃癌根治术后空肠食管Roux-en-Y吻合术能促进贲门癌患者胃肠功能的恢复,减少并发症的发生,改善患者临床症状,提高患者生活质量。     

脓毒症大鼠肠系膜淋巴结与机体免疫功能相关性研究

Objective To investigate the changes in T helper cells (Th1 and Th2) of mesenteric lymph node (MLN) and blood Th1 and Th2 cells in septic rats. Methods Ninety-six male Wistar rats were randomly divided into two groups according to random number table method: sham operation group and model group. Intra-abdominal infection with sepsis was induced by cecal ligation and puncture (CLP). Eight rats in each group were sacrificed after collection of blood samples and MLN samples at 0, 6, 12, 24, 48 and 72 hours after CLP. The ratio of Th1/Th2 and the percentage of regulatory T cell (Treg) in CD4+ T cells in blood and MLN were respectively determined by flow cytometry. Results In model group, the ratio of Th1/Th2 in abdominal aorta blood increased significantly at 6 hours and reached summit at 12 hours, then it decreased persistently, and when compared with sham group, the ratio of Th1/Th2 was significantly higher at 6, 12, 24 hours (0.82±0.15 vs. 0. 60±0. 22, 1. 23±0. 44 vs. 0. 76±0. 31, 0. 85±0. 25 vs. 0. 66±0. 32)and lower at 72 hours (0. 41±0.16 vs. 0. 59±0. 13, P＜0. 05 or P＜0. 01). The ratio of Th1/Th2 in MLN of model group reached summit at 6 hours, then decreased significantly, and when compared with sham group, the ratio of Th1/Th2 was significantly higher at 6 hours (1. 01±0.16 vs. 0. 52±0.13) and lower at 12, 24, 48 and 72 hours (0. 34±0.11 vs. 0. 53±0. 09, 0. 23±0. 08 vs. 0. 51±0. 09, 0.17±0. 07 vs. 0. 47±0.15, 0.16±0. 06 vs. 0. 53±0.11, P＜0. 05 or P＜0. 01). Compared with sham group, the percentage of Treg in MLN of model group was increased at 12, 24, 48 and 72 hours after CLP (9. 62±0. 69 vs. 7. 65±0.67, 9. 84±0. 74 vs. 8.08±1. 06, 10. 95±2. 09 vs. 7. 83±1.15, 10. 81±1. 34 vs. 8. 35±1.12, P＜0. 05 or P＜0. 01). There was a negative correlation between the ratio of Th1/Th2 and the percentage of Treg in MLN (r=-0. 882, P＜0. 05). Conclusion Cellular immune function of MLN is suppressed during severe intra-abdominal infection, which induces translocation of gut-derived endotoxin to mesenteric lymphatics,resulting in corporal immuno-suppression, with manifestation of Th1/Th2 cell shift. Immuno-suppression of MLN is related to a higher percentage of Treg due to the effect of endotoxin.     

孟鲁司特钠联合氨溴索对支气管哮喘患儿血清sE-SLT和sICAM-1水平的影响

目的探讨孟鲁司特钠联合氨溴索对支气管哮喘患儿血清可溶性E-选择素(s E-SLT)、可溶性细胞间黏附分子-1(sICAM-1)水平的影响。方法前瞻性研究2014年3月至2017年3月宝鸡市人民医院收治的支气管哮喘患儿100例,按照随机数字表法将患儿分为孟鲁组和常规组,每组各50例,常规组给予常规对症和氨溴索治疗,孟鲁组在此基础上给予孟鲁司特钠治疗,比较两组患儿治疗前后血清sE-SLT、sICAM-1水平,肺功能[一秒钟用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC]和治疗疗效、不良反应情况。结果孟鲁组和常规组治疗后血清sE-SLT(220. 25±24. 19 pg/ml vs. 284. 34±29. 87pg/ml,256. 25±26. 65 pg/ml vs. 282. 77±28. 45 pg/ml)、sICAM-1(223. 54±15. 21 ng/ml vs. 277. 43±27. 67 ng/ml,245. 12±15. 75 ng/ml vs. 274. 45±28. 01 ng/ml)水平明显低于治疗前,孟鲁组治疗后血清sE-SLT、sICAM-1水平明显低于常规组,差异具有统计学意义(P 0. 05);孟鲁组和常规组治疗后FVC(3. 63±0. 51 L vs. 2. 76±0. 32 L,3. 34±0. 43 L vs. 2. 75±0. 42 L)、FEV1(2. 82±0. 42 L vs. 1. 93±0. 26 L,2. 53±0. 27L vs. 1. 94±0. 33 L)、FEV1/FVC(62. 01±7. 66 vs. 46. 67±5. 56,56. 28±6. 67 vs. 46. 32±5. 28)水平明显高于治疗前,孟鲁组治疗后FVCL、FEV、FEV1/FVC水平明显高于常规组,差异具有统计学意义(P 0. 05);孟鲁组治疗有效率为96. 00%,明显高于常规组的78. 00%,差异具有统计学意义(P 0. 05);孟鲁组和常规组的不良反应发生率为10. 00%、14. 00%基本相同,差异无统计学意义(P 0. 05)。结论孟鲁司特钠联合氨溴索治疗可有效改善支气管哮喘患儿血清s E-SLT、sICAM-1水平和肺功能,有利于提高患儿的治疗疗效,且具有良好的安全性,值得临床推广应用。     

妊娠26周至产后42天Kegel运动对分娩结局和产妇盆底功能的影响

目的探讨妊娠26周至产后42天Kegel运动对产妇分娩结局和盆底功能的影响。方法回顾性选取2018年3月至2019年12月在福建医科大学漳浦教学医院门诊检查的180例初产妇,根据是否进行Kegel运动分为观察组(n=89)和对照组(n=91),观察组产妇从妊娠26周开始至产后42 d进行Kegel运动,对照组产妇正常产检,不进行Kegel运动。观察两组产妇的分娩结局和产后盆底功能的情况。结果观察组产妇孕晚期的非尿失禁率(46. 07%)、阴道分娩率(97. 75%)、会阴完整率(28. 74%)、产后42 d盆底肌张力评分(深I类3. 3±1. 5分;浅I类2. 7±1. 3分;深II类3. 6±1. 4分,浅II类3. 4±1. 5分)明显高于对照组(23. 08%; 86. 81%; 15. 19%;深I类2. 4±1. 7分,浅I类1. 6±1. 2分,深II类2. 3±1. 5分,浅II类2. 2±1. 7分),差异具有统计学意义(P 0. 05)。观察组产妇各阶段的产程时间(第一产程430. 9±41. 7 min;第二产程45. 9±1. 4 min;第三产程5. 8±1. 5 min;总产程482. 6±44. 6 min)、会阴侧切率(13. 79%)、会阴撕裂严重程度(会阴撕裂I度94. 00%;会阴撕裂II度4. 00%)、产后盆底功能恢复正常的时间(25. 8±1. 7 d)明显低于对照组(第一产程547. 6±52. 5 min,第二产程54. 6±1. 2 min,第三产程7. 9±1. 7 min,总产程610. 1±55. 4 min; 26. 58%;会阴撕裂I度71. 74%,会阴撕裂II度19. 56%; 36. 5±1. 9 d),差异具有统计学意义(P0. 05);观察组与对照组两组产妇的助产率(9. 20%vs. 12. 66%)、新生儿窒息率(1. 12%vs. 5. 49%)、产后出血率(1. 12%vs. 4. 40%)、尿潴留率(1. 12%vs. 6. 59%)比较,差异无统计学意义(P0. 05)。结论妊娠26周开始至产后42 d进行Kegel运动可显著改善产妇的分娩结局,提高产后的盆底功能。     

强直性肌营养不良一例

患者男,48岁,因"四肢无力8年,加重1年"入院.入院前8年患者无明显诱因双手力弱,以左手明显,连续上举哑铃仅能完成6个.握拳后不能立即将手伸直、松开手,强直以拇指为重.遇冷加重.双下肢无力见于行走时,略微行走即有酸胀感,休息后可缓解.上楼困难,下楼尚可.言语含混不清.5年来无力渐加重.1年前上述不适明显加重,双手不能持重.双手指端麻木.     

骨关节炎患者滑膜细胞对于成骨细胞骨向分化的影响及机制研究

目的 探索骨关节炎患者滑膜细胞对成骨细胞骨向分化的影响及其相关机制。方法 取骨关节炎患者滑膜组织及正常滑膜组织,采用酶消化法分离培养滑膜细胞,并传代,取第2代滑膜细胞和成骨细胞进行实验。首先将滑膜细胞与成骨细胞在体外进行共培养,实验分为两组,取P2代骨关节炎患者滑膜细胞与成骨细胞transwell共培养作为实验组(A组),正常滑膜细胞与成骨细胞transwell共培养作为对照组(B组),共培养36 h后,利用CCK-8法检测成骨细胞存活率,实时荧光定量PCR检测成骨细胞miR-21表达。然后,体外培养成骨细胞,构建过表达miR-21的重组慢病毒表达载体并转染入成骨细胞,实验分为两组,转染对照组(C组),miR-21转染组(D组),体外培养7 d后,实时荧光定量PCR检测成骨细胞miR-21表达以及成骨相关基因骨钙素(OCN)、RUNX2及I型胶原(Collagen I) mRNA表达,茜素红S法检测钙离子吸光度,ELISA法检测碱性磷酸酶(ALP)活性,western blot法检测OCN、RUNX2蛋白表达。结果 共培养36 h后,A组与B组成骨细胞存活率无显著差异[(98. 21±1. 07)%vs.(96. 14±0. 93)%,P 0. 05],而A组miR-21表达量明显高于B组(4. 61±0. 47 vs. 0. 32±0. 11,P 0. 05);体外培养7 d后,D组miR-21表达量明显高于C组(11. 02±0. 97 vs. 0. 41±0. 08,P 0. 05),而D组OCN、RUNX2及Collagen I基因表达显著低于C组(0. 33±0. 06 vs. 1. 04±0. 27,0. 27±0. 03 vs. 0. 99±0. 12,0. 73±0. 08 vs. 1. 05±0. 08,P 0. 05),D组钙离子吸光度和ALP活性显著低于C组(P 0. 05),此外,D组OCN、RUNX2蛋白相对表达量均明显低于C组(1. 02±0. 16 vs. 15. 66±1. 37,1. 03±0. 11 vs. 8. 47±0. 94,P 0. 05)。结论 骨关节炎成骨细胞内miR-21水平呈高表达,而成骨细胞存活率却未受明显影响。骨关节炎患者滑膜细胞miR-21可抑制成骨细胞的矿化作用。     

126例青春期女性盆腔包块的病因及诊治分析

Objective To explore the clinical characteristics,causes,diagnosis and treatment of pelvic mass in adolescents caused by gynecologic diseases. Methods One hundred and twenty-six adolescents with gynecologic diseases presented as pelvic mass were retrospectively reviewed. Results The average age of all patients was 17. 6 years,ranging from 10. 0 to 19. 0 years. Ectopic pregnancy was found in 38 patients(30. 2%) ,the average age of the patients was 18.6 ±0.5 years, ranging from 17.0 to 19.0 years. Ovarian neoplasm was found in 35 patients (27. 8%) ,the average age of the patients was 17. 1 ± 2. 1 years, ranging from 10. 0 to 19. 0 years. Twenty cases (57. l%)had germ cell tumor, eighteen with mature teratomas, one with endodermal sinus tumor and one with immature teratoma. Thirteen cases(37. 2%)had epithelial ovarian tumors;eight with serous cystadenomas,three with mucinous cystadenoma, one with mucinous cystadenoma complicated with serous cystadenoma and one with borderline mucinous cystadenoma. Two cases had simple cyst of the ovary (5. 7%) . Congenital abnormality of reproductive tract was found in 14 patients (11. 1%), the average age was 14. 7 ±2. 2 years, ranging from 13.0 to 19. 0 years. Seven had imperforate hymens, two had rudimentary horn of uterus,four had atresia of vagina,one had atresia of vagina complicated with rudimentary horn of uterus,and one had oblique septum of vagina. Corpus luteum rupture was found in 11 patients (8. 7%) , the average age was 18. 1 ± 1. 9 years, ranging from 13. 0 to 19. 0 years. 116 patients underwent operative treatment and 10 patients underwent conservative therapy. Conclusions According to the stage of adolescents, main causes of pelvic mass in adolescents are different Main causes of pelvic mass in early adolescents are tumorous disease. Congenital abnormalities of reproductive tract are usually in middle adolescents. The gonads develop closely mature in late adolescent period; main causes of pelvic mass are ectopic pregnancy, ovarian neoplasm and physiologic ovarian cyst Surgery is the main therapy of pelvic mass in adolescents.     

常用文献类型的著录格式

<正>1.专著[序号]主编姓名.书名[M].版次(第1版可省略).出版地:出版者,出版年:起-止页.例如:[1]徐敏.出版集团研究[M].北京:中国书籍出版社,2001:179-193.2.专著析出文献[序号]析出文献主要责任者.析出文献题名[M]//专著主要责任者.专著题名.版次.出版地:出版者,出版年:起-止页.例如:程根伟.1988年长江洪水的成因与减灾对策[M]//许厚泽,赵其国.长江流域洪涝灾害与科技对策.北京:科学出版社,1999:32-36.