目的 探讨功能训练在Haglund病伴轻度认知障碍患者中的应用效果。方法 成立功能训练培训小组对46例关节镜Haglund病伴轻度认知障碍术患者实施功能训练,干预时间6个月。训练前后对患者Baird-Jackson踝关节评分、自我效能和临床疗效评估进行测评。结果 训练后,患者Baird-Jackson踝关节评分、自我效能优于训练前,临床疗效优良率升高,训练前后比较,差异均有统计学意义(P＜0.01)。结论 功能训练能促进关节镜Haglund病伴轻度认知障碍术患者踝关节功能康复和提高自我效能。

Objective To investigate the effects of application of functional training to Haglund disease patients with mild cognitive impairment. Methods The functional training group was built and gave functional training to 46 patients of Haglund disease with mild cognitive impairment. The period of intervention lasted 6 months. Before and after the training, We assessed patients in terms of scores of Baird-Jackson ankle joint, self-efficacy and clinical efficacy. Results After the training, scores of Baird-Jackson ankle joint and self-efficacy became higher and the excellent rate of clinical efficacy has risen. Compared with those before the training, the difference had statistic significance (P<0.01). Conclusion Functional training has a positive impact on the recovery of ankle joint function of Haglund disease patients with mild cognitive impairment and improve their self-efficacy.

目的 探讨经针刺治疗爆裂性眶壁骨折伴眼球运动障碍的临床疗效及安全性。方法 选取2013年10月—2015年9月在我院接受治疗的70例(70只眼)爆裂性眶壁骨折致眼球 运动障碍患者,按照治疗方式的不同分为常规组和针刺组,每组各35例,其中常规组给予常规药物治疗,针刺组除了接受常规治疗外,依据眶壁骨折部位的不同选取相应临近眼外肌穴进行针刺,每日1次,每次留针30 min,15天为一个疗程,两组患者均持续治疗两个疗程。对比分析两组患者治疗前后的角膜缘移动范围、眼球运动障碍级别以及临床疗效。结果 经过治疗后,两组患者的角膜缘移动范围均较治疗前明显改善,且与常规组患者相比,针刺组患者改善得更显著(P<0.05);经过治疗后,针刺组0级、I级、II级、III级的眼数分别为14、15、3、3只眼,其中0级的眼数明显多于常规组患者,差异有统计学意义(P<0.05);针刺组的治疗总有效率高达91.43%,明显高于常规组的62.86%,差异有统计学意义(P<0.05)。结论 针刺眼外肌穴有助于改善爆裂性眶壁骨折伴眼球运动障碍患者的角膜缘移动范围,促进患者眼外肌功能的恢复而降低眼球运动障碍级别,明显提高治疗总有效率,在临床上值得推广应用。

Objective To explore the clinical effect of eye-acupuncture on eye movement disorders caused by orbital blowout fracture and its security. Methods 70 eyes movement disorder patients with burst orbital wall fracture treated in our hospital from October 2013 to September of 2015 were selected and divided into two groups, each group contains 35 cases. The routine group was given routine drug treatment, beside this, we gave the therapy of eye-acupuncture for 30 minutes to the acupuncture group according to the type to select the corresponding extraocular muscle holes. Both with 15 days was for a course of treatment. After two courses, compared the eye movement disorder level changes and the limbus range of movement of the two groups before and after treatment, we evaluated the efficacy based on efficacy standard. Results After treatment, the corneal limbus range of movement were significantly improved of both groups, and the acupuncture group were better than that of the routine group(P<0.05);after treatment, the eye movement disorder rating of the acupuncture group was as follows: the number of level 0,1,2,3 was 14,15,3,3,respectively, among which the number of level 0 was significantly higher than that of the routine group(P<0.05);The total effective rate of the acupuncture group was 91.43 %, which was significantly higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion Eye-acupuncture may improve the corneal limbus range of movement in patients with eye movement disorders caused by orbital blowout fracture. It could promote the recovery of extraocular muscles function and thus lower the level of eye movement disorders. It significantly improves the total efficiency and is worthy of popularization and application clinically.

目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均＜0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。

Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.

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.

凝血功能障碍是围术期临床关注的重点,评价方式较多,其中血栓弹力图(TEG)可根据凝血过程中血凝块的黏弹性变化所描绘出的图像,反映全血的凝血和纤溶能力,其结果快速准确,被广泛应用围术期凝血功能监测。

Coagulopathy is a key concern around operation period.Thromboelastography (TEG) is in the process of image based on viscoelastic changes of coagulation of blood clots depicted, to reflect the blood coagulation and fibrinolytic capacity. TEG test result is quickly and accurately, therefore it is widely used in the perioperative monitoring of blood coagulation function, blood transfusion guide, hypercoagulation monitoring, prevention of thrombosis.

目的 检测抑郁障碍患者血清中IL-2和TNF-α水平,探讨IL-2和TNF-α水平与认知功能情况相关性。方法 采用酶联免疫吸附法(ELISA)检测100例抑郁障碍患者(观察组)和100例健康人(对照组)的血清IL-2、TNF-α的水平,并结合汉密尔顿抑郁量表(HAMD)观察患者抑郁障碍的严重程度,应用Loewenstein 认知评定量表评定患者的认知状态情况进行相关分析。结果 与对照组相比,观察组的IL-2、TNF-α的水平明显更高(P<0.05)。IL-2、TNF-α的水平与HAMD,LOTCA总分呈正相关(P<0.05)。结论 抑郁障碍患者血清中IL-2、TNF-α的水平与抑郁障碍患者的严重程度和认知状态情况呈正相关。

Objective To study the levels of serum IL-2 and TNF-α in depressed patients and theircorrelations with the cognitive function. Methods 100 depressed patients (observation group) and 100 healthy people (control group) were enrolled to this study and we compared their levels of serum IL-2 and TNF-α detected by enzyme-linked immunosorbent (ELISA) from two groups. The correlation analyses of the serum IL-2 and TNF-α levels with the severity of depression of depressed patients observed with Hamilton depression scale (HAMD), and the serum IL-2 and TNF-α levels with the cognitive function evaluated with Loewenstein were conducted. Results The levels of serum IL-2 and TNF-α in the observation group were significantly higher than control group (P<0.05).There were positive correlations between the levels of IL-2 and TNF-α and HAMD scores and between the levels of IL-2 and TNF-α and LOTCA scores (P<0.05). Conclusion The levels of serum IL-2 and TNF-α in the depressed patients were positively correlative with the severity of depression and their cognitive function.

目的 探讨盆底肌康复仪配合中药补中益气汤对盆底功能障碍性疾病的治疗疗效。方法 对300例女性盆底功能障碍性疾病(FPFD)的患者采用盆底肌康复仪同时配合中药补中益气汤协同治疗从而弥补单纯盆底康复治疗不足。结果 产后一年内的早期盆底肌力松弛治愈率达83.82%; SUI组治疗后的临床症状控制效果及盆底肌力、持续时间优于POP组,P＜0.01。结论 产后及时、早期干预盆底肌功能可有效防止盆底功能障碍性疾病的不良发展,同时配合经典方补中益气汤可益气、升阳举陷调理脏腑机能产生协同作用。

目的 探讨对注意缺陷多动障碍（ADHD）患儿联合应用维生素D与盐酸托莫西汀的效果及对其行为功能障碍和神经功能损伤的影响。方法 选择于我院接受治疗的105例ADHD患儿,纳入时间为2023年7月—2024年3月,按照计算机分组法分为对照组52例给予盐酸托莫西汀治疗,观察组53例给予维生素D联合盐酸托莫西汀治疗,比较两组临床疗效、神经与行为功能、不良反应。结果 观察组总有效率（96.23%）高于对照组（78.85%）（P<0.05）。治疗后,与对照组比较,观察组神经元特异性烯醇化酶水平与行为、学习、躯体、冲动多动、焦虑及多动指数评分更低（P<0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论 对于ADHD患儿,使用维生素D联合盐酸托莫西汀显示出更为显著的疗效,能有效缓解行为功能障碍,减少神经功能损伤,且具有良好的安全性。

Objective To explore the effect of combined use of vitamin D and atomoxetine hydrochloride on children with attention deficit hyperactivity disorder（ADHD）and its impact on their behavioral dysfunction and neurological damage. Methods A total of 105 children with ADHD treated in the hospital were included from July 2023 to March 2024. They were divided into control group with 52 cases treated with atomoxetine hydrochloride, and observation group with 53 cases treated with vitamin D combined with atomoxetine hydrochloride using a computerized grouping method. The clinical efficacy, neurological function, behavioral function, and adverse reactions were observed in both groups. Results The total effective rate of the observation group（96. 23%）was higher than that of the control group（78. 85%）（P<0. 05）. After treatment, compared with the control group, the levels of neuron-specific enolase in the observation group were significantly lower in terms of behavior, learning, physical fitness, impulsivity hyperactivity, anxiety and hyperactivity index scores（P<0. 05）. The comparison of the incidence of adverse effects between the two groups was not significant（P>0. 05）. Conclusions The combined use of vitamin D and atomoxetine hydrochloride has a more significant therapeutic effect on children with ADHD, which can effectively alleviate behavioral dysfunction, reduce neurological damage, and has good safety.

目的 利用可视化软件CiteSpace分析近20年儿童注意缺陷多动障碍（ADHD）及其共患病的相关文献,得出该领域的研究现状和发展趋势,为儿童注意缺陷多动障碍及其共患病的研究和诊疗提供参考。方法 检索2004—2024年发表在中国知网、维普、万方数据库关于儿童注意缺陷多动障碍及其共患病的相关文献,运用CiteSpace软件对纳入文献进行可视化分析,对来源、机构、发文量、作者、关键词绘制科学知识图谱。结果 共纳入383个机构、500个作者、235种期刊、577篇有效文献。自2012年发文量总体上呈波动上升趋势;在发文来源中,《中国儿童保健杂志》以47篇居首;研究机构以北京大学精神卫生研究所为代表;王玉凤作者发文21篇为最多;ADHD患儿的主要共患病为抽动障碍、癫痫、对立违抗障碍、学习障碍;主要治疗药物为托莫西汀;主要影响患儿的执行功能。ADHD患儿共患病研究分为3个阶段,第一阶段为2004—2009年,研究对象主要为品行障碍、对立违抗障碍、学习障碍、焦虑障碍,主要研究内容为患儿的脑损伤与基因;第二阶段为2009—2017年,重视研究患儿的心理问题,如焦虑、抑郁,也重视患儿的生活及家庭环境;第三阶段为2017—2024年,重点研究托莫西汀、阿立哌唑等药物,并重视ADHD共患癫痫的研究。结论 目前对ADHD共患病的研究仍较为局限,主要集中研究共患抽动障碍、对立违抗障碍、癫痫,未来应重视研究其他共患病,进一步探索更好的诊治方法。

Objective To analyze the literature on attention deficit hyperactivity disorder（ADHD）and its comorbidities in children in the past 20 years by using the visualization software CiteSpace, and to obtain the research status and development trend of this field, so as to provide reference for the research, diagnosis and treatment of ADHD and its comorbidities in children. Methods The relevant literature on ADHD and its comorbidities in children published in CNKI, VIP and Wanfang data bases from 2004 to 2024 was searched, and the included literature was visually analyzed by CiteSpace 6. 2R6 software, and the scientific knowledge graph was drawn by the source, institution, number of publications, authors and keywords. Results A total of 383 institutions, 500 authors, 235 journals, and 577 valid articles were included. Since 2012, the number of published documents has fluctuated and increased. Among the sources of publication, the Chinese Journal of Child Health ranked first with 47 articles. The research institutions were represented by the Institute of Mental Health of Peking University. Wang Yufeng was the most prolific author with 21 articles. The main comorbidities of ADHD children were tic disorder, epilepsy, oppositional defiant disorder and learning disorder. The main treatment drug was tomoxetine. It mainly affects the executive function of the children. The study on comorbidity in children with ADHD was divided into three stages. The first stage was from 2004 to 2009. The research objects mainly included conduct disorder, oppositional defiant disorder, learning disorder and anxiety disorder, and the main research content was brain injury and genes in children. The second stage, from 2009 to 2017, focused on the psychological problems of children, such as anxiety and depression, and also paid attention to the life and family environment of children. The third stage was 2017-2024, focusing on tomoxetine, aripiprazole and other drugs, and paying attention to the study of ADHD co-induced epilepsy. Conclusions The current research on ADHD and its comorbidities is still limited, and its pathogenesis should be explored in the future, so as to quickly and accurately identify comorbidities and further study better treatments.

        目的   探讨帕金森病（PD）患者执行功能障碍与脑小血管病（CSVD）总负荷的关系。方法   回顾性分析2020年1月1日—2024年6月30日在佛山市第一人民医院住院的156例PD患者收集患者的临床资料，包括性别、年龄、教育年限、高血压病史等，采用简易精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）评估认知功能以及采用额叶功能评定表（FAB）评估执行功能。根据患者的认知功能和执行功能评定结果，将156例患者分为PD认知功能正常（PD-NC）组、PD执行功能异常组（PD-EF）和PD非执行功能异常组（PD-NEF）。所有研究对象均行头颅磁共振检查，行CSVD总负荷的评分。比较3组患者一般临床资料、CSVD及其标志物的差异。结果  PD-EF组的年龄、病程、H-Y分期、脑室周围白质高信号（PVWMH）、皮层下白质高信号（DWMH）、腔隙性脑梗死（LI）、CSVD 总负荷评分高于PD-NEF组、PD-NC组，差异均有统计学意义（均P＜0.05）。Spearman相关性分析结果显示，PD患者FAB评分与PWMH评分、DWMH评分、LI数目、CSVD总负荷评分均呈负相关（均P＜0.05）。多元线性回归分析显示，PD患者FAB评分越低，DWMH评分、LI数目、CSVD总负荷评分均越高（均P＜0.05）。结论  PD患者执行功能障碍和CSVD总负荷相关。

       Objective  To explore whether total burden of cerebaral small vessel disease（CSVD）detected with MRI was associated with the executive functions in patients with Parkinson's disease（PD）．Methods  In total，156 patients with PD in First People’s Hospital of Foshan from January 2020 to June 2024 were retrospectively enrolled．Detailed clinical data were obtained．The clinical data of all the patients such as age，gender，years of education，hypertension history were collected．The MiniMental State Examination（MMSE）and the Montreal Cognitive Assessment Scale（MoCA）were used to assess cognitive function，the Frontal Assessment Battery（FAB）was used to assess executive function．According to the function levels，all cases were divided into PD with normal cognition（PD-NC）group，PD with executive function（PD-EF）and PD with non-executive function（PD-NEF）．All the patients underwent brain MRI to determine the presence and burden of CSVD，scoring between 0 and 4．Results  The age，course of disease，Hoehn-Yahr staging，the scores of periventricular white matter hyperintensities（PWMH），the scores of deep subcortical white matter hyperintensities（DWMH），the numbers of lacunar infarcts（LI），the CSVD scores were significantly higher in the patients of PD-EF group than PD-NC group and PD-NEF group（P＜0.05）．Spearman’s correlation analysis showed that FAB scores had a significant correlation with scores of PWMH，the scores of DWMH，the numbers of LI，and the CSVD burden scores（P＜0.05）．Multivariable analysis showed that there was a significant negative correlation between FAB scores and the scores of DWMH，the numbers of LI，the CSVD scores．Conclusions  The total MRI CSVD burden was associated with the executive functions in patients with PD in this study．