目的 探讨抗肿瘤联合营养支持治疗对老年晚期恶性肿瘤癌因性疲倦及厌食行为的影响。方法 选取2015年4月—2017年4月晚期恶性肿瘤老年患者160例,随机分为抗肿瘤治疗组(对照组)和抗肿瘤联合营养支持治疗组(观察组),各80例,对比分析两组治疗前、后癌因性疲倦及厌食行为评分情况。结果 治疗前,两组厌食行为、癌因性疲倦评分比较无差异(P>0.05);治疗后,观察组厌食行为及癌因性疲倦评分均低于对照组(P<0.05)。结论 营养支持治疗在老年晚期恶性肿瘤患者厌食行为及癌因性疲倦方面的改善效果显著,一定程度上提高患者生活质量,减轻痛苦,具有较高临床应用价值。

目的 本研究从细胞生物学角度检测二甲双胍对小鼠胰岛瘤MIN6的影响,并探讨此过程中包含的分子生物学机制。方法 MTT法检测不同浓度二甲双胍(1、2、5、10、20 mmol/L)对MIN6细胞活力的影响,细胞划痕实验检测二甲双胍对MIN6细胞迁移的影响,免疫印记实验检测此过程中细胞凋亡相关蛋白Bcl-2、Bax、caspase3表达的变化,及AMPK和JNK信号通路蛋白磷酸化水平的变化。结果 二甲双胍浓度大于10 mmol/L时可以抑制MIN6细胞的活力(P<0.01),降低其迁移能力(P<0.01),高浓度二甲双胍可以上调细胞内凋亡蛋白Bax(P<0.05)和p-AMPK的表达(P<0.05),降低抗凋亡蛋白Bcl-2的表达,增加caspase3剪切体(P<0.05)。同时,二甲双胍可以降低MIN6细胞内JNK信号通路的磷酸化水平(P<0.05)。结论 高浓度二甲双胍可以抑制MIN6细胞的增殖和迁移,其作用可能与降低了JNK信号的通路活化有关。

Objective This study aims to investigate the effect of metformin on proliferation and migration of MIN6 cells, and to explore the underlying mechanism. Methods The viability of MIN6 cells that were treated with various metformin (1,2,5,10 and 20 mmol/L) was detected by MTT assay. The migration of MIN6 cells was determined by wound-healing assay. Meanwhile, the proteins expression of Bcl-2, Bax, caspase3 and the phosphorylation of AMPK, JNK was detected by western bolt assay. Results The cell viability and the migration of MIN6 cells were decreased when the concentration of metformin above 10 mmol/L(P<0.01). The expression of apoptosis-related protein Bax(P<0.05) and p-AMPK(P<0.05)was up-regulated, anti-apoptosis-related protein Bcl-2 was down-regulated and cleaved caspase3 (P<0.05)was increased after high metformin treatment. At the same time, the phosphorylation of JNK was down-regulated by metformin(P<0.05). Conclusion High concertration of metformin may inhibit the proliferation and migration of MIN6 cells through suppressing the activation of JNK signaling pathway.

目的 探讨布地奈德联合特布他林对中度哮喘患儿血清变态反应及Th相关指标的影响。方法 选择本院2016年3月—2017年4月收治的中度哮喘患儿100例,将其随机分为2组,各50例。对照组采用布地奈德雾化吸入治疗,观察组采用布地奈德联合特布他林雾化吸入治疗,比较两组临床疗效、血清变态反应与Th相关指标、药物不良反应。结果 1周后,观察组治疗总有效率较对照组高,MCP-1、IgE、IL-10及IL-6水平均较对照组低,差异具有统计学意义(P＜0.05);观察组药物不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 布地奈德联合特布他林可提高中度哮喘患儿临床疗效,减轻血清变态反应,改善Th相关指标,且用药安全性较高。

目的 了解住院老老年心房颤动(atrial fibrillation,AF)患者的临床特征及抗凝现况。方法 收集2015年6月—2017年9月住院老老年(≥80岁)房颤患者的抗凝用药,合并疾病,合并用药等临床信息,统计并分析,非正态分布的计量资料以中位数表示,采用秩和检验,两组计数资料采用χ²检验。结果 621例老老年患者根据性别分为男女两组,男354人,女267人,159例患者(25.6%)使用华法林,33例患者(5.31%)使用达比加群,30例患者(4.83%)使用利伐沙班,抗凝总人数为222例(35.75%)。174例患者(28.02%)使用阿司匹林,27例患者(4.35%)使用氯吡格雷,抗血小板总人数为201例(32.37%)。余198例患者(31.89%)未使用任何抗血小板或抗凝药物。结论 老老年房颤患者目前抗凝率低,抗凝药物以华法林为主。

Objective This study investigated the clinical characteristics and antithrombotic status in elderly patients with atrial fibrillation AF. Methods In this study, we collected, analyzed and characterized the data of the patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results 621 cases of elderly patients were divided into two groups according to their gender between men and women, 159 patients (25.6%) take warfarin, 33 patients (5.31%) with dabigatran, 30 patients (4.83%) uses of rivaroxaban, the total number of anticoagulation is 222 (35.75%),174 patients (28.02%) were treated with aspirin, and 27 patients (4.35%) used clopidogrel, and the total number of antiplatelet agents was 201 (32.37%). 198 patients (31.89%) did not use any antiplatelet or anticoagulant drugs. Conclusion patients with atrial fibrillation anticoagulant rate is low, and the anticoagulant is mainly warfarin.

目的 探讨揭阳地区急性下呼吸道感染住院患儿病毒病原学特点。方法 对2 125例急性下呼吸道感染患儿应用直接免疫荧光法(DIF)进行A型流感病毒(甲型流感病毒IFA)、B型流感病毒(乙型流感病毒IFB)、呼吸道合胞病毒(RSV)、腺病毒(AdV)、副流感病毒1(PIVⅠ)、2(PIVⅡ)和3型(PIVⅢ)进行病毒学检测。结果 2 125例患儿鼻咽部分泌物标本中有538例检测出至少1种病毒,总阳性率25.3％,其中RSV 阳性率(19.7%)明显高于其他病毒,具有统计学意义。春、夏、冬季的RSV阳性率大致相当,明显高于秋季。婴儿期组RSV阳性率(27.2%)最高,幼儿期组(18.7%)次之,均显著高于学龄前期、学龄期,后2组阳性率无统计学差异,青春期组未检出RSV。结论 病毒是急性下呼吸道感染的重要病原体,而其中又以RSV为著,RSV感染具有显著的季节性和年龄特征性。

Objective To investigate the viral etiology feature in hospitalized children with acute lower respiratory infection in Jieyang area. Methods A total of 2 125 children with acute lower respiratory tract infection were screened by direct immune fluorescence assay (DIF) for influenza virus A (IFA), influenza virus B (IFB), respiratory syncytial virus (RSV), adenovirus (AdV), parainfluenza virus I (PIV Ⅰ), PIV Ⅱ and PIV Ⅲ. Results In 2 125 cases of nasopharyngeal secretory specimens, 538 cases were detected at least one kinds of viruses. The total positive rate was 25.3%, of which the positive rate of RSV (19.7%) was higher than that of other viruses. The positive rate of RSV was similar in spring, summer and winter, much higher than that in autumn.The positive rate of RSV in infancy group (27.2%) was the highest,then the second was the toddler's age(18.7%), both of which were higher than that in preschool age group and school age group. There was no significant difference in the positive rate between preschool age group and school age group. In addition, RSV was not detected in the adolescence group. Conclusion Virus is an important pathogen of acute lower respiratory tract infection. The most common virus is RSV, infection of which has seasonal and age characteristics.

目的 探讨品管圈活动提高出院产妇母乳喂养调查问卷在随访系统回复率中的效果。方法 成立“品管圈组织”,确立“提高出院产妇母乳喂养调查问卷在随访系统的回复率”为主题,对活动前2月~14月回复率低进行原因分析,拟定实施对策,比较实施前后问卷的回复率。结果 出院产妇母乳喂养调查问卷在随访系统的回复率由29.9%提高到了71.7%,差异有统计学意义(P<0.001)。结论 通过品管圈活动可提高出院产妇母乳喂养调查问卷在随访系统的回复率。

Objective To explore the application and effect of the quality control circle(QCC) on the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system. Methods We set up a quality control circle, identified the project of improving the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system, analyzed the reasons of the low response rate from February to April. Then, we established and implemented improvement measures and compared the result before and after implementation. Results The response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system was raised from 29.9% to 71.7% (P<0.001). Conclusion With application of QCC program, the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system is improved.

目的 探讨血碱性磷酸酶水平对维持性透析患者血管钙化与骨质疏松的评估价值。方法 纳入我院186例维持性透析患者,记录相关临床资料并完善实验室检查,以X线片评价血管钙化情况,双能X线吸收法检查骨密度。对上述资料进行双变量相关分析、ROC曲线分析等统计学处理。结果 血碱性磷酸酶水平与股骨颈骨密度负相关,与腹主动脉钙化评分正相关。腹主动脉钙化评分与骨密度负相关。ALP对骨质疏松及严重腹主动脉钙化诊断的ROC曲线下面积分别为0.777及0.701。结论 碱性磷酸酶是评估透析患者血管钙化骨质疏松的良好指标。

Objective To explore evaluation value of alkaline phosphatase in vascular calcification and osteoporosis in maintenance dialysis patients. Methods 186 patients in maintenance dialysis were enrolled in this study. The related clinical data was recorded. The examination of X-ray (lateral abdomens) was done to estimate vascular calcification in patients. Bone mineral density was measured by dual energy X-ray absorptiometry. The results above were analyzed by bivariate correlation analysis and receiver operator characteristic curve. Results By bivariate correlation analysis,serum alkaline phosphatase level was negatively associated with femoral neck bone mineral density, and was positively associated with abdominal aortas calcification scores. Abdominal aortas calcification scores were negatively associated with femoral neck bone mineral density. ROC curve revealed AUCs were respectively 0.777 and 0.701 for serum alkaline phosphatase level in diagnosis of osteoporosis and severe abdominal aortas calcification. Conclusion Alkaline phosphatase may be a good index to evaluate calcification and osteoporosis in maintenance dialysis patients.

目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

目的 探讨多种教学模式在加强医学生人文素养、沟通意识和沟通能力中的作用。方法 考察多种教学模式培养的临床学生(教学组)和传统模式培养的临床学生(对照组)在人文关怀、沟通技巧、职业素养、医患关系等方面的理论知识和病史询问为主的实践考核情况,并进行对比。结果 多种教学模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(21.03±2.00、20.78±2.11、21.01±2.12、20.91±2.07),病史询问成绩为(16.03±2.13)分,传统模式培养的临床学生在人文关怀、沟通技巧、职业素养、医患关系方面的理论成绩分别为(20.29±2.26、19.84±2.33、20.24±2.49、20.05±2.32),病史询问成绩(14.89±2.43)分,均较多种模式培养组分数低,两组对比差异均有统计学意义(P<0.05)。结论 在神经病学教学中采用多种教学模式对提高学生沟通能力及人文素养有良好的效果。