目的 观察体重管理对轻型代谢综合征患者的体重指数、血糖、血压、甘油三酯等指标的影响。方法 将40例新诊断的轻型代谢综合征患者随机分成体重管理组和对照组,每组20例。两组患者分别于干预前、干预3月、干预6月检测体重指数、血糖、血压、甘油三脂等治疗,并比较两组患者上述指标。结果 干预6月后,体重管理组的体重指数、甘油三酯均显著性低于对照组,差异有统计学意义(P均＜0.05);体重管理组的高密度脂蛋白高于对照组,但无统计学差异。干预6月,体重管理组中血压、血糖达标率高于对照组,差异有统计学意义。结论 体重管理能改善轻型代谢综合征患者的体重指数、血糖、血压、甘油三脂等指标。

Objective To investigate the influence of weight management to body index, blood glucose, blood pressure and triglycerides in mild metabolic syndrome. Methods 40 mild metabolic syndrome patients were randomly divided into weight management group (20 patients) and control group (20 patients). The body index, blood glucose, blood pressure and triglycerides were observed and compared before intervention, 3 months and 6 months after intervention. Results After 6 months intervention, the body index and triglycerides in weight management group were significantly lower than the control group (P＜0.05). High density lipoprotein cholesterol in the weight management was higher than the control group, but there was no significant. The success rate of blood glucose and blood pressure were significantly higher than the control group. Conclusion Weight management can significantly improve the body index, blood glucose, blood pressure and triglycerides in patients with mild metabolic syndrome.

目的 探讨血浆脑利钠肽前体(proBNP)和心肌损伤标志物(CK-MB和cTnI)联合检测对老年脓毒症患者心肌损伤及预后评估的临床意义。方法 选择60例老年脓毒症患者按病情严重程度分为一般脓毒症组和严重脓毒症组,另选取同期在我院行健康体检的同龄人30例作为对照组。比较三组和不同预后患者血浆proBNP、cTNI、CK-MB水平及急性生理和慢性健康状态评分Ⅱ(APACHE Ⅱ) ,并对各指标进行相关性分析。结果 脓毒症患者血浆proBNP、cTnI水平高于对照组,且严重脓毒症组APACHEⅡ评分高于一般脓毒症组(均P＜0. 05);死亡组患者其血浆中的proBNP,cTNI和CK-MB水平及APACHE Ⅱ评分均高于存活组患者(均P＜0.05),差异有统计学意义;严重脓毒症组患者血浆proBNP 水平与cTnI及CK-MB水平呈正相关性(P＜0.05); 血浆proBNP水平、cTnI水平、CK-MB水平分别与APACHEⅡ评分呈正相关性(P＜0.05)。结论 血浆proBNP 及cTnⅠ水平可有效反映老年脓毒症患者心肌受损程度,早期血浆proBNP、cTnI、CK-MB水平联合检测对老年脓毒症患者预后判断可能有重要临床意义。

Objective To study the clinical significance of cardiac injury biomarkers(CK-MB and cTnI) and pro-brain natriuretic peptide(proBNP) joint detection for prognosis value in Elderly sepsis. Methods Sixty elderly patients with sepsis were selected. According to the severity of disease divided into general and severe sepsis group.Meanwhile, 30 healthy volunteers as a control group. Comparative study of plasma proBNP, cTnI, CK-MB levels and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in three groups;and the correlation analysis of the indicators. Results Compared with control group, the plasma levels of proBNP and cTnI were significantly higher in patients with sepsis; And the APACHEⅡ score in the severe sepsis group was significantly higher than the general sepsis group (P<0. 05). The plasma proBNP, cTnI, CK-MB level and APACHE Ⅱ scores in death group were significantly higher than the survival group (P<0. 05). The proBNP plasma levels, cTnⅠ and CK-MB levels in severe sepsis patients were positively correlated (P<0. 05); They were positively correlated between ProBNP level, cTnⅠ level and the APACHEⅡ score(P<0. 05). Conclusions ProBNP plasma levels and cTnⅠ can effectively reflect the extent of the cardiac damage in elderly sepsis; Early plasma proBNP level, cTnI and CK-MB combined detection of elderly sepsis may have important clinical significance.

目的 探讨内科治疗的高血压基底节区出血的疗效及预后相关的因素。方法 回顾性分析2005年4月—2014年12月贵阳市第二人民医院神经外科收治的174例高血压脑出血患者的临床资料,所有患者均采用内科保守治疗,对疗效及影响患者预后的因素进行分析。结果 174例患者中,死亡50例,持续植物生存状态4例,对124例存活患者进行随访,随访时间2~117个月,随访ADL分级Ⅰ级43例,Ⅱ级53例,Ⅲ级21例,Ⅳ级3例,Ⅴ级4例,预后较好者(ADL分级Ⅰ~Ⅱ级)96例,预后不良者(ADL分级Ⅲ~Ⅴ级)28例。χ²检验显示入院 GCS评分和出血量是影响患者预后的因素。结论 影响高血压基底节区脑出血患者的预后因素较多,GCS评分较高、出血量少的患者可采用内科治疗,多数患者预后较好。

Objective To investigate treatment efficacy and the factors influencing prognosis of conservative treatment of hypertensive intracerebral hemorrhage in basal ganglia. Methods A retrospective analysis was conducted on the clinical data of 174 patients with hypertensive intracerebral hemorrhage in basal ganglia who were admitted to our hospital during the period from April 2005 to December 2014. All the patients were given internal medicine conservative treatment and followed up to observe the clinical curative effect to analyze the prognosis. Results Of the 174 patients, 50 patients died and 4 patients were persistent vegetative state. 124 patients were followed up for 2-117 months and they were classified according to ability of daily life(ADL) prognosis scale: 43 cases were in I grade, 53 cases in II grade, 21 cases in III grade, 3 cases in IV grade, 4 cases in V grade. 96 cases achieved favourable outcomes and 28 cases got poor outcomes.The results of Chi square test revealed that GCS scale and intracerebral hemorrhage volume were the factors influencing prognostic of hypertensive intracerebral hemorrhage in basal ganglia. Conclusion There were many prognosis factors related with hypertensive intracerebral hemorrhage. The curative effect and prognosis in patients with conservative treatment is obvious in these patients with high GCS scale and less intracerebral hemorrhage volume.

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 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 调查分析病案首页疾病诊断存在的问题,以提出针对性的干预对策。方法 由病案科编码员根据《卫生部关于修订下发住院病案首页的通知》相关规定,对抽取的4200份病案首页的疾病诊断进行检查,对疾病诊断问题分类记录,同时对其发生原因进行问卷调查,建立相应数据库,应用Excel统计工具进行统计分析。结果 共748份的疾病诊断存在问题,发生率高达17.8%,包括疾病诊断中主要诊断选择错误8.3%、疾病诊断的名称不规范7.6%,以及漏诊问题1.8%。疾病诊断存在问题发生率较高的临床科室为内分泌科38.0%,骨科科32.8%,肿瘤科31.6%。在读研究生最容易出现疾病诊断问题,发生率高达48.0%。结论 对疾病诊断存在问题的高发临床医师群体和临床科室进行针对性干预对策,有望降低病案首页疾病诊断问题的发生率。

Objective To investigate the defects analysis and targeted intervention on the diseases diagnosis in the home pages of medical records. Methods To conduct an inspection analysis on the four thousand and two hundred medical records according to the related requirements of “Notification on Standard writing in Home Pages of Hospitalization Medical Records announced by the Ministry of Health” by professional medical records staff.They found out and classified the defects on the diseases diagnosis in the home pages of medical records,at the same time,questionnaire survey were carried on to investigate the related causes,and the corresponding database establish ed.Excel statistical tools were applied for statistical analysis. Results There were defects on the diseases diagnosis in a total of seven hundred and forty-eight cases,the incidence of which was 17.8%,including 8.3% of mistakes of main diagnosis,7.6% of lack of standardization in diagnosis names,1.8% of missed diagnosis respectively.Defects on the diseases diagnosis occurred in a higher rate in the clinical departments,such as department of endocrine with 38.0%,department of orthopedics with 32.8%,and department of oncology with 31.6%.Graduate students most prone to make mistakes with defects on the diseases diagnosis,the incidence of which was 48.0%. Conclusion Targeted interventions to clinician groups and clinical departments with high incidence of defects on the diseases diagnosis,is expected to reduce the incidence of which in the home pages of medical records.

目的 探察老年冠心病无痛性心肌缺血的临床护理效果。方法 选取我院冠心病患者68例,按照护理方式的不同分为观察组与对照组,每组34例;对照组患者给予常规护理,观察组在对照组的基础上给予患者优质的临床护理;观察两组患者的临床护理效果。结果 临床护理后,两组患者的症状均有缓解,但观察组患者心肌缺血的发作次数、发作时间、ST段压低减少的次数及下移减少量显著优于对照组,结果差异有统计学意义(P＜0.05)。结论 对老年冠心病无痛性心肌缺血患者采用针对性合适的临床护理,缓解了患者的临床症状,减少了心肌缺血的发作次数,改善了患者的并发症,效果显著,值得推广。

目的 体外构建胶原—壳聚糖复合支架材料,分析其物理化学性质及生物相容性,探讨其应用于组织工程支架材料的可行性。方法 利用冷冻干燥的方法构建三维多孔的胶原支架材料,通过甲醛交联以及添加壳聚糖的方法改善其物理化学性能。通过体外降解实验以及电镜扫描的方法检测材料的各项物理化学指标;通过细胞接种的方法研究材料的生物相容性。结果 胶原—壳聚糖复合材料通过冷冻干燥的方法,能够获得稳定的三维多孔结构,电镜显示孔隙贯通,体外降解速度降低,并且能够支持细胞生长。理化性质分析显示该结构适合细胞生长,具有良好的生物相容性。结论 本课题体外构建胶原—壳聚糖复合支架材料,满足组织工程生物材料的理化以及生物相容性要求,为其应用于组织工程支架材料提供重要的依据。

Objective We build up the Collagen-Chitosan compound scaffold in vitro,and study the physical,chemical and biological properties,to analyze the feasibility in tissue engineering. Methods The three-dimensional porous scaffold was obtained by freezing-drying method,and optimized by using formaldehyde and Chitosan.We used hydrolysis in vitro and SEM scanning to investigate its physical and chemical properties.The biocompatibility of scaffold was analyzed in MEF cells. Results Collagen-Chitosan compound scaffold we obtained by freezing-drying method was a kind of stable 3D vesicular structure.The scaffold degenerated in decreased velocity in vitro.The physical and chemical properties showed that it was suitable for the cells grow in it,which suggested that it has a good biocompatibility. Conclusion This kind of Collagen-Chitosan compound scaffold is constructed.It's qualified by the physical and chemical properties,and biocompatibility which the biomaterials require.The evidence are important for its application in tissue engineering.

目的 探讨拉米夫定治疗对乙肝活动的肺结核病人抗结核治疗中的临床价值。方法 通过回顾性分析159例初治肺结核乙肝表面抗原(HBsAg)阳性、HBV-DNA定量阳性病人,所有病例在抗结核前查肝功能均正常,分为两组,治疗组:在抗结核及护肝治疗过程中,加用拉米夫定抗乙肝病毒治疗;对照组:没用任何抗乙肝病毒药物;分别在抗结核治疗前、治疗2周、4周及8周复查肝功能,对比两组间肝损发生率,及肝损发生时间及严重程度。抗结核治疗4周后复查HBV-DNA定量,对比两组间HBV-DNA定量下降例数。结果 治疗组的肝损发生率仅20.5%,对照组病人抗结核治疗后肝损的发生率为53.1%,两者间差异有统计学意义。治疗组肝损出现时间多为大于4周,而且多数是轻度肝损。治疗组出现肝损中断抗结核治疗的病例数低于对照组。抗乙肝病毒治疗后复查HBV-DNA定量降低例数高于对照组。结论 拉米夫定抗乙肝病毒治疗,能抑制乙肝病毒复制,降低乙肝合并肺结核病人的肝损发生率并减轻肝损严重程度,提高病人对抗结核药物的耐受性。

目的 探讨体感音乐疗法对青少年视疲劳患者症状缓解的影响。方法 选择青少年视疲劳患者72例,随机分为观察组和对照组各36例,两组患者均给予矫正用眼习惯、多运动、均衡饮食等护理,观察组在此基础上给予体感音乐疗法,3个月后比较两组视疲劳症状缓解情况。结果 干预后观察组视疲劳症状缓解程度及症状评分优于对照组,两组比较差异有统计学意义(P＜0.05)。结论 对青少年视疲劳患者实施体感音乐疗法,可起到促进眼部肌肉放松,改善微循环,增强睫状肌收缩力,改善虹膜睫状体调节功能,缓解视疲劳的效果。

Objective To explore the influence of vibroacoustic therapy on visual fatigue teenagers. Methods 72 visual fatigue teenagers were randomly and equally divided into the observation group and the control group. Both groups were accepted nursing in terms of the correction of eye habits, doing more sports and balanced diet, while the observation group was also accepted vibroacoustic therapy. After three months the conditions of these two groups in terms of visual fatigue were compared. Results After the intervention the degree of visual fatigue relief and the score of symptoms in the observation group were higher than those in the control group, and these differences have statistic significance (P＜0.05). Conclusion Vibroacoustic therapy can help visual fatigue teenagers to relax muscles of eyes, improve microcirculation, strengthen ciliary muscle contractile force, improve the regulatory function of iris ciliary and relieve visual fatigue.