目的 分析基于视觉传达理论的照顾者思维导图教育在宫颈环扎手术患者中的应用效果。方法 选取2018年1月—2020年1月在我院顺利完成宫颈环切手术的116例患者及主要照顾者为研究对象,采用简单随机法将其分为对照组和观察组,各58例。对照组照顾者给予常规健康教育,观察组照顾者给予基于视觉传达理论的照顾者思维导图教育。比较2组主要照顾者干预前后的照顾负担评分和家属照顾能力测量表(FCTI)评分,并比较2组患者干预前后的焦虑、抑郁水平和健康行为评分,比较2组患者的妊娠结局。结果 干预后较干预前2组主要照顾者的各项照顾负担评分、FCTI评分均降低,且观察组较低;干预后较干预前2组患者的焦虑自评量表、抑郁自评量表评分均降低,且观察组较低。干预后2组患者的各项健康行为评分较干预前均升高,且观察组较高,差异有统计学意义(P＜0.05)。观察组患者的流产、感染的发生率低于对照组,观察组患者的足月分娩产的发生率高于对照组,差异有统计学意义(P＜0.05)。结论 宫颈环扎手术患者的主要照顾者采用基于视觉传达理论的照顾者思维导图教育能够有效缓解其照顾负担,提升照顾能力,进而缓解患者的负性情绪,提高其健康行为,改善妊娠结局。

Objective To analyze the application effect of caregiver mind mapping education based on visual communication theory in patients undergoing cervical cerclage. Methods A total of 116 patients who successfully completed cervical cerclage in our hospital and their main caregivers from January 2018 to January 2020 were selected as the research objects.They were divided into control group and observation group by simple random method, with 58 cases in each group.The caregivers in the control group were given routine health education, and those in the observation group were given mind mapping education based on visual communication theory.The scores of care burden and family caregiver task inventory (FCTI score) of the two groups of main caregivers before and after intervention were compared, and the anxiety, depression levels and health behavior score of the two groups before and after the intervention were compared, and the pregnancy outcome of the two groups was also compared. Results After the intervention, the care burden score and FCTI score of the main caregivers of the two groups were lower than those before the intervention, and the observation group was lower; after intervention, the Self-Rating Depression Scale, Self-Rating Anxiety Scale scores of the two groups were lower than those before intervention, and the observation group was lower.The health behavior scores after intervention were higher than that before intervention, and the observation group were higher (P<0.05).The incidence of abortion and infection in the observation group was lower than that in the control group, and the incidence of full-term delivery in the observation group was higher than that in the control group (P<0.05). Conclusions The caregiver mind mapping education based on visual communication theory can effectively alleviate the care burden, improve the care ability, alleviate the negative emotion of patients, improve their health behavior and improve the pregnancy outcome.

近年来,由于抗生素的不合理使用,导致新型耐药性细菌不断出现,严重危害人类健康,迫使我们急需发现新型抗菌药物来对抗耐药性细菌引起的感染。FtsZ蛋白是细菌分裂的必需蛋白,在细菌分裂增殖过程中起着关键作用。当FtsZ的功能受到抑制时,细菌的分裂增殖亦会被抑制,最终导致细菌死亡。FtsZ蛋白是目前热门的抗菌新靶点之一。本文回顾了FtsZ蛋白的生物学功能,总结了以FtsZ为靶标的新型抗菌分子的研究进展。

Antibiotic-resistant bacterial infection has become epidemic all over the world. To overcome the drug resistance problem, antibacterial agents targeting at new binding sites become critical. FtsZ, a bacterial cell division protein, has become a new attractive target for antibacterial agents’ discovery because it is the most important and conserved protein in bacterial cell division. Cell division will be inhibited when the functions of FtsZ were disturbed. In this article, the biological functions of FtsZ have been reviewed, and recent advances in discovery of FtsZ inhibitors were summarized.

目的 探索视频喉镜下经食道超声(TEE)探头插入在急诊重症患者中的应用。方法 全麻下行非心脏手术的急诊重症患者60名,美国麻醉医师协会分级Ⅱ-Ⅳ级,采用随机数字法分成A组(n=30)和B组(n=30)2组。A组采用盲法插入TEE探头,B组采用视频喉镜辅助插入TEE探头。比较2组探头一次插入成功率、插入所需时间、插入时血流动力学变化、插入时不良反应的情况。结果 B组一次插入成功率(82.8%)高于A组(58.6%),差异有统计学意义(P<0.05)。B组第一次尝试成功插入所需时间长于A组,(24.6±3.1) s vs (15.5±3.0) s, 差异有统计学意义(P<0.05)。成功插入探头所需的总时间2组无差异,差异无统计学意义(P>0.05)。咽喉部损伤B组少于A组(3.4% vs 27.6%),差异有统计学意义(P<0.05)。探头插入时2组患者平均动脉压、心率无明显差异,差异无统计学意义(P>0.05)。结论 视频喉镜可以改善经食道超声探头插入的条件,提高插入成功率,减少相应并发症,可安全用于急诊重症患者的TEE探头插入。

Objective To explore the application of transesophageal echocardiography (TEE) probe insertion under video laryngoscopy in acute severe patients. Methods Sixty acute severe patients, ASA grade II-IV, underwent non-cardiac surgery under general anesthesia were divided into two groups (A and B) evenly by random number method.TEE probe was blindly inserted into the group A patients, and in group B, a video laryngoscope was used to assist the insertion.The first insertion success rate, the time required for insertion, the changes of hemodynamics during insertion, and the adverse reactions incidence during insertion of the two groups were compared. Results The first insertion success rate of the group B (82.8%) was significantly higher than that of the group A (58.6%), the difference was statistically significant (P<0.05). The time required for the first successful insertion of the group B was significantly longer than that of the group A, (24.6±3.1) s vs (15.5±3.0) s, and the difference was statistically significant (P<0.05). The total time required to insert the probe was not significantly different between the two groups (P> 0.05). Throat injury in the group B was significantly less than that in the group A (3.4% vs 27.6%), the difference was statistically significant (P<0.05). The hemodynamics (MAP and HR) of the two groups during insertion were not significantly different (P>0.05). Conclusions Video laryngoscope can improve the conditions of transesophageal ultrasound probe insertion, increase the success rate of insertion, and reduce the corresponding complications.It can be safely used for TEE probe insertion in acute severe patients in an emergency.

目的 观察阶梯式呼吸管理策略在改善感染性休克伴急性肺损伤（ALI）患者中的价值。方法 纳入我院2019年1月—2020年12月收治的感染性休克伴ALI患者共146例为研究对象,数字表法随机分为观察组（73例）与对照组（73例）。对照组常规护理方案,观察组阶梯式呼吸管理,对比干预前后患者心肺功能的差异。结果 观察组平均动脉压、PaCO₂水平低于对照组,心脏指数、中心静脉压、血管外肺水指数、PaO₂与氧合指数高于对照组（P<0.05）;观察组复苏成功率与临床总有效率高于对照组,复苏时间与呼吸平稳时间低于对照组（P<0.05）;观察组气管切开率、有创呼吸机使用率及呼吸机相关性肺炎与气道并发症发生率均低于对照组（P<0.05）。结论 感染性休克并急性肺损伤患者建立阶梯化呼吸管理策略能够显著改善患者的心肺功能,提高临床复苏效果,降低相关并发症风险。

Objective To observe the value of stepwise respiratory management strategy in improving patients with septic shock and acute lung injury（ALI）．Methods A total of 146 patients with septic shock and ALI treated in our hospital from January 2019 to December 2020 were included as the research objects．They were randomly divided into observation group（73 cases）and control group（73 cases）by digital table method．The control group received routine nursing plan,and the observation group received stepwise respiratory management．The differences of cardiopulmonary function before and after the intervention were compared．Results The levels of mean arterial pressure,PaCO₂ in the observation group were significantly lower than those in the control group,cardiac index,central venous pressure,extravascular lung water index,PaO₂ and oxygenation index in the observation group were significantly higher than those in the control group（P<0.05）．The success rate of resuscitation and total clinical effective rate in the observation group were significantly higher than those in the control group,and the resuscitation time and respiratory stability time in the observation group were significantly shorter than those in the control group（P<0.05）．The tracheotomy rate,the rate of using invasive ventilator and the incidence of ventilator associated pneumonia and airway complications in the observation group were lower than those in the control group（P<0.05）．Conclusions The establishment of stepwise respiratory management strategy in patients with septic shock and ALI can significantly improve their cardiopulmonary function,improve the effect of clinical resuscitation and reduce the risk of related complications.

目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例（占比57.52%）,随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低（P<0.05）。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好（P<0.05）,是男性生育的黄金年龄。

Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects．Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases（57.52%）of male semen data of childbearing age in Baiyun District were within the normal range．With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually（P < 0.05）. Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups（P < 0.05）,which is the golden age of male fertility.

肿瘤相关巨噬细胞（TAMs）是肿瘤微环境中最丰富的免疫细胞之一,M2-TAMs在肿瘤发生、发展、转移和治疗过程中发挥重要作用,被认为是肿瘤治疗中的重要靶点。已有的研究表明,通过将促肿瘤的M2-TAMs重编程为促炎的M1-TAMs可实现抑制肿瘤生长和转移。本综述在介绍TAMs与肿瘤治疗相关背景的基础上,重点关注纳米药物重编程TAMs增强抗肿瘤的研究进展。本文将从TAMs靶向递送各种活性物质进行重编程TAMs和纳米药物介导的异常肿瘤微环境调节的间接重编程TAMs两种方式,综述近年来基于纳米药物递送系统的调控策略及典型例子。

Tumor associated macrophages（TAMs）is one of the most abundant immune cells in the tumor microenvironment．M2-TAMs play an important role in tumor genesis,progression,metastasis and treatment,and is additionally a very important target in tumor therapy．Previous studies have shown that inhibition of tumor growth and metastasis can be achieved by reprogramming M2-TAMs to M1-TAMs．On the basis,this review focuses on the analysis progress of nano-drug reprogramming TAMs to boost anti-tumor．In this paper,we reviewed two methods of reprogramming TAMs for targeted delivery of various active substances and indirect reprogramming TAMs for abnormal tumor microenvironment regulation mediated by nanomedicine．The regulatory strategies and typical samples of nanomedicine delivery systems in recent years were summarized.

目的 探究麦默通（Mammotome）微创旋切术加置引流对乳腺良性肿物患者术后疼痛、炎性应激指标及并发症的影响。方法 选取本院2020年1月—2022年1月收治的100例乳腺良性肿物患者,简单随机法进行分组,每位患者赋予1位随机数,1~51号为实验组,采用Mammotome微创旋切术加置引流,52~100号为对照组,实施Mammotome微创旋切术。对比2组治疗效果、围术期指标、术前及术后1 d、3 d疼痛程度（NRS评分）、术前及术后3 d炎性应激指标及并发症情况。结果 2组病灶清除率（100.00%、97.96%）、并发症发生率（3.92%、16.32%）间无差异（P>0.05）;相较于对照组,实验组手术时间较长,残腔积液较少,住院时间较短（P<0.05）;术后1 d、3 d实验组NRS评分低于对照组（P<0.05）;术后3 d 2组C反应蛋白、白介素-6、白介素-1β、降钙素原水平较术前上升,且实验组上升幅度小于对照组（P<0.05）。结论 Mammotome微创旋切术加置引流治疗乳腺良性肿物能减少残腔积液,降低炎症反应程度,有助于术后切口愈合,缓解术后疼痛,且不增加并发症风险。

Objective To investigate the effect of Mammotome minimally invasive excision with drainage on postoperative pain,inflammatory stress indexes and complications in patients with benign breast tumors．Methods A total of 100 patients with benign breast tumors admitted to our hospital from January 2020 to January 2022 were selected and grouped by simple random method,each patient was assigned a random number．Patients No.1 to No.51 were included in the experimental group,treated with Mammotome minimally invasive excision with drainage．Patients No.52 to No.100 were included in the control group,treated with Mammotome minimally invasive excision．The treatment effect,perioperative indicators,pain level（NRS score）and inflammatory stress indexes before and 1st and 3rd days after operation and complications were compared between the two groups．Results There were no significant differences in the lesion clearance rate（100.00% vs 97.96%）and the complication rate（3.92% vs 16.32%）between the two groups（P>0.05）．Compared with the control group,the experimental group had longer operation time,less residual cavity liquid and shorter hospital stay（P<0.05）．The NRS score of the experimental group was lower than that of the control group at 1st and 3rd days after operation（P<0.05）．On the third day after operation,the levels of C-reactive protein,interleukin- 6,interleukin-1β and procalcitonin in the two groups were increased compared with those before operation,and the increase in the experimental group was smaller than that in the observation group（P<0.05）．Conclusions Mammotome minimally invasive excision with drainage in the treatment of benign breast tumors can reduce residual cavity fluid accumulation,reduce the degree of inflammatory response,help postoperative incision healing,relieve postoperative pain,and without increasing the risk of complications．

目的 探讨不同分期的子宫内膜异位症（EMs）患者行体外受精-胚胎移植（IVF-ET）助孕结局与成本效果分析。方法 回顾性分析2016年1月—2022年1月Ⅰ~Ⅱ期、Ⅲ~Ⅳ期EMs患者应用卵泡期长方案及同期因“输卵管因素”患者采用黄体期长方案行IVF-ET的助孕结局以及成本费用。结果 EMs各组的启动日LH、E₂以及hCG日E₂水平低于对照组（P<0.05）,Ⅲ~Ⅳ期EMs组的可利用胚胎数、着床率、临床妊娠率、活产率明显低于对照组及Ⅰ~Ⅱ期EMs组（P<0.05）,其流产率偏高,但组间比较差异无统计学差异（P>0.05）。各组间的Gn剂量、Gn天数、hCG日的LH水平、hCG日≥14 mm卵泡数、hCG日子宫内膜厚度、获卵数、受精率、卵裂率比较差异无统计学意义（P>0.05）。成本效果分析提示：各组平均周期总成本无明显差异,Ⅰ~Ⅱ期EMs组患者患者获得一例妊娠所花费的成本与对照组相当,而Ⅲ~Ⅳ期EMs组患者获得一例妊娠所花费的成本最高。结论 对于不同分期的EMs,Ⅰ~Ⅱ期患者应用卵泡期长方案的患者可获得良好的妊娠结局,其妊娠率及成本与传统方案相当,而Ⅲ-Ⅳ期的患者妊娠率偏低,获得妊娠的成本更高,可能与该疾病严重程度及方案选择有关。

Objective To analyze the outcome and cost-effectiveness of invitrofertilization-embryotransfer（IVF-ET）assisted pregnancy in endometriosis（EMs）patients with different stages．Methods The outcomes and costs of patients with stageⅠ-Ⅱ and Ⅲ-Ⅳ EMs treated with follicular phase long protocol and patients treated with luteal phase long protocol due to“tubal factors” during the same time from January 2016 to January 2022 were retrospectively analyzed．Results The levels of LH,E2 on initiation day and the levels of E2 on hCG day in EMs groups were lower than those in control group（P<0.05）,the number of available embryos,implantation rate,clinical pregnancy rate and live birth rate in stage Ⅲ-Ⅳ EMs group were significantly lower than those in control group and stageⅠ-Ⅱ EMs group（P<0.05）,and the abortion rate was higher．But there was no significant difference between groups（P>0.05）．There were no significant differences in the dosage of Gn,duration of Gn,the levels of LH on hCG day,the number of follicles with diamete≥14 mm on hCG day,endometrial thickness on hCG day,number of oocytes retrieved,fertilization rate and cleavage rate among the three groups（P>0.05）．Conclusions For different stages of endometriosis,patients in stageⅠ-Ⅱ who apply the follicular phase long protocol can achieve good pregnancy outcomes,and their pregnancy rate and cost are comparable to the traditional regimen,while patients in stage Ⅲ-Ⅳ have a low pregnancy rate,and the cost of pregnancy is higher,which should be related to the severity of the disease and the choice of regimen.

目的 研究母代不同孕期巨细胞病毒（CMV）感染对自身精神及行为的影响。方法 72只BALB/c雌鼠随机分为12组（A1、A2、A3、B1、B2、B3、C1、C2、C3、D1、D2、D3,每组6只）,A为孕期再感染、B为既往感染、C为孕期原发感染、D为空白对照,1为孕早期、2为孕中期、3为孕晚期。母鼠腹腔注射小鼠CMV（murine CMV,MCMV）Smith株建立播散性感染模型,或注射无菌生理盐水建立对照模型。母鼠产仔后同笼合养,产后22 d分笼;母鼠做行为学试验。试验结束,每组随机处死3只母鼠;测量子宫、肝、脑脏器重量系数及唾液腺中MCMV含量。结果 A、B、C组母鼠产后次日体质量均低于D组（均P<0.05）,其中C2、C3组母鼠低体质量情况持续至产后22日（均P<0.05）。A、B、C组母鼠唾液腺组织均测出MCMV。与D组母鼠相比,A1、C1组母鼠活胎率降低（均P<0.05）,A、C组母鼠的子宫、肝、脑脏器系数升高（均P<0.05）且脑组织有病损表现。产后6天时,A3、B3、C组母鼠水平运动总距离和直立次数减少（均P<0.05）,糖水偏好量降低（均P<0.05）,悬尾不动时间延长（P<0.05）;其中,C2、C3组母鼠以上行为退缩情况至产后22天仍存在,且有逃避潜伏时间延长（均P<0.01）,穿越原平台位置次数减少（均P<0.01）情况。结论 孕期CMV感染损害母代身心健康,有可能增加子代不良抚养的风险。

Objective To investigate the effects of cytomegalovirus（CMV）infection in different stages of maternal pregnancy on its own spirit and behavior．Methods A total of 72 female BALB/c mice were randomly divided into 12 groups（each group had 6 mice）：A1-A3,B1-B3,C1-C3,D1-D3（group A had re-infection,group B had previous infection,group C had primary infection,group D was blank control,group 1 was in early pregnancy,group 2 was in middle pregnancy,group 3 was in late pregnancy）．The disseminative infection model was established by intraperitoneal inoculation of murine CMV（MCMV）Smith strain,and the blank control model was established by intraperitoneal inoculation of 0.9% sterile saline（NaCl）．After 21 days of parturition,the mothers and offspring were reared in separate cages,mothers were selected for the behavior experiments．At the end of all the behavior tests,3 mothers in each group were killed randomly．Weighed and calculated the organ coefficients of the uteri,livers and brains,and detected the expression levels of MCMV in salivary gland．Results On the first day after delivery,the weights of mothers in groups A,B and C were lower than those in group D（all P<0.05）,the low body weight of mice in C2 and C3 groups lasted to the 22th day（all P<0.05）．The MCMV in salivary gland tissue were found in groups A,B and C,but not in group D．The live fetus rates of groups A1 and C1 were significantly lower than that of group D．The organ coefficients of uteri,livers and brains in groups A and C were higher than those in group D（all P<0.05）．And the lesions of brain tissues in groups A and C were more serious than in the other groups．On the 6th day,compared with the other groups,the mothers of groups A3,B3 and C were significantly abnormal in the open field test,the tail suspension test and the sugar preference test（all P<0.05）．But on 22th day,only the mothers of groups C2 and C3 were significantly abnormal in those tests（all P<0.01）,and even in the water maze test（all P<0.01）．Conclusions Maternal CMV infection in different stages pregnancy have impacts on mother mice's physical and mental health．Those bad situations may bring poor parenting to the offspring．

目的 探讨与分析推拿联合补肾祛瘀针刺法治疗慢性腰肌劳损恢复期患者对腰部疼痛及表面肌电图的影响。方法 选择2019年9月—2022年4月我院收治的72例慢性腰肌劳损恢复期患者为研究对象,根据随机1∶1数字表法,分为联合组与对照组各36例。对照组给予推拿治疗,联合组在此基础上,给予补肾祛瘀针刺法治疗,2组均治疗并观察4周,评价腰部疼痛及表面肌电图变化情况。结果 治疗后联合组与对照组的总有效率分别为97.2%和75%,联合组高于对照组（P<0.05）;治疗前,2组患者的视觉类比疼痛评分法（VAPS）和下腰痛失能问卷（OPDG）评分比较差异无统计学意义,治疗后,2组患者的VAPS和OPDG评分均降低,且联合组低于对照组（P<0.05）;2组治疗后的腰椎前屈力度都高于治疗前（P<0.05）,且联合组更高（P<0.05）;2组治疗后的表面肌电图神经根振幅和潜伏期均低于治疗前（P<0.05）,且联合组更低（P<0.05）。联合组与对照组治疗后的血清5-HT含量均高于治疗前（P<0.05）,联合组更高（P<0.05）。结论 推拿联合补肾祛瘀针刺法在慢性腰肌劳损恢复期患者中的应用具有良好的安全性,有效改善患者的腰椎功能,缓解患者疼痛,提高整体治疗效果,也能改善患者的表面肌电图状况,促进血清5-HT的释放。

Objective To explore and analyze the effects of massage combined with kidney tonifying and blood stasis removing acupuncture on lumbar pain and surface electromyography in patients with chronic lumbar muscle strain in the recovery period．Methods From September 2019 to April 2022, 72 cases of patients in the recovery period of chronic lumbar muscle strain treated in our hospital were selected as the research objects, and were divided into the combined group and the control group with 36 cases in each group by the random 1∶1 number table method．The control group were given massage therapy, and the combination group were given kidney tonifying and stasis removing acupuncture additionally．Results After treatment, the total effective rates of combined group and control group were 97.2% and 75%, respectively, and the combined group was significantly higher than the control group（P<0.05）．Before treatment, there was no significant difference in the visual analogue pain scale（VAPS）and Oswestry low pain & disability questionnaire（OPDG）scores between the two groups, but after treatment, the scores of the two groups were significantly decreased, and the combined group was significantly lower than the control group（P<0.05）．The lumbar flexion intensity after treatment was significantly higher in both groups than before treatment（P<0.05）, and higher in combination group（P<0.05）．The amplitude and latency of surface electromyogram nerve roots after treatment were significantly lower in both groups than before treatment（P<0.05）, and even lower in combination group（P<0.05）．The serum 5-HT content in combination group and control group after treatment was significantly higher than that before treatment（P<0.05）, and that in combination group was higher（P<0.05）．Conclusions The application of massage combined with kidney tonifying and blood stasis removing acupuncture in patients recovering from chronic lumbar muscle strain has good safety, which can improve the lumbar function of patients, relieve the pain of patients, improve the overall therapeutic effect, improve the surface electromyography of patients and promote the release of serum 5-HT．