[目的]探讨食管癌患者血管内皮生长因子(VEGF)、中性粒细胞明胶酶相关载脂蛋白(NGAL)及转化生长因子(TGF-β1)水平与细胞侵袭、转移的关系.[方法]选择80例食管癌患者设为食管癌组,将同期体检正常者50例设为正常组,比较两组血清VEGF、NGAL及TGF-β1水平;依据食管癌组患者是否发生细胞侵袭、转移分为转移组(n=30)及非转移组(n=50),比较各组基本资料及血清VEGF、NGAL、TGF-β1水平,并对患者发生细胞侵袭、转移的影响因素进行多因素Logistic回归分析,采用受试者工作特征(ROC)曲线评估相关指标预测患者发生细胞侵袭、转移的价值.[结果]食管癌组患者血清VEGF、NGAL及TGF-β1水平均高于正常组(P＜0.05).转移组肿瘤发生胸上段部位、分化为低度、肿瘤直径≥2 cm、有淋巴结转移占比及血清VEGF、NGAL及TGF-β1水平均高于非转移组(P＜0.05);ROC分析证实,血清VEGF、NGAL、TGF-β1水平可用于患者发生细胞侵袭、转移的预测,曲线下面积分别为0.806、0.934、0.912(P＜0.05);Logisitic回归分析显示,肿瘤发生胸上段部位、分化为低度、肿瘤直径≥2 cm、VEGF≥266.976 pg/mL、有淋巴结转移、NGAL≥5.088 μg/L、TGF-β1≥10.025 ng/L均是导致食管癌发生细胞侵袭、转移的危险因素(P＜0.05).[结论]食管癌患者VEGF、NGAL及TGF-β1水平显著高于正常人,且转移患者明显高于非转移患者,VEGF、NGAL、TGF-β1与食管癌细胞产生、侵袭、转移密切相关,可作为食管癌筛查和病情评估的指标.
[目的]探讨将赋能理论下多维心理疏导及抗组训练应用在乳腺癌根治性术后患者中对其上肢淋巴水肿和生活质量的影响.[方法]在本院实施手术治疗的90例乳腺癌患者,根据倾向性评分将其分为两组,每组45例.对照组给予常规护理及抗阻训练,观察组在对照组基础上实施赋能理论下多维心理疏导.比较两组上肢淋巴水肿、心理资本状态及生活质量改善情况.[结果]干预前,两组患者上肢水肿情况、各项积极心理资本问卷(PPQ)评分、各项乳腺癌生命质量量表(FACT-B)评分比较,差异均无统计学意义(P＞0.05);干预后8周,观察组上肢周径差、上肢体积差、上肢淋巴流量等上肢水肿指标均低于对照组(P＜0.05);观察组乐观、韧性、希望、自我效能及PPQ总分均优于对照组(P＜0.05);观察组各项FACT-B评分均优于对照组(P＜0.05).[结论]乳腺癌根治性术后患者采用赋能理论下多维心理疏导及抗组训练,可提升患者对治疗和护理的配合度,促进肢体水肿快速消除,提高患者生活质量.
[目的]探讨慢性病轨迹模式的流程护理在术后放疗的脑胶质瘤患者中的应用效果.[方法]选取2020年4月至2021年4月渭南市中心医院收治的118例术后放疗的脑胶质瘤患者,根据随机数字表法将其分为观察组和对照组,每组59例.对照组实施常规护理流程,观察组实施慢性疾病轨迹模式的流程护理.比较两组不良反应发生率,采用心理弹性量表简化表(CD-RISC)、癌症患者生命质量测定量表(EORTC QOL-C30)评估两组护理前、护理1周后的心理弹性水平和生活质量.[结果]观察组不良反应发生率低于对照组,差异有统计学意义(P＜0.05).护理1周后,两组患者坚韧、乐观、自强评分高于护理前,且观察组高于对照组,差异有统计学意义(P＜0.05);两组患者躯体功能、社会功能、情绪功能、角色功能、认知功能、总体健康评分均高于护理前,且观察组高于对照组,差异有统计学意义(P＜0.05).[结论]慢性病轨迹模式的流程护理有助于降低脑胶质瘤患者术后放疗不良反应发生率,提高其心理弹性水平,改善其生活质量.
[Objective]To explore the clinical effect of scalp acupuncture and rehabilitation therapy com-bined with traditional Chinese medicine five tone therapy on children with autism and intellectual impairment.[Methods]A total of 124 children with autism and intellectual disabilities admitted to our hospital from August 2020 to February 2022 were selected and randomly divided into a control group(treated with traditional Chinese medicine five tone therapy)and an observation group(treated with scalp acupuncture and intellectual rehabilita-tion therapy on the basis of the control group)using a random number table method,with 62 cases in each group.Both groups received continuous treatment for 6 months.The behavioral and symptom scores of autism in both groups were compared before and after treatment,as well as the clinical efficacy of the two groups.The changes in emotions,sleep scores,visual and auditory functions,and intelligence levels of the two groups of children were compared before and after treatment.[Results]The difference in scores of the childhood autism rating scale(CARS)and Autism Behavior Rating Scale(ABC)before and after treatment in the observation group was higher than that in the control group(P＜0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The difference in scores of the emotional regulation scale(ER)and children's sleep habits questionnaire(CSHQ)be-fore and after treatment in the observation group was higher than that in the control group(P＜0.05).The difference in attention quotient(FAQ)and comprehensive response control quotient(FRCQ)scores between the observation group and the control group before and after treatment was higher(P＜0.05).The difference in verbal intelligence(VIQ)and operational intelligence(PIQ)before and after treatment in the observation group was higher than that in the control group(P＜0.05).[Conclusion]The combination of scalp acupunc-ture and rehabilitation therapy with traditional Chinese medicine five tone therapy can improve the symptoms of loneliness in children with autism and intellectual disorders.The clinical efficacy is good,and it can improve the emotional and sleep conditions of children,and help improve their visual and auditory functions and intelli-gence levels.
[Objective]To investigate the efficacy of magnesium sulfate in treating elderly patients with cerebral hemorrhage complicated with hypomagnesemia and its effects on endothelin(ET)and nitric oxide(NO)levels.[Methods]A total of 93 patients with cerebral hemorrhage complicated with hypomagnesemia ad-mitted to our hospital were randomly divided into the observation group(n=47)and the control group(n=46).Both groups received conventional symptomatic treatments such as intracranial pressure reduction,hemo-stasis,and oxygen inhalation.The control group was intravenously dripped with Xingnaojing,while the obser-vation group received magnesium sulfate treatment on top of the control group's treatment.The clinical effica-cy,serum magnesium,ET,NO levels,and scores from the National Institutes of Health Stroke Scale(NIHSS)and activities of daily living(ADL)were compared before and after treatment.[Results]The total effective rate of treatment in the observation group was higher than that in the control group(P＜0.05).After treatment,the serum magnesium levels in both groups increased compared to before treatment,while ET and NO levels decreased(P＜0.05).The observation group had higher post-treatment serum magnesium levels and lower post-treatment ET and NO levels than the control group(P＜0.05).One and two weeks post-treatment,the ADL scores of both groups showed an upward trend,and the NIHSS scores showed a downward trend(P＜0.05).Moreover,the post-treatment ADL score of the observation group was higher and the post-treatment NIHSS score was lower in the observation group than those in the control group(P＜0.05).[Conclusion]Magnesium sulfate has a good therapeutic effect on elderly patients with cerebral hemorrhage complicated with hypomagnesemia.It helps to increase serum magnesium,reduce NO and ET levels,promote the recovery of neurological function,and has significant application value.
[Objective]To explore the value of early CT score(ASPECTS)and CT perfusion imaging pa-rameters(CTP)in the prognosis evaluation of patients with acute ischemic stroke(AIS)in the Alberta Stroke Project.[Methods]A total of 65 AIS patients were divided into a good prognosis group of 36 cases and a poor prognosis group of 29 cases based on their prognosis.We compared the clinical data,National Institutes of Health Stroke Scale(NIHSS)scores,stroke types,ASPECTS scores,and CTP between two groups of pa-tients,and performed multiple logistic regression analysis on the data with differences between the two groups to identify the factors affecting the prognosis of AIS patients.The value of predicting poor prognosis in AIS pa-tients was predicted by analyzing the receiver operating characteristic(ROC)curve of cerebral blood flow(CBF),cerebral blood volume(CBV),and mean transit time(MTT).[Results]The proportion of patients in the poor prognosis group with NIHSS score＞7,multiple stroke,cardioembolic stroke,cerebral arteritis,and ASPECTS score ≤7 was significantly higher than that in the good prognosis group(P＜0.05);The CBF,CBV,and MTT of the poor prognosis group were significantly lower than those of the good prognosis group(P＜0.05).ROC analysis showed that CBF,CBV,and MTT can all be used for predicting poor prog-nosis in AIS patients,with areas under the curves of 0.828,0.992,and 0.754,respectively(all P＜0.05).Multivariate logistic regression analysis showed that NIHSS score＞7,multiple stroke,cardioembolic stroke,cerebral arteritis,ASPECTS score ≤7,CBF≤12.870 mL/100 g/min,CBV≤8.890 mL/100 g,MTT≤16.425 s were risk factors affecting the prognosis of AIS patients(P＜0.05).[Conclusion]NIHSS score,multi-ple stroke,cardioembolic stroke,cerebral arteritis,ASPECTS score,and CTP parameters are all factors that affect the prognosis of AIS patients,and should be taken seriously in clinical practice.
[Objective]To explore the application value of serum 25-hydroxyvitamin D3 combined with bone metabolism index in the screening of elderly osteoporosis.[Methods]A total of 96 elderly osteoporosis patients admitted to our hospital from July 2020 to July 2022 were selected as the observation group,and 96 healthy elderly people who underwent physical examination during the same period were selected as the control group.Patients in both groups underwent lumbar spine bone density,femoral neck bone density measure-ments,as well as measurements of serum 25-hydroxyvitamin D3[25-(OH)D3],bone metabolism indices(N-MID,P1NP,β-CTX),and inflammatory factors(TNF-α,IL-6).The test results of the two groups were compared.[Results]The lumbar spine bone density and femoral neck bone density of the observation group were significantly lower than those of the control group,while levels of N-MID,P1NP and β-CTX in the obser-vation group were higher than those in the control group.The serum 25-(OH)D3 level in the observation group was lower than that in the control group,and levels of inflammatory factors TNF-α and IL-6 in the observation group were significantly higher than those in the control group.The differences were statistically significant(P＜0.05).[Conclusion]The detection of serum 25-(OH)D3 combined with bone metabolism index in the screen-ing of elderly osteoporosis can significantly improve the screening effect and early detection rate,help to assess the patient's condition and quality of life,and has important clinical application value.
[目的]探讨宫颈癌组织内糖类抗原19-9(CA19-9)、碱性成纤维细胞生长因子(bFGF)水平及其与患者临床病理特征的相关性.[方法]获取100例经手术治疗的宫颈癌患者的癌组织及癌旁正常组织标本,采用免疫组化法检测组织中的CA19-9、bFGF表达情况,分析宫颈癌组织中CA19-9、bFGF水平与病理特征的关系.[结果]宫颈癌组织中bFGF、CA19-9阳性表达率分别为31.00％(31/100)和46.00％(46/100),明显高于癌旁组织的5.00％(5/100)和8.00％(8/100),且两组比较差异均有统计学意义(P＜0.05).宫颈癌组织bFGF和CA19-9阳性表达中有淋巴结转移,低分化,FIGO分期Ⅲ、Ⅳ期及肌层浸润程度≥1/2占比均明显高于癌组织中bFGF阴性表达(P＜0.05);Logisitic回归分析显示,有淋巴结转移,低分化,FIGO分期Ⅲ、Ⅳ期,肌层浸润程度≥1/2均是导致宫颈癌组织bFGF和CA19-9阳性表达的危险因素(P＜0.05).[结论]CA19-9、bFGF在宫颈癌组织中的表达水平升高,且表达水平与宫颈癌的淋巴转移、分化程度、肌层浸润程度、临床分期存在相关性,可作为评估宫颈癌严重程度的有效指标.
[目的]探讨基于依从性曲线规律为指导的阶段康复联合共情理念对脑梗死患者康复效果的影响.[方法]选取2018年2月至2020年2月本院收治的80例脑梗死患者,根据随机数字表法将其分为对照组和观察组,每组40例.对照组实施常规干预及共情理念干预,观察组在对照组基础上实施依从性曲线规律为指导的阶段康复训练.比较两组患者负性情绪改善情况、肢体功能、平衡能力、日常生活能力、遵医嘱行为依从性.[结果]干预后,观察组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均低于对照组,差异有统计学意义(P＜0.05);观察组改良Barthel指数评分、Berg平衡量表评分及Fugl-Meyer运动功能量表评分均高于对照组,差异有统计学意义(P＜0.05);观察组患者服药、饮食、肢体功能训练、生活方式遵医嘱行为依从性好所占比例均高于对照组,差异有统计学意义(P＜0.05).[结论]基于依从性曲线规律为指导的阶段康复联合共情理念有助于改善脑梗死患者负性情绪,提高其对康复训练的依从性,有助于改善患者的 日常生活能力、运动功能、平衡功能.
[目的]比较阿芬太尼与舒芬太尼麻醉在吸脂手术中的效果及安全性.[方法]80例择期行吸脂手术的患者,随机分为观察组与对照组,每组40例.两组患者术前常规禁食、禁水,观察组患者静脉输注阿芬太尼,对照组静脉输注舒芬太尼,比较两组麻醉效果,围术期指标,麻醉前、手术开始时、清醒时血流动力学指标[平均动脉压(MAP)、心率(HR)、脉氧饱和度(SPO2)]和不良反应发生情况.[结果]两组麻醉效果比较,差异无统计学意义(P＞0.0 5).观察组起效时间、意识恢复时间、清醒时间显著短于对照组,观察组依托咪酯用量显著低于对照组(P＜0.05).两组麻醉前、手术开始时、清醒时MAP、HR、SPO2水平比较,差异均无统计学意义(P＞0.05).观察组不良反应总发生率显著低于对照组(P＜0.05).[结论]阿芬太尼与舒芬太尼在吸脂手术中的麻醉效果相当,但阿芬太尼更适合于吸脂类小型手术,能够缩短起效时间、意识恢复时间等围术期指标,且使用阿芬太尼不良反应发生少,具有较高安全性.
[Objective]To discuss the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),diffusion-weighted imaging(DWI),and multislice spiral CT(MSCT)enhancement scanning in the differential diagnosis of hepatic hemangioma and liver metastatic carcinoma.[Methods]Thirty-eight patients with liver metastatic carcinoma were enrolled in the metastasis group,and thirty-two patients with hepatic he-mangioma were recruited in the hemangioma group.All patients received examination of DCE-MRI,DWI,and MSCT before surgery.According to pathology diagnosis as gold standard,the imaging characteristics of the two groups were compared,and diagnostic value of indicators were calculated by drawing 2×2 contingency ta-bles for each type of examination.[Results]The proportion of patients in the hemangioma group with arterial enhancement and portal venous enhancement was significantly lower than that in the metastasis group,and the proportion of patients in the hemangioma group with high signal in the delay phase was significantly higher than that in the metastasis group(P＜0.05).The ADC value of DWI in the hemangioma group were signifi-cantly higher than that in the metastasis group(P＜0.05).Preoperative MSCT examination showed that the mean transit time,liver blood volume,and capillary surface permeability measurements of the hemangioma group were higher than those of the metastasis group(P＜0.05),while lesion arterial perfusion and liver blood flow measurements in the hemangioma group were lower than those in the metastasis group(P＜0.05).The sensitivity and specificity of DCE-MRI for differentiating liver metastatic carcinoma and hemangioma were 76.32％and 87.50％,respectively;The sensitivity and specificity of DWI were 78.95％and 90.63％,respectively;And the sensitivity and specificity of MSCT were 71.05％and 93.75％,respectively.The sensitivity of the three combined differential diagnosis of liver metastatic carcinoma and hemangioma was 92.11％and the speci-ficity was 87.50％.[Conclusion]The combined application of DCE-MRI,DWI,and MSCT in the differential di-agnosis of liver metastatic carcinoma and hepatic hemangioma can significantly improve sensitivity while main-taining high specificity.
[目的]探讨成人支气管扩张(简称支扩)合并哮喘的痰培养结果及影响因素.[方法]回顾性分析2017年4月至2023年4月神木市医院(西北大学附属神木医院)收治的180例成人支扩患者的临床资料,根据患者是否合并哮喘分为合并组(n=56)和支扩组(n=124).比较两组患者一般资料、第一秒用力呼气容积(FEV1)、FEV1占预测值百分比(FEV1％pred)、用力肺活量(FVC)、FE V1/FVC及痰培养结果,采用受试者工作特征(ROC)曲线分析FEV1、FEV1％pred、FEV1/FVC对成人支扩患者合并哮喘的预测价值;采用多因素非条件Logistic逐步回归分析成人支扩患者合并哮喘的危险因素.[结果]合并组FEV1、FEV1％pred、FEV1/FVC显著低于支扩组(P＜0.05).痰培养结果显示:合并组阳性18例(32.14％),其中铜绿假单胞菌10例(17.86％)、流感嗜血杆菌2例(3.57％)、鲍曼不动杆菌2例(3.57％)、肺炎克雷伯菌2例(3.57％)、白色念珠菌2例(3.57％);支扩组阳性36例(29.03％),其中铜绿假单胞菌22例(17.74％)、流感嗜血杆菌4例(3.23％)、鲍曼不动杆菌2例(1.61％)、肺炎克雷伯菌4例(3.23％)、阴沟肠杆菌2例(1.61％)、金黄色葡萄球菌2例(1.61％).两组痰培养阳性率比较,差异无统计学意义(P＞0.05).ROC曲线分析结果显示:FEV1、FEV1％pred、FEV1/FVC预测成人支扩患者合并哮喘的曲线下面积分别为0.816、0.849、0.725.Logistic分析结果显示:FEV1＜1.455 L、FEV1％pred＜58.645％、FEV1/FVC＜64.095％是成人支扩患者合并哮喘的危险因素(P＜0.05).[结论]肺通气功能下降是成人支扩患者合并哮喘的重要原因,其痰培养结果以铜绿假单胞菌为主.
[目的]探讨肺动脉CT血管造影(CTA)量化指标联合血清可溶性血栓调节蛋白(sTM)对肺动脉栓塞(PE)的诊断价值.[方法]选取2018年1月至2023年3月西安市长安区医院收治的92例疑似PE患者,根据肺动脉CTA检查情况分为PE组(55例)、非PE组(37例),根据PE患者病情严重程度分为高危组(20例)、非高危组(35例).比较PE组、非PE组的肺动脉CTA指标及sTM水平,分析其对PE的诊断价值;比较高危组、非高危组的肺动脉 CTA指标及sTM水平,分析肺动脉CTA指标及血清sTM对PE患者病情严重程度的评估价值.[结果]PE组右心室最大内径与左心室最大内径比值(RVD/LVD)、右心室与左心室最大距离比值(RVLD/LVLD)、Qanadli栓塞指数均高于非PE组(P＜0.05).PE组sTM水平低于非PE组(P＜0.05).受试者工作特征(ROC)曲线分析结果显示:RVD/LVD、RVLD/LVLD、Qanadli栓塞指数、sTM及四者联合诊断PE的曲线下面积(AUC)分别为0.716、0.729、0.750、0.715、0.902.高危组 RVD/LVD、RVLD/LVLD、Qanadli 栓塞指数均高于非高危组(P＜0.05),sTM 水平低于非高危组(P＜0.05).ROC曲线分析结果显示:RVD/LVD、RVLD/LVLD、Qanadli栓塞指数、sTM及四者联合评估PE患者病情严重程度的AUC分别为0.704、0.735、0.741、0.702、0.907.[结论]肺动脉CTA指标RVD/LVD、RVLD/LVLD、Qanadli栓塞指数及sTM联合诊断PE及病情严重程度的效能良好,可为临床诊断、治疗PE患者提供参考.
[目的]探讨无托槽隐形矫治器联合微种植支抗在青少年口腔正畸中的应用效果.[方法]选取2019年6月至2020年1月本院收治的106例青少年错(牙合)畸形患者,按照随机数字表法分为对照组(给予自锁槽矫治+微种植支抗治疗)和观察组(给予无托槽隐形矫治器+微种植支抗治疗),每组53例.治疗30个月后,比较两组矫治效果、牙排齐时间、关闭间隙时间、满意度评分及矫治前后矢状向、水平向和垂直向指标、软组织指标、骨桥蛋白(OPN)、Fascin蛋白水平的差值.[结果]两组患者牙排齐时间、关闭间隙时间比较,差异无统计学意义(P＜0.05);观察组满意度评分高于对照组(P＜0.05).观察组矫治前后上颌突度(A-Y)、上颌6牙冠近中根尖至Y轴距离(U6A-Y)、上颌6牙冠近中尖至Y轴距离(U6S-Y)、下颌突度(B-Y)、上颌6牙冠近中根尖至Y轴距离(L6A-Y)、上颌6牙冠近中尖至Y轴距离(L6s-Y)及下颌平面角(G-SN)差值均高于对照组(P＜0.05);观察组矫治前后上唇至审美平面(鼻尖点与颏前点的连线)距离(Ls-E)、下唇至审美平面距离(Li-E)、上唇倾角(A-FH)及下唇倾角(B-FH)差值均高于对照组(P＜0.05);观察组矫治前后OPN、Fascin蛋白差值均低于对照组(P＜0.05).[结论]无托槽隐形矫治器联合微种植支抗与 自锁槽矫治联合微种植支抗矫治青少年错(牙合)畸形的牙排齐时间、关闭间隙时间比较,差异无统计学意义,但无托槽隐形矫治器联合微种植支抗可提高青少年口腔正畸患者满意度和矫治效果,同时对OPN、Fascin蛋白的影响较小.
[Objective]To explore the clinical value of microvolt T wave alternation(MTWA)in predicting ma-jor adverse cardiovascular events(MACE)in patients with chronic heart failure.[Methods]A total of 100 patients with CHF admitted to Baoji Hospital affiliated to Xian Medical College from December 2019 to December 2021 were se-lected and divided into MACE group(n=28)and non-MACE group(n=72)according to whether they had MACE.All patients underwent ambulatory electrocardiogram examination,and the risk factors for MACE in patients with CHF were analyzed using univariate and multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the value of MTWA in predicting MACE in patients with chronic heart failure.[Results]The age ≥65 years old,BMI ≥25 kg/m2,history of arrhythmia,smoking history,NYHA classification Ⅳ,history of hypertension,overwork history,and the proportion of V1 lead maximum MTWA(MTWA max),maximum heart rate(MTWA peakhr),and average MTWA(MTWA overall)in the MACE group were higher than those in the non-MACE group(P＜0.05).ROC curve analysis showed that MTWAmax,MTWApeakhr,and MTWAoverall had higher val-ues for predicting MACE in patients with CHF,with areas under the curve of 0.903,0.686,and 0.825,respectively(P＜0.05).Logistic regression analysis showed that age ≥65 years old,history of arrhythmia,smoking history,NYHA classification Ⅳ,history of hypertension,overwork history,MTWAmax≥24.706,MTWApeakhr≥1.586,and MTWAoverall≥1.489 were all risk factors for MACE in patients with CHF(P＜0.05).[Conclusion]The application value of am-bulatory electrocardiogram MTWA in predicting MACE in patients with chronic heart failure is high,and it is worthy of clinical reference.
[目的]探讨肺栓塞合并睡眠呼吸暂停低通气综合征(SAHS)的危险因素.[方法]选取2019年1月至2022年1月杨凌示范区医院收治的90例肺栓塞患者,根据睡眠呼吸暂停低通气指数(AHI)不同分为SAHS组[AHI≥5次/h,n=30]和单纯组(AHI＜5次/h,n=60),SAHS组根据是否合并周期性中枢型呼吸暂停分为合并组(n=7)和未合并组(n=23),比较各组患者基本资料及睡眠情况.[结果]单纯组患者体重指数(BMI)、颈围、Epworth日间多睡量表(ESS)评分、肺栓塞栓子所累及的肺段数、碳酸氢根离子(HCO3-)水平少于SAHS组(P＜0.05),单纯组动脉血氧分压(PaO2)水平、年龄高于SAHS组(P＜0.05);单纯组患者睡眠呼吸暂停指数(AI)、氧减指数(ODI)、AHI、微觉醒指数(Arl)、SpO2＜90％的时间占总睡眠时间百分比(SLT90％)、二氧化碳分压(TcPCO2)均低于SAHS组,最低血氧饱和度(LSaO2)高于SAHS 组(P＜0.05);Logisitic回归模型分析显示:BMI、颈围、ESS 评分、HCO3-、PaO2 水平、AI、ODI、AHI、Arl、SLT90％、TcPCO2、LSaO2 均是导致肺栓塞合并SAHS的危险因素(P＜0.05).未合并组年龄低于合并组(P＜0.05),BMI、动脉血二氧化碳分压(PaCO2)、HCO3-、TcPCO2 水平高于合并组(P＜0.05);Logisitic 回归模型分析结果显示:BMI、PaCO2、HCO3-、TcPCO2均是导致SAHS合并中枢型呼吸暂停的危险因素(P＜0.05).[结论]年龄、BMI、颈围、HCO3-、PaO2等可能与合并SAHS有关,对于已知风险的肺栓塞患者可加大SAHS筛查力度.
[Objective]To explore the correlation between thyroid peroxidase antibody level(TPO-Ab)and endo-crine metabolism in patients with polycystic ovary syndrome(PCOS)with normal thyroid function.[Methods]The clinical data of 112 patients with PCOS with normal thyroid function treated in our hospital from March 2018 to July 2021 were retrospectively analyzed.According to the test results of serum TPO-Ab,they were divided into 21 cases in the TPO-Ab positive group and 91 cases in the TPO-Ab negative group.The thyroid function indexes[thyroid stim-ulating hormone(TSH),free thyroxine(FT4),total thyroxine(TT4)],differences in sex hormone indexes[testoster-one(T),prolactin(PRL),estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)],and lipid me-tabolism indexes[high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triacylg-lycerol(TG),total cholesterol(TC)]between the two groups were compared.Pearson correlation analysis was used to analyze the relationship of TPO-Ab level with TSH,PRL,E2,TG,FT4,TT4 and HDL-C.[Results]The levels of ser-um TSH,PRL and E2 in the TPO-Ab positive group were higher than those in the TPO-Ab negative group(P＜0.05),and the levels of serum FT4 and TT4 were lower than those in the TPO-Ab negative group(P＜0.05).The level of HDL-C in the TPO-Ab positive group was lower than that in TPO-Ab negative group,while the level of TG was higher than that in the TPO-Ab negative group(P＜0.05).The correlation coefficients between serum TPO-Ab level and TSH,PRL,E2,TG,FT4,TT4 and HDL-C in PCOS patients with normal thyroid function were 0.501,0.634,0.498,0.631,-0.479,-0.663 and-0.689,respectively(P＜0.05).[Conclusion]The level of serum TPO-Ab in PCOS patients with normal thyroid function was positively correlated with TSH,PRL,E2 and TG,while nega-tively correlated with FT4,TT4 and HDL-C.
[Objective]To explore the effects of different doses of simvastatin on the levels of soluble E-selectin(sE-Selectin)and soluble intercellular adhesion molecule-1(sICAM-1)in the serum of patients with hyperlipi-demia.[Methods]A total of 80 patients with hyperlipidemia were divided into two groups based on differently used dosage of simvastatin with each group of 40 patients.The control group was given a conventional dose(20 mg/d),while the observation group received a high dose(40 mg/d)treatment.The clinical efficacy,lipid profiles[total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cho-lesterol(LDL-C)],serum levels of sE-Selectin and sICAM-1,and the incidence of adverse reactions were compared between the two groups.[Results]The total effective rate in the observation group was 92.50％(37/40),which was significantly higher than the 75.00％(30/40)in the control group(P＜0.05).After treatment,the TG,TC,LDL-C levels of both groups were lower than before treatment,and HDL-C levels were higher than before treat-ment(P＜0.05).Furthermore,the TG,TC,and LDL-C levels in the observation group were lower,and the HDL-C levels were higher than those in the control group(P＜0.05).After treatment,the serum sE-Selectin and sI-CAM-1 levels in both groups were lower than before treatment(P＜0.05),with the levels in the observation group being significantly lower than those in the control group(P＜0.05).The overall incidence of adverse reactions in both groups showed no significant difference(P＞0.05).[Conclusion]Compared to the conventional dosage,the high dose of simvastatin treatment for hyperlipidemia has a more remarkable therapeutic effect and better lipid-lowering results.
[目的]探讨消肿生肌汤对行高位虚挂引流术治疗的肛瘘患者术后肛门直肠压力的影响.[方法]选取2021年2月至2022年2月本院收治的110例行高位虚挂引流术的肛瘘患者,采用随机数字表法将其分为观察组与对照组,每组55例.对照组给予熏蒸洗浴及凡士林油纱条治疗,观察组给予口服消肿生肌汤治疗.比较两组临床疗效,记录并比较两组创面症状评分,检测两组治疗前及治疗后炎症指标[C反应蛋白(CRP)、激活素A(ACTA)、趋化因子配体5(CCL5)、淀粉样蛋白A(SSA)]水平,比较两组治疗前后直肠压力[肛管最长收缩时间(ALCT)、肛管静息压(ARP)、肛管最大收缩压(AMCP)].[结果]治疗后,观察组总有效率显著高于对照组(P＜0.05).治疗后,两组创面分泌物、肉芽形态、创面疼痛评分低于治疗前(P＜0.05),且观察组低于对照组(P＜0.05);两组患者血清CRP、ACTA、CCL5、SAA水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P＜0.05).两组患者ALCT、AMCP高于治疗前,ARP低于治疗前(P0.05),且观察组ALCT、AMCP高于对照组,ARP低于对照组(P＜0.05).[结论]消肿生肌汤对行高位虚挂引流术治疗的肛瘘患者术后创面愈合疗效较好,同时能够减轻炎症反应,较好地改善患者直肠压力.
[Objective]To investigate the effect of fenofibrate combined with statins on cardiac function and se-rum lipid levels in patients with coronary heart disease and hyperlipidemia.[Methods]A total of 120 patients with CHD and hyperlipidemia admitted to Genertec Universal Xi'an Beihuan Hospital from January 2019 to December 2021 were selected and divided into an observation group and a control group according to a random number table method,with 60 cases in each group.The control group was treated with rosuvastatin,while the observation group was treated with fenofibrate in addition to the control group.The therapeutic effects,changes in cardiac function in-dicators,serum inflammatory indicators,and serum lipid levels before and after treatment,as well as the incidence of adverse reactions,were compared between the two groups.[Results]The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).After treatment,the left ventricular end-diastolic diameter(LVEDD)in both groups was lower than that before treat-ment,while the left ventricular ejection fraction(LVEF)and cardiac output(CO)were higher than before treat-ment.The LVEDD in the observation group was lower than that in the control group,while the LVEF and CO were higher than those in the control group,and the differences were statistically significant(P＜0.05).The levels of high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in both groups were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P＜0.05).The total cholesterol(TG),triglyceride(TC),and low-den-sity lipoprotein(LDL-C)levels in both groups were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P＜0.05).There was no signif-icant difference in the incidence of adverse reactions between the two groups(P＞0.05).[Conclusion]The clinical application of fenofibrate combined with rosuvastatin in the treatment of coronary heart disease with hyperlipidemia is better than the use of rosuvastatin alone,which can effectively improve the patient's cardiac function,improve se-rum inflammatory factors,and improve serum lipid levels.
