Objective To observe the weight-loss effect of probiotics combined with low-GI and low-carb diet therapy on obese patients. Methods A total of 100 obese patients recruited by our hospital from March 2020 to December 2021 were enrolled and divided into control group and observation group randomly, with 50 cases in each group. Both groups received conventional education for obese patients, while the observation group was additionally given probiotics combined with low-GI and low-carb diet therapy for 3 months. The obesity status（BMI, muscle percentage and body fat percentage）,hypertension incidence, hyperlipidemia incidence and physical self-perception profile（PSPP） were compared between the two groups before and after the intervention to evaluate the intervention effect. Results After intervention, there were no significant differences in BMI, muscle percentage, body fat percentage, PSPP score, incidence of hypertension and hyperlipidemia in control group compared with those before intervention（all P＞0.05）. After intervention, the muscle percentage and PSPP score in the observation group were higher than those in the control group respectively（t = 5.890, 3.012;P＜0.001, = 0.003）, while the BMI, body fat percentage, hyperlipidemia incidence and hypertension incidence in the observation group were lower than those in the control group respectively（t/χ2 = 13.335, 10.036, 4.310, 4.167; P＜0.001,＜0.001, = 0.037, = 0.041）. Conclusion Probiotics combined with low-Gi and low-carb diet therapy helps to reduce not only the fat mass of obese, but also the incidence of hypertension, hyperlipidemia and improve body self-confidence of obese patients.

目的 调查北京市出租车司机骨密度减少、骨质疏松的低骨量患病率及其影响因素.方法 选取我院接受健康检查的2 500名出租车司机为观察组,1 683名机关事业单位人员为对照组,两组人员在年龄、性别比例等比较差异无显著性(P＞0.05).超声骨密度仪检测骨密度,自制健康问卷调查骨密度有关因素.结果 观察组发放2 500份问卷,回收有效问卷2 398份,有效率为95.9％.观察组骨密度减少率、骨质疏松率和低骨量率分别为24.8％、8.3％和33.1％,明显高于对照组的13.0％、5.1％、18.1％,差异有统计学意义(x2=86.234、15.126、112.342,均P＜0.05).Logistic回归分析显示,年龄≥45岁、从业年限≥10a、日均开车时间≥15 h、每周饮浓茶或咖啡≥7次和每周饮碳酸饮料≥3次显著增加出租车司机低骨量的患病风险(OR=3.247、2.579、1.816、1.853、2.642,均P＜0.05),而每周喝牛奶量≥5包(250 ml/包)、每周服用钙片或钙剂≥5次和日均运动锻炼时间≥30 min则有助于降低出租车司机低骨量发.生风险(OR=0.453、0.525、0.669,均P＜0.05).结论 北京市出租车司机低骨量患病率较高,尤其是年龄≥45岁、从业年限≥10 a、日均开车时长≥15 h、每周饮浓茶或咖啡≥7次及每周饮碳酸饮料≥3次的司机.

目的 探讨支气管肺泡灌洗术(BAL)联合局部应用敏感抗菌药物对慢性阻塞性肺疾病(COPD)合并支气管扩张患者血气分析、炎症因子及肺功能的影响.方法 前瞻性选取62例COPD合并支气管扩张患者为研究对象,采用随机数字表法将患者分为观察组(31例)与对照组(31例).对照组给予常规干预措施,观察组在对照组基础上给予BAL联合局部应用敏感抗菌药物.比较2组干预前后的血气分析[动脉血血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、肺功能[肺活量(VC)、第一秒用力呼气容积(FEV1)、用力肺活量(FVC)]及干预后临床疗效.结果 2组干预前血气分析、炎症因子及肺功能指标比较,差异均无统计学意义(P>0.05).2组干预后PaO2、SaO2、VC、FEV1、FEV1/FVC均高于干预前,且观察组高于对照组(P<0.05);而PaCO2及血清IL-6、TNF-α、hs-CRP水平均低于干预前,且观察组低于对照组(P<0.05).观察组临床疗效优于对照组(P<0.05).结论 BAL联合局部应用敏感抗菌药物可改善COPD合并支气管扩张患者的血气分析结果,降低血清炎症因子水平,促进肺功能康复,临床疗效明显,值得临床推广应用.

目的 探讨血清脂质代谢指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平、内脏脂肪面积(VFA)与糖代谢异常合并肥胖的相关性.方法 选取2019年2-10月就诊于该院内分泌科的1243例2型糖尿病患者纳入研究,根据是否合并肥胖分为糖代谢异常合并肥胖组(725例)和糖代谢异常不合并肥胖组(518例),以性别、年龄、烟酒史为配对因素选取相匹配的同期于该院体检中心体检的66例糖代谢正常的肥胖成人作为糖代谢正常合并肥胖组,66例体检健康的成人作为糖代谢正常不合并肥胖组.比较4组人群的临床特征及生化指标,分析糖代谢异常合并肥胖患者各指标的相关性,不同脂质代谢指标水平和VFA发生糖代谢异常合并肥胖的趋势,以曲线下面积(AUC)评估脂质代谢指标和VFA对糖代谢异常合并肥胖的预测价值.结果 4组人群间收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、VFA、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、TC、TG、LDL-C、HDL-C和尿酸比较,差异有统计学意义(P<0.05);TC、TG和LDL-C水平与BMI、FBG、HbA1c、VFA呈正相关,HDL-C水平与BMI、FBG、HbA1c、VFA呈负相关(P<0.05);VFA水平与BMI、FBG、HbA1c呈正相关(P<0.05);随着TC、TG、LDL-C水平和VFA的增加,糖代谢异常合并肥胖的相对危险度(RR)值呈升高的线性趋势,随着HDL-C降低,糖代谢异常合并肥胖的RR呈升高的线性趋势(P<0.05);TC、TG、LDL-C、HDL-C和VFA预测糖代谢异常合并肥胖的AUC分别为0.736、0.778、0.752、0.754、0.773.结论 血清脂质代谢指标水平、VFA与糖代谢异常合并肥胖有关,可作为糖代谢异常患者肥胖预测和代谢状态监控的指标.

Objective: To investigate the effects of cardiac rehabilitation protocol centered with personalized - exercise training (ET) on further improvement of holistic function in patients with stable angina after percutaneous coronary intervention (PCI). Methods: 20 patients who were diagnosed with stable angina in Beijing Rehabilitation Hospital from June 2016 to December 2019, were randomly divided into control group (n=10) and ET group (n=10). All patients were received PCI selectively. After PCI, patients in Control group were treated with conventional cardiac rehabilitation without ET; patients in ET group were treated with ET-based cardiac rehabilitation for 12 weeks. Cardiopulmonary exercise testing (CPET) parameters, echocardiogram and 6-minute walking distance (6MWD) of 2 groups of patients were recorded respectively before PCI, 2 weeks after PCI and 12 weeks after ET. Results: All patients in 2 groups finished symptom limited maximum CPET, and patients in ET group finished 12 weeks - ET safely without complications. Before PCI and 2 weeks after PCI, there were no differences in parameters including anaerobic threshold (AT), peak oxygen uptake, peak oxygen pulse, left ventricular ejection fraction (LVEF) and 6MWD between control group and ET group（P>0.05）; after 12-week treatment, AT(ml/min,ml/(min·kg)), peak oxygen uptake(ml/(min·kg)), peak oxygen pulse(ml/beat) and 6MWD of patients in ET group were higher significantly than those of patients in control group (P<0.05). In ET group, the variables including AT (ml/min、ml/(min·kg)、%pred), peak oxygen uptake(ml/min,ml/(min·kg),%pred), peak oxygen pulse (ml/beat) and 6MWD of patients after 12-week ET were significantly higher than those of patients before PCI treatment (P<0.05); notably, AT (ml/(min·kg)) and peak oxygen uptake (ml/(min·kg)) of patients in ET group were significantly higher after 12-week ET program compared with those of patients 2 weeks after PCI ( P<0.05). In Control group, AT（ml/min）and peak oxygen pulse（ml/beat）of patients after 12-week treatment were higher than those of patients before PCI ( P<0.05), but there were no difference between 2 weeks after PCI and 12-week treatment ( P>0.05). Conclusion: Personalized - exercise training after PCI could further improve the cardiac function and exercise endurance, ET - based cardiac rehabilitation is an important part of secondary prevention for patients after PCI, which needs to be widely promoted.

目的 观察呼吸功能锻炼联合应用孟鲁司特、布地奈德福莫特罗治疗老年稳定期慢性阻塞性肺疾病(COPD)的效果.方法 将99例老年稳定期COPD患者随机分为A、B、C三组各33例,分别在呼吸功能锻炼基础上给予孟鲁司特、布地奈德福莫特罗、孟鲁司特+布地奈德福莫特罗,持续12周.干预前后行血气分析、肺功能检查及COPD评估测试评分(CAT),检测痰液中性粒细胞(N)、嗜酸性粒细胞(E)及白细胞介素8(IL-8)、髓过氧化物酶(MPO);评价临床疗效,记录不良反应.结果 三组干预前各指标比较,差异无统计学意义.与干预前比较,干预后三组一秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、动脉氧分压(PaO2)均升高,动脉二氧化碳分压(Pa?CO2)和痰液中N、E、IL-8、MPO水平及CAT问卷得分均降低(P均<0.05).干预后C组FEV1、FVC、PaO2均高于A、B组,FEV1/FVC高于A组,PaCO2和痰液中N、IL-8、MPO水平及CAT问卷得分低于A、B组,痰液中E低于A组;干预后B组PaO2高于A组,痰液IL-8水平低于A组(P均<0.05).C组临床疗效总有效率97.0％,高于A组的69.7％、B组的75.8％(P均<0.05).患者均未出现严重不良反应,三组头痛、心悸、腹痛等发生率差异均无统计学意义.结论 呼吸功能锻炼联合应用孟鲁司特、布地奈德福莫特罗能改善老年COPD稳定期患者的呼吸功能,抑制气道炎症反应,缓解临床症状,且安全有效.

目的 调查北京市男性在职出租车司机前列腺患病情况,为改善其健康状况提供相关依据.方法 按照纳入标准随机选取2018年5月-2019年6月间来首都医科大学附属北京康复医院健康管理中心接受健康检查的580名男性在职出租车司机作为调查对象,使用自制检查表对其进行问卷调查及健康检查,分析患前列腺疾病的影响因素.结果 回收有效问卷563份,有效率为97.07％.563名在职出租车司机检出前列腺疾病者242名,检出率为42.98％.单因素分析显示,不同年龄、体质指数、从业年限、日出车时长、日饮水量、日下车活动时长的出租车司机前列腺疾病患病率比较,差异均有统计学意义(均P＜0.05).多因素logistic回归分析显示,年龄≥50岁(OR=2.099)、肥胖(OR=1.708)、从业年限≥6年(OR=2.167)、日出车时长≥14 h(OR =2.444)、日饮水量＜250 mL(OR=4.198)是北京市男性出租车司机患前列腺疾病的危险因素(均P＜0.05),而日下车活动≥20 min(OR=0.249)是出租车司机前列腺的保护因素(P＜0.05).结论 男性出租车司机应重视前列腺健康的自我保健,尤其是年龄≥50岁、肥胖、从业年限≥6年、日出车时长≥14 h、日下车活动＜5 min、日饮水量＜250 mL的司机.

目的 探究人群并发肺结节的危险因素及肺结节与幽门螺旋杆菌感染的相关性.方法 选取2018年1月至2018年12月在首都医科大学附属北京康复医院劳模健康管理中心进行体格检查的人员1168例;依据是否发生肺结节分为肺结节组757例及无肺结节组411例,分别比较两组体检人员的年龄、性别、体质量指数(BMI)、吸烟指数、肺结节家族史、肺结核病史、慢性支气管炎病史、胃肠道症状、胸痛胸闷、咳嗽咳痰、血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE),细胞角蛋白19片段(CY21-1)、白细胞计数(WBC)、中性粒细胞百分比(NEUT％)、C反应蛋白(CRP)及是否幽门螺旋杆菌感染(Hp)等危险因素情况.结果 肺结节组体检人员的年龄、男性例数、肺结核病史例数及Hp阳性例数均高于无肺结节组,差异有统计学意义(P<0.05);两组体检人员的BMI、吸烟指数情况、肺结节家族史、慢性支气管炎病史、合并胃肠道症状例数、胸闷胸痛例数、咳嗽咳痰例数、CEA、NSE、CY21-1、WBC、NEUT％及CRP等差异无统计学意义(P>0.05);经Logistic回归分析高龄及Hp阳性是发生肺结节的独立危险因素,差异有统计学意义(P<0.05).结论 高龄、男性、肺结核病史及Hp阳性为发生肺结节的高危因素,其中Logistic回归分析显示高龄及Hp阳性为发生肺结节的独立危险因素,因此在体检工作中应重点关注高龄体检人员及Hp阳性体检人员结节发生情况,以便于适时进行早期干预,降低癌变风险.

目的 了解北京地区出租车司机身体健康现状,为建立、健全成熟的出租车行业健康管理模式提供科学依据.方法 对1 175名北京地区出租车司机体检结果进行分析,了解出租车司机慢性疾病检出情况及职业相关健康问题,并与北京市社会体检人群体检结果进行比较.结果 1 175名出租车司机慢性疾病检出率为92.43％,其中男性检出率为92.38％,女性检出率为92.73％,慢性疾病检出率随年龄、工龄增加呈上升趋势(P＜ 0.01),吸烟组慢性疾病检出率显著高于非吸烟组(P＜ 0.01).男性慢性疾病检出率前9位顺位为脂肪肝(60.55％)、骨质增生(54.55％)、甲状腺结节(50.48％)、前列腺增大(40.06％)、颈动脉斑块(39.35％)、脊柱生理曲度僵直(37.72％)、项韧带钙化/骨化(35.44％)、颈动脉内膜增厚(26.37％)、高血压(23.44％);女性慢性疾病检出率前9位顺位为甲状腺结节(67.08％)、骨质增生(52.98％)、宫颈腺囊肿(51.32％)、脊柱生理曲度僵直(43.71％)、宫颈肥大(43.42％)、子宫肌瘤(38.96％)、脂肪肝(37.04％)、乳腺结节(37.04％)、阴道壁膨出(34.21％).经北京市社会自然人群年龄别结构标准化后,出租车司机脂肪肝、甲状腺结节、颈动脉斑块、早搏、血压增高检出率均高于北京市社会体检人群(P＜0.05).出租车司机身体不适情况主要为颈肩痛(占56.79％)和腰背痛(54.78％).结论 北京市出租车司机健康状况堪忧.应根据北京地区出租车司机体检结果异常的特点,采取系统综合的干预措施,改善该职业人群的健康水平,为公共交通安全提供保障.

为有效提高医疗体检业务的工作效率和诊断精度,设计并实现了一种基于ARM Cortex-A8和模糊推理模型的体检护理数据采集管理系统.首先,采用健康护理中较为重要的检测信号作为数据采集模块的输入,包括体温、心电和血氧等生理指标.然后,利用ARM Cortex-A8开发板作为主控核心芯片,将各采集子模块的数据通过TCP网络传输到Tomcat后台服务器.最后,通过模糊推理模型对数据进行融合处理,完成体检结果的决策判断.此外,实际判读过程中采用模糊权值系数进行简化观测.采用MySQL数据库和HTML语言实现了系统的管理模块.系统运行结果表明,该系统能够顺利完成生理指标的采集、远程传输和体检结果的网页显示.测试数据分析表明,体检诊断准确率提高了1.6％.

目的 分析北京地区环卫工人生活方式与健康现状,为改善环卫工人的健康状况提供科学依据.方法 基于1422名环卫工人体检数据、健康调查问卷所得数据对环卫工人的疾病情况和影响因素进行分析.结果 总的环卫工人中甲状腺结节、肝囊肿、脂肪肝、颈动脉斑块、血压增高人数所占比例均明显高于自然人群(P<0.01);其中男性环卫工人甲状腺结节、脂肪肝、颈动脉斑块、血压增高、前列腺增生人数所占比例均明显高于男性自然人群(P<0.01);女性环卫工人甲状腺结节、脂肪肝、血压增高、子宫肌瘤人数所占比例均明显高于女性自然人群(P<0.01),乳腺增生人数所占比例明显低于女性自然人群(P<0.01).影响健康的不良因素有职业环境暴露、吸烟、缺乏锻炼等(P<0.05).结论 北京地区环卫工人健康状况不佳,存在一些不健康的行为生活方式,应根据环卫工人的健康状况开展针对性的健康教育和干预措施,提高他们对疾病的认识和自我保健能力,改善该职业人群的健康水平.

Objective To observe the changes and clinical significance of vasostatin-2 (VS-2) in patients with chronic heart failure (CHF). Methods CHF patients (n=159, observation group) and healthy volunteers (n=120, control group) were chosen from Beijing Rehabilitation Hospital affiliated to Capital University of Medical Sciences from Jan. 2015 to Jan. 2018. And observation group were divided, according to disease status, into subgroups of pre-heart failure stage, pre-clinical heart failure stage, clinical heart failure stage and refractory end-stage heart failure stage. The levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and VS-2 were detected in observation group and control group. The changes of left ventricular end-diastolic inner diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected by using color ultrasound. The correlation among VS-2, NT-proBNP, LVEF and LVEDd was analyzed. Results Compared with control group, the levels of serum NT-proBNP and LVEDd increased (P＜0.05) and VS-2 and LVEF decreased (P＜0.05) in observation group. The comparison among different groups with different NYHA grades showed that NT-proBNP and LVEDd had an ascending trend (P＜0.05) and VS-2 and LVEF had descending trend (P＜0.05) with the increase of NYHA grades. The comparison among subgroups of different stages showed that VS-2 decreased continuously (P＜0.05) and NT-proBNP had an ascending trend (P＜0.05) with the development of heart failure. The results of correlation analysis showed that the level of serum VS-2 was positively correlated to LVEF, and negatively correlated to NT-proBNP and LVEDd. Conclusion The level of serum VS-2 will significantly decrease in CHF patients, which can reflect to some extent the progress and stages of CHF.

目的 探讨个体化精准恒定功率运动对慢性病患者脉搏波波形特征的影响.方法 选取2017年6月在首都医科大学附属北京康复医院接受本团队管理的慢性病(以血糖、血脂、血压异常为主)患者中的11例为慢病组,同期选取在中国医学科学院阜外医院学习的正常人8例为正常组.以心肺运动试验评估制定个体化精准恒定功率运动处方,每天运动30 min,在运动前和运动后5、15、30、40 min测量其桡动脉脉搏波波形.对受试者脉搏波原始数据用Origin作图,对桡动脉脉搏波的上升、下降、切迹或平台等波形特征及其运动前后变化进行定性分析,并比较两组运动前、后切迹出现率.结果 运动前慢病组切迹出现率低于正常组(P=0.010).运动后两组脉搏波均较运动前的波峰变高、波形变窄.运动后5、15、30、40 min慢病组切迹出现率同运动前比较,差异无统计学意义(P>0.05),正常人切迹出现率始终为100.0％;运动后5、15、30、40 min慢病组切迹出现率与正常组比较,差异无统计学意义(P>0.05).结论 个体化精准恒定功率运动可改变脉搏波波形,其可能作为运动疗法有效管控慢性病的指标,其机制有待进一步研究.

目的:通过对恶性肿瘤患者的人文关怀,提高化疗效果和患者的生活质量。方法:对2008年1～12月入本科的开展人文关怀前的恶性肿瘤患者264名与2009年1～12月医院号召开展人文关怀后入科的270名患者进行对照,制作《护理工作满意度调查表》,采取问卷调查的形式,给两组患者每人发放一份,介绍调查目的,出院前将表交回。结果:通过问卷调查,实施人文关怀后患者满意度明显提高。结论:做好患者的人文关怀,能有效地提高患者对疾病的认识能力和战胜疾病的信心,提高患者的生活质量。

目的:观察硫酸氨基葡萄糖联合塞来昔布治疗骨关节炎(OA)的临床疗效。方法:选择OA 106例,随机分为观察组55例和对照组51例;观察组给予硫酸氨基葡萄糖联合塞来昔布治疗,对照组给予美洛昔康治疗;两组均治疗6周并停药4周后采用Le-quesne指数评价疗效,并记录不良反应。结果:(1)观察组治疗前Lequesne评分为(18.2±7.6)分,治疗6周并停药4周后降至(10.6±6.7)分;对照组治疗前Lequesne评分为(17.8±7.7)分,治疗6周并停药4周后降至(15.3±6.3)分;两组比较,差异均显著(P<0.05)。(2)观察组服药期间出现胃肠道不适2例,便秘1例,不良反应发生率为5.4%;对照组服药期间出现胃肠道不适6例,轻度腹痛2例,恶心2例,不良反应发生率为19.6%;两组比较,差异均显著(P<0.05)。(3)两组各项实验室检查指标治疗前后均无显著变化(P>0.05)。结论:硫酸氨基葡萄糖联合塞来昔布治疗OA疗效较好,且不良反应少。

Objective This study presents the outcomes of patients with idiopathic degenerative and posttraumatic atlantoaxial osteoarthritis who were treated with upper cervical manipulation in combination with mobilization device therapy. Clinical Features A retrospective case review of 10 patients who were diagnosed with either degenerative or posttraumatic atlantoaxial arthritis based on histories, clinical symptoms, physical examination, and radiographic presentations was conducted at a multidisciplinary integrated clinic that used both chiropractic and orthopedic services. All 10 patients selected for this series were treated with a combination of upper cervical manipulation and mechanical mobilization device therapy. Outcome measures were collected at baseline and at the end of the treatment period. Assessments were measured using patients' self-report of pain using a numeric pain scale (NPS), physical examination, and radiologic changes. Average premanipulative NPS was 8.6 (range, 7-10), which was improved to a mean NPS of 2.6 (range, 0-7) at posttreatment follow-up. Mean rotation of C1-C2 at the end of treatment was improved from 28° (±3.1) to 52° (±4.5). Restoration of joint space was observed in 6 patients. Overall clinical improvement was described as "good" or "excellent" in about 80% of patients. Clinical improvements in pain and range of motion were seen in 80% and 90% of patients, respectively. Conclusion Chiropractic management of atlantoaxial osteoarthritis yielded favorable outcomes for these 10 patients.

Objective: To explore therapeutic effects of chiropractic in treating pelvic obliquity and subsequent low back pain. Methods: Spinal adjusting instrument was used in the sacrum region following chiropractic manipulation,based on comprehensive evaluation of medical record, X-ray and clinical examination. Results: In 13 cases, pain relieved or disappeared after treatment, and height differences of adjacent iliac crest were reduced from (1.73±0.61) cm to (0.28±0.10) cm. Conclusion: Height difference of adjacent iliac crest is an effective and convenient index to measure pelvic lesions and therapeutic effect. Chiropractic technique combined with spinal adjusting instrument has significant effects on pelvic obliquity and subsequent low back pain.

为适应和满足外科微创手术方法对手术配合工作的要求,提高工作效率和质量,我们运用流程管理改进我院腹腔镜手术配合工作,采取评估、优化重组、规范等措施,使手术配合工作效率和质量提高,手术医生和患者的满意度提升。

<正>尊敬的《中国骨伤》杂志编辑部:我今天浏览到贵刊的一篇文章,感触颇深。我认为这篇文章存在一些失误,在今后的科学研究工作中应该引以为戒!尤其对较敏感或存在争议较多的领域更应如此。本着实事求是

<正>腰椎间盘突出症是临床常见的腰部疾病,我脊柱治疗中心自2005年3月～2007年3月以中药离子导入为主配合SEP脉冲电刺激治疗本症102例,取得良好效果,报告如下。