Objective:To investigate the effects of mild hypothermia on the expression of small ubiquitin-like modifier proteins specific protease 3 (SENP3) in mouse neuro-blastoma (N2a) cells during oxygen-glucose deprivation/reoxygenation (OGD/R) injury.Methods:Mouse N2a cells were cultured in vitro and exposed to OGD/R to establish a model of OGD/R simulating cerebral ischemia/reperfusion and a mild hypothermia model. N2a cells were divided into three groups according to the random number table method ( n=5): group sham operation (S), group OGD/R and group OGD/R + mild hypothermia (OGD/R+HT). Cell counting kit -8 (CCK-8) assay was used to detect N2a cell viability after OGD/R, while the release rate of lactate dehydrogenase (LDH) was detected to evaluate N2a cytotoxicity after OGD/R. Hoechst 33258 staining was used to observe N2a cell apoptosis. Real-time quantitative PCR (RT-qPCR) was used to analyze the relative amounts of SENP3 mRNA. Western blot was used to measure the levels of SENP3 protein. Results:Compared with group S, groups OGD/R and OGD/R+HT presented decreases in cell survival rate as well as increases in LDH release rate, the number of apoptotic cells, and the relative amounts of SENP3 mRNA and protein ( P<0.05). Compared with group ODG/R, group OGD/R+HT showed increases in cell survival rate and decreases in LDH release rate, the number of apoptotic neurons, and the relative amounts of SENP3 mRNA and protein ( P<0.05). Conclusions:Mild hypothermia alleviates OGD/R injury in N2a cells, which is related with the inhibition of SENP3 expression.

OBJECTIVE:To study the therapeutic effects of the ultramicro needle-knife combine with cervical spine fine adjusting on youth cervical curvature abnormality case. METHODS:From November 2016 to October 2018, 88 young patients with abnormal curvature of cervical spine were treated. Due to loss of follow up, 86 cases were actually completely including 37 males and 49 females, ranging in age from 20 to 40 years old, with an average of (30.55±5.21) years old, and the course of disease ranged from 1 to 42 months, with a mean of (14.21±7.38) months. All the patients were divided into two groups:treatment group (44 cases) and control group (42 cases). The patients in the treatment group were treated with ultramicro needle-knife and cervical spine fine adjusting, and the patients in the control group were treated with conventional acupuncture and manipulation. The treatments were done 1 time per week in the treatment group while 3 times per week in control group every week, with a duration of 3 weeks for both groups. Before treatment, 3 weeks after treatment, and at the end of 1 month follow-up, the score of neck pain questionnaire(NPQ), range of the motion(ROM) in the cervical region and the D values of cervical physiological curvature were recorded. The efficacy at the end of treatment and in the follow up was evaluated. During the treatment, the patients were also required to correct the bad posture in daily life, to sleep in a low pillow position, and put a moderately columnar pillow behind the neck for 0.5 hours every morning and evening. RESULTS:Two patients in the control group were dropped out after 3 weeks treatment. No adverse reactions were found in the 2 groups during the treatment period. Compared with those before treatment, all scores at all the observation time points were significantly improved between two groups after treatment(all P<0.05). The NPQ scores of cervical symptoms were different significantly between two groups(all P<0.05). The changing range of the the NPQ score of cervical symptoms and cervical spine alignment curve of the treatment group were better than those of the control group (P<0.05).There was statistical difference in NPQ scores between different time points, in the other words, there was time effect(F=203.63, P=0.000). There was interaction between time factor and group factor(F=4.964, P=0.012). There was no statistical difference in the changing range of the ROM score between two groups (all P>0.05). There was statistical difference in ROM scores between different time points, there was time effect (F=240.32), P=0.000). There was no interaction between time factor and group factor (F=0.311, P=0.734). The effective rate of the treatment group and control group were 90.91%(40 / 44) and 80.95%(34 / 42) respectively, the treatment group was more effective than the control group (P<0.05). During the follow-up period, the effective rate of the treatment group and the control group were 84.09%(37 / 44) and 76.19%(32 / 42) respectively. Obviously, the difference of total effective rate between two groups had no statistical signification(P>0.05) in the follow-up duration. CONCLUSION:The method of needle knife combined with cervical spine fine adjusting has a better therapeutic efficiency than conventional acupuncturecombined with manipulation in treating youth cervical curvature abnormality patients. Because this novel method can recover the cervical curvature, relieve the neck pain, and improve cervical mobility.

目的 探讨三维插植后装放疗联合顺铂治疗宫颈癌患者的临床疗效.方法 选取梅州市人民医院2018年5月至2020年5月收治的根治性放疗的初治宫颈癌患者64例作为研究对象,按照患者意愿治疗方式分为二维后装放疗组与三维后装放疗组,各32例.二维组行容积调强外照射放疗加二维后装放疗,三维组行容积调强外照射放疗加三维插植后装放疗,两组患者给予顺铂同期化疗.放疗结束后1～3月评价近期疗效,放化疗期间记录两组患者不良反应发生情况.结果 放疗结束1～3个月,两组治疗有效率比较差异无统计学意义(P=0.302).两组患者骨髓抑制发生率比较,差异无统计学意义(P=0.242).二维组1～2级急性放射性肠炎发生率68.75％,三维组37.50％,两组无3级及以上放射性肠炎反应,差异有统计学意义(P=0.028).仅二维组发生2例1级急性放射性膀胱炎事件,其他患者无明显急性放射性膀胱炎临床表现.结论 顺铂同步放化疗治疗宫颈癌近期不良反应可耐受,三维插植后装放疗联合顺铂治疗宫颈癌与二维组比较降低了放射性肠炎发生率,提高了患者治疗的依从性及生命质量.

目的 探索鼻咽癌放化疗与TBNK淋巴细胞亚群的相关性.方法 回顾性分析我院2019年1—11月诊治的50例鼻咽癌患者,收集、整理治疗前、治疗结束TBNK淋巴细胞亚群情况,探索放化疗与免疫功能的相关性.结果 治疗后CD3+CD8+、CD16+CD56+淋巴细胞水平分别为(34.83±10.67)％、(22.95±11.40)％ 均高于治疗前(26.54±7.09)％、(16.57±7.43)％,P值分别为(0.000、0.001);治疗后CD3+CD4+、CD19+淋巴细胞水平分别为(30.41±11.09)％、(4.55±3.32)％ 均低于治疗前(37.80±9.18)％、(13.42±4.85)％,P值分别为(0.000、0.000),差异具有统计学意义.结论 机体免疫功能受放化疗影响,通过监测鼻咽癌患者外周血TBNK淋巴细胞亚群的变化情况可评估患者的免疫功能状态.

目的 研究鼻咽癌患者治疗前后心理状态与免疫功能的相关性.方法 回顾性分析50例鼻咽癌患者放化疗前后的心理痛苦评分及TBNK(淋巴细胞亚群)水平变化,通过二分类logistic回归模型分析影响心理痛苦的主要因素,同时探索心理状态与免疫功能的相关性.结果 通过二分类logistic回归分析发现,分期、浅表淋巴结肿大是引起鼻咽癌患者心理痛苦的主要因素.治疗后心理痛苦评分较治疗前降低(P=0.000),差异有统计学意义.低心理痛苦评分组(4分以下)的患者CD3+CD4+水平较高(P=0.036),差异有统计学意义.结论 鼻咽癌患者普遍存在心理痛苦状态.机体免疫功能受情绪影响,提高鼻咽癌病人的心理健康水平,可能有助于改善其免疫功能.

目的 探讨Ⅱ、Ⅲ期直肠癌根治术后采用卡培他滨单药或联合奥沙利铂同步放化疗效果和安全性.方法 选取2010年7月～2015年10月我院收治的Ⅱ、Ⅲ期直肠癌根治术后行同期放化疗患者40例行回顾性分析,根据治疗方式不同分为干预组21例和对照组19例,干预组行卡培他滨联合奥沙利铂同步放化疗,对照组行卡培他滨单药同步放化疗,比较两组治疗和随访3年间无病生存率、局部复发率、转移率、总生存率及不良反应发生率.结果 干预组无病生存率、总生存率、局部复发率、转移率与对照组比较,无明显差异(P＞0.05).干预组Ⅲ、Ⅳ度血液毒性和神经毒性发生率显著高于对照组(P＜0.05),两组恶性呕吐、腹泻、手足综合征、放射性皮炎发生率比较,无显著差异(P＞0.05).结论 Ⅱ、Ⅲ期直肠癌根治术后采用卡培他滨联合奥沙利铂同步放化疗治疗,相对于卡倍他滨单药同步放化疗治疗,疗效基本相似,但增加治疗毒副反应.

目的:探究并分析我院鼻咽癌放疗后无瘤生存患者的放疗毒副反应及生存质量.方法:收集我院调强放疗的鼻咽癌患者临床资料,共纳入50例患者,统计分析患者的急性放射性毒副反应和晚期放射性损伤,使用健康状况调查量表SF-36进行生存质量评估,比较各因素和生存质量的关系.结果:急性放射性毒副反应中黏膜反应、口干发生率高,晚期放射性损伤中听力损伤最高,其次是口干和皮肤组织纤维化;年龄、慢性病数量、临床分期、T stage(局部分期)和生存质量密切相关(P<0.05).结论:调强放疗的鼻咽癌患者中皮肤黏膜、口干,听力损伤发生率较高,Ⅲ、Ⅳ级放疗反应已不常见.尽早诊断治疗、改进放疗技术,进行放疗后健康宣教及后期功能锻炼,可提高患者的生存质量.

目的:利用IGRT技术,对ORFIT架固定,俯卧体位放疗的直肠癌患者进行分次间摆位误差分析研究,确定放疗计划临床靶区CT V至计划靶区PT V的外放边界大小,为临床精确治疗提供依据.方法:选取某院IGRT放疗的直肠癌患者29例,均采用俯卧位,热塑定位膜联合ORFIT架固定.每位患者从放疗开始,连续3次行治疗前锥形束CT扫描,后续治疗期间不定期行CBCT扫描7次,共采集10次锥形束CT图像,与计划CT图像进行配准,得出校正前的摆位误差数据.结果:29例患者共扫描290次图像,左右x、头脚y和前后z方向的摆位误差数值分别为(0.20±0.06)cm、(0.27±0.10)cm、(0.19±0.07)cm.根据Van Herk等推导的摆位扩边公式外放边界=2.5Σ+0.7σ,推算出CT V至PT V的x、y、z轴方向上外扩边界为0.56cm、0.75cm、0.53cm.

目的 探讨术前新辅助放化疗联合全直肠系膜切除(TME)治疗中低位局部进展期直肠癌的近期临床疗效.方法 40例中低位局部进展期直肠癌患者,所有患者均给予术前新辅助放化疗后联合TME治疗,评价术前及新辅助放化疗后的病理完全缓解率、肿瘤降期情况、根治性切除率(R0切除率)、保肛率.并记录患者治疗期间的不良反应发生情况.结果 40例患者中37例手术,7例病理完全缓解,完全缓解率为18.9％.降期情况:T降期28例,降期率为75.7％;临床分期N+患者31例,N降期24例,降期率为77.4％.术后根治性切除患者36例,R0切除率97.3％,1例患者阴道侵犯,未能完整切除病灶;术前新辅助放化疗过程中出现2例肝转移,1例腹腔转移,无法行TME手术.低位直肠癌患者20例,行miles手术患者10例,保肛率50.0％.40例患者中出现Ⅲ级血液系统毒性反应2例,1例为白细胞降低,1例为血小板降低,经对症治疗后血液指标均可恢复正常.术后出现不完全性肠梗阻患者2例,予保守治疗后缓解.无Ⅳ级不良反应,未见肠穿孔、吻合口瘘等严重并发症发生.结论 术前新辅助放化疗联合TME治疗局部进展期直肠癌的近期临床疗效显著,完全缓解率和降期率、保肛率较高,且安全性较好,值得在临床上推广应用.

Objective To study the prone position of carbon fiber web heating plastic film fixation technique on radiotherapy posture of rectal cancer, and its protection on the organs at risk.Methods A total of 50 postoperative patients with rectal cancer were randomly divided into two groups, with 25 cases in each group.The observation group underwent prone carbon fiber web heating plastic film fixed Intensity-modulated radiation therapy (IMRT), while the control group was treated with supine thermoplastic film and special plate fixation IMRT.The mean dose (Dmean) and total volume (VT) of the planned target area (PTV), the small bowel and bladder irradiation dose and volume were compared between two groups;the setup errors and incidence of acute radioactive reaction were compared between two groups.Results There were no significant difference of Dmean and VT in PTV between the two groups(P>0.05);the Dmean and irradiation volume in the small bowel and bladder of the observation group were significantly lower than those in the control group (P<0.05).There were no significant difference of displacement error of head-foot, left-right, and front-back between the two groups (P>0.05).The severity of gastrointestinal reactions and urinary tract reactions in the observation group was significantly lighter than those of the control group during the treatment period and after treatment (P<0.05).Conclusions The prone position of carbon fiber web heating plastic film fixation technique used in radiotherapy after radical resection of rectal cancer can ensure the efficacy of radiotherapy, protect the small intestine and bladder, and has good position repeatability and high safety.

目的 研究Ⅱ、Ⅲ期直肠癌术后调强放疗同期口服卡培他滨化疗的疗效.方法 126例Ⅱ、Ⅲ期直肠癌术后患者为研究对象,依据患者术后放化疗差异分为观察组(采取调强放疗同期口服卡培他滨化疗)及对照组[先行FOLFOX4方案3程化疗后实施调强放疗],各63例.对比治疗效果,观察用药不良反应.结果 观察组患者总生存率为95.24%(60/63),其中无病生存率为76.19%(48/63),局部复发率为1.59%(1/63);对照组患者总生存率为82.54%(52/63),其中无病生存率为58.73%(37/63),局部复发率为23.81%(15/63);观察组患者总生存率、无病生存率、局部复发率均优于对照组,差异均有统计学意义(χ2=5.143、4.375、14.032,P<0.05).观察组不良反应发生率79.37%高于对照组73.02%,但差异无统计学意义(χ2=0.700,P>0.05).结论 在Ⅱ、Ⅲ期直肠癌术后实施调强放疗联合卡培他滨同期化疗,疗效确切,提高患者生存质量,降低肿瘤局部复发风险,用药方案具有良好安全可行性,值得应用.

目的 探讨紫杉醇+卡铂(TC)化疗联合调强放疗治疗Ⅲ期子宫内膜癌术后的应用效果.方法 80例Ⅲ期子宫内膜癌患者,按照数字表法分为对照组和观察组,每组40例.对照组患者术后给予TC化疗,观察组患者术后给予TC化疗联合调强放疗,对比两组患者临床疗效与随访3年存活率.结果 观察组局部复发率明显低于对照组,差异具有统计学意义(χ2=5.16,P<0.05).随访3年,观察组患者生存36例,生存率为90.0%;对照组患者生存35例,生存率为87.5%.观察组生存率与对照组比较,差异无统计学意义(χ2=0.13,P>0.05).观察组毒性反应发生率高于对照组,但差异无统计学意义(χ2=1.25,P>0.05).结论 临床中对Ⅲ期子宫内膜癌患者术后实施TC化疗联合调强放疗可降低局部复发率,但在生存率方面未能体现明显优势,有待临床进一步研究及探讨.

目的 比较直肠癌术后容积调强弧形治疗(VMAT)同期化疗与调强放射治疗(IMRT)同期化疗的急性不良反应,探讨VMAT同期化疗的临床应用价值.方法 选取2010年7月～2017年1月于梅州市人民医院就诊的50例局部进展期直肠癌患者(T2～T4或N+)作为研究对象.根据不同的治疗方式,将其分为VMAT组(n=20例)和IMRT组(n=30例).其中VMAT组患者采用VMAT联合卡培他滨同期化疗,IMRT组患者采用IMRT联合卡培他滨同期化疗,两组同期化疗方案均为卡培他滨825mg/m2,2次/d,5次/周.辅助化疗为8～10次改良FOLFOX6方案.比较两组患者治疗期间皮肤黏膜、消化道、泌尿系及血液系统等急性不良反应的发生情况.结果 VMAT组患者均完成放疗,IMRT组有3例患者因不能耐受不良反应终止放疗.两组患者中急性不良反应最常见的依次是下消化道反应、皮肤黏膜反应及上消化道反应;IMRT组Ⅱ～Ⅳ级下消化道发生率显著高于VMAT组(P＜0.05);两组皮肤黏膜反应、泌尿系反应、上消化道反应及白细胞减少、血小板下降、贫血等骨髓抑制反应比较,差异无统计学意义(P＞0.05).结论 直肠癌术后VMAT联合卡培他滨同期化疗急性不良反应发生率较低,与IMRT联合卡培他滨同期化疗相比能显著减少严重的下消化道反应,治疗耐受性好.

目的:分析高危子宫内膜癌术后治疗中,调强放疗联合紫杉醇+卡铂(TC)化疗治疗方案的应用效果.方法:应用随机数字表法,将80例已接受手术治疗的高危子宫内膜癌患者分为对照组和观察组,每组40例.对照组术后接受调强放疗,观察组术后接受调强放疗联合TC化疗.对比两组近期疗效及随访生存情况.结果:两组完成治疗并随访3个月时,均无患者死亡.入组时,两组各项FACT-G-V4评分比较,差异均无统计学意义(P>0.05),完成治疗并随访3个月时,观察组各项FACT-G-V4评分均低于对照组(P<0.05).治疗及随访期间,两组不良反应发生率比较,差异无统计学意义(P>0.05).此外,截至2016年12月31日,观察组中位生存期明显优于对照组,差异有统计学意义(P<0.05).结论:调强放疗联合TC化疗治疗方案可有效提高高危子宫内膜癌术后的生存质量.

目的：探讨放疗联合奥沙利铂与卡培他滨治疗局部晚期直肠癌的临床疗效。方法回顾性分析我院2009年1月至2011年12月收治的70例局部晚期直肠癌患者的资料，所有患者均经手术治疗，按照患者术后治疗方式分为观察组（30例）及对照组（40例），观察组患者采用放疗联合奥沙利铂与卡培他滨治疗，对照组患者仅采用奥沙利铂与卡培他滨联合化疗，随访3年，比较两组患者的对两组患者的3年生存率、局部复发率及远处转移率，同时对两组患者不良反应进行评价。结果观察组患者局部复发率低、远处转移率低，比较差异有统计学意义（P＜0.05）；两组患者生存率比较有明显差异（P＜0.05）。两组患者不良反应比较无明显差异，无统计学意义（P＞0.05）。结论放疗联合奥沙利铂与卡培他滨治疗局部晚期直肠癌，能提高手术成功率，不增加不良反应，可作为晚期直肠癌的标准治疗方法。

腰椎间盘突出症(LIDH)是临床的常见病、多发病[1-2],电针腰突穴疗法作为治疗LIDH的非手术疗法之一,近年来有诸多成功报道[3,4].为进一步证实及推广这一治疗腰突症的特色方法,本研究自2012年5月-2013年1月,采用单穴电针腰突穴并与常规取穴电针组比较,观察了78例LIDH患者.现报告如下.

目的 探寻神经干取穴电针治疗腰椎间盘突出症的有效方法.方法 将61例单纯L4-5椎间盘突出症患者随机分为2组,两点神经干取穴电针为治疗组,常规取穴电针为对照组,2组的电针治疗参数一致.比较2组腰椎功能改善情况及临床综合疗效.结果 2组患者治疗后腰椎ODI评分较治疗前均有明显改善,治疗组改善情况优于对照组(P＜0.01);随访临床疗效,治疗组总有效率明显高于对照组(P＜0.05).结论 两点神经干取穴电针治疗腰椎间盘突出症较常规取穴电针具有更好的临床疗效.

目的:探讨膝骨关节炎患者股四头肌肌张力与膝关节功能的关系.方法:选择80例单侧膝骨关节炎患者,采用Myotonometer肌肉状态测试系统测定并对比患者双侧股四头肌的肌张力,同时采用美国特种外科医院膝关节评分标准评定患侧膝关节功能,采用相关分析和回归分析的方法研究股四头肌肌张力与膝关节功能的关系.结果:①股四头肌肌张力.静息状态下健侧股内侧肌压力-位移曲线下面积、股直肌压力-位移曲线下面积、股外侧肌压力-位移曲线下面积及股四头肌压力-位移曲线下面积均值均低于患侧,差异均有统计学意义[(20.97±3.36) kg·mm,(22.78±2.85)kg· mm,t=-4.935,P=0.000;(18.00±3.69)kg· mm,(18.98±3.91)kg· mm,t=-3.309,P =0.002;(17.78±3.55)kg· mm,(19.19±3.31) kg· mm,t=-4.437,P =0.000;(18.89±3.02)kg·mm,(20.32±2.94) kg·mm,t=-7.704,P=0.000].②股四头肌肌张力与膝关节功能的相关分析.本组患者患侧美国特种外科医院膝关节功能评分为(74.72±8.87)分.直线相关分析结果显示,患侧膝关节功能评分与静息状态下股内侧肌压力-位移曲线下面积、股直肌压力-位移曲线下面积、股外侧肌压力-位移曲线下面积及股四头肌压力-位移曲线下面积均值均呈负相关(r=-0.686,P=0.000;r=-0.570,P=0.000;r=-0.656,P=0.000;r=-0.719,P=0.000).③股四头肌肌张力与膝关节功能的回归分析.本组患者患侧美国特种外科医院膝关节功能评分与股四头肌静息状态下压力-位移曲线下面积均值的散点图提示二者存在直线相关趋势.以患侧膝关节功能评分为自变量(X),以患侧股四头肌静息状态下压力-位移曲线下面积均值为因变量(y),建立直线回归方程,Y=38.57-0.244X(F=62.126,P=0.000).结论:膝骨关节炎患者患侧股四头肌肌张力与膝关节功能呈负线性关系.由此推测,股四头肌肌张力降低可能既是膝骨关节炎的病变结果又是其病因,而通过改善患侧股四头肌肌张力或许能从力学机制上阻断或减缓膝骨关节炎发展的恶性循环.

Objective:To evaluate the effectiveness of anesthesia nurse(NBAS APS) pain management use for cesarean section.Methods:500 cases of first cesarean section were selected into traditional APS group from February to July 2012.500 cases of cesarean section from July to December 2012 were selected into NBAS APS group.The one-time analgesic pump after operation was used in both the two groups.The two groups were compared in terms of the analgesic effect,complications and overall satisfaction.Results:Compared with the traditional APS group,lower analgesic effect indicators(VAS values)(P<0.01),more maternal satisfaction(P<0.01) and more overall satisfaction significantly were observed in NBAS APS group(P<0.01).Conclusion:NBAS APS pain management mode significantly improves the safety and efficacy in cesarean section analgesia,and improves the maternal and family satisfaction.

Objective To explore the effect of fundamental causes analyzing on reduction of nursing defects in operation room. Methods The method of fundamental causes analyzing was adopted to find out the causes of nursing defects in the operation room during January 2008 to December 2009. The measures were worked out and the nursing defects in the room were recorded and analyzed after the countermeasures were taken. Result The nursing defects fell from 62 cases to 6 cases in the operation room. Conclusion The method of fundamental causes analyzing, together with the countermeasures may be effective in reducing the nursing defects in operation room and thus improving the nursing quality.