OBJECTIVE To investigate the clinical characteristics of non-tuberculous Mycobacteria pulmonary disease（NTMPD）, identify the species of non-tuberculous Mycobacteria（NTM） with metagenomic sequencing and perform the cluster analysis. METHODS A total of 79 patients who were diagnosed with NTMPD in Fujian Provincial Hospital from Jan 2015 to Dec 2020 were enrolled in the study, the related clinical data were collected, the whole genome sequencing was carried out for 29 clinical NTM isolates by means of metagenomic next generation sequencing（mNGS）, the average nucleotide identity（ANI） analysis was performed for identification of the strains, and the cluster heat map of the ANI value was drawn for the clinical NTM isolates. RESULTS The number of confirmed cases of NTMPD was increased year by year. Among the 79 patients with NTMPD, there were 40 male cases and 39 female cases, the average age was（60.78±12.04） years old, and about 55.70%（44/79） had bronchiectasia. Cough（86.08%） and expectoration（75.95%） were the major clinical manifestations of the NTMPD patients; bronchiectasis（55.70%, 44/79）, tree-in-bud signs（43.04%, 34/79） and nodules（35.44%, 28/79） were the common CT imaging features. Alveolar lavage fluid specimens were dominant among the specimens cultured positive for NTM, accounting for 60.76%（48/79）. Totally 10 species of NTM were identified among the 29 strains of NTM, 58.62% of which were Mycobacterium avium complex, and 24.14% were Mycobacterium abscess. Among the M.avium complex strains, M. intracellulare, M.paraintracellulare and M. chimera had close ties of consanguinity, and the fast-growing M. abscess was distantly related to slow-growing NTM strains. CONCLUSION The patients with NTMPD lack typical clinical symptoms. It is necessary to remain vigilant for the possibility of NTM infection among the patients with CT imaging manifested as bronchiectasis complicated with nodules and tree-in-bud signs. There is certain association between the genotypes and the phenotypes of the NTM strains.

Objective To retrospectively analyze the clinical features and risk factors for death of patients with bloodstream infection （BSI） caused by Klebsiella pneumonia in adults for improving early prevention and effective treatment of K.pneumoniae BSI.Methods The medical records were collected from 114 adult patients with K.pneumoniae BSI and 335 patients with non-BSI infection caused by K.pneumoniae who were treated in Fujian Provincial Hospital from June 1,2017 to May 31,2019.The clinical characteristics,antimicrobial treatment,and outcomes of K.pneumoniae BSI were analyzed.SPSS 26.0 software was used to perform multivariate binary logistic regression analysis to identify the risk factors for the occurence and mortality of K.pneumoniae BSI.Results The K.pneumoniae BSI mainly occurred in intensive care unit （28.95%,33/114）,departments of hepatobiliary surgery （14.91%,17/114）,and gastroenterology （14.04%,16/114）.Malignant tumor,liver abscess,and deep venous catheterization were independent risk factors for the occurrence of K.pneumoniae BSI.K.pneumoniae BSI was associated with a significantly higher 28-day mortality rate compared with K.pneumoniae non-BSI infection （25.44% vs 14.93%,P=0.011）.The patients with K.pneumoniae BSI were also more likely to develop septic shock and complicated with multiple organ dysfunction syndrome （MODS）（P ＜ 0.001）.The prevalence of carbapenem-resistant K.pneumoniae （CRKP） was 20.18% （23/114） in adult patients with K.pneumoniae BSI.CRKP BSI was associated with significantly higher mortality rate than carbapenem-susceptible K.pneumoniae （CSKP） BSI （69.57% vs 14.29%）.Presence of ≥ 2 sites of infection,CRKP infection,and APACHE II score ≥ 10 were independent risk factors for death in patients with K.pneumoniae BSI.Conclusions Patients with K.pneumoniae BSI have a high mortality rate and are prone to MODS and septic shock.Clinicians should be aware of the risk of K.pneumoniae BSI in patients with malignant tumor,liver abscess,and deep venous catheterization.Multiple sites of infection,CRKP infection,and critical condition will increase the risk of death in patients with K.pneumoniae BSI.

目的 研究2种清洗消毒器对腔镜器械的清洗效果.方法 采用目测法、杰力试纸法和ATP生物荧光法对2种清洗消毒器清洗腔镜器械的效果进行检测.结果 清洗消毒干燥后2组腔镜器械目测、杰力试纸法和ATP生物荧光法检测结果合格率均无差别(均P>0.05),但喷淋清洗消毒器处理速度较慢,干燥合格率较低.相同腔镜器械一锅次装载量试验组(6套)多于对照组(2套),工作效率提高.结论 2种清洗消毒机对腔镜器械清洗效果均比较可靠,但脉动真空清洗消毒器的干燥效果更好.

Rhabdomyolysis syndrome is a clinical emergency that can cause disturbance of the internal environment and even acute renal failure.Rhabdomyolysis caused by viral infection is rare.This paper reported a case of COVID-19 who developed lower extremity muscle pain with soya urine during the progression of the disease and was clinically diagnozed with rhabdomyolysis syndrome.Through the analysis of clinical diagnosis and treatment data, clinicians will improve the alertness in the early recognition and diagnosis of this syndrome.

目的 探讨慢性阻塞性肺疾病(以下简称"慢阻肺")急性加重期患者痰标本人巨细胞病毒(human cytomegalovirus,HCMV)阳性的临床特征及危险因素.方法纳入2015年9月至2018年2月本院慢阻肺急性加重期住院患者106例,采集其痰标本.应用实时荧光聚合酶链反应(real-time fluorescence PCR,以下简称"实时荧光PCR")方法检测12种呼吸道常见病毒.其中检测出25例HCMV阳性患者,以其为HCMV阳性组.按1:2比例选择与HCMV阳性组患者具有同种基础疾病,且HCMV病毒检测阴性其他检测病原相同的50例患者进行匹配作为对照,即HCMV阴性组.回顾性分析慢阻肺急性加重期患者痰标本HCMV阳性的临床特征及易于检测出HCMV的危险因素.结果痰标本HCMV阳性组凝血酶原时间(prothrombin time,PT)(12.73±0.75)s低于痰标本HCMV阴性组(13.31±1.06)s,差异有统计学意义(P=0.016);HCMV阳性组患者尿素氮(blood urea nitrogen,BUN)[5.60(4.05,6.85)μmol/L]高于HCMV阴性组[4.30(3.30,5.33)μmol/L,P=0.012];HCMV阳性组住院天数[14(11,15)d]长于HCMV阴性组[11(8,13)d,P=0.002];HCMV阳性组合并心功能不全的比率(56％)高于HCMV阴性组(30％,P=0.029).多因素logistic回归分析结果提示吸入皮质激素(inhaled corticosteroid,ICS)是慢阻肺急性加重期患者痰液易于检测出HCMV的独立危险因素(OR:3.988;95％CI:1.214～13.099;P=0.023);而戒烟是其保护性因素(OR:0.159;95％CI:0.047～0.537;P=0.003).结论慢阻肺急性加重期患者痰液检出HCMV,其大部分可能属于潜伏感染,但对患者存在一定直接影响,如增加心血管风险、延长住院时间.长期吸入ICS治疗是导致慢性肺急性加重期患者痰液易于检出HCMV的独立危险因素,戒烟是其保护性因素.

目的:本研究对临床血流感染分离的碳青霉烯类药物耐药肺炎克雷伯菌(CRKP)的特征进行分析,以期为临床感染控制提供指导.方法:笔者连续收集了2017年1-12月福建省立医院微生物室从不同病区血标本培养出的CRKP共32株,对所有菌株均应用法国梅里埃公司VITEK2-compact全自动细菌分析仪进行细菌鉴定及药敏试验,同时应用微量肉汤稀释法测定替加环素的最低抑菌浓度(MIC)值,通过荧光定量聚合酶链反应(PCR)方法检测耐药基因,多位点序列分析(MLST)进行细菌同源性分析.结果:32株血流感染的CRKP对大多数抗生素具有较高的耐药率,发现了1株替加环素中介,余31株对替加环素均敏感,本院血流感染的CRKP对替加环素保持高度的敏感性.荧光定量PCR检出耐药基因KPC-224株(75.00％),CTX-M922株(68.75％),CTX-M13株(9.38％),膜孔蛋白编码基因Ompk36缺失29株(90.63％),膜孔蛋白Ompk37缺失2株(6.25％),MLST分型ST11型25株(78.13％).结论:本院临床血流感染分离的CRKP主要耐药机制是携带耐药基因KPC-2、CTX-M9,同时主要伴有膜孔蛋白Ompk36缺失,序列型ST11型是全国范围内主要的流行序列型,应引起临床重视.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解水果摄入联合吸烟、饮酒与食管癌发病的关系,为食管癌的预防控制提供参考依据。方法采用以医院为基础的病例对照研究方法,对2010年1月—2016年12月在福建省肿瘤医院和福建医科大学附属漳州市医院经病理组织确诊的1 181例原发性食管癌新发病例作为病例组及按病例组同性别、年龄（±5岁）频数匹配的同期在福建医科大学附属第一医院和福建医科大学附属漳州市医院骨科就诊的1 196例非肿瘤患者作为对照组进行问卷调查。结果在调整了性别、年龄、民族、文化程度、婚姻状况、人均月收入等混杂因素后,多因素非条件logistic回归分析结果显示,水果摄入较多是食管癌发病的保护因素,水果摄入频率与食管癌发病风险存在剂量–反应关系（χ²趋势=193.60,P &lt;0.001）;无论是否吸烟和饮酒,随着水果摄入频率的增加,食管癌的发病风险均呈下降趋势（均P &lt;0.001）;水果摄入、吸烟和饮酒存在相乘交互作用（P交互=0.040）,当吸烟和饮酒不存在时,水果摄入会降低食管癌的发病风险,水果摄入1～3次/周者和≥4次/周者食管癌的发病风险分别为水果摄入&lt;1次/周者的0.37倍（OR=0.37,95%CI=0.26～0.52）和0.16倍（OR=0.16,95%CI=0.08～0.30）;当水果摄入、吸烟和饮酒同时存在时,水果摄入&lt;1次/周、1～3次/周且吸烟和饮酒者食管癌的发病风险分别为水果摄入&lt;1次/周且不吸烟和不饮酒者的6.28倍（OR=6.28,95%CI=4.13～9.55）、1.68倍（OR=1.68,95%CI=1.09～2.58）,≥4次/周且吸烟和饮酒者与水果摄入&lt;1次/周且不吸烟和不饮酒者食管癌的发病风险差异无统计学意义（P&gt; 0.05）。结论水果摄入是食管癌发病的保护因素,其与吸烟和饮酒存在相乘交互作用,当三者同时存在时,水果摄入可降低吸烟和饮酒对食管癌发病的影响。</span>

目的 研究术前血清癌抗原19-9(cancer antigen 19-9,CA19-9)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)对食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者预后的影响.方法 前瞻性分析176例经病理确诊的食管鳞癌新发病例.应用x2检验分析CA19-9和NSE与患者一般临床特征之间的关系.运用Kaplan-Meier法绘制生存曲线,通过Log-rank法进行生存率的比较,利用Cox比例风险回归模型进行多因素分析.结果 高CA19-9和NSE联合检测组的食管鳞癌患者预后较差(总生存:HR=2.310,95％ CI:1.209 ～4.418;无病生存:HR=2.354,95％ CI:1.265 ～4.381).相比于两种标志物单独检测,联合检测CA19-9和NSE对食管鳞癌患者生存预测的准确性更高(总生存:C-index=0.686;无病生存:C-index=0.684).结论 术前血清CA19-9和NSE是食管鳞癌患者预后的危险因素,联合检测对食管鳞癌患者预后预测的准确性更高.

Objective To develop a method for rapid detection of influenza virus and its subtypes based on flow fluorescence technology, and then detect the clinical specimens by our established method . Methods We designed degenerate primers and specific probes, synthesized plasmids, used Luminex platform to establish detection method and later detected 430 clinical specimens, and compared the result with those of Fujian Center for Disease Control and prevention. Results A method for the simultaneous determination of influenza viruses A, B, C and its subtypes (H116, N19) was established. The time consumption was 3.5 hours, with good specificity, high sensitivity and feasible stability. The detection result of 430 clinical specimens showed high consistency with the result of Fujian Center for Disease Control and Prevention. Conclusions We established a method for simultaneous determination of influenza viruses and its subtypes, high sensitivity, specificity and stability. Key words: Influenza virus; Subtypes; Genotyping; Flow fluorescence technology

OBJECTIVE To elucidate the association between lifestyle and dietary factors and esophageal squamous cell carcinoma( ESCC) in three different sections of the esophagus. METHODS From January 2010 to December 2016, a hospital-based case-control study was conducted, and a total of 550 patients with ESCC and gender and age( ±3 age) frequency-matched 550 cancer-free control subjects were recruited in this study. Odds ratios( ORs) and their corresponding 95% confidence intervals( CIs) were calculated by using unconditional binary or multinomial logistic regression. Multiple correspondence analysis( MCA) was applied to illustrate the influence of the risk factors on different sections of the esophagus. RESULTS Tea drinking was associated with lower risk of upper( Ut) and lower thoracic( Lt) ESCC( OR = 0. 40, 95% CI 0. 22-0. 73; OR= 0. 50, 95% CI 0. 31-0. 81; for Ut and Lt, respectively), and lower intake of vegetables increased the risk of Ut and Lt ESCC( OR = 3. 93, 95% CI 1. 61-9. 61; OR =2. 68, 95% CI 1. 30-5. 53; for Ut and Lt, respectively). Intake of hot food, hard food and lower intake of fruits were associated with an elevated risk of the ESCC in all subsites( P<0. 05). The strength of association between drinking and ESCC was lower in middle thoracic( Mt) compared with the Lt ESCC( OR = 0. 58, 95% CI 0. 35-0. 98). Moreover, this reduction of association strength were also found in eating hot food( OR = 0. 45, 95%CI 0. 27-0. 76) and lower intake of vegetables( Ut OR = 0. 44, 95% CI 0. 20-0. 99). However, the association between lower intake of fruits and the Mt ESCC risk was stronger compared with Lt ESCC( OR = 1. 66, 95% CI 1. 08-2. 55). In additional, the association between lower intake of fruits and the Ut ESCC risk was stronger compared with Mt ESCC. Joint category plot of MCA also identified the heterogeneous associations between risk factors and different sections of the esophagus. CONCLUSION Differences in risk factors of ESCC in different subsites, intake of hot food, hard food, and lower intake of vegetables were common risk factors for three subsites of ESCC.

Objective To investigate the association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with non-operative therapy.Methods The clinical data of 325 non-operative treated ESCC patients were collected in this study.The X-title software was applied to establish optimal threshold of neutrophil reduction to the lowest value.According to the optimal threshold,the patients were divided into early group (115 cases) and late group (210 cases).The clinical features and survival time of the two groups were compared,and the factors of prognosis were analyzed by Cox regression model with univariate and multivariate analysis.Results The X-title software demonstrated the optimal cutoff values for the time of neutrophils to the lowest was 39 days.The median overall survival time was 21.0 months in the early group which was significantly higher than that in the late group (16.0 months).Multivariate Cox regression analysis showed that the treatment methods and the time of neutrophils to the lowest were independent factors for overall survival of patients with ESCC treated by non-surgical therapy.Compared with radiotherapy alone,concurrent chemoradiation could benefit the survival (HR=0.64,P=0.026).The prognosis of patients in the late group of neutrophils to the lowest (HR =1.38,P =0.038) was poor compared with the early group.Furthermore,stratified by treatment methods,the overall survival of two groups showed statistically significant difference only in patients received concurrent chemoradiation.The mortality risk in the late group was higher than that in the early group (HR=3.53,P=0.010).Conclusion The time of neutrophils to the lowest is an independent prognosis factor for non-operative treated ESCC patients.The prognosis of patients in the early group is better than that in the late group.

目的 探讨恒温扩增芯片法在下呼吸道感染细菌耐药基因检测中的应用.方法 收集2017年5～10月我院外科重症监护室103例肺部感染患者的下呼吸道分泌物,进行恒温扩增芯片法检测和细菌培养+药敏试验,分析患者的耐药基因检出情况、细菌培养+药敏试验结果、恒温扩增芯片法与药敏试验符合率.结果 恒温扩增芯片法在90例患者中检测到13种耐药基因,阳性检出率为87.4％(90/103).103例患者中49例细菌培养阳性,细菌培养阳性率为47.6％,培养得到50株菌株.对培养的50株菌株进行药敏试验,显示氨曲南和环丙沙星等11种抗生素的出现频率均在20％以上.以细菌培养为金标准,恒温扩增芯片法与药敏试验耐药药物种类相符的样本符合率为65.3％;其中以CTX-M9、OXA-23、MecA、OXA-66、KPC-2和ermB这6个基因符合率最高,且按类别组合分析的结果符合率更佳.结论 恒温扩增芯片法的检出率都明显高于传统的细菌培养+药敏试验,且两者符合率较高,在临床上具有良好的应用前景.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解非吸烟非饮酒人群中茶和奶制品摄入与原发性肺癌发病的关系,为原发性肺癌的预防控制提供参考依据。方法采用以医院为基础的病例对照研究方法,对2006年1月—2015年7月在福建医科大学附属第一医院、福建医科大学附属协和医院和南京军区福州总医院经病理组织确诊的564例非吸烟非饮酒的原发性肺癌新发病例作为病例组及按病例组同性别、年龄（±2岁）匹配的同期在此3家医院访视病人的564名非吸烟非饮酒的健康人群作为对照组进行问卷调查。结果在调整了性别、年龄、民族、文化程度、体质指数、是否家庭场所被动吸烟、是否工作场所被动吸烟、肺部疾病史、肿瘤家族史、厨房油烟情况等混杂因素后,多因素非条件logistic回归分析结果显示,饮茶的非吸烟非饮酒人群原发性肺癌发病风险为不饮茶的非吸烟非饮酒人群的0.457倍（OR=0.457,95%CI=0.341～0.613）,且饮茶年限、每周饮茶次数、饮茶浓度和每月饮茶量均与原发性肺癌发病风险存在剂量–反应关系（均P &lt;0.001）,饮红茶、绿茶和花茶者原发性肺癌发病风险分别为不饮茶者的0.351倍（OR=0.351, 95%CI=0.187～0.657）、 0.493倍（OR=0.493, 95%CI=0.326～0.745）和0.207倍（OR=0.207, 95%CI=0.090～0.474）;食用奶制品的非吸烟非饮酒人群原发性肺癌发病风险为不食用奶制品的非吸烟非饮酒人群的0.503倍（OR=0.503,95%CI=0.387～0.653）,且食用奶制品频次和饮奶量均与原发性肺癌发病风险存在剂量–反应关系（均P &lt;0.001）;饮茶和食用奶制品对原发性肺癌发病存在相乘交互作用（P交互=0.001）,饮茶和食用奶制品的非吸烟非饮酒人群原发性肺癌发病风险为不饮茶和不食用奶制品的非吸烟非饮酒人群的0.195倍（OR交互=0.195,95%CI=0.129～0.294）。结论茶和奶制品摄入是非吸烟非饮酒人群原发性肺癌的保护因素,两者联合作用时可显著降低非吸烟非饮酒人群原发性肺癌的发病风险。</span>

Objective To analyze the clinical manifestations of pulmonary fungal disease in patients with different pathogen infection and different immune states. Methods A retrospective analysis was carried out with the clinical data of 78 patients with pulmonary fungal disease who were treated in Fujian Provincial Hospital from June 2012 to June 2016. Results The identified pathogens included Cryptococcus (78.2％, 61/78), Aspergillus(17.9％, 14/78), Talaromyces marneffei, Mucor, and Trichosporon asahii (one each). Cryptococcus was mostly found in healthy individuals without underlying disease and Aspergillus largely infected those with underlying disease. Diabetes mellitus was the most common underlying disease. Pulmonary fungal infection was confirmed by pneumonectomy (41.0％, 32/78), CT-guided percutaneous transthoracic biopsy (43.6％, 34/78), transbronchial lung biopsy (14.1％, 11/78), or blood culture (1.3％, 1/78). Pulmonary cryptococcosis was often asymptomatic (47.5％, 29/61). Hemoptysis was only found in the patients with underlying disease. The patients with pulmonary aspergillosis showed higher prevalence of hemoptysis (57.1％, 8/14) than the patients with other pulmonary fungal diseases. Bronchoscopy usually gave negative finding in case of pulmonary cryptococcosis (77.8％, 14/18). Inflammatory exudation was the primary finding of pulmonary aspergillosis (6/10). Intraluminal necrosis and neoplasia were only found in the aspergillosis patients with underlying disease. The primary imaging findings in pulmonary cryptococcosis was nodule or mass (78.7％, 48/61). Halo sign and crescent sign were rarely found in pulmonary aspergillosis. Of the 78 patients, 45 (57.7％) patients received pharmacological therapy alone, 15 (19.2％) surgical treatment alone, and 18 (23.1％) received drugs in combination with surgery. Six patients died, 25 lost to follow-up, and 47 with stable disease. Conclusions The clinical characteristics of pulmonary fungal disease vary with the pathogen and the immune states of patients. Clinical symptoms and immune status of patients should be taken into account when making diagnosis of pulmonary fungal disease for the purpose to speculate the probable fungal pathogen and choose the most appropriate diagnostic tool.

Objective: To investigate the effect of "patients' family participation and quiz" health education in high-quality nursing of patients with breast cancer. Methods: 100 cases of patients who received modified radical mastectomy for breast cancer were randomly divided into experimental group (50 cases) and control group (50 cases), the control group used conventional health education method, while experimental group emphasized the family participation and quiz on the basis of conventional education, and compared the recovery of hand's function, knowledge of health education and satisfaction of the two groups. Results: The recovery of hand's function, knowledge mastery and satisfaction of experimental group were significantly better than those of control group (P<0.01). Conclusion: "Patients' family participation and quiz" health education has a satisfactory effect in high-quality nursing of patients with breast cancer, which has improved the quality of nursing and satisfaction of patients.

肺癌作为21世纪最常见且高发的恶性肿瘤之一,其发病率和死亡率在全球已跃居第一,严重威胁人们的生命健康.目前关于肺癌的病因除遗传因素外,行为生活方式的影响也起重要作用.该文对吸烟、饮食、饮茶和个人行为导致的室内空气污染、睡眠及体力活动等相关因素进行综述,为肺癌的防治提供参考.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解腌制食品摄入联合吸烟、饮酒与食管癌发病的关系,为食管癌防治策略的制定提供理论依据。方法采用以医院为基础的病例对照研究方法,对2010年1月—2015年12月在福建医科大学附属漳州市医院经病理组织确诊的645例原发性食管癌新发病例作为病例组及按病例组同性别、年龄（±5岁）匹配的同期在该院就诊的646例非肿瘤患者作为对照组进行问卷调查。结果在调整了性别、年龄、文化程度、婚姻状况、人均月收入等混杂因素后,多因素条件logistic回归分析结果显示,腌制食品是食管癌发病的危险因素,腌制食品摄入频率与食管癌发病风险存在剂量–反应关系（χ2趋势=21.030,P&lt;0.001）;腌制食品摄入5⁷次/周且吸烟者食管癌发病风险为腌制食品摄入&lt;1次/周且不吸烟者的2.517倍（OR=2.517,95%CI=1.412⁴.485）;腌制食品摄入5⁷次/周且饮酒者食管癌发病风险为腌制食品摄入&lt;1次/周且不饮酒者的3.683倍（OR=3.683,95%CI=2.101⁶.456）;腌制食品摄入3⁷次/周且吸烟和饮酒者食管癌发病风险为腌制食品摄入≤2次/周且不吸烟和不饮酒者的4.455倍（OR=4.455,95%CI=2.502⁷.931）。结论腌制食品的摄入是食管癌发病的危险因素,腌制食品摄入联合吸烟和饮酒会明显增加食管癌发病的风险。</span>

随着城市化 、工业化 、老龄化及全球化进程的加剧 ,以及生态环境恶化 、生活方式改变 、生物学和遗传学因素的影响 ,恶性肿瘤的危险因素暴露频率与水平均不断增长 ,全世界恶性肿瘤发病率和死亡率均呈上升态势 ,2012 年全球肿瘤流行病统计数据显示 :2012 年全球新增约 1410 万例癌症病例 ,癌症死亡人数达 820 万 ,与之相比 ,2008 年的数据分别为1270 万和 760 万 . 中国恶性肿瘤发病例数占世界恶性肿瘤发病例数的 25 .49％ ,死亡例数占世界死亡例数的 26 .70％ ,其发病率和死亡率均居世界恶性肿瘤第 1 位 ,已成为严重威胁人类生命和社会发展的重大公共卫生问题[1] .

目的 探讨宫腔填塞Bakri球囊在产后出血中的止血效果.方法 回顾性分析2013-2014年在福建省妇幼保健院分娩并发产后出血行宫腔填塞Bakri球囊患者12例的疗效.结果 采用Bakri球囊止血的12例产后出血患者,11例有产科并发症或合并症,平均30.9岁;初产妇4例,经产妇8例;剖宫产9例,阴道分娩3例,产后平均出血1414.2 mL.有6例输入血液制品,平均输血580 mL.12例经Bakri球囊填塞宫腔后血止,无子宫切除及并发感染,患者取出球囊后均未再出血.结论 产后出血时采用宫腔填塞Bakri球囊止血,其操作简单、快速,止血效果好,值得推广.

目的 探讨早期甲状腺激素检测在妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)患者中的临床价值.方法 回顾性分析2014年7月1日—2017年2月28日福建省妇幼保健院妇产科收治的妊娠期肝内胆汁淤积症患者62例(研究组),同期随机选择30例健康孕妇(对照组),对两组孕妇临床资料进行统计比较,并分析甲状腺激素早期检测在ICP患者中的临床价值.结果 研究组TBA和TSH水平均高于对照组(P<0.05);而研究组FT3与FT4水平均低于对照组(P<0.05);对照组和研究组TBA异常率分别为0%和96.77%;对照组和研究组FT3异常率分别为6.67%和91.94%;对照组和研究组FT4异常率分别为13.33%和90.32%;对照组和研究组TSH异常率分别为6.67%和91.94%;研究组TBA、FT3、FT4、TSH异常率均高于对照组(P<0.05);FT3、FT4、TSH检测在ICP患者诊断中其敏感性与特异性均较高,可以作为ICP早期诊断的辅助检测指标.结论 甲状腺激素检测在妊娠期肝内胆汁淤积症患者中具有重要的临床价值,可以作为早期诊断的辅助性指标.