目的 分析加味补阳还五汤联合甲钴胺片与神经肌肉电刺激治疗,对外伤性周围神经损伤患者的运动神经功能传导速度(MNCV)、感觉神经传导速度(SNCV)、炎症因子水平的影响.方法 选取南京紫金医院 2020 年 8 月至 2022 年 8 月收治的外伤性周围神经损伤患者60 例,并通过随机数字表法将其分为对照组(30 例)和观察组(30 例).对照组患者口服甲钴胺联合神经肌肉电刺激治疗,观察组患者在对照组的基础上结合加味补阳还五汤治疗,两组患者均治疗 3 个月.对比两组患者治疗效果,治疗前后MNCV、SNCV、核因子-κB及炎症因子水平变化.结果 观察组患者治疗总有效率高于对照组;与治疗前比,治疗后两组患者腓总神经、股神经、正中神经、尺神经的MNCV、SNCV均加快,观察组快于对照组;治疗后两组患者血清核因子-κB、肿瘤坏死因子-α、C-反应蛋白水平均降低,且观察组低于对照组(均P<0.05).结论 加味补阳还五汤联合甲钴胺片与神经肌肉电刺激治疗外伤性周围神经损伤患者,可有效改善患者神经传导功能,减轻炎症反应,提高治疗效果.

Objective:To study the reliability and validity of the Chinese Nanjing persistent vegetative state scale（CNPVSS）in assessing the state of consciousness of brain-damaged patients in different gender and age subgroups，so as to provide a point of scientific reference for the clinical application of the scale.Methods:The reliability of the CNPVSS was calculated by statistically analyzing the CNPVSS scores of 1 100 patients in different states of consciousness after brain injury. The validity of the scale was analyzed by applying it to four states of consciousness：coma，vegetative state / unresponsive awakening syndrome（VS/UWS），minimally conscious state（MCS），and conscious wakefulness. The male and female patients were further divided into four age subgroups，respectively：1–20 years old，21–40 years old，41–60 years old，and 61–80 years old. The reliability and validity of CNPVSS scale in the eight groups were then evaluated.Results:The reliability of CNPVSS was good，and the Cronbach’s alpha coefficient was 0.969；the internal consistency was good（ P<0.001），and the correlation between the score of each item and the total score was statistically significant（ P<0.001）；the total scores of different states of consciousness：coma［1（1，2）］，VS / UWS［2（2，3）］，MCS［7（6，9）］，and conscious wakefulness［19（16，20）］，with statistically significant difference（ P<0.001）. The reliability and validity of the scale in different gender and age subgroups come out well，and the results were basically consistent with the overall analysis. Conclusion:CNPVSS is a good instrument for assessing the state of consciousness，which can be used for quantitative analysis of consciousness states of brain-damaged patients under 80 of different gender.

目的 研究通腑醒神汤对脑出血患者神经功能恢复及炎性因子的影响.方法 选取60例脑出血患者,均于2018年10月—2020年1月收治,按随机数字表法分为对照组(30例)和试验组(30例).对照组使用吡拉西坦注射液治疗,试验组在此基础上联合使用通腑醒神汤治疗.2组患者均连续治疗2个疗程,共14 d,其中7 d为一个疗程.比较2组患者MoCA评分、Barthel评分、NIHSS评分、血清hs-CRP、TNF-α、IL-6水平及中医证候积分于治疗前后的变化.结果 2组患者MoCA评分、Barthel评分在治疗后均升高,且试验组高于对照组;而NIHSS评分、血清hs-CRP、NSE、IL-6水平、偏身麻木、口舌歪斜、气短乏力、大便干结等中医证候积分均降低,且试验组低于对照组(均P<0.05).结论 通腑醒神汤可修复脑出血患者的神经功能,降低血清hs-CRP、NSE、IL-6水平,抑制炎症反应,缓解临床症状,且效果显著,优于单纯使用吡拉西坦注射液治疗.

Objective:To investigate hospital acquired infection (HAI) in hospitalized patients who were mainly treated with hyperbaric oxygen (HBO) during the period when the whole society and the hospital were in level one public health emergency response to COVID-19.Methods:The HAI incidence and infectious pathogen test results of 138 patients (the observation group) who were given HBO therapy in Nanjing Zijin Hospital in February 2020, the period of level one public health emergency response to COVID-19, were collected, and they were analyzed in year-on-year comparison with the corresponding data of the 133 patients (the control group I) admitted to the hospital in February 2019, and in month-on-month comparison with the corresponding data of the 213 patients (the control group II) admitted to the hospital in December 2019.Results:The HAI incidence of the observation group (10.87%) was about 5% lower than that (15.04%) in the control group I and that (15.02%) in the control group II, but there was no statistical difference ( χ2=1.43, P=0.49). The pathogens detected in the observation group were pseudomonas aeruginosa, acinetobacter baumannii, and serratia marcescens, which were less than those detected in the control group II. Conclusion:Strict social isolation and ward infection control measures can effectively reduce HAI incidence in patients given HBO therapy, but the reliability of such measures needs further demonstration by multi-center and large-sample data.