Objective :To explore influence of Tongxinluo capsule ,Shuxuetong injection combined carvedilol on ECG , serum levels of matrix metalloproteinase (MMP)‐9 and P‐selectin in patients with unstable angina pectoris (UAP). Methods :A total of 105 UAP patients were randomly divided into routine treatment group (n＝52) and combined treatment group (n＝53 ,received Tongxinluo capsule ,Shuxuetong injection and carvedilol based on routine treat‐ment group) ,both groups were continuously treated for one month .LVEF ,cardiac output (CO) ,serum levels of MMP‐9 and P‐selectin , therapeutic effects of ECG and angina pectoris , and incidence of adverse reactions were measured and compared between two groups before and after treatment .Results :Compared with routine treatment group , there were significant rise in total effective rates of ECG (59. 62% vs.79. 25%) and angina pectoris (71.15% vs.90.57%) in combined treatment group , P＜0. 05 both .Compared with routine treatment group after one‐month treatment ,there were significant rise in LVEF [ (45.30 ± 5.60 )% vs.(59. 33 ± 5. 31 )%] and CO [ (3.15 ± 1.14) L／min vs .(4. 92 ± 1. 18) L／min] ,and significant reductions in serum levels of P‐selectin [ (25. 40 ± 2.34) ng／ml vs.(16.85 ± 1. 62) ng／ml] and MMP‐9 [ (37. 30 ± 8. 91) μg／L vs.(27.80 ± 8.63) μg／L] in com‐bined treatment group , P＝0. 001 all.There was no significant difference in incidence of adverse reactions between two groups , P＝0.334. Conclusion :Tongxinluo capsule ,Shuxuetong injection combined carvedilol possess significant therapeutic effect on UAP patients .They can significantly improve cardiac function ,serum levels of P‐selectin and MMP‐9 with satisfying safety ,which is worth extending .

Objectives:To investigate the influence of Guizhi Fuling capsule on the clinical effects and inflammatory factors in patients with chronic pelvic inflammatory disease.Methods:120 patients with chronic pelvic inflammatory disease in our hospital from February 2015 to October 2016 were chosen and divided into research group and control group.The control group were treated with moxifloxacin and research group were treated with Guizhi Fuling capsule on the basis of control group.After 3 weeks' treatments,the clinical effects,inflammatory factors and adverse reaction between the two group were compared.Results:The total effective rate of research group was higher than control group (95.00％ vs 81.67％),with statistically significant difference (x2 =51.175,P ＜ 0.05).Before treatment,inflammatory factors between the two group had no significant difference (t =0.729,0.148,0.136,0.098,0.289,0.517,P ＞ 0.05).After treatment,TNFα,IL-1 β,IL-8 of research group were lower than these in the control group,while TGFβ1,IL-4 and IL-10 were higher than control group,with statistically significant difference (t =14.453,8.717,5.569,22,788,9.372,8.348,P ＜ 0.05).In the course of treatment,no serious adverse events occurred in research group,and in control group,3 patients (5.00％) had nausea after taking the medicine.There was no significant difference in the incidence of adverse reactions between the two groups (x2 =1.372,P ＞ 0.05).Conclusion:Guizhi Fuling capsule can effectively improve the inflammation of patients with chronic pelvic inflammatory disease,with good clinical effects and safety.

目的 回顾性分析孕前进行优生遗传咨询与检查的结果,探究其临床意义.方法 回顾性分析我院2015年1月～ 2017年8月155例进行孕前优生遗传咨询与检查的临床资料,对其检查结果进行分析.结果 155例进行孕前优生遗传咨询的咨询者均进行了孕前优生遗传检查(检查率100％);检查出不良孕产史31例(检出率20％),高危产妇15例(检出率9.68％),染色体异常14例(检出率9.03％);14例异常核型中不孕不育5例(检出率9.62％),妊娠胎儿丢失3例(检出率6.00％),智力低下3例(检出率12.00％),原发性闭经3例(检出率13.04％).结论 染色体异常是引发不孕不育、妊娠胎儿丢失、智力低下、不良孕产史、原发性闭经等疾病的主要原因,也是孕前优生遗传咨询的主要问题所在;开展孕前优生遗传咨询与检查是重要的孕前保健措施,进行科学合理指导能够有效降低新生儿缺陷,提升优生水平,增强人口素质.

在20世纪70年代初期临床开始应用腹腔镜 ,主要用于疾病的治疗和诊断.在近年来国外妇科腹腔镜手术的水平逐渐落后于我国[1 ] .作为一种现代微创手术 ,腹腔镜在各类妇科疾病中的治疗与诊断也逐渐广泛.腹腔镜手术与传统的开腹手术比较具有明显的优越性 ,如术后并发症发生的概率低、出血少、切口较小、恢复快、住院时间短等.

妇科恶性肿瘤在妇科病中是较为严重也较为常见的一类疾病，给患者带来严重的身心创伤［1，2］。目前，化疗是治疗肿瘤的常见手段之一，但是药物对患者的胃、肠刺激较大，常有恶心、呕吐等反应。呕吐、恶心等不良症状会严重影响患者的心理健康，继而影响治疗效果［3］。因此，对恶性肿瘤患者进行心理干预也是治疗的重要组成部分，但常规的心理干预效果不是很明显。本科将循证护理应用于恶性肿瘤药物化疗患者的心理干预，已取得较好效果。报告如下。

目的:探讨替罗非班对急性ST段抬高型心肌梗死(STEMI)诊经皮冠状动脉介入(PCI)治疗后,患者心肌生化标志物及心功能的影响.方法:104例STEMI患者随机分为观察组与对照组,每组52例,均给予急诊经皮冠状动脉介入术(PCI)治疗,术后对照组给予常规治疗,观察组在对照组基础上加用替罗非班治疗,对比两组患者治疗后血小板聚集率、血清肌酸激酶同工酶(CK-MB)水平、肌钙蛋白Ⅰ水平、心肌梗死溶栓治疗(TIMI)分级、心电图ST段回落情况、左室射血分数(LVEF)、不良心血管事件(MACE)发生率.结果:治疗后两组患者CK-MB水平、肌钙蛋白Ⅰ水平及血小板聚集率、TIMI分级、LVEF均显著优于治疗前,观察组显著优于对照组(P＜0.01);观察组治疗后ST段回落幅度显著优于对照组(P＜0.01),治疗后MACE发生率显著低于对照组(P＜0.05).结论:替罗非班可能能够通过抑制血小板聚集,有效改善PCI术后患者心肌生化指标及心功能.

在当今医患关系日趋紧张的环境中,不慎的用药及检查都将引起严重的医疗纠纷,其中又以妊娠期孕妇为甚.特别是在妇科病区里,妊娠孕妇占有1/3～1/6的高比例,有些是终止妊娠的,另一些是继续妊娠的孕妇,处理措施截然相反,一旦用药及检查出错,将对继续妊娠的孕妇带来不可逆或难以估计的不良后果.为了加强对这类高危人群的风险管理,我科于2007年2月始对继续妊娠孕妇的床头卡做身份标记,杜绝了2例差错事故的发生。