目的:探讨会阴收缩力计联合Kegel运动对中重度盆腔脱垂行腹腔镜阴道骶骨固定术患者盆底功能的影响.方法:以我院152例因中重度盆腔脱垂行腹腔镜阴道骶骨固定术患者为研究对象,根据入组时患者的术后时间分为3组,术后≥2年的患者为A组,1年≤术后<2年的的患者为B组,3个月≤术后<1年的患者为C组.根据术后治疗方法分为对照组(予以盆底肌电刺激及生物反馈治疗)和观察组(在对照组基础上予以会阴收缩力计与Kegel运动配合治疗);比较观察组和对照组干预前后尿失禁调查问卷(ICI-Q-SF)、国际女性下尿路症状调查问卷(ICIQ-FLUTS)、盆腔器官脱垂/尿失禁性生活质量问卷(PISQ-12)得分及盆底肌最大肌电压水平.结果:(1)观察组和对照组干预前ICI-Q-SF、ICIQ-FLUTS、PISQ-12得分及盆底肌最大肌电压比较,差异均无统计学意义(均P>0.05);(2)观察组和对照组干预后各随访时间点的各项评分及盆底肌最大肌电压均优于干预前,差异均有统计学意义(均P<0.05);(3)观察组在干预后各随访时间点的各项评分及盆底肌最大肌电压均优于对照组,差异均有统计学意义(均P<0.05);(4)观察组和对照组中的C组患者术后各项评分及盆底肌最大肌电压优于其他两个时间组.结论:中重度盆腔脱垂行腹腔镜阴道骶骨固定术的患者术后早期采用会阴收缩力计与Kegel运动配合可有效改善患者术后盆底功能,值得推广.

OBJECTIVE To investigate various factors affecting anticoagulant effects of warfarin,promote the rational use of warfarir.METHODS Medical records of 125 hospitalized patients receiving warfarin were collected from January 2014 to December 2015.Correlation of patient gcnder,age,treatment,pathological factors,drug interactions and concomitant diseases to warfarin were compared.RESULTS Infection prolonged hospital stay,hyperthyroidism increased ADR rate of warfarin related hemorrhage.Acarbose,enoxaparin and moxifloxacin had probable effects on anticoagulant effects of warfafin.CONCLUSION Anticoagulant effects of warfarin are affected by multiple factors,and should be closely monitored by medical staff.

Objective To explore the diagnostic and score value of ultrasound on hemophiliac arthropathy referring to MRI on the diagnosis and score of hemophiliac arthropathy Methods The ultrasound and MRI examinations were performed on 42 joints of 42 hemophilia patients 14 knees 14 ankles and 14 elbows The consistency of ultrasound and magnetic resonance imaging in the detection and score of joint diseases was compared Finally inter-and intra-observer agreement of ultrasound scoring system were tested Results The consistency of ultrasound and magnetic resonance imaging was excellent κ=0 763-0 896 P < 0 001 in the detection of early soft tissue lesions effusion or hemarthrosis synovial hypertrophy hemosiderin excellent κ=0 793 P <0 001 in the detection of cartilage loss poor κ=0 133 P = 0 132 in the detection of erosions and poor κ= 0 100 P = 0 137 in the detection of subchondral cysts The consistency of ultrasound and magnetic resonance imaging was good to excellentκ=0 684-0 833 P < 0 001 in the score of early soft tissue lesions effusion or hemarthrosis synovial hypertrophy and hemosiderin and poor to good κ=0 145 -0 635 P <0 001 in the score of advanced osteochondral lesions cartilage loss and bone erosions The inter-observer agreement was good to excellent κ=0 676-0 870 P <0 001 for early soft tissue lesions and moderate to excellent κ=0 421- 0 75 1 P < 0 001 for advanced osteochondral lesions The intra-observer agreement was good to excellent κ=0 705-0 885 P <0 001 for early soft tissue lesions and moderate to good κ=0 532 -0 732 P <0 001 for advanced osteochondral lesions Conclusions Ultrasound plays an important role in detecting early soft tissue changes effusion or hemarthrosis synovial hypertrophy hemosiderin and cartilage loss which helps follow-up and guide clinical treatment.

Objective To investigate the optimal preparation of the complex of paclitaxel-loaded heparin nanoparticles and microbubbles and screen the optimized ultrasound (US) condition for highly aggressive breast cancer cells MDA-MB-231 and less aggressive breast cancer cells MCF-7.Methods Paclitaxel-loaded nanoparticles were prepared using heparin as nanocarrier,and biotinlyated microbubbles were prepared by mechanical shaking.Paclitaxel-loaded nanoparticles was conjugated with microbubbles to prepare the complex using avidin-biotin system.The optimized method was screened.Breast cancer cell MDA-MB-231 and MCF-7 were treated with the prepared complex and different ultrasonic parameters including irradiation intensity and exposure duration were evaluated by cellular uptake experiments.Results The drug loading in the complex was 106.7 μg/108 microbubbles when the paclitaxel-nanoparticle concentration was 2 mg/ml.For MDA-MB-231 cells,the optimal irradiation intensity was 1.0 W/cm2 and the optimal exposure duration was 40 s,and they were 1.5W/cm2 and 40s for MCF-7 cells,respectively.Conclusions The complex with high drug loading weight,composed of paclitaxel loaded heparin nanoparticles and microbubbles,was successfully prepared,and it was found the optimal ultrasound condition was different in two breast cancer cells.

目的:探讨Celitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响效果.方法:选取我院口腔科已确诊为牙周炎患者60例,根据治疗方案不同分为实验组与对照组,对照组进行传统洁刮术治疗,实验组在对照组基础上将Cervitec凝胶涂抹于牙齿及牙周袋周围,比较两组患者的口腔健康指数、探诊及龈沟液水平、菌群抑制效果及主要细菌杀灭水平变化情况,其数据结果应用统计学软件SPSS 17.0处理.结果:与对照组相比较,实验组患者口腔指数、牙龈水平及菌群杀灭抑制效果明显,表现为:菌斑指数、牙龈指数、出血指数明显降低(P＜0.05);探诊深度、附着水平、龈沟液含量明显下降(P＜0.05);总菌群、G-及G+菌群抑制程度提高(P＜0.05);高登链球菌、缓症链球菌、变黑普氏菌、牙龈卟啉单胞菌杀灭程度明显提高(P＜0.05).其结果均有统计学意义.结论:Cervitec凝胶局部应用联合洁刮治术对牙周炎牙龈下菌群有良好抑制效果,并维持长久疗效,降低刺激程度及过敏情况,提高临床有效率,保护牙龈健康,对牙体产生较小的副作用.

OBJECTIVE:To screen the risk factors for osteopenia in youths. METHODS:Ninety-nine subjects aged 15 to 43 years with primary osteopenia(-2.580%). Joint clicking and skeletal pain were the most common symptoms, and most of the patients had complaints of fatigue, insomnia and gastric discomforts. CONCLUSIONS:Inactivity, prolonged use of computers, imbalanced diet, staying up late at night, and alcohol drinking are the risk factors for osteopenia in youths. Most of the patients have a sub-health status, indicating the necessity of relevant interventions to prevent the occurrence of osteoporosis.

<正>原发性骨质疏松症(osteoporosis,OP)是以骨量减少、骨组织微观结构破坏为特征的,致使骨的脆性增加以及易于发生骨折的一种全身性骨骼疾病[1]。近几十年来的研究表明:OP与人们的生活习惯、饮食及营养结构等密切相关,而这些因素恰好是健康管理的环节,故笔者认为健康管理是预防OP的有效手段。笔者在综述国内外OP健康管理研究现状的基础上,发现其存在"重视已病,疏于预防,未体现中医药学预防思想"等问题,报道如下。