目的 分析早期活动康复对机械通气患儿肌力的影响,探讨影响肌力的相关因素。方法 采取回顾性研究,选择2021年4月—2023年4月医院收治的104例机械通气患儿临床资料,根据康复方法分为两组,其中采取常规康复训练的52例患儿为对照组,采取早期活动康复的52例患儿为观察组。两组均连续干预至出院,比较两组患儿的机械通气、住ICU、总住院时间、不同时点（转出ICU时、出院时、出院1个月）的肌力及Barthel日常生活能力（Barthel）评分;参照《中国重症肌无力诊断和治疗指南（2015年简版）》中诊断标准,评估机械通气患儿获得性肌无力（AW）发生情况。统计并比较两组基线资料,采用二元Logistic回归分析机械通气患儿AW发生的影响因素。结果 观察组的机械通气、住ICU及总住院时间[（7.28±2.47）d、（15.27±3.64）d、（27.08±5.68）d]均短于对照组[（10.64±3.39）d、（17.74±3.55）d、（32.57±6.14）d]（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时英国医学研究委员会（MRC）肌力评定法评分升高,且观察组转出ICU时、出院时MRC评分[（53.57±5.13）分、（56.84±2.16）分]均高于对照组[（50.13±4.57）分、（53.67±2.42）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时Barthel评分升高,且观察组转出ICU时、出院时Barthel评分[（65.03±12.47）分、（90.58±7.59）分]均高于对照组[（55.25±11.12）分、（84.13±9.62）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;住院期间104例机械通气患儿发生AW 31例,发生率29.81%,AW组机械通气时间、营养风险筛查量表2002（NRS）评分[（11.84±4.19）d、（3.07±1.04）分]高于非AW组[（8.18±2.26）d、（1.61±0.75）分],且有创机械通气模式、使用罗库溴铵患儿[77.42%（24/31）、32.26%（10/31）]占比均高于非AW组[53.42%（39/73）、13.70%（10/73）]（P<0.05）;二元Logistic回归分析结果显示,机械通气时间长、有创机械通气模式、使用罗库溴铵、NRS评分高是机械通气患儿AW发生的危险因素（OR>1,P<0.05）。结论 早期活动康复能够有效缩短机械通气患儿患儿通气时间及住院时间,改善肌力,提高生活自理能力,同时机械通气时间、创机械通气模式、使用罗库溴铵、NRS评分与机械通气患儿肌力下降有关。

Objective To analyze the effect of early mobilization and rehabilitation on muscle strength in children with mechanical ventilation and to explore the risk factors affecting muscle strength．Methods A retrospective study was conducted on 104 children with mechanical ventilation admitted to the hospital from April 2021 to April 2023．According to the rehabilitation methods,they were divided into two groups．The clinical data of children with routine rehabilitation training were included in the control group（52 cases）,and the clinical data of children with early mobilization and rehabilitation were included in the observation group（52 cases）．Both groups were continuously intervened until discharged．The mechanical ventilation time,ICU stay and total hospital stay were compared between the two groups．Muscle strength and self-care ability at different time points（transfer out of ICU,discharge,1 month after discharge）,the incidence of acquired weakness（AW）in children with mechanical ventilation were evaluated according to the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis． Baseline data was collected and compared between the two groups．Binary logistic regression was used to analyze the risk factors of AW in children with mechanical ventilation．Results The mechanical ventilation time,ICU and total hospitalization time in the observation group[（7.28±2.47）d,（15.27±3.64）d,（27.08±5.68）d] were shorter than those in the control group[（10.64±3.39）d,（17.74±3.55）d,（32.57±6.14）d]（P<0.05）．Compared with those at the time of transfer out of ICU and discharge,the Medical Research Council（MRC）scores of the two groups increased at 1 month after discharge,and the MRC scores of the observation group at the time of transfer out of ICU and discharge[（53.57±5.13）,（56.84±2.16）] were higher than those of the control group[（50.13±4.57）,（53.67±2.42）]．There were significant differences between the two groups,time points and between groups · time points（P<0.05）．Compared with those at the time of transferring out of ICU and at discharge,the Barthel scores of the two groups increased at 1 month after discharge,and the Barthel scores of the observation group at the time of transferring out of ICU and at discharge[（65.03±12.47）,（90.58±7.59）] were higher than those of the control group[（55.25±11.12）,（84.13±9.62）]．There were significant differences in Barthel scores between the two groups,time points and groups · time points（P<0.05）．AW occurred in 31 of 104 children with mechanical ventilation during hospitalization,with an incidence of 29.81%．The mechanical ventilation time and Nutritional Risk Screening（NRS）score in the AW group[（11.84±4.19）d,（3.07±1.04）] were higher than those in the non-AW group[（8.18±2.26）d,（1.61±0.75）]．The proportion of children with invasive mechanical ventilation mode and the use of rocuronium[77.42%（24/31）,32.26%（10/31）] were higher than those in the non-AW group[53.42%（39/73）,13.70%（10/73）]（P<0.05）．Binary logistic regression analysis showed that long mechanical ventilation time,invasive mechanical ventilation,use of rocuronium and high NRS score were risk factors for AW in children with mechanical ventilation（OR>1,P<0.05）．Conclusions Early mobilization and rehabilitation can effectively shorten the ventilation time and hospitalization time of patients with mechanical ventilation,improve muscle strength and improve the ability of self-reliance．At the same time,mechanical ventilation time,mechanical ventilation mode,use of rocuronium and NRS score are related to the decrease of muscle strength in children with mechanical ventilation．

目的 探讨骨肉瘤（OS）和软组织肉瘤（STS）的关键核心基因（Hub基因）及其潜在作用,为肿瘤诊断和预后提供新依据。方法 从基因表达综合数据库（GEO）获得OS数据集GSE16088及STS数据集GSE21122,采用GEO2R在线工具筛选GSE16088和GSE21122数据集的差异表达基因（DEGs）。通过韦恩图获得2个数据集共同DEGs。选取2个数据集中差异表达最显著的上调和下调基因各20个,分别绘制聚类热图。通过使用注释、可视化和综合发现数据库（DAVID）对2个数据集的共同DEGs进行功能（GO）和通路（KEGG）富集分析。构建蛋白互作网络并使用最大中心度（MCC）算法筛选排名最前的10个基因作为潜在的关键Hub基因。采用受试者工作特征（ROC）曲线探讨关键Hub基因对肉瘤患者的诊断价值。通过Kaplan-Meier Plotter进行生存期分析。通过实时荧光定量PCR技术对得分靠前的5个Hub基因进行验证。结果 GSE16088数据集筛选出5 210个DEGs,其中上调和下调的DEGs分别为1 028、4 182个;GSE21122数据集共筛选出1 224个DEGs,其中上调和下调的DEGs分别为451、773个;2个数据集共获得498个共同DEGs。共同DEGs参与到多个生物学过程和信号通路。基于PPI网络和MCC算法最终获得10个关键Hub基因,ROC曲线验证结果符合预期,且生存期分析10个关键Hub基因与肉瘤预后显著相关（P<0.05）。Hub基因在mRNA表达水平和生物信息学分析结果一致（P<0.05）。结论 10个关键Hub基因可用于肉瘤的诊断和预后,为后续免疫治疗提供新视野。

Objective To explore the Hub genes of osteosarcoma（OS）and soft tissue sarcoma（STS）and their potential roles,and to provide evidence for tumor diagnosis and prognosis．Methods The GSE16088 dataset and the GSE21122 dataset were screened in the Gene Expression Omnibus database of the National Center for Biotechnology Information in the United States．The online editing tool GEO2R was used to screen the DEGs of the GSE16088 dataset and the GSE21122 dataset and the Veen map was drawn to find the common DEGs of the GSE16088 dataset and the GSE21122 dataset．20 up-regulated and 20 down-regulated genes with the most significant differential expression were selected from 2 datasets,and heatmaps were drawn for each．The Database for Annotation,Visualization and Integrated Discovery was used to perform GO function enrichment analysis and KEGG pathway enrichment analysis on DEGs of GSE16088 dataset and GSE21122 dataset．PPI network of DEGs was constructed by STRING．PPI sub-modules and Hub genes with high connectivity were screened．Maximal clique centrality（MCC）score was used to select the Hub genes in the protein interaction network．The predictive value of 10 Hub genes in sarcoma patients was analyzed by receiver operating characteristic（ROC）curve．Survival analysis was performed by means of the Kaplan-Meier Plotter．The top five core genes were verified by real-time fluorescence quantitative PCR．Results A total of 5 210 genes were screened in GSE16088 dataset,including 1 028 and 4 182 genes with upregulated and downregulated expression．A total of 1 224 genes were selected from the GSE21122 dataset,including 451 and 773 genes with upregulated and downregulated expression．The cluster heatmap was used to show the top 20 DEGs with high and low expression in GSE16088 and GSE21122 datasets．By differential analysis of gene expression between the two datasets,498 co-DEGs were obtained．GO and KEGG enrichment showed that common DEGs were associated．Ten Hub genes were obtained by PPI and MCC algorithm,the ROC curve verification results were as expected．Survival analysis showed that 10 Hub genes were significantly associated with the prognosis of sarcoma（P<0.05）．The mRNA expression level of Hub genes was the same as the results of bioinformatics analysis（P<0.05）．Conclusions The 10 Hub genes can be used for the diagnosis and prognosis of osteosarcoma,and provide a new vision for subsequent immunotherapy．

目的 探讨富血小板血浆（PRP）联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为（91.00±9.27）%、（0.29±0.12）%、（29.98±6.68）%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组（P<0.05）。经重复方差测量分析,两组美国特种外科医院膝关节评分系统（HSS）评分、西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟疼痛评分法（VAS）交互（F_交互=1.869、F_交互=1.482、F_交互=2.193）比较差异均有统计学意义（P<0.05）;与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降（P<0.05）;观察组并发症总发生率4.55%低于对照组30.43%（χ²=5.156、P=0.023）。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。

Objective To investigate the clinical effect of platelet rich plasma（PRP）combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function．Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method．Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group．The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared．Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were（91.00±9.27）%,（0.29±0.12）%,and（29.98±6.68）% respectively．The PRP preparation quality is stable and controllable．The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group（P<0.05）．After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery（HSS）Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,and visual analogue pain scales（VAS）interacted(F_Interaction=1.869,F_interaction=1.482,F_interaction=2.193),the differences were statistically significant（P<0.05）．Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased（P<0.05）;the total incidence of complications in the observation group was 4.55%,lower than that in the control group（30.43%,χ²=5.156,P=0.023）．Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time．It has good effects and is relatively safe．

目的 分析烟雾病患者在血管重建术并发脑高灌注综合征的危险因素,为指导预防血管重建术后并发症提供参考依据。方法 选择2022年9月—2023年9月期间医院接收的148例烟雾病患者为研究对象,采用血管重建术治疗,统计术后高灌注综合征发生率,单因素分析术后并发高灌注综合征与性别、年龄、既往史、类型、铃木分期、灌注分期、手术侧别、入院改良Rankin 量表（mRS）评分、术后脑血流量（CBF）等因素的关系,并采取非条件Logistic多因素回归分析烟雾病患者血管重建术后并发高灌注综合征的危险因素。结果 148例患者血管重建术后,共42例并发脑高灌注综合征,发生率为28.38%。其中术后并发脑高灌注综合征与无并发脑高灌注综合征患者的性别、总胆固醇、甘油三酯、空腹血糖、入院mRS评分及基础疾病类型、手术侧别和手术时间比较差异无统计学意义（P>0.05）。烟雾病血管重建术后并发脑高灌注综合征患者年龄、是否合并高血压、铃木分期、灌注分期、收缩压、舒张压、术后CBF与无脑高灌注综合征患者比较差异有统计学意义（P<0.05）。年龄、收缩压、舒张压、铃木分期、灌注分期、CBF为烟雾病血管重建术后并发脑高灌注综合征的影响因素（P<0.05）。结论 烟雾病患者血管重建术后并发高灌注综合征的危险因素主要为高龄、收缩压升高、舒张压升高、铃木分期中晚期、灌注分期高、CBF降低,对此类患者需引起重视,做好针对性干预。

目的 分析恩格列净对2型心肾综合征（CRS）患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组（44例,给予常规治疗）、实验组（44例,在常规治疗的同时加用恩格列净）,通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组（均P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。

Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome（CRS）．Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group（44 cases,receiving conventional treatment）and experimental group（44 cases,receiving conventional treatment combined with englaglitzin）by computer program．The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions．Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group．The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment（P<0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion．

目的 探讨男性人乳头瘤病毒（HPV）基因分型感染情况。方法 收集采用聚合酶链式反应反向斑点杂交法进行28种HPV基因分型检测的1 137例男性检查结果,进行回顾性分析。结果 1 137例男性患者中阳性441例,阳性率为38.79%,感染率居前5位的亚型依次为HPV6（11.35%）、HPV11（7.92%）、HPV16（5.10%）、HPV52（3.52%）、HPV43（2.64%）;就诊人群以20~39岁为主,感染人数也最多,各年龄组间阳性率比较差异无统计学意义（P>0.05）,≥50岁组HPV52型阳性率高于20~29岁组（P<0.05）和30~39岁组（P<0.05）。单一感染占67.35%,多重感染占32.65%,单一感染中低危型占比最多（41.27%）,多重感染中,二重感染占比最多（19.50%）,高低危混合感染为各种类型感染之首（15.87%）。结论 1 137例样本中HPV阳性率为38.79%,感染亚型以HPV6、HPV11、HPV16、HPV52、HPV43为主,单一低危型感染较为常见,各年龄组间阳性率相近。

Objective To investigate the genotypes of human papillomavirus（HPV）infection．Methods A total of 1 137 male patients’ diagnoses were collected and analyzed retrospectively,which came from the detections using polymerase chain reaction reverse dot blot hybridization to genotype 28 HPV．Results Among 1 137 male patients,441 were HPV positive,with a positive rate of 38.79%,the infections of top five HPV types were HPV6（11.35%）,HPV11（7.92%）,HPV16（5.10%）,HPV52（3.52%）,HPV43（2.64%）．The majority of the patients were the 20-39 age group,and the number of infections was also the highest．There was no statistical significance on the difference in the positive rate among different age groups（P>0.05）．The positive rate of HPV52 in ≥50 years old group was higher than the groups of aged 20~29（P<0.05）and 30~39（P<0.05）．The single and multiple infections accounted for 67.35% and 32.65%．The low-risk HPV accounted for the highest proportion（41.27%）in single infections,while in patients with multiple infections,the proportion of dual infections was the largest（19.50%）and the high- and low-risk HPV mixed infections was the maximum of the infection types（15.87%）．Conclusions The detection rate of positive HPV in 1 137 male patients was 38.79%,mainly were type 6,type 11,type 16,type 52 and type 43,and the single low-risk HPV infected was common．Positive rates were similar among different age groups．

目的 探讨产科监护室妊娠期糖尿病产妇泌乳启动延迟及影响因素,以期作为预防泌乳启动延迟的参考依据。方法 选择2021年1月—2023年5月期间医院产科监护室接收的妊娠期糖尿病产妇80例为研究对象,采用单因素和多因素分析产妇的年龄、体质指数、产次、定期复查血糖、妊娠期高血压、分娩方式、开奶时间、新生儿体质量、产后焦虑、产后抑郁、产后疲乏、吸吮次数等对泌乳启动延迟的影响。结果 妊娠期糖尿病产妇泌乳启动延迟33例,发生率41.25%;泌乳启动延迟产妇的年龄≥35岁者占51.52%、未定期复查血糖者占39.39%、合并妊娠期高血压者占54.55%、开奶时间≥6 h者占57.58%、产后焦虑者占30.0%、产后抑郁者占36.36%、产后疲乏者占36.36%、吸吮次数<6次者占60.61%,与非泌乳启动延迟产妇比较差异均有统计学意义（P<0.05）。两组孕前体质指数、产次、分娩方式、新生儿出生体质量比较差异无统计学意义（P>0.05）。年龄≥35岁、未定期复查血糖、合并妊娠期高血压、开奶时间≥6 h、产后焦虑、产后抑郁、产后疲乏、吸吮次数<6次为妊娠期糖尿病产妇泌乳启动延迟的危险因素（P<0.05）。结论 产科监护室妊娠期糖尿病产妇泌乳启动延迟发生率较高,主要受到年龄、未定期复查血糖、合并妊娠期高血压、开奶时间、产后心理状态、吸吮次数等因素影响,应重视健康教育和早期辅助干预,降低泌乳启动延迟发生率。

Objective To explore the delayed lactation initiation and its influencing factors of pregnant women with diabetes in the obstetric care unit,so as to provide a reference for preventing delayed lactation initiation．Methods A total of 80 pregnant women with diabetes who were received by the hospital obstetric care unit from January 2021 to May 2023 were selected as the research objects．The age,body mass index,parity,regular blood glucose recheck,pregnancy hypertension,delivery mode,starting time,neonatal weight,postpartum anxiety,postpartum depression,postpartum fatigue,sucking times and other factors that led to the delay of lactation initiation were analyzed by single factor and multi factor analysis．Results The onset of lactation was delayed in 33 pregnant women with diabetes,with an incidence of 41.25%．The age of postpartum women with delayed lactation initiation over 35 years old accounted for 51.52%,blood sugar was not regularly rechecked accounted for 39.39%,pregnancy induced hypertension accounted for 54.55%,lactation time over 6 hours accounted for 57.58%,postpartum anxiety accounted for 30.0%,postpartum depression accounted for 36.36%,postpartum fatigue accounted for 36.36%,and sucking frequency <6 times accounted for 60.61%,which were higher than that of non-delayed lactation initiation women（P<0.05）．There was no statistically significant difference between the two groups in terms of pre pre-pregnancy body mass index,parity,delivery method and newborn birth weight（P>0.05）．The risk factors of delayed lactation initiation in pregnant women with diabetes were age ≥ 35 years,no regular blood glucose review,hypertension during pregnancy,≥ 6 h of first milk expression time,postpartum anxiety,postpartum depression,postpartum fatigue and sucking times<6（P<0.05）．Conclusions The incidence of delayed lactation initiation in pregnant women with diabetes in the obstetric care unit is high,which is mainly affected by age,pregnancy induced hypertension,time of starting breast feeding,postpartum psychological state and sucking times．Health education and early auxiliary intervention should be emphasized to reduce the incidence of delayed lactation initiation．

目的 通过分析奥氮平的群体药代动力学研究,探讨影响奥氮平药动学参数的因素,为临床制定个体化给药方案提供依据。方法 在中国知网、万方、维普、迈特思创、PubMed和Embase等中英文数据库,以“奥氮平”“群体药代动力学”“模型”“非线性混合效应模型”及“olanzapine pamoate”“olanzapine”“population pharmacokinetic”“pharmacokinetic model”“nonlinear mixed effect”“NONMEM”为检索策略,检索建库至2023年5月所有关于奥氮平群体药代动力学的研究。结果 共纳入14篇奥氮平的群体药代动力学研究,大多数研究将奥氮平的药代动力学描述为一个单室模型。成人群体药代动力学模型群体典型值吸收速率常数：（0.3~2.85）/h;表观分布清除率：（10.4~25.4）L/h;表观分布容积：（223~2 390）L。儿童青少年模型群体典型值吸收速率常数：（0.142~0.758）/h;表观分布清除率：（13.6~16.8）L/h;表观分布容积：（322~899）L。年龄、体质量、性别、种族、吸烟状况、合并用药是影响奥氮平药动学参数的显著协变量。结论 奥氮平药动学参数估计值存在差异且有不同程度的个体间变异,未来应侧重于对特殊人群的研究。有必要对先前发表的模型进行外部验证,以便更准地的描述模型的适用性。

Objective By analyzing the population pharmacokinetics of olanzapine,the factors affecting the pharmacokinetic parameters of olanzapine were discussed,so as to provide a basis for the clinical formulation of individualized dosing regimens．Methods In Chinese and English databases such as CNKI,Wanfang,Wipro database,FMRS,PubMed and Embase,all studies on population pharmacokinetics of olanzapine from the establishment of the database to May 2023 were searched with “olanzapine pamoate”“olanzapine”,“population pharmacokinetics”,“pharmacokinetic model”,“nonlinear mixed-effect” and “NONMEM” as key words．Results A total of 14 population pharmacokinetic studies of olanzapine were included．Most studies described the pharmacokinetics of olanzapine as a single-chamber model．Adult pharmacokinetic model population typical values absorption rate constant was（0.3-2.85）/h;apparent distribution clearance was（10.4-25.4）L/h;apparent volume of distribution was（223-2390）L．absorption rate constants of the population of children and adolescents was（0.142-0.758）/h,apparent distribution clearance was（13.6-16.8）L/h,apparent volume of distribution was（322-899）L．Age,weight,gender,ethnicity,smoking status and concomitant medication were significant covariates affecting the pharmacokinetic parameters of olanzapine．Conclusions Estimates of pharmacokinetic parameters of olanzapine vary and have varying degrees of inter-individual variation．In the future,research should focus on special populations．Externally validation of previously published models should also be performed to more accurately describe the applicability of the models．

目的 分析PDCA管理法在医院药事管理中的应用效果。方法 将我院2 000批药品设置为研究对象,样本纳入的起始、截止时间分别为2022年1月、2022年12月,依据时间对纳入样本开展组别划分,将2022年1月—6月1 000批药品设置为PDCA管理前研究对象,期间接受常规药品管理;将2022年7月—12月1 000批药品设置为PDCA循环法管理后研究对象。对比PDCA管理前后药品不良事件发生率及药事管理质量评分。结果 PDCA循环法管理后药学差错事件发生率低于PDCA循环法管理前,分别为0.30%、1.90%,对比差异有统计学意义（P<0.05）;PDCA循环法管理后建立药品质量监控体系、药品调剂制度、抗肿瘤药物分级管理方案和处方管理、临床药师参与四个维度评分较PDCA循环法管理前均有明显提升,分别为18.15±1.83、18.15±1.64、18.22±1.67、18.07±1.84,管理前后评分对比差异具有统计学意义（P<0.05）。结论 医院药事管理采用PDCA管理法可提升药事管理质量,降低药品不良事件发生率,值得应用。

Objective To analyze the application effect of PDCA cycle method in hospital pharmaceutical management．Methods A total of 2 000 batches of drugs in our hospital were included as research objects,the inclusion start and end of samples were January 2022 and December 2022．The included samples were divided into groups according to the time,1 000 batches of drugs from January 2022 to June 2022 were included as research objects before PDCA management,during which they were subjected to routine drug management．1 000 batches of drugs from July 2022 to December 2022 were included as the research objects under management by PDCA cycle method．The incidence of adverse drug events and the quality score of drug administration before and after PDCA administration were compared．Results The incidence of pharmaceutical error events after PDCA cycle management was lower than that before PDCA cycle management,which were 0.30% and 1.90%,respectively,and the differences were statistically significant（P<0.05）．After PDCA cycle management,the scores of establishment of drug quality control system（18.15±1.83）,drug dispensing system（18.15±1.64）,anti-tumor drug grading management scheme and prescription management（18.22±1.67）,clinical pharmacist participation（18.07±1.84）were significantly improved compared with those before PDCA cycle management,and the difference between scores before and after PDCA cycle management was statistically significant（P<0.05）．Conclusions PDCA cycle can improve the quality of pharmaceutical management and reduce the incidence of adverse drug events,which is worthy of application．

目的 对比分析在产程不同阶段对妊娠期高血压产妇给予分娩镇痛的效果差异。方法 选择2021年1月—2022年12月在福清市妇幼保健院接受无痛分娩治疗的240例妊娠期高血压产妇,随机分为在产程活跃期实施镇痛的对照组（n=120）和产程潜伏期实施镇痛的实验组（n=120）,比较两组产妇的产程时间、子宫动脉、胎儿脐动脉血流动力学参数、镇痛效果以及母婴结局。结果 实验组的第一、第二、第三产程时间分别为（389.71±35.05）（58.62±5.26）（8.71±0.69）min,略低于对照组的（403.72±42.19）（60.74±7.22）（8.91±1.62）min,但组间比较差异无统计学意义（P>0.05）;实验组镇痛前、活跃期、第二产程的疼痛评分分别为（9.18±0.13）（1.16±0.22）（2.83±1.16）分,与对照组的（9.22±0.16）（1.24±0.32）（2.72±1.09）分比较差异无统计学意义（P>0.05）,但在潜伏期,实验组产妇疼痛评分为（3.32±0.36）分,低于对照组的（8.11±0.32）分（P<0.05）;关闭镇痛泵后,实验组胎儿脐动脉阻力指数、搏动指数、收缩期峰值流速/舒张期流速分别为（0.58±0.09）（0.81±0.14）（2.31±0.29）,与对照组的（0.54±0.11）（0.79±0.13）（2.24±0.27）比较差异无统计学意义（P>0.05）,实验组产妇子宫动脉阻力指数、搏动指数、收缩期峰值流速/舒张期流速分别为（0.42±0.08）（0.64±0.08）（2.31±0.29）,均高于对照组的（0.39±0.06）（0.58±0.11）（1.65±0.08）（P<0.05）;实验组自然分娩、中转剖宫产、阴道助产例数及新生儿Apgar评分分别为87例、23例、10例、（8.88±0.15）分,与对照组的83例、28例、9例、（8.81±0.19）分比较差异无统计学意义（P>0.05）。结论 潜伏期与活跃期对妊娠期高血压产妇实施分娩镇痛对产程时间以及母婴结局的影响不大,但潜伏期镇痛可改善产妇潜伏期的疼痛,可尽早缓解产妇痛苦,且对产妇子宫动脉血流灌注的影响更小。