目的 了解门诊老年患者补充与替代医学（CAM）使用现状及影响因素。方法 采用便利抽样法,选取2020年11月—2021年2月广东省某三甲医院老年科门诊就诊的老年患者作为研究对象,调查方法采用一般资料调查表和CAM使用情况调查表进行横断面调查。应用二元Logistics回归分析探讨门诊老年患者使用CAM的影响因素。结果 参与调查的123例老年患者中,有75例（61.0%）老年患者使用CAM,使用CAM的项目主要为中草药、药膳等中国传统医学项目。支付方式是门诊老年患者是否使用CAM的影响因素,使用医保支付的患者较公费、自费患者更愿意使用CAM（OR=5.054,95%CI：1.452~17.590,P<0.05）。结论 CAM在门诊应用广泛,我们应充分发挥我国传统医学优势,为老年人疾病防治提供更多的思路。政府层面也可进一步提高医保覆盖范围,让更多的患者有经济能力可以接受安全、有效的治疗。

Objective To investigate the current status of complementary and alternative medicine（CAM）use and the influencing factors of elderly patients in outpatient clinic．Methods Using the convenience sampling method,the elderly patients treated in the geriatric outpatient department of a Class A tertiary Hospital in Guangdong from November 2020 to February 2021 were selected．General data and the CAM usage questionnaire were collected．Binary logistics regression analysis was used to explore the factors influencing CAM use in elderly patients．Results Seventy-five（61.0%）of 123 elderly patients used CAM．Chinese herbal medicine and medicinal diet were the most common CAM．Payment method was a factor affecting whether elderly outpatient patients use CAM．Insured patients were more willing to use CAM than self-funded patients（OR=5.054,95%CI：1.452-17.590,P<0.05）．Conclusions CAM is widely used in outpatient clinics．We should make full use of our country’s traditional medicine,to provide different thoughts of diseases prevention and treatment in elderly patients．The government can also further enlarge the coverage of health insurance,so that more patients can afford safe and effective treatment．

目的 探讨癫痫患者疾病进展恐惧水平的影响因素。方法 选取2021年1月—2022年8月本院收治的82例癫痫患者,评估所有患者的疾病进展恐惧水平,设计基线资料调查表,详细统计所有患者的基线资料,比较不同资料特征癫痫患者的恐惧疾病进展简化量表（FoP-Q-SF）评分,重点分析癫痫患者疾病进展恐惧水平的影响因素。结果 经评估,82例癫痫患者的FoP-Q-SF评分为（34.73±5.16）分;不同年龄、社会支持、希望水平、发作频率及受教育程度癫痫患者的FoP-Q-SF评分比较差异有统计学意义（均P<0.05）,其他不同资料特征癫痫患者的FoP-Q-SF评分比较,差异无统计学意义（P>0.05）;多元线性回归分析结果显示,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素（P<0.05）。结论 癫痫患者疾病进展恐惧呈中高水平,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素。

目的 了解广州市社区居民对中医“治未病”的认知现状,分析其影响因素,并为中医“治未病”的进一步发展提出可行建议。方法 采用多阶段整群抽样法,对广州市不同区域的652名居民进行问卷调查,通过描述性分析和χ²检验分别对基本认知情况与影响因素进行阐述。结果 广州市居民对“治未病”服务了解情况不太理想（67.80%）,接受“治未病”服务的意愿情况较好（77.91%）,对于中医“治未病”服务的认知还比较片面,主要通过手机、网络、社区等方式了解相关内容。影响居民接受意愿的因素主要是年龄、学历、户口、职业类型等。结论 目前广州市社区中医“治未病”服务具有一定群众基础和发展潜力,但是还存在居民认知不足、宣传力度不够、服务能力不足等问题,应当着重从这些方面进行改进。

Objective To understand the current cognitive status of community residents in Guangzhou regarding traditional Chinese medicine（TCM）pre-treatment,analyze its influencing factors,and provide feasible suggestions for the further development of TCM pre-treatment．Methods By multi-stage cluster sampling method,a questionnaire survey was conducted on 652 residents in different regions of Guangzhou．Descriptive analysis and chi-square test were used to elucidate the basic cognitive situation and influencing factors．Results The understanding of TCM pre-treatment services among residents in Guangzhou was not ideal（67.8%）,and their willingness to receive TCM pre-treatment services was good（77.91%）．Their understanding of TCM pre-treatment services was quite one-sided,mainly through mobile phones,internet,communities and other means．The main factors affecting residents' willingness to accept this service were age,education level,household registration and occupation．Conclusions At present,the TCM pre-treatment service in the community of Guangzhou has a certain mass basis and development potential．However,there are still problems such as insufficient residents' awareness,insufficient publicity,and insufficient service capabilities,which should be improved in the future．

目的 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为（30.69±8.98）分,口腔健康评估平均为（8.59±3.68）分,口腔健康相关生活质量GOHAI总分为（25.65±8.10）分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关（P<0.05）。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素（P<0.05或P<0.01）。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。

Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people．Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people．Results The 266 middle-aged and elderly people had a mean score of（30.69±8.98）for general knowledge and behavioral scores of oral health,a mean score of（8.59±3.68）for oral health assessment,a total score of（25.65±8.10）for oral health-related quality of life GOHAI．The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people（P<0.05）．The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly（P<0.05）．Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents．

目的 探究精神分裂症患者应用帕利哌酮后剂量校正浓度（C/D）的影响因素,旨在为精神分裂症患者的临床用药提供参考。方法 选择2021年9月–2022年5月在我院择期接受帕利哌酮治疗的122例精神分裂症患者作为研究对象,收集患者的年龄、性别、给药剂量、给药频次以及合并用药等状况。结果 不同性别间帕利哌酮C/D存在差异,其中女性的C/D明显比男性的C/D更高。在关于年龄、性别、给药剂量、给药频次以及合并用药对帕利哌酮C/D的影响分析中,合并用药阿立哌唑、性别对帕利哌酮C/D有影响。结论 帕利哌酮应用在精神分裂症患者治疗中,性别、合并应用阿立哌唑会对帕利哌酮C/D产生显著影响。

Objective To explore the influencing factors of dose-corrected through concentration（C / D）of paliperidone in patients with schizophrenia,in order to provide reference for clinical medication of patients with schizophrenia．Methods A total of 122 patients with schizophrenia treated with paliperidone in our hospital from September 2021 to May 2022 were selected as the research objects．The patient's age,gender,dosage,frequency of administration and combined medication were collected．Results There were differences in the C / D of paliperidone between different genders,and the C / D of women was significantly higher than that of men．In the analysis of the effects of age,gender,dosage,frequency of administration and combined medication on the C / D of paliperidone,the combined medication of aripiprazole and gender had effect on the C / D．Conclusions The application of paliperidone in the treatment of patients with schizophrenia,gender and combined application of aripiprazole can have significant impact on C / D．

目的 研究高胆红素血症新生儿溶血三项及抗体效价的相关影响因素。方法 采用回顾性分析,选取我院2022年7月—2023年3月期间收治的新生儿高胆红素血症85例,所有患儿均接受溶血三项检查及母亲IgG 抗体效价检测,其中溶血三项包括直接抗人球蛋白试验、抗体释放试验、血清游离抗体试验。记录患儿出生孕周、性别、日龄、母亲怀孕次数、母亲分娩方式、母亲IgG 抗体效价及血红蛋白水平、总胆红素水平指标,观察上述因素对溶血三项检测阳性有无影响,并开展影响溶血三项检测阳性的多因素Logistic回归分析。结果 85例高胆红素血症患儿中,高胆红素血症阳性63例（74.12%）;其中男婴32例（50.79%）、女婴31例（49.21%）,A型30例（47.62%）、B型31例（49.21%）、O型2例（3.17%）、AB型0例（0.00%）。不同血型高胆红素血症患儿溶血三项阳性率比较差异无统计学意义（χ²=0.857,P=0.652）,不同母亲IgG 抗体效价高胆红素血症患儿溶血三项阳性率比较差异有统计学意义（χ²=19.807,P<0.001）。结论 新生儿溶血阳性可能与母体中血型抗体效价密切相关,可随其升高而升高,应针对特定人群开展针对性干预,改善新生儿结局。

目的 探讨急性胆囊炎患者术后胆管损伤发生的诊治及影响因素分析。方法 随机选取2019年3月—2020年6月经腹腔镜胆囊切除术后发生胆管损伤的86例急性胆囊炎患者作为观察组,另选同期腹腔镜胆囊切除术治疗未发生胆管损伤的56例患者作为对照组,观察2组患者的影响因素将其进行对比分析。结果 2组患者病历资料中的胆囊壁厚度≥ 4 mm、Calot三角充血、Calot三角水肿经统计学分析有差异(P＜0.01);手术情况中比较发现,胆囊三角区的解剖变异、术中操作不当、术中经验不足情况,经统计学分析有差异(P＜0.05);胆囊壁厚度≥ 4 mm、Calot三角充血、Calot三角水肿、胆囊三角区的解剖变异、术中操作不当、术中经验不足均为急性胆囊炎术后胆管损伤的独立影响因素(P＜0.05)。结论 急性胆囊炎患者术后发生胆管损伤的影响因素较多,应制定精准化的手术方案,在最大程度上减少胆管损伤的发病率,从而确保手术的安全性。

目的 探讨性别、年龄、日剂量、合并用药、药物厂家等因素对使用阿立哌唑患者稳态血药浓度的影响,为临床合理用药提供依据。方法 收集深圳市康宁医院2019年1月—2021年2月使用阿立哌唑住院患者血药浓度监测数据样本229份,包括患者性别、年龄、日剂量、合并用药、药物厂家等基本信息,使用SPSS 25.0统计学软件对数据进行回顾性分析。结果 经多元线性回归分析,本研究仅性别、日剂量能解释阿立哌唑血药浓度的变化。使用阿立哌唑患者血药浓度剂量比值(C/D)女性组高于男性组(P＜0.01),阿立哌唑合用丙戊酸盐组高于无合用组(P＜0.05),年龄、其他合并、药物厂家用药对阿立哌唑(C/D)值的影响无统计学差异。结论 阿立哌唑C/D值与性别有关,合并用药对其有一定影响,不同药物厂家的阿立哌唑C/D值无统计学差异,临床应加强治疗药物监测,根据血药浓度及临床诊疗效果,结合药物经济学因素优化给药方案。

Objective To provide the reference for clinical rational use of aripiprazole,to investigate the effects of gender, age, daily dose, concurrent medication, drug manufacturer and other factors on the steady-state serum concentration in aripiprazole patients. Methods Serum concentration monitoring data of 229 inpatients using aripiprazole in Shenzhen Kangning Hospital from January 2019 to February 2021 was collected, including patients' gender, age, daily dose, concurrent medication, drug manufacturer and other basic information, which were retrospectively analyzed by SPSS 25.0 statistical software. Results In this study, only gender and daily dose could explain the significant changes of aripiprazole serum concentration after multiple linear regression analysis. The serum concentration/dose ratio (C/D) was significantly higher in female patients than in male patients (P＜0.01), and the group of aripiprazole combined with valproate was markedly higher than the non-combined group (P＜0.05). Nevertheless, there were no statistically significant differences in the effects of age, concurrent medication and drug manufacturer on aripiprazole C/D values. Conclusions The C/D value of aripiprazole was closely related to gender, and concurrent medication had a certain effect on it. There was no statistical difference in the aripiprazole C/D value among different drug manufacturers. This study suggested that clinical monitoring of therapeutic drugs should be strengthened, and the prescription should be optimized based on serum concentration and therapeutic efficacy, combined with pharmacoeconomic factors.

目的 探讨分析胃肠道套细胞淋巴瘤的临床病理学特点分析及预后情况。方法 选取2019年1月—2021年2月间赣州市人民医院收治的50例胃肠道套细胞淋巴瘤患者为观察组,选取本院同期就诊的50例非胃肠道套细胞淋巴瘤患者为对照组。结果 50例胃肠道套细胞淋巴瘤患者的主要临床表现以腹痛为主占比50.00%;好发于回盲部、回肠、升结肠、直肠、乙状结肠,占比依次为54.00%、42.00%、36.00%、36.00%、28.00%;以多发性黏膜息肉样病变40.00%多见,死亡16例(32.00%)。年龄＞60岁、伴有脾脏肿大的胃肠道套细胞淋巴瘤死亡率更高(P<0.05)。观察组患者浅表淋巴结侵犯的比例明显高于对照组(P<0.05)。结论 胃肠道套细胞淋巴瘤主要表现为腹痛等,多发于结直肠,浅表淋巴结侵犯相对更多,以多发性黏膜息肉样病变多见,年龄＞60岁、伴有脾脏肿大的患者预后相对较差。

目的 评估产后女性的认知功能,并分析其认知功能受损的特点,以及分析可能的影响因素。方法 病例组选取健康单胎足月顺产初产妇、二胎产妇,对照组选取一般资料匹配的未生育女性,选用蒙特利尔认知评估(Montreal Cognitive Assessment Test,MoCA)北京版、伯明翰认知评估量表(Birmingham Cognitive Screen test,BCoS)普通话版评估认知功能。结果 实际入组病例组80例产妇,均完成MoCA量表,共42例产妇完成BCoS量表,对照组30例均完成MoCA、 BCoS评估。产妇组(80例)MCA得分为(26.26±2.28)分,低于未生育女性对照组MoCA分数(27.47±1.28)分(P<0.05),产妇组认知障碍发生率为30%高于对照组6.7%(P<0.05)。初产妇组MoCA分数(26.52±2.13)分,认知障碍发生率为26%,二胎产妇组MoCA分数(25.83±2.49)分,认知障碍发生率为36.7%,两者对比无明显差别(P>0.05)。产妇组(80例)在MoCA量表视空间与执行功能分项得分低于对照组(P<0.01);产妇组BCoS评分在故事瞬时回想、苹果删除总数、听觉注意、规则转换、手势模仿5个分项低于对照组(P<0.05)。产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素(P<0.05)。结论 ①产后妇女可能发生认知功能障碍,但初产妇与二胎产妇的认知障碍发生率无明显差别。②MoCA量表可以用于产妇产后认知功能筛查,BCoS量表可做为全面评估产妇产后认知功能的工具,产妇产后认知受损主要在视空间、注意力、执行功能(实践与行动能力)、记忆力领域。③产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素。

Objective To evaluate the cognitive function of postpartum women, and analyze the characteristics of cognitive dysfunction and the possible affecting factors. Methods The case group selected healthy single-born full-term primiparae (50 cases) and second birth parturient (30 cases), and the control group (30 cases) selected non-fertile women with general data matching. The Montreal Cognitive Assessment Test (MoCA) Beijing version and Birmingham Cognitive Screen test(BCoS) were used to evaluate cognitive function. Results Of the 80 cases in the case group, all completed the MoCA test, only 42 cases completed the BCoS test. The 30 cases in the control group all completed the MoCA and BcoS.The MoCA score of the case group (80 cases) was (26.26±2.28), which was lower than that of the control group (27.47±1.28) (P<0.05). The incidence of cognitive impairment in the case group was 30%, higher than the control group 6.7% (P<0.05). The MoCA score of the primiparae group was (26.52±2.13); the incidence of cognitive impairment was 26%; the MoCA score of the second birth parturient group was (25.83±2.49); the incidence of cognitive impairment was 36.7%.There was no significant difference in the MoCA score and the incidence of cognitive impairment between primiparae and second birth parturient (P> 0.05).The case group had lower scores on visual space and executive function of MoCA test than the control group (P<0.01).The score of BCoS test in the case group was lower than that in the control group in the five items of the instantaneous recall item of the story, apple deletion, auditory attention, Birmingham rule conversion and gesture imitation (P<0.05).The years of education, labor analgesia, and the total duration of labor were the factors that affected the cognitive function of postpartum women (P<0.05). Conclusion ①Postpartum women may have cognitive dysfunction, but there was no significant difference in the incidence of cognitive impairment between primiparae and second birth parturient group. ②The MoCA test can be used for the screening of cognitive impairment of postpartum women, and the BCoS test can be used as a tool to comprehensively evaluate the cognitive function of postpartum women. The cognitive impairment of postpartum women was mainly in the fields of visual space, attention, executive function (practice and action ability), and memory. ③The years of education, labor analgesia, and the total duration of labor were the factors that affect the cognitive function of postpartum women.