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综述

IMB模型应用于日间腹腔镜胆囊切除术患者术后早期康复质量的研究进展

Research progress on the application of IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy

:419-424
 
       本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题,IMB模型通过向患者提供科学的疾病知识,改变其疾病认知与态度,最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示,IMB模型可显著降低患者术后疼痛发生率,并提高患者参与治疗决策的程度,为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考,以便后期实施相关个性化干预措施,并提供相关理论依据。
       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy.The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge,and ultimately promotes their adoption and maintenance of healthy behaviors.It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy,the research background of this study,the current research status at home and abroad,as well as the future development trends and challenges.The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making.This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model,so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis.
论著

血清乳酸脱氢酶在中晚期肝细胞癌靶向及免疫治疗中的预后预测价值研究

The prognostic value of serum lactate dehydrogenase level as a predictor of prognosis in targeted therapy and immunotherapy for advanced hepatocellular carcinoma

:446-452
 
      目的 探讨血清乳酸脱氢酶(LDH)在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料,随访截止2025年8月,并记录随访结果,包括患者的疾病缓解情况和死亡情况,以及无疾病进展生存期(PFS)、总生存期(OS)。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线,并通过Log-rank检验比较生存曲线。同时,运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示,在50例肝癌患者中,基线LDH低于200 U/L的有15例,而高于200 U/L的有35例。与基线LDH<200 U/L组相比,基线 LDH≥200 U/L患者PFS、OS更短,差异均有统计学意义(χ2分别为5.51、15.6,P值分别为0.019、0.017)。治疗8周后,与LDH降低患者相比,LDH升高患者OS更短,差异有统计学意义(χ2=13.2,P=0.04)。多因素Cox比例风险回归分析结果表明,基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素[P=0.035,HR(95%CI)=5.03(1.12,22.54)]。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 
   Objective To evaluate the prognostic significance of serum lactate dehydrogenase(LDH)levels in patients with advanced hepatocellular carcinoma(HCC)undergoing targeted therapy combined immunotherapy.Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024,diagnosed with pathological and imaging examinations results.Patient baseline data were collected from the hospital’s electronic medical records,with follow-up extending until August 2025.We documented outcomes such as disease response and mortality,along with progression-free survival(PFS)and overall survival(OS).Kaplan-Meier survival curves were constructed based on baseline LDH levels,and the Log-rank test was employed for comparison.Additionally,multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy.Results Among the 50 patients,15 had baseline LDH levels below 200 U/L,while 35 had levels above.Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH <200 U/L(χ2=5.51 and 15.6 for PFS and OS,respectively;P=0.019 and 0.017,respectively).After 8 weeks of treatment,patients with increased LDH had significantly shorter OS compared with patients with decreased LDH(χ2=13.2,P=0.04).Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy(P=0.035,HR 5.03[1.12,22.54]).Conclusions Patients with lower baseline LDH levels demonstrated better OS,suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy.
论著

小针刀、局部浸润麻醉及其联合疗法治疗腰椎间盘突出症的临床研究

A clinical study on acupotomy,local infiltration anesthesia,and their combined use for lumbar disc herniation

:606-612
 
      目的 系统比较小针刀、局部浸润麻醉及两者联合疗法治疗腰椎间盘突出症(LDH)的临床疗效。方法 采用前瞻性随机对照设计,选取2023年1月—2025年1月收治的120例保守治疗无效的LDH患者,随机分为小针刀组(A组,n=40)、局部浸润麻醉组(B组,n=40)和联合治疗组(C组,n=40)。A组实施标准化小针刀松解术,采用“三点九刀”布点法松解粘连组织;B组采用超声引导下椎间孔外口及关节突关节囊周围利多卡因联合曲安奈德浸润麻醉;C组实施“麻醉-松解序贯疗法”(即先B组方案,后A组方案)。比较三组治疗前后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腰椎活动度(ROM)、表面肌电图(sEMG)、疼痛压力阈值(PPT)及改良Macnab优良率。结果 治疗后,三组VAS、ODI评分均较治疗前下降(P<0.001)。组间比较显示,C组VAS(2.08±0.90分)、ODI(14.65±3.70分)改善显著优于A组(3.80±1.20分,21.00±4.25分)和B组(3.93±1.15分,22.10±4.65分)(均P<0.05),A、B两组间无统计学差异(P>0.05)。C组在腰椎前屈ROM(67.78±9.18°)、竖脊肌静息sEMG比值(0.19±0.05)、腰椎旁PPT(4.60±0.91 kg/cm2)上亦显著优于A、B两组(均P<0.05)。改良Macnab评价显示C组优良率达85.00%(34/40),高于A组的52.50%(21/40)和B组的55.00%(22/40)(P<0.05)。结论 小针刀与局部浸润麻醉单一疗法对LDH均有效,但联合应用可产生多模式协同效应,通过阻断疼痛传导、调节炎性微环境和改善生物力学失衡,在缓解疼痛、促进功能恢复及改善客观生理指标方面均展现出显著优势,为中西医结合治疗LDH提供了更优化的创新性方案,具有重要临床推广价值。
      Objective To systematically evaluate and compare the clinical effectiveness and mechanistic actions of acupotomy,local infiltration anesthesia,and their combination in treating lumbar disc herniation(LDH).Methods This prospective,randomized controlled trial included 120 LDH patients unresponsive to conservative management,admitted between January 2023 and January 2025.Participants were randomly allocated to three groups:the Acupotomy Group(Group A,n=40)receiving standardized acupotomy release with a “three-point nine-needle” technique to address adhesions;the Local Infiltration Anesthesia Group(Group B,n=40)receiving ultrasound-guided infiltration of lidocaine combined with triamcinolone acetonide around the extraforaminal outlet and facet joint capsule;and the Combined Therapy Group(Group C,n=40)undergoing a sequential “anesthesia-release” protocol(first applied Group B therapy then Group A therapy).Assessments conducted before and after treatment included the Visual Analog Scale(VAS),Oswestry Disability Index(ODI),lumbar range of motion(ROM),surface electromyography(sEMG),pain pressure threshold(PPT),and the modified Macnab criteria.Results Following treatment,significant reductions from baseline were observed in VAS and ODI scores across all three groups(P<0.001).Between-group comparisons indicated that Group C achieved significantly greater improvement in VAS(2.08±0.90)and ODI scores(14.65±3.70)compared to Group A(3.80±1.20;21.00±4.25)and Group B(3.93±1.15;22.10±4.65)(all P<0.05),with no significant difference between Groups A and B(P>0.05).Group C also showed superior outcomes in lumbar flexion ROM(67.78±9.18°),the resting sEMG amplitude ratio of the erector spinae muscles(0.19±0.05),and paravertebral PPT(4.60±0.91 kg/cm2)compared to the other two groups(all P<0.05).Based on the modified Macnab criteria,the excellent-good rate was 85.00%(34/40)in Group C,significantly higher than the rates of 52.50%(21/40)in Group A and 55.00%(22/40)in Group B(P<0.05).Conclusions While both acupotomy and local infiltration anesthesia as standalone treatments are effective for LDH,their combined application produces a multimodal synergistic effect.This integrated strategy,which concurrently interrupts pain signaling,modulates the local inflammatory milieu,and ameliorates biomechanical dysfunction,demonstrates significant advantages in pain relief,functional recovery,and normalization of objective physiological measures.The findings present an optimized and novel integrative approach for LDH management,highlighting its considerable potential for broader clinical adoption.
论著

尿沉渣评分对急性肾损伤诊断的临床应用研究

Clinical application of urinary sediment score in diagnosis of acute kidney injury

:600-605
 
       目的 验证尿沉渣评分(USS)对肾前性急性肾损伤(AKI)与急性肾小管坏死(ATN)的鉴别价值,评估USS与AKI严重程度及预后的相关性,为优化AKI分层管理提供依据。方法 回顾性分析2021年3月至2022年2月在郑州市中医院治疗的120 AKI患者,根据肾组织活检及改良FENa-UA诊断标准分为肾前性AKI组(n=68)与ATN组(n=52),于入院日检测USS、血清胱抑素C(Cys-C)及尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL),分析USS诊断效能。结果 ATN组USS高于肾前性组(P<0.001),且评分随AKI分期升高而增加(P<0.001)。USS诊断肾前性AKI的ROC曲线下面积(AUC)为0.892,联合Cys-C与NGAL后AUC提升至0.941,灵敏度与特异度分别达90.12%和88.51%。结论 USS通过量化肾小管结构性损伤,可早期鉴别肾前性AKI与ATN,其与Cys-C、NGAL的联合应用提高诊断准确性,且对AKI预后具有重要价值,为临床分层管理提供客观依据。

       Objective To validate the discriminative value of urinary sediment score(USS)in differentiating prerenal acute kidney injury(AKI)from acute tubular necrosis(ATN),and to evaluate the correlation between USS and AKI severity/prognosis,providing evidence for optimizing stratified AKI management.Methods A retrospective analysis was conducted on 120 AKI patients treated at Zhengzhou Traditional Chinese Medicine Hospital from March 2021 to February 2022.According to renal tissue biopsy and modified FENa-UA diagnostic criteria,patients were divided into a prerenal AKI group(n=68)and an ATN group(n=52).On the day of admission,USS,serum cystatin C(Cys-C),and urinary neutrophil gelatinase-associated lipocalin(NGAL)were measured to analyze the diagnostic performance of USS.Results USS was significantly higher in ATN group than prerenal group(P<0.001),and increased with advancing AKI stages(P<0.001).The area under the ROC curve(AUC)of USS for diagnosing prerenal AKI was 0.892,which improved to 0.941 when combined with Cys-C and NGAL,yielding sensitivity and specificity of 90.12% and 88.51%,respectively.Conclusions USS quantifies structural damage to the renal tubules,allowing for early differentiation between prerenal AKI and ATN.Its combined use with Cys-C and NGAL improves diagnostic accuracy and is of significant value in predicting AKI prognosis,providing an objective basis for clinical stratified management.
论著

重型β地中海贫血患儿照顾者负担现状及其影响因素研究

Current burden situation and influencing factors of caregiver in pediatric β thalassemia major

:481-490
 
       目的 调查重型β地中海贫血患儿照顾者的负担现状,并分析其影响因素,为医护人员制定干预方案提供依据。方法 采用便利抽样法,于2024年1月—12月选取华南地区5家医院就诊的重型β地中海贫血患儿的主要照顾者作为调查对象,采用一般资料调查表、Zarit照顾者负担量表、中文简化版家庭弹性量表和社会支持评定量表进行调查,并采用单因素分析、相关性分析及多重线性回归探究其影响因素。结果 共发放问卷242份,回收232份,回收率为95.87%。重型β地中海贫血患儿主要照顾者照顾负担的总体平均得分为(36.67±18.63)分。多重线性回归分析结果显示,患儿输血频率、输血相关性皮肤过敏和社会支持是患儿照顾负担的影响因素(P<0.001),可解释总变异的23.9%。结论 重型β地中海贫血患儿照顾者负担程度以中重度为主。患儿曾出现输血不良反应、输血频率更高,其照顾者负担更重;而主要照顾者具有良好的社会支持水平有助于降低其照顾者负担。医护人员应针对以上因素制定干预方案,以减轻重型β地中海贫血患儿照顾者负担水平。

      Objective To investigate the current burden in caregivers of children with β thalassemia major and analyze its influencing factors,so as to provide a basis for medical staff to formulate intervention plans.Methods By using the convenience sampling method,primary caregivers of children with β thalassemia major from five hospitals in South China from January to December 2024 were selected as the survey subjects.The general information questionnaire,Zarit Caregiver Burden Scale,Simplified Chinese Family Resilience Scale and Social Support Rating Scale were used for the survey.And univariate analysis,correlation analysis and multiple linear regression were adopted to explore its influencing factors.Results A total of 242 questionnaires were distributed and 232 were retrieved,with a recovery rate of 95.87%.The overall average score of care burden for primary caregivers of children with β thalassemia major was(36.67±18.63).The results of multiple linear regression analysis showed that the frequency of blood transfusion in children,transfusion-related skin allergy and social support were the influencing factors of the care burden(P<0.001),which could explain 23.9% of the total variation.Conclusions The burden level in caregivers of children with β thalassemia major is mainly moderate to severe.The children with adverse reactions to blood transfusion and higher frequency of blood transfusion impose a heavier burden on its caregivers.The primary caregivers who have good social support can help reduce the burden.Medical staff should formulate intervention plans based on the above factors to reduce the burden level of caregivers of children with β thalassemia major.

专家述评

自闭症谱系障碍人工智能早期诊断研究进展与挑战

AI-driven early diagnosis of autism spectrum disorder:Progress and challenges

:534-544
 
       自闭症谱系障碍(ASD)是一类神经发育障碍性疾病,其核心临床表现为社交行为障碍、语言沟通困难以及重复刻板行为。早期诊断并进行早期行为干预,是目前能改善患者临床症状且减少终身残疾的主要措施。但早期诊断困难,因为目前所采用的行为量表,比如ABC(异常行为检查表)等,在儿童生命早期阶段,如2岁左右,很难准确地反应出被试者的社交行为或者语言交流能力;而且,其判断也非常依赖于医生的经验,具有一定的主观性。近年来,随着脑影像技术,比如核磁共振(MRI),特别是功能性核磁共振(fMRI),以及人工智能技术(AI)的飞速发展,为ASD的早期诊断,从无创、客观、以及神经活动异常-行为异常偶联的角度,展示了一种新的机遇。本文比较系统地介绍了ASD的临床基础与诊断挑战,并详细阐述了AI在ASD早期诊断中的数据来源、核心算法和典型研究案例。通过分析当前技术面临的挑战与局限性,提出未来研究方向与临床转化路径,以期进一步加强AI在ASD早期诊断中的临床使用研究,使之最终能高效的服务于临床。
   Autism spectrum disorder(ASD)is a group of neurodevelopmental disorders clinically characterized by deficits in social interaction and verbal communication,along with repetitive behaviors.Early diagnoses,followed by early behavioral interventions,are currently effective strategies to attenuate clinical symptoms and improve patient outcomes in ASD; however,early diagnosis remains challenging at present.Current diagnostic tools,such as the Aberrant Behavior Checklist(ABC),have difficulty in accurately evaluating social engagement and verbal communication in early childhood(e.g. ,at 2 years of age).Furthermore,such evaluations may be somewhat subjective,as they rely,at least partially,on clinicians’ experience.Recently,with the rapid development of brain imaging techniques(e.g. ,MRI,especially fMRI)and artificial intelligence(AI),a significant opportunity has emerged to develop novel early-diagnostic tools for ASD.These tools exhibit clear advantages,including being non-invasive,more objective,and focusing on the coupling of abnormalities in both neuronal activity and behavioral responses.Here,we systematically introduce the clinical features of ASD,discuss the challenges in early diagnosis,and review the current status of AI-driven diagnostic tool development in detail,including data acquisition methods,computational architectures,and typical clinical applications.Through a detailed analysis of the technical challenges,advantages,and limitations of these tools,we propose future research directions,aiming to eventually establish highly valuable AI-based diagnostic approaches for clinical use in ASD care.
医院管理

运用信息技术完善医用耗材监督管理的研究——供应链溢出视角

Research on utilizing information technology to enhance the supervision and management of medical consumables——From the perspective of supply chain spillover

:899-904
 
在按病种分值付费(DIP)模式深化实施的背景下,医用耗材管理作为医院成本控制与医疗质量保障的核心环节,其监督效能直接影响医院运营效益。本文基于供应链溢出视角,以某医院医用耗材信息化管理实践为案例,从技术溢出、管理溢出、风险溢出三个维度,探讨信息技术对医院内部医用耗材监督管理的优化路径。研究表明,通过构建医疗器械唯一标识(UDI)系统、收拾耗占比动态监控、专项议价管控等措施,可实现监督技术跨环节渗透、管理标准全链条协同、风险防控全周期覆盖。实践表明,该模式有效控制了医院耗材的整体运营成本,并显著提升了高值耗材的用后结算管理水平,为公立医院构建精准、高效的内部监管机制提供了有价值的实践路径。

Under the deepening implementation of the diagnosis-intervention packet(DIP) payment model,the management of medical consumables serves as a core aspect of hospital cost control and medical quality assurance,with its supervision efficiency directly impacting hospital operational benefits.Based on the perspective of supply chain spillover,this paper takes the informatization management practices of medical consumables in a hospital as a case study,exploring the optimization paths of information technology in the internal supervision and management of medical consumables from three dimensions:technological spillover,managerial spillover,and risk spillover.The research shows that by establishing a unique device identification(UDI) system,implementing dynamic monitoring of the consumption ratio of medical consumables,and conducting special negotiation controls,cross-process penetration of supervision technology,full-chain coordination of management standards,and comprehensive risk prevention and control throughout the entire cycle can be achieved.Practice demonstrates that this model has reduced the hospital’s overall cost of medical consumables by 2.75%,increased the post-use settlement rate of high-value consumables to 80%,and provided practical references for public hospitals to establish a precise and efficient internal supervision system.
论著

实时动态血糖监测系统对2型糖尿病患者胰岛素泵强化治疗中血糖波动监测的价值研究

The value of real-time continuous glucose monitoring system in monitoring blood glucose fluctuation in type 2 diabetes mellitus patients during intensive insulin pump therapy

:893-898
 
       目的 深入分析实时动态血糖监测系统(CGMS)在2型糖尿病患者接受胰岛素泵强化治疗过程中的实际应用意义。方法 本研究采用前瞻性随机对照试验设计,收集2025年1月至2026年3月间收治的80名2型糖尿病患者,运用随机数字表法将其随机分配为两组,每组40名患者。对照组患者接受常规指尖血糖检测与胰岛素泵治疗,研究组采用深圳硅基传感公司生产的GS1型动态血糖监测系统辅助胰岛素泵治疗,两组患者的治疗周期均延长至14天。主要观测指标:目标血糖范围内时间占比(TIR,3.9~10.0 mmol/L);次要观测指标:糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2 h血糖(2hPBG)等代谢指标,低血糖发生频率、日内血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、血糖高于目标范围时间占比(TAR,>10.0 mmol/L)、血糖低于目标范围时间占比(TBR,<3.9 mmol/L)。结果 治疗14天后,两组患者的血糖指标均较治疗前改善,研究组主要指标TIR(78.65%±8.23%)高于对照组(62.34%±9.56%)(P<0.001);次要指标中,研究组HbAlc、FBG和2hPBG的改善幅度及MAGE、MODD的降低幅度均优于对照组(P<0.05);研究组低血糖发生率(2.5%)、TBR(1.82%±0.95%)低于对照组(20%、5.68%±1.32%),TAR(19.53%±7.81%)低于对照组(31.98%±8.64%)(P<0.05)。研究组动态血糖图谱(AGP)显示血糖波动更平稳,峰值与谷值差异缩小,TIR分布更集中。结论 实时动态血糖监测技术通过提供连续、完整的血糖数据,精准捕捉血糖波动规律,为胰岛素泵参数调整提供科学依据,显著提升目标血糖达标时间占比,优化整体血糖控制效果,同时有效降低低血糖事件及血糖偏离目标范围的风险,是2型糖尿病患者胰岛素泵强化治疗的重要辅助手段。

      Objective To analyze the practical significance of real-time continuous glucose monitoring system(CGMS) in patients with type 2 diabetes mellitus(T2DM) receiving intensive insulin pump therapy.Methods A prospective randomized controlled trial design was used to collect 80 patients with T2DM from January 2025 to March 2026.The patients were randomly divided into two groups by random number table method,with 40 patients in each group.The patients in the control group received routine fingertip blood glucose detection and insulin pump therapy,while the patients in the study group received insulin pump therapy assisted by GS1 type CGMS produced by Shenzhen Sili-based Sensor company.The treatment period of the two groups was extended to 14 days.Primary outcome measures:time in range(TIR,3.9-10.0 mmol/L);secondary outcomes:hemoglobin A1c(HbAlc),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),frequency of hypoglycemia,mean amplitude of glycemic excursion(MAGE),mean of daily differences(MODD),time above range(TAR,>10.0 mmol/L) and time below the target range(TBR,<3.9 mmol/L),and other metabolic indicators.Results After 14 days of treatment,the blood glucose indexes of the two groups were significantly improved compared with those before treatment.The main index TIR in the study group(78.65%±8.23%) was significantly higher than that in the control group(62.34%±9.56%)(P<0.001).Among the secondary indexes,the improvement of HbAlc,FBG and 2hPBG and the reduction of MAGE and MODD in the study group were significantly better than those in the control group(P<0.05).The incidence of hypoglycemia(2.5%),TBR(1.82%±0.95%) and TAR(19.53%±7.81%) in the study group were significantly lower than those in the control group(20%,5.68%±1.32%,31.98%±8.64%)(P<0.05).The ambulatory glucose profile(AGP) of the study group showed that blood glucose fluctuation was more stable,the difference between peak and trough was reduced,and TIR distribution was more concentrated.Conclusions Real-time CGMS can accurately capture blood glucose fluctuation by providing continuous and complete blood glucose data,provide scientific basis for insulin pump parameter adjustment,significantly improve the proportion of time to reach the target blood glucose,optimize the overall blood glucose control effect,and effectively reduce the risk of hypoglycemia events and blood glucose deviation from the target range.It is an important auxiliary method for intensive insulin pump therapy in patients with type 2 diabetes.
论著

血脂异常诱导左心室不良重塑的实验研究及其与心肌微循环损伤的关联性

Experimental study on dyslipidemia-induced adverse left ventricular remodeling and its association with myocardial microcirculatory injury

:871-877
 
       目的 探究血脂异常对左心室结构的影响及其与微循环损伤之间的关联。方法 将20只新西兰大白兔随机划分为血脂异常组和正常对照组。饲养8周后获取所有实验兔的离体心肌组织,测量左心室心肌结构评估指标(包括心肌质量、心腔内径大小以及室壁厚度)和病理学指标(心肌微血管密度和胶原体积百分比);另外,通过对心肌组织氧化应激标记物的测定,评估实验兔心肌组织中一氧化氮(NO)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)以及丙二醛(MDA)等生化指标。结果 对于左心室结构指标,血脂异常组的左心室心肌质量及室间隔厚度较正常对照组显著增加(P均<0.001);对于组织病理学指标,血脂异常组的心肌微血管密度显著降低,而胶原体积百分比则显著升高(P均<0.001)。对于生化指标,血脂异常组NO、SOD以及GSH-Px水平均显著降低,MDA水平显著升高(P均<0.001)。室间隔厚度与心肌组织胶原体积百分比、MDA水平呈正相关,与心肌组织微血管密度、NO、SOD、以及GSH-Px水平呈负相关(P均<0.001)。与正常对照组对比,血脂异常组心肌组织出现明显脂肪变性、炎细胞浸润以及心肌纤维组织增生、排列紊乱。结论 血脂异常可导致新西兰大白兔左心室不良重塑,且与心肌微循环损伤之间存在密切关联,这提示血脂异常早期防控可能有助于改善心血管事件不良预后。

      Objective To explore the impact of dyslipidemia on left ventricular(LV) structure and its association with myocardial microcirculatory injury.Methods Twenty New Zealand white rabbits were randomly divided into the dyslipidemia group and the normal control group.After 8 weeks of feeding,the isolated myocardial tissues of all experimental rabbits were obtained.The LV myocardial structure assessment indicators(including myocardial mass,heart cavity diameter and ventricular wall thickness) and pathological indicators(myocardial microvascular density and collagen volume fraction[CVF]) were measured.Additionally,the biochemical indicators such as nitric oxide(NO),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px) and malondialdehyde(MDA) in the myocardial tissues of the experimental rabbits were evaluated by measuring the oxidative stress markers in the myocardial tissues.Results For the LV structural indicators,the myocardial mass and interventricular septal thickness in the dyslipidemia group were significantly increased compared with the normal control group(P<0.001 for both).For the histopathological indicators,the myocardial microvascular density in the dyslipidemia group was significantly decreased,while the CVF was significantly increased(P<0.001 for both).For the biochemical indicators,the levels of NO,SOD,and GSH-Px in the dyslipidemia group were significantly decreased,while the MDA level was significantly increased(P<0.001 for all).The interventricular septal thickness was positively correlated with the CVF and MDA level in myocardial tissue,and negatively correlated with the myocardial microvascular density,NO,SOD,and GSH-Px levels(P<0.001 for all).Compared with the normal control group,the myocardial tissue in the dyslipidemia group showed obvious fatty degeneration and inflammatory cell infiltration,as well as myocardial fibrous tissue hyperplasia and disordered arrangement.Conclusions Dyslipidemia can lead to adverse LV remodeling in New Zealand white rabbits and is closely related to myocardial microcirculatory injury.This suggests that early prevention and control of dyslipidemia may help improve the poor prognosis of cardiovascular events.
论著

ARIMA时间序列模型对耐碳青霉烯类肺炎克雷伯菌医院感染预测效果研究

Application of ARIMA model in prediction of incidence of carbapenem-resistant Klebsiella pneumoniae healthcare-associated infection

:864-870
 
       目的 探讨自回归求和时间序列模型(ARIMA)在耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染预测中的应用,为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率,应用SPSS 19.0建立ARIMA模型,利用该模型对2024年1—12月每月CRKP医院感染数据进行验证,以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合,建立最优模型ARIMA(1,1,1),模型拟合值与实际值较吻合,模型对CRKP医院感染率实际值与预测值吻合度较高,平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况,为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average(ARIMA)model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae(CRKP).Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected,and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model.Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024.The fitted value of the ARIMA(1,1,1)model was in good agreement with the actual value.The incidence of CRKP infection were in good agreement with the predicted value.The average relative errors were 5.40%.Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate,providing scientific guidance for the prevention and control of CRKP infection.

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