目的 对川南地区重症专科联盟认知与需求进行调查，为该地区重症专科联盟建设提供参考。方法 采用分层随机抽样，在川南地区（乐山、宜宾、泸州、自贡）31个区县的二级医院内随机抽取213名医务人员作为调查对象。采用自制问卷收集调查对象基本情况，并评估其对重症医学专科联盟概念的认知情况，通过开放式问卷收集调查对象对重症医学专科联盟的需求。根据认知评估结果将研究对象分为了解充分组与了解不充分组，比较两组基本情况，并用多因素Logisitic回归筛选出独立性影响因素。结果 在纳入的213名医护人员中有68名（31.92%）对重症专科联盟了解不充分，单因素分析显示：两组在性别、年龄、工作岗位、职务及职称差异均具有统计学意义（P＜0.05）。多因素Logistic回归分析显示：性别、学历为本科 、学历为博/硕士研究生、工作岗位、职务为中层干部、院领导职务及职称为川南地区重症专科联盟认知的独立性影响因素（P＜0.05）。川南地区重症专科联盟需求排名前9位依次：派出专家技术指导、派出管理干部开展业务管理、接收联盟单位人员培训、协助开展新技术、为联盟单位成员开展培训与讲座、业务资源共享、接收联盟单位转诊、开展远程医疗、科研项目申报指导。结论 川南地区重症专科联盟认知情况主要与性别、学历、工作岗位、职务、职称及基层对于专家技术指导、管理干部业务指导及技能培训的需求较大。

      Objective To investigate the awareness and demand for the Critical Care Specialty Alliance in Southern Sichuan，providing a reference for the development of the alliance in this region．Methods Using stratified random sampling，213 medical staff were randomly selected from secondary hospitals in 31 districts/counties of the Southern Sichuan region（Leshan，Yibin，Luzhou，Zigong）as survey subjects．A self-designed questionnaire was used to collect basic information from the respondents，assess their understanding of the concept of the Critical Care Specialty Alliance，and gather their demands for the alliance through open-ended questions．Based on the assessment results，respondents were divided into a well-informed group and a poorly informed group．The basic characteristics of the two groups were compared，and multivariate logistic regression was used to identify independent influencing factors．Results Among the 213 medical staff included in the study，68（31.92%）had insufficient understanding of the Critical Care Specialty Alliance．Univariate analysis revealed statistically significant differences（P＜0.05）in gender，age，job position，administrative role，and professional title between the group with sufficient understanding and the group with insufficient understanding．Multivariate Logistic regression analysis showed that gender，undergraduate education，master’s/doctoral education，job position，middle management role，hospital leadership role，and professional title were independent influencing factors for the awareness of the Critical Care Specialty Alliance in the Southern Sichuan region（P＜0.05）．The top nine demands for the alliance in Southern Sichuan were dispatching experts for technical guidance，sending management cadres for operational management，providing training for personnel from alliance units，assisting in the development of new technologies，organizing training and lectures for alliance unit members，sharing business resources，accepting referrals from alliance units，implementing telemedicine，and providing guidance on research project applications．Conclusions Awareness of the Critical Care Specialty Alliance in Southern Sichuan is primarily associated with gender，educational background，job position，and professional title．There is significant demand at the primary level for expert technical guidance，operational management guidance from cadres，and skills training．

       脑卒中后认知障碍（PSCI）是脑卒中患者常见的并发症，严重影响患者的生活质量和社会功能。近年来，随着认知储备理论的发展和早期干预理念的普及，PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展，包括干预的理论基础、具体措施及未来发展方向，以期为临床实践和科研提供参考。

       Post-stroke cognitive impairment（PSCI）is a common complication among stroke patients．It seriously affects the patients’ quality of life and social functions．In recent years，with the development of the cognitive  reserve theory and the popularization of the concept of early intervention，the early intervention model for PSCI has gradually become a research hotspot．This article reviews the current research status and progress of the early intervention model for PSCI，including the theoretical basis of the intervention，specific measures，and future development directions，aiming to provide  references for clinical practice and scientific research．

       目的   了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法   于2019年11月—2020年9月，采用中文版癌症后生育忧虑量表（RCAC）-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查，应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时，应用倾向性评分匹配法控制混杂因素。结果   育龄期乳腺癌患者对子代健康和遗传风险担忧得分为（11.40±2.99）分；匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义（P＞0.05）。结论   育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变，但其对子代健康和遗传风险担忧处于较高水平，临床医护人员应提高对这一现象的重视，可通过多渠道科普相关知识，开展遗传咨询服务以减轻患者的担忧。

      Objective  To explore the current status of childbearing age breast cancer patients’  concerns  about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis．Methods  From November 2019 to September 2020，the Chinese version of the Reproductive Concern After Cancer Scale（RCAC）- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou，and SPSS 26.0 and PSM plug-in were used to analyze the results statistically．The  propensity  score matching method was used to control confounding factors when comparing the change  rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale．Results  The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was（11.40±2.99）．There was no statistically significant difference in the change  rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health．Conclusions   Despite not significantly impacting fertility intentions，the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness．It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress．

       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象，采用随机数字表法将患者分为A、B组，B组56例患者采取治疗性沟通干预，A组66例患者采用认知行为疗法联合治疗性沟通干预，两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异，对比两组干预依从性。结果   干预后，两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326，P＜0.05）；干预后，两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622，P＜0.05）；干预后，两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794，P＜0.05）；A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ ² =8.782，P＜0.05）。结论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想，能够明显改善患者负性情绪，提高心理弹性及对疾病康复的希望水平，有效提升依从性。

       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods  Prospectively，122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method，and 56 patients in group B were treated with therapeutic communication，66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication，and both groups were continuously intervened for 2 months．The  scores of Self-Rating Anxiety Scale（SAS），Self-Rating Depression Scale（SDS），Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results  After treatment，the SAS and SDS scores of the two groups were decreased，and the scores of group A was lower than that of group B（t=12.096，10.326，P＜0.05）after the intervention，the scores of the CD-RISC scale of the two groups were improved，and the score of group A was higher than that of group B（t=18.483，12.060，13.622，P＜0.05）．After intervention，the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B（t=11.289，11.568，12.527，13.794，P＜0.05）．The total compliance rate of patients in group A was 96.97%（64/66），which was significantly higher than 80.36%（45/56）in group B（χ ² =8.782，P＜0.05）．Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients，which can significantly improve patients’ negative emotions，psychological resilience and hope for disease recovery，and also therapy compliance．

目的 探讨氟哌噻吨美利曲辛联合帕罗西汀对重度抑郁障碍（MDD）患者躯体化症状、睡眠和认知功能的影响分析以及临床应用效果。方法 回顾性分析2020年8月—2023年2月在南昌市某医院接受治疗的120例MDD患者相关资料,按照其治疗方案不同分为帕罗西汀治疗组（常规组,n=55）和氟哌噻吨美利曲辛联合帕罗西汀治疗组（联合组,n=65）。两组患者治疗周期均为4周,比较两组患者治疗前和治疗第2、4周的汉密尔顿抑郁量表（HAMD-17）评分、躯体化症状自评量表（SSS）评分、睡眠质量评分（PSQI）、神经心理状态评定量表（RBANS）;且治疗后对患者进行1个月的随访比较两组患者治疗后总体疗效及不良反应发生情况。结果 经治疗第2、4周联合组RBANS评分高于常规组（P<0.05）,而PSQI评分、SSS评分、HAMD-17评分均低于常规组（P<0.05）。治疗后1个月随访资料显示,两组患者不良反应总发生率比较,差异无统计学意义（P>0.05）,且总有效率高于常规组（P<0.05）。结论 氟哌噻吨美利曲辛联合帕罗西汀对MDD患者临床应用疗效确切,还可以帮助患者减轻躯体化症状,改善患者睡眠质量,并且提高患者认知功能。

Objective To investigate the effect of haloperitoxine melitraxine combined with paroxetine on somatic symptoms,sleep and cognitive function in patients with major depressive disorder（MDD）and its clinical application effects．Methods A retrospective analysis was performed on the relevant data of 120 patients with MDD who received treatment in our hospital from August 2020 to February 2023,and divided into conventional group（treated with paroxetine,55 cases）and combined group（haloperitoxetex melitraxine combined with paroxetine,65 cases）according to their different treatment regimens．The treatment duration of the two groups was 4 weeks,and the Hamilton Rating Scale for Depression（HAMD-17）score,Somatized Symptom Self-rating Scale（SSS）score,Sleep Quality Score（PSQI） and Neuropsychological State Rating Scale（RBANS）scores were compared before treatment and at the 2nd and 4th week of treatment．After treatment,the patients were followed up for 1 month,and the total efficacy and adverse reactions of the two groups of patients after treatment were compared．Results After 2 and 4 weeks of treatment,the combined group showed significantly higher RBANS scores compared to the control group（P<0.05）,while PSQI scores,SSS scores and HAMD-17 scores were significantly lower in the combined group compared to the control group（P<0.05）．One month after treatment,follow-up data showed that there was no statistically significant difference in the overall incidence of adverse reactions between the two groups（P>0.05）．Additionally,the total effective rate was significantly higher in the combined group compared to the control group（P<0.05）．Conclusions Haloperitoxine melitrexine combined with paroxetine has a definite clinical effect in patients with MDD,and can also help patients reduce somatization symptoms,improve patients' sleep quality,and improve patients' cognitive function．

目的 调查眼科患者对荧光素眼底血管造影认知情况及健康教育需求,为眼底造影医护人员实施高效、个性化健康教育提供依据。方法 采用自制眼底造影认知及健康教育需求问卷,对本院2021年6月—8月的123例眼底血管造影患者进行问卷调查,使用Spearman相关性分析、非参数秩和检验及多元线性逐步回归分析患者眼底血管造影认知的影响因素。结果 患者荧光素眼底血管造影认知得分为（33.77±8.09）分,其中,患者对于检查中的相关知识认知最低,相对得分为0.59;患者健康教育需求的得分为（43.95±7.63）分,其中,检查后的相关知识需求度最高,相对得分为0.77;不同年龄、文化程度、主要照顾者、眼造影检查次数及是否合并全身病的患者的认知水平差异有统计学意义（P<0.05）。多元线性逐步回归分析表明,眼造影检查史是患者眼底血管造影认知的独立影响因素。结论 眼科患者对荧光素眼底血管造影认知水平较低,健康教育需求高,医护人员应重视健康教育的实施,结合FFA操作流程及患者特点,制定标准化健康教育流程,探索有效的线上+线下的健康教育模式,以提高造影患者认知水平,保障患者安全。

Objective To investigate fundus fluorescein angiography（FFA）cognition and health education needs in ophthalmic patients,and to provide basis for efficient and personalized health education for FFA medical staff．Methods A self-made questionnaire was used in a survey of 123 patients from June to August 2021．The influencing factors of FFA cognition were analyzed by Spearman correlation analysis,non parametric rank sum test and multiple linear stepwise regression．Results The score of FFA cognition was（33.77 ± 8.09）．Patients had the lowest cognition of relevant knowledge during the examination,with a relative score of 0.59．The score of patient's health education needs was（43.95 ± 7.63）,while the score of relevant knowledge needs after examination was the highest,with a relative score of 0.77．There were significant differences in cognitive level among patients with different ages,educational levels,main caregivers,angiographic times,and complication of systemic diseases（P<0.05）．Multiple linear stepwise regression analysis showed that the number of ocular angiography was an independent factor affecting the cognition of FFA．Conclusions Patients with FFA have low cognitive level and high demand for health education．Medical staff should pay attention to the implementation of health education,formulate a standardized health education process with the combination of operation process and patient characteristics,and explore an effective online-to-offline health education mode,so as to improve the cognitive level of angiography patients and ensure the safety of patients．

目的 明确上海市闵行区社区老人轻度认知功能障碍（MCI）发生现状,分析MCI发生的影响因素间的交互作用关系。方法 采用横断面研究方法,应用AD-8与CSI-D对该区2021年65岁以上老人MCI发生现状进行双量表评估。应用SPSS 26.0 软件,先后采用χ²检验分析受检老人吸烟、饮酒、慢性病等因素在不同检出情况的构成、二分类非条件Logistic回归分析MCI发生的影响因素,再将各因素依次纳入双因素交互作用分析模型,分析各变量对MCI发生的交互作用。结果 应用AD8与CSI-D双量表评估法具有较高的灵敏度,评估闵行区社区老人MCI阳性率为26.6%,高于其他研究,低年龄（OR=1.09,95%CI：1.04~1.14）、良好的健康心态（OR=1.67,95%CI：1.15~2.42）是减少老人MCI的保护因素,职业类型（OR=1.19,95%CI：1.04~1.38）、照料者类型（OR=1.56,95%CI：1.09~2.22）与老人MCI的发生存在相关关系。家庭月总收入与照料者类型之间、是否饮酒与照料者类型之间对老人MCI的发生存在交互作用（P均<0.05）。结论 保持良好的心态可以降低老人MCI发生风险,不同职业类型、照料者类型与老人MCI的发生具有相关关系,照料者选择保姆可能会增加老人MCI风险。

Objective To clarify the current situation of mild cognitive impairment（MCI）in the community elderly in Minhang District,Shanghai,and analyze the interaction relationship between the influencing factors of MCI．Methods A cross-sectional study method was used,and AD8 and CSI-D were used to evaluate the current situation of MCI in the elderly over 65 years old in this district in 2021．SPSS 26.0 software,chi-square test and binary unconditional Logistic regression model were used to analyze the composition of smoking,drinking,chronic diseases and other factors in different detected conditions and the influencing factors of MCI occurrence in the elderly．A factor interaction analysis model was used to analyze the interaction of each variable on the occurrence of MCI．Results The AD8 and CSI-D double-scale evaluation method had high sensitivity．The positive rate of MCI in the community elderly in Minhang District was 26.6%,which was higher than other studies．Younger age（OR=1.09,95%CI：1.04~1.14）,good health mentality（OR=1.67,95%CI：1.15~2.42）were protective factors for reducing MCI in the elderly,occupation type（OR=1.19,95%CI：1.04~1.38）,caregiver type（OR=1.56,95%CI：1.09~2.22）were correlated with the occurrence of MCI in the elderly．There were interaction effects between the total monthly household income and the type of caregivers,whether drinking or not and the type of caregivers on the occurrence of MCI in the elderly（all P<0.05）．Conclusions Maintaining a good attitude can reduce the risk of MCI in the elderly．Different occupational types and types of caregivers are related to the occurrence of MCI in the elderly．Caregivers choosing nanny may increase the risk of MCI in the elderly．

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 观察靳三针治疗卒中后认知功能障碍(PSCI)的临床疗效。方法 选取广州市第一人民医院南沙医院中医科、神经内科、精神科卒中后出现认知功能障碍的患者60 例,随机分为治疗1组,治疗2组和对照组,每组20例。对照组予盐酸多奈哌齐片口服,治疗1组予靳三针治疗,治疗2组予多奈哌齐口服及靳三针治疗。各组均在治疗前、治疗12周进行中医症候临床疗效评定和精神状态简易量表(MMSE)评定。结果 MMSE疗效评定中,治疗1组和对照组总有效率相当,治疗2组治疗有效率高于对照组及治疗1组。中医症候疗效评定中,治疗2组愈显率高于对照组及治疗1组,治疗2组愈显率较治疗1组明显升高,对比差异有统计学意义(P<0.05)。对照组、治疗1组、治疗2组经过12周治疗后MMSE评分较前升高,治疗前后比较差异均有统计学意义(P<0.05)。3组中风病诊断与疗效评定评分治疗后有所下降,治疗前后比较差异有统计学意义(P<0.05)。治疗2组与对照组、治疗1组对比,2组对比差异均有统计学意义(P<0.05)。结论 靳三针联合多奈哌齐治疗PSCI效果明显,针刺与药物结合应用治疗更有利于PSCI的恢复。

Objective To observe the clinical effect of Jin's three-needle therapy on post-stroke cognitive impairment (PSCI). Methods A total of 60 patients with cognitive dysfunction after stroke in the department of traditional Chinese medicine (TCM), department of neurology and department of psychiatry in Nansha Hospital of Guangzhou First People's Hospital were randomly divided into treatment group 1, treatment group 2 and control group, 20 cases in each group.The control group was given donepezil hydrochloride orally, the treatment group 1 was given Jin's three-needle therapy, the treatment group 2 was given donepezil oral therapy and Jin's three-needle therapy.All groups were assessed with mini-mental state examination (MMSE) before and 12 weeks after treatment. Results In MMSE, the total effective rate of treatment group 1 was similar to that of control group, and the effective rate of treatment group 2 was higher than that of control group and treatment group 1.In the evaluation of TCM symptom curative effect, the cure rate of the group 2 was higher than that of the control group and the group 1.The effective rate of group 2 was significantly higher than that of group 1 (P< 0.05). After 12 weeks of treatment, MMSE scores in control group, group 1 and group 2 were significantly higher than those before treatment (P< 0.05). The score of diagnosis and curative effect of stroke in three groups decreased after treatment, and the difference was statistically significant (P<0.05). There were significant differences between control group, group 1 and group 2 (P< 0.05). Conclusion Jin's three-needle therapy combined with donepezil is effective in the treatment of PSCI.Acupuncture combined with medicine is more beneficial to the recovery of PSCI.

目的 分析团体认知行为干预联合揿针全程护理对胃癌晚期癌痛患者心理状态的影响。方法 选取我院115例胃癌晚期癌痛患者(2018年3月—2021年1月),依照干预方案不同分为3组。对照1组(37例)接受团体认知行为干预,对照2组(38例)接受揿针全程护理干预,观察组(40例)接受团体认知行为干预联合揿针全程护理干预,比较3组干预效果。结果 疼痛爆发时疼痛缓解情况:观察组疼痛爆发时疼痛缓解率均较对照1组、对照2组高(P＜0.05);心理状态:干预1个月后,3组心理状态均得到改善,且观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均较对照1组、对照2组低(P＜0.05);护理满意度:与对照1组、对照2组对比,观察组护理满意度较高(P＜0.05)。结论 团体认知行为干预联合揿针全程护理应用于胃癌晚期癌痛患者,能有效缓解疼痛,改善心理状态,且护理满意度高。

Objective To analyze the effect of group cognitive behavior intervention combined with whole-process nursing of pressing needle on the psychological state of patients with advanced gastric cancer pain. Methods A total of 115 patients with advanced gastric cancer pain in our hospital (from March 2018 to January 2021) were selected and divided into 3 groups according to different intervention methods. Control group 1 (37 cases) received group cognitive behavioral intervention, control group 2 (38 cases) received whole-course nursing intervention of pressing needle, and observation group (40 cases) received whole-process nursing intervention of group cognitive behavioral intervention combined with pressing needle. The intervention effects of the three groups were compared. Results Pain relief when pain burst: the pain relief rate of observation group was higher than control group 1 and control group 2 (P<0.05). Mental state: after 1 month of intervention, the mental state of the 3 groups was improved, and the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the observation group were lower than those in control group 1 and control group 2 (P<0.05). Nursing satisfaction: compared with control group 1 and control group 2, nursing satisfaction of observation group was higher (P<0.05). Conclusions Group cognitive behavior intervention combined with whole-process nursing of pressing needle applied to patients with advanced gastric cancer pain could effectively relieve pain, improve psychological state, and nursing satisfaction.