目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.

目的 评价自我管理小组干预对社区2型糖尿病患者的管理效果。方法 在2013年底选取本区社区卫生服务中心100例患者研究,运用自身对照方法,管理1年后对其自我管理效能、生化指标、空腹血糖、糖化血红蛋白进行比较。结果 管理一年后饮食控制、运动控制、药物依从性、监测依从性、足部护理等指标差异有统计学意义(P<0.05)。空腹血糖、糖化血红蛋白、总胆固醇、尿酸下降,差异有统计学意义(P<0.05)。空腹血糖达标率由12%上升到37%,糖化血红蛋白达标率由10%上升到34%,差异有统计学意义(P<0.05)。结论 自我管理小组干预提高了社区2型糖尿病患者自我管理水平,改善了主要的生化指标,值得社区推广应用。

Objective To evaluate the function of self-management group program on patients with type 2 diabetes in community. Methods Self-management was carried out for one year among 100 patients with type 2 diabetes, the effect of management was analyzed. Results There was statistically significant difference in diet control, motion control, drug compliance, monitoring compliance, and foot care after one year intervention (P<0.05). GLU, HbA1c, CHOL, UA were decreased. The difference was statistically significant (P<0.05). Conclusion Self-management of group intervention is effective in patients with type 2 diabetes, is worthy of further popularization and application.

目的 探讨优质护理服务对促进心胸外科患者恢复和提高患者护理满意度的效果。方法 将478例患者按时段分为按常规护理的对照组和实施优质护理的实验组,观察患者住院天数、拔除胸腔引流管时间、早期离床活动时间、护患纠纷发生率及满意度。结果 实验组患者住院天数、拔除胸腔引流管时间、早期离床活动时间、护患纠纷发生率明显缩短/降低,满意度显著提高,与对照组比较均差异有统计学意义(P＜0.01)。结论 优质护理服务有利于心胸外科患者术后恢复、减少护患纠纷和提高护理满意度,值得推广。

目的 探讨分析白带涂片多功能染色技术(BTR 法)在妇科疾病患者中的临床应用价值。方法 选取300 例有明显感染症状的妇科疾病患者取白带,采用BTR 法、盐水法和巴氏染色法进行检测。结果 BTR 法病原体阳性率:滴虫42%、霉菌36.7%、线索细胞17.3%、纤毛菌12%、淋球菌6.7%、球杆菌86%、核异质细胞6.3%和癌细胞2.7%,阴道清洁度95%;阳性率高于盐水法和巴氏染色法,差异有统计学意义(P<0.01);而且BTR法操作简单,耗时少,检出率高,成本低,优于盐水法和巴氏染色法,差异有统计学意义(P<0.01)。结论 BTR 法可在几分钟内检出滴虫性或霉菌性或细菌性阴道炎、宫颈炎、宫颈癌、卵巢癌等异常情况,可提高妇科疾病病原体的检出率,为诊断和治疗提供可靠依据,适用于大型妇科普查和癌症筛查,值得在基层医院推广应用。

Objective To explore and analysis the application of leucorrhea smear multi-function BTR staining techniques(method) in gynecological disease. Methods Leucorrhea were taken in 300 gynecological disease patients with obvious infection symptoms, BTR, saline smear, pap staining were performed at the same sample. Results Pathogene positive rate ofBTR method of trichomonad, mould, clue cell, leptotrichia, gonococci, coccobacillus, dyskaryotic cell, cancer cell and vaginal cleanliness detection rate is 42%,36.7%,17.3%,12%,6.7%,86%,6.3%,2.7% and 95% respectively. The pathogens detection rate of BTR was higher than saline smear, pap staining. It showed statistical difference(P<0.01). BTR method operated simply, timely, low cost, positively than saline smear, pap staining,it showed statistical difference(P<0.01). Conclusion BTR method can detect bacterial vaginitis, colpitis mycotica, cervicitis, cervical carcinoma and ovarian cancer. It can provide reliable evidence for gynecological disease diagnosis and treatment. It can be applied in big gynecological and cancer screening. BTR method is deserved to popularize and apply in primary hospital.

目的 通过建立急性心力衰竭（AHF）患者服药依从性预测模型,提高AHF患者的服药依从性和临床管理效果。方法 纳入2021年1月—2023年12月在广州市番禺区何贤纪念医院住院治疗的580例AHF患者,通过收集患者的一般人口学资料、疾病相关资料及出院后6个月的服药依从性数据,应用Logistic回归模型分析患者服药依从性的影响因素,并基于影响因素建立预测模型。结果 患者服药依从性总体良好（75%）。依从性良好组与依从性差组的年龄、独居情况、合并基础病、服药种类、疾病了解评分、治疗信心评分和自我控制信心评分比较差异有统计学意义（P<0.05）。Logistic 回归分析显示危险因素包括年龄≥60岁（OR=1.774）、独居（OR=1.871）、合并基础病≥2种（OR=1.719）和服药种类≥7种（OR=1.456）。而疾病了解评分（OR=0.923）、治疗信心评分（OR=0.946）和自我控制信心评分（OR=0.901）是保护因素（P<0.05）。基于上述因素建立的预测模型,通过ROC曲线验证,曲线下面积为0.815（95%CI：0.780~0.850）,提示所构建的模型具有良好的区分度。对该模型的校准度进行评价,P=0.528,提示该预测模型拟合度良好。此外,该预测模型的一致性指数为0.738,说明模型的预测性能良好。绘制的决策曲线中,曲线位于极端线之上,当阈概率取值在9%~59%时,对应的净获益率为0~27%,提示建立的模型具有优秀的临床有效性。结论 AHF患者的服药依从性受到多种因素的影响,包括年龄、居住状态、合并基础病种类及服药种类等。

Objective To establish a predictive model for medication compliance among acute heart failure（AHF）patients in order to enhance their therapeutic compliance and optimize clinical outcomes. Methods A total of 580 AHF inpatients at He Xian Memorial Hospital in Panyu District, Guangzhou between January 2021 and December 2023 were enrolled. Demographic information, disease-specific data,as well as post-discharge medication compliance records within six-month were collected by investigators. Utilizing logistic regression analysis revealed several influential determinants affecting medication compliance which formed the basis for constructing our predictive model. Results Generally,patient compliance was good（75%）. The comparison between the good compliance group and the poor compliance group showed that there were significant differences in age, living alone,combined with underlying diseases, types of medication, disease understanding score, treatment confidence score and self-control confidence score（P<0. 05）. Logistic regression analysis showed that independent risk indicators including individuals aged ≥60 years（odds ratio[OR]=1. 774）, those living alone（OR=1. 871）, presence of two or more underlying diseases（OR=1. 719）, along with consumption of seven or more medications daily（OR=1. 456）. Conversely,disease awareness score（OR=0. 923）, treatment confidence score（OR=0. 946）, and self-control confidence score（OR=0. 901）were identified as independent protective factors. Validation using receiver operating characteristic curves demonstrated robust predictive performance with an area under curve value of 0. 815（95%CI：0. 780-0. 850）, affirming its efficacy. The calibration of the model was evaluated, with a P-value of 0. 528, indicating good fit of the predictive model. Additionally, the concordance index（C-index）of the model was 0. 738, suggesting its excellent predictive performance. The decision curve analysis revealed that the curve was above the extreme lines, with a net benefit rate ranging from 0 to 27% when the threshold probability falls between. Conclusions The medication compliance of AHF patients is influenced by various factors, including age, living arrangement, the number of underlying diseases, and the number of medications taken. Targeted interventions such as enhancing patient education, simplifying treatment regimens, and improving social support can effectively improve the medication compliance of AHF patients. The predictive model established in this study provides a scientific basis for clinicians to develop more precise and effective individualized intervention measures,thereby improving the prognosis and quality of life.

       目的     探讨内镜下黏膜切除术患者肠道准备教育程序的优化方法及改善效果。方法    选择2022年12月—2023年12月广州市中西医结合医院接收的内镜下黏膜切除术患者180例进行研究，电脑随机编号按奇偶数分为两组各90例，对照组采取常规肠道准备教育工作，观察组实施基于优化的教育程序展开教育工作，比较两组依从性、肠道准备质量、满意度、不适症状发生情况。结果    观察组饮食依从率96.88%、服药依从率98.44%、运动依从率93.75%，均高于对照组的78.13%、79.69%、71.88%（χ ² 分别为6.172、7.745、7.120，P分别为0.012、0.005、0.007）。观察组左侧、横结肠、右侧等评分及肠道准备质量总分高于对照组（t分别为7.175、6.442、5.971、8.234，均P＜0.001）。观察组肠道准备满意度为98.89%，高于对照组的88.89%（χ ² =7.842，P=0.005）。观察组恶心11.11%、呕吐4.44%、腹胀5.56%、腹痛0.00%，低于对照组的22.22%、13.33%、14.44%、6.67%（χ ² 分别为4.000、4.390、3.950、4.310，P分别为0.045、0.036、0.046、0.037）。结论    对内镜下黏膜切除术患者实施基于优化的教育程序展开肠道准备教育工作可提高患者肠道准备依从性，保证良好的肠道准备质量和肠道清洁度，提高患者的满意度，有助减少肠道不适症状。

       Objective  To explore the optimization method and improvement effect of bowel preparation education program in patients undergoing endoscopic mucosal resection．Methods  A total of 180 patients with endoscopic mucosal resection admitted to the hospital from December 2022 to December 2023 were selected for the study．They were randomly divided into two groups with 90 cases in each group．The control group was given routine bowel preparation education，and the observation group was given education based on optimized education procedures．The compliance，quality of bowel preparation，satisfaction and discomfort symptoms were compared between the two groups．Results  The diet compliance rate 96.88%，medication compliance rate 98.44%，exercise compliance rate 93.75% in the observation group were significantly higher than 78.13%，79.69%，71.88% in the control group（χ ² =6.172，7.745，7.120，P=0.012，0.005，0.007）．The scores of left colon，transverse colon and  right colon and the total score of bowel preparation quality in the observation group were significantly higher than those in the control group（t=7.175，6.442，5.971，8.234，all P＜0.001）．The satisfaction of bowel preparation in the observation group（98.89%）was significantly higher than that in the control group（88.89%）（χ ² =7.842，P=0.005）．Nausea 11.11%，vomiting 4.44%，abdominal distension 5.56%，abdominal pain 0.00% in the observation group were significantly lower than 22.22%，13.33%，14.44%，6.67% in the control group（χ ² =4.000，4.390，3.950，4.310，P=0.045，0.036，0.046，0.037）．Conclusions  The implementation of bowel preparation education based on optimized education program in patients undergoing endoscopic mucosal  resection can improve the compliance of bowel preparation，ensure good quality of bowel preparation and bowel cleanliness，improve patient satisfaction，and reduce the occurrence of intestinal discomfort symptoms，which is worthy of promotion．

       目的   对该培训基地师资2021—2023年教学能力进行评价，了解和分析“1+3+n”的院级督导推行前的2021年、“1+3+n”的院级督导推行后的 2022年、2023年师资的教学能力变化。方法   采用问卷调查法收集评价数据，采用SPSS.27.0对教学评价资料进行统计分析，采用净推荐值计算教学口碑，对多年度结果进行纵向比较分析。结果  2021—2023年教学评价次数共5 483次；2021—2023年对师资教学设计能力评价由实施前的8.8提高到9.6、教学实施能力由实施前的9.0提高到9.5、教学热情由实施前的9.0提高到10.0、时间投入由实施前的9.3提高到10.0，不同年份组间比较的差异均有统计学意义（P＜0.001）；课程净推荐值由实施前的60.5%提高到81.3%，师资课程推荐者占比由实施前的65.5%提高到83.2%，贬损者占比由实施前的5.0%降低到1.9%，差异有统计学意义（χ ² =175.4，P＜0.001）。结论   “1+3+n”院级督导模式的相关举措，对师资教学能力的提高具有促进作用，且该促进作用持续存在，师资教学能力逐年递增。

    Objective  To evaluate the teaching ability change of teachers  from 2021 to 2023，including of teachers’ teaching ability in 2021 before the implementation of "1+3+n" college-level supervision，and in  2022  and  2023  after the implementation of "1+3+n" college-level supervision．Methods  Questionnaire survey was used to collect evaluation data，SPSS.27.0 was used to make statistical analysis of teaching evaluation data，and NPS（Net Promoter Score）was used to evaluate teaching quality．Results  From 2021 to 2023，there were 5483 teaching evaluations．From 2021 to 2023，teaching design ability evaluation score increased from 8.8 before the implementation to 9.6，teaching implementation ability evaluation score increased from 9.0 before the implementation to 9.5，teaching enthusiasm evaluation score increased from 9.0 before the implementation to 10.0，time investment evaluation score increased from 9.3 before the implementation to 10.0，and the differences between different years were statistically significant（P＜0.001）．The courses quality increased from 60.5% before the implementation to 81.3%，and the proportion of teachers' course recommenders has increased from 65.5% before the implementation to 83.2%，while the proportion of detractors has decreased from 5.0% before the implementation to 1.9%，with statistical significance（χ ² =175.4，P＜0.001）．Conclusions  The measures of "1+3+n" college-level supervision mode promote the improvement of teachers’ teaching ability，the promotion effect persists，and the teaching ability increases year by year．

       药源性心脏毒性是临床常见的药物不良反应，是药物研发和临床治疗需面临的严峻考验。对药源性心脏毒性的评价是目前研究的重点，基于其机制复杂多样、临床表现不一、影响因素多，早期评价具有困难。生物标志物是评价心脏毒性的重要指标之一，文章总结了目前已经报道的多种心脏毒性标志物及其潜在的生物标志物，希望能从中找到特异性强、敏感性高的标志物，以贡献于药物心脏安全性评价工作。

    As a common clinical adverse reaction，pharmacogenic cardiotoxicity is a severe challenge for drug development and clinical treatment．The evaluation of pharmacogenic cardiotoxicity is the focus of current research，and early evaluation is difficult with its complex and diverse mechanisms，varying clinical manifestations，and numerous influencing factors．Biomarker is an important index to evaluate cardiotoxicity．This article summarizes a variety of cardiotoxicity biomarkers and other potential biomarkers that have been reported so far，hoping to find  biomarkers with strong specificity and high sensitivity，so as tocontribute to the evaluation on cardiac safety of drugs．