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论著

右美托咪定对腋路臂丛神经阻滞联合肩胛上神经阻滞患者术后反弹性疼痛的影响

Effect of dexmedetomidine on postoperative rebound pain in patients with axillary brachial plexus block combined with suprascapular nerve block

:829-833
 
       目的 探究右美托咪定对腋路臂丛神经阻滞联合肩胛上神经阻滞患者术后反弹性疼痛的影响。方法 收录2024年9月—2025年10月期间我院接受肩关节镜手术治疗的患者,合计收录样本量为150例,将患者随机分为两组(n=150):常规腋路臂丛神经阻滞联合肩胛上神经阻滞组(N组,n=75)、复合右美托咪定的腋路臂丛神经阻滞联合肩胛上神经阻滞组(D组,n=75);评价组间反弹性疼痛、术后恢复情况及应急指标差异。结果 术后2 h、6 h、12 h、24 h疼痛视觉模拟量表(VAS)评分D组较N组更低(P<0.05)。反弹性疼痛发生率D组(5.33%)较N组(20.00%)更低,首次发作时间D组较N组更迟,持续时间D组较N组更短(P<0.05)。术后补救镇痛次数、阿片类药物用量、非甾体药物使用率D组较N组更低(P<0.05)。术后首次下床时间和住院时长D组较N组更短,满意度评分D组较N组更高(P<0.05)。不良反应发生率D组与N组比较,差异无统计学意义(P>0.05)。术前组间应激反应指标未见明显差异,术后24 h两组均有不同程度的指标变化,但相较N组而言,D组心率、平均动脉压、收缩压、舒张压变化幅度更小(P<0.05)。结论 右美托咪定用于腋路臂丛神经阻滞联合肩胛上神经阻滞患者,在降低术后疼痛程度及反弹性疼痛发生率、促进术后康复进程有显著价值,对术后不良反应发生率及应激反应的影响较小。

       Objective To explore the effect of dexmedetomidine on postoperative rebound pain in patients with axillary brachial plexus block combined with suprascapular nerve block.Methods From September 2024 to October 2025,150 patients who underwent arthroscopic surgery in our hospital were randomly divided into two groups(n=150):conventional axillary brachial plexus block combined with suprascapular nerve block group(N group,n=75) and axillary brachial plexus block combined with dexmedetomidine group(D group,n=75).The differences of rebound pain,postoperative recovery and emergency indicators between groups were evaluated.Results The pain scores at 2 hours,6 hours,12 hours and 24 hours after operation in group D were lower than those in group N(P<0.05).The incidence of rebound pain in group D(5.33%) was lower than that in group N(20.00%),the first attack time in group D was later and the duration in group D was shorter than those in group N(P<0.05).The times of postoperative salvage analgesia,the dosage of opioids and the utilization rate of non-steroidal drugs in group D were lower than those in group N(P<0.05).The time of getting out of bed for the first time and the length of hospitalization in group D were shorter than those in group N,and the satisfaction score in group D was higher than that in group N(P<0.05).There was no significant difference in the incidence of adverse reactions between group D and group N(P>0.05).There was no significant difference in stress response indexes between groups before operation,and the indexes of both groups changed in different degrees 24 hours after operation,but compared with group N,the changes of heart rate,mean arterial pressure,systolic pressure and diastolic pressure in group D were smaller(P<0.05).Conclusions Dexmedetomidine used in axillary brachial plexus block combined with suprascapular nerve block has significant value in reducing postoperative pain and incidence of rebound pain,promoting postoperative rehabilitation process,and has little effect on postoperative adverse reactions and stress response.

基于 synNotch 合成受体的逻辑门控策略在肿瘤治疗中的应用与展望

Logic-gated strategies of synthetic Notch(synNotch)receptors in cancer therapy:Applications and future perspectives

:-
 
       嵌合抗原受体(CAR)T细胞疗法在血液系统恶性肿瘤中疗效显著,但在实体瘤应用中面临肿瘤异质性、免疫抑制微环境和在靶脱瘤毒性等挑战。合成Notch受体(synNotch)作为一种模块化的跨膜信号传导工具,通过将抗原识别与定制化的转录激活程序人工耦联,赋予T细胞整合多重信号、执行布尔逻辑运算的能力。将synNotch与CAR等效应模块结合,可构建“与”、“非”、“或”等逻辑门控回路,可实现对肿瘤微环境的精确识别与响应,极大提升CAR-T细胞的靶向特异性。本文系统综述了synNotch受体的结构演进与逻辑门控设计原理;重点阐明了其在提升细胞疗法靶向特异性、克服实体瘤抗原异质性、动态调控肿瘤微环境以及扩展至其他免疫细胞工程化领域的最新应用进展,并探讨了当前该技术在载体系统构建、受体信噪比优化等方面面临的挑战及未来的发展方向。
   Chimeric antigen receptor(CAR)T-cell therapy has demonstrated remarkable efficacy in hematological malignancies;however,its application in solid tumors is confronted with significant challenges,including tumor heterogeneity,the immunosuppressive microenvironment,and on-target off-tumor toxicity.As a highly modular transmembrane signal transduction tool,the synthetic Notch(synNotch)receptor innovatively links antigen recognition with customized transcriptional activation programs,thereby empowering T cells with the capacity to integrate multiple signals and perform Boolean logic operations.By combining synNotch with effector modules such as CARs,logic-gated circuits,including AND,NOT,and OR gates,can be constructed,which enables precise discrimination of and response to the tumor microenvironment,substantially enhancing the targeting specificity of CAR-T cells.This review systematically summarizes the structural evolution of synNotch receptors and the principles of logic-gated design.Furthermore,it highlights recent advances in their application for enhancing the targeting specificity of cell-based therapies,overcoming solid tumor antigen heterogeneity,dynamically regulating the tumor microenvironment,and extending to the engineering of other immune cell types.Finally,we discuss current challenges,such as the construction of vector systems and the optimization of receptor signal-to-noise ratios,as well as future directions for this technology.
护理研究

肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理对疗效及气道重塑的影响

Effects of multidimensional enhanced nursing on the efficacy and airway remodeling in patients with pulmonary tuberculosis and type Ⅱ respiratory failure during nasal high-flow humidified oxygen therapy

:778-783
 
      目的 分析肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理的效果。方法 纳入2022年12月—2025年1月在河北省胸科医院进行经鼻高流量湿化氧疗的肺结核合并Ⅱ型呼吸衰竭患者294例,随机分为强化护理组(147例,多维度强化护理)、对照组(147例,常规护理),测量比较两组患者在护理前后气道重塑指标、肺功能指标、血气分析指标,进行疗效评估。结果 护理后强化护理组气道壁面积、气道壁厚度低于对照组,气道腔面积高于对照组(P<0.05);护理后强化护理组第1秒用力呼气容积、用力肺活量高于对照组(P<0.05);护理后强化护理组动脉血氧分压高于对照组,动脉血二氧化碳分压低于对照组(P<0.05);强化护理组总有效率高于对照组(P<0.05)。结论 肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间接受多维度强化护理可改善其气道重塑及肺功能,有利于血气分析指标恢复,应用效果显著。

       Objective To analyze the efficacy of multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy in patients with pulmonary tuberculosis and type Ⅱ respiratory failure.Methods A total of 294 patients with pulmonary tuberculosis and type Ⅱ respiratory failure who received nasal high-flow humidified oxygen therapy at Hebei Chest Hospital between December 2022 and January 2025 were enrolled and randomly divided into an enhanced nursing group(147 patients,receiving multidimensional enhanced nursing)and a control group(147 patients,receiving conventional nursing).Airway remodeling,pulmonary function,and blood gas analysis were measured and compared between the two groups before and after nursing,and the efficacy was evaluated.Results After nursing,the enhanced nursing group had lower airway wall area and airway wall thickness,and higher airway lumen area than the control group(P<0.05).The forced expiratory volume in 1 second and forced vital capacity in the enhanced nursing group were higher than those in the control group(P<0.05).The blood oxygen partial pressure(PaO2)in the enhanced nursing group was higher than that in the control group,and the carbon dioxide partial pressure(PaCO2)was lower than that in the control group(P<0.05).The total effective rate in the enhanced nursing group was higher than that in the control group(P<0.05).Conclusions Multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy can improve airway remodeling and lung function in patients with pulmonary tuberculosis and type Ⅱ respiratory failure,and is beneficial for the recovery of blood gas analysis indicators.The application effect is significant.
论著

数字化口内扫描印模技术对重度牙周炎患者口腔种植修复效果及龈沟液炎症因子水平的影响

The influence of digital intraoral impression technology on the restorative effect of oral implants and the levels of inflammatory factors in gingival crevicular fluid in patients with severe periodontitis

:762-766
 
       目的 研究数字化口内扫描印模技术(DIOS)对重度牙周炎(SP)患者口腔种植修复效果及龈沟液炎症因子水平的影响并进行分析。方法 选取医院2022年1月—2025年1月收治的100例SP患者进行研究。以密封信封抽签法分为数字化组(n=50)及常规组(n=50)。两组均开展口腔种植修复,常规组采用常规硅橡胶印模技术,数字化组则采用DIOS。对比两组印模制取时间、印模过程中疼痛程度及种植成功率、修复体满意度、龈沟液炎症因子水平、并发症发生情况。结果 数字化组印模制取时间短于常规组,VAS评分低于常规组,而种植成功率高于常规组(均P<0.05)。数字化组边缘密合度、咬合关系、邻接关系满意度均高于常规组(均P<0.05)。修复3个月后两组龈沟液各项炎症因子水平均低于修复前,且数字化组低于常规组(均P<0.05)。数字化组并发症总发生率低于常规组(P<0.05)。结论 DIOS可显著提高SP患者口腔种植修复效果,降低龈沟液炎症因子水平,减少并发症的发生。

      Objective To investigate the effects of digital intraoral scanner(DIOS)on the oral implant restoration effect and the levels of inflammatory factors in gingival crevicular fluid in patients with severe periodontitis(SP).Methods A total of 100 SP patients admitted to the hospital from January 2022 to January 2025 were selected for the study.They were divided into the digital group(n=50)and the conventional group(n=50)by the sealed envelope lottery method.Both groups underwent oral implant restoration.The conventional group used the conventional silicone rubber impression technology,while the digital group underwent DIOS.The time of impression preparation,the degree of pain during the impression process,the success rate of implantation,the satisfaction of restorations,the levels of inflammatory factors in gingival crevicular fluid,and the occurrence of complications were compared between the two groups.Results The impression acquisition time of the digital group was shorter than that of the conventional group,the VAS score was lower than that of the conventional group,while the implantation success rate was higher than that of the conventional group(all P<0.05).The marginal fit,occlusal relationship and adjacent relationship in the digital group were all higher than those of the conventional group(all P<0.05).Three months after repair,the levels of various inflammatory factors in gingival crevicular fluid in both groups were lower than those at admission,and the digital group was lower than the conventional group(all P<0.05).The total incidence of complications in the digital group was lower than that in the conventional group(P<0.05).Conclusions DIOS can significantly improve the oral implant restoration effect of SP patients,reduce the levels of inflammatory factors in gingival crevicular fluid,and reduce the occurrence of complications.

论著

不同附着体类型对上颌种植覆盖义齿周围软硬组织健康影响的对比研究

A comparative study of the effects of different attachment types on peri-implant soft and hard tissue health in maxillary implant-supported overdentures

:756-761
 
       目的 探讨不同附着体类型对上颌种植覆盖义齿修复患者种植体周围软硬组织健康状况的影响。方法 选取2020年1月—2023年12月于南京医科大学附属口腔医院就诊并接受上颌种植覆盖义齿修复的90例患者,根据所用附着体类型分为杆卡组(n=30)、球帽组(n=30)和Locator组(n=30)。戴用后随访12个月,比较三组种植体周围探诊深度(PD)、探诊出血(BOP)、菌斑指数(PLI)、牙龈指数(GI)、边缘骨吸收(MBL)等指标,并记录机械并发症发生情况。结果 佩戴12个月后,杆卡组在PD[(3.25±0.41) mm vs (3.58±0.50) mm,校正后P<0.016 7]、PLI(1.25±0.38 vs 1.55±0.44,校正后P<0.016 7)、GI(1.15±0.35 vs 1.37±0.42,校正后P<0.016 7)及MBL[(0.38±0.11) mm vs (0.63±0.14) mm,校正后P<0.016 7]方面的表现均优于Locator组;球帽组PLI(1.42±0.41 vs 1.55±0.44,校正后P<0.016 7)、GI(1.28±0.39 vs 1.37±0.42,校正后P<0.016 7)低于Locator组;三组间BOP阳性率两两比较差异均无统计学意义(校正后P>0.016 7)。三组机械并发症总发生率的总体差异具有统计学意义(P<0.05),进一步两两比较显示,杆卡组并发症发生率最低(16.67%),Locator组最高(50.00%)(校正后P<0.016 7)。结论 对于上颌种植覆盖义齿修复,杆卡式附着体在维持种植体周围软硬组织健康、减少边缘骨吸收及降低机械并发症方面表现出相对优势,临床适用性较高。

       Objective To investigate the effects of different attachment types on the health of peri-implant soft and hard tissues in patients rehabilitated with maxillary implant-supported overdentures.Methods A total of 90 patients who received maxillary implant-supported overdentures at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2020 and December 2023 were selected and divided into three groups based on the attachment type:bar-clip group(n=30),ball attachment group(n=30),and Locator group(n=30).After prosthesis delivery,patients were followed up for 12 months.Parameters including probing depth(PD),bleeding on probing(BOP),plaque index(PLI),gingival index(GI),and marginal bone loss(MBL)were compared among the groups,and mechanical complications were recorded.Results At 12 months after delivery,the bar-clip group demonstrated significantly better performance in PD([3.25±0.41]mm vs [3.58±0.50]mm,adjusted P<0.016 7),PLI([1.25±0.38] vs [1.55±0.44],adjusted P<0.016 7),GI([1.15±0.35] vs [1.37±0.42],adjusted P<0.016 7),and MBL([0.38±0.11]mm vs [0.63±0.14]mm,adjusted P<0.016 7)compared to the Locator group.The ball attachment group showed significantly lower PLI([1.42±0.41] vs [1.55±0.44],adjusted P<0.016 7)and GI([1.28±0.39] vs [1.37±0.42],adjusted P<0.016 7)values than the Locator group.No statistically significant difference was observed in BOP positive rates among the three groups in pairwise comparisons(adjusted P>0.016 7).The overall difference in the total incidence of mechanical complications among the three groups was statistically significant(P<0.05),and further pairwise comparisons showed that the bar-clip group had the lowest incidence(16.67%),while the Locator group had the highest(50.00%)(adjusted P<0.016 7).Conclusions For maxillary implant-supported overdentures,bar-clip attachments demonstrate relative advantages in maintaining peri-implant soft and hard tissue health,reducing marginal bone loss,and minimizing mechanical complications,suggesting good clinical applicability.

综述

肺癌患者术后肺功能预测模型的研究进展

Research progress on predictive models of postoperative lung function in patients with lung cancer

:717-723
 
       肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种,手术是其主要治疗手段。然而,肺切除手术常引起肺功能下降,影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前,研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型,用于评估肺癌患者术后肺功能变化。然而,现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素,并对现有预测模型进行总结与评价,以期为患者术前评估、手术方案选择及术后管理提供参考,进而为改善治疗效果与患者生活质量提供理论依据。

       Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world,and surgery is the main treatment.However,pneumonectomy is often accompanied by the loss of lung function,which seriously affects the recovery of lung function and the  quality of life.Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans,reducing the risk of complications and improving the prognosis of patients.At present,researchers have developed a variety of predictive models that combine clinical indicators,imaging parameters,and biomarkers to evaluate postoperative lung function changes in patients with lung cancer.However,there are still many challenges in the accuracy,specificity,standardization and clinical promotion of existing models.This paper systematically reviews the influencing factors of lung function after lung cancer surgery,and summarizes and evaluates the existing prediction models,in order to provide a reference for preoperative evaluation,surgical plan selection and postoperative management of patients,and then provide theoretical basis for improving treatment effect and quality of life of patients.

专题:体重管理

体成分变化对肥胖患者肾小球高滤过的影响

The impact of alterations in body composition on glomerular hyperfiltration in obese patients

:671-678
 
       目的 探究体成分变化对肥胖患者肾小球高滤过的影响。方法 根据纳入排除标准,连续收集在中南大学湘雅二医院营养科及代谢内分泌科就诊的肥胖患者(体质指数≥28 kg/m2),对其随访3个月以上,纳入体质量减轻≥5%的患者,记录一般人口学、人体测量学、体脂率(BFP)、体脂肪量(BFM)、内脏脂肪面积(VFA)和骨骼肌量(SMM)等体成分和实验室检验数据,计算估计肾小球滤过率(eGFR)。肾小球高滤过被定义为eGFR大于普通人群第95个百分位数,根据此标准分为肾小球高滤过组和正常滤过组,比较组间一般人口学资料、生化指标及体成分的差异,绘制限制性立方样条图分析体成分的变化与eGFR变化之间的非线性关联。结果 (1)共收集85例肥胖患者初复诊资料,其中肾小球正常滤过患者43例,肾小球高滤过患者42例,男性35例,女性50例;(2)单因素分析提示肾小球高滤过患者减重前后eGFR差异有统计学意义[143.34 mL/(min·1.73 m2 vs 125.68 mL/(min·1.73 m2);(3)非线性相关分析结果显示肥胖肾小球高滤过患者eGFR的变化与VFA的变化相关(P=0.015 1),与BFP的变化相关(P=0.022 6)。结论 肥胖患者减重后,随着VFA和BFP的下降可能改善肾小球高滤过。
    Objective This study aimed to investigate the impact of alterations in body composition on glomerular hyperfiltration in obese patients.Methods According to predefined inclusion and exclusion criteria,obese patients(body mass index ≥28 kg/m2)from the department of clinical nutrition and the department of metabolism and endocrinology at Second Xiangya Hospital of Central South University were consecutively enrolled.Patients who achieved a weight loss of ≥5% after more than three months of follow-up were included.Data on general demographics,anthropometric measurements,body composition parameters-including body fat percent(BFP),body fat mass(BFM),visceral fat area(VFA),and skeletal muscle mass(SMM)-and laboratory test results were collected.The estimated glomerular filtration rate(eGFR)was calculated.Glomerular hyperfiltration was defined as an eGFR greater than the 95th percentile for the general population.Based on this criterion,patients were categorized into a hyperfiltration group and a normofiltration group.Differences in demographic characteristics,biochemical indices,and body composition parameters between the two groups were compared.Restricted cubic spline curves were plotted to analyze the non-linear relationship between changes in body composition and changes in eGFR.Results (1)A total of 85 obese patients(35 males and 50 females) with initial and follow-up data were included,comprising 43 patients with normofiltration and 42 with hyperfiltration;(2)Univariate analysis indicated a statistically significant difference in eGFR before and after weight loss in the hyperfiltration group(143.34 mL/min/1.73m2 vs 125.68 mL/min/1.73m2P<0.001);(3)Non-linear correlation analysis revealed that changes in eGFR among obese patients with hyperfiltration were significantly associated with changes in VFA(P=0.015 1)and changes in BFP(P=0.022 6).Conclusions Weight loss in obese patients may ameliorate glomerular hyperfiltration,potentially mediated through reductions in VFA and BFP.
论著

补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床观察及疗效评价:一项随机对照试验

Clinical observation and curative effect evaluation of Shenshu Tuina combined with Bushen Yiqi herbal ointment on cancer-induced fatigue in convalescent stage of colorectal cancer

:333-340
 
       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者,随机平均分为两组。行常规对症支持治疗的为对照组;在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组;两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标(CD3+  、CD4+、CD8+  、CD4+ /CD8+ )较治疗前均有明显改善;干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果,提高生活质量和免疫功能,减少不良反应。
       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy.Methods  From June 2023 to June 2025,80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups.The patients who received routine symptomatic supportive treatment were enrolled as the control group.The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group.The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment.Adverse reactions were detected on the day before treatment,theseventh day and 14th day during treatment.Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment.Adverse  reactions occurred less in the intervention group than in the control group.Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer,improve the quality of life and immune function,reduce adverse reactions.
论著

胸部肿瘤术后早期排痰的临床研究

Clinical study on early expectoration after thoracic tumor surgery

:327-332
 
       目的  探讨胸部肿瘤患者手术后早期排痰的效果,降低肺部并发症的发生率。方法  选择2024年6月—2025年7月在本院进行胸部肿瘤切除的60例术后患者作为研究对象。采用非同期回顾对照设计,以不同时间段病例分组,分为对照组(n=30)和观察组(n=30)。两组胸部手术后患者均给予常规围术期护理,观察组胸部手术后患者增加早期排痰护理。统计两组排痰效果[咳痰难度、血氧饱和度(SPO2)]变化、疼痛评分,并统计两组肺部相关并发症及住院时间进行比较。结果  观察组患者术后的SPO2水平高于对照组(P<0.05),咳痰难度评分低于对照组患者(P<0.05)。干预后第B、C时间点观察组患者的疼痛评分均低于对照组(P<0.05)。观察组住院时间短于对照组(P<0.05),胸部并发症总发生率低于对照组(P<0.05),满意度高于对照组(P<0.05)。结论  胸部肿瘤术后早期排痰有助于促进术后患者排痰,减少肺部相关发症,缩短住院时间。
       Objective  To investigate the efficacy of early expectoration management in reducing pulmonary complications for patients following thoracic tumor surgery.Methods  Sixty patients undergoing thoracic tumor  resection at our hospital between 2024 and 2025 were enrolled.A non-concurrent retrospective control design was adopted.Cases were grouped according to different time periods,divided into a control group(n=30)and an observation group(n=30).The control group  received  standard perioperative care,while the observation group received additional early expectoration nursing interventions.Outcome measures included expectoration efficacy(assessed by cough difficulty score and oxygen saturation[SpO2]),pain scores,incidence of pulmonary complications,and hospital stay duration.Results  Postoperative SpO2 levels were higher in the observation group than in the control group (P<0.05),while cough difficulty scores were significantly lower(P<0.05).At time points B and C after the intervention,the pain scores of patients in the observation group were lower than those in the control group(P<0.05).The observation group demonstrated a significantly shorter hospital stay(P<0.05),a lower overall incidence of thoracic complicationsP<0.05),and higher patient satisfaction  than the control group(P<0.05).Conclusions  Implementing early expectoration protocols after thoracic tumor surgery facilitates sputum clearance can reduce pulmonary complications,and shorten hospitalization time.
医院管理

《医疗保障基金使用监督管理条例》实施情况调查分析——以广东省为例

Investigation and analysis on the implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds” :Based on data from Guangdong Province

:248-256
 
       目的 了解《医疗保障基金使用监督管理条例》(以下简称《条例》)在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。
        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”(hereinafter referred to as the “Regulations”)in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions.Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff.Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations.” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization.However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities.Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision.
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