目的 探讨微RNA-29b（miR-29b）对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组（MM组）、miR-29b阻遏物组（MR组）和阴性对照物组（MNC组）,分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑（WST-1）检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物（PTEN）-蛋白激酶 B（AKT）通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为（2 032.1±873.4）、（19 272.8±2 087.9）、（472.7±105.6）,组间比较差异有统计学意义（P<0.05）。MM组0、3、5、7 d时OD值分别为（0.32±0.06）、（0.53±0.08）、（1.13±0.12）和（1.92±0.14）,MNC组0、3、5、7 d时OD值分别为（0.34±0.09）、（0.71±0.08）、（1.67±0.21）和（3.49±0.24）,MR组0、3、5、7 d时OD值分别为（0.38±0.09）、（0.84±0.18）、（2.43±0.24）和（5.67±0.15）,3组0 d时OD值比较差异无统计学意义（P=0.216）,三组3 d、5 d、7 d时OD值比较差异存在统计学意义（P<0.001）。MNC组、MM组和MR组迁移细胞数分别为（403.9±23.8）（102.6±15.7）和（685.7±46.8）个,上述3组侵袭细胞数分别为（82.1±12.7）（38.2±10.6）和（124.6±21.6）个,MM组和MNC组上述指标比较差异均有统计学意义（P<0.05）,MR组和MM组上述指标比较差异均有统计学意义（P<0.05）。MNC组、MM组、MR组PTEN蛋白相对表达量分别为（0.25±0.08）、（0.69±0.11）、（0.11±0.05）,上述3组p-AKT蛋白相对表达量分别为（0.58±0.10）、（0.13±0.06）和（0.79±0.08）,上述3组AKT蛋白相对表达量分别为（0.38±0.09）、（0.37±0.11）和（0.37±0.08）,MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义（P<0.05）,AKT水平比较差异无统计学意义（P>0.05）;MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义（P<0.05）,AKT水平比较差异无统计学意义（P>0.05）。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。

Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells．Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group（MM group）,micro29b repressor group（MR group）and negative control group（MNC group）,and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group．The real-time quantitative reverse transcription polymerase chain reaction（RT-PCR）was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein．Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were（2 032.1±873.4）,（19 272.8±2 087.9）and（472.7±105.6）,respectively,and there were significant differences between groups（P<0.05）．OD values of MM group at 0 d,3 d,5 d and 7 d were（0.32±0.06）,（0.53±0.08）,（1.13±0.12）and（1.92±0.14）respectively．The OD values of MNC group at 0,3,5 and 7 days were（0.34±0.09）,（0.71±0.08）,（1.67±0.21）and（3.49±0.24）respectively．The OD values of MR group at 0 d,3 d,5 d and 7 d were（0.38±0.09）,（0.84±0.18）,（2.43±0.24）and（5.67±0.15）respectively．There was no significant difference in OD value between the three groups on day 0 （P=0.216）．There were significant differences in OD value between the three groups on day 3,day 5 and day 7（P<0.001）．The number of migrating cells in MNC group,MM group and MR group were（403.9±23.8）cells,（102.6±15.7）cells and（685.7±46.8）cells,respectively．The number of invasive cells in the above three groups were（82.1±12.7）cells,（38.2±10.6）cells and（124.6±21.6）cells．There were significant differences in the above indexes between MM group and MNC group（P<0.05）,also between MR group and MM group（P<0.05）．The relative expression levels of PTEN protein in MNC group,MM group and MR group were（0.25±0.08）,（0.69±0.11）and（0.11±0.05）．The relative expression levels of p-AKT protein in the above three groups were（0.58±0.10）,（0.13±0.06）and（0.79±0.08）．The relative expression levels of AKT protein in the above three groups were（0.38±0.09）,（0.37±0.11）and（0.37±0.08）,respectively．Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance（P<0.05）,but there was no statistical difference in AKT level（P>0.05）．Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance（P<0.05）,and there was no statistical difference in AKT level（P>0.05）．Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway．

慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数（SII）作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。

Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis．As a new type of inflammatory index,the systemic immune inflammatory index（SII）was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields．SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development．

目的 初步探讨无创产前基因检测（NIPT）筛查胎儿患猫叫综合征临床性能。方法 收集2018年4月—2019年3月行NIPT提示胎儿患猫叫综合征高风险的孕妇,并收集其羊水细胞培养染色体核型分析或微阵列芯片检测结果,分析NIPT与羊水产前诊断结果的符合率。结果 NIPT提示猫叫综合征病例11例,孕妇均接受了羊水穿刺,染色体核型分析或微阵列芯片检测出胎儿染色体异常6例,符合率为54.5%。结论 NIPT对胎儿猫叫综合征的筛查具有临床价值,当提示高风险时必须行有创性产前诊断。

Objective To investigate the value of non-invasive prenatal testing（NIPT）for the screening of fetal Cri du Chat Syndrome（CdCS）. Methods Pregnant women who accepted NIPT with the results with high risk of fetal CdCS were selected in the study from April 2018 to March 2019．They were also accepted prenatal genetic counseling and the chromosome karyotype analysis or CMA detection of amniotic fluid cell culture．The coincidence rate of NIPT with chromosome karyotype and microarray analysis results were conducted. Results There were 11 cases with high risk of fetal CdCS in NIPT．All of them had received amniocentesis chromosome karyotype or microarray analysis,6（54.5%）cases were confirmed. Conclusions NIPT has some clinical value in screening fetal CdCS from maternal blood．Therefore,it was suggested to perform the invasive chromosomal karyotyping and CMA for high risk of fetal CdCS．

目的 探讨风险防范护理干预对颅内动脉瘤介入术后患者血管并发症的应用。方法 选取天津市人民医院2020年6月—2023年10月收治的80例颅内动脉瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。所有患者均采取血管内介入栓塞术治疗,对照组患者实施常规护理,观察组患者在对照组基础上增加风险防范护理干预。对比两组患者干预前后负面情绪变化、术后并发症发生率、干预前后生活质量变化以及护理满意度。结果 干预后,两组焦虑、抑郁评分降低,观察组分别为（39.78±1.80）（44.73±3.78）分,低于对照组的（54.63±3.91）（49.23±4.14）分,对比差异有统计学意义（t=21.823、5.078,P<0.05）;观察组术后并发症发生率低于对照组（7.50% vs 27.50%,χ²=5.541,P=0.019）;干预后两组中文版明尼苏达心功能不全生命质量（MLHFQ）相关维度评分均升高,且观察组分别为（30.73±3.82]（21.13±2.70）（27.08±4.28）分,高于对照组的（26.20±3.50）（17.20±2.79）（23.20±2.35）分,对比差异有统计学意义（t=5.530、6.389、5.021,P<0.05）;观察组护理满意度高于对照组（92.50% vs 72.50%,χ²=5.541,P=0.019）。结论 颅内动脉瘤介入术后采取风险防范护理干预可改善患者焦虑、抑郁情绪,降低术后并发症,改善患者术后生活质量,患者护理满意度较高。

Objective To investigate the application effect of risk prevention nursing intervention on vascular complications in patients with intracranial aneurysms after interventional surgery．Methods Eighty patients with intracranial aneurysm admitted in Tianjin People’s Hospital from June 2020 to October 2023 were selected and divided into observation group and control group with 40 cases each．All the patients were treated with endovascular interventional embolization,the control group patients underwent routine care,and the observation group patients added risk prevention nursing intervention on the basis of the control group．The negative mood changes before and after the intervention,the incidence of postoperative complications,the quality of life before and after the intervention,and nursing satisfaction were compared between the two groups．Results After the intervention,the anxiety and depression scores in both groups decreased,and the observation group[（39.78±1.80）and （44.73±3.78）] scores were lower than the control group[（54.63±3.91）and（49.23±4.14）] scores,significantly（t=21.823,5.078,P<0.05）．The postoperative complication rate was significantly lower than the control group（7.50% vs 27.50%,χ²=5.541,P=0.019）．After the intervention,MLHFQ related dimension scores were increased in both groups,and the observation group（30.73±3.82,21.13±2.70 and 27.08±4.28）scores were higher than the control group（26.20±2.50,17.20±2.79 and 23.20±2.35）scores,statistically significant（t=5.530,6.389,5.021,P<0.05）．The nursing satisfaction was higher than the control group（92.50% vs 72.50%,χ²=5.541,P=0.019）．Conclusion sRisk prevention nursing intervention after intracranial aneurysm intervention can improve patient anxiety and depression,assist in reducing the incidence of postoperative complications,improve patient quality of life,and increase patient satisfaction with nursing．

目的 探讨超声监测导向下早期肠内营养（EEN）在重症脓毒血症（SS）有创通气（IV）患者中的应用效果。方法 选取2021年2月—2023年11月连州市人民医院收入的115例SS-IV患者,依据随机数字表法分为对照组（n=57）、超声监测组（n=58）。所有患者均予重症监护病房（ICU）综合治疗,在此基础上对照组实施临床经验的传统肠内营养（EN）干预,超声监测组实施超声监测导向下EEN干预,均监测至治疗结束。统计两组IV时间、ICU停留时间、EN达标时间、EN不耐受发生率、相关并发症发生率,比较干预前、EN结束时营养状况[白蛋白（ALB）、总蛋白（TP）、前白蛋白（PA）]、序贯器官衰竭评分（SOFA）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。结果 对照组剔除放弃治疗1例,死亡2例,纳入54例;超声监测组剔除放弃治疗1例,死亡1例,纳入56例。超声监测组EN达标时间[（40.18±8.46）h]、IV时间[（7.12±1.44）d]、ICU停留时间[（9.21±1.63）d]短于对照组[（46.03±10.15）h、（8.02±1.62）d、（10.18±1.54）d]（t=3.288、3.082、3.206,均P<0.05）。EN结束时超声监测组SS-IV患者血清ALB[（32.05±3.13）g/L]、TP[（65.36±3.62）g/L]、PA[（0.24±0.06）g/L]高于对照组[（30.28±2.24）g/L、（63.28±4.24）g/L、（0.21±0.05）g/L]（t=3.400、2.770、2.843,均P<0.05）。EN结束时超声监测组APACHEⅡ评分[（15.85±1.93）分]、SOFA评分[（7.42±1.64）分]低于对照组[（17.02±2.04）分、（8.35±2.03）分]（t=3.091、2.648,均P<0.05）。超声监测组EN不耐受发生率[12.50%（7/56）]低于对照组[29.63%（16/54）],超声监测组相关并发症发生率[8.93%（5/56）]低于对照组[24.07%（13/54）]（χ²=4.878、4.608,均P<0.05）。结论 超声监测导向下EEN干预应用于SS-IV患者,可改善患者病情与营养状况,降低EN不耐受及相关并发症发生风险,缩短恢复时间。

Objective To investigate the effect of ultrasound monitoring guided early enteral nutrition（EEN）in patients with severe sepsis（SS）and invasive mechanical ventilation（IV）．Methods A total of 115 SS-IV patients admitted to Lianzhou People's Hospital from February 2021 to November 2023 were randomly divided into control group（n=57）and ultrasound monitoring group（n=58）．All patients were given comprehensive treatment in intensive care unit（ICU）．On this basis,traditional enteral nutrition（EN）intervention with clinical experience was implemented in control group,and EEN intervention guided by ultrasonic monitoring was implemented in ultrasound monitoring group．All patients were monitored until the end of treatment．IV time,ICU stay time,EN compliance time,incidence of EN intolerance,and incidence of related complications were analyzed in the 2 groups．Nutritional status [albumin（ALB）,total protein（TP）,prealbumin（PA）],sequential organ failure assessment（SOFA）,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）were compared before intervention and at the end of EN．Results In control group,1 cases gave up,2 cases died,and 54 cases were included．In ultrasound monitoring group,1 case gave up,1 case died,and 56 cases were included．The EN compliance time [（40.18±8.46）h],IV time [（7.12±1.44）d] and ICU stay time [（9.21±1.63）d] of ultrasound monitoring group were shorter than those of control group [（46.03±10.15）h,（8.02±1.62）d,（10.18±1.54）d]（t=3.288,3.082,3.206,all P<0.05）．At the end of EN,serum ALB[（32.05±3.13）g/L],TP[（65.36±3.62）g/L],PA[（0.24±0.06）g/L] of SS-IV patients in ultrasound monitoring group were higher than those in control group [（30.28±2.24）g/L,（63.28±4.24）g/L,（0.21±0.05）g/L]（t=3.400,2.770,2.843,all P<0.05）．At the end of EN,APACHEⅡ scores [（15.85±1.93）points] and SOFA scores [（7.42±1.64）points] of ultrasound monitoring group were lower than those of control group [（17.02±2.04）points and（8.35±2.03）points]（t=3.091,2.648,all P<0.05）．The incidence of EN intolerance in ultrasound monitoring group [12.50%（7/56）] was lower than that in control group [29.63%（16/54）],and the incidence of related complications in ultrasound monitoring group [8.93%（5/56）] was lower than that in control group [24.07%（13/54）]（χ²=4.878,4.608,all P<0.05）．Conclusions EEN intervention guided by ultrasonic monitoring in SS-IV patients can improve the nutritional status of patients,reduce the risk of EN intolerance and related complications,shorten the recovery time,and reduce the progression of patients' disease．

目的 探究麦默通（Mammotome）微创旋切术加置引流对乳腺良性肿物患者术后疼痛、炎性应激指标及并发症的影响。方法 选取本院2020年1月—2022年1月收治的100例乳腺良性肿物患者,简单随机法进行分组,每位患者赋予1位随机数,1~51号为实验组,采用Mammotome微创旋切术加置引流,52~100号为对照组,实施Mammotome微创旋切术。对比2组治疗效果、围术期指标、术前及术后1 d、3 d疼痛程度（NRS评分）、术前及术后3 d炎性应激指标及并发症情况。结果 2组病灶清除率（100.00%、97.96%）、并发症发生率（3.92%、16.32%）间无差异（P>0.05）;相较于对照组,实验组手术时间较长,残腔积液较少,住院时间较短（P<0.05）;术后1 d、3 d实验组NRS评分低于对照组（P<0.05）;术后3 d 2组C反应蛋白、白介素-6、白介素-1β、降钙素原水平较术前上升,且实验组上升幅度小于对照组（P<0.05）。结论 Mammotome微创旋切术加置引流治疗乳腺良性肿物能减少残腔积液,降低炎症反应程度,有助于术后切口愈合,缓解术后疼痛,且不增加并发症风险。

Objective To investigate the effect of Mammotome minimally invasive excision with drainage on postoperative pain,inflammatory stress indexes and complications in patients with benign breast tumors．Methods A total of 100 patients with benign breast tumors admitted to our hospital from January 2020 to January 2022 were selected and grouped by simple random method,each patient was assigned a random number．Patients No.1 to No.51 were included in the experimental group,treated with Mammotome minimally invasive excision with drainage．Patients No.52 to No.100 were included in the control group,treated with Mammotome minimally invasive excision．The treatment effect,perioperative indicators,pain level（NRS score）and inflammatory stress indexes before and 1st and 3rd days after operation and complications were compared between the two groups．Results There were no significant differences in the lesion clearance rate（100.00% vs 97.96%）and the complication rate（3.92% vs 16.32%）between the two groups（P>0.05）．Compared with the control group,the experimental group had longer operation time,less residual cavity liquid and shorter hospital stay（P<0.05）．The NRS score of the experimental group was lower than that of the control group at 1st and 3rd days after operation（P<0.05）．On the third day after operation,the levels of C-reactive protein,interleukin- 6,interleukin-1β and procalcitonin in the two groups were increased compared with those before operation,and the increase in the experimental group was smaller than that in the observation group（P<0.05）．Conclusions Mammotome minimally invasive excision with drainage in the treatment of benign breast tumors can reduce residual cavity fluid accumulation,reduce the degree of inflammatory response,help postoperative incision healing,relieve postoperative pain,and without increasing the risk of complications．

目的 探讨桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响,以便临床寻找出更有效的治疗方案,进而改善患者预后。方法 本次研究对象为赣州市人民医院2017年6月—2022年1月收治的82例桥小脑角肿瘤患者,用随机数字表法将其分为对照组（41例）和实验组（41例）。对照组患者给予常规显微手术治疗,实验组患者给予神经内镜辅助常规显微手术治疗,2组患者均于术后观察8周。比较2组患者肿瘤全切率,手术时间、住院时间及住院费用,术前及术后2、4、8周格拉斯哥预后量表（GOS）评分,以及术后8周内并发症发生情况。结果 肿瘤全切率：实验组患者术后8周（90.24%）与对照组（73.17%）相比,处于更高水平;手术时间、住院时间：实验组患者与对照组相比,处于更短水平;GOS评分：术前至术后2周,2组患者评分均呈下降趋势,术后2周至8周,2组患者评分呈升高趋势,其中实验组术后2、4、8周与对照组相比,处于更高水平,差异有统计学意义（P<0.05）;并发症总发生率：术后8周内,实验组患者（4.88%）与对照组（17.07%）相比,差异无统计学意义（P>0.05）。结论 桥小脑角肿瘤微创切除术中应用神经内镜,可有效缓解患者的临床症状,优化手术相关指标,减轻神经功能受损,提高肿瘤全切率,改善预后,且安全性高。

Objective To investigate the effect of neuroendoscope on functional recovery and prognosis of patients with cerebellopontine angle tumor after microinvasive resection,so as to find out more effective treatment and improve the prognosis of patients．Methods The subjects were 82 patients with cerebellopontine angle tumors admitted to Ganzhou People's Hospital from June 2017 to January 2022．They were divided into control group（n = 41）and experimental group（n = 41）by random number table method．Patients in the control group were treated with conventional microsurgery,while patients in the experimental group were treated with neuroendoscope assisted conventional microsurgery．All patients were observed for 8 weeks after operation．The total tumor resection rate,operation time,hospitalization time,hospitalization expense,Glasgow Outcome Scale（GOS）score before and 2,4,8 weeks after operation,and complications within 8 weeks after operation were compared between the two groups．Results Compared with the control group（73.17%）,the patients in the experimental group had a higher resection removal rate of tumor after 8 weeks of operation（90.24%）．Patients in the experimental group had a shorter operation time and hospital stay than those in the control group．From pre-operation to 2 weeks after operation,the GOS scores of patients in both groups showed a downward trend,and from 2 weeks to 8 weeks after operation,the scores of patients in both groups showed an upward trend,and the patients in the experimental group were at a higher level than those in the control group at 2,4,8 weeks after operation,the difference were statistically significant（P < 0.05）．Within 8 weeks after surgery,there was no significant difference in total incidence of complications between the experimental group（4.88%）and the control group（17.07%,P > 0.05）．Conclusions The application of neuroendoscope in the minimally invasive surgery of cerebellopontine angle tumor can effectively relieve the clinical symptoms of patients,optimize the operation-related indexes,reduce the damage of nerve function,increase the total resection rate of tumor,improve the prognosis,and with high safety．

目的 基于影像组学方法,探讨多层螺旋CT（MSCT）四期增强扫描单一/不同期相及不同容积感兴趣区（VOI）的选择,在术前预测原发性肝细胞癌（HCC）微血管侵犯（MVI）中的价值。方法 回顾性收集88例经手术病理证实为HCC并行术前MSCT四期增强扫描的患者,其中包括47例MVI阳性患者和41例MVI阴性患者。在MSCT增强扫描的动脉早期、动脉晚期、门静脉期及延迟期图像中手动逐层勾画肿瘤ROI,获得瘤体容积感兴趣区VOI（Vt）,然后基于计算机自动膨胀算法将Vt外扩10 mm获得瘤体及瘤周VOI（Vt+Vp）。使用Pyradiomics软件分别从Vt和Vt+Vp中提取影像组学特征,随后采用15种特征选择方法和10种分类器构建150个预测模型,并通过十折交叉检验以验证模型的效能。使用准确度、敏感度、特异度、受试者工作特性曲线下面积（AUC）评估模型的效能,并比较性能最优的前三个预测模型。结果 MSCT四期增强扫描图像中预测HCC MVI状态的影像组学模型在门静脉期的表现优于其它期相及各期相的不同组合,其中最大的AUC值在Vt和Vt+Vp两种ROI中分别为0.768和0.782。此外,基于Vt+Vp的影像组学模型对MVI的预测效能优于基于Vt的影像组学模型,基于Vt+Vp性能最优的预测模型的AUC值、准确度、敏感度和特异度分别0.782、0.728、0.745和0.705。结论 采用影像组学方法术前无创性预测HCC MVI状态首选增强扫描的门静脉期,ROI首选瘤体联合瘤周10 mm区域。

Objective To investigate the value of single or different phases of contrast-enhanced multi-slice spiral CT（MSCT）in different volumetric regions of interest（ROI）to preoperatively predict the state of microvascular invasion in primary hepatocellular carcinoma（HCC）based on radiomics methods．Methods A total of 88 patients with HCC confirmed by surgical pathology who underwent preoperative MSCT quadruple-enhanced scan were retrospectively recruited,including 47 MVI-positive patients and 41 MVI-negative patients．The ROI was manually delineated slice-by-slice in the early arterial phase,late arterial phase,portal venous phase,and equilibrium phase of enhanced MSCT images to obtain the volume of tumor VOI（Vt）,and then Vt was expanded by 10 mm through the computer expansion algorithm automatically to obtain the volume of tumor and peritumor（Vt+Vp）．Pyradiomics software was used to extract radiomic features from Vt and Vt+Vp,followed by 150 discriminant models constructed with 150 feature selection methods and 10 classifiers,and then 10-fold cross-validation was used to evaluate the performance of these models．Using accuracy,sensitivity,specificity,area under the receiver operating characteristic curve（AUC）to assess model performance．The top three predictive models with the best performance were also compared．Results The radiomics model for predicting HCC MVI status in portal venous phase among quadruple-enhanced MSCT images outperformed other phases and different combinations of phases,achieving the highest AUC values of 0.768 and 0.782 in Vt and Vt+Vp respectively．In addition,the prediction performance of the radiomics model based on Vt+Vp was superior to models based on Vt．AUC value,accuracy,sensitivity,and specificity of the model with the best performance based on Vt+Vp were 0.782,0.728,0.745 and 0.705 respectively．Conclusions Radiomics models based on the portal venous phase of contrast-enhanced MSCT and tumor combined with the 10mm peritumoral area were more recommended to be employed to preoperative non-invasively predict the state of HCC MVI．

目的 通过静脉输液批次决策的自动化、标准化以及个体化,实现静脉用药调配中心（PIVAS）工作同质化和高效化,进而促进临床安全合理用药。方法 根据药物使用的时辰药理学,调查分析人工决策输液批次存在的问题,建立批次时间划分表和制定批次决策规则,基于医院信息系统构建自动输液批次决策系统。由药师维护自动输液批次决策系统,针对该系统的应用效果评价分析。结果 应用自动批次决策软件后,PIVAS 批次不合格率下降,输液时间合理性提高。审方药师用于决策输液批次的时间减少,大幅度提高 PIVAS 和病区护士工作效率,同时降低 PIVAS输液配送出错频率。结论 自动输液批次决策系统构建完成之后,用药时间更合理,提高药物治疗效果;PIVAS工作效率明显提高,工作质量显著提升,输液批次不合格率降低,患者输液批次真正做到编排一致性,提高用药时间合理性,进而使临床用药更合理、更安全,实现个体化治疗。

ObjectiveThrough the automation, standardization and individualization of intravenous（IV）fluid batch decision-making, to realize the homogenization and high efficiency of Pharmacy Intravenous Admixture Services（PIVAS）, to promot safe and rational clinical drug use．Methods According to the pharmacology of drug use, the problems existing in manual IV fluid batch decision were investigated and analyzed, and an automatic IV fluid batch decision system was constructed based on hospital information system．Batch time division table and batch decision rules were established, automatic IV fluid batch decision system was maintained by pharmacists, the application effect of the system were evaluated and analyzed．Results The unqualified rate of PIVAS batch decreased, and the rationality of IV transfusion time increased．The time for prescription checking pharmacists to make IV fluid batch decisions was shortened, which greatly improved the work efficiency of PIVAS and nurses, and reduced the error frequency of PIVAS IV fluid distribution．Conclusions After the completion of the automatic IV fluid batch decision system, the medication time is more reasonable and the drug treatment effect is improved．The work efficiency and quality of PIVAS are significantly improved, and the unqualified rate of IV fluid batches is reduced．The IV fluid batches of patients are really arranged in a consistent way, and the rationality of medication time is improved, so that clinical medication is more reasonable and safer, and individualized treatment is realized．

目的 探讨亚实性肺腺癌结节CT征象在预测侵袭风险中的价值。方法 选取经胸部CT检查发现并经病理证实为肺腺癌的亚实性结节共76个病灶,病灶分为侵袭前组与侵袭组2组,分析结节CT征象,行统计学分析,明确亚实性肺腺癌结节侵袭性的预测因素。结果 侵袭前组（包括原位腺癌、微浸润性腺癌）共31例;侵袭组[浸润性腺癌（IAC）]共45例。2组在最大平均直径、结节平均CT值、结节形状、分叶、毛刺、胸膜牵拉征、有无实性成分、肿瘤微血管CT成像征间比较差异有统计学意义（P<0.05）,而在空泡征、空气支气管征方面比较差异无统计学意义（P>0.05）。结节最大直径预测浸润性腺癌侵袭性界值为13.63 mm,敏感度、特异度分别为68.9%、96.8%,AUC为0.885;平均CT值预测IAC侵袭性界值为-528 HU,敏感度、特异度分别为84.4%、83.9%,AUC为0.867。回归分析显示病灶最大平均直径（OR=2.015、P=0.01）可以作为浸润性肺腺癌结节的独立预测因子。结论 亚实性肺腺癌结节侵袭前组和侵袭组在最大直径、平均CT值、形状、分叶、毛刺、微血管征存在差异;结节的最大平均直径是IAC的独立预测因子。

Objective To investigate the value of CT signs in predicting the risk of invasion of subsolid lung adenocarcinoma nodules．Methods A total of 76 subsolid pulmonary adenocarcinoma nodules detected by chest CT and pathologically confirmed were selected,and the lesions were divided into pre-invasion group and invasion group．CT signs of nodules were analyzed and statistical analysis was performed to determine the predictive factors of invasion of subsolid pulmonary adenocarcinoma nodules．Results There were 31 cases in the pre-invasion group（including adenocarcinoma in situ and minimally invasive adenocarcinoma）and 45 cases ininvasion group[invasive adenocarcinoma（IAC）]．There were significant differences in maximum mean diameter,mean CT value of nodule,nodule shape,lobule,burr,pleural stretch sign,solid component and microvascular CT imaging signs between the two groups（P<0.05）,but there were no significant differences in vacuole sign and air bronchial sign between the two groups（P>0.05）．The maximum diameter of nodules predicted the invasion boundary of invasive adenocarcinoma was 13.63 mm,the sensitivity and specificity were 68.9% and 96.8%,respectively,and the AUC was 0.885．The mean CT value predicted the invasive boundary of IAC was -528 HU,the sensitivity and specificity were 84.4% and 83.9%,respectively,and the AUC was 0.867．Regression analysis showed that the maximum mean lesion diameter（OR=2.015,P=0.01）was an independent predictor of infiltrating lung adenocarcinoma nodules．Conclusions There were differences in the maximum diameter,mean CT value,shape,lobed,burr and microvascular signs between the pre-invasion group and the invasion group．The maximum mean diameter of nodules was an independent predictor of IAC．