目的 探讨老年髋部骨折（GHF）患者围术期隐性失血的影响因素及护理措施。方法 回顾性分析2020年3月—2023年3月我院收治的86例老年GHF患者,所有患者均采取手术治疗,计算所有患者围术期失血量,并收集所有患者的一般资料及围术期相关治疗情况,分析不同一般资料患者围术期隐性失血情况,不同手术方式及麻醉方式围术期隐性失血情况,不同术后处理方式围术期隐性失血情况,随后采取Logistic回归分析老年GHF患者围术期隐性失血的影响因素,最后针对结果制定老年GHF隐性失血的护理措施。结果 不同性别和是否合并冠状动脉粥样硬化、高血压患者围术期隐性失血量比较差异无统计学意义（P>0.05）,不同年龄、合并糖尿病、骨折类型患者围术期隐性失血量比较差异有统计学意义（P<0.05）;不同手术方式、麻醉方式患者围术期隐性失血量比较差异有统计学意义（P<0.05）;不同术后引流、使用肝素情况患者围术期隐性失血量比较差异有统计学意义（P<0.05）;Logistic回归分析结果表明：年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素都是造成GHF老年患者围术期隐性失血的影响因素（P<0.05）。患者经相关护理后,恢复较佳。结论 老年GHF患者围术期会存在大量隐性失血情况,同时年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素与围术期隐性失血量密切相关,临床上可采取针对性措施减少GHF患者隐性失血。

Objective To explore the influencing factors and nursing measures of perioperative hidden blood loss in elderly patients with geriatric hip fractures（GHF）．Methods From March 2020 to March 2023,86 elderly patients with GHF admitted to our hospital were selected as the study objects for retrospective analysis．All patients were treated with surgery．The perioperative blood loss of all patients was calculated,general information and perioperative treatment status of all patients were collected,the hidden blood loss of patients with different general information,different surgical and anesthesia methods and different postoperative treatment methods were analyzed．Logistic regression analysis was used to analyze the influencing factors of hidden blood loss of elderly GHF patients during the perioperative period．Nursing measures for hidden blood loss in elderly hip fractures were developed based on the results．Results There was no statistical difference in the amount of perioperative hidden blood loss among patients with different gender,complicated with coronary heart disease and hypertension or not（P>0.05）,but there was statistical difference in the amount of perioperative hidden blood loss among patients with different ages,complicated with diabetes and fracture types（P<0.05）．There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different surgical and anesthesia methods（P<0.05）．There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different postoperative drainage and use of heparin（P<0.05）．The results of Logistic regression analysis showed that age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use were independent risk factors for perioperative hidden blood loss in elderly patients with GHF（P<0.05）．Conclusions There will be a lot of hidden blood loss in the perioperative period of elderly patients with GHF．At the same time,age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use are closely related to the amount of hidden blood loss in the perioperative period．Targeted measures can be taken clinically to reduce the hidden blood loss in patients with GHF．

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 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为（30.69±8.98）分,口腔健康评估平均为（8.59±3.68）分,口腔健康相关生活质量GOHAI总分为（25.65±8.10）分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关（P<0.05）。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素（P<0.05或P<0.01）。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。

Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people．Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people．Results The 266 middle-aged and elderly people had a mean score of（30.69±8.98）for general knowledge and behavioral scores of oral health,a mean score of（8.59±3.68）for oral health assessment,a total score of（25.65±8.10）for oral health-related quality of life GOHAI．The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people（P<0.05）．The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly（P<0.05）．Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents．

目的 探究精神分裂症患者应用帕利哌酮后剂量校正浓度（C/D）的影响因素,旨在为精神分裂症患者的临床用药提供参考。方法 选择2021年9月–2022年5月在我院择期接受帕利哌酮治疗的122例精神分裂症患者作为研究对象,收集患者的年龄、性别、给药剂量、给药频次以及合并用药等状况。结果 不同性别间帕利哌酮C/D存在差异,其中女性的C/D明显比男性的C/D更高。在关于年龄、性别、给药剂量、给药频次以及合并用药对帕利哌酮C/D的影响分析中,合并用药阿立哌唑、性别对帕利哌酮C/D有影响。结论 帕利哌酮应用在精神分裂症患者治疗中,性别、合并应用阿立哌唑会对帕利哌酮C/D产生显著影响。

Objective To explore the influencing factors of dose-corrected through concentration（C / D）of paliperidone in patients with schizophrenia,in order to provide reference for clinical medication of patients with schizophrenia．Methods A total of 122 patients with schizophrenia treated with paliperidone in our hospital from September 2021 to May 2022 were selected as the research objects．The patient's age,gender,dosage,frequency of administration and combined medication were collected．Results There were differences in the C / D of paliperidone between different genders,and the C / D of women was significantly higher than that of men．In the analysis of the effects of age,gender,dosage,frequency of administration and combined medication on the C / D of paliperidone,the combined medication of aripiprazole and gender had effect on the C / D．Conclusions The application of paliperidone in the treatment of patients with schizophrenia,gender and combined application of aripiprazole can have significant impact on C / D．

目的 上消化道出血发作急、变化快,具有较高的危险性,本研究目的在于分析急性上消化道出血患者的临床特征及危险因素,为临床诊治提供参考。方法 将2019年1月—2021年2月年我院的242例疑似急性上消化道出血患者作为研究对象,收集患者的年龄、性别、是否有长期抽烟史、饮酒史,是否有合并症以及并发症等一般资料,运用单因素分析其临床特征,运用多因素Logistic回归分析其独立危险因素。结果 患者年龄、长期饮酒史、消化性溃疡、门脉高压、急性胃黏膜病变、服用阿司匹林(ASA药物)、Hp感染等临床特征与急性上消化道出血具有相关性,与患者的性别、长期抽烟史不具有相关性;年龄、消化性溃疡、门脉高压、服用ASA药物、Hp感染是急性上消化道出血的危险性因素。结论 急性上消化道出血病势程度较重,死亡率高,出血需及时针对性治疗;对于急性上消化道出血高危患者,严密监测病情变化,评估其风险系数。

Objective Upper gastrointestinal bleeding has a high risk because of its rapid change. The purpose of this study is to analyze the clinical characteristics and risk factors of patients with acute upper gastrointestinal bleeding, so as to provide reference for clinical diagnosis and treatment. Methods A total of 242 patients with suspected acute upper gastrointestinal bleeding in our hospital from January 2019 to February 2021 were selected as the research objects. The general data such as patients' age, gender, whether they had a long-term history of smoking or drinking, whether they had complications and data of complications were collected. The clinical characteristics were analyzed by univariate analysis, and the independent risk factors were analyzed by multivariate Logistic regression analysis. Results Age, long-term drinking history, peptic ulcer, portal hypertension, acute gastric mucosal lesions, taking aspirin (ASA drugs), Hp infection and other clinical characteristics were correlated with acute upper gastrointestinal bleeding, but gender and long-term smoking history were not. Age, peptic ulcer, portal hypertension, taking ASA drugs and Hp infection were the risk factors of acute upper gastrointestinal bleeding. Conclusion The acute upper gastrointestinal bleeding is a serious disease, with high mortality, and the bleeding needs timely targeted treatment. For patients with high-risk acute upper gastrointestinal bleeding, closely monitor the changes of the disease and evaluate the risk coefficient are needed.

目的 统计分析Ⅲ型食管闭锁与食管气管瘘(esophageal atresia and tracheoesophageal fistula,EA-TEF)术后气管食管瘘复发(recurrent tracheoesophageal fistula,RTEF)的高危因素,并计算高危因素预测RTEF的能力。方法 回顾分析2015年9月—2021年1 月我院EA-TEF患儿的临床资料,并根据术后是否气管食管瘘复发分成复发组(recurrent组,R组)及无复发组(not recurrent组,NR组),比较两组患儿的基本情况、开放手术或胸腔镜手术、手术时间、气管食管瘘结扎方式等术中情况,统计分析RTEF的高危因素,分析其预测RTEF的能力。结果 研究期间共纳入Ⅲ型食管闭锁患儿154例,男98例,女56 例,R组11例,NR组143例,单因素对比分析R组与NR组患儿除吻合口瘘外其余均无统计学差异,其中R组吻合口瘘6人,占该组54.55%;NR组13人,占该组9.10%,P<0.001;Logistic回归模型调整后可见有吻合口瘘相对于无吻合口瘘发生RTEF的风险增加12倍(OR=12.000,95%CI:3.216~44.771)。结论 RTEF与患儿基本情况、术中情况无关,与吻合口瘘显著相关,且有吻合口瘘的患儿出现RTEF风险是无吻合口瘘患儿的12倍。

Objective To statistical analyze the high-risk factors of recurrent tracheoesophageal fistula (RTEF) after the repair of type Ⅲ esophageal atresia and tracheoesophageal fistula (EA-TEF),and evaluate the ability of these high-risk factors predicting RTEF. Methods Retrospectively analyzed the clinical data of children with type Ⅲ EA-TEF in our hospital from September 2015 to January 2021. Patients were divided into two groups (recurrent and non-recurrent group,R and NR group) according to whether there was RTEF. The general situation of those patients, situation during surgery like open or thoracoscopic surgery,operation time,method of tracheoesophageal fistula ligation were compared. Those factors of two groups were analyzed, the high-risk factors of RTEF were summarized, and Logistic regression analysis on the high-risk factors was performed to analyze the ability of predicting RTEF. Results A total of 154 infants with type Ⅲ EA-TEF were included in the study, 98 males, 56 females. There were 11 cases in R group, 143 cases in NR group. Univariate comparative analysis was carried out on R group and NR group, and no statistical differences were found except in anastomotic fistula. There were 6 patients in R group with anastomotic fistula, accounting for 54.55%, and 13 patients in NR group, accounting for 9.10%,P< 0.001. After adjusting the Logistic regression model with the high-risk factors, there was 12-fold increase in the risk of RTEF with anastomotic fistula (OR=12.000, 95%CI: 3.216~44.771) compared with no anastomotic fistula. Conclusion RTEF was not related to patients' general situation or surgery situation, but significantly related to anastomotic fistula. Patients who with anastomotic fistula had a 12-fold increase in the risk of RTEF compared with no anastomotic fistula.

目的 探讨老年吸入性肺炎的危险因素,建立风险预测模型,以期降低老年吸入性肺炎的发病率。方法 选取2017年8月28日—2020年 10月30日广州市第一人民医院老年病科住院治疗的老年肺炎患者205例,按照是否发生吸入性肺炎分为吸入性肺炎组和非吸入性肺炎组,对比2组患者的各项指标,分析老年吸入性肺炎的危险因素,建立风险预测模型,采用ROC曲线对模型进行预测效果检验。结果 多因素Logistic回归分析结果显示,脑梗塞、帕金森、留置胃管、长期卧床为老年吸入性肺炎的危险因素(P<0.05)。模型公式为Logit(P)=-2.952+1.221X₂+2.417X₃+2.388X₈+1.683X₁₀。该模型ROC曲线下面积为0.894。结论 本研究中的模型预测效果良好,可为医护人员预测老年患者发生吸入性肺炎的概率,及时采取相应的预见性护理及干预性治疗。

Objective To explore the risk factors of aspiration pneumonia in the elderly and establish the risk prediction model, in order to reduce the incidence of aspiration pneumonia in the elderly. Methods A total of 205 elderly patients with pneumonia who were hospitalized in the department of geriatrics, Guangzhou First People's Hospital from August 28, 2017 to October 30, 2020, were divided into aspiration pneumonia group and non-aspiration pneumonia group according to whether aspiration pneumonia occurred. The indicators of the two groups of patients were compared, the risk factors of aspiration pneumonia in the elderly were analyzed, the risk prediction model was established, and the prediction effect of the model was tested by receiver operating characteristic curve. Results Multivariate Logistic regression analysis showed that cerebral infarction, Parkinson's disease, indwelling nasogastric tube, and being bedridden were risk factors for aspiration pneumonia in elderly patients (P<0.05). The model formula was Logit (P)=-2.952+1.221X₂+2.417X₃+2.388X₈+1.683X₁₀. The area under receiver operating characteristic curve of this model was 0.894. Conclusion The prediction effect of the model in this study was good, which could predict the probability of aspiration pneumonia in elderly patients for medical staff, and to timely take the corresponding predictive care and interventional treatment.

目的 探究2型糖尿病患者的肾糖阈(RTG)及相关因素。方法 本院对2014年12月—2018年9月466例2型糖尿病患者为研究对象,正常肾糖阀值为8.9～10 mmol/L,据此将患者分为高阀值组、中等阀值组以及低阀值组,不同组肾糖范围分别为RTG＞10 mmol/L、8.9 mmol/L≤RTG≤10 mmol/L、RTG＜8.9 mmol/L,以此对各组生化特征进行分析。结果 高阀值组与中等阀值组相比,RTG值、年龄、病程、空腹血糖(FPG)、体质量指数(BMI)、总胆固醇(TC)、血糖均值(MBG)、24 h血糖对比差异明显,P＜0.05。高阀值组与低阀值组相比,RTG值、性别、FPG、BMI、TC、MBG、糖化血红蛋白(HbA1C)对比有差异,P＜0.05。性别、年龄、BMI、HbA1C、TC以及低密度酶蛋白胆固醇(LDL-C)与2型糖尿病相关,且呈正比关系,P＜0.05;通过多元线性回归分析发现,2型糖尿病的影响因素主要有BMI、HbA1C、LDL-C,数据具有统计学意义,P＜0.05。结论 较多2型糖尿病患者肾糖阀值较高,且肾糖阀值与HbA1C、LDL-C相关。

目的 探讨性别、年龄、日剂量、合并用药、药物厂家等因素对使用阿立哌唑患者稳态血药浓度的影响,为临床合理用药提供依据。方法 收集深圳市康宁医院2019年1月—2021年2月使用阿立哌唑住院患者血药浓度监测数据样本229份,包括患者性别、年龄、日剂量、合并用药、药物厂家等基本信息,使用SPSS 25.0统计学软件对数据进行回顾性分析。结果 经多元线性回归分析,本研究仅性别、日剂量能解释阿立哌唑血药浓度的变化。使用阿立哌唑患者血药浓度剂量比值(C/D)女性组高于男性组(P＜0.01),阿立哌唑合用丙戊酸盐组高于无合用组(P＜0.05),年龄、其他合并、药物厂家用药对阿立哌唑(C/D)值的影响无统计学差异。结论 阿立哌唑C/D值与性别有关,合并用药对其有一定影响,不同药物厂家的阿立哌唑C/D值无统计学差异,临床应加强治疗药物监测,根据血药浓度及临床诊疗效果,结合药物经济学因素优化给药方案。

Objective To provide the reference for clinical rational use of aripiprazole,to investigate the effects of gender, age, daily dose, concurrent medication, drug manufacturer and other factors on the steady-state serum concentration in aripiprazole patients. Methods Serum concentration monitoring data of 229 inpatients using aripiprazole in Shenzhen Kangning Hospital from January 2019 to February 2021 was collected, including patients' gender, age, daily dose, concurrent medication, drug manufacturer and other basic information, which were retrospectively analyzed by SPSS 25.0 statistical software. Results In this study, only gender and daily dose could explain the significant changes of aripiprazole serum concentration after multiple linear regression analysis. The serum concentration/dose ratio (C/D) was significantly higher in female patients than in male patients (P＜0.01), and the group of aripiprazole combined with valproate was markedly higher than the non-combined group (P＜0.05). Nevertheless, there were no statistically significant differences in the effects of age, concurrent medication and drug manufacturer on aripiprazole C/D values. Conclusions The C/D value of aripiprazole was closely related to gender, and concurrent medication had a certain effect on it. There was no statistical difference in the aripiprazole C/D value among different drug manufacturers. This study suggested that clinical monitoring of therapeutic drugs should be strengthened, and the prescription should be optimized based on serum concentration and therapeutic efficacy, combined with pharmacoeconomic factors.

目的 分析阴道灌洗液中炎性因子表达水平与高危型人乳头瘤病毒(HPV)持续感染的相关性。方法 选择本院2019年3月—2021年3月接诊的80例高危型HPV持续感染患者作为试验组,以病理组织检查结果分组,将19例宫颈癌患者作为试验组1、将30例宫颈上皮不典型增生(CIN)I级患者作为试验组2,将31例CIN II、III级患者作为试验组3,选取同期门诊体检的30例健康女性作为对照组,均进行TGF-β、IFN-γ、IL-17、IL-6表达水平检测,比较4组TGF-β、IFN-γ、IL-17、IL-6水平、高危型HPV负荷量,Pearson分析TGF-β、IFN-γ、IL-17、IL-6水平与高危型HPV负荷量的相关性。结果 阴道灌洗液炎症因子水平、高危型HPV负荷量4组相比较,差异均有统计学意义(P<0.05)。TGF-β、IL-17、IL-6水平与高危型HPV负荷量呈正相关性,与IFN-γ水平呈负相关性,P＜0.05。结论 高危型HPV持续感染患者机体阴道灌洗液中炎性因子水平与高危型HPV负荷量存在一定的相关性,高危型HPV负荷量与IFN-γ水平呈负相关性,与TGF-β、IL-17、IL-6水平呈正相关性,通过检测阴道灌洗液中炎性因子水平,可评估HPV感染程度。

Objective To analyze the correlation between the expressions of inflammatory factors in vaginal lavage fluid and persistent infection of high-risk human papillomavirus(HR-HPV). Methods A total of 80 patients with HR-HPV persistent infection in our hospital from March 2019 to March 2021 were selected as the experimental group. According to the pathological examination results, 19 patients with cervical cancer were selected as the experimental group 1, 30 patients with CIN grade I were selected as the experimental group 2, and 31 patients with CIN grade II and III were selected as the experimental group 3. Thirty healthy women in the same period were selected as the control group. HR-HPV load, TGF- β, IFN-γ, IL-17 and IL-6 levels were detected and were compared among the four groups. Pearson analysis of correlation between TGF- β, IFN-γ, IL-17, IL-6 levels and HR-HPV load was carried out. Results There were significant differences in the levels of inflammatory factors in vaginal lavage fluid and HR-HPV load among the four groups (P<0.05). TGF- β、IL-17 and IL-6 levels were positively correlated with HR-HPV load and negatively correlated with IFN-γ (P<0.05). Conclusions There is a certain correlation between inflammatory factors in vaginal lavage fluid and HR-HPV load in patients with HR-HPV persistent infection. HR-HPV load is negatively correlated with IFN-γ, and positively correlated with TGF-β, IL-17 and IL-6. The degree of HPV infection could be evaluated by detecting the inflammatory factors in vaginal lavage fluid.