动脉粥样硬化（AS）是一种起始于炎症介导的内皮损伤的慢性血管疾病，其本质是免疫炎症驱动的病理过程，是众多心血管疾病的病理基础。CD4⁺  T细胞亚群［包括辅助性T细胞1型（T helper 1 cell，Th1）、Th2、Th17、调节性T细胞等］通过分泌特异性细胞因子参与AS的炎症反应，其中促炎性CD4+  T细胞与抗炎性CD4⁺  T细胞的抗炎功能失衡是推动斑块进展的关键环节，在AS斑块形成与发展中起关键作用。近年来，多项研究表明某些中药单体、经典复方及其有效成分，具有多靶点、多层次机制调控CD4⁺  T细胞分化及功能，这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等，延缓AS斑块形成与发展，为AS防治提供了新思路，展现了中医药在该领域的研究展现出独特优势与广阔前景，本文综述了中医药通过干预CD4⁺  T细胞亚群平衡防治AS的最新研究进展，及其影响相关细胞因子网络及关键信号通路的作用机制，为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。

       Atherosclerosis（AS）is a chronic vascular disease that originates from inflammation mediated endothelial 

damage．Its essence is a pathological process driven by immune inflammation，and it is the pathological basis of many cardiovascular diseases．CD4⁺  T cell subsets（including Th1，Th2，Th17，Treg，etc.）participate in the inflammatory response of AS by secreting specific cytokines．The imbalance of anti-inflammatory function between pro-inflammatory CD4⁺  T cells and anti-inflammatory CD4⁺T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques．In recent years，a number of studies have shown that the monomers，classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target，multi-level mechanism to regulate the differentiation and function of CD4⁺  T cells．These effects together reduce the inflammatory reaction of vascular endothelium，inhibit the foam formation of macrophages and smooth muscle cell migration，delay the formation and development of AS plaque，provide new ideas for the prevention and treatment of AS，and make the research of Chinese medicine show unique advantages and broad prospects in this field．This article  reviews the latest  research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4⁺  T cell subsets，as well as the mechanism of its effects on related cytokine networks and key signal pathways．This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages．

       目的   评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法   将156例脑梗死患者随机分为对照组和试验组，各78例。试验组使用新型穿戴式气压治疗仪（邦普医疗/VW100）进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d，观察临床疗效及安全性，比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果   治疗10 d后，试验组与对照组深静脉血栓未发生率差值为1.2%，相应的95%置信区间为–5.3%～7.9%，下限高于–10%，医护人员和患者对试验组的评价优于对照组（P＜0.001）。结论   新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪，治疗过程中未见明显不良反应，临床使用安全有效。

        Objective  To  evaluate the  effectiveness  and  safety  of  new wearable  pneumatic  compression  pump in preventing deep vein thrombosis．Methods  One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group．Study group was treated with the new wearable pneumatic compression pump（Bangpu Medical / VW100）．Control group was treated with pneumatic compression pump（Wonjin-POWER）．The course of both groups was 10 days，comparing the deep vein thrombosis  rate and useage satisfaction of patients and staffs between the two groups．Results  After 10 days of treatment，the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%．The corresponding 95% confidence interval was（-5.3%，7.9%），and the lower limit was greater than -10%．The appraisal from medical staffs and the patients of study group was better than that of the control group（P＜0.001）．Conclusions  The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump，which clinical practice experience is better．There is no obvious adverse reactions in the treatment process，and the clinical practice is also safe and effective．

目的 统计洛阳市涧西区各作业场的职业病危害因素,分析职业病发生的主要原因,并探讨具体防控策略。方法 收集洛阳市涧西区内2021年1月—2022年12月期间针对各作业场的职业病危害因素监测信息,录入Excel 2010进行数据统计;随机抽取辖区内200名重点职业从业人员,开展回顾性分析,结合职业健康检查结果,将确认存在职业病的115名从业人员列为病例组,其余未发生职业病的85名从业人员列为对照组,比较2组一般资料、临床资料,经统计学单因素、Logistic多因素回归分析归纳可导致职业病发生的影响因素,结合分析结果,探讨具体防控措施。结果 针对辖区内15家厂矿企业,2021年共设立584个监测点,共测得68处锰及其化合物危害、48处矽尘危害、4处苯及其苯系物危害、12处噪声危害,超标率为22.60%（132/584）;2022年共设立1 575个监测点,共测得158处粉尘危害、154处锰及其化合物危害、10处矽尘危害、13处噪声危害,超标率为21.27%（335/1 575）;单因素分析结果显示,2组从业人员的年龄、工作年限、职业类型、体检频率、体检结果等比较差异均存在统计学意义;Logistic多因素回归分析显示,年龄≥50岁,工作年限≥10年,从事制造业、采矿业,未规律体检,血常规异常,免疫力差,X线胸片异常,双耳高频听力阈值≥40 dB均是发生职业病的重要原因（均P<0.05）。结论 洛阳市涧西区的职业危害因素以粉尘、锰及其化合物为主,高龄、工作年限长的制造业、采矿业人员发生职业病的风险相对较高,优化职业病防治措施并规范上述重点人群的职业健康体检能实现对职业病的有效防控。

Objective To analyze the occupational disease hazards in various workplaces in Jianxi District,Luoyang City,and to analyze the main causes of occupational disease occurrence,explore specific prevention and control strategies．Methods Monitoring information on occupational disease hazards in various workplaces within the jurisdiction from January 2021 to December 2022 was collected,Excel 2010 was used for data statistics．Two hundred key occupational employees within the jurisdiction were selected randomly for retrospective analysis．Based on the results of occupational health examinations,115 employees confirmed to have occupational diseases were included in the case group,while 85 employees who did not have occupational diseases were included in the control group．General and clinical data of the two groups were compared,and the influencing factors that could lead to the occurrence of occupational diseases were summarized through statistical single factor and multivariate logistic regression analysis． Combined with the analysis results,specific prevention and control measures were discussed．Results For 15 factories and mining enterprises within the jurisdiction,a total of 584 monitoring sites were established in 2021,and a total of 68 manganese and its compound hazards,48 silica dust hazards,4 benzene and its benzene series hazards,and 12 noise hazards were measured,which the exceeding rate was 22.60%（132/584）．In 2022,a total of 1 575 monitoring sites were established,with a total of 158 dust hazards,154 manganese and its compounds hazards,10 silica dust hazards,and 13 noise hazards detected,which the exceeding rate was 21.27%（335/1 575）．The results of statistical univariate analysis showed that there were certain differences in the age,years of work,occupational type,frequency of physical examinations,and results of physical examinations between the two groups of employees．Multivariate logistic regression analysis showed that age≥50 years old,working experience≥10 years,engaged in manufacturing and mining industries,irregular physical examinations,abnormal blood routine,immune differences,chest X-ray abnormalities,and binaural high-frequency hearing threshold≥40 dB were all important reasons for the occurrence of occupational diseases．Conclusions The occupational hazards in this jurisdiction are mainly dust,manganese,and their compounds．The risk of occupational diseases among elderly manufacturing and mining workers with long working years is relatively high．Optimizing occupational disease prevention and control measures and standardizing occupational health examinations for the above-mentioned key populations can achieve effective prevention and control of occupational diseases．

目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表（MoCA）评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高（P<0.05）;住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少（P<0.05）;护理后,联合组MoCA评分高于对照组（P<0.05）。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。

Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children．Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected．They were divided into two groups according to the nursing method,with 58 cases in each group．The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention．The satisfaction,the compliance rate and MoCA score were compared between two groups．Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group（P<0.05）．Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group（P<0.05）．After nursing,the MoCA score of the combined group was higher than that of the control group（P<0.05）．Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction．

肉芽肿性小叶性乳腺炎（GLM）是一种临床较为难治的、慢性、炎症性的疾病,虽不会影响患者的生命,但是对患者的生理、心理造成了一定程度的影响,近年来该病的发病率有逐年上升的趋势。“治未病”是中医的基本思想之一,在疾病的预防、诊治方面具有重要意义。该文尝试将中医“治未病”思想应用于GLM的预防和治疗中,试图构建独特的中医预防GLM质量管理模式,以期为GLM防治提供新的思路。

Granulomatous lobular mastitis（GLM）is a chronic,inflammatory disease that is difficult to treat．Although it does not affect the patient's life,it has a certain degree of physiological and psychological impact on the patient,and in recent years the incidence of this disease has been increasing year by year．“Treating Disease Before Its Onset” is one of the basic ideas of Chinese medicine,which is of great significance in the prevention,diagnosis and treatment of diseases．In this paper,we try to apply the idea of “Treating Disease Before Its Onset” in Chinese medicine to the prevention and treatment of GLM,and attempt to construct a unique quality management model of Chinese medicine for the prevention of GLM,with a view to providing new ideas for the prevention and treatment of GLM．

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 调查护理人员对预防跌倒知识掌握的情况,以提高其对防跌倒相关知识的认知水平,减少住院患者跌倒的发生。方法 用自编住院患者跌倒相关知识掌握量表对护理人员进行问卷调查。结果 护理人员对跌倒知识的掌握正确率最高为跌倒分级64.04%、最低为跌倒后干预措施17.10%。外科护理人员对患者跌倒风险评估时机的把握为88.69%,妇儿科护理人员的正确率（71.11%）高（χ²=21.319,P=0.003）,住院患者发生跌倒后的处理正确率急诊为76.67%,高于门诊的42.67%（χ²=27.651,P<0.001）;在把握患者跌倒风险评估的时机方面工作年限<5年的护理人员为 89.81%,比工作年限>20年的护理人员（64.15%）更容易把握患者跌倒风险评估的时机（χ²=18.921,P<0.001）,工作年限11~20年的护理人员对住院患者预防跌倒的干预措施正确率为24.66%,比工作年限<5年的护理人员（11.46%）高（χ²=9.678,P=0.022）;工作年限>20年的护理人员对住院患者发生跌倒后的处理正确率为58.49%比工作年限<20年以下的护理人员（34.25%）高（χ²=12.787,P=0.005）。结论 护理人员跌倒预防相关知识掌握度总体较低,应加强对护理人员关于患者跌倒预防知识的系统培训,减少住院患者跌倒的发生。

Objective To investigate the mastery of falls prevention knowledge among nursing staffs,in order to improve their cognitive level of falls prevention related knowledge and reduce the occurrence of falls in hospitalized patients．Methods A questionnaire survey was conducted among nursing staffs with a self-designed questionnaire on the mastery of falls related knowledge among hospitalized patients．Results The highest accuracy rate of nursing staffs' mastery of falls knowledge was 64.04% for falling classification,and the lowest was 17.10% for falls intervention measures．Nursing staffs' accuracy of the timing of patient fall risk assessment was 88.69% in surgery,which was higher than 71.11% in nursing staff in obstetrics,gynecology,and pediatrics（χ²=21.319,P=0.003）．The accuracy of emergency treatment for hospitalized patients after falls was 76.67%,which was higher than 42.67% in outpatient treatment（χ²=27.651,P<0.001）．The accuracy of the timing of patient fall risk assessment in nursing staffs with less than 5 years of work experience was 89.81%,which was better than nursing staff with more than 20 years of work experience（64.15%）（χ²=18.921,P<0.001）．Nursing staff with 11-20 years of work experience had a correct intervention rate for preventing falls in hospitalized patients of 24.66%,which was higher than nursing staffs with less than 5 years of work experience（11.46%）（χ²=9.678,P=0.022）．The accuracy rate of handling falls in hospitalized patients by nursing staffs with more than 20 years of work experience was 58.49%,which was higher than that of nursing staff with less than 20 years of work experience,which is 34.25%（χ²=12.787,P=0.005）．Conclusions Overall,nursing staff had a low level of falls prevention knowledge,and systematic training on patient fall prevention should be strengthened to reduce the occurrence of falls in hospitalized patients．

目的 探讨医院消毒供应中心清洗全程质量控制用于院内感染风险预防价值。方法 选取2019年1月—2021年6月期间医院消毒供应中心待清洗消毒的1 000件手术器械（观察组）,采用全程质量控制;另选取1 000件手术器械（对照组）,常规流程清洗;比较2组患者器械清洗质量,统计清洗后因术中器械的院内感染率。结果 观察组清洗消毒后器械血渍、污垢、锈斑总发生率0.20%,低于对照组的1.50%,器械清洗、消毒、灭菌合格率高于对照组（P<0.05）。观察组器械操作流程与标准、科室管理、安全管理、综合质量管理高于对照组,院内感染率0.10%低于对照组的1.00%,医护人员满意度95.00%高于对照组的75.00%（P<0.05）。结论 医院消毒供应中心清洗质量控制,可增加手术器械清洗质量,减少院内感染的发生。

Objective To explore the value of whole process cleaning quality control in hospital disinfection supply center for risk prevention of hospital infection．Methods From January 2019 to June 2021,1000 surgical instruments to be cleaned and disinfected in the hospital disinfection supply center（observation group）were selected,and the whole process quality control was applied;another 1000 surgical instruments（control group）were selected for routine cleaning．The quality of instrument cleaning in the two groups was compared,and the hospital infection rate after the application of cleaned instrument was calculated．Results After cleaning and disinfecting instruments,the total incidence of blood stains,dirt and rust was 0.20% in the observation group,lower than that in the control group,which was 1.50%,and the qualified rate of instrument cleaning,disinfecting and sterilizing was higher than that in the control group（P<0.05）．The equipment operation procedures and standards,department management,safety management,and comprehensive quality management of the observation group were higher than those of the control group,the hospital infection rate was 0.10%,lower than that of the control group（1.00%）,and the satisfaction rate of medical staff was 95.00% in the observation group,higher than that of the control group（75.00%,P<0.05）．Conclusions The cleaning quality control of hospital disinfection supply center can improve the cleaning quality of surgical instruments and reduce the occurrence of hospital infection.

目的 探究前瞻性护理对老年吸入性肺炎的影响和作用。方法 选择2017年8月—2018年12月住院采取常规护理的94例老年患者作为对照组,选择2019年1月—2020年10月住院的114例老年患者作为观察组进行前瞻性护理,比较对照组和观察组吸入性肺炎的发病率。结果 观察组吸入性肺炎发病率低于对照组（P<0.05）。结论 前瞻性护理可及早筛选并识别老年患者发生吸入性肺炎的危险因素,依此采取相应的护理措施,降低吸入性肺炎的发病率。

Objective To explore the effect of prospective nursing on preventing aspiration pneumonia in elderly patients．Methods A total of 94 elderly patients who were hospitalized from August 2017 to December 2018 and received routine care were selected as the control group,and 114 elderly patients who were hospitalized from January 2019 to October 2020 were selected as the observation group for prospective care,and the incidence of aspiration pneumonia in the control group and the observation group were compared．Results The incidence of aspiration pneumonia in the observation group was lower than that in the control group（P<0.05）．Conclusions Prospective nursing can identify risk factors of aspiration pneumonia in elderly patients,and take appropriate nursing measures to reduce the incidence of aspiration pneumonia．

目的 了解越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况,为更好地贯彻落实消除艾滋病母婴传播工作提供下一步工作策略和措施依据。方法 于2022年7月—8月,对广州市越秀区5家助产机构妇产科、保健科和医务科的医务人员进行艾滋病母婴阻断知识政策及HIV感染孕产妇相关权益知识的问卷调查。结果 465名医务人员对个别艾滋病母婴阻断政策了解不足,包括“人类免疫缺陷病毒（HIV）感染孕产妇到定点医疗机构终止妊娠或住院分娩时可以获得一定的减免”（知晓率79.78%）、“HIV感染孕产妇的宝宝可以免费领取一定数量的奶粉”（知晓率66.88%）;医务人员对HIV感染孕产妇的生育相关权益认识严重不足,对HIV感染孕产妇生育权益认识正确的仅有45.59%。临床护士群体对上述艾滋病母婴阻断政策及HIV感染孕产妇相关权益的知晓率低于临床医生及其他医务人员,组间比较差异有统计学意义（P<0.05）。结论 越秀区助产机构医务人员对艾滋病母婴阻断知识有一定的了解,但掌握不够完整、全面,对HIV感染患者的生育权认识严重不足,应进一步加强对助产机构医务人员、尤其是护士群体关于艾滋病母婴阻断政策知识及患者相关权益的培训,以更好地贯彻落实消除艾滋病母婴传播工作,保障HIV感染患者的权益。

Objective To understand the knowledge of medical staff of midwifery institutions in Yuexiu District about AIDS prevention of mother-to-children transmission（PMTCT）and patients' rights and interests,in order to provide the basis for the following work strategy and measures for better implementation of the elimination of mother-to-child transmission of HIV．Methods From July to August in 2022,a questionnaire survey about knowledge and policies of AIDS PMTCT and rights of HIV infected pregnant women was conducted among the medical staff of obstetrics and gynecology department,health care department and medical department in five midwifery institutions in Yuexiu District of Guangzhou City．Results A total of 465 medical workers had insufficient understanding of some policies on PMTCT of AIDS,including HIV-infected pregnant women can obtain certain fee waiver when they go to designated medical institutions to terminate pregnancy or hospitalized deliver（awareness rate of 79.78%）,HIV-infected pregnant women's babies can receive a certain amount of free milk powder（awareness rate of 66.88%）．There was a serious lack of awareness of reproductive rights of HIV-infected pregnant women among medical staff,and only 45.59% of them had correct understanding．The awareness rate of the PMTCT and the rights and interests of HIV-infected pregnant women among clinical nurses was significantly lower than that among clinicians and other medical staff．Conclusions The medical staff of midwifery institutions in Yuexiu District have some knowledge about the PMTCT of AIDS,but their knowledge is not complete and comprehensive,and their understanding of the reproductive rights of HIV-infected patients is seriously inadequate,so it is necessary to further strengthen the training of medical staff in midwifery institutions,especially nurses,on the policy knowledge of PMTCT of AIDS and the related rights and interests of patients,in order to better implement the elimination of mother-to-child transmission of AIDS and protect the rights and interests of infected patients．