约10%~30%的新发结直肠癌患者会出现急性肠梗阻，传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略，展现出显著优势。肠道支架可迅速解除梗阻，改善患者症状，降低手术风险，为肿瘤微创切除创造条件，同时为新辅助化疗提供可能，但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视，且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展，旨在为临床研究和实践提供参考依据。

    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction．Traditional emergency surgical intervention is characterized by high rates of postoperative complications，elevated mortality，and diminished quality of life．Combined stent and curative elective surgery（CSCES）has emerged as a novel therapeutic strategy，exhibiting significant clinical benefits．Intestinal stenting can rapidly alleviate obstruction，thereby improving patient symptoms，reducing surgical risks，and facilitating minimally invasive tumor resection．Additionally，it provides an opportunity for neoadjuvant chemotherapy．However，potential complications，including bleeding，stent migration，recurrent obstruction，and intestinal perforation，must be carefully considered．Moreover，the long-term safety and impact on oncologic outcomes remain to be elucidated．This review aims to provide a comprehensive overview of the current status，controversies，and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer，with the goalof informing clinical research and practice．

    因气候与生活习惯影响，广东地区老年性肩周炎临床特点及康复需求具有独特性，亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案，广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起，省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识（2026年版）》。该共识以ICF框架为基础，立足肩周炎康复循证医学证据，结合多学科专家产教研实践经验，对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布，将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。

   Due to climatic and lifestyle influences，the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features，necessitating the development of standardized and locally tailored rehabilitation protocols．To formulate regionally differentiated rehabilitation plans，the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder（2026 Edition）” through collaboration with multiple provincial institutions and experts．Based on the International Classification of Functioning，Disability and Health（ICF）framework and evidence-based rehabilitation medicine for periarthritis of the shoulder，this consensus integrates multidisciplinary expertise from industry，academia，and research to establish unified guidelines on ICF assessment，application of appropriate TCM techniques and rehabilitation therapies，implementation of stepwise intervention measures，and integrated TCM-Western medicine full-cycle rehabilitation approaches．The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder．

       小柴胡汤是《伤寒杂病论》中的一首经典方剂，是和解法的基础方，后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索，探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用，有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂，小柴胡汤亟需进一步的发扬与创新，以期更有效地应用于未来的临床实践。

    Xiaochaihu Decoction，as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases，laid the foundation for reconciliation．It has a wide range of applications in the treatment of gynecological diseases．Through a literature search，this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application．This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain，bleeding，leucorrhea disease，tumors and other related diseases．Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea，pelvic inflammatory disease，menstrual irregularities，gynecological tumors，and perimenopausal syndrome through its role of soothing the liver and promoting bile flow，strengthening the spleen and stomach，and harmonizing and releasing the pivot．As a commonly used gynecological prescription in clinical practice，Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future．

       本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题，IMB模型通过向患者提供科学的疾病知识，改变其疾病认知与态度，最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示，IMB模型可显著降低患者术后疼痛发生率，并提高患者参与治疗决策的程度，为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考，以便后期实施相关个性化干预措施，并提供相关理论依据。

       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy．The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge，and ultimately promotes their adoption and maintenance of healthy behaviors．It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy，the research background of this study，the current research status at home and abroad，as well as the future development trends and challenges．The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making．This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model，so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis．

       目的 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经（PENG）阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例，随机分为两组，A 组（38例）行PENG阻滞联合椎管内麻醉，C 组（38例）行椎管内麻醉。比较两组入室（T0）、摆放体位时（T1）、术后6 h（T2）、术后12 h（T3）、术后24 h（T4）静息和活动状态的数字等级评定量表（NRS）疼痛评分；术后非甾体抗炎药及阿片类药物补救次数；术后 6 h、24 h患侧股四头肌徒手肌力分级（MMT）；首次下床活动时间、住院时间。结果 A组T1～T4时刻静息状态NRS疼痛评分分别为2（1，3）分、1（1，2）分、2（1，2）分、3（2，4）分均低于C组的5（4，7）分、4（3，5）分、5（3，6）分、4（2，6）分，比较差异有统计学意义（均P＜0.001）；A组T1～T4时刻活动状态NRS疼痛评分分别为5（4，7）分、3（2，4）分、4（3，5）分、6（4，7）分均低于C组的10（9，10）分、8（6，9）分、8（7，9）分、9（8，10）分，比较差异有统计学意义（均P＜0.001）。A组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.01）；C组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.05）；A组在T1～T4时的活动状态NRS疼痛评分均低于T0时的（均P＜0.001）；C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的（均P＜0.01）。A组术后非甾体抗炎药及额外阿片类药物补救次数为4（0，8）、2（0，3）次，均低于C组的15（7，19）、5（3，7）次，比较差异有统计学意义（均P＜0.001）。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义（P＞0.05）。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛，不影响其术后下肢肌力。

   Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group（PENG）block combined with spinal-epidural anesthesia in hip joint surgery for frail patients．Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups：Group A（38 cases）received PENG block combined with intraspinal anesthesia，while Group C（38 cases）received only intraspinal anesthesia．The numerical rating scale（NRS）pain scores of resting and active states were compared between the two groups at the time of entering the room（T0），placing the position（T1），6 hours after surgery（T2），12 hours after surgery（T3），and 24 hours after surgery（T4）．Postoperative non-steroidal drugs and opioids remedy times，muscle strength grading（MMT）of quadriceps femoris at 6 hours and 24 hours after operation，and the first time out of bed activity time，hospitalization time were also compared．Results The resting NRS pain scores at T1-T4 in Group A were 2（1，3），1（1，2），2（1，2）and 3（2，4），respectively，which were lower than 5（4，7），4（3，5），5（3，6）and 4（2，6）in Group C，and the difference was statistically significant（all P＜0.001）．The NRS pain scores at T1-T4 in Group A were 5（4，7），3（2，4），4（3，5）and 6（4，7），respectively，which were lower than 10（9，10），8（6，9），8（7，9）and 9（8，10）in Group C，and the difference was statistically significant（all P＜0.001）．The resting NRS pain score of Group A at T1-T4 was lower than that at T0（all P＜0.01）；the resting NRS pain score of Group C at T1-T4 was lower than that at T0（all P＜0.05）．The NRS pain scores at T1-T4 in Group A were lower than those at T0（all P＜0.001）；the NRS pain scores at T1 and T2 in Group C were lower than those at T0（all P＜0.01）．The number of postoperative non-steroidal drugs and additional opioids in group A（4［0，8］，2［0，3］）was lower than that in Group C（15［7，19］，5［3，7］），and the difference was statistically significant（all P＞0.001）．There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation，the first time of getting out of bed and the number of days of hospitalization between the two groups（P＞0.05）．Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength．

      目的 调查住院老年患者因经外周静脉置入中心静脉导管（PICC）而引发的血栓情况，并分析其影响因素，为老年患者置入PICC产生的相关性血栓（PICC-CRT）和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间，选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型，并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例，最终纳入277例患者的完整资料，其中123例患者出现了PICC-CRT，发生率为44.40%（123/277）。血栓分级中，I级78例，Ⅱ级37例，Ⅲ级8例。无症状血栓83例，占67.48%，发生率29.96%（83/277）；症状性血栓40例，占32.52 %，发生率14.44%（40/277）。单因素分析联合多因素Logistic回归显示，卒中史、凝血酶原时间（PT）、导管留置时间是住院老年患者PICC-CRT的关键因素（P＜0.05），预测模型ROC曲线下面积为0.719；置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素（P＜0.05），预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素，基于关键因素构建了预测模型预测其发生，为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter（PICC）placement in hospitalized elderly patients and to analyze its influencing factors，in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis（PICC-CRT）and symptomatic thrombosis in this population．Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled．Comprehensive assessments were conducted using general patient information forms，motor function evaluation，muscle strength testing，Barthel Index，and Padua score．Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis，with variable selection optimized via stepwise regression．Model performance was evaluated using receiver operating characteristic（ROC）curve analysis．Results After excluding 40 patients with incomplete clinical data，277 cases were included in the final analysis．Among them，123 patients developed PICC-CRT，with an incidence rate of 44.40%（123/277）．Thrombosis was graded as Grade I in 78 cases，Grade II in 37 cases，and Grade III in 8 cases．Asymptomatic thrombosis occurred in 83 cases（29.96%），accounting for 67.48% of PICC-CRT；symptomatic thrombosis occurred in 40 cases（14.44%），accounting for 32.52%．Univariate and multivariate Logistic regression analyses identified history of stroke，prothrombin time（PT），and catheter dwell time as key risk factors for PICC-CRT（P＜0.05），with the area under the curve（AUC）of 0.719．History of catheterization，malignancy，catheter dwell time，and number of post-catheterization complications were independent predictors of symptomatic thrombosis（P＜0.05），with an AUC of 0.812．Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients．Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis．

      目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

      目的 探究磁共振成像三维快速自旋回波序列（CUBE）序列在眼眶肿瘤及肿瘤样病变中的诊断价值。方法 选取2023年5月—2025年6月郑州市第二人民医院收治的眼眶肿瘤及肿瘤样病变患者89例为研究对象，依据病理诊断结果分为眼眶肿瘤组（43例）及肿瘤样病变组（46例）。分别采用病理检查及磁共振成像CUBE序列对研究对象进行检测。比较眼眶肿瘤组与肿瘤样病变组的资料。采用Kappa检验比较病理金标准与磁共振成像CUBE序列鉴别诊断的一致性。采用2×2列联表分析磁共振成像CUBE鉴别眼眶肿瘤及肿瘤样病变的诊断效能。结果 病理鉴别诊断结果与磁共振成像CUBE序列结果比较，差异无统计学意义（P＞0.05）。眼眶肿瘤组与肿瘤样病变组的资料比较，差异无统计学意义（P＞0.05）。Kappa检验发现，磁共振成像CUBE序列鉴别眼眶肿瘤与肿瘤样病变与病理金标准比较的Kappa值为0.820，一致性较高（P＜0.05）。磁共振成像CUBE序列鉴别眼眶肿瘤及肿瘤样病变的灵敏度为88.37%，特异度为93.48%，准确度为91.01%，误诊率为6.52%，漏诊率为11.63%，约登指数为81.85%，阳性预测概率为92.68%，阴性预测概率为89.58%。结论 磁共振成像CUBE序列鉴别诊断成人眼眶肿瘤及肿瘤样病变与病理诊断结果的一致性较高。

     Objective To investigate the diagnostic value of the three-dimensional fast spin echo sequence（CUBE）in magnetic resonance imaging for orbital tumors and tumor-like lesions．Methods From May 2023 to June 2025，89 patients with orbital tumors and tumor like lesions were included as the study subjects．Based on pathological diagnosis results，they were separated into orbital tumor group（43 cases）and tumor like lesion group（46 cases）．The pathological examination and magnetic resonance imaging CUBE sequence were used to scan the study subjects．The data were compared between the orbital tumor group and the tumor like lesion group．Kappa test was used to compare the consistency of differential diagnosis between pathological gold standard and magnetic resonance imaging CUBE sequence．A 2×2 contingency table was uesd to analyze the diagnostic performance of magnetic resonance imaging CUBE in differentiating orbital tumors and tumor-like lesions．Results The difference between the pathological differential diagnosis results and the magnetic resonance imaging CUBE sequence was not statistically significant（P＞0.05）．The data comparison between the orbital tumor group and the tumor like lesion group showed no statistical difference（P＞0.05）．The Kappa test found that the Kappa value of 0.820 for differentiating orbital tumors from tumor like lesions using the magnetic resonance imaging CUBE sequence compared to the pathological gold standard was highly consistent（P＜0.05）．The sensitivity，specificity，accuracy，misdiagnosis rate，missed diagnosis rate，Youden index，positive predictive probability，and negative predictive probability of magnetic resonance imaging CUBE sequence in differentiating orbital tumors and tumor like lesions were 88.37%，93.48%，91.01%，6.52%，11.63%，81.85%，92.68% and 89.58%，respectively．Conclusions The magnetic resonance imaging CUBE sequence has a high consistency with pathological diagnosis results in the differential diagnosis of orbital tumors and tumor like lesions．

       目的 探究肺泡灌洗液靶向高通量测序（tNGS）在鹦鹉热衣原体肺炎中应用效果。方法 选取2021年5月—2025年3月我院收治的35例鹦鹉热衣原体肺炎患者进行研究，患者均接受肺泡灌洗液tNGS检测、肺泡灌洗液常规病原检测，以病原学为金标准，分析肺泡灌洗液tNGS对鹦鹉热衣原体肺炎的诊断效能。结果 金标准对鹦鹉热衣原体阳性检出35例，检出率100.00%，肺泡灌洗液tNGS阳性检出率高于传统病原检测，检测结果回报耗时短于肺泡灌洗液传统病原检测（P＜0.05）。结论 鹦鹉热衣原体肺炎临床症状缺乏特异性，容易转为重症肺炎，肺泡灌洗液tNGS可提高鹦鹉热衣原体肺炎检出率且结果回报较快，采用四环素类、喹诺酮类抗生素有助于改善患者预后。

     Objective To investigate the application effect of targeted next-generation sequencing（tNGS）of bronchoalveolar lavage fluid（BALF）in Chlamydia psittaci pneumonia．Methods Thirty-five patients with Chlamydia psittaci pneumonia admitted to our hospital from May 2021 to March 2025 were selected for the study．All patients underwent BALF tNGS and conventional BALF pathogen detection．With etiology as the gold standard，the diagnostic efficacy of BALF tNGS for Chlamydia psittaci pneumonia was analyzed．Results The gold standard detected 35 cases of Chlamydia psittaci positive，with a detection rate of 100.00%．The positive detection rate of tNGS in alveolar lavage fluid was higher than that of traditional pathogen detection，and the results report time of tNGS was shorter than that of traditional pathogen detection（P＜0.05）．Conclusions Chlamydia psittaci pneumonia lacks specificity in clinical symptoms and is easy to turn into severe pneumonia，bronchoalveolar lavage fluid tNGS can improve the detection rate of Chlamydia psittaci pneumonia and the results return quickly，and the use of tetracyclines and quinolones antibiotics can help improve the prognosis of patients．

      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

       目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料，按照7︰3比例随机化分为训练列（293例）和验证队列（126例）。统计基于开发队列数据，采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素，并构建风险预测模型。基于开发队列和验证队列数据，采用校准曲线、受试者操作特征（ROC）曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎，发生率为26.97%。美国国立卫生研究院卒中量表（NIHSS）评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值（NPAR）、中性粒细胞计数与淋巴细胞计数比值（NLR）、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素（P＜0.05）。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型，校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近；ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906（95%CI：0.867~0.937）、0.884（95%CI：0.815~0.934）；决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。

      Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage（ICH）and validate the predictive performance of the model．Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022．They were randomly divided into a development cohort（293 cases）and a validation cohort（126 cases）according to a 7∶3 ratio．The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data，and a risk prediction model was constructed．Based on the development cohort data and validation cohort data，the predictive performance of the model was analyzed using calibration curves，receiver operating characteristic（ROC）curve，and decision curve analysis．Results Among 419 patients，113 developed stroke associated pneumonia，with a rate of 26.97%．The National Institutes of Health Stroke Scale（NIHSS）score，swallowing difficulties，initial hematoma volume，neutrophil percentage to albumin ratio（NPAR），neutrophil count to lymphocyte count ratio（NLR），surgical treatment，endotracheal intubation，and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH（P＜0.05）．Based on the above influencing factors，a risk prediction model for stroke associated pneumonia in patients with ICH was constructed．The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence．The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906（95%CI：0.867-0.937）and 0.884（95%CI：0.815-0.934），respectively．The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%，and the threshold probability of the validation cohort was between 2%-76%，the intervention using this model was more clinically valuable than all/no intervention．

Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score，swallowing difficulties，initial hematoma volume，NPAR，NLR，surgical treatment，tracheal intubation，and indwelling gastric tube has good predictive performance and clinical application value．

       目的 调查重型β地中海贫血患儿照顾者的负担现状，并分析其影响因素，为医护人员制定干预方案提供依据。方法 采用便利抽样法，于2024年1月—12月选取华南地区5家医院就诊的重型β地中海贫血患儿的主要照顾者作为调查对象，采用一般资料调查表、Zarit照顾者负担量表、中文简化版家庭弹性量表和社会支持评定量表进行调查，并采用单因素分析、相关性分析及多重线性回归探究其影响因素。结果 共发放问卷242份，回收232份，回收率为95.87%。重型β地中海贫血患儿主要照顾者照顾负担的总体平均得分为（36.67±18.63）分。多重线性回归分析结果显示，患儿输血频率、输血相关性皮肤过敏和社会支持是患儿照顾负担的影响因素（P＜0.001），可解释总变异的23.9%。结论 重型β地中海贫血患儿照顾者负担程度以中重度为主。患儿曾出现输血不良反应、输血频率更高，其照顾者负担更重；而主要照顾者具有良好的社会支持水平有助于降低其照顾者负担。医护人员应针对以上因素制定干预方案，以减轻重型β地中海贫血患儿照顾者负担水平。

      Objective To investigate the current burden in caregivers of children with β thalassemia major and analyze its influencing factors，so as to provide a basis for medical staff to formulate intervention plans．Methods By using the convenience sampling method，primary caregivers of children with β thalassemia major from five hospitals in South China from January to December 2024 were selected as the survey subjects．The general information questionnaire，Zarit Caregiver Burden Scale，Simplified Chinese Family Resilience Scale and Social Support Rating Scale were used for the survey．And univariate analysis，correlation analysis and multiple linear regression were adopted to explore its influencing factors．Results A total of 242 questionnaires were distributed and 232 were retrieved，with a recovery rate of 95.87%．The overall average score of care burden for primary caregivers of children with β thalassemia major was（36.67±18.63）．The results of multiple linear regression analysis showed that the frequency of blood transfusion in children，transfusion-related skin allergy and social support were the influencing factors of the care burden（P＜0.001），which could explain 23.9% of the total variation．Conclusions The burden level in caregivers of children with β thalassemia major is mainly moderate to severe．The children with adverse reactions to blood transfusion and higher frequency of blood transfusion impose a heavier burden on its caregivers．The primary caregivers who have good social support can help reduce the burden．Medical staff should formulate intervention plans based on the above factors to reduce the burden level of caregivers of children with β thalassemia major．

      目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为（知信行）水平的现状，探究各因素是否对患者的营养风险、营养知信行水平具有影响，并分析两者之间的相关性。方法 选取中山大学附属第八医院（深圳福田）2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象，采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查，数据收集后进行统计分析，从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险，营养风险评分为（2.72±1.42）分。消化系统恶性肿瘤患者营养知识水平得分为（12.30±5.26）分、营养态度水平得分为（14.80±2.68）分、营养行为水平得分为（22.82±4.55）分、营养知信行水平总分为（49.96±9.50）分。家庭经济收入是患者营养风险水平的核心影响因素（P＜0.05），学历水平是患者营养知信行水平的核心影响因素（P＜0.05）。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关（r=-0.143，P＜0.05）。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平，但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要，这将有助于提升患者的营养知识水平，从而整体性改善其营养知信行素养并降低其营养风险，但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。

    Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors，to analyze the influencing factors of nutritional risk，nutritional knowledge-attitude-behavior，and explore the correlation between them．Methods From February 2024 to October 2024，244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects．A general information questionnaire，Nutritional Risk Screening 2002，and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3，and the overall score was（2.72±1.42）．The scores of nutritional knowledge，attitude，behavior and total score of digestive system malignant tumors patients were（12.30±5.26），（14.80±2.68），（22.82±4.55）and（49.96±9.50），respectively．Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors，while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior．Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level，but there is a widespread situation of relatively high nutritional risk．It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period，which will help enhance patients’ nutritional knowledge level，thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks．However，when conducting nutrition education and formulating personalized nutrition plans，the patient’s family economic income，medical payment methods and educational level should be fully considered．

      目的 探讨广州市公职人员中眼睑黄色瘤（XP）患病情况与生化检验指标异常的相关性。方法 从2018年来广州市干部和人才健康管理中心体检的公职人员中选取1 090例，其中筛选患XP人员545例，作为病例组，依性别、年龄分层随机抽取的未患XP的人员作为对照组，测定空腹血糖、血脂、甲状腺功能等生化指标，采用回顾性病例对照研究的方式，比较两组相关指标水平。P＜0.05为差异有统计学意义。结果 XP的患病率为0.94%（男性为0.89%，女性为1.01%）。男性和女性的XP患病率比较差异无统计学意义（χ²=2.142，P=0.143）。两组间体质量、舒张压、血脂等多项指标上的差异具有统计学意义（P＜0.05）。高体质量（OR=1.021，95%CI：1.004~1.038，P=0.017）、高舒张压（OR=1.019，95%CI：1.004~1.035，P=0.011）、低高密度脂蛋白（OR=6.127，95%CI：2.568~14.619，P＜0.001）、高低密度脂蛋白（OR=2.084，95%CI：1.456~2.981，P＜0.001）是患病的危险因素。结论 广州市公职人员中XP的患病率男性和女性接近；高体质量、高舒张压、高密度脂蛋白水平降低、低密度脂蛋白水平升高是患XP的危险因素。

   Objective To investigate the correlation between xanthelasma palpebrarum（XP）and abnormal biochemical indices in healthy individuals in Guangzhou，China．Methods A retrospective case-control study was conducted，selecting 1 090 individuals from a total of 58 053 who underwent health examinations at the Guangzhou Cadre and Talent Health Management Centre in 2018．The case group consisted of 545 individuals diagnosed with XP，while the control group included age- and sex-matched individuals without XP，randomly selected from the same database．Biochemical indices analyzed included fasting blood glucose，blood lipids，liver and kidney function，thyroid indicators，body weight，and blood pressure．Statistical significance was set at P＜0.05．Results The prevalence of XP was 0.94%（0.89% in men and 1.01% in women）．No significant difference was observed in the prevalence of XP between men and women（χ²=2.142，P=0.143）．Similarly，no significant differences were observed in thyroid-stimulating hormone（P=0.937），free triiodothyronine（P=0.216），free thyroxin（P=0.206），or fasting blood glucose levels（P=0.668）between the case and control groups．However，significant differences were noted in body weight，diastolic blood pressure，blood lipid levels，and liver and renal biochemical indicators between the two groups（P＜0.05）．Specifically，higher body weight（OR=1.021，95%CI：1.004–1.038，P=0.017），higher diastolic blood pressure（OR=1.019，95%CI：1.004–1.035，P=0.011），lower high-density lipoprotein（OR=6.127，95%CI：2.568–14.619，P＜0.001），and higher low-density lipoprotein（OR=2.084，95%CI：1.456–2.981，P＜0.001）were identified as risk factors for XP．Conclusions The prevalence of XP did not differ between males and females．However，high body weight，high diastolic blood pressure，low high-density lipoprotein，and high low-density lipoprotein are risk factors for XP．

      目的 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者应用基于Caprini量表评估的干预模式联合充气加压泵（IPC）预防静脉血栓（VTE）的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象，经随机数表法分为对照组41例予以VTE常规干预，观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓（VTE）发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组（P＜0.05）。干预前，两组AECOPD患者凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体水平比较差异无统计学意义（P＞0.05）；干预后，两组患者TT、PT、APTT、D-二聚体水平均降低，观察组较低（P＜0.05）。干预前，两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义（P＞0.05）；干预后，两组患者平均流速、血流峰速均升高，观察组高于对照组（P＜0.05）；阻力指数均降低，观察组低于对照组（P＜0.05）。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率，改善凝血指标与股静脉血流速。

   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression（IPC）in preventing venous thromboembolism（VTE）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group（41 cases）and an observation group（41 cases）using a random number table．The control group received routine VTE prevention，while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care．The extremity conditions，occurrence of VTE，coagulation parameters，and femoral venous blood flow velocity were compared between the two groups．Results The rates of extremity swelling，extremity pain，and VTE incidence in the observation group were lower than those in the control group（P＜0.05）．Before the intervention，there were no statistically significant differences in thrombin time（TT），prothrombin time（PT），activated partial thromboplastin time（APTT），or D?dimer levels between the two groups（P＞0.05）．After the intervention，TT，PT，APTT，and D?dimer levels decreased in both groups，with lower values in the observation group（P＜0.05）．Before the intervention，there were no statistically significant differences in mean flow velocity，peak flow velocity，or resistance index between the two groups（P＞0.05）．After the intervention，mean flow velocity and peak flow velocity increased in both groups，with higher values in the observation group（P＜0.05），while the resistance index decreased，with a lower value in the observation group（P＜0.05）．Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling，extremity pain，and VTE incidence，and improve  coagulation parameters and femoral venous blood flow velocity．

      目的 合并肺纤维化的慢性阻塞性肺疾病（COPD）是COPD的特殊亚型，患者兼具气流受限与肺组织纤维化病理特征，临床症状更严重、肺功能下降更快，且现有单一治疗方案难以同时改善气流受限与纤维化进展，预后较差。基于此，本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响，为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者，采用前瞻性随机对照研究设计，应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗，对照组48例采取尼达尼布治疗，试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后，比较治疗前后症状评分、肺功能、纤维化指标、炎症指标，并分析两组治疗安全性。结果 治疗后，两组CAT评分、mMRC评分及VAS降低（P＜0.05）；且与对照组比较，试验组CAT评分、mMRC评分及咳嗽VAS评分较低（P＜0.05）。治疗后，两组FVC、FEV₁、DLCO及FEV₁/FVC比值均较治疗前改善（P＜0.05）；且与对照组比较，试验组FVC、FEV₁、DLCO及FEV₁/FVC比值较优（P＜0.05）。治疗后，两组血清KL-6、SP-D水平及CT纤维化评分均降低（P＜0.05）；且与对照组比较，试验组血清KL-6、SP-D水平及CT纤维化评分较低（P＜0.05）。治疗后，两组血清IL-6、TNF-α及TGF-β1水平降低（P＜0.05）；且与对照组比较，试验组血清IL-6、TNF-α及TGF-β1水平较低（P＜0.05）。试验组总不良反应发生率为8.33%（4/48），对照组为10.42%（5/48），两组比较差异无统计学意义（P＞0.05）。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好，可减轻患者临床症状，改善肺功能与肺纤维化，降低机体炎症反应，安全性较高。

   Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease（COPD）patients with associated pulmonary fibrosis and its impact on lung function，providing a basis for optimizing clinical treatment strategies．Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected，and divided into experimental group and control group using a random number table method．Using a prospective randomized controlled study design，all patients received conventional treatment，with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide．After 24 weeks of treatment in both groups，the symptom scores，lung function，fibrosis indicators，and inflammation indicators were compared before and post-treatment，and the drug safety of the two groups was analyzed．Results Post-treatment，CAT score，mMRC score and VAS decreased in both groups（P＜0.05）．Compared with the control group，CAT score，mMRC score and cough VAS score were lower in the experimental group（P＜0.05）．Post-treatment，FVC，FEV₁，DLCO and FEV₁/FVC ratio of both groups improved compared with that before treatment（P＜0.05）．Compared with the control group，FVC，FEV₁，DLCO and FEV₁/FVC ratio of the experimental group were better（P＜0.05）．Post-treatment，serum KL-6，SP-D levels and CT fibrosis scores of both groups decreased（P＜0.05）．Compared with the control group，serum KL-6，SP-D levels and CT fibrosis scores of the experimental group were lower（P＜0.05）．Post-treatment，serum IL-6，TNF-α and TGF-β1 levels in both groups decreased（P＜0.05）．Compared with the control group，serum IL-6，TNF-α and TGF-β1 levels in the experimental group were lower（P＜0.05）．The incidence of total adverse reactions in the experimental group was 8.33%（4/48），and that in the control group was 10.42%（5/48）．There was no difference between the two groups（P＞0.05）．Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis，which can alleviate its clinical symptoms，improve lung function and pulmonary fibrosis，reduce the body’s inflammatory response，which is relatively safe．

       目的 通过年龄、性别等多方面研究各亚型注意缺陷多动障碍（ADHD）儿童的智力结构分布特征的临床研究，为ADHD的个体化干预提供科学依据。方法 实验组纳入ADHD儿童754例，其中注意缺陷型（ADHD-I）280例（37.13%）、多动-冲动型（ADHD-HI）212例（28.12%）、混合型（ADHD-C）262例（34.75%），按年龄分为三组：低龄组（6~8岁）、中龄组（9~11岁）及高龄组（12~14岁）；对照组为正常儿童412例，为同期选择的性别、年龄相匹配的儿童。选择采用韦氏智力评估等方法分别对两组儿童进行评估等，对评估结果进行比较和综合分析。结果 ADHD儿童的智力评估结果低于对照组（P＜0.01），且在言语智商方面表现更为明显，在各分测验中以A因子（言语理解）和C因子（记忆/注意集中）为主，而B因子（知觉组织能力）方面则无差异。ADHD-HI型及ADHD-C型的总智商及操作智商均高于ADHD-I型，ADHD-C型言语智商和A因子均高于ADHD-I型（P＜0.01），ADHD-HI型的智力水平最高，而ADHD-I型与ADHD-C型的智力水平差异无统计学意义（P＞0.05）。各年龄段ADHD儿童的智力发育均受到不同程度的影响，尤其是中龄组儿童及高龄组女童所受影响更明显；低、中龄组儿童的智力发育水平均高于高龄组儿童，提示ADHD儿童的智力损害随年龄增长而加重；同一年龄段ADHD女童的智力损害较男童更为严重。结论 本地区6~14岁ADHD儿童的智力水平较低，以言语智商低下更为明显，ADHD-HI型在3个亚型中智力损害最小，ADHD儿童的智力损害随年龄增长而加重，同一年龄段ADHD女童的智力损害较男童更为严重。

   Objective To investigate the distribution characteristics of intellectual structure in children with different subtypes of attention deficit hyperactivity disorder（ADHD）by age and gender，providing scientific basis for individualized treatment and intervention of ADHD．Methods The experimental group consisted of 754 children with ADHD，including 280 cases（37.13%）of inattentive type（ADHD-I），212 cases（28.12%）of hyperactivity impulsive type（ADHD-HI），and 262 cases（34.75%）of combined type（ADHD-C）．They were divided into three groups by age：young group（6-8 years old），middle group（9-11 years old），and older group（12-14 years old）．The control group consisted of 412 normal children with matched sex and age recruited during the same period and had similar sex ratio．The specific methods of Wechsler Intelligence Scale were mainly applied to evaluate normal children and children with ADHD，and the evaluation results were subjected to multidimensional analysis and comparison．Results The intelligence assessment results of ADHD children were significantly lower than those of the control group（P＜0.01），with a more pronounced performance in verbal intelligence．In various sub tests，factors A（verbal comprehension）and C（memory and attention concentration）were the main factors，while there was no difference in factor B（perceptual organization ability）．The ADHD-HI and ADHD-C types had higher total intelligence and operational intelligence than the ADHD-I type，and the ADHD-C type had higher verbal intelligence and factor A than the ADHD-I type（P＜0.01）．The intelligence level of the ADHD-HI type is the highest，while there is no statistically significant difference in intelligence level between the ADHD-I type and the ADHD-C type．The intellectual development of children in different age groups was affected to varying degrees，especially in the middle and older groups of girls．This study found that the intellectual development of children in the young and middle group was higher than that of children in the older group，indicating that the intellectual development of ADHD children will be increasingly damaged with age．At the same time，it was also found that ADHD girls in the same age group had more severe intellectual development impairment than boys．Conclusions The intelligence level of children with ADHD aged 6-14 in this region is relatively low，with verbal intelligence quotient being more pronounced．ADHD-HI has the smallest intellectual impairment among the three subtypes，and the intellectual development of ADHD children becomes more severe with age．ADHD girls in the same age group have more severe intellectual development impairment than boys．

       目的 分析药品集中带量采购（集采）政策下医院药品供应保障实况，提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据，描述性统计分析集采药品供应情况。结果 采购的416个中标药品中，69个在购销合同期内短缺，短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关，季节性强，以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力，保障供应。

   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement（hereinafter referred to as “central procurement”），and proposes optimization strategies and suggestions for the policy and guarantee．Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024，descriptive statistical analysis of the drug supply situation through centralized procurement was conducted．Results Among the 416 selected drugs purchased，69 were in short supply during the contract period，with a shortage rate of 16.59%．The reasons for the shortage were related to the production capacity of the enterprise，seasonal demand fluctuations，strong seasonality，and mainly chronic diseases and anti-infective．Conclusions It is suggested to build a monitoring platform，improve the reporting system，formulate emergency plans，and evaluate the supply capacity to ensure supply．