脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。
Spinal tuberculosis is the most common types of infectious diseases affecting the spine．This article reviews the current status and progress of surgical treatment for spinal tuberculosis．In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life．However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability．In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention．In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread．The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes．However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan．Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved．
弥漫性大B细胞淋巴瘤（DLBCL）是最常见的高度异质性非霍奇金淋巴瘤（NHL）,不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植（ASCT）和嵌合抗原受体T细胞免疫治疗（CAR-T）是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。
Diffuse large B-cell lymphoma（DLBCL）is a highly heterogeneous type of non-Hodgkin lymphoma（NHL）and its prognosis is different for different disease stages or clinical subtypes．Radiation therapy（RT）is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL．When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients．Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion．For treating relapsed / refractory DLBCL,autologous stem cell transplantation（ASCT）and chimeric antigen receptor T cell immunotherapy（CAR-T）are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure．With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options．
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 探讨131I治疗儿童及青年格雷夫斯病（GD）的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例：男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例（69%）患者获得治愈,22例（31%）未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义（均P>0.05）。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease（GD）in children and young adults and its influencing factors．Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed．The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass．According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured．The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect．Results Seventy-one patients were included：23 males and 48 females,aged 11-22．The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g．The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi．Forty-nine patients（69%）were cured and 22（31%）were not cured．Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group（all P>0.05）．Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%．
目的 研究探讨全面触发工具（GTT）在新生儿医源性皮肤损伤（ISI）不良事件监测中的应用,检验其有效性与适用性。方法 根据GTT白皮书中推荐的护理模块触发器,结合江西省妇幼保健院医院新生儿科ISI发生的特点和实际情况,建立科室审查团队,回顾性分析我院新生儿科重症监护室（NICU）2021年1月—2021年9月168例新生儿的病历。初级审查员负责审查病历;高级审查员负责对确定的ISI和伤害分级作最终决策,对ISI不良事件发生率进行综合的分析,制定符合科室的不良事件触发器,评价GTT在提高新生儿医源性不良事件检出率的优势。结果 168份病历中,设计的14项触发器中14项显示为阳性,触发器阳性检测率为100.00%,触发器阳性总频次为66次,阳性检出频次12例,阳性预测值为18.18%;168份病历GTT检出不良事件频次12次,涉及患儿8例,GTT检出率4.76%;GTT检出E级5例（2.98%）,F级3例（1.79%）;自愿上报E级3例（1.79%）,F级2例（1.19%）,均未发生G级、H级、I级事件;自愿上报事件5例,上报率为（2.98%）。结论 建立新生儿ISI不良事件触发器,并规范皮肤管理、规范和监督ISI医疗护理工作,可以最大限度保证患儿安全,提高新生儿综合救治能力,提升医疗护理服务水平。
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．
目的 探讨住院儿童甲型流感病毒肺炎合并其他病原菌感染的临床特征。方法 通过回顾性研究方法,分析2021年6月—2023年6月广州市妇女儿童医疗中心住院治疗的153例甲型流感病毒肺炎患儿的临床资料,针对有无合并其他病原菌感染,分为混合感染组及非混合感染组两组,分别为98例及55例,分析并对比两组的临床特征。结果 甲型流感病毒肺炎患儿以发热、咳嗽、呕吐/腹泻等症状为主,其中混合感染组患儿呕吐/腹泻症状占比高于非混合感染组（P<0.05）;两组患儿其他症状及并发症对比差异无统计学意义（P>0.05）;儿童甲型流感病毒肺炎患儿检出合并细菌感染的患儿65例（29.41%）,合并肺炎支原体感染的患儿33例（21.57%）;合并病毒感染的患儿20例（13.07%）。与非混合感染组比较,混合感染组患儿乳酸脱氢酶水平更高,白细胞计数<4×109/L的人数占比更少（P<0.05）;其他实验室指标对比差异无统计学意义（P>0.05）;经过抗病毒及对症治疗后,150例（98.04%）患儿痊愈出院,3例出现严重并发症,其均伴有其他病原菌感染。与非混合感染组比较,混合感染组患儿住院天数更长、住院费用更高（P<0.05）;其他预后指标对比差异无统计学意义（P>0.05）。结论 甲型流感病毒肺炎患儿易感染其他的病原菌,导致疾病治疗难度加大,因此临床要提高警惕,以防混合感染情况发生,尽早采取有效的诊治措施,提高疾病早期治愈率。
Objective To explore the clinical characteristics of hospitalized children with influenza A virus pneumonia complicated with other pathogens．Methods The clinical data of 153 children with influenza A virus pneumonia hospitalized in Guangzhou Women and Children Medical Center in the past two years（June 2021 ~ June 2023）were analyzed retrospectively． According to whether they were infected with other pathogens,they were divided into mixed infection group and non-mixed infection group,with 98 cases and 55 cases respectively．The clinical characteristics of the two groups were analyzed and compared．Results Fever,cough,vomiting and diarrhea were the main symptoms in children with influenza A virus pneumonia,and the proportion of vomiting and diarrhea in children with mixed infection group was higher than that in children without mixed infection group（P<0.05）．There was no significant difference in other symptoms and complications between the two groups（P>0.05）．There were 65 children（29.41%）with influenza A virus pneumonia and 33 children（21.57%）with mycoplasma pneumonia,20 children（13.07%）with virus infection．Compared with non-mixed infection group,the level of lactate dehydrogenase in children with mixed infection group was higher,and the proportion of children with white blood cell count<4×109/L was less（P<0.05）．There was no significant difference in other laboratory indexes（P>0.05）．After antiviral and symptomatic treatment,150 cases（98.04%）were cured and discharged,and 3 cases had serious complications,all of which were accompanied by other pathogens．Compared with non-mixed infection group,children in mixed infection group had longer hospitalization days and higher hospitalization expenses（P<0.05）．There was no significant difference in other prognostic indicators（P>0.05）．Conclusions Children with influenza A virus pneumonia are easily infected with other pathogens,which makes it more difficult to treat the disease．Therefore,we should be vigilant in clinic to prevent mixed infection and take effective diagnosis and treatment measures as soon as possible to improve the early cure rate of the disease．
目的 探讨乳腺癌术后疼痛综合征（PMPS）的发生率及影响因素。方法 选择2021年1月—2023年2月医院收治的82例乳腺癌患者为研究对象,采取手术治疗,统计PMPS发生率,分析PMPS的特征,比较PMPS患者和非PMPS患者的临床资料,采用 Logistic 逐步回归分析。结果 82例中有20例患者术后发生PMPS,发生率为24.39%,其中患侧腋窝45.00%、麻木样疼痛35.00%、中度疼痛60.00%、术后即刻疼痛50.00%、每日发作疼痛50.00%占比较高。PMPS患者和非PMPS患者的体质指数、教育程度、病理分期、肿瘤占位、手术方式、术前使用非甾体抗炎药、术前化学治疗、术后化学治疗比较差异均无统计学意义（P>0.05）。PMPS患者年龄低于非PMPS患者,负性情绪率30.00%高于非PMPS患者8.06%,清扫腋窝淋巴结率95.00%高于非PMPS患者72.58%,术后放射治疗率30.00%高于非PMPS患者6.45%（P<0.05）。年龄、负性情绪、清扫腋窝淋巴结、术后放射疗为PMPS发生的危险因素（P<0.05）。结论 乳腺癌术后较容易发生PMPS,主要表现为术后即刻腋窝疼痛、麻木,发作频率较高,疼痛较重,其中年龄小、术前焦虑、清扫腋窝淋巴结、术后放疗为引发PMPS的危险因素,需加强监测和针对性处理,研究价值较高。
Objective To investigate the incidence and influencing factors of post-mastectomy pain syndrome（PMPS）in breast cancer patients．Methods A total of 82 patients with breast cancer admitted to our hospital from January 2021 to February 2023 were selected as the research objects,and underwent surgical treatment．The incidence of PMPS was counted,the characteristics of PMPS were analyzed,and the clinical data of PMPS patients and non-PMPS patients were compared．Results Among the 82 patients,20 patients had PMPS after surgery,with an incidence of 24.39%．Among them,the affected axilla accounted for 45.00%,numbness pain 35.00%,moderate pain 60.00%,immediate postoperative pain 50.00%,and daily pain 50.00%．There were no significant differences in body mass index,education level,pathological stage of disease,tumor location,surgical method,preoperative use of non-steroid anti-inflammatory drugs,preoperative chemotherapy and postoperative chemotherapy between PMPS patients and non-PMPS patients（P>0.05）．The age of PMPS patients was significantly higher than that of non-PMPS patients,the rate of negative emotion was 30.00%,the rate of axillary lymph node dissection was 95.00%,and the rate of postoperative radiotherapy was 30.00%,which was significantly higher than that of non-PMPS patients（P<0.05）．Age,negative emotion,axillary lymph node dissection and postoperative radiotherapy were independent risk factors for PMPS（P<0.05）．Conclusions PMPS is prone to occur after breast cancer surgery,mainly characterized by immediate postoperative axillary pain and numbness,with a high frequency and severe pain．Young age,preoperative anxiety,axillary lymph node dissection,and postoperative radiotherapy are independent risk factors for PMPS,which need to be strengthened monitoring and targeted treatment．
目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义（P<0.05）;Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关（均P<0.05）;Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素（P<0.05）。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。
Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients．Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects．The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients．The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients．Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness．Results There was a statistically significant difference（P<0.05）in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits．Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality（all P<0.05）．Logistic regression analysis showed that the residential style score was an independent influencing factor（P<0.05）for the discharge readiness scale score．Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low．By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness．
目的 总结儿童嗜酸细胞性胃肠炎（EG）的临床表现、内镜检查和病理学特点、治疗和预后。方法 回顾性分析2019年1月—2022年12月滨州医学院附属医院儿科确诊的48例EG患儿临床资料,包括临床症状、实验室检查、影像学检查、内镜和病理学检查、治疗和随访情况。结果 48例患儿中,男26例（54.17%）,女22例（45.83%）,中位年龄7.8岁,20例（41.67%）患儿有过敏史或家族史,临床症状主要有腹痛（34例,70.83%）、腹泻（18例,37.5%）和腹胀（12例,25%）。外周血嗜酸性粒细胞（EOS）升高36例（75%）,血清总IgE升高14例（29.17%）。48例行胃镜检查,最常见的表现是黏膜充血水肿（32例,66.67%）、点状红斑（28例,58.33%）和糜烂（22例,45.83%）,28例行结肠镜检查,表现为黏膜充血水肿（18例,64.29%）、点状红斑（15例,53.57%）和结节样隆起（12例,42.86%）。黏膜组织病理表现为大量EOS浸润,主要累及十二指肠降部、胃窦和回肠末端。所有患儿均采用饮食干预的治疗,6例（12.5%）单纯饮食干预治疗后好转,16例（33.33%）孟鲁司特钠、酮替芬、奥美拉唑治疗后好转,26例（54.17%）联合泼尼松治疗后好转,随访10个月~3年,8例（16.67%）停药后复发,再次治疗后好转。结论 儿童EG临床症状和内镜表现多样化、缺乏特异性,内镜下黏膜组织病理检查有助于确诊。大多数患儿外周血EOS升高,饮食干预和糖皮质激素治疗效果显著,但存在复发的可能,需长期维持治疗和随访。
Objective To summarize the clinical manifestations,endoscopic and pathological features,treatment and prognosis of eosinophilic gastroenteritis（EG）in children．Methods A retrospective analysis was carried out on clinical data of 48 patients with EG diagnosed at the Department of Pediatrics of Binzhou Medical University Hospital from January 2019 to December 2022,including clinical symptoms,laboratory examination,imaging examination,endoscopic and pathological examination,treatment and follow-up．Results A total of 48 patients were included in the analysis,including 26 males（54.17%）and 22 females（45.83%）,with the median age of 7.8 years（7 months to 13 years）．Twenty patients（41.67%）had a history or family history of allergy．The most clinical symptoms were abdominal pain（34 cases,70.83%）,diarrhea（18 cases,37.5%）and abdominal distension（12 cases,25%）．Peripheral blood eosinophils（EOS）increased in 36 cases（75%）,and the serum total IgE increased in 14 cases（29.17%）．48 cases underwent gastroscopy,the most common manifestations were mucosal hyperemia and edema（32 cases,66.67%）,punctate erythema（28 cases,58.33%）and erosion（22 cases,45.83%）．Twenty-eight cases underwent colonoscopy,the manifestations were mucosal hyperemia and edema（18 cases,64.29%）,spotted erythema（15 cases,53.57%）and nodular eminence（12 cases,42.86%）．Mucosal histopathology showed a large number of EOS infiltration,mainly involving the descending duodenum,gastric antrum and terminal ileum．All children were treated with dietary intervention,6 cases（12.5%）were improved after simple diet intervention,16 cases（33.33%）were improved after treatment with montelukast,ketotifen,omeprazole,26 cases（54.17%）were improved after combined treatment with prednisone acetate．Followed up for 10 months to 3 years,8 cases（16.67%）relapsed after drug withdrawal and improved after retreatment．Conclusions The clinical symptoms and endoscopic manifestations of EG in children are diverse and lack of specificity,endoscopic mucosal histopathological examination is helpful for diagnosis．The EOS in peripheral blood of most children increased,diet intervention and glucocorticoid therapy are effective,but there is a possibility of recurrence,which need long-term maintenance treatment and follow-up．
目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组（n=43,予以常规护理）与观察组（n=42,实施常规护理基础上给予基于时机理论的护理干预）,通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表（NRS）、抑郁自评量表（SDS）、焦虑自评量表（SAS）评分分别为（2.13±0.57）（42.45±3.17）（42.45±3.17）分,低于对照组的（3.23±0.78）（52.34±4.45）（48.23±3.23）分（P<0.05）;观察组术后1个月简明健康状况调查表（SF-36）生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为（38.12±8.27）（42.22±9.12）（52.34±8.23）（64.11±8.92）（70.12±9.03）（34.46±6.18）（71.34±8.17）（75.24±8.46）分,高于对照组的（35.23±8.13）（38.56±9.23）（45.03±8.11）（60.57±8.23）（65.23±8.78）（30.14±6.13）（66.23±8.08）（72.12±8.35）分（P<0.05）。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。
Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia．Methods The research period was from July 2020 to June 2023．The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery．They were divided into a control group（n=43,receiving routine care）and an observation group（n=42,receiving timing based nursing intervention on the basis of routine care）through odd and even number drawing．A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire．Results The scores of NRS,SDS and SAS in the observation group at discharge were（2.13±0.57）,（42.45±3.17）and（42.45±3.17）respectively,which were significantly lower than those in the control group（3.23±0.78）, （52.34±4.45）and（48.23±3.23）．The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were（38.12±8.27）,（42.22±9.12）,（52.34±8.23）, （64.11±8.92）, （70.12±9.03）, （34.46±6.18）, （71.34±8.17） and（75.24±8.46）, which were significantly higher than those of the control group（35.23±8.13）, （38.56±9.23）, （45.03±8.11）, （60.57±8.23）, （65.23±8.78）, （30.14±6.13）, （66.23±8.08）and（72.12±8.35）（P<0.05）．Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life．
目的 评价早产儿经胃管喂养后采用空气冲管的应用效果。方法 选择2021年1月–2021年12月广州市第一人民医院收治的经胃管喂养后采用温水冲管的60例早产儿为对照组,选择2022年1月–2022年12月收治的经胃管喂养后采用空气冲管的57例早产儿为研究组。喂养1周后,比较两组患儿体质量增加量、血清白蛋白浓度增加量、大便量、喂养不耐受发生率、胃管堵塞率等指标的差异。结果 无患儿发生胃管堵塞。研究组的血清白蛋白浓度增加量[（2.86±5.61）g/L]高于对照组[（0.84±5.27）g/L]（P<0.05）,而两组患儿在体质量增加量、大便量、喂养不耐受发生率等方面比较差异无统计学意义（P>0.05）。多元线性回归分析结果显示空气冲管为血清白蛋白浓度增加量的影响因素（P<0.05）。结论 采用空气进行胃管冲管的方法可改善早产儿的营养状态。
Objective To evaluate the effects of flushing gastric tube by air after feeding in premature infants．Methods A total of 60 premature infants admitted to Guangzhou First People's Hospital from January 2021 to December 2021 whose gastric tube were flushed with water after feeding were selected as the control group,while 57 admitted from January 2022 to December 2022 whose gastric tube were flushed with air after feeding were selected as the study group．After 1 week of feeding,the differences of weight increase,serum albumin concentration increase,stool volume,feeding intolerance incidence and gastric tube blockage rate were compared between the 2 groups．Results No gastric tube blockage occurred．The increase of serum albumin concentration in the study group[（2.86±5.61）g/L] was significantly higher than that in the control group[（0.84±5.27）g/L]（P<0.05）,but there were no significant differences in weight increase,stool volume and feeding intolerance incidence between the 2 groups．Multiple linear regression analysis showed that the flushing gastric tube with air was an independent influencing factor for the increase of serum albumin（P<0.05）．Conclusions Flushing gastric tube with air can improve the nutritional status of premature infants,which is worthy of clinical application．
目的 探讨右美托咪定（Dex）分别联合丙泊酚或依托咪酯在颅内动脉瘤介入术中的镇静效果及对患者血流动力学的影响。方法 将60例颅内动脉瘤介入术患者按照随机数表法分为A组（Dex+丙泊酚,n=30）、B组（Dex+依托咪酯,n=30）。记录两组不同时间点的平均动脉压（MAP）、心率（HR）,比较苏醒期的镇静效果、呛咳程度、拔管时间、苏醒时间、清醒时间及术后不良反应。结果 A组患者T1MAP、HR为（84.56±5.13）mmHg、（65.87±5.14）次/分和T2（83.29±5.47）mmHg、（65.87±5.14）次/分均低于B组T1（87.89±3.88）mmHg、（70.22±5.67）次/分和T2（86.71±3.75）mmHg、（69.97±5.87）次/分（t分别为2.836、2.825、3.113、3.391,均P<0.001）。两组苏醒期各项指标和躁动（10.00% vs 0%,P=0.757）、呼吸抑制发生率（3.33% vs 0%,P=0.313）比较差异均无统计学意义（均P>0.05）,A组恶心、呕吐发生率（3.33%）较B组（20.00%）更低（χ2=4.043,P=0.044）。结论 Dex联合丙泊酚、依托咪酯麻醉在颅内动脉瘤介入术中均可发挥良好安全的麻醉作用,降低患者术后躁动和呼吸抑制的发生率,使用Dex联合依托咪酯在患者围插管期的血流动力学的稳定性效果更好,但在降低患者术后恶心呕吐的风险方面效果较差。
Objective To evaluate the sedative effect of dexmedetomidine（Dex）combined with propofol or etomidate during cerebral aneurysm intervention and its effect on patient hemodynamics．Methods A total of 60 cerebral aneurysm patients were randomly divided into two groups：Group A（Dex + propofol,n=30）and Group B（Dex + etomidate,n=30）．Mean arterial pressure（MAP）and heart rate（HR）were recorded at different time points in the two groups,and the sedation effect,choking degree,extubation time,waking up time,waking time and postoperative side effects were compared．Results T1 MAP,HR of（84.56±5.13）mmHg,（65.87±5.14）times / min and T2（83.29±5.47）mmHg,（65.87±5.14）times / min in group A were lower than those in group B T1（87.89±3.88）mmHg,（70.22±5.67）times / min and T2（86.71±3.75）mmHg,（69.97±5.87）times / min（t=2.836,2.825,3.113,3.391,all P<0.001）．There was no significant difference in the incidence of emergence agitation（10.00 % vs 0.00 %,P=0.757）and respiratory depression（3.33 % vs 0.00 %,P=0.313）between the two groups（P>0.05）．The incidence of nausea and vomiting in group A（3.33 %）was lower than that in group B（20.00 %）（χ2=4.043,P=0.044）．Conclusions Dex combined with propofol and etomidate anesthesia can have a good and safe anesthesia effect in intracranial aneurysm intervention,and reduce the incidence of postoperative agitation and respiratory depression in patients．Hemodynamic stabilization during the tube phase is more effective,but less effective in reducing the risk of postoperative nausea and vomiting in patients．
目的 探讨胆囊结石并发肝外胆管结石经腹腔镜胆囊切除术（LC）联合内窥镜逆行胰胆管造影术（ERCP）/内窥镜下括约肌切开术（EST）治疗的临床效果。方法 选取2020年1月—2023年6间就诊于南平市第一医院的86例胆囊结石合并肝外胆管结石患者,根据治疗方案不同分为对照组（n=40）和观察组（n=46）。对照组给予LC联合经腹腔镜胆总管切开取石术（LCBDE）治疗,观察组给予LC联合ERCP、EST在治疗,观察两组手术相关指标情况、血管紧张素水平、肝功能以及并发症发生情况。结果 观察组患者术中出血量少于对照组的（t=12.440,P<0.001）,观察组手术用时、肛门排气时间以及住院时间均短于对照组（均P<0.001）;观察组血管紧张素1-7（Ang1-7）、血管紧张素Ⅰ（AngⅠ）、血管紧张素Ⅱ（AngⅡ）水平低于对照组,组间比较差异均无统计学意义（均P>0.05）;观察组总胆红素（TBIL）、谷氨酸转氨酶（ALT）水平低于对照组水平,组间比较差异无统计学意义（均P>0.05）;观察组无患者发生胆漏、结石残留,对照组胆漏、结石残留发生率分别为5.00%、2.50 %,组间对比差异均无统计学意义（均P>0.05）,观察组出血、胆道感染生率分别为4.35 %、2.17 %低于对照组10.00%、5.00 %,组间对比差异均无统计学意义（均P>0.05。结论 LC联合ERCP/EST治疗胆囊结石合并肝外胆管结石可以减少术中出血,缩短手术用时和住院时间。
Objective This study aims to investigate the clinical efficacy of laparoscopic cholecystectomy（LC）combined with endoscopic retrograde cholangiopancreatography（ERCP）or endoscopic sphincterotomy（EST）in the treatment of gallbladder stones complicated by extrahepatic bile duct stones．Methods A total of 86 patients with gallbladder stones and extrahepatic bile duct stones treated at the First Hospital of Nanping from January 2020 to June 2023 were selected．According to different treatment regimens,they were divided into a control group（n=40）and an observation group（n=46）．The control group received LC combined with laparoscopic common bile duct exploration（LCBDE）,while the observation group received LC combined with ERCP and EST．Surgical-related indicators,angiotensin levels,liver function,and complications were observed in both groups．Results The observation group had less intraoperative bleeding than the control group（t=12.440,P<0.001）．The observation group had a shorter operation time,postoperative anal exhaust time,and hospital stay than the control group（all P<0.001）．The levels of angiotensin 1-7（Ang1-7）,angiotensin I（AngⅠ）,and angiotensin II（AngⅡ）in the observation group were lower than those in the control group,with no statistically significant differences between the groups（all P>0.05）．Total bilirubin（TBIL）and alanine aminotransferase（ALT）levels in the observation group were comparable to those in the control group（all P>0.05）．No patients in the observation group experienced bile leakage or residual stones,while the incidence rates in the control group were 5.00% and 2.50%,respectively,with no statistically significant differences between the groups（all P>0.05）．The observation group had lower rates of bleeding and biliary tract infection at 4.35% and 2.17%,respectively,compared to the control group at 10.00% and 5.00%,with no statistically significant differences between the groups（all P>0.05）．Conclusions LC combined with ERCP/EST in the treatment of gallbladder stones complicated by extrahepatic bile duct stones can reduce intraoperative bleeding,shorten operation time,and decrease hospital stay．
目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表（GDS）进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例（34.4%）,社会行为发育正常40例（32%）。早产儿语言发育商平均为（67.99±25.75）,社会行为发育商平均为（67.75±23.98）,处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义（P>0.05）。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义（P<0.05）;且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义（P<0.05）;但在社会行为发育方面比较差异无统计学意义（P>0.05）。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义（P<0.05）。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。
Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care．Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale（GDS）was used to assess their language-social behavior and intellectual development．Results Preterm infants had normal language development in 43 cases（34.4%）and normal social behavioral development in 40 cases（32%）．The mean language development quotient of preterm infants was（67.99±25.75）and the mean social behavioral development quotient was（67.75±23.98）,which was at the low developmental level．There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior（P>0.05）．Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior（P<0.05）;and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development．Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development（P<0.05）,but in social behavior there was no significant difference（P>0.05）．The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant（P<0.05）．Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period．It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis．
目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组（n=49）与对照组（n=49）。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮（NO）、内皮素（ET）、血管紧张素Ⅱ（AngⅡ）相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%（χ2=4.356,P=0.037）;治疗后两组AngⅡ、ET水平均降低,且观察组[（13.62±2.24）ng/mL、（68.62±6.66）ng/L]低于对照组[（16.25±4.32）ng/mL、（74.26±9.35）ng/L],对比差异有统计学意义（t1=3.783,t2=3.439,P<0.001）;NO水平升高,观察组[（54.26±3.42）μmol/L]高于对照组[（50.51±2.37）μmol/L],对比差异有统计学意义（t=6.309,P<0.001）;治疗后两组血肌酐（Scr）、尿素氮（BUN）、胱抑素C（CysC）水平均降低,且观察组[（404.36±92.12）μmoI/ L、（13.34±4.31）mmol / L、（2.19±0.24）mg / L]低于对照组[（443.49±80.19）μmoI / L、（15.07±4.23）mmol / L、（2.87±0.38）mg / L],对比有统计学意义（t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001）;两组不良反应发生率对比差异无统计学意义（10.20% vs 8.16%,P>0.05）。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。
Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment．Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023．Random number table method was used as the grouping method,and they were divided into an observation group（n=49）and a control group（n=49）．The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally．The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared．Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group（χ2=4.356,P=0.037）．Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[（13.62±2.24）ng/mL,（68.62±6.66）ng/L] was lower than the control group[（16.25±4.32）ng/mL,（74.26±9.35）ng/L],the difference was statistically significant（t1=3.783,t2=3.439,P<0.001）．Elevated NO levels in the observation group[（54.26±3.42）μmol/L] was higher than the control group[（50.51±2.37）μmol/L],the difference was statistically significant（t=6.309,P<0.001）．Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[（404.36±92.12）μmoI/L,（13.34±4.31）mmol/L,（2.19±0.24）mg/L] were lower than the control group[（443.49±80.19）μmoI/L,（15.07±4.23）mmol/L,（2.87±0.38）mg/L],the differences were statistically significant（t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001;P<0.05）．There was no difference in the incidence of adverse effects between the two groups（10.20% vs 8.16%,P>0.05）．Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety．
目的 分析血流感染（BSI）患者血小板参数的动态变化及其在患者预后中的价值。方法 回顾性分析南通市中西医结合医院检验科明确BSI的66例患者,分为生存组（55例）和死亡组（11例）。比较不同组间病原菌分布及1周内血小板参数动态变化情况,并通过Logistic回归分析评估血小板参数动态变化的在治疗预后评估中的价值。结果 （1）BSI患者病原菌分为革兰氏阳性菌（G+）25株、革兰氏阴性菌（G-）39株、真菌2株;G+病原菌中前三位为金黄色葡萄球菌（10.61%）、表皮葡萄球菌（7.58%）、头状葡萄球菌（4.55%）;G-病原菌中前三位为大肠埃希菌（24.24%）、肺炎克雷伯菌肺炎亚种（15.15%）、肠炎沙门菌血清型（3.03%）;真菌为新生隐球酵母（1.52%）、光滑假丝酵母（1.52%）。（2）生存组序贯性器官功能衰竭评分（SOFA）评分为（3.24±0.53）分,低于死亡组的（6.02±1.17）分（t=12.535,P<0.001）;生存组BSI病程为（20.50±2.17）d,低于死亡组的（25.71±4.81）d（t=3.352,P<0.001）;生存组肺部原发感染灶30.91%,高于死亡组的63.64%（χ2=4.243,P=0.039）;生存组最大平均血小板体积（MPV）为（10.96±1.58）fL,低于死亡组的（11.99±1.42）fL（t=2.004,P=0.049）;生存组入院血小板计数（PLT）为（144.33±23.18）109/L,低于死亡组的（166.91±20.29）109/L（t=3.005,P=0.004）;生存组最低PLT为（113.48±30.76）109/L,高于死亡组的（80.16±38.24）109/L（t=3.148,P=0.002）。（3）两组入院及BSI时、BSI后4 d内的指标比较差异均无统计学意义（P>0.05）,在BSI后的5~7 d,生存组PLT为（210.83±102.37）109/L,高于死亡组的（112.75±116.84）109/L（t=2.835,P=0.006）;生存组MPV为（10.12±1.58）fL,低于死亡组的（11.27±1.85）fL（t=2.142,P=0.036）;生存组MPV/PLT 比值（MPR）为（5.69±2.89）,低于死亡组的（11.64±8.23）（t=4.290,P<0.001）。（4）多因素Logistic回归分析发现,入院SOFA（OR=5.461,95%CI：1.544~19.319,P=0.008）、BSI病程（OR=0.773,95%CI：0.622~0.960,P=0.020）、5~7 d MPR（OR=18.976,95%CI：1.776~202.709,P=0.015）是BSI的预测因素。结论 BSI患者血小板参数动态变化较为明显,而入院SOFA、BSI病程、5~7 d MPR对于预测患者死亡风险有重要意义。
目的 接触苯及苯系化合物作业人员血常规检查结果的分析。方法 收集2022年1月—2022年12月726名接触苯系物作业人员健康监护资料,均行血常规检测,并对其进行分析。结果 男性苯及苯系物接触作业人员的红细胞计数（RBC）（t=16.253）、血红蛋白（Hb）（t=25.345）、淋巴细胞绝对值（t=4.420）高于女性,血小板计数（PLT）（t=-5.523）低于女性,差异有统计学意义（P<0.001）;30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的Hb比较差异有统计学意义（F=6.581,P=0.001）,<30岁和≥50岁作业人员、30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的PLT比较差异有统计学意义（F=7.082,P=0.001）。结论 苯及苯系化合物的接触对劳动者血常规的结果有一定的影响,其中女性、高龄更为明显,应加强相应的职业健康防护措施,应改善作业环境,完善防护设备,防止职业疾病的发生。
Objective Analysis of blood routine test results for workers exposed to benzene and its derivatives．Methods Collect health monitoring data from 726 workers exposed to benzene derivatives from January 2022 to December 2022,all of whom underwent blood routine tests and were analyzed．Results The absolute values of RBC（t=16.253）,Hb（t=25.345）,and lymphocytes（t=4.420）in male workers exposed to benzene and its derivatives were higher than those in females,while PLT（t=-5.523）was lower than that in females,with statistical significance（P<0.001）;There was a significant difference in Hb between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50（F=6.581,P=0.006,P<0.001）．There was a significant difference in PLT between workers aged 30-39 and≥50,between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50（F=7.082,P=0.005,P=0.001,P<0.001）．Conclusions The exposure to benzene and its derivatives has a certain impact on the blood routine results of workers,with females and elderly being more prominent．Corresponding occupational health protection measures should be strengthened,the working environment should be improved,protective equipment should be perfected,and occupational diseases should be prevented．
目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表（FaMM）评分均升高,且观察组高于对照组（P<0.05）;观察组患儿哮喘控制率高于对照组（P<0.05）;护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表（PAQLQ）评分均升高,且观察组高于对照组（P<0.05）。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。
Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma．Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected．They were randomly divided into observation group and control group,with 50 cases in each group．The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care．After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared．Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group（P<0.05）．The asthma control rate of the children in the observation group was higher than that in the control group（P<0.05）;after nursing,the PAQLQ score increased,and the observation group was higher than the control group（P<0.05）．Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion．
目的 针对精神分裂症患者接受喹硫平与帕利哌酮联合治疗对其代谢功能及血清因子的影响。方法 纳入2022年1月—2023年3月驻马店市第二人民医院收治的120例精神分裂症患者,根据住院号进行编号,并通过通过随机抽签方法分为两组,对照组60例应用单一喹硫平治疗,观察组60例应用喹硫平与帕利哌酮联合治疗,对比两组的治疗效果。结果 经治疗,观察组临床总疗效高于对照组（P<0.05）;该组各项代谢功能指标均与对照组比较差异无统计学意义（P>0.05）;该组各项血清因子测定该结果均高于对照组（P<0.05）;该组各项精神症状评分均低于对照组（P<0.05）;该组不良反应发生率与对照组比较差异无统计学意义（P>0.05）。结论 采用喹硫平与帕利哌酮联合的方式治疗精神分裂症患者,可以提升临床疗效,对患者各种精神症状及血清因子改善效果更好,虽然药物会对患者代谢功能产生一定的影响,但是联合用药与单独用药的影响情况无差异,未增加不良反应发生率,安全性良好。
Objective To evaluate the combination of quetiapine and paliperidone on metabolic function and serum factors in schizophrenia．Methods A total of 120 patients with schizophrenia admitted to Zhumadian Second People's Hospital from January 2022 to March 2023 were included,numbered according to the hospitalization number,and divided into two groups by random drawing method．Sixty patients in the control group were treated with quetiapine alone,and 60 patients in the observation group were treated with quetiapine combined with paliperidone,and the therapeutic effects of the two groups were compared．Results After treatment,the total clinical efficacy of the observation group was higher than that of the control group,P<0.05;the metabolic function indexes comparison were P> 0.05;the serum factor of observation group was higher,P<0.05;the scores of psychiatric symptoms in the group were all lower than the control group,P<0.05;the incidence of adverse reactions in the observation improve group was not different from the control group,P>0.05．Conclusions Using quetiapine and schizophrenia,can improve clinical curative effect,various mental symptoms and serum factors,although certain effect on patient metabolic function may occur,but did not significantly increase the incidence of adverse reactions,with high safety．
目的 以临床二级学院附属医院的管理为例,对当下医科类高校研究生校院二级管理存在问题进行探讨。方法 对某医科高校附属医院474名临床医学研究生及9名辅导员进行调查。结果 55.56%的研究生表示导师的约束力最大,但42.56%的学生与导师是不定期沟通;39.83%的学生不认可在培养方式上严格区分培养,其中学术型硕士二年级学生中44.3%认为有一定区别,但区别不大;学院配备的学生工作管理专职人员不足、学院层级的管理制度和机制不健全和二级学院权责不清运行机制不顺畅。结论 明确医科类高校与二级附属医院之间的关系、提高治理效能激活医科类高校二级附属医院人才培养的自主性和内生动力、医科类高校二级附属医院研究生施行差异化培养和整合资源,共同提升医科高校与附属医学院的整体水平。
Objective To discuss the existing problems of secondary management in medical colleges and universities,taking the management of secondary college of affiliated hospital as an example．Methods Through the investigation of 474 clinical medical graduate students and 9 counselors in the affiliated hospital of a medical university．Results There was 55.56% of the graduate students said that the supervisor was the most binding force,but 42.56% of the students communicated with the supervisor irregularly;39.83% of the students do not recognize the strict differentiation of training methods,44.3% of the students in the second year of study believed that there was a certain difference,but the difference was not big．The college was equipped with insufficient full-time staff for student work management,the management system and mechanism at the college level were not perfect,and the power and responsibility of the second-level college were not clear and the operation mechanism is not smooth．Conclusions Clarify the relationship between medical colleges and secondary affiliated hospitals,improve governance efficiency and activate the autonomy and endogenous motivation of talent training in secondary affiliated hospitals of medical colleges and universities,implement differentiated training the graduates of secondary affiliated hospitals of medical colleges and universities,integrate resources,so as to jointly improve the overall level of medical colleges and universities and affiliated medical schools．
伴随着对医疗领域人才水平要求的逐步提高,医院人力资源管理尤其是医院人才引进工作正在由规模化发展向精细化发展转变。当前医院人才引进过程中存在缺乏人力资源发展规划、高层次人才引进方法有待完善、人才管理能力亟须提高、科室用人需求脱离实际、忽视对于岗位胜任力的分析等问题。人力资源成熟度模型（People Capability Maturity Model,P-CMM）作为一种系统的管理理论,其具备很强的实践性,文章对人力资源成熟度模型在医院人才引进工作中的本土化应用进行相关讨论与研究,将P-CMM不同成熟度等级、过程域目标与医院人才引进工作相结合,并提出可操作性指导,具有一定的理论与实践价值。
With the gradual improvement of the requirements for talents in the medical field,hospital human resource management,especially the introduction of talents in hospitals,is changing from large-scale development to refined development．At present,there are some problems in the process of hospital talent introduction,such as lack of human resource development plan,improvement of high-level talent introduction method,improvement of talent management ability,separation of department employment demand from reality,neglect of post competency analysis,etc．People Capability Maturity Model（P-CMM）,as a systematic management idea,has strong practicality．This study discusses and studies the localization application of human resource maturity model in hospital talent introduction,combines different maturity levels and process area objectives of P-CMM with hospital talent introduction,and puts forward operational guidance It has certain theoretical and practical value．
在“放管服”改革的背景下,基于业财融合管理理念对医院科研物资进行一体化管理是发展趋势。但由于科研项目管理涉及众多部门,流程繁杂,致使医院科研物资管理面临诸多问题。为了改变现状,广州市某三甲医院探索构建基于业财融合的医院科研物资一体化信息系统,分别上线了科研物资采购平台和经费管理系统,并在实践中对信息系统进行了优化与设计。实践证明,该系统具有创新性和应用价值,对医院的财务管理和科研项目管理具有重要的参考意义。
Under the background of streamlining administration and delegating power,the integrated management of hospital scientific research materials based on the concept of integrating industry and finance is a development trend．However,due to the involvement of multiple departments and complicated processes in scientific research project management,the management of hospital scientific research materials faces many problems．In order to change the current situation,a Tertiary Grade A Hospital in Guangzhou explored the construction of an integrated information system for hospital scientific research materials based on the integration of industry and finance．They launched a scientific research material procurement platform and a funding management system,and optimized and designed the information system in practice．Practice has proven that the system is innovative and valuable,and it has important reference significance for the financial management and scientific research project management of hospitals．
