目的 分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法 选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组（n=50）及参照组（n=50）。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果 治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义（P>0.05）,治疗后两组患儿的降钙素原（procalcitonin,PCT）、C-反应蛋白（C-reactive protein,CRP）、白细胞计数（white blood cell count,WBC）、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善（P<0.05）,其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率（94.00%）与参照组的临床有效率（86.00%）比较差异无统计学意义（P>0.05）;两组患儿的不良反应发生率比较差异无统计学意义（P>0.05）,但其中研究组腹泻的发生率高于参照组（P<0.05）。结论 在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药（头孢他啶）的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。

Objective To analyze the application effect of amoxicillin clavulanate potassium combined with third-generation cephalosporin antibiotics in children with neonatal pneumonia and its impact on the intestinal microbiota．Methods From February 2021 to November 2022,100 newborns with pneumonia who received relevant treatment in the Department of Neonatology at the First People’s Hospital of Shangqiu City were randomly divided into a study group（n=50）and a reference group（n=50）using a simple randomization method．Routine treatment was provided for neonatal pneumonia in the reference group,and on this basis,a combination treatment of amoxicillin,clavulanate potassium,and third-generation cephalosporin antibiotics was applied on the study group patients．After treatment,the serum factor levels,intestinal colony status,clinical efficacy,and incidence of adverse reactions were compared between the two groups of children．Results Before treatment,there were no statistically significant differences in serum factor levels and intestinal microbiota between the two groups of children（P>0.05）．After treatment,the levels of procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell count（WBC）,Enterococcus,Enterobacter,Bifidobacterium,and Lactobacillus in the two groups of children improved（P<0.05）,with the levels of PCT,CRP,WBC,the number of Enterococcus,Bifidobacterium,and Lactobacillus in the study group was lower than that in the reference group,while the number of Enterobacter in the study group was higher．There was no statistically significant difference（P>0.05）in the clinical response rate between the study group（94.00%）and the reference group（86.00%）．There was no statistically significant difference in the incidence of adverse reactions between the two groups of children（P>0.05）,but the incidence of diarrhea in the study group was higher than that in the reference group（P<0.05）．Conclusions The clinical efficacy of amoxicillin clavulanate potassium alone and amoxicillin clavulanate potassium+third-generation cephalosporin antibiotics（ceftazidime）in the treatment of newborns with pneumonia is comparable．Although the combination therapy can significantly reduce the number of bacteria in the body of children and improve serum factor levels,it is more prone to complications of diarrhea．In order to reduce drug resistance,separate medication should be appropriately used．

目的 探讨近端和远端结直肠无蒂锯齿状病变在临床和内镜特征上的区别。方法 回顾性分析103例结直肠无蒂锯齿状病变患者的临床内镜资料,对近端和远端结直肠无蒂锯齿状病变患者在性别、年龄、内镜特征（息肉大小、山田分型、内镜NICE分型、蛇形微血管、黏液帽）等方面进行比较。结果 与远端结直肠无蒂锯齿状病变相比,近端结肠无蒂锯齿状病变发病年龄更早（P=0.014）,内镜下山田1型息肉更为常见（P=0.050）,黏液帽也是近端结肠无蒂锯齿状病变的重要内镜特征（P<0.001）。结论 近端无蒂锯齿状病变内镜下扁平隐匿,容易漏诊,掌握其内镜特征有助于提高该病的检出率。

Objective To explore the differences in clinical and endoscopic characteristics of sessile serrated lesions in the proximal and distal colorectum．Methods The clinical endoscopic data of 103 patients with sessile serrated lesions of the colorectum were retrospectively analyzed．The gender,age and endoscopic features（polyp size,Yamada classification,NICE classification,dilate vessels and the mucus cap）of patients with proximal and distal colorectal sessile serrated lesions were compared retrospectively．Results Compared with distal colorectal sessile serrated lesions,the age of onset of proximal colon sessile serrated lesions was earlier（P=0.014）,endoscopic Yamada type 1 polyps were more common（P=0.050）,and mucus cap was also an important endoscopic feature of proximal colon sessile serrated lesions（P<0.001）．Conclusions The proximal sessile serrated lesions are flat and hidden under endoscopic examination which are easily missed．Understanding their endoscopic characteristics can help improve the detection rate of the disease．

目的 探讨与分析回旋支急性闭塞的心电图表现及相关临床表现和病变血管特点。方法 选择2018年1月—2023年6月在鹤壁市人民医院诊治的回旋支闭塞引起急性心肌梗死46例,检测与调查患者的心电图表现、相关临床表现、病变血管特点,随访患者的预后情况。结果 在46例患者中,冠状动脉造影检查判断为近中段闭塞23例（近中段组）,远段闭塞23例（远段组）。近中段组与远段组一般资料比较差异无统计学意义（P>0.05）。近中段组的心电图特征中的ST V1~ V3压低、ST Ⅱ、Ⅲ、aVF抬高、ST Ⅱ、Ⅲ、aVF压低、TV2>TV5、ST Ⅰ~aVL压低、ST Ⅰ~aVL 抬高、ST V7~V9抬高等占比分别为60.87%、47.83%、8.70%、43.48%、69.57%、17.39%、60.87%,远段组的占比分别为4.35%、82.61%、0%、17.39%、30.43%、8.70%、60.87%;近中段组与远段组心电图表现有相似处及各自特征。所有患者随访至2023年8月1日,近中段组与远段组的平均随访时间为（32.69±4.20）个月与（32.92±3.28）个月,近中段组与远段组心血管不良事件发生率比较差异无统计学意义（P>0.05）。受试者操作特征（ROC）曲线分析显示心电图对近中段回旋支急性闭塞患者的预测曲线下面积为0.793（95%CI：0.678~0.914,P=0.000）,灵敏度为78.22%,特异度为81.91%。结论 心电图在急性梗死患者的应用能辅助判定梗死相关动脉回旋支状况,可辅助判断患者的梗死部位,对患者的预后评估也具有重要价值。

Objective To explore and analysis the electrocardiogram manifestations,related clinical manifestations and pathological vascular characteristics of acute occlusion of the circumflex branch. Methods A total of 46 cases of acute myocardial infarction caused by circumflex branch occlusion diagnosed and treated in Hebi People's Hospital from January 2018 to June 2023 were selected as the study subjects,and the electrocardiographic manifestations,related clinical manifestations and characteristics of diseased blood vessels of the patients were detected and investigated,and the prognosis of the patients was followed up. Results Among the 46 patients,23 cases were diagnosed with proximal mid-segment occlusion（proximal mid-segment group）and 23 cases were diagnosed with distal segment occlusion（distal segment group）by coronary angiography．There was no significant difference in the comparison of the general data of the two groups（P>0.05）．The ECG features of ST V1- V3 depression,ST Ⅱ,Ⅲ,aVF elevation,ST Ⅱ,Ⅲ,aVF depression,TV2>TV5,ST I-aVL depression,ST I-aVL elevation and ST V7-V9 elevation in the proximal mid-segment group were 60.87%,47.83%,8.70%,43.48%,and 69.57%,17.39%,60.87%,and 4.35%,82.61%,0%,17.39%,30.43%,8.70%,60.87% in the distal segment group;there were similarities in the electrocardiographic manifestations of the proximal mid-segment group and the distal segment group as well as their respective characteristics．All patients were followed up until August 1,2023,and the mean follow-up time of the proximal mid- and distal segment groups was 32.69±4.20 months versus 32.92±3.28 months,and the incidence of adverse cardiovascular events was 26.09% in the proximal mid-group．There was no difference in the incidence of cardiovascular adverse events between the two groups（P>0.05）．ROC curve analysis showed that the area under the prediction curve of electrocardiogram for patients with acute occlusion of the proximal circumflex artery were 0.793（95% CI：0.678-0.914,P<0.001）,sensitivity was 78.22% and specificity was 81.91%．Conclusions Electrocardiogram has important predictive value in diagnosing acute myocardial infarction in which the infarct related artery is a circumflex branch．It can auxiliary determine the infarct site of patients and also auxiliary evaluate the prognosis of acute myocardial infarction patients．

目的 通过公共数据库筛选急性肺损伤（ALI）及急性呼吸窘迫综合征（ARDS）相关分子标志物,并探索其临床意义。方法 利用基因表达综合数据库（GEO）中有关ALI/ARDS基因表达芯片研究的两个数据集GSE76293和GSE10474,通过STRING网站和Cytoscape软件对差异基因进行蛋白互作网络分析并筛选ALI/ARDS相关关键基因。采用A549细胞构建ALI模型,并通过转录组测序验证关键基因在细胞中的表达差异情况。结果 2个GEO数据集中共筛选出共同上调基因27个,共同下调基因26个。主要参与抗原加工和外源抗原递呈、免疫受体活性调节、内质网膜构成等生物学功能,且与抗原加工、细胞分化等信号通路有关。蛋白互作网络分析共筛选出10个ALI/ARDS相关关键基因,分别为CD4、HLA-DQB1、CD74、HLA-DRA、FCGR2B、TOR1A、RELA、NME8、RNF19B、RHOB。细胞转录组测序结果显示,关键基因的上调或下调特征及表达差异情况与GEO数据集分析结果一致。结论 CD4等关键基因可能参与ALI/ARDS发生、发展的生物学过程,是ALI/ARDS临床诊断及预后预测的潜在个体化分子标志物。

Objective To identify molecular biomarkers associated with acute lung injury（ALI）/ acute respiratory distress syndrome（ARDS）and to explore their clinical significance with public databases. Methods Two datasets GSE76293 and GSE10474 in Gene Expression Omnibus（GEO）database for ALI/ARDS gene expression chip study were used to screen genes with significant differences in both datasets．The protein-protein interaction（PPI）analysis of co-expression genes was performed based on the STRING website and Cytoscape software,and then key genes related to ALI/ARDS were identified with cytoHubba method．The ALI model was constructed using A549 cells cultured in vitro,and the expression differences of key genes in the cells were verified by RNA sequencing. Results A total of 27 up-regulated genes and 26 down-regulated genes were screened in both the two GEO datasets with Venn Diagramm．These co-expression genes were mainly involved in biological functions such as antigen processing and presentation of exogenous peptide antigen,immune receptor activity,integral component of lumenal side of endoplasmic reticulum membrane and were related to signal pathways such as antigen processing and cell differentiation．A total of 10 key genes（CD4,HLA-DQB1,CD74,HLA-DRA,FCGR2B,TOR1A,RELA,NME8,RNF19B,RHOB）related to ALI/ARDS were identified． The results of cell RNA sequencing showed that the up-regulated or down-regulated characteristics and expression differences of key genes were consistent with the results of GEO datasets. Conclusions Several key genes identified in this study may be involved in the biological process of ALI/ARDS development,and may be potential individualized molecular markers for clinical diagnosis and prognosis prediction of ALI/ARDS．

目的 探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症（PSA）的治疗效果。方法 收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验（WAB）、汉语失语检查量表（ABC）、副反应量表（TESS）于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果 经2周治疗后,试验组各组WAB中的失语指数（AQ）、操作指数（PQ）、大脑皮质指数（CQ）评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义（P<0.05）;试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义（P<0.05）;治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义（P<0.05）。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学（P<0.05）。试验各组在2周及12周时,TESS评分比较差异无统计学意义（P<0.05）。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论 解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。

Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke．Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group．The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment．The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks．The Western Aphasia Battery（WAB）,Aphasia Battery of Chinese（ABC）and Treatment Emergent Symptom Scale（TESS）were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia．Results After 2 weeks of treatment,the aphasia quotient（AQ）,performance quotient（PQ）,cortical quotient（CQ）scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences（P<0.05）．Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference（P<0.05）．After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively．Compared with 2 weeks of treatment,the difference was statistically significant（P<0.05）．The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc．,with statistical significance（P<0.05）．At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups（P<0.05）．Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks．Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke．The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke．

目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组（C组）40例和丙泊酚组（P组）40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前（T₀）、睫毛反射消失时（T₁）、置入胃镜后即刻（T₂）和操作结束时（T₃）的心率（HR）和平均动脉压（MAP）;记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义（P>0.05）。与T₀时间点（102.6±14.1 mmHg）比较,P组患者的MAP在T₁（86.0±12.5 mmHg）、T₂（86.1±13.2 mmHg）、T₃（92.8±12.6 mmHg）时间点明显下降,差异有统计学意义（P<0.05）;与C组T₁（95.9±10.8 mmHg）、T₂（96.3±9.6 mmHg）时间点比较,P组的MAP在T₁（86.0±12.5 mmHg）、T₂（86.1±13.2 mmHg）时均明显降低（P<0.05）。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组（P<0.05）;2组体动和呛咳的发生率比较差异无统计学意义（P>0.05）。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。

Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients．Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol（Group C）and a group of 40 patients receiving propofol（Group P）．All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds．The heart rate（HR）and mean arterial pressure（MAP）of two groups of patients before anesthesia（T₀）,at the disappearance of eyelash reflex（T₁）,after gastroscopy insertion（T₂）,and at the end of the procedure（T₃）were recorded．The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded．Results There were no significant differences（P>0.05）in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups．Compared with T₀ time point（102.6±14.1 mmHg）,the MAP of group P patients significantly decreased at T₁（86.0±12.5 mmHg）,T₂（86.1±13.2 mmHg）and T₃（92.8±12.6 mmHg）time points（P<0.05）．Compared with Group C at T₁（95.9±10.8 mmHg）,T₂（96.3±9.6 mmHg）time points,the MAP of Group P decreased significantly at T₁（86.0±12.5 mmHg）and T₂（86.1±13.2 mmHg）time points（P<0.05）．The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P（P<0.05）．There was no statistically significant difference in the incidences of body movements and cough between the two groups（P>0.05）．Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients．The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower．

目的 探讨妊娠期高血压疾病患者血尿酸、淀粉酶水平的变化的临床意义。方法 选择2020年2月—2023年2月期间焦作市第二人民医院收治的150例合并妊娠期高血压疾病孕妇作为观察组,另选择同期接收的50例正常妊娠孕妇作为对照组,测定两组孕妇孕早期、孕中期、孕晚期的血尿酸、淀粉酶水平,比较两组检测结果,并采取受试者工作特征曲线分析（ROC）血尿酸、淀粉酶水平筛查妊娠期高血压疾病的诊断效能,比较观察组妊娠期高血压、子痫前期、子痫孕妇的检测结果。结果 观察组孕妇在孕早期、孕中期、孕晚期的血尿酸水平高于对照组,淀粉酶水平低于对照组（P<0.05）;孕早期与孕中期的血尿酸、淀粉酶水平比较,两组孕妇比较差异均无统计学意义（P>0.05）;孕晚期两组孕妇的血尿酸水平升高,淀粉酶水平降低,与孕早期、孕中期比较差异有统计学意义（P<0.05）。ROC曲线分析显示,妊娠期高血压疾病的筛查中血尿酸灵敏度为58.15%、特异度为88.72%,淀粉酶灵敏度为56.47%、特异度为92.24%,血尿酸联合淀粉酶灵敏度为82.24%、特异度为98.57%。子痫、重度子痫前期、轻度子痫前期、妊娠期高血压孕妇的血尿酸、淀粉酶水平比较差异均有统计学意义（P<0.05）。结论 与正常妊娠孕妇相比,合并妊娠期高血压疾病孕妇的血尿酸水平升高、淀粉酶水平降低,二者联合可实现对妊娠期高血压疾病的准确筛查,而且可评估病情进展。

目的 探讨茵栀黄口服液、还原型谷胱甘肽联合光疗对新生儿黄疸的临床疗效。方法 以2020年2月—2023年3月河南省驻马店市中医院收治的100例黄疸患儿为研究对象。按照随机数字表法分为A组和B组,每组各50例。A组和B组患儿均接受蓝光治疗,B组予以还原型谷胱甘肽治疗,A组在B组的基础上联合茵栀黄口服液。观察A组和B组患儿临床疗效、黄疸消退时间、胆红素水平、T淋巴细胞亚群以及不良反应发生情况。结果 A组总有效率高于B组（96.00% vs 82.00%）（P<0.05）;治疗7 d后,A组和B组患儿组总胆红素、间接胆红素、直接胆红素水平均低于治疗前,且A组低于B组（P<0.05）;A组和B组患儿组CD3⁺、CD4⁺、CD4⁺/CD8⁺均高于治疗前且A组高于B组,A组和B组CD8⁺低于治疗前且A组低于B组（P<0.05）;A组皮疹、腹泻等不良反应的总发生率和B组组间对比差异无统计学意义（10.00% vs 6.00%,P>0.05）。结论 茵栀黄口服液联合还原型谷胱甘肽和光疗用于新生儿黄疸的治疗中可加快总胆红素水平的降低,改善T淋巴细胞亚群,进而提高临床疗效且不增加不良反应。

目的 检验婴儿孤独症观察量表中文版（AOSI）临床应用的灵敏度与特异度,评价其临床应用效果。方法 随机抽取1岁时曾在清远市妇幼保健院行AOSI评估,于2~3岁时诊断为孤独症谱系障碍（ASD）的48例患儿为ASD组,诊断为正常发展的46例幼儿作为对照组。比较两组患儿的18个条目得分和总分,采用受试者操作特征（ROC）曲线计算AOSI的特异度、灵敏度、阳性预测值与阴性预测值,并判断AOSI的最佳诊断（阳性）分界值;分析AOSI评估结果与《精神障碍诊断与统计手册（第5版）》（DSM-5）中ASD诊断标准的一致性。结果 两组研究对象性别、年龄比较差异无统计学意义（P>0.05）。ASD组各条目得分和总分均高于对照组,且差异具有统计学意义（P<0.01）。AOSI的曲线下面积（AUC）为1.00（P<0.01）,95%置信区间为（1.00,1.00）。不同阳性分界线的灵敏度、特异度、阳性预测值、阴性预测值及一致性相比较,当约登指数等于1.00时AOSI的最佳诊断（阳性截断值）界线为9分时,其上述值均为1.00。AOSI评估结果与DSM-5中ASD的诊断标准完全相一致（Kappa=1,P<0.01）。结论 AOSI应用于评估1岁的婴儿,当取9分为诊断界值时,具有高度的灵敏度与特异度,能较好地预测该婴儿在2~3岁时是否患ASD;AOSI是婴儿期ASD筛查的重要工具,其评估结果可作为ASD高危儿早期干预的证据和ASD的辅助诊断工具,适合于临床推广应用。

Objective To test the sensitivity and specificity of the Chinese version of the Autism Observation Scale for Infants（AOSI）in clinical application and evaluate its clinical application effect．Methods Forty-eight children with autism spectrum disorder（ASD）diagnosed at the age of 2 to 3 years who had undergone AOSI evaluation in Qingyuan Maternal and Child Health Hospital at the age of 1 year（2021）were randomly selected as the ASD group,and 46 children with normal development were randomly selected as the control group．The scores of 18 items and total scores of the two groups of subjects were compared．The specificity,sensitivity,positive predictive value and negative predictive value of AOSI were calculated using the receiver operating characteristic curve（ROC）,and the best diagnostic（positive）cut-off value of AOSI was confirmed．The consistency of AOSI evaluation results with the ASD diagnostic criteria in DSM-5 were compared．Results There was no statistically significant difference in genders or age between two groups（P>0.05）．The scores of each item and total scores in the ASD group were significantly higher than those in the control group,and the difference was statistically significant（P<0.01）．The area under the curve of AOSI（AUC=1.00,P<0.01）had a 95% confidence interval of（1.00,1.00）．Comparing the sensitivity,specificity,positive predictive value,negative predictive value and consistency of different positive boundary points,when the Youden index was equal to 1.00,the optimal diagnostic（positive cut-off value）boundary for AOSI was 9 points,and all of the above values were 1.00． The AOSI evaluation results were completely consistent with the diagnostic criteria for ASD in DSM-5（Kappa=1,P<0.01）．Conclusions AOSI has high sensitivity and specificity when it is used to evaluate the 1-year-old infant．When “9 points” is taken as the diagnostic threshold,it can better predict whether the infant has ASD at the age of 2~3 years．AOSI is an important tool for screening ASD in infancy．Its evaluation results can be used as evidence for early intervention of high-risk infants with ASD and as a assisting tool to diagnosis ASD,which is suitable for clinical application．

脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。

Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients．Warm needling is a characteristic therapy of traditional Chinese medicine．In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice．This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application．