目的 分析音乐治疗焦虑领域研究热点的演变与趋势。方法 利用文献计量学方法对近20年（2003——2023）发表音乐治疗焦虑方面的研究与文献进行了可视化分析：对中国知网（CNKI）及Web of Science（WOS）文献库中收录的文献进行关键词（中文关键词：音乐治疗、焦虑;英文关键词：Music therapy、Anxiety）检索,利用CiteSpace 6.3 R2软件绘制知识图谱进行可视化分析。结果 通过文献的检索与筛选最终纳入中文文献506篇及英文文献1 782篇,其中国内外主要发文者为刘月芳、刘春艳、Bradt、Cold、Silverman等研究者团队,国内外主要研究机构均为高校,但国内高校相对于国外相关研究开展较为独立且合作联系较少;发文国家主要为美国、中国以及土耳其,西方国家之间的合作联系较为密切,我国开展相关跨地域研究主要是与亚洲国家进行多中心合作。国内研究热点为“音乐疗法”“心理干预”“五行音乐”等,国外研究热点为“Pain”“Depression”“Quality of life”等。结论 本文通过CiteSpace软件进行文献计量学分析发现,音乐治疗与焦虑结合是国内外研究的热点,国内研究聚焦于焦虑,而国外研究更关注音乐治疗在广泛心理问题中的应用。尽管该研究领域发展迅速,但国内外合作交流较少,国际研究团队间合作不够紧密。未来研究需进一步探索音乐治疗的机制和最佳实践方法,加强跨学科合作,利用科技创新,结合中国文化特色,以期实现音乐治疗在焦虑治疗中的更广泛应用,并提升患者的生活质量。同时,未来相关研究方法需多样化,以全面掌握研究趋势,为音乐治疗焦虑提供更有力的证据支持。

Objective To explore the evolution and trends of research hotspots in the field of music therapy for anxiety and provide reference and basis for related research．Methods Bibliometric analysis method was used to visualize and analyze the research and literature on music therapy for anxiety in the past 20 years（2003-2023）．Keyword searches were conducted in Chinese National Knowledge Infrastructure（CNKI）and Web of Science（WOS）databases,and a knowledge map was drawn using CiteSpace 6.3 R2 software for visualization analysis．Results Through the literature search and screening,506 Chinese and 1782 English literatures were included,and the main authors at home and abroad were researcher teams such as Liu Yuefang,Liu Chunyan,Bradt,Cold and Silverman．The main research institutions at home and abroad were universities,but domestic universities were more independent and had fewer collaborative relationships than foreign ones．The main publishing countries were the United States,China and Turkey,and there was closer cooperation between western countries．Multicenter cooperation with Asian countries was the main form of cross-region research in China．The research hotspots at home were “music therapy”,“psychological intervention”,“five elements music”,while the foreign research hotspots were “pain”,“depression”,and “quality of life”．Conclusions The combination of “music therapy” and “anxiety” is the main research hotspot at home and abroad in recent years．Among them,foreign scholars mainly use anxiety and other psychological problems as research topics to explore the application of music therapy to these issues,while domestic scholars focus on the research of anxiety and propose many music therapy programs for anxiety．In addition,there is relatively little cooperation and communication between domestic and foreign research sectors,and the degree of coincidence among international research teams is not high．Therefore,research teams at home and abroad should strengthen cooperation and communication．Based on the analysis of research hotspots in music therapy for anxiety in the past 20 years,this field has received considerable attention and has developed rapidly,but there are still many aspects that need to be explored and improved through continuous efforts and innovation．

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 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 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 分析神经系统副肿瘤综合征（PNS）的临床特点以提高对该病的早期诊断和治疗效果。方法 回顾性分析惠州市第一人民医院和惠州市中心人民医院神经内科2019年10月—2022年10月收治的21例PNS患者的临床表现、实验室检查结果和治疗效果,并作文献回顾。结果 21例患者中出现了10种副肿瘤综合征,其中经典综合征占比28.6%（6/21）,最多见的是边缘叶脑炎;20例在血液或脑脊液中发现检测到抗神经元抗体,非特征性抗体阳性率最高（12/20）,其中以半定量脑组织切片TBA检测阳性率最高（7/20）;有特征性抗体的8例以抗Yo抗体阳性率最高（6/8）。21例患者均随访至2023年3月,8例发现原发肿瘤,其中4例在神经系统病变之后。69.25%（9/13）的患者使用糖皮质激素治疗和（或）丙种球蛋白治疗有效。结论 21例PNS患者中以非经典综合征占比较多,经典与非经典副肿瘤综合征均应进行肿瘤筛查,未发现肿瘤者应密切随访。非特征性抗体阳性率最高,提示PNS可能仍有许多相关抗体未明确,临床工作中也应对非特征性抗体阳性予以重视。

Objective To analyze the clinical features of paraneoplastic neurological syndrome（PNS）to improve the early diagnosis and treatment of this disease. Methods The clinical manifestations,laboratory results and treatment effects of 21 patients with PNS admitted to Huizhou First People's Hospital and Huizhou Central People's Hospital from October 2019 to October 2022 were retrospectively analyzed,and literature review was performed. Results There were 10 paraneoplastic syndromes in 21 patients,of which classical syndrome accounted for 28.6%（6/21）,the most common was limbic lobe encephalitis．Anti-neuronal antibodies were detected in blood or cerebrospinal fluid in 20 cases,with the highest positive rate of non-characteristic antibodies（12/20）,among which the positive rate of TBA detection by semi-quantitative brain tissue sections was the highest（7/20）;Eight cases with characteristic antibodies had the highest positive rate of anti-Yo antibody（6/8）．All 21 patients have been followed up so far,and 8 cases have found primary tumors,4 of which were after neurological lesions．There was 69.25%（9/13）of patients responded to hormone therapy or（and）gamma globulin therapy. Conclusions Non-classical syndrome accounts for more patients with PNS,and both classical and non-classical paraneoplastic syndromes should be screened for tumors,and those who have not found tumors should be closely followed．The positive rate of non-characteristic antibodies is the highest,indicating that there may still be many related antibodies in PNS that are not clear,and the positive of non-characteristic antibodies should also be paid attention to in clinical work．

目的 探讨血浆置换联合泼尼松（PDN）联合环磷酰胺（CTX）治疗抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎（DM）伴肺间质纤维化（ILD）患者疗效及安全性。方法 回顾性分析2014年6月—2023年6月普洱市人民医院诊断的MDA5阳性DM伴ILD患者40例,其中治疗组20例,采用血浆置换联合PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗;另20例设为对照组,采用PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗,分别于治疗后3月、6月检测一氧化碳弥散量（DLCO）、第1秒用力呼气量（FEV₁）,血清铁蛋白（SF）、C-反应蛋白（CRP）、涎液化糖链抗原（KL-6）、MDA5转阴率行疗效评估。结果 在治疗3个月和6个月时,两组患者的DLCO、FEV1、SF、CRP、KL-6、MDA5转阴率等指标的完全缓解率不一致。其中,3个月时,治疗组上述指标的完全缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为15%、20%、20%、15%、0%、0%。两组患者在治疗3个月的DLCO、FEV1、SF、CRP、KL-6水平和MDA5转阴数均有所不同。其中治疗组的DLCO、KL-6、CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,治疗组SF水平较对照组降低（P<0.05）,两组治疗6个月时,治疗组上述指标缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为20%、25%、20%、20%、20%、5%。两组患者在DLCO、FEV₁、SF、CRP、KL-6水平以及MDA5转阴数和死亡例数方面比较差异均有统计学意义,其中治疗组的DLCO、KL-6和CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,SF水平治疗组较对照组降低（P<0.05）。结论 在MDA5抗体阳性DM伴ILD患者治疗中,给予血浆置换联合PDN、CTX治疗,可以提高疗效,降低病死率。

Objective To explore the effect of plasmapheresis combined with prednisone（PDN）plus cytoxan（CTX）on patients with anti-melanoma differentiation-associated gene 5（MDA 5）antibody-positive dermatomyositis（DM）with interstitial lung disease（ILD）. Methods The data of 40 patients with MDA 5 positive DM and ILD diagnosed in the People's Hospital of Pu'er City from June 2014 to June 2023 were retrospectively was analyzed．Twenty patients of the treatment group were treated with plasmapheresis combined with PDN 1mg / kg once daily,which was reduced by 10% per week after 4 weeks．The other 20 patients of the control group were treated with PDN 1mg / kg once daily,which was reduced after 4 weeks by 10% per week,and CTX 1g once per month．diffusing capacity of the lungs for carbon monoxide（DLCO）,forced expiratory volume in the first second（FEV₁）,serum ferritin（SF）,C-reactive protein（CRP）,Krebs Von den Lungen-6（KL-6）and MDA5 negative conversion rate were measured at 3 and 6 months after treatment,respectively. Results At 3 and 6 months of treatment,complete remission rates of DLCO,FEV₁,SF,CRP,KL-6,MDA 5 conversion and other indicators were inconsistent．Among them,at 3 months,the complete response rate of the above indicators in the treatment group was successively：95%,85%,90%,90%,90% and 85%．The control group was 15%,20%,20%,15%,and 0%,0%．Statistical analysis showed that the levels of DLCO,FEV₁,SF,CRP,KL-6 and MDA 5 significantly varied at 3 months of treatment．Pairwise comparison of LSD found that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower than the control group（P<0.01）,the FEV₁ level in the treatment group was significantly higher（P<0.01）,and the SF level in the treatment group was significantly lower（P<0.05）．After 6 month of treatment,the complete response rate of the above indicators in the treatment group were 95%,85%,90%,90%,90% and 85%,and the complete response rate of the above indicators in the control group was 20%,25%,20%,20%,20% and 5%．Statistical analysis showed the levels of DLCO,FEV₁,SF,CRP,KL-6 for the amount of MDA 5 and the number of deaths between two groups were significantly different．Further pairwise comparison of LSD showed that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower compared with the control group（P<0.01）,the FEV₁ level was significantly increased compared with the control group（P<0.01）,and the SF treatment group was significantly decreased compared with the control group（P<0.05）. Conclusions In the treatment of patients with MDA 5 antibody positive DM with ILD,the treatment of plasmapheresis combined with PDN and CTX can significantly improve the efficacy and reduce the mortality rate．

目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者（均行无痛胃肠镜检查）为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义（t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05）;重复测量方差分析结果显示,分组因素间收缩压（SBP）（F=30.019,P<0.001）、心率（HR）（F=282.057,P<0.001）、SpO₂（F=64.518,P<0.001）、;时间因素SBP（F=21.780,P<0.001）、HR（F=345.118,P<0.001）、SpO₂（F=41.762,P<0.001）;分组与时间交互时间因素SBP（F=12.941,P<0.001）、HR（F=193.295,P<0.001）、SpO₂（F=13.546,P<0.001）,差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO₂、较B组低。;A组患者围术期不良反应发生率（20.00%）低于B组患者（56.67%）（χ²=25.593,P<0.001）。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。

Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients（all underwent painless gastroscopy）admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects．They were randomly divided into groups using a random number table method．Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol．Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups．There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients（t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05）．The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP（F=30.019,P<0.001）,HR（F=282.057,P<0.001）,SpO₂（F=64.518,P<0.001）,time factors SBP（F=21.780,P<0.001）,HR（F=345．118,P<0.001）,SpO₂（F=41.762,P<0.001）,and interaction factors SBP（F=12.941,P<0.001）,HR（F=193.295,P<0.001）,and SpO₂（F=13.546,P<0.001）．The line chart visually shows that the SBP,HR,SpO₂ of Group A patients were lower than those of Group B．The incidence of perioperative adverse reactions in Group A patients（20.00%）was lower than that in Group B patients（56.67%）（χ²=25.593,P<0.001）. Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions．

目的 分析早产儿发生新生儿坏死性小肠结肠炎（NEC）的临床特点及危险因素。方法 选取2021年3月—2023年3月在濮阳市人民医院出生的早产儿160例,根据有无NEC分为NEC组（40例）和非NEC组（120例）,总结和比较两组患儿的临床资料,分析早产儿NEC的危险因素。结果 NEC组早产儿的发病时间主要集中在出生后的3~21 d,平均发病时间为（12.84±3.5）d。主要临床症状包括肉眼便血23例（57.5%）、腹胀31例（77.5%）、呕吐18例（45.0%）、呼吸暂停7例（17.5%）、肠穿孔9例（22.5%）。Logistic回归分析发现,败血症、输血、呼吸窘迫综合征及新生儿窒息是早产儿发生NEC的危险因素（P<0.05）,而预防应用益生菌以及母乳喂养是NEC的保护因素（P<0.05）。结论 NEC的主要临床表现包括肉眼便血、腹胀、呕吐、呼吸暂停、肠穿孔等;患儿出现NEC与败血症、输血、呼吸窘迫综合征及新生儿窒息等因素相关;母乳喂养和益生菌的应用是其保护因素。

Objective To analyze the clinical characteristics and risk factors of necrotizing enterocolitis（NEC）in premature infants. Methods A total of 160 premature infants born in Puyang People's Hospital from March 2021 to March 2023 were selected and divided into NEC group（40 cases）and non-NEC group（120 cases）according to the presence or absence of NEC．The clinical data were obtained and compared between the two groups．The clinical data of two groups were compared,and the related risk factors of NEC in premature infants were analyzed and summarized. Results The onset time of NEC premature infants is mainly between 3-21 days after birth,with an average onset time of（12.84±3.5）days．The main clinical symptoms included 23 cases（57.5%）of bloody stool,31 cases（77.5%）of abdominal distension,18 cases（45.0%）of vomiting,7 cases（17.5%）of apnea,and 9 cases（22.5%）of intestinal perforation．Logistic regression analysis found that sepsis,blood transfusion,respiratory distress syndrome,and neonatal asphyxia were risk factors for NEC in premature infants（P<0.05）,while prophylactic use of probiotics and breastfeeding were protective factors for NEC（P<0.05）. Conclusions The main clinical manifestations of NEC include bloody stool,abdominal distension,vomiting,apnea,intestinal perforation,etc．NEC in infants is related to sepsis,blood transfusion,respiratory distress syndrome and neonatal asphyxia．Breastfeeding and the application of probiotics are its protective factors．

目的 探究高原地区世居居民与常住居民的心脏结构和功能的差异性。方法 选择2022年6月—2023年8月在西藏林芝市人民医院体检的200例世居居民与常住居民作为研究对象,将世居居民和常住居民按照性别分为男女亚组,按照年龄段分为18~31岁、31~40、41~50岁亚组。比较各亚组心脏结构参数、左心功能参数、多普勒超声检测参数差异。结果 与高原常住居民男性和女性比较,世居居民男性和女性的左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标比较差异均无统计学意义（P>0.05）;而主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速增加,两组间比较差异具有统计学意义（P<0.05）。18~31岁、31~40、41~50岁组世居居民和常住居民左房内径、右房内径、右室内径、肺动脉内径、升主动脉内径、主动脉根径、室间隔厚度、左室后壁厚度、左室舒张末内径、左室收缩末内径、左室射血分数、二尖瓣 A 峰流速指标等指标比较差异均无统计学意义（P>0.05）,但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民,差异具有统计学意义（P<0.05）。结论 高原地区世居居民和常住居民心脏结构参数和左心功能参数无明显差异。但世居居民主动脉瓣口流速、肺动脉瓣口流速、二尖瓣 E 峰流速均高于常住居民。

Objective To explore the ethnic differences in heart structure and function between aborigines and long term residents in the plateau area. Methods A total of 200 aborigines and long term residents who underwent physical examination in our hospital from June 2022 to August 2023 were selected as the study subjects,and the aborigines and long term residents were divided into male and female subgroups,and subgroups aged 18-30 years,31-40 years and 41-50 years．The differences of cardiac structure parameters,left ventricular function parameters and Doppler parameters were compared among subgroups. Results The left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction mitral valve A peak velocity were compared between Aborigines and plateau Long Term Residents,which were no significant difference（P>0.05）．However,the velocity of aortic valve orifice,pulmonary valve orifice and mitral valve E peak velocity increased,and the differences were statistically significant（P<0.05）．There were no significant differences in left atrial diameter,right atrial diameter,right ventricular diameter,pulmonary artery diameter,ascending aorta diameter,aortic root diameter,interventricular septal thickness,posterior left ventricular wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,left ventricular diameter,left ventricular diameter,and left ventricular ejection fraction mitral valve A peak velocity indexes in aborigines and long term residents between among aged 18-30 years,31-40 years,41-50 years（P>0.05）,but the differences of aortic valve orifice velocity,pulmonary valve orifice velocity and mitral valve E peak velocity were statistically significant（P<0.05）. Conclusions There were no significant difference in cardiac structure parameters and left heart function parameters between aborigines and long term residents in plateau area．However,the aortic orifice velocity,pulmonary orifice velocity and mitral E-peak velocity of aborigines were higher than those of long term residents．