目的   分析现代文献中穴位贴敷疗法干预矮小症研究现状，为临床治疗该病提供依据。方法   整理近2018年1月—2023年12月6年间国内医学期刊上公开发表的关于穴位贴敷疗法治疗矮小症的中文文献，对文献年代分布、发表期刊、研究内容、贴敷穴位、贴敷药物、贴敷的时间、频次、治疗时间、观察指标、中西医结合治疗矮小症、不良反应等进行统计分析。结果   最终纳入的文献共10篇，近6年间均有相关文献发表；发表期刊《中医儿科杂志》《新中医》《中国现代医生》《中医外治杂志》《中国中西医结合儿科学》；研究内容涉及矮小症分型、穴位贴敷联合重组人生长激素法、畲医法、中药内服法、拉伸操法、营养干预指导、推拿等方法治疗矮小症。结论   穴位贴敷疗法联合其他疗法在临床上对儿童矮小症的改善效果显著，不良反应轻微，相信随着矮小症成因的进一步明确，穴位贴敷疗法治疗矮小症的机制会更加清晰，为改善矮小症提供科学理论依据，同时，为矮小症等相关疾病的治疗提供新思路。

      Objective  To analyze the research status of acupoint application therapy in short stature from January 2018 to December 2023，and to provide basis for clinical treatment of the disease．Methods  To review the Chinese literature published in domestic medical journals in recent 6 years on the treatment of short stature by acupoint application therapy，including the distribution of time and journals，the research contents，the acupoint application，the drug application，the application time，the treatment frequency and duration，the observation index，treatment of short stature with integrated traditional，Chinese and Western medicine and adverse reactions were statistically analyzed．Results  There were 10 articles in this review，and all of them were published in the past 6 years，published journal were Pediatrics of Traditional Chinese medicine，new Traditional Chinese medicine，modern Chinese doctor，Journal of external treatment of traditional Chinese medicine，Pediatrics of integrated traditional Chinese and Western medicine in China．The research content involved the short stature classification，acupoint application combined with  recombinant human growth hormone therapy，the She medical therapy，traditional Chinese medicine，stretching manipulation，nutrition intervention guidance，massage and other methods．Conclusions  The combination of acupoint application therapy and other therapies has a significant clinical effect on the improvement of short stature in children，with slight adverse reactions．It is believed that with the further clarification of the causes of short stature，the mechanism of point application therapy for short stature will be more clear and provide scientific basis for improving short stature．At the same time，it may provide a new idea for the treatment of dwarfism and other related diseases．

       目的  探讨转录因子E盒结合锌指蛋白1（ZEB1）、溶酶体相关膜蛋白5（LAMP5）在结直肠癌组织中的表达水平分析及预后预测价值。方法  选取驻马店市中心医院2018年1月—2020年1月收治的120例结直肠癌患者，分别采取所有患者的结直肠癌组织及癌旁组织进行免疫组化染色，对比ZEB1、LAMP5阳性率。对比不同病理特征结直肠癌患者ZEB1、LAMP5表达水平差异。对所有患者进行4年随访，依照随访结果将患者分为2个亚组，即预后不良组（n=35）和预后良好组（n=85），对比两组患者一般临床特征及ZEB1、LAMP5表达水平，应用Logistic回归分析ZEB1、LAMP5对结直肠癌预后的预测价值。结果 结直肠癌组织ZEB1、LAMP5相对表达量（38.26±5.49、26.77±3.85）与ZEB1、LAMP5阳性率（86.67%、72.22%）高于癌旁组织（15.46±2.54、8.04±1.59、23.33%、15.56%］，对比差异有统计学意义（t=41.280，χ²=25.437；t=49.255，χ ² =16.071；P＜0.05）。不同TNM分期［Ⅰ~Ⅱ期（35.55±4.13）、Ⅲ~Ⅳ期（42.32±4.75）］、淋巴结转移患者［是（44.37±4.28）、否（35.84±3.77）］、肿瘤分化程度［低分化（35.27±4.57）、中高分化（41.34±4.60）］ZEB1相对表达量对比差异有统计学意义（t=-8.281，P＜0.001；t=10.746，P＜0.001；t=-7.253，P＜0.001）；不同TNM分期［Ⅱ期（24.88±3.37）、Ⅲ~Ⅳ期（29.61±2.57）］、淋巴结转移［是（30.72±2.19）、否（25.21±3.19）］、肿瘤分化程度［低分化（24.57±3.62）、中高分化（29.04±2.55）］患者LAMP5相对表达量对比差异有统计学意义（t=-8.254，P＜0.001；t=9.227，P＜0.001；t=-7.797，P＜0.001）；预后良好组与预后不良组患者性别、年龄、大体类型、肿瘤大小对比差异无统计学意义（P＞0.05），预后良好组与预后不良组患者TNM分期、淋巴结转移、肿瘤分化程度、ZEB1、LAMP5阳性比例对比差异有统计学意义（P＜0.05）；Logistic回归分析显示：淋巴结转移、ZEB1阳性、LAMP5阳性为结直肠癌预后不良独立预测因素（P＜0.05）。结论  ZEB1、LAMP5在结直肠癌组织中呈现高表达状态，且与结直肠癌的发生有关，同时ZEB1、LAMP5是结直肠癌预后的独立预测因素，两者有希望成为结直肠癌的治疗靶点。

       Objective  To investigate the expression levels and prognostic value of transcription factor E-box binding to zinc finger protein 1（ZEB1）and lysosomal associated membrane protein 5（LAMP5）in colorectal cancer tissues．Methods  A total of 120 colorectal cancer patients admitted to a hospital from January 2018 to January 2020 were selected．Immunohistochemical staining was performed on the colorectal cancer tissues and adjacent tissues of all patients，and the positivity rates of ZEB1 and LAMP5 were compared．The expression levels of ZEB1 and LAMP5 in colorectal cancer patients with different pathological characteristics were compared．All patients were followed up for 4 years and divided into two subgroups based on the follow-up results，namely the poor prognosis group（n=35）and the good prognosis group（n=85）．The general clinical characteristics and expression levels of ZEB1 and LAMP5 were compared between the two groups．Logistic  regression analysis was used to evaluate the predictive value of ZEB1 and LAMP5 for the prognosis of colorectal cancer．Results The relative expression level of ZEB 1 and LAMP 5 in colorectal cancer tissues ［（38.26±5.49），（26.77±3.85）］ and the positive rate of ZEB 1 and LAMP 5（86.67%，72.22%）were significantly higher than that of adjacent tissues ［（15.46±2.54），（8.04±1.59），23.33%，15.56%］，the contrast  difference was statistically significant（t=41.280，χ²=25.437；t=49.255，χ ² =16.071；P＜0.05）．Relative ZEBI expression levels in different TNM stages ［I-Ⅱstage（35.55±4.13），Ⅲ-Ⅳstage（42.32±4.75）］，lymph node metastasis［Yes（44.37±4.28），No（35.84±3.77）］，degree of tumor differentiation ［hypodifferentiated（35.27±4.57），and middle or high differentiated （29.04±2.55）］，those differences were statistically significant（t=-8.254，P＜0.001；t=9.227，P＜0.001；t=-7.797，P＜0.001）．The relative expression of LAMP 5 between different TNM stages ［I-Ⅱstage（24.88±3.37），Ⅲ-Ⅳstage（29.61±2.57）］，lymph node metastasis ［yes（30.72±2.19），no（25.21±3.19）］，degree of tumor  differentiation ［hypodifferentiated（24.57±3.62），and middle or high differentiated（29.04±2.55）］，the contrast was statistically significant（t=-8.254，P＜0.001；t=9.227，P＜0.001；t=-7.797，P＜0.001）．There were no differences in gender，age，gross type，and tumor size between the good prognosis group and the poor prognosis group（P＞0.05），while there were differences in TNM stages，lymph node metastasis，tumor differentiation degrees，ratio of ZEB 1 and LAMP 5（P＜0.05）．Logistic regression analysis showed that TNM stage，lymph node metastasis，ZEB 1 positive，and LAMP 5 positive were independent predictive factors of poor prognosis in colorectal cancer（P＜0.05）．Conclusions  ZEB1 and LAMP5 are highly expressed in colorectal cancer tissues and closely related to the occurrence and development of colorectal cancer．ZEB1 and LAMP5 are independent prognostic factors for colorectal cancer，and they have the potential to become therapeutic targets for colorectal cancer．

       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例，评估所有患者的应对方式，根据结果分为积极应对组与消极应对组，设计基线资料调查表，详细统计两组患者的基线资料并比较，重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估，78例阴道分娩后尿失禁患者疾病消极应对有40例，占比51.28%；积极应对组与消极应对组患者的产次（χ ² =4.110，P=0.043）、文化水平（Z=2.094，P=0.036）、家庭关怀度（Z=2.069，P=0.040）与自我效能（Z=2.249，P=0.025）比较差异有统计学意义，组间年龄（t=0.096，P=0.924）、孕次（t=1.257，P=0.212）、体质指数（BMI）（t=0.125，P=0.901）、工作（χ ² =0.778，P=0.378）、家庭月人均收入（χ ² =0.044，P=0.834）、漏尿（χ ² =0.040，P=0.842）比较差异无统计学意义；经回归分析发现，家庭关怀度低（OR=1.799，P=0.041）、自我效能低（OR=1.942，P=0.026）、经产妇（OR=2.554，P=0.045）及文化水平低（OR=1.837，P=0.038）均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高，可能与产次、文化水平、家庭关怀度及自我效能有关。

       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery．Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected．The coping strategies of all patients were evaluated，and they were divided into a positive coping group and a negative coping group based on the results．A baseline data questionnaire was designed，and the baseline data of the two groups of patients were compared in detail．The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery．Results After evaluation，40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies，accounting for 51.28%．The parity of patients in the positive and negative coping groups（χ ² =4.110，P=0.043），educational level（Z=2.094，P=0.036），family care（Z=2.069，P=0.040），and self-efficacy（Z=2.249，P=0.025）among the groups were different．Age between groups（t=0.096，P=0.924），gestational age（t=1.257，P=0.212），body mass index（t=0.125，P=0.901），and work experience（χ ² =0.778，P=0.378），monthly per capita income of households（χ ² =0.044，P=0.834），urinary leakage（χ 2 =0.040，P=0.842）had no statistically significant difference in comparison．Through regression analysis，it was found that low family care（OR=1.799，P=0.041），low self-efficacy（OR=1.942，P=0.026），postpartum women（OR=2.554，P=0.045），and low educational level（OR=1.837，P=0.038）were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery．Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease，which may be related to parity，educational level，family care and self-efficacy．

       目的 评价人工晶状体（IOL）集中带量采购政策对于白内障摘除术中人工晶状体选择的影响。方法 回顾性分析2020年6月—2022年5月在广州市第一人民医院眼科完成白内障超声乳化摘除联合IOL植入术的患者，根据医院开始集采的时间（2021年5月）将患者分为集采前组与集采后组。比较两组患者的一般资料、IOL类别、IOL价格、手术费用、国产IOL占比等。结果 集采前组（2020年6月—2021年5月）与集采后组（2021年6月—2022年5月）的白内障手术量分别为1 188例及1 099例（双眼手术者仅纳入一眼），两组患者的年龄及性别比例比较差异均无统计学意义（P＞0.05）。集采前IOL价格为3 770（3 162~7 950）元，高于集采后的1 613（1 079~4 994）元（P＜0.001）。两组患者中非球面单焦点IOL所占比例均为最高，集采后多焦点及散光IOL的数量较集采前增加（集采前vs.集采后：多焦IOL：1.9% vs15.0%；散光IOL：0.2% vs 1.3%，均P＜0.05），球面IOL的数量减少（集采前后：7.7% vs 0.6%，P＜0.05）。集采后国产IOL的使用率由0.5%增加至3.5%（P＜0.001）。并且集采后选择多焦点IOL的患者年龄更大［集采前（62.3±12.4）岁，集采后（66.1±10.5）岁，P=0.02］。结论  IOL集中带量采购政策减轻了白内障患者的经济负担，增加了高端IOL的使用量，同时减少了国家医疗保险的支出，并且促进国产医用耗材的使用。

     Objective  To evaluate the influence of intraocular lens（IOLs）purchasing policy in  a  centralized volume-based manner on patients’ selection of cataract extraction surgery．Methods The  patients who  completed  cataract phacoemulsification combined with IOLs implantation in the ophthalmology department of Guangzhou First People’s Hospital from June 2020 to May 2022 were retrospectively analyzed．According to the time of centralized  IOLs procurement policy implemented in our hospital（May 2021），the patients were divided into before centralized purchase group（from June 2020 to May 2021）and centralized purchase group（from June 2021 to May 2022）．The demographics of study population，IOLs category，IOLs cost，operation cost and the proportion of Chinese-made IOLs were compared between the two groups．Results The total numbers of operations in the before centralized purchase group and centralized purchase group  were 1 188 and 1 099 eyes（only one eye was included in the binocular surgery），respectively．There was no significant difference in the age and sex between the two groups（P＞0.05）．The median cost of IOLs in the before centralized purchase group was 3 770（3 162，7 950），which was higher than that of centralized purchase group ［1 613（1 079，4 994），P＜0.001］．The proportion of aspherical  IOLs was the highest in both groups．The number of multifocal and astigmatic  IOLs in the centralized purchase group increased significantly compared with those of before centralized purchase group（multifocal IOLs：1.9% and 15.0%；astigmatic IOLs：0.2% and 1.3%，all P＜0.05）．The number of spherical IOLs decreased significantly（7.7% and 0.6%，P＜0.05）．The utilization rate of domestic IOLs increased from 0.5% to 3.5%（P＜0.001）．The patients who chose multifocal IOLs in centralized purchase group were older than patients in before centralized purchase group ［（62.3±12.4）vs（66.1±10.5），P=0.02］．Conclusions The centralized volume-based procurement policy of IOLs reduces the economic burden of patients and increase the use of high-end IOLs．At the same time，it reduces the expenditure of national medical insurance and promotes the use of domestic medical consumables．

      目的 探讨老年营养风险指数（GNRI）与慢性阻塞性肺疾病者急性加重期患者预后的相关性。方法 选择贵州省六盘水水旷医院2019年1月—2022年1月收治的COPD急性加重期患者，根据GNRI值，分为正常营养组（GNRI＞98）和营养不良组（GNRI≤98），应用生存曲线和Cox比例风险回归评估营养状况与死亡率之间的关联。结果 共纳入198例COPD急性加重期患者，正常营养组90例，营养不良组108例，营养不良发生率为54.5%；Kaplan-Meier曲线表明，营养不良组的全因累积死亡率更高（58.3% vs 35.0%，P＜0.001）。Cox比例风险回归分析显示在未校正模型中，HR为2.31（1.25~4.28），P＜0.001。在完全校正模型中，HR为2.48（1.37~4.51），P=0.005，提示与正常营养状况相比，营养不良与全因死亡风险升高相关。结论  GNRI低是COPD患者急性加重期全因死亡的独立危险因素。

      Objective  To investigate the correlation between elderly nutritional risk index（GNRI）and prognosis of patients with AECOPD．Methods  Patients with AECOPD admitted to our hospital from January 2019 to January 2022 were selected and divided into normal nutrition group（GNRI＞98）and malnutrition group（GNRI≤98）according to GNRI value．Survival curve and Cox regression were used to evaluate the association between nutritional status and mortality．Results  A total of 198 patients with AECOPD were included in this study．According to GNRI scores，90 patients were in the normal nutrition group and 108 were in the malnutrition group，with malnutrition incidence of 54.5%．The Kaplan-Meier curve showed that the cumulative all-cause mortality was higher in the malnutrition group（58.3% vs 35%，P＜0.001）．Cox proportional hazard  regression analysis showed that HR in the uncorrected model was 2.31（1.25-4.28），P＜0.001．In the fully corrected model，HR was 2.4（1.37-4.51）and P=0.005，suggesting that malnutrition was associated with a significantly higher risk of all-cause mortalitycompared with normal nutritional status．Conclusions  Low GNRI is an independent risk factor for all-cause death in AECOPD patients．

       目的   总结女性生殖系统中恶性中胚叶混合瘤（MMMT）的临床病理特征及预后，分析P53及错配修复蛋白与MMMT发病之间的关系。方法   收集大理大学第一附属医院2015年9月—2022年9月15例经手术切除病理诊断为MMMT的病例，总结临床病理特点、免疫表型（P53、错配修复蛋白等）、治疗方案并随访。结果  15例MMMT原发于子宫10例，卵巢5例。发病年龄范围49~76岁，平均年龄60岁，中位年龄58岁。临床表现为阴道流血或流液，伴或不伴腹痛或盆腔包块。镜下肿瘤均由不同比例的恶性上皮和间叶源性肿瘤构成，P53野生型12例，突变型3例；错配修复蛋白（MSH6、MSH2、MLH1、PMS2）检测存在缺失的有4例。15例患者中均行手术治疗，12例行盆腔淋巴结清扫术，术后辅以放化疗。随访失访2例，死亡4例，复发6例，3例术后无复发和转移。结论   恶性中胚叶混合瘤临床少见，恶性程度高，病理诊断上存在困难，需要辅以免疫组织化学染色，P53及错配修复蛋白缺失与MMMT的发生存在一定关系。治疗上需要手术切除，辅以放化疗。

    Objective  To summarize the clinical and pathological characteristics and prognosis of malignant mesodermal mixed tumor（MMMT）in the female reproductive system，and analyze the relationship between P53 and mismatch  repair proteins and the onset of MMMT．Methods  A total of 15 cases diagnosed with MMMT after surgical resection at the First Affiliated Hospital of Dali University from September 2015 to September 2022 were collected．The clinical and pathological characteristics，immune phenotype（P53，mismatch repair protein，etc. ），treatment plan were summarized．And the patients were followed-up．Results  Ten of 15 cases of MMMT were primary in the uterus and 5 of 10 in the ovaries．The age range of onset was 49 to 76 years old，with an average age of 60 and a median age of 58．Clinical manifestations included vaginal bleeding or fluid discharge，with or without abdominal pain or pelvic masses．Under the microscope，all tumors were composed of malignant epithelial and mesenchymal tumors in different proportions，with 12 cases of P53 wild-type and 3 cases of mutant type．There were 4 cases of missing mismatch repair proteins（MSH6，MSH2，MLH1，PMS2）detected．Among the 15 patients，all underwent surgical treatment，and 12 underwent pelvic lymph node dissection with postoperative adjuvant chemotherapy and radiotherapy．Two cases were lost to follow-up，four cases died，six cases recurred，and three cases had no recurrence or metastasis after surgery．Conclusions  MMMT are rare in clinical practice，with high malignancy and poor prognosis．Pathological diagnosis is difficult，and immunohistochemical staining is needed．The absence of P53 and mismatch repair protein is related to the occurrence of MMMT. Surgical  resection is required for treatment，supplemented by radiotherapy and chemotherapy．

     目的   分析谷草转氨酶（AST）、胆碱酯酶（CHE）、糖类抗原125（CA125）以及甲胎蛋白（AFP）对肝硬化患者的诊断效能。方法   选择70例肝硬化患者为观察组研究对象，另取70例同期健康体检者为对照组。两组研究对象均接受生化检验、肿瘤标志物检验。对比两组研究对象的AST、CHE、CA125、AFP检测结果，分析上述指标对肝硬化患者的诊断效能。结果   观察组肝硬化患者的CHE低于对照组，AST、CA125与AFP高于对照组（P＜0.05）；AST与CHE在肝硬化诊断中具有良好的灵敏度、特异度；CA125联合AFP的灵敏度、特异度、符合率均高于CA125或AFP单独检验（P＜0.05）。结论  AST、CHE、CA125、AFP在肝硬化患者临床诊断中具有良好的应用表现，是反映患者肝硬化病情进展的重要参考指标。

     Objective  To analyze the diagnostic efficacy of aspartate aminotransferase（AST），cholinesterase（CHE），carbohydrate antigen 125（CA125），and alpha fetoprotein（AFP）in patients with liver cirrhosis．Methods  A total of 70 patients with liver cirrhosis were included in the observation group as the study subjects，and 70 healthy individuals who underwent physical examinations during the same period were selected as the control group．Both groups of  research subjects underwent biochemical testing and tumor marker testing．The AST，CHE，CA125，and AFP detection  results of two groups of research subjects were compared，and the diagnostic effect of the above indicators on patients with liver cirrhosis were analyzed．Results  The CHE test  results of patients with liver cirrhosis in the observation group were significantly lower than those of healthy individuals undergoing physical examination，and the AST，CA125，and AFP test results were higher（P＜0.05）．AST and CHE had good sensitivity and specificity in the diagnosis of liver cirrhosis．The sensitivity，specificity and coincidence  rate of CA125 combined with AFP were higher than those of CA125 or AFP alone．Conclusions  AST，CHE，CA125，and AFP have good clinical application performance in the diagnosis of liver cirrhosis patients，and are important reference indicators reflecting the progression of liver cirrhosis in patients．

       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站，检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验，采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究，共1 596例患者。结果显示，镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义［OR（95%CI）=537.70（4.18，124 511.88）、0（0，0.52），P＜0.05］；湿化满意度方面，注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义［OR（95%CI）=8.55（1.40，73.35），P＜0.05］；其余比较差异无统计学意义（P＞0.05）。概率排序显示，降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生，最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果，考虑到喉癌患者术后早期下床活动，推荐便携式持续湿化方法。

       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer．Methods  PubMed，Cochrane Library，EMbase，Web of Science，Ovid，China National Knowledge Infrastructure，Wanfang database，CBM and Google Scholar were searched systematically from establishment to February 2023，respectively．Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation．The network Meta analysis was performed using ADDIS 1.16.5 softwares．Results  A total of 18 articles and 1596 patients were inciuded．The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum［OR（95%CI）=537.70（4.18，124 511.88），0（0，0.52），P＜0.05］．In terms of satisfaction of wetness，the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different［OR（95%CI）=8.55（1.40，73.35），P＜0.05］，the others were not statistically different（P＞0.05）．Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway，the analgesia pump continued to pump into the airway，the MR400 humidifier and the infusion set continuously pumped into the airway，which were beneficial to the reduction in pulmonary infection，tracheal mucosal hemorrhage and formation of phlegm callus，the degree of sputum viscosity，cough and unsatisfactory wetness．Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results，a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients．

       目的  识别医院在医患沟通、服务态度、医疗服务和医疗质量方面存在的问题，研究提升医院医疗质量与安全的对策。方法   通过收集和整理2024年1-6月某三甲医院医患沟通科处理的医疗诉求数据，包括患者投诉、咨询、建议及求助调查结果，采用定性分析和定量分析相结合的方法，对134件医疗诉求数据进行详细分类和统计，深入分析投诉事由，并结合实际有责投诉量与诊疗总人数，计算投诉千人发生率。投诉千人发生率与2023年同期对照。结果   共处理医疗诉求134件，其中投诉116件（占86.56%）、求助11件（8.21%）、咨询5件（3.73%）、建议2件（1.5%）。投诉中，医患沟通不畅和服务态度问题占42%，医疗服务问题32%，医疗质量问题占26%。实际有责投诉量为63件，投诉千人发生率约为0.12‰。通过对诉求数据的深入分析，识别出医疗服务过程中的薄弱环节和改进点。结论   针对分析结果及同期对照，提出相应的对策建议，包括加强医患沟通培训，改善服务态度，优化医疗服务流程，并对投诉高发科室进行特别关注和改进等措施，以提高患者满意度和医院整体医疗质量。

Objective To identify issues in hospital communication, service attitude medical services, and medical  quality and to explore strategies for enhancing hospital medical quality and safety.  Methods  By collecting and organizing medical  appeal data processed by the Medical Communication Department of a tertiary hospital from January to June 2024, including patient  complaints, inquiries, suggestions, and requests for help. A combined qualitative and quantitative analysis was conducted on 134  medical appeal cases. Detailed classification and statistics were performed on these cases, and an in-depth analysis of the  reasons  for complaints was carried out. Furthermore, the actual number of  responsible complaints was compared with the total number of  treated patients to calculate the complaint rate per thousand people. This complaint  rate was then compared with the same period  in 2023.  Results  A total of 134 medical appeals were processed including 116 complaints（accounting for 86. 56%）, 11  requests for help（8. 21%）, 5 inquiries（3. 73%）, and 2 suggestions（1. 5%）. Among the complaints, issues  related to poor  communication between doctors and patients and service attitude accounted for 42%, medical service issues accounted for 32%, and  medical quality issues accounted for 26%. The actual number of responsible complaints was 63, and the complaint rate per thousand  people was approximately 0. 12‰. Through in-depth analysis of the appeal data, weak links and improvement points in the medical  service process were identified.  Conclusions Based on the analysis results and comparisons with the same period, corresponding  countermeasures and suggestions are proposed, including strengthening communication training between doctors and patients,  improving service attitude, optimizing medical service processes, and paying special attention to and improving departments with high  complaint rates in order to improve patient satisfaction and overall hospital medical quality.