目的 了解深圳市助产士培训的现况,为今后进一步加强助产士培训工作提供参考依据。方法 利用方便整群抽样法选取2022年在深圳市助产医疗机构工作的助产士,通过问卷调查及数据分析,了解他们在2009—2020年间参加助产士培训的情况以及对临床实操技能掌握的自评现况。结果 本研究共调查481名助产士,大部分来自三级医院,平均拥有9（5,15）年的助产工作经验,根据其工作年限和经验分别参加初级、中级和（或）高级培训,以参加一次初级或中级培训居多。助产士未参加培训的主要原因为医院人员不足和新入职。临床实操技能掌握自评现况分析显示,助产士初、中级母儿急救实操技能亟待加强,中级培训的助产士带教能力需提升。不同职称助产士的实操技能自评分数比较差异有统计学意义（Z=9.23,P=0.026）。结论 深圳市助产士对于初级培训和中级培训的参与度较高,但对部分临床实操技能的掌握仍存在不足,有必要进一步强化助产士临床实操技能培养,以全面满足孕产妇的健康需求。

Objective To understand the current state of midwifery training in Shenzhen,providing insights for the enhancement of future midwifery training programs．Methods Using a convenience cluster sampling method,midwives working in obstetric medical institutions in Shenzhen in 2022 were selected．Through questionnaire surveys and data analysis,the participation in midwifery training from 2009 to 2020 was examined along with their self-assessment of mastery over clinical practical skills．Results A total of 481 midwives,mostly from tertiary hospitals,with an average of 9（5,15）years of midwifery experience,were surveyed in this study and participated in primary,intermediate and/or advanced training according to their years of experience and years of work,with the majority participating in primary or intermediate training once．The main reasons for midwives not attending training were insufficient hospital staff and new recruits．The analysis of the self-assessment of the mastery of clinical practical skills showed that the practical skills of midwives in maternal and pediatric emergencies at the primary and intermediate levels needed to be strengthened,and the teaching ability of midwives with intermediate training needed to be improved．There was a difference in the self-rating of practical skills among midwives of different titles（Z=9.23,P=0.026）．Conclusions Though participation in primary and intermediate midwifery training in Shenzhen City is high,there remains a deficiency in mastering specific clinical practical skills．This research suggests that there’s a pressing need to further enhance the practical clinical skill training for midwives to comprehensively meet the health needs of pregnant and postnatal women．

目的 探讨黏附因子E-钙粘蛋白(E-cadherin)和Toll样受体9(TLR9)在系统性红斑狼疮(SLE)发病机制中的作用。方法 随机选取SLE患者41例,健康对照组18例,采用酶联免疫吸附试验(ELISA)法检测血清中sE-cadherin的表达,采用流式细胞技术(FCM)检测外周血单核细胞上TLR9的表达。分析 sE-cadherin,TLR9与系统性红斑狼疮患者病情的活动性。结果 SLE组血清中sE-cadherin的表达水平高于正常组(P=0.00),差异有统计学意义;SLE活动组血清中sE-cadherin表达水平高于稳定组(P=0.06),但差异无统计学意义;SLE组TLR9表达高于健康组(P=0.00),活动组高于稳定期组(P=0.00),差异均有统计学意义;SLE患者TLR9表达与SLEDI呈正相关(r=0.727,P=0.00),差异有统计学意义。结论 血清中sE-cadherin和外周血单核细胞内TLR9均参与了SLE患者病情发展的过程,并且二者在SLE发病机制中可能具有协调作用。

Objective To explore the effect of adhesion molecule E-cadherin and Toll-like receptor-9(TLR9) in the pathogenesis of systemic lupus erythematosus(SLE). Methods 41 patients with SLE and 18 healthy controls were selected randomly.Expression of TLR9 in peripheral blood mononuclear cells determined by FCM. SE-cadherin levels were measured in the serum by ELISA analysis. The correlation between sE-cadherin、TLR9 and the patient's condition of SLE was analyzed. Results Compared with healthy subjects,the expression of sE-cadherin in serum was higher among SLE patients(P=0.00),there was statistically significant between two groups;activity group was higher than inactivity group and healthy controls(P=0.06),but there was no statistically significant between activity group and inactivity group. Compared with healthy subjects,the expression of TLR9 in peripherql blood mononuclear cells was higher among SLE patients(P=0.00);activity group was higher than inactivity group(P=0.00),there was all statistically significant between two groups.The positive correlation was observed between TLR9 expression levels and clinical measure of the SLEDAI(r=0.727,P=0.00),there was statistically significant between two groups. Conclusion SE-cadherin and TLR9 may play an important role in SLE,and may interact with each other which needed further study.