目的 探讨氟哌噻吨美利曲辛联合帕罗西汀对重度抑郁障碍（MDD）患者躯体化症状、睡眠和认知功能的影响分析以及临床应用效果。方法 回顾性分析2020年8月—2023年2月在南昌市某医院接受治疗的120例MDD患者相关资料,按照其治疗方案不同分为帕罗西汀治疗组（常规组,n=55）和氟哌噻吨美利曲辛联合帕罗西汀治疗组（联合组,n=65）。两组患者治疗周期均为4周,比较两组患者治疗前和治疗第2、4周的汉密尔顿抑郁量表（HAMD-17）评分、躯体化症状自评量表（SSS）评分、睡眠质量评分（PSQI）、神经心理状态评定量表（RBANS）;且治疗后对患者进行1个月的随访比较两组患者治疗后总体疗效及不良反应发生情况。结果 经治疗第2、4周联合组RBANS评分高于常规组（P<0.05）,而PSQI评分、SSS评分、HAMD-17评分均低于常规组（P<0.05）。治疗后1个月随访资料显示,两组患者不良反应总发生率比较,差异无统计学意义（P>0.05）,且总有效率高于常规组（P<0.05）。结论 氟哌噻吨美利曲辛联合帕罗西汀对MDD患者临床应用疗效确切,还可以帮助患者减轻躯体化症状,改善患者睡眠质量,并且提高患者认知功能。

Objective To investigate the effect of haloperitoxine melitraxine combined with paroxetine on somatic symptoms,sleep and cognitive function in patients with major depressive disorder（MDD）and its clinical application effects．Methods A retrospective analysis was performed on the relevant data of 120 patients with MDD who received treatment in our hospital from August 2020 to February 2023,and divided into conventional group（treated with paroxetine,55 cases）and combined group（haloperitoxetex melitraxine combined with paroxetine,65 cases）according to their different treatment regimens．The treatment duration of the two groups was 4 weeks,and the Hamilton Rating Scale for Depression（HAMD-17）score,Somatized Symptom Self-rating Scale（SSS）score,Sleep Quality Score（PSQI） and Neuropsychological State Rating Scale（RBANS）scores were compared before treatment and at the 2nd and 4th week of treatment．After treatment,the patients were followed up for 1 month,and the total efficacy and adverse reactions of the two groups of patients after treatment were compared．Results After 2 and 4 weeks of treatment,the combined group showed significantly higher RBANS scores compared to the control group（P<0.05）,while PSQI scores,SSS scores and HAMD-17 scores were significantly lower in the combined group compared to the control group（P<0.05）．One month after treatment,follow-up data showed that there was no statistically significant difference in the overall incidence of adverse reactions between the two groups（P>0.05）．Additionally,the total effective rate was significantly higher in the combined group compared to the control group（P<0.05）．Conclusions Haloperitoxine melitrexine combined with paroxetine has a definite clinical effect in patients with MDD,and can also help patients reduce somatization symptoms,improve patients' sleep quality,and improve patients' cognitive function．

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．

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．

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．

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 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ²检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义（χ²=7.570,P=0.006）,“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。

Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded．According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests．With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities．All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence．There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue（χ²=7.570,P=0.006）,the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence．

目的 探讨与分析基于信息-动机-行为（IMB）模型的护理干预对造口患者并发症及生活质量的影响。方法 选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果 IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多（P<0.05）。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多（P<0.05）。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多（P<0.05）。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低（P<0.05）,护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低（P<0.05）。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高（P<0.05）。结论 基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。

Objective To explore and analysis the effects of nursing intervention based on Information-Motivation-Behavioral（IMB）model on complications and quality of life of patients with stoma. Methods Eighty-four cases of patients with colorectal cancer undergoing enterostomy in our hospital from May 2021 to Aprilt 2023 were selected as the study subjects．According to the principle of 1∶1 random computer lottery,the patients were divided into IMB group（42 cases）and traditional group（42 cases）．The traditional group were given routine nursing intervention,and the IMB group were given nursing intervention based on the IMB model on the basis of the traditional group．The nursing observation time of the traditional group and IMB group were 3 months,the changes in complications,quality of life,psychological status,and self-management ability scores of patients were observed and recorded. Results The incidence of complications such as abdominal abscess,intestinal obstruction,pulmonary infection and stoma infection in IMB group during nursing were 4.8%,which were significantly lower than 19.0% in the traditional group（P<0.05）．The compliance of IMB group during nursing were 100.0%,which were significantly higher than 90.5% in the traditional group（P<0.05）．After nursing of 3 months,the scores of self-management ability such as symptom recognition,symptom treatment and post-treatment evaluation in IMB group were significantly higher than those in the traditional group（P<0.05）．The scores of anxiety and depression in the traditional group and IMB group after nursing of 3 months were significantly lower than those before nursing（P<0.05）,and the scores of anxiety and depression in the IMB group after nursing of 3 months were also significantly lower than those in the traditional group（P<0.05）．After nursing of 3 months,the scores of IMB group on function scale,symptom scale,symptom subscale and total quality of life scale were significantly higher than those of the traditional group（P<0.05）. Conclusions The application of nursing intervention based on the IMB model in patients with stoma can improve the compliance with medical treatment,reduce the occurrence of complications,improve the self-management ability of patients,relieve anxiety and depression,and continue to improve the prognosis and quality of life of patients．

目的 基于计划行为理论探讨妊娠期糖尿病（GDM）孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别：①行为态度：认知不足,积极态度,消极态度;②主观规范：家庭影响,医护压力,人际压力;③知觉行为控制：知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。

Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus（GDM）based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including（1）Behavioral Attitudes：cognition deficiency,positive attitude,and negative attitude,（2）Subjective norms：family influence,medical pressure,interpersonal pressure,and（3）Perceptual behavior control：self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions．Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency．