目的 血清同型半胱氨酸（Hcy）水平与慢性肾脏病（CKD）的进展相关,但中年人群的非线性关联研究较少,本研究旨在寻找慢性肾脏病危险因素。方法 本研究基于NHANES 1996—2006年数据,纳入5 361例45~65岁参与者,以估算肾小球滤过率（eGFR）<60 mL/（min·1.73 m²）和尿白蛋白/肌酐比值（uACR）≥30 mg/g评估肾功能下降。结果 通过逻辑回归及平滑曲线拟合分析发现,Hcy每升高1 µmol/L,eGFR降低的风险增加8%（OR=1.08,95%CI：1.06~1.10）,uACR升高的风险增加2%（OR=1.02,95%CI：1.00~1.04）。非线性分析显示,Hcy对eGFR的阈值效应拐点为13.4 µmol/L（拐点左侧OR=1.59,95%CI：1.49~1.70;右侧无显著关联）。亚组分析表明,性别、高血压、糖尿病等协变量无交互作用,然而,在敏感性分析中,糖尿病患者中Hcy与eGFR降低的关联更强（交互P=0.015 8）。结论 本研究提示,控制Hcy水平或可延缓美国中年人群（尤其是糖尿病患者）的肾功能衰退。

Objective Elevated serum homocysteine（Hcy）levels are linked to chronic kidney disease（CKD）progression,yet the nonlinear relationship in middle-aged populations remains underexplored．Methods This study analyzed data from 5 361 participants aged 45-65 years in the NHANES 1996-2006 cohort．Renal dysfunction was defined as an estimated glomerular filtration rate（eGFR）<60 mL/min/1.73 m² and urinary albumin-to-creatinine ratio（uACR）≥30 mg/g．Results Logistic regression and smoothed curve fitting revealed that each 1 µmol/L increase in Hcy elevated the risk of reduced eGFR by 8%（OR=1.08,95% CI：1.06-1.10）and uACR by 2%（OR=1.02,95% CI：1.00-1.04）．A nonlinear threshold effect was identified at 13.4 µmol/L,with a stronger association below this threshold（OR=1.59,95% CI：1.49-1.70）and no significant effect above it．Subgroup analyses showed no interactions with gender or hypertension,but a stronger Hcy-eGFR association was observed in diabetics（interaction P=0.0158）．Conclusions These findings suggest that controlling Hcy levels may mitigate renal decline,particularly in diabetic populations,warranting further causal investigations．

目的 探讨慢性阻塞性肺疾病（COPD）住院患者口腔功能状态现状及影响因素。方法 采用便利抽样法,选择2022年9月—2023年7月在深圳市龙岗区某三甲医院呼吸内科、胸外科的老年COPD住院患者191例作为研究对象。使用一般资料调查表、日常生活自理能力评估量表（BADL）、反复唾液吞咽试验（RSST）、改良版呼吸困难量表（mMRC）、改良版Beck口腔评分量表进行调查及评估。采用单因素分析老年COPD住院患者口腔功能状态的影响因素,采用Logistic回归分析老年COPD住院患者口腔功能状态的影响因素。结果 191例老年COPD患者中,入院时、住院第3天（D3）、住院第5天（D5）、出院的Beck口腔评分分别为（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）分,比较差异无统计学意义（P>0.05）。单因素分析结果显示,COPD患者在D3、D5、出院时,Beck口腔功能状态的影响因素有：年龄、性别、婚姻状况、牙齿缺失情况、抽烟史以及生活自理能力影响,差异具有统计学意义（P<0.05）。二元Logistic回归分析结果显示,年龄、吸烟状况、牙齿缺失数量、生活自理能力是COPD住院患者口腔功能状态的影响因素（P<0.05）。结论 老年COPD患者口腔卫生状况较差,且受到年龄、吸烟情况、牙齿缺失、生活自理能力的影响,应采取针对性预防和干预策略,改善老年COPD住院患者的口腔卫生状况,以降低COPD患者发生并发症的风险。

Objective To investigate the status quo and influencing factors of oral function in hospitalized patients of chronic obstructive pulmonary disease（COPD）．Methods A total of 191 patients with COPD who were hospitalized in the Respiratory Department and Thoracic Surgery Department of a hospital in Longgang,Shenzhen from September 2022 to July 2023 were selected by convenience sampling．The general data questionnaire,the Barthel index of activity of daily living（BADL） the repetitive saliva swallowing test（RSST）,modified Medical Research Council Dyspnea Scale（mMRC）,the Modified Beck Oral Assessment Scale（BOAS）were used for investigation and evaluation．Single factor analysis was used to analyze the influencing factors of oral function status in elderly COPD patients,and logistic regression was used to analyze the independent risk factors affecting oral function status in elderly COPD patients．Results Among 191 elderly patients with COPD,the BOAS scores were（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）at admission,the 3rd day,the 5th day and discharged day,respectively,with no statistical significance．The results of univariate analysis indicated that the independent risk factors of Beck oral function status in COPD patients at D3,D5 and discharge were gender,age,marital status,tooth loss,smoking history and Barthel index score,and the differences were statistically significant（P <0.05）．Binary logistic regression analysis indicated that age,smoking status,tooth loss and Barthel index score were independent risk factors for oral function status in hospitalized patients with COPD（P<0.05）．Conclusions Elderly patients with COPD have poor oral health status,which is affected by patient's age,smoking history,tooth loss and self-care ability．Targeted prevention and intervention strategies should be adopted to improve the oral health status of hospitalized patients with COPD,so as to reduce the COPD patient's risk of complications．

目的 探讨积极综合护理措施对早期宫颈癌术后患者性功能、抑郁和主观幸福感的影响。方法 对我院收治的84例50岁以下宫颈癌患者的临床资料进行回顾性分析,将行常规护理的43例患者作为对照组、行综合护理的41例患者作为治疗组,治疗组除了常规护理内容,还采用幸福理论框架模型下（PERMA模型）的性健康管理多学科团队干预方案。分别在干预前、干预后3个月、干预后6个月采用女性性功能指数、抑郁自评量表评分和幸福感指数,对性功能指数、抑郁评分和幸福指数进行评估。结果 与对照组相比,治疗组干预3个月及6个月患者的性功能改善（F=91.08,P<0.001）。干预3个月及6个月后,治疗组抑郁评分低于对照组（F=1 092.59,P<0.001）,幸福感改善指数高于对照组（F=107.90,P<0.001）。Spearman相关分析结果显示,女性性功能指数同抑郁自评量表得分呈负相关（r_s=-0.918,P<0.001）,同幸福感指数得分呈正相关（r_s=0.844,P<0.001）。结论 综合护理在性功能、抑郁和主观幸福感方面均有明显改善。通过PERMA模式下性健康管理的多学科团队干预方案,可以提高患者的性生活质量,降低患者的抑郁程度,及改善患者的主观幸福感。

Objective To explore the effects of active and comprehensive care measures on sexual function,depression and subjective well-being of patients after early cervical cancer surgery．Methods The clinical data of 84 cervical cancer patients（under 50 years old）admitted to our hospital were retrospectively analyzed．There were 43 cases with conventional care in control group and 41 cases with comprehensive care group in treatment group．Besides the conventional care components,the comprehensive care group also adopted a multidisciplinary team intervention program for sexual health management under the framework model of well-being theory（PERMA model）．We used the female sexual function index,depression self-rating scale score and happiness index to assess the sexual function index,depression score and happiness index before,3 months and 6 months after the intervention,respectively．Results In comparison with the control group,the patients in the treatment group had a significant improvement in sexual function at 3 and 6 months of intervention（F=91.08,P<0.001）．After 3 and 6 months of intervention,the depression score was significantly lower in the comprehensive care group than in the control group（F=1 092.59,P<0.001）,and the happiness improvement index was significantly higher than in the control group（F=107.90,P<0.001）．Spearman’s correlation analysis showed that the female sexual function index was negatively correlated with the depression self-rating scale score（r_s=-0.918,P<0.001）and positively correlated with the well-being index（r_s=0.844,P<0.001）．Conclusions The comprehensive care group showed significant improvements in sexual function,depression,and subjective well-being．A multidisciplinary team intervention program for sexual health management under the PERMA model can improve the quality of patients’ sexual life,reduce their depression,and improve their subjective well-being．

目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组（P<0.05）。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组（P<0.05）。干预后两组生活质量综合评定量表评分升高,观察组高于对照组（P<0.05）。观察组并发症发生率低于对照组（P<0.05）。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。

Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders．Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases．Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training．The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications．Results The observation group was generally more effective than the control group（P<0.05）．After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group（P<0.05）．After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group（P<0.05）．The complication rate was lower in the observation group（P<0.05）．Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes．

目的 探讨富血小板血浆（PRP）联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为（91.00±9.27）%、（0.29±0.12）%、（29.98±6.68）%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组（P<0.05）。经重复方差测量分析,两组美国特种外科医院膝关节评分系统（HSS）评分、西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟疼痛评分法（VAS）交互（F_交互=1.869、F_交互=1.482、F_交互=2.193）比较差异均有统计学意义（P<0.05）;与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降（P<0.05）;观察组并发症总发生率4.55%低于对照组30.43%（χ²=5.156、P=0.023）。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。

Objective To investigate the clinical effect of platelet rich plasma（PRP）combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function．Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method．Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group．The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared．Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were（91.00±9.27）%,（0.29±0.12）%,and（29.98±6.68）% respectively．The PRP preparation quality is stable and controllable．The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group（P<0.05）．After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery（HSS）Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,and visual analogue pain scales（VAS）interacted(F_Interaction=1.869,F_interaction=1.482,F_interaction=2.193),the differences were statistically significant（P<0.05）．Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased（P<0.05）;the total incidence of complications in the observation group was 4.55%,lower than that in the control group（30.43%,χ²=5.156,P=0.023）．Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time．It has good effects and is relatively safe．

目的 探讨不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性。方法 选取天津市第一医院2020年10月—2023年10月收治的150例高血压患者作为研究对象,将患者分为：1级组（n=50）,即140~159 mmHg和（或）舒张压90~99 mmHg,2级组（n=60）,即收缩压160~179 mmHg和（或）舒张压100~109 mmHg,3级组（n=40）,即收缩压≥180 mmHg和（或）舒张压≥110 mmHg。测量所有患者收缩压加权标准差（SBP_wSD）和舒张压加权标准差（DBP_wSD）评价血压变异性,检测空腹血糖、空腹甘油三酯水平,计算空腹甘油三酯血糖指数（TyG）,以及记录丙二醛（MDA）、一氧化氮（NO）、内皮素-1（ET-1）、超氧化物歧化酶（SOD）水平对内皮功能进行评价。采用Spearman相关分析法分析血压变异性与空腹TyG及内皮功能的相关性。结果 1级组DBP_wSD、SBP_wSD低于2级组和3级组（P<0.05）;1级组空腹血糖、空腹甘油三酯、TyG低于2级组和3级组（P<0.05）;1级组MDA、ET-1低于2级组和3级组,NO、SOD高于2级组和3级组（P<0.05）; DBPwSD、SBPwSD与空腹血糖、空腹甘油三酯无关（P>0.05）,DBP_wSD、SBP_wSD与NO、SOD水平呈负相关,与TyG、MDA、ET-1呈正相关（P<0.05）。结论 不同血压分级的高血压患者血压变异性、TyG及血管内皮功能具有明显差异,且高血压患者血压变异性与TyG和血管内皮功能具有明显相关性。

Objective To explore the correlation between blood pressure variability and fasting triglyceride blood glucose index and endothelial function in different hypertension grades．Methods A total of 150 hypertensive patients admitted to our hospital from October 2020 to October 2023 were selected as study participants．Patients were classified into group level 1 （n=50）,with systolic blood pressure 140~159 mmHg and/or diastolic blood pressure 90~99 mmHg,group level 2（n=60）,with systolic blood pressure 160~179 mmHg and/or diastolic blood pressure 100~109 mmHg,and group level 3（n=40）,with systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg．SBPwSD and DBP_wSD of all patients were measured to assess their blood pressure variability．Fasting blood glucose and fasting triglyceride levels were measured to calculate TyG．MDA,NO,ET-1 and SOD were used to evaluate endothelial function．The correlation between blood pressure variability and glycemic index and endothelial function was analysed using Spearman correlation analysis．Results The DBP_wSD and SBP_wSD of the group level 1 were significantly lower than those of the groups level 2 and 3（P<0.05）．The fasting blood glucose,fasting triglycerides and TyG in the group level 1 were significantly lower than those in the groups level 2 and 3（P<0.05）．MDA and ET-1 values in the group level 1 were significantly lower than in the groups level 2 and 3,while NO and SOD values in the group level 1 were significantly higher than those in the other two groups（P<0.05）．DBP_wSD and SBP_wSD did not correlate significantly with fasting blood glucose and fasting triglycerides（P>0.05）,while DBP_wSD and SBP_wSD correlated negatively with NO and SOD values and correlated positively with TyG,MDA and ET-1（P<0.05）．Conclusions There are significant differences in blood pressure variability,TyG,and endothelial function among hypertensive patients with different grades,and there is a significant correlation between blood pressure variability and TyG and endothelial function in hypertensive patients．

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 探讨心理因素对儿童功能性腹泻的影响。方法 选取贵州省人民医院儿科2018年1月—2023年1月收治的200例功能性腹泻患儿,依照患儿年龄进行分组,将3~9岁患儿纳入儿童期观察组（n=116）、将10~14岁纳入青少年期观察组（n=84）,另选取同期体检的200名健康儿童志愿者作为对照组,将3~9岁儿童纳入儿童期对照组（n=110）、10~14岁纳入青少年期对照组（n=90）。对所有3~9岁儿童采用幼儿心理健康评定量表（CMHA-80）评价心理健康水平。对所有10~14岁儿童采用青少年版中国心理健康量表（MSSMHS）评价心理健康水平。心理因素与儿童功能性腹泻的相关性采用Spearman相关性分析,采用Logistic回归分析分析儿童功能性腹泻的影响因素。结果 儿童期观察组与对照组儿童人际关系、意志力、认知、注意力相关CMHA-80评分对比差异无统计学意义（P>0.05）,观察组儿童适应性、社会行为、性格、自我意识、情绪情感、其他相关CMHA-80评分明显低于对照组儿童（P<0.05）;青少年期观察组与对照组儿童环境适应、人际交往相关MSSMHS评分对比差异无统计学意义（P>0.05）,青少年期观察组儿童自我认识、情绪体验、认知效能相关MSSMHS评分低于对照组儿童（P<0.05）。儿童期儿童适应性、社会行为、性格、自我意识、情绪情感与功能性腹泻呈负相关（P<0.05）,青少年期自我认识、情绪体验、认知效能与功能性腹泻负正相关（P<0.05）。Logistic回归分析结果表明,性格、情绪情感、其他为儿童期功能性腹泻的影响因素（P<0.05）,情绪体验、认知效能为青少年期功能性腹泻的影响因素（P<0.05）。结论 心理因素对于儿童功能性腹泻具有较大影响。对于儿童期儿童来说,性格、情绪情感、其他不良习惯、抽动、睡眠、饮食等均是引发功能性腹泻的影响因素,对于青少年期来说,情绪体验、认知效能为引功能性腹泻的影响因素。

Objective To explore the influence of psychological factors on functional diarrhea in children．Methods A total of 200 children with functional diarrhea admitted to Pediatric Department of Guizhou Provincial People's Hospital from January 2018 to January 2023 were selected．They were grouped according to their age．Children aged 3-9 were included in the preschool observation group（n=116）,while those aged 10-14 were included in the adolescent observation group（n=84）．Additionally,200 healthy children volunteers who underwent physical examinations during the same period were selected as the control group．Children aged 3-9 were included in the preschool control group（n=110）,and those aged 10-14 were included in the adolescent control group（n=90）．Use the CMHA-80 Preschool Mental Health Assessment Scale to evaluate the level of mental health for all children aged 3-9．Evaluate the mental health level of all children aged 10-14 using the MSSMHS．The correlation between psychological factors and functional diarrhea in children was analyzed using Spearman correlation analysis,and the influencing factors of functional diarrhea in children were analyzed using logistic regression analysis．Results The results showed that there was no statistically significant difference in the CMHA-80 scores of interpersonal relationships,willpower,cognition and attention between the preschool observation group and control group（P>0.05）．The CMHA-80 scores of adaptability,social behavior,personality,self-awareness,emotions and other factors in the observation group in childhood were significantly lower than those in the control group（P<0.05）．There was no statistically significant difference in the MSSMHS scores of environmental adaptation and interpersonal communication between the adolescent observation group and control group（P>0.05）．The MSSMHS scores of self-awareness,emotional experience and cognitive efficacy in the adolescent observation group were lower than those in the adolescent control group（P<0.05）．There was a negative correlation（P<0.05）between adaptability,social behavior,personality,self-awareness,emotions and functional diarrhea in preschool children．Adolescent self-awareness,emotional experience,cognitive efficacy,and functional diarrhea were negatively and positively correlated（P<0.05）．The results of Logistic regression analysis showed that personality,emotions and other factors were the influencing factors of functional diarrhea in preschool childhood（P<0.05）．Emotional experience and cognitive efficacy were influencing factors for adolescent functional diarrhea（P<0.05）．Conclusions Psychological factors have a significant impact on functional diarrhea in children．For preschool children,personality,emotions,other bad habits,tics,sleep,diet are all factors that can cause functional diarrhea．For adolescents,emotional experience and cognitive efficacy are factors that can cause functional diarrhea．

目的 探究肺炎支原体（MP）感染大叶性肺炎患儿常规通气、脉冲振荡肺功能特点。方法 将2022年5月—2023年5月广州市妇女儿童医疗中心收治的90例MP感染大叶性肺炎患儿为观察组,通气体检健康儿童50例为对照组,依据病变将累及多肺叶作为观察A组（10例）,累及单肺叶作为观察B组（80例）。均接受常规通气与脉冲振荡肺功能测定,观察测定结果,以此为基础,分析肺功能特点。结果 观察组各常规通气肺功能指标测定结果均低于对照组健康儿童,差异有统计学意义（P<0.05）。观察组R5、R20的实测值/预计值高于对照组,X5实测值低于对照组,差异有统计学意义（P<0.05）。气道阻力指标与肺功能呈负相关关系（P<0.05）。观察组两组最大肺活量（VCMAX）、呼气流量峰值（PEF）、用力肺活量（FVC）75%、FVC50%、FVC25%的实测值/预计值差异无统计学意义,观察A组患儿FVC、FEV₁的实测值/预计值低于观察B组患儿,差异有统计学意义（P<0.05）。两组患儿脉冲振荡肺功能对比差异无统计学意义（P>0.05）。90例患儿中,常规通气异常患儿12例,患儿治疗前后VCMAX、FVC75%、FVC50%的实测值/预计值差异无统计学意义,患儿治疗前FVC、FEV₁、PEF、FVC25%的实测值/预计值均低于治疗后,差异有统计学意义（P<0.05）。结论 常规通气与脉冲振荡相关性良好,气道阻力对VCMAX及FVC具有反向作用,MP感染大叶性肺炎主要表现为小气道通气功能受损,气道阻力升高。

Objective To explore the lung function characteristics of routine ventilation and pulse oscillation in children with lobar pneumonia infected with Mycoplasma pneumoniae（MP）．Methods Ninety children with MP infected lobar pneumonia admitted to Guangzhou Women and Children's Medical Center from May 2022 to May 2023 were selected as the observation group,and 50 healthy children undergoing ventilation examination were selected as the control group．Based on the lesion,cases with multi lobar involvement were selected as the observation group A（10 cases）,cases with single lobar involvement were selected as the observation group B（80 cases）．All patients underwent routine ventilation and pulse oscillation received pulmonary function measurement,and the measurement results were observed．Based on this,the characteristics of lung function were analyzed．Results The results of routine ventilation lung function indicators in the observation group were lower than those in the control group,and the difference was statistically significant（P<0.05）．The measured/expected values of R5 and R20 in the observation group were higher than those in the control group,while the measured values of X5 were lower than those in the control group,with statistical significance（P<0.05）．There is a negative correlation between airway resistance indicators and lung function（P<0.05）．The measured/predicted values of vital capacity max（VCMAX）,peak expiratory flow（PEF）,forced vital capacity（FVC）75%,FVC50%,and FVC25% in the observation group were not with statistically significant difference．The measured/predicted values of FVC and FEV₁ in the observation group A were lower than those in the observation group B,and the difference was statistically significant（P<0.05）．There was no statistically significant difference in pulmonary function between the two groups of pediatric patients with pulse oscillation（P>0.05）．Among the 90 patients,12 had abnormal conventional ventilation．The measured/predicted values of VCMAX,FVC75%,and FVC50% before and after treatment were not significantly different．The measured/predicted values of FVC,FEV₁,PEF,and FVC25% before treatment were lower than those after treatment,and the difference was statistically significant（P<0.05）．Conclusions There is good correlation between conventional ventilation and pulse oscillation．Airway resistance has a reverse effect on VCMAX and FVC．MP infected lobar pneumonia is mainly characterized by impaired small airway ventilation function and increased airway resistance．

目的 针对精神分裂症患者接受喹硫平与帕利哌酮联合治疗对其代谢功能及血清因子的影响。方法 纳入2022年1月—2023年3月驻马店市第二人民医院收治的120例精神分裂症患者,根据住院号进行编号,并通过通过随机抽签方法分为两组,对照组60例应用单一喹硫平治疗,观察组60例应用喹硫平与帕利哌酮联合治疗,对比两组的治疗效果。结果 经治疗,观察组临床总疗效高于对照组（P<0.05）;该组各项代谢功能指标均与对照组比较差异无统计学意义（P>0.05）;该组各项血清因子测定该结果均高于对照组（P<0.05）;该组各项精神症状评分均低于对照组（P<0.05）;该组不良反应发生率与对照组比较差异无统计学意义（P>0.05）。结论 采用喹硫平与帕利哌酮联合的方式治疗精神分裂症患者,可以提升临床疗效,对患者各种精神症状及血清因子改善效果更好,虽然药物会对患者代谢功能产生一定的影响,但是联合用药与单独用药的影响情况无差异,未增加不良反应发生率,安全性良好。

Objective To evaluate the combination of quetiapine and paliperidone on metabolic function and serum factors in schizophrenia．Methods A total of 120 patients with schizophrenia admitted to Zhumadian Second People's Hospital from January 2022 to March 2023 were included,numbered according to the hospitalization number,and divided into two groups by random drawing method．Sixty patients in the control group were treated with quetiapine alone,and 60 patients in the observation group were treated with quetiapine combined with paliperidone,and the therapeutic effects of the two groups were compared．Results After treatment,the total clinical efficacy of the observation group was higher than that of the control group,P<0.05;the metabolic function indexes comparison were P> 0.05;the serum factor of observation group was higher,P<0.05;the scores of psychiatric symptoms in the group were all lower than the control group,P<0.05;the incidence of adverse reactions in the observation improve group was not different from the control group,P>0.05．Conclusions Using quetiapine and schizophrenia,can improve clinical curative effect,various mental symptoms and serum factors,although certain effect on patient metabolic function may occur,but did not significantly increase the incidence of adverse reactions,with high safety．