目的 分析2016—2024年宜春市5岁以下儿童死亡水平、死因构成、县区分布特征及变化趋势，为制定儿童健康干预策略提供依据。方法 回顾性收集2016—2024年宜春市5岁以下儿童死亡监测资料，统计各年度新生儿、婴儿及5岁以下儿童死亡率，分析死因构成比、顺位变化及县区分布特征，采用线性趋势χ2检验分析死亡率年度变化趋势。结果 2016—2024年宜春市各年龄段儿童死亡率均呈下降趋势（均P＜0.05），新生儿、婴儿、5岁以下儿童9年平均死亡率分别为1.35‰、2.62‰、5.02‰，较2016年分别下降26.79%、43.55%、43.06%。死因顺位整体呈现小幅变迁，肺炎占比逐步下降，溺水、意外窒息等意外伤害相关死因顺位持续前移。各县区死亡率存在差异，高死亡率县区集中在袁州区、奉新县，低死亡率县区以铜鼓县为主。结论 2016—2024年宜春市5岁以下儿童死亡率呈下降趋势，但意外伤害已成为主要死因，县区差异客观存在。应重点加强意外伤害预防工作，针对高死亡率县区实施差异化干预。

目的 探讨院外延续性护理联合院内心理指导对重症烧伤患者创伤应激的影响。方法 选取2020年6月—2022年6月南开大学附属医院（天津市第四医院）重症烧伤科收治的86例重度烧伤患者为研究对象,应用随机数字表法将患者分为观察组与对照组,每组各43例。对照组采取常规护理,观察组在常规护理基础上增加院外延续性护理联合院内心理指导,评估患者的创伤应激指标[血清肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、β-内啡肽（β-ep）]、心理韧性程度、应对行为、创伤后成长水平,并分析患者创伤应激与心理韧性的相关性。结果 干预前,两组的TNF-α、IL-6、β-ep水平比较差异无统计学意义（P>0.05）;干预后,两组创伤应激相关指标水平均下降,且观察组降低幅度更大（P<0.05）。干预后,两组患者乐观性、力量性、坚韧性相关中文版创伤后成长评定量表（C-PTGI）评分均升高,且观察组更高（P<0.05）;Pearson相关性分析显示,TNF-α、IL-6、β-ep等创伤应激指标水平与心理韧性水平呈负相关（P<0.05）;干预后,两组患者积极应对特质应对方式问卷（TCSQ）评分均升高,观察组高于对照组,人消极应对评分均降低,观察组低于对照组（P<0.05）;干预后,两组患者人际关系、精神变化、生活欣赏、个人力量、新的可能相关C-PTGI评分分量表得分均升高,观察组高于对照组（P<0.05）。结论 对重度烧伤患者采取院外延续性护理联合院内心理指导能够降低患者的创伤后应激水平、消极应对评分,提升患者心理韧性程度、创伤后成长水平以及积极应对评分,且创伤后应激水平与心理韧性水平呈负相关。

Objective To explore the effect of out-hospital continuous nursing combined with in-hospital psychological guidance on traumatic stress in severe burn patients．Methods A total of 86 patients with severe burn treated in the Affiliated Hospital of Nankai University（Tianjin Fourth Hospital）from June 2020 to June 2022 were selected as the research objects．The patients were divided into observation group and control group by random number table method,with 43 cases in each group．The control group received routine care,and the observation group was supplemented with out-hospital continuous nursing and in-hospital psychological guidance on the basis of routine care．The traumatic stress indexes [serum tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,β-endorphin（β-ep）],psychological toughness,coping behavior and post-traumatic growth level of the patients were evaluated．The correlation between traumatic stress and mental toughness was analyzed．Results Before intervention,the levels of TNF-α,IL-6 and β-ep were not significantly different between the two groups（P>0.05）．After intervention,the levels of traumatic stress-related indicators were decreased between the two groups,and the reduction was greater in the observation group（P<0.05）．After intervention,C-PTGI scores related to optimism,strength and fortitude were increased in both groups,which were higher in observation group（P<0.05）．Pearson correlation analysis showed that the levels of TNF-α,IL-6,β-ep and other traumatic stress indexes were significantly negatively correlated with the levels of mental toughness（P<0.05）．After intervention,the positive coping TCSQ scores of both groups were increased,the observation group was higher,and the negative coping scores were decreased,while the observation group was lower（P<0.05）．After the intervention,the scores of interpersonal relationships,mental changes,life appreciation,personal strength,and new possibly relevant C-PTGI score subscale were increased in both groups,and higher in the observation group（P<0.05）．Conclusions The combination of out-hospital continuous nursing and in-hospital psychological guidance for severe burn patients can reduce the level of post-traumatic stress and negative response score of patients,and improve the level of mental toughness,post-traumatic growth and positive score of patients,and the level of post-traumatic stress is significantly negatively correlated with the level of mental toughness．

目的 探讨妊娠期高血压疾病患者血尿酸、淀粉酶水平的变化的临床意义。方法 选择2020年2月—2023年2月期间焦作市第二人民医院收治的150例合并妊娠期高血压疾病孕妇作为观察组,另选择同期接收的50例正常妊娠孕妇作为对照组,测定两组孕妇孕早期、孕中期、孕晚期的血尿酸、淀粉酶水平,比较两组检测结果,并采取受试者工作特征曲线分析（ROC）血尿酸、淀粉酶水平筛查妊娠期高血压疾病的诊断效能,比较观察组妊娠期高血压、子痫前期、子痫孕妇的检测结果。结果 观察组孕妇在孕早期、孕中期、孕晚期的血尿酸水平高于对照组,淀粉酶水平低于对照组（P<0.05）;孕早期与孕中期的血尿酸、淀粉酶水平比较,两组孕妇比较差异均无统计学意义（P>0.05）;孕晚期两组孕妇的血尿酸水平升高,淀粉酶水平降低,与孕早期、孕中期比较差异有统计学意义（P<0.05）。ROC曲线分析显示,妊娠期高血压疾病的筛查中血尿酸灵敏度为58.15%、特异度为88.72%,淀粉酶灵敏度为56.47%、特异度为92.24%,血尿酸联合淀粉酶灵敏度为82.24%、特异度为98.57%。子痫、重度子痫前期、轻度子痫前期、妊娠期高血压孕妇的血尿酸、淀粉酶水平比较差异均有统计学意义（P<0.05）。结论 与正常妊娠孕妇相比,合并妊娠期高血压疾病孕妇的血尿酸水平升高、淀粉酶水平降低,二者联合可实现对妊娠期高血压疾病的准确筛查,而且可评估病情进展。

目的 分析血流感染（BSI）患者血小板参数的动态变化及其在患者预后中的价值。方法 回顾性分析南通市中西医结合医院检验科明确BSI的66例患者,分为生存组（55例）和死亡组（11例）。比较不同组间病原菌分布及1周内血小板参数动态变化情况,并通过Logistic回归分析评估血小板参数动态变化的在治疗预后评估中的价值。结果 （1）BSI患者病原菌分为革兰氏阳性菌（G+）25株、革兰氏阴性菌（G-）39株、真菌2株;G+病原菌中前三位为金黄色葡萄球菌（10.61%）、表皮葡萄球菌（7.58%）、头状葡萄球菌（4.55%）;G-病原菌中前三位为大肠埃希菌（24.24%）、肺炎克雷伯菌肺炎亚种（15.15%）、肠炎沙门菌血清型（3.03%）;真菌为新生隐球酵母（1.52%）、光滑假丝酵母（1.52%）。（2）生存组序贯性器官功能衰竭评分（SOFA）评分为（3.24±0.53）分,低于死亡组的（6.02±1.17）分（t=12.535,P<0.001）;生存组BSI病程为（20.50±2.17）d,低于死亡组的（25.71±4.81）d（t=3.352,P<0.001）;生存组肺部原发感染灶30.91%,高于死亡组的63.64%（χ²=4.243,P=0.039）;生存组最大平均血小板体积（MPV）为（10.96±1.58）fL,低于死亡组的（11.99±1.42）fL（t=2.004,P=0.049）;生存组入院血小板计数（PLT）为（144.33±23.18）10⁹/L,低于死亡组的（166.91±20.29）10⁹/L（t=3.005,P=0.004）;生存组最低PLT为（113.48±30.76）10⁹/L,高于死亡组的（80.16±38.24）10⁹/L（t=3.148,P=0.002）。（3）两组入院及BSI时、BSI后4 d内的指标比较差异均无统计学意义（P>0.05）,在BSI后的5~7 d,生存组PLT为（210.83±102.37）10⁹/L,高于死亡组的（112.75±116.84）10⁹/L（t=2.835,P=0.006）;生存组MPV为（10.12±1.58）fL,低于死亡组的（11.27±1.85）fL（t=2.142,P=0.036）;生存组MPV/PLT 比值（MPR）为（5.69±2.89）,低于死亡组的（11.64±8.23）（t=4.290,P<0.001）。（4）多因素Logistic回归分析发现,入院SOFA（OR=5.461,95%CI：1.544~19.319,P=0.008）、BSI病程（OR=0.773,95%CI：0.622~0.960,P=0.020）、5~7 d MPR（OR=18.976,95%CI：1.776~202.709,P=0.015）是BSI的预测因素。结论 BSI患者血小板参数动态变化较为明显,而入院SOFA、BSI病程、5~7 d MPR对于预测患者死亡风险有重要意义。

目的 探讨终末期肾病患者血液透析中实施基于依从性曲线变化规律的阶段性护理的效果。方法 选择2022年1月—2023年10月濮阳市人民医院收治的接受血液透析治疗的86例终末期肾病患者,将其通过单双号抽签的方式分组,即对照组与观察组,各43例,前者实施常规护理,后者在此基础上实施基于依从性曲线变化规律的阶段性护理,对比两组患者护理前后心理状态评分情况、生活质量评分情况及治疗依从性。结果 两组患者护理前后正性负性情绪量表（PANAS评分有一定差距,其中负性情绪显著降低,正性情绪显著提升,而护理后观察组负性情绪评分为（11.67±2.55）分,低于对照组的（16.11±3.02）分,正性情绪为（25.07±5.28）,高于对照组的（20.11±5.23）分（t=7.366、4.376,P<0.05）;护理后观察组生活质量综合评定量表（GQOLI-74）躯体、心理、社会及物质生活等维度评分分别为（82.17±7.11）分、（82.02±7.45）分、（81.11±7.78）分及（81.11±7.42）分,高于对照组的（71.22±7.23）分、（72.12±7.56）分、（71.23±7.45）分及（70.23±7.33）分（t=7.081、6.116、6.015、6.840,P<0.05）;观察组（95.35%）与对照组（76.74%）的治疗依从性比较,前者更高（χ²=6.198,P<0.05）。结论 基于依从性曲线变化规律的阶段性护理对于接受血液透析治疗的终末期肾病患者,不仅有助于调整其心理状态,还有助于提高其治疗依从性,使其生活质量也得以全面提高。

Objective To explore the effect of implementing phased nursing based on compliance curve changes in hemodialysis for end-stage renal disease patients. Methods The research deadline was from January,2022 to October,2023．The research object was 86 patients with end-stage renal disease who received hemodialysis treatment in Puyang People's Hospital,and they were divided into control group and observation group with 43 patients in each group by odd and even numbers．The former was given routine care,while the latter was given stage nursing based on the change of compliance curve．The psychological state score,quality of life score and treatment compliance of the two groups were compared before and after care. Results There was a certain difference in the Positive and Negative Affect Scale（PANAS）scores between the two groups before and after nursing,in which the negative emotion was significantly reduced and the positive emotion was significantly improved．After nursing,the negative emotion score of the observation group was（11.67±2.55）,which was significantly lower than that of the control group（16.11±3.02）,and the positive emotion score was（25.07±5.28）,which was significantly higher than that of the control group（20.11±5.23）（t=7.366,4.376,P<0.05）．After nursing,the scores of Generic Quality of Life Inventory-74（GQOLI-74）in the observation group were（82.17±7.11）,（82.02±7.45）,（81.11±7.78）and（81.11±7.42）,which were significantly higher than those in the control group（71.22±7.23）,（72.12±7.56）,（71.23±7.45）and（70.23±7.33）（t=7.081,6.116,6.015,6.840,P<0.05）．The treatment compliance of the observation group（95.35%）was higher than that of the control group（76.74%）（χ²=6.198,P<0.05）. Conclusions Choosing stage nursing based on the variation pattern of compliance curve for end-stage renal disease patients undergoing hemodialysis not only helps to adjust their psychological state,but also improves their treatment compliance,leading to a comprehensive improvement in their quality of life．

目的 分析安氏Ⅲ类错牙合正畸治疗牙合患者中切牙牙根及牙槽骨形态变化的影响。方法 分析2020年1月—2021年12月于我院口腔科进行正畸治疗的23例安氏Ⅲ类错牙合患者基本资料,对患者予以治疗前后的对锥形束CT测量,记录并对比相关数据,分析正畸治疗对于患者中切牙牙根及牙槽骨的影响。结果 （1）治疗后牙体及牙根长度较治疗前明显减小;（2）患者在治疗后唇、舌侧牙槽骨宽度呈下降趋势,与其他位点相比,上下颌舌侧中牙槽骨更易出现牙根吸收;下颌唇侧中牙槽骨宽度增加明显;（3）治疗后唇、舌侧牙槽骨缺损高度上有所增加,骨开窗、骨开裂位点增多。结论 安氏Ⅲ类错牙合有一定概率会出现牙根吸收等损伤,定期对患者实施锥形束CT检查能够为医生提供清晰准确图像资料支持,帮助医生更好判断患者状况并及时调整和优化治疗方法,以此进一步改善患者预后。

目的 探讨腹主动脉瘤腔内修复术后瘤体直径和瘤体体积的转归以及与术后内漏的关系。方法 回顾性分析2015年—2020年在我院行腹主动脉瘤腔内修复术的83例患者的临床及影像学资料。测量术前和术后各随访时间点瘤体最大直径及体积。CT评价术后内漏发生情况。定义瘤体（直径/体积）扩张/回缩及瘤体（直径/体积）稳定。以术前瘤体最大直径大小和术后内漏发生情况将患者分组,比较组间各随访时点的瘤体直径和体积转归情况。结果 患者术后平均随访时间24（10~62）个月。以瘤体直径<50 mm及≥50 mm分组,术后各随访时间点2组间瘤体体积及瘤体直径比较均无统计学差异。以术后有无内漏分组,术后各随访时间点组间比较瘤体体积变化比较差异均有统计学意义（P<0.05）,但瘤体直径变化组间比较差异均无统计学意义。结论 主动脉瘤瘤体体积与直径变化并不存在一致性,监测瘤体体积可以发现那些直径变化不明显的瘤体变化;腹主动脉瘤腔内修复术后内漏可能是导致瘤体增大的因素之一。

Objective To evaluate the outcome of aneurysm diameter and volume,and the role of endoleak after endovascular aneurysm repair of abdominal aortic aneurysm．Methods The clinical and imaging data from 83 patients who underwent endovascular repair of abdominal aortic aneurysm in our hospital from 2015 to 2020 were retrospectively analyzed．The maximum aneurysm diameter and volume were measured at the preoperative and postoperative follow-up time points．CT was used to evaluate the incidence of postoperative leakage．The aneurysm（diameter/volume）expansion/shrinkage and aneurysm（diameter/volume）stability were defined．Patients were divided into different groups according to the maximum preoperative aneurysm diameter and the incidence of postoperative endoleak,and the outcomes of aneurysm diameter and volume were compared at established follow-up points．Results The mean follow-up time was 24（10-62）months．There were no statistically significant differences in postoperative aneurysm volume and diameter at follow-up points between the patients with aneurysm diameter <50 mm and patients with aneurysm≥50 mm．There were statistically significant differences in postoperative aneurysm volume between the patients with postoperative endoleak and patients without postoperative endoleak（P<0.05）．However,there were no statistically significant differences in postoperative diameter between the two groups．Conclusions The changes of aneurysm volume and diameter were not closely related,and the detection of aneurysm volume can help to find the aneurysm changes with no obvious diameter changes．The postoperative endoleak after endovascular aneurysm repair may be one of the factors leading to aneurysm enlargement．

目的 丹酚酸B是传统中药丹参的重要生物活性组分,临床应用广泛。新近发现,丹酚酸B具有防治骨质疏松的作用。本研究拟在前期工作基础上,系统地研究丹酚酸B对去卵巢骨质疏松小鼠的作用,探讨其对小鼠间充质干细胞（MSCs）成骨分化的影响。方法 将18只8周龄SPF级别的C57雌性小鼠分为假手术组、骨质疏松组、丹酚酸B治疗组。骨质疏松组和丹酚酸B治疗组行双侧卵巢摘除术。而假手术组则保持正常的卵巢结构,同时去除局部的脂肪。3组均于术后3日内给予抗生素进行抗感染治疗。4周内,丹酚酸B治疗组给予丹酚酸B 2.5 mg/kg腹腔注射,连续12周,2天1次,其余2组在相同的时间内给予等量生理盐水。16周后,在麻醉状态下将所有小鼠处死。应用MicroCT测量了小鼠右后股骨的骨密度。采用qRT-PCR技术,分析小鼠左后股骨骨髓MSCs中Runx2和Osterix的表达。将小鼠右后股骨进行液氮研磨处理,提取蛋白质,用WB法测定OPG和RANKL的含量。结果 骨质疏松组小鼠股骨骨密度比假手术组低（P<0.05）,丹酚酸B治疗组小鼠股骨骨密度比骨质疏松组高,但差异无显著性意义（P<0.05）。骨质疏松组小鼠Runx2和Osterix水平低于假手术组（P<0.05）,丹酚酸B治疗组小鼠Runx2和Osterix水平比骨质疏松组高（P<0.05）。骨质疏松组小鼠OPG和RANKL蛋白水平低于假手术组（P<0.05）,丹酚酸B组小鼠OPG和RANKL蛋白水平比骨质疏松组高（P<0.05）。结论 绝经后骨质疏松症早期对小鼠的骨质疏松具有一定的影响,但还需要更多的实验来验证本研究的结论。

Objective Salvianolic acid B is an important bioactive component of traditional Chinese medicine Salvia miltiorrhiza and is widely used in clinic．Recently,salvianolic acid B has been found to have the effect of preventing osteoporosis．On the basis of previous work,this study intends to systematically explore the effect of salvianolic acid B on ovariectomized mice with osteoporosis,and its effect on the osteogenic differentiation of mouse mesenchymal stem cells（MSCs）．Methods Eighteen eight-week-old SPF C57 female mice were divided into sham operation group,osteoporosis group and salvianolic acid B treatment group（6 mice in each group）．The osteoporosis group and salvianolic acid B group underwent bilateral ovariectomy．The sham group maintained normal ovarian structure while removing local fat tissue．All three groups were given antibiotics for anti-infection treatment within 3 days after operation．Within 4 weeks,salvianolic acid B treatment group was given salvianolic acid B 2.5 mg/kg intraperitoneal injection for 12 weeks,once every 2 days,and the other 2 groups were given the same amount of saline at the same time．After 16 weeks,all mice were sacrificed under anesthesia．The bone density of the mouse right posterior femur was measured by MicroCT．The expressions of Runx2 and Osterix in the bone marrow of mouse left posterior femur were analyzed by qRT-PCR．The right posterior femur of mice was ground with liquid nitrogen to extract protein,and the contents of OPG and RANKL were determined by WB．Results The bone mineral density of the femur in the osteoporosis group was lower than that in the sham operation group（P<0.05）,and the bone mineral density of the femur in the salvianolic acid B treatment group was higher than that in the osteoporosis group,but the difference was not significant（P<0.05）．The levels of Runx2 and Osterix in the osteoporosis group were significantly lower than those in the sham operation group（P<0.05）,and the levels of Runx2 and Osterix in the salvianolic acid B treatment group were higher than those in the osteoporosis group（P<0.05）．The levels of OPG and RANKL protein in the osteoporosis group were significantly lower than those in the sham operation group（P<0.05）,while the levels of OPG and RANKL protein in the salvianolic acid B group were higher than those in the osteoporosis group（P<0.05）．Conclusions The early stage of postmenopausal osteoporosis has certain effects on osteoporosis in mice,but more experiments are needed to verify the conclusions of this study．

目的 了解广州市某三甲综合医院2016—2022年住院病例的疾病分布特征,探究新型冠状病毒感染（新冠）疫情对疾病谱的影响,为医院合理配置医疗资源、提高医院医疗水平提供参考。方法 回顾性收集广州市某三甲综合医院2016—2022年间住院病例的病例数据,按照ICD-10国际统计分类标准进行分类,建立Joinpoint回归模型对不同类别疾病构成比的时间变化趋势进行分析。结果 2016—2022年间,前12顺位的疾病种类不变,构成比呈上升趋势的有4种,分别是循环系统疾病、肿瘤、消化系统疾病以及眼和附器疾病,构成比呈下降趋势的有3种,分别是呼吸系统疾病、肌肉骨骼系统和结缔组织疾病以及妊娠、分娩和产褥期。对这7类系统疾病进行不同性别、不同年龄段和不同居住地（广州市内/市外）的亚组分析,结果显示,除眼和附器疾病与妊娠、分娩和产褥期外,其余5种系统疾病在男性和女性中变化趋势比较差异无统计学意义（均P>0.05）。25岁以上人群循环系统疾病、肿瘤和消化系统疾病比例呈上升趋势。45岁以上人群眼和附器疾病的住院比例逐年上升。呼吸系统疾病的下降趋势集中出现在0~5岁和65岁以上人群,肌肉骨骼系统和结缔组织疾病的下降趋势可在45岁以上人群中被观测到,妊娠、分娩和产褥期的下降趋势则可在45岁以下人群中被观测到。总体和市内来源的住院病例的各系统疾病构成比变化趋势均未发现有2019年的连接拐点。但对于居住地在广州市外的病例,有6种系统疾病均存在一个2019年的连接拐点,与2016—2019年相比,2020—2022年增长趋势普遍减弱或者略有降低,但均无统计学意义,2022年市外来源住院病例的多种疾病占比低于2019年。≤24岁年龄组的病例因妊娠、分娩和产褥期住院的比例在2019年以后降低趋势加快,但也无统计学意义,2020—2022年≤24岁人群因妊娠、分娩和产褥期住院的比例低于2019年水平。结论 2016—2022年期间住院病例疾病谱有较大变化,这种变化趋势在不同性别、不同年龄段和居住地间效应存在差异。2020—2022年的新冠疫情流行主要降低了居住地在广州市外的住院病例多个系统疾病的比例以及24岁及以下患者因妊娠、分娩和产褥期住院的比例。

Objective To understand the disease distribution characteristics of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022,to explore the impact of the COVID-19 on the disease spectrum,and to provide reference for hospitals to reasonably allocate medical resources and improve medical level. Methods Inpatient case data of a 3-A-grade general hospital from 2016 to 2022 were retrospectively collected and were classified according to the ICD-10 international statistical classification standard. A Joinpoint regression model was established to analyze the temporal trend of disease composition ratios in different categories. Results From 2016 to 2022,the type of top 12 diseases remained unchanged. There were 4 diseases showing an upward trend in composition,namely circulatory system diseases,tumors,digestive system diseases and eye and accessory organ diseases. There were 3 diseases showing a downward trend in composition,namely respiratory system diseases,musculoskeletal system and connective tissue diseases,as well as pregnancy,childbirth and postpartum period. A subgroup analysis was conducted on these 7 types of systemic diseases by gender,age group and place of residence(within/outside Guangzhou). The results showed that except for eye and accessory organ diseases and pregnancy,childbirth and postpartum period,there was no significant difference in the trend of changes in the other 5 systemic diseases between males and females(all P>0. 05). The upward trend of circulatory system diseases,tumors and digestive system diseases could be observed in people over the age of 25. The hospitalization rate of eye and accessory organ diseases among people over 45 years old was increasing year by year. The downward trend of respiratory diseases was concentrated in people aged 0~5 and over 65 years old,while the downward trend of musculoskeletal and connective tissue diseases could be observed in people aged 45 and above. The downward trend of pregnancy,childbirth and postpartum period could be observed in people under 45 years old. The trend of changes in the proportion of systemic diseases among inpatient cases from both overall and within Guangzhou had not been found to have a joinpoint in 2019. However,for cases residing outside of Guangzhou,there were six systemic diseases that all had a joinpoint in 2019. Compared with the growth trend from 2016 to 2019,the growth trend from 2020 to 2022 generally weakened or showed a slightly downward trend,but none of them were statistically significant. In 2022,the proportion of multiple diseases in hospitalized cases from outside Guangzhou was lower than that in 2019. The proportion of cases in the age group ≤24 years old who are hospitalized due to pregnancy,childbirth and postpartum period has been decreasing rapidly since 2019,but there was no statistical significance. The proportion of cases hospitalized due to pregnancy,childbirth and postpartum period in the population ≤24 years old from 2020 to 2022 was significantly lower than the level in 2019. Conclusions The disease spectrum of inpatients had undergone significant changes between 2016 and 2022,and these trends of changes were different among different genders,age groups and places of residence. The prevalence of the COVID-19 from 2020 to 2022 mainly reduced the proportion of inpatients with multiple systemic diseases living outside Guangzhou,and the proportion of inpatients aged 24 and under hospitalized for pregnancy,childbirth and puerperium.

目的 采用体外试验的方法,研究弱酸性培养对人正常食管内皮细胞（HEEC）活力的影响及潜在的调控机制。方法 细胞培养液的pH值分别设为（6.0~6.5）和（7.0~7.4）。以中性培养组为对照。利用CCK8实验,检测弱酸培养条件下,不同时间点食管内皮细胞活力的变化。采用蛋白免疫印迹法检测p38和磷酸化p38（p-p38）的表达。利用酶联免疫吸附剂测定法检测培养基上清液中IL-1β和IL-8的表达水平,并检测加入p38激酶活性抑制剂SBS 203580后两者浓度的变化。结果 弱酸环境下,细胞活力下降。培养1 h时,弱酸组细胞活力为（96.4±8.0）%,培养3 h和6 h时分别为（88.7±6.2）%和（87.7±7.4）%。细胞中p38的水平与培养基的pH值无关。弱酸培养可以促使细胞内p-p38的含量增加。基线时,弱酸组p-p38的灰度值比值为（0.37±0.02）,在培养2 h和6 h时分别为（0.64±0.09）、（0.84±0.11）,差异显著（P<0.01）。弱酸刺激诱导食管内皮细胞表达更多的IL-8和IL-1β。基线时弱酸组上清液中IL-8和IL-1β的浓度分别为（8.64±1.31）pg/mL,（3.35±0.49）pg/mL。培养6 h后,二者的浓度分别上升至（36.85±2.02）pg/mL和（19.19±1.60）pg/mL,差异显著（P<0.01）。加入SBS 203580后,IL-8和IL-1β的浓度明显下降（P<0.05）。结论 弱酸刺激可以降低食管内皮细胞的活力。p38 MAPK可能通过调控IL-8和IL-1β的表达参与该调节过程。

Objective To study the effect of weak acidic culture on the viability of normal human esophageal endothelial cells(HEEC)and the potential regulatory mechanisms. Methods The pH values of cell culture medium were set at(6. 0-6. 5)and(7. 0-7. 4),respectively. The group in neutral medium was set as control. CCK8 experiment was used to detect the change of cell viability at different time points. The expressions of p38 and phosphorylated p38(p-p38)were detected by Western Blot experiment. Enzyme linked immunosorbent assay was used to detect IL-1β and IL-8 concentration in the medium supernatant before and after adding p38 activity inhibitor(SBS 203580). Results HEEC viability was decreased under weak acidic conditions. After 1 hour of cultivation,the HEEC viability was(96. 4±8. 0)%,after 3 and 6 hours,it decreased to(88. 7±6. 2)% and(87. 7±7. 4)%,respectively. The level of p38 in cells was independent of culture medium pH values. Weak acidic stimulation could promote an increase of p-p38 in HEEC. At baseline,the gray value ratio of p-p38 in the weak acidic group was(0. 37±0. 02),and after 2 and 6 hours of culturing,it increased to(0. 64±0. 09)and(0. 84±0. 11),respectively,which differences were significant(P<0. 01). More IL-8 and IL-1β were expressed after weak acidic stimulation. At baseline,the concentrations of IL-8 and IL-1β in the medium supernatant of weak acidic group were(8. 64±1. 31)pg/mL and(3. 35±0. 49)pg/mL. After 6 hours of culturing,they increased significantly to(36. 85±2. 02)pg/mL and(19. 19±1. 60)pg/mL(P<0. 01),while the concentrations were decreased after adding SBS 203580(P<0. 05). Conclusions The HEEC viability was reduced by weak acidic stimulation,p38 MAPK may participate in the process by regulating the expression of IL-8 and IL-1β.