目的   通过对急性深静脉血栓形成（DVT）患者经导管接触性溶栓治疗（CDT）中，影响血管导管相关感染（VCAI）危险因素及病原菌分析，为VCAI的预防提供合理、有效的措施。方法   收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料，回顾性调查患者诊疗相关资料及血培养结果，并对发生VCAI和病原菌情况进行分析。结果   本研究共调查急性DVT行CDT治疗的患者437例，发生VCAI的患者共21例，千日感染率为0.543‰。多因素Logistic回归分析结果显示：溶栓频率＞3次/天［OR=3.49（95%CI：1.86~6.45）］、导管留置时间＞7 d［OR=3.86（95%CI：1.26~10.18）］和有导管回送［OR=8.67（95%CI：4.83~12.65）］是患者发生VCAI的危险因素（P＜0.05）。发生VCAI的21例患者，血培养共培养出24株病原菌，有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见，共培养出13株，占比54.17%，革兰阴性菌9株，占比37.5 %。结论   导管留置时间＞7 d、溶栓频率＞3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主，可合并其他病原菌感染，其中以革兰阳性球菌为主。

        Objective  By analyzing the risk factors and pathogens of vessel catheter associated infection（VCAI）in patients with acute deep vein thrombosis（DVT）undergoing catheter directed thrombolysis（CDT），to provide  reasonable and effective measures for the prevention and treatment of VCAI ．Methods  Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected，patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized，and the occurrence of VCAI and pathogenic bacteria was statistically analyzed．Results  This study investigated 437 patients undergoing CDT treatment for acute DVT，and a total of 21 patients developed VCAI，with an infection rate of 0.543‰．The  results of multiple Logistic  regression analysis show that thrombolysis frequency＞3 times/day（OR=3.49［95%CI：1.86-6.45］），catheter retention days＞7 days（OR=3.86［95%CI：1.26-10.18］），and the presence of catheter return（OR=8.67［95%CI：4.83-12.65］） were risk factors for the occurrence of VCAI in patients．Among the 21 patients with VCAI，a total of 24 strains of pathogenic bacteria were discoveredin blood culture，and 3 patients developed composite pathogen infections．Among them，Gram  positive cocci were the most common，with a total of 13 strains cultured，accounting for 54.17%，9 strains of Gram negative bacteria，accounting for 37.5%．Conclusions  The duration of catheter retention＞7 days，thrombolysis frequency＞3 times/day，and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment．The pathogen of VCAI is mainly single pathogen，which can be combined with other pathogens，among which Gram positive cocci are the main pathogen．

目的 探讨行动研究法的倾向、强化及促成因素（PRECEDE）护理模式在冠心病患者中的应用效果。方法 选取2022年3月—2023年3月新乡市中心医院心内科收治的120例冠心病患者为研究对象,根据其住院ID号,以1：1比例分为对照组与观察组各60例,前者实施PRECEDE护理模式,后者实施基于行动研究法的PRECEDE护理模式,对比两组心功能指标干预前后检测情况、遵医行为及疾病相关知识掌握情况。结果 干预后3个月,观察组左室射血分数（LVEF）高于对照组及干预前,左心室收缩末期容积指数（LVESVⅠ）及左心室舒张末期容积指数（LVEDVⅠ）低于对照组及干预前（P<0.05）。观察组遵医行为比例和相关知识总掌握率均高于对照组（P<0.05）。结论 冠心病患者实施基于行动研究法的PRECEDE护理模式,不仅有助于改善其心功能指标,还能改善其遵医行为,提高其疾病知识掌握率。

目的 研究细胞周期调控因子E2F-1和p16蛋白与宫颈上皮内瘤变及宫颈鳞癌的表达及其临床意义。方法 通过免疫组化SP法检测宫颈上皮内瘤变Ⅰ-Ⅱ级(CINⅠ-Ⅱ级)、宫颈上皮内瘤变Ⅲ级(CINⅢ级)、宫颈鳞癌各40例中E2F-1和p16蛋白的表达情况,并用20例慢性宫颈炎组织作对照。结果 E2F-1蛋白在CINⅠ-Ⅱ级、CINⅢ级和宫颈鳞癌组中阳性率分别为17.5%、67.5%和80.0%, 3组间有差异(χ²=37.278,P<0.001)。p16蛋白表达阳性率分别为27.5%、70.0%和82.5%,3组间差异有统计学意义(χ²=27.708, P<0.001)。CINⅠ-Ⅱ级与CINⅢ级组及宫颈鳞癌组比较均有差异,但CINⅢ级与宫颈鳞癌组间无差异。p16蛋白的表达与E2F-1蛋白表达有正相关关系;在鳞癌组中E2F-1与p16的异常表达与组织学分级、临床分期有关(P<0.05)。结论 子宫颈鳞癌的形成与E2F-1 、p16蛋白过表达是呈正相关关系,E2F-1 、p16 蛋白可能作为子宫颈鳞癌及CIN的标志物,对子宫颈癌筛查和预防有重要意义。

Objective To explore the clinicopathologic significance of the protein expression of cell cycle regulators E2F-1 and P16 in cervical intraepithelial neoplasia(CIN) and cervical squamous cell carcinoma(SCC). Methods Immunohistochemical technique S-P was used to determinate the expression of E2F-1 and P16 protein in 40 cases with CINⅠ-Ⅱ, 40 cases with CINⅢ and 40 cases with cervical squamous cell carcinoma. Results The positive rate of E2F-1 protein expression in CINⅠ-Ⅱ, CINⅢ and cervical squamous cell carcinoma was 17.5%,67.5% and 80.0%, respectively. There were significant differences among the three groups(χ²=37.278,P<0.001). The positive rate of P16 protein expression in CINⅠ-Ⅱ, CINⅢ and cervical squamous cell carcinoma was 27.5%,70.0% and 82.5%, respectively. There were significant differences among the three groups (χ²=27.708, P<0.001). The group with CINⅢ and cervical squamous cell carcinom compared with the group withCINⅠ-Ⅱ did have differences. But there were no significant differences in the group with CINⅢ and the group with cervical squamous cell carcinoma. The relative expressions between P16 and E2F-1 showed positive correlation. In the cervical squamous cell carcinoma group, the abnormal expression of E2F-1 and p16 were correlated with the histological grade and clinical stage. Conclusion It showed positive correlation between very high expression of p16 protein and E2F-1 infection in CIN and SCC. p16 protein and E2F-1 can be an indicator in SCC and CIN,which has very significance in preventing and screening of cervical cancer.

       目的   针对目前常规使用的玻璃体腔注射针头容易引起注射后小鼠眼内出血和损伤晶状体的缺陷，本研究采用直径仅0.08 mm的玻璃毛细管作为实验用小鼠眼内注射针头进行玻璃体腔注射，并评估其安全性和可行性。方法  选取12只6-8周的C57BL/6J雄性小鼠，左眼注射磷酸盐缓冲液为实验组，右眼不做特殊处理为对照组。6只小鼠玻璃体腔注射后立即腹腔注射伊文思蓝，检测视网膜血管渗漏情况；另外6只小鼠玻璃体腔注射后24 h处死，视网膜铺片免疫荧光染色小胶质细胞特异性抗体抗离子钙接头蛋白1，分析小胶质细胞的形态变化。结果  实验组和对照组血管与周围荧光强度比值分别为（4.45±0.30）和（4.51±0.24），小胶质细胞数量分别为（131.00±5.38）个/mm2 和（133.00±5.99）个/mm2 ，小胶质细胞胞体面积分别为34.02（27.82，40.54）μm2 和34.70（26.09，40.54）μm2 ，小胶质细胞分支长度分别为198.80（171.30，258.80）μm和223.30（178.20，278.30）μm，两组相比差异均无统计学意义（均P＞0.05）。结论   经改良的玻璃毛细管直径更细，损伤更小，可以替代传统的注射针头，可作为实验用小鼠眼内注射针头进行玻璃体腔注射。

       Objective  To assess the safety and feasibility of employing an enhanced glass capillary，with a diameter of 0.08 mm，as an intraocular needle for intravitreal injections in experimental mice eyes．Methods  Twelve male C57BL/6J mice，aged 6-8 weeks，were utilized in this investigation．Phosphate buffered saline（PBS）was administered via intravitreal injection into the left eye of each mouse（experimental group），while the right eye received no special treatment（control group）．Six mice received an intraperitoneal injection of Evans blue immediately following intravitreal injection to detect retinal vessel leakage．The remaining six mice were euthanized 24 hours after intravitreal injection，and the retinas were subjected to immunofluorescence staining using a microglia-specific antibody to analyze morphological changes in microglia．Results  In both the experimental and control groups，the ratio of vascular to peripheral fluorescence intensity was（4.45±0.30）and（4.51±0.24），respectively．The number of microglia was（131.00±5.38）/mm2  and（133.00±5.99）/mm2 ，the cell body area of microglia was 34.02（27.82，40.54）μm2  and 34.70（26.09，40.54）μm2 ，and the branch length of microglia was 198.80（171.30，258.80）μm and 223.30（178.20，278.30）μm，respectively．There were no statistically differences observed in any of the above indicators between the two groups（all P＞0.05）．Conclusions  The use of this glass capillary，characterized by a narrower diameter，reduces tissue damage，demonstrates its potential to replace traditional injection needles for performing intravitreal injections in experimental mice．