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 统计洛阳市涧西区各作业场的职业病危害因素,分析职业病发生的主要原因,并探讨具体防控策略。方法 收集洛阳市涧西区内2021年1月—2022年12月期间针对各作业场的职业病危害因素监测信息,录入Excel 2010进行数据统计;随机抽取辖区内200名重点职业从业人员,开展回顾性分析,结合职业健康检查结果,将确认存在职业病的115名从业人员列为病例组,其余未发生职业病的85名从业人员列为对照组,比较2组一般资料、临床资料,经统计学单因素、Logistic多因素回归分析归纳可导致职业病发生的影响因素,结合分析结果,探讨具体防控措施。结果 针对辖区内15家厂矿企业,2021年共设立584个监测点,共测得68处锰及其化合物危害、48处矽尘危害、4处苯及其苯系物危害、12处噪声危害,超标率为22.60%（132/584）;2022年共设立1 575个监测点,共测得158处粉尘危害、154处锰及其化合物危害、10处矽尘危害、13处噪声危害,超标率为21.27%（335/1 575）;单因素分析结果显示,2组从业人员的年龄、工作年限、职业类型、体检频率、体检结果等比较差异均存在统计学意义;Logistic多因素回归分析显示,年龄≥50岁,工作年限≥10年,从事制造业、采矿业,未规律体检,血常规异常,免疫力差,X线胸片异常,双耳高频听力阈值≥40 dB均是发生职业病的重要原因（均P<0.05）。结论 洛阳市涧西区的职业危害因素以粉尘、锰及其化合物为主,高龄、工作年限长的制造业、采矿业人员发生职业病的风险相对较高,优化职业病防治措施并规范上述重点人群的职业健康体检能实现对职业病的有效防控。

Objective To analyze the occupational disease hazards in various workplaces in Jianxi District,Luoyang City,and to analyze the main causes of occupational disease occurrence,explore specific prevention and control strategies．Methods Monitoring information on occupational disease hazards in various workplaces within the jurisdiction from January 2021 to December 2022 was collected,Excel 2010 was used for data statistics．Two hundred key occupational employees within the jurisdiction were selected randomly for retrospective analysis．Based on the results of occupational health examinations,115 employees confirmed to have occupational diseases were included in the case group,while 85 employees who did not have occupational diseases were included in the control group．General and clinical data of the two groups were compared,and the influencing factors that could lead to the occurrence of occupational diseases were summarized through statistical single factor and multivariate logistic regression analysis． Combined with the analysis results,specific prevention and control measures were discussed．Results For 15 factories and mining enterprises within the jurisdiction,a total of 584 monitoring sites were established in 2021,and a total of 68 manganese and its compound hazards,48 silica dust hazards,4 benzene and its benzene series hazards,and 12 noise hazards were measured,which the exceeding rate was 22.60%（132/584）．In 2022,a total of 1 575 monitoring sites were established,with a total of 158 dust hazards,154 manganese and its compounds hazards,10 silica dust hazards,and 13 noise hazards detected,which the exceeding rate was 21.27%（335/1 575）．The results of statistical univariate analysis showed that there were certain differences in the age,years of work,occupational type,frequency of physical examinations,and results of physical examinations between the two groups of employees．Multivariate logistic regression analysis showed that age≥50 years old,working experience≥10 years,engaged in manufacturing and mining industries,irregular physical examinations,abnormal blood routine,immune differences,chest X-ray abnormalities,and binaural high-frequency hearing threshold≥40 dB were all important reasons for the occurrence of occupational diseases．Conclusions The occupational hazards in this jurisdiction are mainly dust,manganese,and their compounds．The risk of occupational diseases among elderly manufacturing and mining workers with long working years is relatively high．Optimizing occupational disease prevention and control measures and standardizing occupational health examinations for the above-mentioned key populations can achieve effective prevention and control of occupational diseases．

目的 探讨全身麻醉（全麻）髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为（56.35±5.86）分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室（AICU）住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素（P<0.05）。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。

Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia．Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected．The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated．The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed．Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was（56.35±5.86）,with a moderate level．Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia（P<0.05）．Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles．

目的 探究维持性血液透析（MHD）患者的病耻感现状,并对其影响因素进行分析。方法 根据便利抽样法,选取2020年2月—2022月10月在河南省郑州市第三人民医院血液净化中心进行MHD治疗的236例患者作为研究对象,并采用一般资料调查问卷、领悟社会支持量表（PSSS）以及社会影响量表（SIS）进行调查。根据SIS得分情况进行分组,采用Logistic回归分析行MHD患者病耻感的影响因素。结果 MHD患者病耻感得分为（65.03±10.68）分,其中病程较短、社会支持度低、家庭平均收入低、文化水平较低以及未参加肾友会的患者病耻感得分较高,病程较长、家庭平均收入高、社会支持度高、参加肾友会以及文化水平较高者病耻感得分较低（P<0.05）。多因素Logistic回归分析结果显示,患者文化水平、家庭平均收入、是否参加肾友会、病程以及社会支持情况是患者病耻感的影响因素（P<0.05）。结论 MHD患者病耻感得分处于中高等水平。指导患者正确认识疾病,多关注家庭收入较低患者,鼓励患者积极参与肾友会,为患者提供良好的社会支持,均有助于降低其病耻感程度。

Objective To explore the current status of shame in maintenance hemodialysis（MHD）patients and analyze its influencing factors．Methods Based on the convenience sampling method,236 patients who underwent MHD treatment at the Blood Purification Center of the Third People’s Hospital of Zhengzhou City,Henan Province from February 2020 to October 2022 were selected as the research subjects．A general information survey questionnaire,Perceived Social Support Scale（PSSS）,and Social Impact Scale（SIS）were used for the survey．Grouping based on SIS scores,logistic regression analysis was used to analyze the influencing factors of shame in MHD patients．Results MHD patients had a shame score of（65.03±10.68）,among which patients with shorter disease course,lower social support,lower average family income,lower education level,and those who did not participate in kidney friend associations had higher shame scores．Patients with longer disease course,higher average family income,higher social support,participation in kidney self-help group,and higher education level had lower shame scores（P<0.05）．The results of multivariate logistic regression analysis showed that the patient’s educational level,average family income,participation in a kidney self-help group,course of illness,and social support were the influencing factors for the patient’s sense of shame（P<0.05）．Conclusions The shame score of MHD patients is at a moderate high level．Guiding patients to have a correct understanding of the disease,paying more attention to patients with lower family income,encouraging them to actively participate in kidney self-help group,and providing good social support to patients can all help reduce their sense of shame．

目的 探讨养老机构老年人死亡态度及其影响因素。方法 选取2018年1月—2022年12月广州市养老机构的593名老年人进行问卷调查,统计养老机构老年群体对死亡的态度,并分析其死亡态度发生的影响因素。结果 经过研究发现,对死亡的态度呈自然接受的老年人数量最少,为42例,占比为7.1%,其次从高到低依次为逃离接受老年人308例,占比为51.9%;死亡恐惧老年人83例,占比为14.0%;死亡逃避老年人81例,占比为13.7%;趋近接受老年人79例,占比为13.3%。患者的死亡态度与患者所患的疾病病种有关,影响死亡态度的因素包括：生理心理因素、文化思想因素、社会环境因素,其中发生概率最高的是生理心理因素,占比为50.9,其次从高到低依次为文化思想因素,占比为26.5%;社会环境因素,占比为22.6%。死亡态度中趋近接受维度的分值相对更高,其次依次为死亡恐惧、自然接受、死亡逃避以及逃离接受。单因素分析显示差异有统计学意义的项目包含家庭内讨论死亡、性别、健康自评状况、年龄、患病种数、经济结构。结论 在养老机构中,大多数老年人对死亡是无法自然接受的,大部分老年群体对死亡的态度是逃离接受,部分群体对死亡的态度是恐惧、逃避;而影响老年群体死亡态度的因素主要是生理心理因素。

Objective To explore the death attitudes and its influencing factors among the elderly in nursing institutions. Methods A questionnaire survey on death attitudes was conducted among 593 elderly individuals in nursing institutions in Guangzhou from January 2018 to December 2022,and their possible influencing factors were analyzed. Results There were 51.9% of the elderly individuals whose death attitudes were characterized by escape acceptance,while 7.1% demonstrated natural acceptance．However,the numbers of the elderly individuals with approaching acceptance,fear of death and escape from death showed no significant statistical difference,all being lower than the number of the elderly individuals with escape acceptance．The influencing factors of death attitude included physiological and psychological factors,cultural and ideological factors,and social environment factors．The probability of physiological and psychological factors influencing death attitudes was higher than that of other factors（P<0.05）．The score for the dimension of approaching acceptance in death attitudes was higher than that for other dimensions（P<0.05）. Conclusions In nursing institutions,the majority of elderly individuals cannot naturally accept death．Most elderly individuals exhibit an attitude of escape acceptance towards death,while some exhibit an attitude of fear and escape．However,the factors influencing the elderly's attitudes towards death are mainly physiological and psychological factors．

目的 探讨影响颈内动脉闭塞（ICAO）患者预后的相关因素,为临床改善ICAO患者预后提供理论依据。方法 回顾性分析2017—2022年广西医科大学附属武鸣医院因ICAO入住神经内科的131例患者,根据ICAO发病时间分为急性颈内动脉闭塞（AICAO）和慢性颈内动脉闭塞（CICAO）,根据预后的不同,分为预后良好和预后不良组,比较两组的基本信息（性别、年龄等）、既往病史（包括高血压、糖尿病、冠心病等）、发病时神经功能损害程度（美国国立卫生研究院卒中神经功能缺损评分NIHSS评分）、侧支循环代偿评分、介入手术开通治疗、出血转化之间的差异,分析影响患者预后的相关因素。结果 CICAO患者总体预后良好,AICAO预后良好组患者发病时NIHSS评分<6分、侧支循环代偿良好比例高于预后不良组,而出血转化率低于预后不良组,组间比较差异均有统计学意义（P<0.05）。二分类Logistic回归分析显示,发病时NIHSS评分、侧支循环代偿评分、介入手术开通治疗、出血转化、次全闭塞对AICAO预后影响有统计学意义（P<0.05）。两组间的基本信息、既往病史、介入手术开通治疗等比较差异无统计学意义（P>0.05）。结论 CIACO较AICAO总体预后良好,发病时NIHSS评分<6分、侧支循环代偿良好、无出血转化是IACO预后良好的相关因素。发病时NIHSS评分高、侧支循环代偿不良、出血转化是ACAO预后不良的危险因素

Objective To evaluate the prognostic significance of a group of clinical indices in the patients with internal carotid artery occlusion（ICAO）. Methods From 2017 to 2022,a total of 131 patients with ICAO were enrolled．All eligible patients were divided into acute ICAO（AICAO）and chronic ICAO groups（CICAO）,which were subdivided into good and poor prognosis groups．A respective analysis was performed to identify a practical profile for the outcome prediction of the patients with ICAO. Results The overall prognosis of CIACO was good．The proportion of NIHSS score < 6 in AICAO group with good prognosis and good collateral circulation compensation was significantly higher than that in poor prognosis group,while bleeding conversion was lower than that in poor prognosis group,with statistical significance（P<0.05）．Dichotomous logistic regression analysis showed that the prognostic effects of NIHSS score,collateral circulatory compensation score,interventional initiation,hemorrhagic transformation,and subtotal occlusion on the prognosis of AICAO were statistically significant．There were no significant differences in basic information,past medical history,interventional operation between the two groups（P>0.05）. Conclusions The patients with CICAO have a better prognosis than those with AICAO．NIHSS score < 6,good collateral circulation and no-hemorrhagic transformation may have strong prognostic relevance to ICAO．High NIHSS score,poor collateral circulation and hemorrhagic transformation at the time of onset are risk factors for poor prognosis of ACAO ．

目的 分析早期活动康复对机械通气患儿肌力的影响,探讨影响肌力的相关因素。方法 采取回顾性研究,选择2021年4月—2023年4月医院收治的104例机械通气患儿临床资料,根据康复方法分为两组,其中采取常规康复训练的52例患儿为对照组,采取早期活动康复的52例患儿为观察组。两组均连续干预至出院,比较两组患儿的机械通气、住ICU、总住院时间、不同时点（转出ICU时、出院时、出院1个月）的肌力及Barthel日常生活能力（Barthel）评分;参照《中国重症肌无力诊断和治疗指南（2015年简版）》中诊断标准,评估机械通气患儿获得性肌无力（AW）发生情况。统计并比较两组基线资料,采用二元Logistic回归分析机械通气患儿AW发生的影响因素。结果 观察组的机械通气、住ICU及总住院时间[（7.28±2.47）d、（15.27±3.64）d、（27.08±5.68）d]均短于对照组[（10.64±3.39）d、（17.74±3.55）d、（32.57±6.14）d]（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时英国医学研究委员会（MRC）肌力评定法评分升高,且观察组转出ICU时、出院时MRC评分[（53.57±5.13）分、（56.84±2.16）分]均高于对照组[（50.13±4.57）分、（53.67±2.42）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时Barthel评分升高,且观察组转出ICU时、出院时Barthel评分[（65.03±12.47）分、（90.58±7.59）分]均高于对照组[（55.25±11.12）分、（84.13±9.62）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;住院期间104例机械通气患儿发生AW 31例,发生率29.81%,AW组机械通气时间、营养风险筛查量表2002（NRS）评分[（11.84±4.19）d、（3.07±1.04）分]高于非AW组[（8.18±2.26）d、（1.61±0.75）分],且有创机械通气模式、使用罗库溴铵患儿[77.42%（24/31）、32.26%（10/31）]占比均高于非AW组[53.42%（39/73）、13.70%（10/73）]（P<0.05）;二元Logistic回归分析结果显示,机械通气时间长、有创机械通气模式、使用罗库溴铵、NRS评分高是机械通气患儿AW发生的危险因素（OR>1,P<0.05）。结论 早期活动康复能够有效缩短机械通气患儿患儿通气时间及住院时间,改善肌力,提高生活自理能力,同时机械通气时间、创机械通气模式、使用罗库溴铵、NRS评分与机械通气患儿肌力下降有关。

Objective To analyze the effect of early mobilization and rehabilitation on muscle strength in children with mechanical ventilation and to explore the risk factors affecting muscle strength．Methods A retrospective study was conducted on 104 children with mechanical ventilation admitted to the hospital from April 2021 to April 2023．According to the rehabilitation methods,they were divided into two groups．The clinical data of children with routine rehabilitation training were included in the control group（52 cases）,and the clinical data of children with early mobilization and rehabilitation were included in the observation group（52 cases）．Both groups were continuously intervened until discharged．The mechanical ventilation time,ICU stay and total hospital stay were compared between the two groups．Muscle strength and self-care ability at different time points（transfer out of ICU,discharge,1 month after discharge）,the incidence of acquired weakness（AW）in children with mechanical ventilation were evaluated according to the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis． Baseline data was collected and compared between the two groups．Binary logistic regression was used to analyze the risk factors of AW in children with mechanical ventilation．Results The mechanical ventilation time,ICU and total hospitalization time in the observation group[（7.28±2.47）d,（15.27±3.64）d,（27.08±5.68）d] were shorter than those in the control group[（10.64±3.39）d,（17.74±3.55）d,（32.57±6.14）d]（P<0.05）．Compared with those at the time of transfer out of ICU and discharge,the Medical Research Council（MRC）scores of the two groups increased at 1 month after discharge,and the MRC scores of the observation group at the time of transfer out of ICU and discharge[（53.57±5.13）,（56.84±2.16）] were higher than those of the control group[（50.13±4.57）,（53.67±2.42）]．There were significant differences between the two groups,time points and between groups · time points（P<0.05）．Compared with those at the time of transferring out of ICU and at discharge,the Barthel scores of the two groups increased at 1 month after discharge,and the Barthel scores of the observation group at the time of transferring out of ICU and at discharge[（65.03±12.47）,（90.58±7.59）] were higher than those of the control group[（55.25±11.12）,（84.13±9.62）]．There were significant differences in Barthel scores between the two groups,time points and groups · time points（P<0.05）．AW occurred in 31 of 104 children with mechanical ventilation during hospitalization,with an incidence of 29.81%．The mechanical ventilation time and Nutritional Risk Screening（NRS）score in the AW group[（11.84±4.19）d,（3.07±1.04）] were higher than those in the non-AW group[（8.18±2.26）d,（1.61±0.75）]．The proportion of children with invasive mechanical ventilation mode and the use of rocuronium[77.42%（24/31）,32.26%（10/31）] were higher than those in the non-AW group[53.42%（39/73）,13.70%（10/73）]（P<0.05）．Binary logistic regression analysis showed that long mechanical ventilation time,invasive mechanical ventilation,use of rocuronium and high NRS score were risk factors for AW in children with mechanical ventilation（OR>1,P<0.05）．Conclusions Early mobilization and rehabilitation can effectively shorten the ventilation time and hospitalization time of patients with mechanical ventilation,improve muscle strength and improve the ability of self-reliance．At the same time,mechanical ventilation time,mechanical ventilation mode,use of rocuronium and NRS score are related to the decrease of muscle strength in children with mechanical ventilation．

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 分析烟雾病患者在血管重建术并发脑高灌注综合征的危险因素,为指导预防血管重建术后并发症提供参考依据。方法 选择2022年9月—2023年9月期间医院接收的148例烟雾病患者为研究对象,采用血管重建术治疗,统计术后高灌注综合征发生率,单因素分析术后并发高灌注综合征与性别、年龄、既往史、类型、铃木分期、灌注分期、手术侧别、入院改良Rankin 量表（mRS）评分、术后脑血流量（CBF）等因素的关系,并采取非条件Logistic多因素回归分析烟雾病患者血管重建术后并发高灌注综合征的危险因素。结果 148例患者血管重建术后,共42例并发脑高灌注综合征,发生率为28.38%。其中术后并发脑高灌注综合征与无并发脑高灌注综合征患者的性别、总胆固醇、甘油三酯、空腹血糖、入院mRS评分及基础疾病类型、手术侧别和手术时间比较差异无统计学意义（P>0.05）。烟雾病血管重建术后并发脑高灌注综合征患者年龄、是否合并高血压、铃木分期、灌注分期、收缩压、舒张压、术后CBF与无脑高灌注综合征患者比较差异有统计学意义（P<0.05）。年龄、收缩压、舒张压、铃木分期、灌注分期、CBF为烟雾病血管重建术后并发脑高灌注综合征的影响因素（P<0.05）。结论 烟雾病患者血管重建术后并发高灌注综合征的危险因素主要为高龄、收缩压升高、舒张压升高、铃木分期中晚期、灌注分期高、CBF降低,对此类患者需引起重视,做好针对性干预。

目的 探讨产科监护室妊娠期糖尿病产妇泌乳启动延迟及影响因素,以期作为预防泌乳启动延迟的参考依据。方法 选择2021年1月—2023年5月期间医院产科监护室接收的妊娠期糖尿病产妇80例为研究对象,采用单因素和多因素分析产妇的年龄、体质指数、产次、定期复查血糖、妊娠期高血压、分娩方式、开奶时间、新生儿体质量、产后焦虑、产后抑郁、产后疲乏、吸吮次数等对泌乳启动延迟的影响。结果 妊娠期糖尿病产妇泌乳启动延迟33例,发生率41.25%;泌乳启动延迟产妇的年龄≥35岁者占51.52%、未定期复查血糖者占39.39%、合并妊娠期高血压者占54.55%、开奶时间≥6 h者占57.58%、产后焦虑者占30.0%、产后抑郁者占36.36%、产后疲乏者占36.36%、吸吮次数<6次者占60.61%,与非泌乳启动延迟产妇比较差异均有统计学意义（P<0.05）。两组孕前体质指数、产次、分娩方式、新生儿出生体质量比较差异无统计学意义（P>0.05）。年龄≥35岁、未定期复查血糖、合并妊娠期高血压、开奶时间≥6 h、产后焦虑、产后抑郁、产后疲乏、吸吮次数<6次为妊娠期糖尿病产妇泌乳启动延迟的危险因素（P<0.05）。结论 产科监护室妊娠期糖尿病产妇泌乳启动延迟发生率较高,主要受到年龄、未定期复查血糖、合并妊娠期高血压、开奶时间、产后心理状态、吸吮次数等因素影响,应重视健康教育和早期辅助干预,降低泌乳启动延迟发生率。

Objective To explore the delayed lactation initiation and its influencing factors of pregnant women with diabetes in the obstetric care unit,so as to provide a reference for preventing delayed lactation initiation．Methods A total of 80 pregnant women with diabetes who were received by the hospital obstetric care unit from January 2021 to May 2023 were selected as the research objects．The age,body mass index,parity,regular blood glucose recheck,pregnancy hypertension,delivery mode,starting time,neonatal weight,postpartum anxiety,postpartum depression,postpartum fatigue,sucking times and other factors that led to the delay of lactation initiation were analyzed by single factor and multi factor analysis．Results The onset of lactation was delayed in 33 pregnant women with diabetes,with an incidence of 41.25%．The age of postpartum women with delayed lactation initiation over 35 years old accounted for 51.52%,blood sugar was not regularly rechecked accounted for 39.39%,pregnancy induced hypertension accounted for 54.55%,lactation time over 6 hours accounted for 57.58%,postpartum anxiety accounted for 30.0%,postpartum depression accounted for 36.36%,postpartum fatigue accounted for 36.36%,and sucking frequency <6 times accounted for 60.61%,which were higher than that of non-delayed lactation initiation women（P<0.05）．There was no statistically significant difference between the two groups in terms of pre pre-pregnancy body mass index,parity,delivery method and newborn birth weight（P>0.05）．The risk factors of delayed lactation initiation in pregnant women with diabetes were age ≥ 35 years,no regular blood glucose review,hypertension during pregnancy,≥ 6 h of first milk expression time,postpartum anxiety,postpartum depression,postpartum fatigue and sucking times<6（P<0.05）．Conclusions The incidence of delayed lactation initiation in pregnant women with diabetes in the obstetric care unit is high,which is mainly affected by age,pregnancy induced hypertension,time of starting breast feeding,postpartum psychological state and sucking times．Health education and early auxiliary intervention should be emphasized to reduce the incidence of delayed lactation initiation．