目的 探究肺泡灌洗液靶向高通量测序（tNGS）在鹦鹉热衣原体肺炎中应用效果。方法 选取2021年5月—2025年3月我院收治的35例鹦鹉热衣原体肺炎患者进行研究，患者均接受肺泡灌洗液tNGS检测、肺泡灌洗液常规病原检测，以病原学为金标准，分析肺泡灌洗液tNGS对鹦鹉热衣原体肺炎的诊断效能。结果 金标准对鹦鹉热衣原体阳性检出35例，检出率100.00%，肺泡灌洗液tNGS阳性检出率高于传统病原检测，检测结果回报耗时短于肺泡灌洗液传统病原检测（P＜0.05）。结论 鹦鹉热衣原体肺炎临床症状缺乏特异性，容易转为重症肺炎，肺泡灌洗液tNGS可提高鹦鹉热衣原体肺炎检出率且结果回报较快，采用四环素类、喹诺酮类抗生素有助于改善患者预后。

     Objective To investigate the application effect of targeted next-generation sequencing（tNGS）of bronchoalveolar lavage fluid（BALF）in Chlamydia psittaci pneumonia．Methods Thirty-five patients with Chlamydia psittaci pneumonia admitted to our hospital from May 2021 to March 2025 were selected for the study．All patients underwent BALF tNGS and conventional BALF pathogen detection．With etiology as the gold standard，the diagnostic efficacy of BALF tNGS for Chlamydia psittaci pneumonia was analyzed．Results The gold standard detected 35 cases of Chlamydia psittaci positive，with a detection rate of 100.00%．The positive detection rate of tNGS in alveolar lavage fluid was higher than that of traditional pathogen detection，and the results report time of tNGS was shorter than that of traditional pathogen detection（P＜0.05）．Conclusions Chlamydia psittaci pneumonia lacks specificity in clinical symptoms and is easy to turn into severe pneumonia，bronchoalveolar lavage fluid tNGS can improve the detection rate of Chlamydia psittaci pneumonia and the results return quickly，and the use of tetracyclines and quinolones antibiotics can help improve the prognosis of patients．

【摘要】目的 探讨脊柱侧弯术后胃肠道功能紊乱患者“温通调补”理论指导下火龙罐综合灸的应用价值。方法 选取2025年6月-2026年6月本院收治的86例脊柱侧弯术后胃肠道功能紊乱患者作为研究对象，采用Excel软件随机函数分为对照组与观察组，每组各43例，评估患者胃肠道功能恢复时间、POGD、中医证候评分、PAC-QOL评分、VAS评分、胃肠道菌群数及胃激素指标水平。结果 治疗后，对照组的肠鸣音恢复时间、首次排气时间、首次排便时间均显著多于观察组（P＜0.05）；对照组的VAS评分、POGD评分、PAC-QOL评分及中医证候评分均显著高于观察组（P＜0.05）；对照组的乳酸杆菌及双歧杆菌数均显著低于观察组（P＜0.05），肠球菌及肠杆菌数均显著高于观察组（P＜0.05）；对照组的VIP水平均显著高于观察组（P＜0.05），MTL、GAS水平均显著低于观察组（P＜0.05）。结论 “温通调补”理论指导下火龙罐综合灸可有效改善患者脊柱侧弯术后胃肠道功能紊乱，调节其肠道菌群、胃肠道激素水平，缓解疼痛，提高患者生活质量。

目的：探讨粒细胞集落刺激因子（GCSF）宫腔灌注联合宫腔粘连冷刀分离术治疗薄型子宫内膜的临床效果。方法：选取2023年9月—2025年9月间在桐乡市妇幼保健院妇科因薄型子宫内膜住院并行手术治疗的患者101例，按治疗方式不同，分为对照组（56例）与治疗组（45例）。对照组采用宫腔镜下宫腔粘连冷刀分离术治疗，治疗组采取G-CSF宫腔灌注联合宫腔粘连冷刀分离术的方式治疗。比较两组手术前后的子宫内膜厚度情况、性激素指标水平、子宫动脉血流参数、术后临床妊娠情况。结果：治疗组子宫内膜厚度、子宫内膜厚度改善值、LH、E2、AMH、PSV、EDV、临床妊娠率均高于对照组，RI、PI低于对照组（P＜0.05）。结论：G-CSF宫腔灌注联合宫腔粘连冷刀分离术在治疗薄型子宫内膜中可取得令人满意的效果，能通过改善子宫的血流，促进子宫内膜的生长，而且还可提升性激素水平，对促进术后妊娠率的上升有积极的作用。

【摘要】 目的 探讨多模态影像定量参数联合血小板与淋巴细胞比值（PLR）对上皮性卵巢癌（EOC）的诊断价值及其对良恶性卵巢病变的鉴别意义。方法 选取2023年6月至2024年12月本院收治的84例卵巢占位性病变患者作为研究对象，其中EOC患者46例纳入EOC组，良性卵巢病变患者38例纳入非EOC组。比较两组CT动脉期碘浓度、CT能谱曲线斜率及ADC值多模态影像定量参数，同时检测外周血指标并计算PLR，分析各指标在EOC诊断中的应用价值。采用受试者工作特征（ROC）曲线评价各指标单独及联合诊断效能。结果 两组年龄、体重指数及绝经情况比较差异均无统计学意义（P＞0.05）。EOC组形态不规则、边界模糊、实性成分为主、壁结节形成、明显不均匀强化、中大量腹腔积液及腹膜、淋巴结转移发生率均高于非EOC组（P＜0.05）。EOC组PLR、CT动脉期碘浓度及CT能谱曲线斜率均高于非EOC组，而ADC值低于非EOC组（P＜0.05）。ROC曲线分析显示，CT动脉期碘浓度、CT能谱曲线斜率、ADC值及PLR诊断EOC的AUC分别为0.801、0.819、0.828及0.867；联合预测模型AUC为0.975，敏感度为94.7%，特异度为91.3%，诊断效能优于各单项指标。结论 EOC患者多模态影像定量参数及PLR均存在明显异常改变，多模态影像参数联合PLR可进一步提高EOC的诊断效能，对良恶性卵巢病变的鉴别具有一定临床应用价值。

【摘要】 目的 探讨多模态影像定量参数联合血小板与淋巴细胞比值（PLR）对上皮性卵巢癌（EOC）的诊断价值及其对良恶性卵巢病变的鉴别意义。方法 选取2023年6月至2024年12月本院收治的84例卵巢占位性病变患者作为研究对象，其中EOC患者46例纳入EOC组，良性卵巢病变患者38例纳入非EOC组。比较两组CT动脉期碘浓度、CT能谱曲线斜率及ADC值多模态影像定量参数，同时检测外周血指标并计算PLR，分析各指标在EOC诊断中的应用价值。采用受试者工作特征（ROC）曲线评价各指标单独及联合诊断效能。结果 两组年龄、体重指数及绝经情况比较差异均无统计学意义（P＞0.05）。EOC组形态不规则、边界模糊、实性成分为主、壁结节形成、明显不均匀强化、中大量腹腔积液及腹膜、淋巴结转移发生率均高于非EOC组（P＜0.05）。EOC组PLR、CT动脉期碘浓度及CT能谱曲线斜率均高于非EOC组，而ADC值低于非EOC组（P＜0.05）。ROC曲线分析显示，CT动脉期碘浓度、CT能谱曲线斜率、ADC值及PLR诊断EOC的AUC分别为0.801、0.819、0.828及0.867；联合预测模型AUC为0.975，敏感度为94.7%，特异度为91.3%，诊断效能优于各单项指标。结论 EOC患者多模态影像定量参数及PLR均存在明显异常改变，多模态影像参数联合PLR可进一步提高EOC的诊断效能，对良恶性卵巢病变的鉴别具有一定临床应用价值。

【摘要】 目的 探讨多模态影像定量参数联合血小板与淋巴细胞比值（PLR）对上皮性卵巢癌（EOC）的诊断价值及其对良恶性卵巢病变的鉴别意义。方法 选取2023年6月至2024年12月本院收治的84例卵巢占位性病变患者作为研究对象，其中EOC患者46例纳入EOC组，良性卵巢病变患者38例纳入非EOC组。比较两组CT动脉期碘浓度、CT能谱曲线斜率及ADC值多模态影像定量参数，同时检测外周血指标并计算PLR，分析各指标在EOC诊断中的应用价值。采用受试者工作特征（ROC）曲线评价各指标单独及联合诊断效能。结果 两组年龄、体重指数及绝经情况比较差异均无统计学意义（P＞0.05）。EOC组形态不规则、边界模糊、实性成分为主、壁结节形成、明显不均匀强化、中大量腹腔积液及腹膜、淋巴结转移发生率均高于非EOC组（P＜0.05）。EOC组PLR、CT动脉期碘浓度及CT能谱曲线斜率均高于非EOC组，而ADC值低于非EOC组（P＜0.05）。ROC曲线分析显示，CT动脉期碘浓度、CT能谱曲线斜率、ADC值及PLR诊断EOC的AUC分别为0.801、0.819、0.828及0.867；联合预测模型AUC为0.975，敏感度为94.7%，特异度为91.3%，诊断效能优于各单项指标。结论 EOC患者多模态影像定量参数及PLR均存在明显异常改变，多模态影像参数联合PLR可进一步提高EOC的诊断效能，对良恶性卵巢病变的鉴别具有一定临床应用价值。

目的 探讨血清胱抑素C（SCys-C）、同型半胱氨酸（Hcy）及尿微量白蛋白（UmAlb）在高血压患者肾损害早期评估中的应用价值。方法 选择2022年9月—2023年9月期间福建中医药大学附属第三人民医院接收的150例高血压患者作为观察组,另选择健康体检者150例为对照组,测定肾小球滤过率（GFR）、SCys-C、Hcy、UmAlb,比较不同血压程度及对照组的各指标水平,比较观察组各指标检测阳性率及诊断符合率,依据GFR值评估肾损害程度,比较不同肾损害程度患者的SCys-C、Hcy、UmAlb水平。结果 高血压2级、高血压3级患者SCys-C、Hcy、UmAlb水平高于高血压1级患者（t=5.255、10.976、21.578,P<0.05;t=7.378、18.012、23.708,P<0.05）及对照组患者（t=8.308、19.675、31.891,P<0.05;t=10.661、31.511、21.578,P<0.05）,高血压3级患者高于高血压2级患者（t=2.776、12.725、7.779,P<0.05）。观察组肾损害患者SCys-C、Hcy、UmAlb的阳性率79.41%、73.53%、83.82%高于无肾损害患者的阳性率6.10%、4.88%、6.10%（χ²=83.733、76.040、92.613,P<0.05）。观察组中重度肾损害、轻度肾损害患者的SCys-C、Hcy、UmAlb水平高于无损害患者（t=7.567、24.214、30.836,P<0.05;t=5.783、16.054、25.164,P<0.05）,中重度肾损害高于轻度肾损害患者（t=2.685、7.179、9.561,P<0.05）。结论 高血压分级越高患者的SCys-C、Hcy、UmAlb水平越高,各指标联合检测的阳性率高,而且SCys-C、Hcy、UmAlb水平越高,肾损害程度越严重。

Objective To explore the application value of serum cystatin C（SCys-C）,homocysteine（Hcy） and urinary microalbumin（UmAlb）in early assessment of renal damage in hypertensive patients．Methods A total of 150 hypertensive patients admitted to the Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the observation group,and 150 healthy individuals were selected as the control group．Glomerular filtration rate（GFR）,serum cystatin C（SCys-C）,homocysteine（Hcy）,and UmAlb were measured,and the levels of various indicators in different blood pressure levels and the control group were compared．The positive rate and diagnostic accuracy of each indicator in the observation group were compared,and the degree of renal damage was evaluated based on GFR values．The levels of SCys-C,Hcy and UmAlb in patients with different degrees of renal damage were compared．Results The levels of SCys-C,Hcy and UmAlb in patients with grade 2 and grade 3 hypertension were significantly higher than those in patients with grade 1 hypertension（t=5.255,10.976,21.578,P<0.05;t=7.378,18.012,23.708,P<0.05）,as well as in the control group（t=8.308,19.675,31.891,P<0.05;t=10.661,31.511,21.578,P<0.05）,patients with grade 3 hypertension were significantly higher than those with grade 2 hypertension（t=2.776,12.725,7.779,P<0.05）．The positive rates of SCys-C,Hcy and UmAlb in patients with renal injury in the observation group were 79.41%,73.53% and 83.82%,which were significantly higher than the positive rates of 6.10%,4.88% and 6.10% in patients without renal injury（χ²=83.733,76.040,92.613,P<0.05）．The levels of SCys-C,Hcy and UmAlb in patients with severe and mild kidney damage in the observation group were significantly higher than those in patients without damage（t=7.567,24.214,30.836,P<0.05;t=5.783,16.054,25.164,P<0.05）,patients with moderate to severe kidney damage were significantly higher than those with mild kidney damage（t=2.685,7.179,9.561,P<0.05）．Conclusions The higher the grading of hypertension,the higher the levels of SCys-C,Hcy and UmAlb in patients,and the higher the positive rate of combined detection of various indicators．Moreover,the higher the levels of SCys-C,Hcy and UmAlb,the more severe the renal damage．

目的 探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法 对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果 CT增强延迟扫描显示观察组患者分叶征（12.50% vs 53.57%）、内部空泡征数量（6.25% vs 39.29%）低于对照组（χ²=26.560、24.680,P<0.05）,观察组患者边缘毛刺（56.25% vs 17.86%）、胸部凹陷征（59.38% vs 14.29%）、高于对照组（χ²=43.330、64.600,P<0.05）;82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%（79/82）,与病理诊断结果100.00%对比差异无统计学意义（χ²=3.060,P=0.080）;82例非小细胞肺癌平均CT增强值为（39.14±7.31）,不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义（P>0.05）,不同病理类型[腺癌（43.75±7.15）vs 鳞癌（34.74±6.12）]、细胞分化程度[中、低分化（45.71±7.21）vs 高分化（32.81±5.11）]、临床分期[Ⅰ期（31.03±2.12）vs Ⅱ期（36.61±3.13）vs Ⅲa期（46.32±6.83）]患者、淋巴结转移[是（42.75±4.21）vs 否（35.77±8.13）]CT增强值对比差异有统计学意义（t/F=5.243、8.804、84.828、4.378,P<0.05）;Spearman相关分析结果显示：病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05）。结论 CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。

Objective To explore the application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer（NSCLC）．Methods A retrospective analysis was conducted on 82 patients with NSCLC who underwent surgical treatment in a hospital from May 2021 to May 2024．They were included into an observation group and another 82 patients with benign lung tumors were included in the control group．The preoperative CT enhanced delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC．And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC．Results CT enhanced delayed scanning showed that the number of lobular（12.50% vs 53.57%）and internal vacuolar signs（6.25% vs 39.29%）in the observation group was significantly lower than that in the control group（χ²=26.560,24.680,P<0.05）,while the edge spicules（56.25% vs 17.86%）and chest depression signs（59.38% vs 14.29%）in the observation group were significantly higher than that in the control group（χ²=43.330,64.600,P<0.05）．A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%（79/82）,with no significant difference from the pathological diagnosis result of 100.00%（χ²=3.060,P=0.080）．The average CT enhancement value of 82 NSCLC cases was（39.14±7.31）．There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration（P>0.05）．Patients with different pathological types [adenocarcinoma（43.75±7.15）vs squamous cell carcinoma（34.74±6.12）],degree of cell differentiation [moderate,and low differentiation（45.7±7.21）vs high differentiation（32.81±5.11）],clinical stage [I（31.03±2.12）vs II（36.61±3.13）vs IIIa（46.32±6.83）] and lymph node metastasis [yes（42.75±4.21）,vs no（35.77±8.13）] CT enhancement had significant difference（t/F=5.243,8.804,84.828,4.378,P<0.05）．The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008）．Conclusions CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC．Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients．

目的 探讨痰涂片找抗酸杆菌、痰利福平耐药实时荧光定量核酸扩增检测技术（Xpert MTB/RIF）、分枝杆菌菌种鉴定、痰抗酸杆菌培养和血γ-干扰素释放检测技术（TB-IGRA）5种检测技术在尘肺合并肺结核临床诊断中的应用价值。方法 纳入2016年7月—2021年5月在厦门大学附属第一医院住院治疗的尘肺合并肺结核患者,按照尘肺患者是否合并肺结核,将患者分为尘肺组（156例）和尘肺合并肺结核组（111例）;比较两组患者的性别、年龄、接尘时间等一般资料,以及患者痰涂片、Xpert MTB/RIF、分枝杆菌菌种鉴定、痰培养和TB-IGRA的检测结果,分析尘肺合并肺结核患者5种检测技术阳性检出率的差异及其诊断价值。结果 在尘肺合并肺结核组中,TB-IGRA检测方法的阳性检出率最高（81.1%）,高于其他4种检测方法（P<0.01）;两两联合检测,以Xpert MTB/RIF+TB-IGRA组合的检测方式检出率最高（96.4%）,高于其他9种组合（P<0.01）。结论 TB-IGRA检测方法对尘肺合并肺结核患者的阳性检出率较高,联合Xpert MTB/RIF检测后可进一步提高诊断效率,对早期诊断尘肺是否合并结核具有重要的临床诊断价值。

Objective To investigate the value of five testing techniques in the clinical diagnosis of pneumoconiosis combined pulmonary tuberculosis,including sputum smear,Xpert Mycobacterium tuberculosis/rifampicin（Xpert MTB/RIF）,identification of Mycobacterium species,sputum acid-fast bacilli culture and tuberculosis-interferon-gamma release assays（TB-IGRA）．Methods Patients with pneumoconiosis combined with tuberculosis who were hospitalized in the First Hospital of Xiamen University from July 2016 to May 2021 were included in the study．The patients were divided into the pneumoconiosis group（156 cases）and pneumoconiosis combined with tuberculosis group（111 cases）according to whether the pneumoconiosis patients were combined with tuberculosis or not．The general data of the patients in the two groups were compared with respect to gender,age,and dust exposure time,and the results of sputum smears,Xpert MTB/RIF,identification of Mycobacterium species,sputum acid-fast bacilli culture and TB-IGRA were collected to analyze the differences and the diagnostic value in the five testing techniques of the positivity rates for patients who have pneumoconiosis combined with pulmonary tuberculosis．Results In the group with pneumoconiosis combined with tuberculosis,the positive detection rate of TB-IGRA was the highest（81.1%）,which was higher than other 4 testing methods（P<0.01）．Combined testing in pairs suggested that the testing method of Xpert MTB/RIF and TB-IGRA combination was the highest（96.4%）,significantly higher than the other 9 combinations（P<0.01）．Conclusions TB-IGRA has higher positive detection rate for patients with pneumoconiosis combined with tuberculosis,and diagnostic efficiency can be further improved by combining Xpert MTB/RIF assay testing,which is of great clinical diagnostic value for the early diagnosis of pneumoconiosis combined with tuberculosis．

目的 探讨基于态度-定义-开放思维-计划-实施（ADOPT）模式的健康教育联合情绪引导对消化内镜诊疗患者配合度的影响。方法 选取2020年1月—2023年1月在我院准备行消化内镜诊疗的80例住院患者,随机分为观察组与对照组各40例。对照组患者在检查前采取常规护理,观察组患者在常规护理基础上增加基于ADOPT模式的健康教育联合情绪引导,在护理前后应用简明心境量表（POMS-SF）分别评估两组患者负面情绪、诊疗配合度、基础值（T₁）、入镜时（T₂）、检查开始后5 min（T₃）、检查结束时（T₄）的Ramsay镇静评分和舒适度评分,并对比两组患者的护理满意度。结果 护理后两组患者的困惑、活力、疲劳、抑郁、生气和紧张方面的POMS-SF评分降低,且观察组低于对照组（P<0.05）;观察组患者配合度为95.00%,高于对照组75.00%（P<0.05）;两组患者T1时间Ramsay镇静评分与舒适度评分比较差异无统计学意义（P>0.05）,观察组T₂、T₃、T₄时间Ramsay镇静评分高于对照组,舒适度评分优于对照组（P<0.05）;观察组患者的总满意度高于对照组（P<0.05）。结论 对消化内镜诊疗患者采取基于ADOPT模式的健康教育联合情绪引导可改善患者内镜诊疗过程前的负面情绪,提升患者配合度,同时能够改善患者诊疗过程中的镇静程度和舒适度,患者护理满意度较高。

Objective To explore the value of health education based on the ADOPT model combined with emotional guidance on the cooperation of patients undergoing digestive endoscopy diagnosis and treatment．Methods From January 2020 to January 2023,80 hospitalized patients who were going to have digestive endoscopy diagnosis and treatment in our hospital were selected as the research subjects．All patients were divided into observation group and control group,with 40 patients in each group．The control group patients received routine care before the examination,while the observation group patients added ADOPT based health education combined with emotional guidance on the basis of routine care．The Profile of Mood States-Short Form（POMS-SF）was used to evaluate the negative emotions of the two groups of patients before and after the examination．The diagnostic and treatment cooperation,basic value（T₁）,at the time of endoscopy（T₂）,and 5 minutes after the examination（T₃）,at the end of the examination（T₄）,the Ramsay sedation score and comfort score were compared between the two groups,and the nursing satisfaction of the two groups of patients was compared．Results After nursing,the POMS-SF scores of confusion,vitality,fatigue,depression,anger,and tension in the two groups of patients were significantly reduced,and the observation group was lower（P<0.05）．The cooperation rate of 95.00% in the observation group was significantly higher than that of 75.00% in the control group（P<0.05）．There was no significant difference in the Ramsay sedation score and comfort score between the two groups of patients at T₁ time（P>0.05）．The Ramsay sedation scores of the observation group at T₂,T₃,and T₄ time were higher,while the comfort score was lower（P<0.05）．The overall satisfaction of the observation group patients was higher（P<0.05）．Conclusions Adopting ADOPT based health education combined with emotional guidance for patients undergoing endoscopic diagnosis and treatment can improve their negative emotions before the endoscopic diagnosis and treatment process,enhance their cooperation level,and improve their level of sedation and comfort during the process．Patients have a high level of nursing satisfaction．