目的 探讨老年髋部骨折术后患者跌倒恐惧的影响因素，构建个体化风险预测列线图模型并进行临床效能验。方法 采用便利抽样法，选取2025年4月-2025年10月在我院骨科住院并接受手术治疗的老年髋部骨折患者227例作为研究对象。采用一般资料调查表、国际版跌倒效能量表、医院综合焦虑抑郁量表、社会支持评定量表、简易体能状况量表、康复自我效能量表、临床衰弱量表及肌少症筛查问卷等进行横断面调查。采用卡方检验筛选预测变量，多因素Logistic回归分析确定跌倒恐惧的独立影响因素，并基于R语言构建列线图预测模型。通过Bootstrap法进行内部验证，采用校准曲线和受试者工作特征曲线评估模型的区分度与校准度。结果 227例患者中，150例存在跌倒恐惧。多因素Logistic回归分析显示：年龄≥75岁（OR=3.28）、视力不良（OR=6.017）、焦虑抑郁（OR=3.738），衰弱（OR=3.821），肌少症（OR=2.704），康复自我效能低（OR=0.275），为患者发生跌倒恐惧的风险因素。基于上述6个预测因子构建的列线图模型，其ROC曲线下面积为0.839（95%CI：0.832-0.916），。校准曲线显示预测概率与实际发生率一致性良好（Bootstrap验证，P=0.028），DCA结果显示，当阈值概率在0.1-0.9时，该模型净收益优于假设所有患者均接受或均不接受治疗的策略。结论 本研究构建的列线图模型能有效预测老年髋部骨折术后患者发生跌倒恐惧的风险，有助于临床医护人员早期识别高危人群并进行多维度靶向干预。

目的 评估中医穴位疗法结合康复护理对脑瘫患儿的积极价值。方法 选取某社会福利院康复医院2024年12月至2025年12月间儿科收治的40例脑瘫患儿，通过随机数字表分为两组，对照组（20例）接受常规康复护理，观察组（20例）则联合应用中医穴位疗法，对比两种方案的康复效果。结果 观察组患儿的临床痉挛指数（包括肢体腱反射、肌张力及阵挛等维度）评分低于对照组，差异具统计学意义（P<0.05）；观察组血清CD4+和CD4+/CD8+免疫功能指标均高于对照组（P<0.05）；观察组在躯干控制测量量表（TCMS）、儿童睡眠习惯问卷（CSHQ）评估中的分数改善较对照组更优（P<0.05）。结论 将中医穴位疗法融入康复护理，对脑瘫患儿实施综合干预，有助于优化其睡眠质量，减轻肌张力异常，提升免疫力和平衡功能，为其康复提供有效支持。

目的：分析急性有机磷农药中毒（AOPP）引发缺血缺氧性脑病预后相关因素，建立相关的预后预测模型。方法：回顾性分析90例（33例预后不良、57例预后良好）AOPP致HIE患者（2022年3月～2025年8月）的临床资料、中毒指标和血清学指标，独立危险因素用Logistic回顾分析筛选，并构建预后不良预测模型，采用ROC工具对模型效能进行验证。结果：Logistic 回归分析显示，年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素（P＜0.05）；AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论：高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局，据此构建风险预测模型可有效预测预后不良的发生风险。

To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

目的 评估中医穴位疗法结合康复护理对脑瘫患儿的积极价值。方法 选取某社会福利院康复医院2024年12月至2025年12月间儿科收治的40例脑瘫患儿，通过随机数字表分为两组，对照组（20例）接受常规康复护理，观察组（20例）则联合应用中医穴位疗法，对比两种方案的康复效果。结果 观察组患儿的临床痉挛指数（包括肢体腱反射、肌张力及阵挛等维度）评分低于对照组，差异具统计学意义（P<0.05）；观察组血清CD4+和CD4+/CD8+免疫功能指标均高于对照组（P<0.05）；观察组在躯干控制测量量表（TCMS）、儿童睡眠习惯问卷（CSHQ）评估中的分数改善较对照组更优（P<0.05）。结论 将中医穴位疗法融入康复护理，对脑瘫患儿实施综合干预，有助于优化其睡眠质量，减轻肌张力异常，提升免疫力和平衡功能，为其康复提供有效支持。

目的 分析基于快速康复外科（ERAS）理念的医护一体化全程护理在先天性巨结肠手术患儿中的护理效果。方法 回顾性选取我院97例HSCR手术患儿（2018年5月—2025年7月）作为研究对象，依照护理模式不同分为对照组（49例）、观察组（48例）。对照组采用常规护理干预，观察组在上述基础上采用基于ERAS理念的医护一体化全程护理。比较2组术后恢复情况、并发症发生率、疼痛程度[FLACC疼痛评分法（FLACC）]、家属照护能力[家属照顾者照顾能力测量表（FCTI）]、家属满意度。结果 干预后，观察组胃管拔除时间、尿管拔除时间、肛管拔除时间、经口进食时间、术后首次排便时间、术后排气时间、肠鸣音恢复时间与住院时长均显著短于对照组，FCTI得分显著低于对照组（P＜0.05）；干预后，观察组并发症发生率显著低于对照组，家属护理满意度高于对照组（P＜0.05）；术后3d、7d，观察组FLACC得分均显著低于对照组（P＜0.05）。结论 基于ERAS理念的医护一体化全程护理可缓解HSCR手术患儿疼痛程度，提高家属照护能力，降低并发症发生率，促进术后恢复，提升家属满意度。

目的 探讨养血清脑颗粒联合银杏叶提取物注射液对脑梗死（CI）恢复期患者神经功能及认知功能的影响。方法 选取我院2024年7月-2025年11月收治的CI恢复期患者120例，按随机数字表法分2组，各组均60例；对照组予银杏叶提取物注射液治疗，治疗组基于对照组予养血清脑颗粒治疗，治疗周期均2周；对比2组疗效、神经功能、脑动脉血流速度、炎症指标、血液流变学指标、认知功能及不良反应。结果 治疗组总治疗有效率（95.00%）较对照组（81.67%）高，治疗后美国国立卫生研究院卒中量表（NIHSS）评分较对照组低（P＜0.05）；治疗组治疗后脑动脉平均血流速度（Vm）较对照组高，搏动指数（PI）、阻力指数（RI）、C反应蛋白（CRP）、同型半胱氨酸（Hcy）水平、血浆黏度、纤维蛋白原（FIB）水平、血小板最大聚集率水平较对照组低（P＜0.05）；治疗组治疗后简明精神状态检查量表（MMSE）评分较对照组高（P＜0.05）；组间不良反应相比无统计学差异（P＞0.05）。结论 养血清脑颗粒联合银杏叶提取物注射液治疗CI恢复期患者效果较好，可减轻神经功能缺损，提高脑动脉血流速度，降低炎症反应，调节血液流变学，改善认知功能。

目的：探讨不同时机宫腔镜检查对反复胚胎移植未孕患者后续体外受精-胚胎移植（IVF-ET）临床妊娠结局的影响。方法：回顾性分析2025年1月至2025年10月于东莞康华医院生殖医学科就诊的206例行IVF-ET助孕研究对象的临床资料。根据宫腔镜检查时机分为三组：A组（胚胎移植前检查，n=82）、B组（胚胎移植1次失败后检查，n=70）、C组（胚胎移植2次失败后检查，n=54）。比较三组研究对象后续IVF-ET周期的临床妊娠率。结果：三组研究对象基线年龄、不孕年限、BMI、AMH等指标差异无统计学意义（P>0.05）。总人群临床妊娠率为53.59%（97/206），其中A组妊娠率为72.0%（59/82），B组为35.7%（25/70），C组为24.1%（13/54），组间差异有统计学意义（P<0.001）。免疫双染阳性研究对象占86.27%（176/206），其在组间分布均衡，未改变主要结论。结论：对于IVF-ET助孕研究对象，胚胎移植前进行宫腔镜检查并处理异常，可能与后续临床妊娠率升高相关；延迟至1次或2次胚胎移植失败后再检查，妊娠获益可能大幅降低。提示胚胎移植前常规行宫腔镜评估的必要性。

Objective: To investigate the impact of different timing of hysteroscopy on the subsequent clinical pregnancy outcomes of patients with recurrent embryo transfer failure undergoing in vitro fertilization - embryo transfer (IVF-ET). Methods: The clinical data of 206 patients who underwent IVF-ET assisted pregnancy treatment at the Reproductive Medicine Department of Dongguan Kanghua Hospital from January 2025 to October 2025 were retrospectively analyzed. The patients were divided into three groups based on the timing of hysteroscopy: Group A (examined before embryo transfer, n = 82), Group B (examined after one failed embryo transfer, n = 70), and Group C (examined after two failed embryo transfers, n = 54). The clinical pregnancy rates of the subsequent IVF-ET cycles of the three groups were compared. Results: There were no statistically significant differences in baseline age, duration of infertility, BMI, AMH, etc. among the three groups (P > 0.05). The overall clinical pregnancy rate of the population was 53.59% (97/206), with the pregnancy rates in Group A being 72.0% (59/82), in Group B 35.7% (25/70), and in Group C 24.1% (13/54). The differences among the groups were statistically significant (P < 0.001). Immunobright staining positive study subjects accounted for 86.27% (176/206), and their distribution among the groups was balanced, without changing the main conclusion. Conclusion: For patients undergoing IVF-ET assisted pregnancy treatment, performing hysteroscopy and treating abnormalities before embryo transfer may be associated with an increased subsequent clinical pregnancy rate; delaying the examination until one or two failed embryo transfers may significantly reduce the pregnancy benefit. It suggests the necessity of routine hysteroscopy assessment before embryo transfer.

【摘要】目的：探讨HEART五步沟通模式对突发性耳聋（SSHL）患者心理状态及恢复情况的影响。方法：将2024年3月~2025年9月就诊于本院的110例SSHL患者作为研究对象，经抛币法将入组患者随机列为常规组、试验组，55例为一组。常规组实施常规临床护理，试验组在常规组的护理基础上联合实施HEART五步沟通模式，比较两组患者的心理状态，治疗依从性，护理结束后开展为期3个月短期随访，比较两组患者的听力改善情况及生活质量。结果：护理后，试验组的医院焦虑抑郁量表（HADS）、疾病不确定感（MUIS）评分分别为（8.25±1.39）分、（20.34±5.49）分，均低于常规组[（10.28±2.46）分、（25.52±6.67）分]（t=5.328，4.447；P＜0.05）。护理后，试验组的用药依从性、康复依从性、随访依从性均高于常规组（x2=9.429，11.733，11.282；P＜0.05）。试验组随访1个月、随访3个月时气导1kHz下平均听阈（PTA）及2kHz下PTA分别为（25.62±5.41）dB HL、（18.35±3.69）dB HL、（28.52±5.44）dB HL、（20.18±5.24）dB HL，均低于常规组[（30.67±6.35）dB HL、（21.33±4.25）dB HL、（33.69±6.37）dB HL、（25.49±6.33）dB HL]（t=4.490，3.927，4.577，4.792；P＜0.05）。截至随访结束时，试验组的成人听力障碍量表（HHIA）中社交维度、情绪维度、躯体维度评分均低于常规组（t=3.787，5.562，12.132；P＜0.05）。结论：HEART五步沟通模式可改善SSHL患者的不良心理状态并提升治疗依从性，对促进患者听力水平恢复及生活质量提升均有积极影响

[Abstract]Objective:To explore the impact of the HEART five step communication model on the psychological state and recovery of patients with sudden sensorineural hearing loss (SSHL).Methods:110 patients with SSHL who visited our hospital from March 2024 to September 2025 were selected as the research subjects. The enrolled patients were randomly divided into a control group and an experimental group using a coin toss method, with 55 patients in each group. The routine group received routine clinical nursing care, while the experimental group received the HEART five step communication model in addition to the routine nursing care. The psychological status and treatment compliance of the two groups of patients were compared. After the nursing was completed, a 3-month short-term follow-up was conducted to compare the hearing improvement and quality of life of the two groups of patients.Results:After nursing, the HADS and MUIS scores of the experimental group were (8.25 ± 1.39) points and (20.34 ± 5.49) points, respectively, which were lower than those of the control group [(10.28 ± 2.46) points and (25.52 ± 6.67) points] (t=5.328，4.447; P<0.05). After nursing, the medication compliance, rehabilitation compliance, and follow-up compliance of the experimental group were higher than those of the conventional group (x2=9.429，11.733，11.282; P<0.05). The PTA of the experimental group at 1kHz and 2kHz were (25.62 ± 5.41) dB HL, (18.35 ± 3.69) dB HL, (28.52 ± 5.44) dB HL, and (20.18 ± 5.24) dB HL, respectively, during a 1-month and 3-month follow-up, which were lower than those of the control group [(30.67 ± 6.35) dB HL, (21.33 ± 4.25) dB HL, (33.69 ± 6.37) dB HL, and (25.49 ± 6.33) dB HL] (t=4.490，3.927，4.577，4.792; P<0.05). As of the end of the follow-up, the scores of social, emotional, and physical dimensions in the HHIA of the experimental group were lower than those of the control group (t=3.787，5.562，12.132; P<0.05).Conclusion:The HEART five step communication model can improve the adverse psychological state of SSHL patients and enhance treatment compliance, which has a positive impact on promoting the recovery of patients' hearing level and improving their quality of life.

目的 分析胃热壅盛证急性非静脉曲张性上消化道出血（Acute Non-variceal Upper Gastrointestinal Bleeding，ANVUGIB）患者应用生地泻心汤联合矛头蝮蛇血凝酶治疗的效果。方法 收集2022-02—2025-09我院确诊的ANVUGIB患者98例为研究对象，按照治疗方案分为研究组与对照组，其中接受矛头蝮蛇血凝酶治疗的49例患者作为对照组，接受生地泻心汤、矛头蝮蛇血凝酶联合治疗的49例作为研究组。观察两组疗效、再出血率、止血效果、中医证候积分、安全性、凝血功能指标[全血活化部分凝血活酶时间（Activated Partial Thromboplastin Time，APTT）、凝血酶原时间（Prothrombin Time，PT）、血浆D-二聚体（D-Dimer，D-D）、纤维蛋白原（Fibrinogen，FIB）水平]、全血血红蛋白（Hemoglobin，Hb）、红细胞压积（Hematocrit，HCT）、红细胞计数（Red Blood Cell Count，RBC）以及血清尿素氮（Blood Urea Nitrogen，BUN）水平。结果 研究组治疗有效率93.88%比对照组77.55%高（P＜0.05）；与对照组相比，治疗12h、24h、48h研究组有效止血率较高，出血停止时间较短（P＜0.05）；治疗1周后，研究组中医证候积分低于对照组（P＜0.05）；研究组再出血率低于对照组（P＜0.05）；治疗1周后，研究组PT、APTT短于对照组，血浆D-D、FIB水平低于对照组（P＜0.05）；治疗1周后，研究组全血RBC、Hb、HCT水平高于对照组，血清BUN水平低于对照组（P＜0.05）；两组治疗期间未发生不良反应。结论 胃热壅盛证ANVUGIB患者应用生地泻心汤联合矛头蝮蛇血凝酶治疗效果确切，可缩短出血时间，减轻临床症状，改善凝血功能与循环血容量，且未见不良反应。

目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭（HFrEF）患者的疗效，并分析其对中医证候积分、心功能的影响。方法 选取2024年8月～2025年8月于本院诊治的150例HFrEF患者进行回顾性分析，依据治疗方案不同将其分为对照组、观察组，其中采取恩格列净治疗的75例患者作为对照组，采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验（6MWT）、心衰因子[心肌肌钙蛋白I（cTnI）、可溶性人基质裂解素2（sST2）、N末端B型利钠肽原（NT-proBNP）]、血流动力学、炎症因子[白细胞介素-6（IL-6）、C反应蛋白（CRP）、白细胞介素-1β（IL-1β）、正五聚蛋白-3（PTX-3）]、氧化应激指标[谷胱甘肽过氧化物酶-3（GPX-3）、丙二醛（MDA）、超氧化物歧化酶（SOD）、脂质过氧化物（LPO）、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组（P＜0.05）；观察组治疗后中医证候积分、Lee氏心衰积分低于对照组（P＜0.05）；观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组，LVEF、6MWT高于对照组（P＜0.05）；观察组治疗后血流动力学改善程度优于对照组（P＜0.05）；治疗后，与对照组比较，观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低，GPX-3、SOD、总抗氧化能力水平升高（P＜0.05）；观察组再住院率低于对照组（P＜0.05），且两组不良反应比较无明显差异（P＞0.05）。结论 活血通络汤联合恩格列净治疗HFrEF患者，可提高治疗效果，改善临床症状、心功能，调节血流动力学，并可降低炎症反应，抑制氧化应激反应，减少再住院的发生，且具有一定安全性。

Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.