目的   探讨剖宫产后再次分娩阴道试产失败的影响因素。方法   选取2021年5月—2024年5月在枣庄市妇幼保健院分娩的138例有剖宫产手术史的足月妊娠产妇进行回顾性分析。所有产妇依照其阴道试产结果将成功阴道分娩的35例产妇分为成功组，将阴道试产失败中转剖宫产的103例产妇分为失败组。对比两组产妇的妊娠结局、孕期情况及围产期情况，最后采用多因素Logistic回归分析法分析剖宫产后再次分娩阴道试产失败的影响因素。结果   两组产妇子宫破裂、胎儿窘迫、产褥感染及产后出血等妊娠不良结局总发生率对比差异无统计学意义（11.43% vs 6.80%，χ ² =0.760，P=0.382 ＞0.05）；通过对比两组产妇孕期情况发现，失败组与成功组孕妇年龄、孕次、身高、孕前体质量、妊娠期合并症、分娩前体质量指数（BMI）比较差异无统计学意义（P＞0.05），失败组与成功组孕妇孕期体质量增长［（4.56±2.56）kg vs（12.45±3.24）kg］、分娩孕周［（39.46±1.25）周 vs（37.95±1.37）周］、阴道分娩史（8.57% vs 26.21%）、妊娠间隔时间［（2.74±0.35）年 vs（3.37±0.57）年］及瘢痕厚度［（4.51±0.56）mm vs（5.42±0.38）mm］，对比差异有统计学意义（t=3.497，P＜0.001；t=5.755，P＜0.001；χ ² =4.780，P=0.029；t=6.148，P＜0.001；t=10.764，P＜0.001）；通过对比两组产妇围产期情况发现，失败组与成功组新生儿性别、是否镇痛比例比较差异无统计学意义（P＞0.05），失败组与成功组孕妇产前新生儿估重［（3352.31±153.67）g vs（3046.25±141.68）g］、是否引产［60.00% vs 52.43%］、胎膜早破［11.43% vs 35.92%］、入院时是否临产［857% vs 27.18%］，对比差异有统计学意义（t=10.805，P＜0.001；χ ² =7.330，P=0.007；χ ² =7.500，P=0.006；χ ² =5.200，P=0.023）；以阴道试产情况作为因变量（失败=1，成功=0）纳入Logistic回归模型，结果显示，分娩孕周过晚、产前新生儿估重过高、引产及入院时未临产为剖宫产后再次分娩阴道试产失败的影响因素（P＜0.05）。结论   分娩孕周过高、产前新生儿估重过高、引产及入院时未临产为剖宫产后再次分娩阴道试产失败的独立影响因素，需针对分娩孕周、产前新生儿估重过高的剖宫产后再次分娩阴道试产产妇给予高度关注并采取相应措施进行干预，同时自然临产能够降低阴道试产失败风险，但针对具有引产指征的产妇，依然需要及时引产。

       Objective   To explore the influencing factors of vaginal trial delivery failure after cesarean section．Methods   A retrospective analysis was conducted on 138 full-term pregnant women with a history of cesarean section who gave birth in our hospital from May 2021 to May 2024．All women were divided into two groups according to the  results of their vaginal trial delivery．Based on their vaginal trial results，35 parturients who successfully delivered were divided into the successful group，and 103 parturients who failed vaginal trial delivery and transitioned to cesarean section were divided into the failed group．The pregnancy outcomes of postpartum women and the pregnancy and perinatal conditions were compared between the two groups，and multivariate Logistic  regression analysis was used to analyze the independent influencing factors of vaginal trial delivery failure after cesarean section．Results   There was no significant difference in the total incidence of adverse pregnancy outcomes such as uterine rupture，fetal distress，postpartum infection，and postpartum hemorrhage between the two groups of parturients （P＞0.05）．By comparing the pregnancy status of two groups of  pregnant women，it was found that there was no difference （P＞0.05）．The average weight gain during pregnancy of failure and successful group，gestational age，cases with vaginal delivery history，intervalbetween pregnancy and scar thickness，the contrast difference was significant （all P＜0.05） ．By comparing the perinatal situation of the two groups，there was no difference in the sex of fetus and analgesia receiving of parturients between the failed group and the successful group （P＞0.05），while there is difference in weight estimation，whether induced labour，premature  rupture of fetal membrane，whether admitted to hospital （all P＜0.05）．Vaginal trial delivery was set as the dependent variable （failure=1，success=0） and it was incorporated into the Logistic regression model．The results showed that high gestational age during delivery，high estimated weight of fetus before delivery，induction of labor，and non-labor upon admission were independent influencing factors for vaginal trial delivery failure after cesarean section （P＜0.05）．Conclusions  Excessive gestational age，high estimated weight of fetus before delivery，induced labor，and non-labor upon admission were independent influencing factors for the failure of vaginal trial delivery after cesarean section．It is necessary to pay high attention and take corresponding measures to intervene in women who have undergone vaginal trial delivery after cesarean section due to excessive gestational age and high estimated weight of fetus before delivery．At the same time，spontaneous labour can reduce the risk of vaginal trial delivery failure．However，for women with indications for induced labor，timely induction is still necessary．

       目的   探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法   选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿，应用随机数字表法分为两组，各50例。对照组患儿实施常规护理，观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表（ATEC）、儿童感觉统合发展评定量表、格塞尔发育量表（GDS）及中国韦氏儿童智力量表（WISC-R）评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果   干预后两组患儿的ATEC各部分评分，包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低，观察组低于对照组（P＜0.05）；干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高，观察组高于对照组（P＜0.05）；干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高，观察组高于对照组（P＜0.05）；干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高，观察组高于对照组（P＜0.05）。结论  运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著，可提升其社会交往能力，促进感觉统合发展，进而促进其神经发育及智力水平提升。

       Objective  To  explore the  effect  of  exercise intervention  combined with therapeutic listening  on  social communication function in children with autism spectrum disorder．Methods  A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method，with 50 children each．The control group received routine care，while the observation group  received exercise intervention combined with therapeutic listening in addition to routine care．The Autism Treatment Evaluation Scale （ATEC），Children’s Sensory Integration Development Scale，Gesell Development Scale，and Wechsler Intelligence Scale for Children-Revised by China （WISC-R）were used before and 6 months after the intervention to evaluate the social communication ability，sensory integration development level，neural development level，and intellectual level changes of the two groups of children．Results  After intervention，the score of every dimension in ATEC including the health/physiology/behavior，perception/cognitive ability，social ability，language expression/communication ability，and total ATEC score of the two groups of children decreased，and the observation group was lower than the control group （P＜0.05）．After intervention，the total scores of the learning ability development insufficient，proprioceptive dysfunction，excessive tactile defense，vestibular dysfunction，and children’s sensory integration development assessment scale in both groups of children increased，with the observation group being higher than the control group （P＜0.05）．After intervention，the neurological development scores related to motor，adapt，language，and social ability in both groups of children increased，and the observation group was higher than the control group （P＜0.05）．After intervention，the WISC-R scores related to verbal intelligence，operational intelligence，and total intelligence in both groups of children increased，and the observation group was higher than the control group （P＜0.05）．Conclusions  The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder，which can enhance their social communication ability，promote sensory integration development，and ultimately promote their neural development and intellectual level improvement．

      目的   探讨在冠状动脉造影术后患者中应用风险防范护理干预对血管并发症的控制效果。方法   选择2022年1月—2023年6月于我院接受治疗的85例冠状动脉造影术后患者。按照随机数字表法分组，其中对照组42例给予常规护理干预，观察组43例给予风险防范护理干预，比较两组干预前后的心理状态、治疗依从性、血管并发症。结果   干预后，观察组正性情绪（PA）评分高于对照组PA评分（t=3.821，P＜0.001），观察组负性情绪（NA）评分低于对照组NA评分（t=5.380，P＜0.001）。与对照组比，观察组治疗依从性更好（Z=2.268，P=0.023）。观察组血管并发症总发生率低于对照组（9.30% vs 30.95%，χ ² =6.224，P=0.013）。结论   采用风险防范护理干预，能够改善冠状动脉造影术后患者的心理状态，提高治疗依从性，并降低血管并发症总发生率。

       Objective  To explore the effect of  risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography．Methods  Eighty-five patients after coronary angiography in our hospital were selected from January 2022 to June 2023．They were grouped according to the random number table．And 42 cases were divided into the control group for routine nursing intervention，and 43 cases in the observation group were given risk prevention nursing intervention．Psychological status，treatment compliance and vascular complications of the two groups were observed．Results  After the intervention，the postive affect score of the observation group was higher than that of the control group（t=3.821，P＜0.001），and the negative affect score of the observation group（21.25±3.31）was lower than the score of the control group（25.35±3.70）（t=5.380，P＜0.001）．Compared with the control group the compliance of observation group was higher（Z=2.268，P=0.023）．The overall incidence of vascular complications in the observation group was lower than that in the control group（9.30% vs 30.95%，χ2=6.224，P=0.013）．Conclusions  Risk prevention nursing intervention can improve the psychological status of patients after coronary angiography，improve treatment compliance，and reduce the overall incidence of vascular complications．

       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例，评估所有患者的应对方式，根据结果分为积极应对组与消极应对组，设计基线资料调查表，详细统计两组患者的基线资料并比较，重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估，78例阴道分娩后尿失禁患者疾病消极应对有40例，占比51.28%；积极应对组与消极应对组患者的产次（χ ² =4.110，P=0.043）、文化水平（Z=2.094，P=0.036）、家庭关怀度（Z=2.069，P=0.040）与自我效能（Z=2.249，P=0.025）比较差异有统计学意义，组间年龄（t=0.096，P=0.924）、孕次（t=1.257，P=0.212）、体质指数（BMI）（t=0.125，P=0.901）、工作（χ ² =0.778，P=0.378）、家庭月人均收入（χ ² =0.044，P=0.834）、漏尿（χ ² =0.040，P=0.842）比较差异无统计学意义；经回归分析发现，家庭关怀度低（OR=1.799，P=0.041）、自我效能低（OR=1.942，P=0.026）、经产妇（OR=2.554，P=0.045）及文化水平低（OR=1.837，P=0.038）均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高，可能与产次、文化水平、家庭关怀度及自我效能有关。

       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery．Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected．The coping strategies of all patients were evaluated，and they were divided into a positive coping group and a negative coping group based on the results．A baseline data questionnaire was designed，and the baseline data of the two groups of patients were compared in detail．The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery．Results After evaluation，40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies，accounting for 51.28%．The parity of patients in the positive and negative coping groups（χ ² =4.110，P=0.043），educational level（Z=2.094，P=0.036），family care（Z=2.069，P=0.040），and self-efficacy（Z=2.249，P=0.025）among the groups were different．Age between groups（t=0.096，P=0.924），gestational age（t=1.257，P=0.212），body mass index（t=0.125，P=0.901），and work experience（χ ² =0.778，P=0.378），monthly per capita income of households（χ ² =0.044，P=0.834），urinary leakage（χ 2 =0.040，P=0.842）had no statistically significant difference in comparison．Through regression analysis，it was found that low family care（OR=1.799，P=0.041），low self-efficacy（OR=1.942，P=0.026），postpartum women（OR=2.554，P=0.045），and low educational level（OR=1.837，P=0.038）were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery．Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease，which may be related to parity，educational level，family care and self-efficacy．

       目的   探讨基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响。方法   根据中心随机法将郑州大学第二附属医院2021年1月—2023年1月收治的88例急性胰腺炎患者作为研究对象，其中传统组44例给予常规干预，微视频组44例在传统组的基础上结合微视频的护理干预，比较两组患者疾病知晓情况、自我管理能力和遵医行为情况。结果   干预2个月后，微视频组病例脱落3例，传统组病例脱落4例，两组疾病知晓各维度高于干预前，且微视频组高于传统组，其中疾病病因（t=3.151，P=0.003）、临床症状（t=7.165，P＜0.001）、并发症（t=5.497，P＜0.001）、如何预防疾病复发（t=8.195，P＜0.001）；两组自我护理能力量表（ESCA）各维度评分高于干预前，且微视频组高于传统组，其中各维度评分结果为自我护理技能（t=2.787，P=0.007）、自我概念（t=2.272，P=0.026）、自护责任感（t=2.644，P=0.011）、健康知识水平（t=3.321，P=0.001）；两组遵医行为各维度评分高于干预前，且微视频组高于传统组，其中各维度评分结果为饮食依从性（t=6.271，P＜0.001）、用药依从性（t=3.539，P=0.001）、锻炼依从性（t=4.469，P＜0.001）、定期复查（t=2.764，P=0.007）。结论   通过运用微视频的护理干预能够提高急性胰腺炎患者疾病知识的掌握，促进机体自我管理水平的恢复，进而提高遵医行为。

       Objective  To explore the impact of micro video based nursing interventions on disease awareness，self-management and compliance behavior in patients with acute pancreatitis．Methods  According to the central randomization method，88 patients with acute pancreatitis admitted to the Second Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were selected as the research subjects．Among them，44 patients in the traditional group received routine intervention，and 44 patients in the micro video group received nursing intervention combined with micro video on the basis of the traditional group．The disease awareness，self-management ability and compliance behavior of the two groups of patients were compared．Results  After two months of intervention，three cases were dropped out in the micro video group and four cases were dropped out in the traditional group．The disease awareness in both groups was higher than that before intervention，and the micro video group was higher than the traditional group，including disease etiology（t=3.151，P=0.003），clinical symptoms（t=7.165，P＜0.001），complications（t=5.497，P＜0.001） and how to prevent disease recurrence（t=8.195，P＜0.001）．The scores of ESCA in both groups were significantly higher than those before intervention，and the micro video group was higher than the traditional group in terms of self-care skills（t=2.787，P=0.007），self-concept（t=2.272，P=0.026），self-care responsibility（t=2.644，P=0.011） and health knowledge level（t=3.321，P=0.001）．The scores of all dimensions of compliance behavior in both groups were significantly higher than those before intervention，and the micro video group had higher scores than the traditional group in terms of dietary compliance（t=6.271，P＜0.001），medication compliance（t=3.539，P=0.001），exercise compliance（t=4.469，P＜0.001） and  regular follow-up（t=2.764，P=0.001）．Conclusions  The use of micro video nursing interventions can improve the mastery of disease knowledge in patients with acute pancreatitis，promote the recovery of the body’s self-management level，and thereby improvemedical compliance behavior．

       目的   分析共同照护模式联合回授法健康教育在2型糖尿病患者中的应用效果。方法   将2023年1月—2023年12月广州市第一人民医院收治 的114例2型糖尿病患者作为此次研究对象，分为研究组（n=57）和对照组（n=57），对照组患者给予常规护理结合健康教育，研究组患者给予共同照护模式联合回授法健康教育，评估两组在培训前及培训后1、3个月的血糖控制情况及糖尿病患者自我管理行为量表（SDSCA）等指标。结果   培训1、3个月后，两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均低于培训前，且研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组（P＜0.05）。培训1、3个月后，两组患者的糖尿病患者SDSCA评分高于培训前，且研究组各项评分高于对照组（P＜0.05）。重复测量方差分析表明随着时间的推移，患者的血糖控制状况随着不同护理培训策略而得到改善。结论   使用共同照护模式联合回授法健康教育对2型糖尿病患者可以更显著改善血糖控制水平、提高自我管理效能。

       Objective  To analyze the effect of co-care mode and feedback  health education on  patients with type  2 diabetes．Methods  From January 2023 to December 2023，114 patients with type 2 diabetes admitted to Guangzhou First People’s Hospital were divided into two groups：experimental group（n=57）and control group（n=57）．Patients in control group were given routine nursing combined with health education．Patients in study group were given co-care and feedback health education．Before intervention and 1，3 months after intervention，patients’ blood glucose control and diabetic self-management behavior scale（SDSCA）were evaluated．Results  After 1 and 3 months of intervention，the fasting blood glucose，2-hour blood glucose and HbA1c of the two groups were significantly lower than those before intervention，and the fasting blood glucose，2-hour blood glucose and HbA1c of the experimental group were significantly lower than those of the control group（P＜0.05）．After 1 month and 3 months of intervention，the SDSCA scores of diabetic patients in both groups were higher than those before intervention，and the scores of study group were higher than those of control group（P＜0.05）．Repeated measures analysis of variance indicating that glycemic control improved significantly over time with different nursing training strategies．Conclusions  Co-care mode and feedback health education can significantly improve blood glucose control and self-management efficiency in patients with type 2 diabetes．

    目的   研究羽毛球颠球运动对低年级小学生近视的改善效果，为制定儿童青少年近视干预方案提供依据。方法   采用方便抽样方法，抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后，以班为单位，采用随机数字表法将4个班分为干预组（2个班，91例）和对照组（2个班，91例），干预组安排羽毛球颠球项目体育活动，对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果  干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较，差异均无统计学意义（P＞0.05）。两组干预后的等效球镜度数（SE）比较，差异无统计学意义（P＞0.05）；对照组干预后的裸眼远视力（UDVA）低于干预组，△UDVA、△SE均高于干预组，差异均有统计学意义（P＜0.05）。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度，均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度，差异均有统计学意义（P＜0.05）。结论   羽毛球颠球运动能降低低年级小学生视力不良进展速度，减少近视的发生率及近视程度，学校可结合引起近视的因素进行灵活应用，以预防近视的发生发展。

      Objective  To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents．Methods  By using the convenience sampling method，182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects．After completing the baseline survey，the four classes were divided into an intervention group（2 classes，91 students）and a control group（2 classes，91 students）using a random number table．The intervention group was arranged to participate in badminton juggling sports activities，while the control group followed the original teaching plan without ball games．The study compared the screening rate of myopia，the rate of poor vision，and the degree of myopia progression before and after the study in both groups．Results  On baseline，there were no statistically significant differences between the two groups in terms of age，gender，rate of screening myopia，poor vision，and myopia grading（P＞0.05）．After 12 months，there was no statistically significant difference in the spherical equivalent（SE） comparison between the two groups（P＞0.05）．However，the uncorrected distance visual acuity（UDVA） of the control group after 12 months was significantly lower than that of the intervention group，and both △UDVA and △SE were significantly higher than those of the intervention group，with all differences being statistically significant（P＜0.05）．Incidence of screening myopia in the control group （29.13%），the cumulative rate of screening myopia（49.45%），the cumulative rate of poor vision （68.13%），and the degree of myopia progression was significantly higher than those in the intervention group，which had incidence of screening myopia at 7.69%，the cumulative rate of screening myopia at 34.07%，cumulative rate of poor vision at 52.74%．All these differences were statistically significant（P＜0.05）．Conclusions  Badminton juggling can slow down vision deterioration，reduce the incidence and severity of myopia in lower grade primary school students．Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development．