目的 构建并验证主动脉夹层B型（TBAD）患者急性期预后的列线图预测模型,帮助临床医生在急性期内更准确地评估TBAD患者的死亡风险,并制定更合适的治疗策略。方法 回顾性分析从重症监护医学信息数据库v2.2 中提取的399例 TBAD患者的人口学资料和临床资料,结局为TBAD患者急性期（≤14 d）内死亡。先采用最小绝对收缩选择算法回归筛选特征变量,再采用多因素分析确定独立预后因素,并据此构建预测模型。通过受试者工作特征曲线、校准曲线、决策曲线分析（DCA）评价列线图预测模型的性能和临床适用性。结果 APS Ⅲ评分、二氧化碳总量、红细胞分布宽度为TBAD患者14 d内死亡的独立预测因素。列线图预测模型在内部验证中的受试者工作特征曲线下面积为0.776（95% CI：0.691 ~ 0.860）,Hosmer-Lemeshow 检验P=0.604,校准曲线和标准曲线高度重合,表明该模型具有良好的区分度和校准度。同时,DCA曲线显示,预测模型在大部分的阈值概率范围内提供了显著的净收益。结论 本研究基于APS Ⅲ评分、二氧化碳总量、红细胞分布宽度构建的列线图预测模型可以较准确地预测TBAD患者14 d内的死亡风险,有助于临床医生制定更合适的个体化治疗策略。

Objective To develop and verify a nomogram for predicting acute phase outcomes in patients with type B aortic dissection（TBAD）,enabling clinicians to more precisely evaluate mortality risk in TBAD patients during the acute stage and to devise better treatment plans．Methods This retrospective study analyzed demographic and clinical data of 399 TBAD patients from the Medical Information Mart for Intensive Care IV v2.2,focusing on mortality within 14 days of the acute phase in TBAD patients． Initially,the Least Absolute Shrinkage and Selection Operator regression was employed for feature variable selection,and then multivariate analysis was used to identify independent prognostic factors for constructing the predictive model．The nomogram predictive model's effectiveness and clinical applicability were assessed via the Receiver Operating Characteristic curve,calibration curve,and Decision Curve Analysis（DCA）．Results Acute Physidogy Score Ⅲ score,total carbon dioxide,and red blood cell distribution width emerged as independent predictors of 14-day mortality in TBAD patients．The internal validation of the nomogram predictive model showed an area under the curve of 0.776（95%CI：0.691-0.860）,with a Hosmer-Lemeshow test P-value of 0.604． The close alignment of the calibration and standard curves suggested the model's strong discriminative power and calibration． Furthermore,the DCA curve revealed that the predictive model offered substantial net benefits within a wide range of threshold probabilities．Conclusions This study's nomogram,developed using APS Ⅲ score,total carbon dioxide,and red blood cell distribution width,accurately predicts the 14-day mortality risk in TBAD patients,assisting clinicians in creating better personalized treatment plans．

目的 探讨综合呼吸康复训练对老年慢性阻塞性肺疾病急性期（AECOPD）患者的临床症状、生活质量、活动能力、肺功能、肺康复依从性的影响。方法 纳入70 例AECOPD 患者,随机数字分为对照组（n=35）和干预组（n=35）,对照组在常规治疗基础上予缩唇腹式呼吸功能锻炼,干预组在常规治疗基础上进行综合呼吸康复训练,干预前后采用慢性阻塞性肺疾病评估测试（CAT）调查问卷、改良版英国医学研究委员会呼吸问卷（mMRC）、肺功能第一秒用力呼气容积（FEV1）预计值进行评估。结果 对照组呼吸康复训练前后CAT评分、mMRC量表呼吸困难评级比较差异均有统计学意义（t=16.781,t=8.103,均P<0.001）;干预组呼吸康复训练前后CAT评分、mMRC呼吸困难评级比较差异也均有统计学意义（t=24.035,t=15.938,均P<0.001）;干预组患者的CAT评分、mMRC量表呼吸困难评级较对照组下降明显。结论 综合呼吸康复训练能有效改善 AECOPD 患者临床症状、增强患者活动能力、提高生活质量、提高肺康复依从性。

Objective To investigate the effects of comprehensive respiratory rehabilitation training on clinical symptoms,quality of life,activity ability,lung function and compliance of elderly patients with acute exacerbation of obstructive pulmonary disease（AECOPD）．Methods Seventy patients with AECOPD were included and randomly divided into control group（n=35）and intervention group（n=35）．The control group was given routine treatment and respiratory muscle function exercise．The intervention group was given routine treatment and comprehensive respiratory rehabilitation training．COPD Assessment Test（CAT）,modified Medical Research Council Scale（mMRC）and FEV1 predicted value of lung function were used to evaluate before and after intervention．Results In the control group,differences of CAT score and mMRC score were significant（t=16.781,t=8.103,P<0.001）before and after respiratory rehabilitation training．In the intervention group,the CAT score before and after respiratory rehabilitation training showed a 0.01 level of significance（t=24.035,P<0.001）,and the mMRC score before and after training showed a 0.01 level of significance（t=15.938,P<0.001）．There were significant differences between control group and intervention group（P<0.01）．Compared with the control group,CAT score and mMRC score were significantly lower in the intervention group．Conclusions Comprehensive respiratory rehabilitation training can effectively improve the clinical symptoms of AECOPD patients,enhance the activity ability of patients,improve the quality of life,and improve the compliance of patients to perform pulmonary rehabilitation．

目的 探讨通络熄风汤联合西医基础治疗对缺血性脑卒中急性期的临床疗效观察及其安全性。方法 选择2013年4月—2015年4月之间于我院收治的缺血性脑卒中急性期患者112例随机分为联合组(n=56)与对照组(n=56)。两组缺血性脑卒中急性期患者均采用常规治疗,联合组在此基础上服用通络熄风汤。比较两组治疗总有效率,神经功能缺损积分,ADL评分,血清NSE水平及用药安全性。结果 联合组总有效率(91.07%)高于对照组(75.00%)(P<0.05);神经功能缺损评分治疗后联合组与对照组低于治疗前(P<0.05);神经功能缺损评分治疗后联合组低于对照组(P<0.05);ADL评分治疗后联合组与对照组高于治疗前(P<0.05);ADL评分治疗后联合组高于对照组(P<0.05);血清NSE水平治疗后联合组与对照组低于治疗前(P<0.05);血清NSE水平治疗后联合组低于对照组(P<0.05);联合组与对照组在用药期间均无发现有严重药物不良反应。结论 通络熄风汤联合西医基础治疗对缺血性脑卒中急性期的临床疗效明显,并且用药安全性良好。

        目的   比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效，以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法   连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例，采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d，阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前（基线）以及连续用药治疗2、4、6周后的PANSS量表评分，以及治疗后的代谢指标［体质量指数（BMI）、血清空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE），并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果   两组的总有效率比较差异无统计学意义（χ ² =1.569，P＞0.05）；两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义（χ ² =0.466、3.640，P=0.926、0.056），时间主效应显著（χ ² =363.24，P＜0.001）。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应（χ ² =7.562、5.991、6.163、6.958、4.397，P=0.006、0.014、0.013、0.008、0.036），两组TG、ApoA时间主效应显著（χ ² =33.473、8.846，P＜0.001、0.003），两组ApoA组别效应显著（χ ² =4.889，P=0.027）。结论   与奥氮平相比，鲁拉西酮治疗女性急性期精神分裂症的疗效相当，且对代谢指标影响更小。

        Objective  To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia，as well as their effects on body mass，glucose and lipid metabolism risk．To provide  reference for the selection of antipsychotic drugs for female patients with acute schizophrenia．Methods  From April 2022 to April 2024，80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study．The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison．The treatment group took oral lorazepine tablets（40 cases；40-80 mg/d），while the positive drug control group took oral olanzapine tablets（40 cases；5-20 mg/d）．The Positive and Negative Symptom Scale（PANSS）scores of two groups before treatment（baseline）and after 2，4，and 6 weeks of continuous medication treatment were measured，as well as metabolic indicators after treatment （body mass index［BMI］，serum fasting blood glucose［FPG］，total cholesterol［TC］，triglycerides［TG］，high-density lipoprotein［HDL］，low-density lipoprotein［LDL］，apolipoprotein A［ApoA］，apolipoprotein B［ApoB］，apolipoprotein E［ApoE］），and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed．Results  The total effective  rate of the two groups was not statistically significant（χ ² =1.569，P＞0.05）．The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant（χ ² =0.466，3.640，P=0.926，0.056），while the time main effect was significant（χ ² =363.24，P＜0.001）．There was a group-time interaction effect between two groups of TG，TC，HDL，ApoA，and ApoB（χ ² =7.562，5.991，6.163，6.958，4.397，P=0.006，0.014，0.013，0.008，0.036）．The time main effect of TG and ApoA was significant in both groups（χ ² =33.473，8.846，P＜0.001，0.003），and the group effect of ApoA was significant in both groups（χ ² =4.889，P=0.027）．Conclusions  Compared with olanzapine，the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable，and it has a smaller impact on metabolic indicators．

       目的   构建并验证主动脉夹层B型（TBAD）患者急性期预后的列线图预测模型，帮助临床医生在急性期内更准确地评估TBAD患者的死亡风险，并制定更合适的治疗策略。方法   回顾性分析从重症监护医学信息数据库v2.2 中提取的399例 TBAD患者的人口学资料和临床资料，结局为TBAD患者急性期（≤14 d）内死亡。先采用最小绝对收缩选择算法回归筛选特征变量，再采用多因素分析确定独立预后因素，并据此构建预测模型。通过受试者工作特征曲线、校准曲线、决策曲线分析（DCA）评价列线图预测模型的性能和临床适用性。结果  APS Ⅲ评分、二氧化碳总量、红细胞分布宽度为TBAD患者14 d内死亡的独立预测因素。列线图预测模型在内部验证中的受试者工作特征曲线下面积为0.776（95% CI：0.691 ~ 0.860），Hosmer-Lemeshow 检验P=0.604，校准曲线和标准曲线高度重合，表明该模型具有良好的区分度和校准度。同时，DCA曲线显示，预测模型在大部分的阈值概率范围内提供了显著的净收益。结论   本研究基于APS Ⅲ评分、二氧化碳总量、红细胞分布宽度构建的列线图预测模型可以较准确地预测TBAD患者14 d内的死亡风险，有助于临床医生制定更合适的个体化治疗策略。

       Objective  To develop and verify a nomogram for predicting acute phase outcomes in patients with type B aortic dissection（TBAD），enabling clinicians to more precisely evaluate mortality  risk in TBAD patients during the acute stage and to devise better treatment plans．Methods  This retrospective study analyzed demographic and clinical data of 399 TBAD patients from the Medical Information Mart for Intensive Care IV v2.2，focusing on mortality within 14 days of the acute phase in TBAD patients．Initially，the Least Absolute Shrinkage and Selection Operator regression was employed for feature variable selection，and then multivariate analysis was used to identify independent prognostic factors for constructing the predictive model．The nomogram predictive model’s effectiveness and clinical applicability were assessed via the Receiver Operating Characteristic curve，calibration curve，and Decision Curve Analysis（DCA）．Results  Acute Physidogy Score Ⅲ score，total carbon dioxide，and red blood cell distribution width emerged as independent predictors of 14-day mortality in TBAD patients．The internal validation of the nomogram predictive model showed an area under the curve of 0.776（95%CI：0.691-0.860），with a Hosmer-Lemeshow test P-value of 0.604．The close alignment of the calibration and standard curves suggested the model’s strong discriminative power and calibration．Furthermore，the DCA curve  revealed that the predictive model offered substantial net benefits within a wide  range of threshold probabilities．Conclusions  This study's nomogram，developed using APS Ⅲ score，total carbon dioxide，and  red blood cell distribution width，accurately predicts the 14-day mortality risk in TBAD patients，assisting clinicians in creating better personalized treatment plans．