目的 探讨复方斑蝥胶囊结合奥沙利铂、卡培他滨对结直肠癌患者疾病控制率及肿瘤标志物的影响。方法 纳入的100例CRC病例均由我院2022年11月-2025年11月收治，按随机数字法分组，联合组（复方斑蝥胶囊+奥沙利铂、卡培他滨）、对照组（奥沙利铂、卡培他滨）各50例。比较两组疾病控制率、肿瘤标志物、免疫指标与不良反应。结果 联合组疾病控制率比对照组优，但无显著差异性（P＞0.05）；治疗后，联合组CEA、CA199、CA125、CD8+均比对照组更低（P＜0.05），CD4+和CD4+/CD8+均比对照组更高（P＜0.05）；联合组不良反应率比对照组略低，但无显著差异（P＞0.05）。结论 复方斑蝥胶囊结合奥沙利铂、卡培他滨治疗CRC能显著提高患者疾病控制率，降低血清肿瘤标志物，提高免疫力，且安全性较好。

目的 分析布地格福吸入、无创正压通气（NIPPV）联合治疗慢性阻塞性肺疾病急性加重（AECOPD）合并呼吸衰竭的效果。方法 本研究采用回顾性对照研究。选取2024-06—2025-05我院96例AECOPD合并呼吸衰竭者，根据治疗方案不同分组，每组48例。对照组接受NIPPV治疗，研究组接布地格福吸入、NIPPV联合治疗，持续治疗1周。观察并对比两组疗效、病情程度、血气指标[动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）]、肺功能[最大呼气压（MEP）、一秒率（FEV1/FVC）]、炎性因子指标[C反应蛋白（CRP）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]、氧化应激指标[超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、过氧化脂质（LPO）]及不良反应。结果 研究组治疗有效率为91.67%（44/48），高于对照组75.00%（36/48）（P＜0.05）；治疗1周后与对照组相比，研究组mMRC分值、CAT分值均较低（P＜0.05）；治疗1周后，与对照组相比，研究组MEP、FEV1/FVC、PaO2较高，PaCO2较低（P＜0.05）；治疗1周后与对照组相比，研究组CRP、TNF-α、IL-6较低（P＜0.05）；治疗1周后与对照组相比，研究组SOD、GSH-Px较高，LPO较低（P＜0.05）；两组不良反应无明显差异（P＞0.05）。结论 布地格福吸入、NIPPV联合治疗AECOPD合并呼吸衰竭，可明显减轻症状，改善血气指标与肺功能，抑制炎症反应，调节氧化应激，且保障安全性。

【摘要】目的：探讨营养控制状态（CONUT）评分与急性心肌梗死（AMI）患者长期预后的相关性。方法：纳入90例AMI患者，于2021年1月～2023年12月入院，随访2年，分为主要心血管不良事件（MACEs）组（32例）与非MACEs组（58例），回顾性分析并对比两组基线资料，并分析CONUT评分与MACEs的相关性及MACEs的影响因素，评估CONUT评分对MACEs的预测效能。结果：90例AMI患者2年MACEs发生率为35.56%；相较于非MACEs组，MACEs组年龄、糖尿病、血肌酐、C反应蛋白（CRP）、降钙素原（PCT）、N末端脑钠肽前体（NT-proBNP）、KillipⅢ~Ⅳ级、CONUT评分更高，白蛋白、血钙、左心室射血分数（LVEF）更低（P＜0.05）；CONUT评分与MACEs发生正相关（P＜0.05）；高CONUT评分是MACEs的独立危险因素（P＜0.05）；MACEs预测中，CONUT评分的灵敏度为93.75%，特异度为93.10%，曲线下面积（AUC）为0.854。结论：CONUT评分与AMI患者长期预后密切相关，营养不良程度越重，MACEs发生风险越高。

Abstract Objective: To explore the correlation between nutritional control status (CONUT) score and long-term prognosis of patients with acute myocardial infarction (AMI). Methods: 90 AMI patients were included, admitted to the hospital from January 2021 to December 2023, and followed up for 2 years. They were divided into major adverse cardiovascular events (MACEs) group (32 cases) and non-MACEs group (58 cases). The baseline data of the two groups were retrospectively analyzed and compared, and the correlation between CONUT score and MACEs and influencing factors of MACEs were analyzed to evaluate the predictive efficacy of CONUT score for MACEs. Results: The 2-year incidence rate of MACEs in 90 AMI patients was 35.56%; compared with the non-MACEs group, the MACEs group had higher age, diabetes, serum creatinine, C-reactive protein (CRP), procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), Killip grades III to IV, and CONUT score. Albumin, blood calcium, and left ventricular ejection fraction (LVEF) were lower (P<0.05); CONUT score was positively correlated with the occurrence of MACEs (P<0.05); high CONUT score was an independent risk factor for MACEs (P<0.05); in the prediction of MACEs, the sensitivity of CONUT score was 93.75 %, the specificity was 93.10 %, and the area under the curve ( AUC ) was 0.854. Conclusion: CONUT score is closely related to the long-term prognosis of AMI patients. The more severe the malnutrition, the higher the risk of MACEs.

       目的   探讨医院药房外包代煎代送服务的质量管理。方法   成立中药代煎质量控制管理小组，研究给出完善质量控制体系的策略，涉及建立标准化操作流程、加强人员培训、优化信息化管理系统以及健全监督评估机制。结果   通过对中药库房的采购、入库验收、在库管理、调剂环节的审方、调剂、煎药质量管理以及物流、发药人员全流程管理，提高了患者的满意度，更多的患者选择了中药代煎服务。结论   实施有效的质量控制措施可提高代煎代送服务的质量，为医院药房提升服务质量给予理论依据与实践指导。

       Objective  To explore quality management of outsourced decoction preparation and delivery services in hospital pharmacies．Methods  A quality control management team for traditional Chinese medicine（TCM）decoction preparation was established to develop strategies for improving the quality control system．These strategies involved establishing standardized operating procedures，strengthening personnel training，optimizing the information management system，and improving the supervision and evaluation mechanism．Results  Through comprehensive process management，covering procurement，warehouse acceptance，inventory management，prescription review in the dispensing stage，dispensing itself，quality control of decoction preparation，logistics，and management of dispensing personnel，patient satisfaction was enhanced，leading more patients to opt for the TCM decoction service．Conclusions  Implementing effective quality control measures can improve the quality of decoction preparation and delivery services，providing a theoretical basis and practical guidance for hospital pharmacies to enhance their service quality．

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．

传统的结肠镜检查质量评估方式具有主观性强、费时费力等缺点。近年来,人工智能（AI）技术在结肠镜检查质量控制方面展现出客观性、即时性、全面性等优势,具有广阔的应用前景。文章全面探讨了AI在结肠镜检查质量控制中的多个应用场景,包括评估肠道准备质量、记录退镜时间、息肉识别和分类、预测早期结直肠癌浸润深度等方面,并通过具体的研究案例和数据分析了AI技术的有效性和优势。AI技术有望在提升结肠镜检查质量、促进结直肠癌的早诊早治方面发挥更加重要的作用,但面对技术、伦理及法规等多方面的挑战,未来需要持续努力,不断优化算法,加强跨学科合作,推动AI技术在医疗领域的健康、快速发展。

Traditional colonoscopy quality assessment methods have strong subjectivity and are time-consuming．In recent years,artificial intelligence technology has shown objectivity,timeliness,and comprehensiveness in colonoscopy quality control,with broad application prospects．This article comprehensively explores multiple application scenarios of AI in colonoscopy quality control,encompassing assessments of bowel preparation quality,recording of withdrawal times,polyp identification and classification,and prediction of early colorectal cancer invasion depth．Through specific research cases and data analysis,the effectiveness and advantages of AI technology are elucidated．AI technology is expected to play an increasingly significant role in enhancing the quality of colonoscopy and promoting early diagnosis and treatment of colorectal cancer．However,facing challenges from technology,ethics,regulations,and other aspects,continued efforts are needed in the future to continuously optimize algorithms,strengthen interdisciplinary collaboration,and promote the healthy and rapid development of AI technology in the medical field．

目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组（n=49）与对照组（n=49）。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮（NO）、内皮素（ET）、血管紧张素Ⅱ（AngⅡ）相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%（χ²=4.356,P=0.037）;治疗后两组AngⅡ、ET水平均降低,且观察组[（13.62±2.24）ng/mL、（68.62±6.66）ng/L]低于对照组[（16.25±4.32）ng/mL、（74.26±9.35）ng/L],对比差异有统计学意义（t₁=3.783,t₂=3.439,P<0.001）;NO水平升高,观察组[（54.26±3.42）μmol/L]高于对照组[（50.51±2.37）μmol/L],对比差异有统计学意义（t=6.309,P<0.001）;治疗后两组血肌酐（Scr）、尿素氮（BUN）、胱抑素C（CysC）水平均降低,且观察组[（404.36±92.12）μmoI/ L、（13.34±4.31）mmol / L、（2.19±0.24）mg / L]低于对照组[（443.49±80.19）μmoI / L、（15.07±4.23）mmol / L、（2.87±0.38）mg / L],对比有统计学意义（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001）;两组不良反应发生率对比差异无统计学意义（10.20% vs 8.16%,P>0.05）。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。

Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment．Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023．Random number table method was used as the grouping method,and they were divided into an observation group（n=49）and a control group（n=49）．The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally．The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared．Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group（χ²=4.356,P=0.037）．Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[（13.62±2.24）ng/mL,（68.62±6.66）ng/L] was lower than the control group[（16.25±4.32）ng/mL,（74.26±9.35）ng/L],the difference was statistically significant（t₁=3.783,t₂=3.439,P<0.001）．Elevated NO levels in the observation group[（54.26±3.42）μmol/L] was higher than the control group[（50.51±2.37）μmol/L],the difference was statistically significant（t=6.309,P<0.001）．Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[（404.36±92.12）μmoI/L,（13.34±4.31）mmol/L,（2.19±0.24）mg/L] were lower than the control group[（443.49±80.19）μmoI/L,（15.07±4.23）mmol/L,（2.87±0.38）mg/L],the differences were statistically significant（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001;P<0.05）．There was no difference in the incidence of adverse effects between the two groups（10.20% vs 8.16%,P>0.05）．Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety．

目的 探讨医院消毒供应中心清洗全程质量控制用于院内感染风险预防价值。方法 选取2019年1月—2021年6月期间医院消毒供应中心待清洗消毒的1 000件手术器械（观察组）,采用全程质量控制;另选取1 000件手术器械（对照组）,常规流程清洗;比较2组患者器械清洗质量,统计清洗后因术中器械的院内感染率。结果 观察组清洗消毒后器械血渍、污垢、锈斑总发生率0.20%,低于对照组的1.50%,器械清洗、消毒、灭菌合格率高于对照组（P<0.05）。观察组器械操作流程与标准、科室管理、安全管理、综合质量管理高于对照组,院内感染率0.10%低于对照组的1.00%,医护人员满意度95.00%高于对照组的75.00%（P<0.05）。结论 医院消毒供应中心清洗质量控制,可增加手术器械清洗质量,减少院内感染的发生。

Objective To explore the value of whole process cleaning quality control in hospital disinfection supply center for risk prevention of hospital infection．Methods From January 2019 to June 2021,1000 surgical instruments to be cleaned and disinfected in the hospital disinfection supply center（observation group）were selected,and the whole process quality control was applied;another 1000 surgical instruments（control group）were selected for routine cleaning．The quality of instrument cleaning in the two groups was compared,and the hospital infection rate after the application of cleaned instrument was calculated．Results After cleaning and disinfecting instruments,the total incidence of blood stains,dirt and rust was 0.20% in the observation group,lower than that in the control group,which was 1.50%,and the qualified rate of instrument cleaning,disinfecting and sterilizing was higher than that in the control group（P<0.05）．The equipment operation procedures and standards,department management,safety management,and comprehensive quality management of the observation group were higher than those of the control group,the hospital infection rate was 0.10%,lower than that of the control group（1.00%）,and the satisfaction rate of medical staff was 95.00% in the observation group,higher than that of the control group（75.00%,P<0.05）．Conclusions The cleaning quality control of hospital disinfection supply center can improve the cleaning quality of surgical instruments and reduce the occurrence of hospital infection.

目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况（CONUT）评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组（P=0.005 3）,且2组性别构成存在差异,男性患者多于女性（P=0.037 0）。CONUT评分>2.5组患者的肿瘤直径较大（P=0.039 4）。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组（P=0.008 3）。单因素Logistic回归分析,年龄（OR=1.127;95%CI：1.028~1.236;P=0.011）、CONUT评分（OR=0.339;95%CI：0.151~0.764;P=0.009）是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄（OR=1.115;95%CI：1.008~1.233;P=0.035）、CONUT评分（OR=0.414;95%CI：0.175~0.982;P=0.045）是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。

Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer．Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed．Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status（CONUT）score was calculated．The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated．Results A total of 223 patients were included in this study．The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter．The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5（P=0.005 3）．Moreover,there was significant difference between the sex ratio of the two groups,with male more than female（P=0.037 0）．The tumor diameter was significantly larger in the group with CONUT score > 2.5（P=0.039 4）．In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5（P=0.008 3）．Univariate logistic regression analysis showed that age（OR=1.127;95% CI：1.028-1.236;P=0.011）and CONUT score（OR=0.339;95% CI：0.151-0.764;P=0.009）were the risk factors for short-term complications．Multivariate logistic regression analysis showed that age（OR=1.115;95% CI：1.008-1.233;P=0.035）and CONUT score（OR=0.414;95% CI：0.175-0.982;P=0.045）were the risk factors for short-term complications．Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications．

目的 探讨全程健康管理对糖尿病患者的血糖控制应用效果分析。方法 选择在我院门诊接受治疗的200例糖尿病患者作为研究对象,采用随机数表法分为对照组和观察组,各100例。对照组采用常规健康教育对患者进行健康指导,观察组在对照组基础上对患者行全程健康管理干预,建立糖尿病健康教育小组,对患者进行个体化的健康指导。比较2组患者干预后心理评估及空腹血糖、餐后2 h血糖的变化情况。结果 观察组患者予全程健康教育指导后,GAD-7焦虑量表及PHQ-9抑郁量表测试结果、空腹血糖及餐后2 h血糖控制效果优于对照组（P<0.05）。结论 行全程健康管理干预可有效改善糖尿病患者焦虑抑郁情绪,有效改善空腹血糖、餐后2 h血糖,增强患者自我保健意识。

Objective To explore the effect of whole process health management on blood glucose control in patients with diabetes．Methods A total of 200 patients with diabetes who were treated in the outpatient department of our hospital were studied and divided into control group and observation group,with 100 cases respectively．The patients in control group were given routine health guidance．The patients in observation group underwent whole-process health management intervention on the basis of control group,the diabetes health education group was established and individualized health coaching was given．Psychological assessment and fasting blood glucose and 2-hour postprandial blood glucose changes in the 2 groups of patients after the intervention were compared．Results After receiving whole course health education and guidance,the score GAD-7 anxity scale,PHQ-9 depression scale,pre-prandial blood glucose and 2 h postprandial blood glucose in observation group were better than those of control group（P<0.05）．Conclusions The whole process of health management intervention can improve anxiety and depression of diabetes patients,lower blood glucose levels before meals and 2 h after meals,enhance patients’ self-awareness．