摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练（ACBT）在非小细胞肺癌（NSCLC）化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者，采用随机数字表法将所有研究对象分为联合组和常规组，每组49例。常规组给予常规干预，联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后，两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组（P<0.05）；联合组FVC、FEV1、MVV及6MWT均显著高于常规组（P＜0.05）；干预前两组6MWT组间对比差异无统计学意义（P>0.05），干预4周、6周、8周、12周后，两组6MWT均较干预前增加，且联合组远于常规组（P<0.05）；干预12周后，两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升，且联合组高于常规组（P<0.05）。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能，提高生活质量和运动耐力。

Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.

摘要：目的：探讨早期床上抗阻训练联合情绪释放技术应用于肝癌介入术后患者效果。 方法：选取中国医学科学院肿瘤医院96例肝癌介入治疗患者，于2024年3月-2025年4月间收治，随机分为两组。两组患者均给予常规肝癌介入术后管理，对照组给予早期床上抗阻训练，观察组在此基础上联合使用情绪释放技术，两组患者均连续干预2周。比较两组术后康复指标[术后首次排便时间、术后肠鸣音恢复时间、术后住院时长、术后首次排气时间]，干预前后应激指标[皮质醇(Cor )、促肾上腺皮质激素(ACTH)、醛固酮（ALD）]、情绪指标[疾病进展恐惧量表（FoP-Q-SF）、心理痛苦温度计（DT）、正负性情绪状态量表（PANAS）]及生活质量[肝癌患者生命质量测定量表（QOL-LC）]。 结果：干预前两组各指标相比无差别（P>0.05）。与对照组相比，观察组干预后Cor、ACTH、ALD、FoP-Q-SF、DT、PANAS消极情绪部分水平较低，PANAS积极情绪部分、QOL-LC各项评分水平较高（P<0.05）。两组中，观察组首次排气排便时间、肠鸣音恢复时间较早，术后住院时长较短（P<0.05）。 结论：早期床上抗阻训练联合情绪释放技术应用于肝癌介入术术后患者效果良好，可促进患者术后胃肠道功能恢复，减轻机体应激反应，缓解患者疾病恐惧及负性情绪，提升患者生活质量。

摘要：目的：探讨早期床上抗阻训练联合情绪释放技术应用于肝癌介入术后患者效果。 方法：选取中国医学科学院肿瘤医院96例肝癌介入治疗患者，于2024年3月-2025年4月间收治，随机分为两组。两组患者均给予常规肝癌介入术后管理，对照组给予早期床上抗阻训练，观察组在此基础上联合使用情绪释放技术，两组患者均连续干预2周。比较两组术后康复指标[术后首次排便时间、术后肠鸣音恢复时间、术后住院时长、术后首次排气时间]，干预前后应激指标[皮质醇(Cor )、促肾上腺皮质激素(ACTH)、醛固酮（ALD）]、情绪指标[疾病进展恐惧量表（FoP-Q-SF）、心理痛苦温度计（DT）、正负性情绪状态量表（PANAS）]及生活质量[肝癌患者生命质量测定量表（QOL-LC）]。 结果：干预前两组各指标相比无差别（P>0.05）。与对照组相比，观察组干预后Cor、ACTH、ALD、FoP-Q-SF、DT、PANAS消极情绪部分水平较低，PANAS积极情绪部分、QOL-LC各项评分水平较高（P<0.05）。两组中，观察组首次排气排便时间、肠鸣音恢复时间较早，术后住院时长较短（P<0.05）。 结论：早期床上抗阻训练联合情绪释放技术应用于肝癌介入术术后患者效果良好，可促进患者术后胃肠道功能恢复，减轻机体应激反应，缓解患者疾病恐惧及负性情绪，提升患者生活质量。

目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病（CSR）患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者（154例）为研究对象进行回顾性分析，根据干预方案分为参照组（77例，采取颈椎功能康复训练）、研究组（77例，采取子午流注穴位按摩联合颈椎功能康复训练）。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分（VAS）与颈椎功能障碍指数量表评分（NDI）、颈椎功能活动度、血液流变学指标［血浆黏度（PV）、全血低切黏度（LSWBV）、纤维蛋白原（FIB）、全血高切黏度（HSWBV）］。结果 与参照组总有效率（83.12%）相比，研究组（96.10%）明显升高（P＜0.05）；研究组干预后各中医证候积分均较参照组低（P＜0.05）；干预后，研究组VAS、NDI评分均低于参照组（P＜0.05）；研究组干预后颈椎活动度高于参照组（P＜0.05）；干预后，研究组LSWBV、PV、FIB、HSWBV水平均较参照组低（P＜0.05）；研究组干预后3个月复发率为2.72%（2/74），低于参照组的14.06%（9/64）（χ2=4.588，P＜0.05）。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果，改善临床症状、颈椎功能、颈椎活动度，调节血液流变学，降低颈椎疼痛程度、复发率。

Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病（CSR）患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者（154例）为研究对象进行回顾性分析，根据干预方案分为参照组（77例，采取颈椎功能康复训练）、研究组（77例，采取子午流注穴位按摩联合颈椎功能康复训练）。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分（VAS）与颈椎功能障碍指数量表评分（NDI）、颈椎功能活动度、血液流变学指标［血浆黏度（PV）、全血低切黏度（LSWBV）、纤维蛋白原（FIB）、全血高切黏度（HSWBV）］。结果 与参照组总有效率（83.12%）相比，研究组（96.10%）明显升高（P＜0.05）；研究组干预后各中医证候积分均较参照组低（P＜0.05）；干预后，研究组VAS、NDI评分均低于参照组（P＜0.05）；研究组干预后颈椎活动度高于参照组（P＜0.05）；干预后，研究组LSWBV、PV、FIB、HSWBV水平均较参照组低（P＜0.05）；研究组干预后3个月复发率为2.72%（2/74），低于参照组的14.06%（9/64）（χ2=4.588，P＜0.05）。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果，改善临床症状、颈椎功能、颈椎活动度，调节血液流变学，降低颈椎疼痛程度、复发率。

Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。

Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice．Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study．This led to the integration of a preliminary evaluation framework．Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project．Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals．This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023．Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application．Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%．Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process．Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors．This system holds considerable potential for widespread clinical adoption and application．

目的 分析谷草转氨酶（AST）、胆碱酯酶（CHE）、糖类抗原125（CA125）以及甲胎蛋白（AFP）对肝硬化患者的诊断效能。方法 选择70例肝硬化患者为观察组研究对象,另取70例同期健康体检者为对照组。两组研究对象均接受生化检验、肿瘤标志物检验。对比两组研究对象的AST、CHE、CA125、AFP检测结果,分析上述指标对肝硬化患者的诊断效能。结果 观察组肝硬化患者的CHE低于对照组,AST、CA125与AFP高于对照组（P<0.05）;AST与CHE在肝硬化诊断中具有良好的灵敏度、特异度;CA125联合AFP的灵敏度、特异度、符合率均高于CA125或AFP单独检验（P<0.05）。结论 AST、CHE、CA125、AFP在肝硬化患者临床诊断中具有良好的应用表现,是反映患者肝硬化病情进展的重要参考指标。

Objective To analyze the diagnostic efficacy of aspartate aminotransferase（AST）,cholinesterase（CHE）,carbohydrate antigen 125（CA125）,and alpha fetoprotein（AFP）in patients with liver cirrhosis．Methods A total of 70 patients with liver cirrhosis were included in the observation group as the study subjects,and 70 healthy individuals who underwent physical examinations during the same period were selected as the control group．Both groups of research subjects underwent biochemical testing and tumor marker testing．The AST,CHE,CA125,and AFP detection results of two groups of research subjects were compared,and the diagnostic effect of the above indicators on patients with liver cirrhosis were analyzed．Results The CHE test results of patients with liver cirrhosis in the observation group were significantly lower than those of healthy individuals undergoing physical examination,and the AST,CA125,and AFP test results were higher（P<0.05）．AST and CHE had good sensitivity and specificity in the diagnosis of liver cirrhosis．The sensitivity,specificity and coincidence rate of CA125 combined with AFP were higher than those of CA125 or AFP alone．Conclusions AST,CHE,CA125,and AFP have good clinical application performance in the diagnosis of liver cirrhosis patients,and are important reference indicators reflecting the progression of liver cirrhosis in patients．

目的 分析恩格列净对2型心肾综合征（CRS）患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组（44例,给予常规治疗）、实验组（44例,在常规治疗的同时加用恩格列净）,通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组（均P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。

Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome（CRS）．Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group（44 cases,receiving conventional treatment）and experimental group（44 cases,receiving conventional treatment combined with englaglitzin）by computer program．The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions．Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group．The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment（P<0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion．

目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者（均行无痛胃肠镜检查）为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义（t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05）;重复测量方差分析结果显示,分组因素间收缩压（SBP）（F=30.019,P<0.001）、心率（HR）（F=282.057,P<0.001）、SpO₂（F=64.518,P<0.001）、;时间因素SBP（F=21.780,P<0.001）、HR（F=345.118,P<0.001）、SpO₂（F=41.762,P<0.001）;分组与时间交互时间因素SBP（F=12.941,P<0.001）、HR（F=193.295,P<0.001）、SpO₂（F=13.546,P<0.001）,差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO₂、较B组低。;A组患者围术期不良反应发生率（20.00%）低于B组患者（56.67%）（χ²=25.593,P<0.001）。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。

Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients（all underwent painless gastroscopy）admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects．They were randomly divided into groups using a random number table method．Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol．Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups．There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients（t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05）．The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP（F=30.019,P<0.001）,HR（F=282.057,P<0.001）,SpO₂（F=64.518,P<0.001）,time factors SBP（F=21.780,P<0.001）,HR（F=345．118,P<0.001）,SpO₂（F=41.762,P<0.001）,and interaction factors SBP（F=12.941,P<0.001）,HR（F=193.295,P<0.001）,and SpO₂（F=13.546,P<0.001）．The line chart visually shows that the SBP,HR,SpO₂ of Group A patients were lower than those of Group B．The incidence of perioperative adverse reactions in Group A patients（20.00%）was lower than that in Group B patients（56.67%）（χ²=25.593,P<0.001）. Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions．

目的 探讨不同分期的子宫内膜异位症（EMs）患者行体外受精-胚胎移植（IVF-ET）助孕结局与成本效果分析。方法 回顾性分析2016年1月—2022年1月Ⅰ~Ⅱ期、Ⅲ~Ⅳ期EMs患者应用卵泡期长方案及同期因“输卵管因素”患者采用黄体期长方案行IVF-ET的助孕结局以及成本费用。结果 EMs各组的启动日LH、E₂以及hCG日E₂水平低于对照组（P<0.05）,Ⅲ~Ⅳ期EMs组的可利用胚胎数、着床率、临床妊娠率、活产率明显低于对照组及Ⅰ~Ⅱ期EMs组（P<0.05）,其流产率偏高,但组间比较差异无统计学差异（P>0.05）。各组间的Gn剂量、Gn天数、hCG日的LH水平、hCG日≥14 mm卵泡数、hCG日子宫内膜厚度、获卵数、受精率、卵裂率比较差异无统计学意义（P>0.05）。成本效果分析提示：各组平均周期总成本无明显差异,Ⅰ~Ⅱ期EMs组患者患者获得一例妊娠所花费的成本与对照组相当,而Ⅲ~Ⅳ期EMs组患者获得一例妊娠所花费的成本最高。结论 对于不同分期的EMs,Ⅰ~Ⅱ期患者应用卵泡期长方案的患者可获得良好的妊娠结局,其妊娠率及成本与传统方案相当,而Ⅲ-Ⅳ期的患者妊娠率偏低,获得妊娠的成本更高,可能与该疾病严重程度及方案选择有关。

Objective To analyze the outcome and cost-effectiveness of invitrofertilization-embryotransfer（IVF-ET）assisted pregnancy in endometriosis（EMs）patients with different stages．Methods The outcomes and costs of patients with stageⅠ-Ⅱ and Ⅲ-Ⅳ EMs treated with follicular phase long protocol and patients treated with luteal phase long protocol due to“tubal factors” during the same time from January 2016 to January 2022 were retrospectively analyzed．Results The levels of LH,E2 on initiation day and the levels of E2 on hCG day in EMs groups were lower than those in control group（P<0.05）,the number of available embryos,implantation rate,clinical pregnancy rate and live birth rate in stage Ⅲ-Ⅳ EMs group were significantly lower than those in control group and stageⅠ-Ⅱ EMs group（P<0.05）,and the abortion rate was higher．But there was no significant difference between groups（P>0.05）．There were no significant differences in the dosage of Gn,duration of Gn,the levels of LH on hCG day,the number of follicles with diamete≥14 mm on hCG day,endometrial thickness on hCG day,number of oocytes retrieved,fertilization rate and cleavage rate among the three groups（P>0.05）．Conclusions For different stages of endometriosis,patients in stageⅠ-Ⅱ who apply the follicular phase long protocol can achieve good pregnancy outcomes,and their pregnancy rate and cost are comparable to the traditional regimen,while patients in stage Ⅲ-Ⅳ have a low pregnancy rate,and the cost of pregnancy is higher,which should be related to the severity of the disease and the choice of regimen.