目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

目的 观察地西他滨与小剂量CAG方案治疗白血病的短期疗效。方法 选取66例AML患者进行前瞻性研究,按随机数表法分为观察组与对照组,各33例。观察组采取地西他滨与小剂量CAG方案进行治疗,对照组采取标准CAG方案,两组接受相同的支持治疗,均治疗1个疗程。比较两组化疗结束后4周的完全缓解率(CRR)、总缓解率(ORR)、红细胞输注量、血小板输注量、抗生素应用情况、不良反应发生率。结果 观察组CRR与CRR分别为69.70%与81.82%,高于对照组39.40%与57.58%（P<0.05）。两组红细胞输注量、血小板输注量、抗生素应用次数的差异均无统计学意义（P>0.05）。两者均未见肾功能损伤与治疗相关死亡患者。两组肝功能异常与恶心呕吐总发生率的差异及血小板减少与粒细胞缺乏的严重程度均无统计学意义（P>0.05）。结论 地西他滨联合小剂量CAG方案治疗白血病可提高疗效,且不增加不良反应,是治疗AML的有效方案之一。

目的 探讨阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响。方法 选取社区门诊2014年4月—2016年4月收治的100例行静脉输液治疗的患儿作为研究对象,采取随机数字表法将其分成两组,每组50例。观察组患儿给予阳性强化法干预,对照组给予常规护理干预,对比两组患儿穿刺疼痛相关指标、穿刺效果、患儿静脉输液依从性及患儿家长的满意度。结果 观察组患儿疼痛面容持续时间明显短于对照组,穿刺后心率明显慢于对照组,啼哭时间>30s的患儿占比明显低于对照组(P<0.01)。观察组一次穿刺成功率、穿刺耗时>5min占比分别为94.00%、24.00%,对照组分别为74.00%、62.00%,观察组一次穿刺成功率明显高于对照组,穿刺耗时>5min占比明显低于对照组(P<0.01)。观察组患儿静脉输液依从率为90.00%,与对照组的66.00%对比有明显上升(P<0.01)。观察组患儿家长满意度为96.00%,与对照组的80.00%对比有明显上升(P<0.05)。结论 对社区门诊静脉输液患儿实施阳性强化法干预可有效减轻穿刺疼痛,提高患儿的输液依从性,患儿家长满意度高。

Objective To explore positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion. Methods Select 100 cases of children who receive intravenous infusion in community outpatients from April 2014 to April 2016 as research objectives and divide them into two groups randomly with each group of 50 cases. Provide positive reinforcement to observation group while provide routine nursing to control group. Compare two groups' puncture pain relevant indicator, puncture effect, children's intravenous infusion compliance and parents' satisfaction. Results Children in observation had less duration of pain face expression, lower heart rate after puncture and less children crying >30s than those in control group (P<0.01). Observation group's first puncture success rate, puncture time duration >5mins rate were 94.00% and 24.00% respectively while control group's data were 74.00% and 62.00%. Observation group's first success rate was significant higher than that of control group. Observation group's puncture time duration >5mins rate was significant lower than that of control group (P<0.01). Children's intravenous infusion compliance rate in observation group was 90.00% which was significant higher than control group's 66.00% (P<0.01). Parents satisfaction rate in observation groups was 96.00% which was significant higher than control group's 80.00% (P<0.05). Conclusion Implementing positive reinforcement on children in community outpatient may help to relieve puncture pain, improve children's compliance to intravenous infusion and increase parents' satisfaction.