目的 对川南地区重症专科联盟认知与需求进行调查，为该地区重症专科联盟建设提供参考。方法 采用分层随机抽样，在川南地区（乐山、宜宾、泸州、自贡）31个区县的二级医院内随机抽取213名医务人员作为调查对象。采用自制问卷收集调查对象基本情况，并评估其对重症医学专科联盟概念的认知情况，通过开放式问卷收集调查对象对重症医学专科联盟的需求。根据认知评估结果将研究对象分为了解充分组与了解不充分组，比较两组基本情况，并用多因素Logisitic回归筛选出独立性影响因素。结果 在纳入的213名医护人员中有68名（31.92%）对重症专科联盟了解不充分，单因素分析显示：两组在性别、年龄、工作岗位、职务及职称差异均具有统计学意义（P＜0.05）。多因素Logistic回归分析显示：性别、学历为本科 、学历为博/硕士研究生、工作岗位、职务为中层干部、院领导职务及职称为川南地区重症专科联盟认知的独立性影响因素（P＜0.05）。川南地区重症专科联盟需求排名前9位依次：派出专家技术指导、派出管理干部开展业务管理、接收联盟单位人员培训、协助开展新技术、为联盟单位成员开展培训与讲座、业务资源共享、接收联盟单位转诊、开展远程医疗、科研项目申报指导。结论 川南地区重症专科联盟认知情况主要与性别、学历、工作岗位、职务、职称及基层对于专家技术指导、管理干部业务指导及技能培训的需求较大。

      Objective To investigate the awareness and demand for the Critical Care Specialty Alliance in Southern Sichuan，providing a reference for the development of the alliance in this region．Methods Using stratified random sampling，213 medical staff were randomly selected from secondary hospitals in 31 districts/counties of the Southern Sichuan region（Leshan，Yibin，Luzhou，Zigong）as survey subjects．A self-designed questionnaire was used to collect basic information from the respondents，assess their understanding of the concept of the Critical Care Specialty Alliance，and gather their demands for the alliance through open-ended questions．Based on the assessment results，respondents were divided into a well-informed group and a poorly informed group．The basic characteristics of the two groups were compared，and multivariate logistic regression was used to identify independent influencing factors．Results Among the 213 medical staff included in the study，68（31.92%）had insufficient understanding of the Critical Care Specialty Alliance．Univariate analysis revealed statistically significant differences（P＜0.05）in gender，age，job position，administrative role，and professional title between the group with sufficient understanding and the group with insufficient understanding．Multivariate Logistic regression analysis showed that gender，undergraduate education，master’s/doctoral education，job position，middle management role，hospital leadership role，and professional title were independent influencing factors for the awareness of the Critical Care Specialty Alliance in the Southern Sichuan region（P＜0.05）．The top nine demands for the alliance in Southern Sichuan were dispatching experts for technical guidance，sending management cadres for operational management，providing training for personnel from alliance units，assisting in the development of new technologies，organizing training and lectures for alliance unit members，sharing business resources，accepting referrals from alliance units，implementing telemedicine，and providing guidance on research project applications．Conclusions Awareness of the Critical Care Specialty Alliance in Southern Sichuan is primarily associated with gender，educational background，job position，and professional title．There is significant demand at the primary level for expert technical guidance，operational management guidance from cadres，and skills training．

目的 探讨头位分娩评分法在孕妇分娩过程中的应用价值。方法 选取2020年1月—2022年12月于郑州市妇幼保健院进行建档住院的4 000例待产分娩孕妇作为研究对象,所有孕妇在宫口已开时都给予头位分娩评分,观察与记录所有孕妇的分娩方式与头位分娩评分法状况,记录新生儿出生1 min与出生5 min的Apgar评分,记录所有孕妇的产后并发症发生情况。结果 在4 000例孕妇中,Apgar评分≤8分者156例、9~10分者894例、≥11分者2 950例。不同头位分娩评分法孕妇的年龄、孕周、孕次、产次对比差异无统计学意义（P>0.05）。≤8分者的剖宫产率为100.0%,9~10分者、≥11分者分别为35.3%、5.7%,对比差异有统计学意义（P<0.05）。≤8分者、9~10分者、≥11分者的新生儿出生1 min与出生5 min的Apgar评分对比差异无统计学意义（P>0.05）。≤8分者、9~10分者、≥11分者的产后发热、产后出血、产后血肿、产后尿潴留等并发症发生率为分别为13.5%、2.0%、0.2%,对比差异有统计学意义（P<0.05）。结论 头位分娩评分法在产科中处理头位分娩时具有指导价值,值得推广应用。

Objective To explore and analyze the application values of the head position delivery scoring method in the delivery process of 4 000 pregnant women．Methods Selected 4 000 cases of pregnant women as the study object,all pregnant women gave head delivery score,observed and recorded the delivery mode and head delivery scoring method,recorded the Apgar score of 1 min and 5 min,and recorded the occurrence of postpartum complications of all pregnant women．Results Among the 4 000 pregnant women,156 scored ≤8,894 scored 9-10,and 2 950 scored ≥11．There was no significant difference in the age,gestational age,pregnancy time and delivery status of pregnant women in different head delivery scoring methods（P>0.05）．The cesarean section of patients with ≤8 score was 100.0%,those with 9-10 score and those with ≥11 score were 35.3% and 5.7%,respectively,and there were significant differences（P<0.05）．There was no significant difference in Apgar score between newborns with ≤8 scores,9-10 scores and ≥11 scores at 1 min and 5 min after birth（P>0.05）．The incidence rates of puerperal fever,postpartum hemorrhage,postpartum hematoma and postpartum urinary retention were 13.5%,2.0% and 0.2% in patients with ≤8 score,9~10 score and ≥11 score,respectively,and there were significant differences（P<0.05）．Conclusions The head delivery scoring method has guiding value in handling head delivery in obstetrics and is worth promoting and applying．

目的 分析广州北部区域某胸痛中心不同性别的急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗的结果。方法 纳入广州市花都区人民医院2016年12月—2020年1月期间接受直接经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者。按照不同的性别,评估患者的危险因素、治疗时限性和主要心血管不良事件情况。结果 入选389名患者,73名(18.8%)为女性。和男性患者对比,女性患者年龄更大(69.3±10.8岁vs 55.8±13.1 岁,P＜0.05),具有更高比例的2型糖尿病(26.0% vs 17.7%,P＜0.05)、高血压病(58.9.0% vs 43.0%,P＜0.05)病史。女性患者的症状-首次医疗接触时间和总缺血时间均长于男性患者(分别为229.2 min vs 174.5 min,P＜0.05;424.9 min vs 317.4 min,P＜0.05),PCI术中出现慢血流/无复流的比例更高(26.0% vs 16.5%,P＜0.05)。女性患者主要住院心血管事件风险更高(11.0% vs 4.4%, P＜0.05),其中院内死亡率(4.1% vs 1.6%, P＜0.05)。女性患者在院期间发生心衰及心源性休克的比例更高(分别为34.2% vs 21.2%,P＜0.05; 30.1% vs 18.7%,P＜0.05)。结论 在行急诊介入治疗的急性ST段抬高型心肌梗死患者中,女性患者预后差于男性,具有更高的心血管事件风险,死亡率更高。

Objective We investigated sex-based outcomes after primary percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) in a chest pain center of northern Guangzhou. Methods From December 2016 to January 2020, consecutive STEMI patients who underwent PPCI in Guangzhou Huadu District People's Hospital were recruited. Risk factors, time variables, and major cardiovascular adverse events (MACE) were assessed according to gender. Results A total of 389 patients were enrolled,with 73(18.8%)women. Compared to men, women patients presented higher risk profiles with old age(69.3±10.8 years vs 55.8±13.1 years,P＜0.05),diabetes (26.0% vs 17.7%,P＜0.05), hypertension (58.9.0% vs 43.0%,P＜0.05).Women had longer symptom onset to first medical contact time and total ischemic time than men had(229.2min vs 174.5min,P＜0.05;424.9min vs 317.4min,P＜0.05).During PCI procedure,women presented higher ratio of slow flow/no reflow(26.0% vs 16.5%,P＜0.05).Women had increased major adverse events(11.0% vs 4.4%, P＜0.05), and higher in-hospital mortality(4.1% vs 1.6%, P＜0.05).Women presented more heart failure incidence (34.2% vs 21.2%,P＜0.05),and cardiac shock incidence(30.1% vs 18.7%,P＜0.05). Conclusion Women with acute STEMI who underwent PPCI had worse outcomes compared to men.They had higher MACE and in-hospital mortality.