目的 探讨桑白皮汤加减辅助常规西药治疗痰热郁肺型保留比率的肺功能减损（PRISm）患者的治疗效果，并分析其对中医证候积分、肺功能、气道阻力、免疫功能的影响。方法 选取2024年6月～2025年6月于本院诊治的88例PRISm患者为研究对象，按照随机数字表法将其分为对照组（常规西药治疗）、研究组（桑白皮汤加减联合常规西药治疗），各44例。比较两组临床疗效、不良反应及治疗前后中医证候积分、慢阻肺评估测试（CAT）量表、改良版英国医学研究委员会呼吸困难问卷（mMRC）、吸入支气管扩张剂后检测肺功能、肺弥散功能[一氧化碳弥散量占预计值百分比（DLCO%pred）、残气量/肺总量（RV/TLC）]、气道阻力[抗阻指数（R5-20）、共振频率（Fres）、呼吸总阻抗（Zrs）]、炎症指标[白细胞介素-6（IL-6）、可溶性细胞间黏附分子-1（sICAM-1）、单核细胞趋化蛋白-1（MCP-1）、嗜酸性粒细胞（EOS）、肿瘤坏死因子-α（TNF-α）]、气道重塑[基质金属蛋白酶-2（MMP-2）、缺氧诱导因子-1α（HIF-1α）、转化生长因子-β1（TGF-β1）、碱性成纤维细胞生长因子（bFGF）]、T淋巴细胞亚群水平。结果 研究组总有效率高于对照组（P＜0.05）；治疗后，与对照组比较，研究组中医证候积分、CAT评分、mMRC评分级RV/TLC降低，FEV1、FEV1/FVC、FEV1%pred、VC%pred、DLCO%pred升高（P＜0.05）；治疗后，与对照组比较，研究组R5-20、Fres、Zrs降低（P＜0.05）；治疗后，与对照组比较，研究组血清IL-6、sICAM-1、MCP-1、EOS、TNF-α及MMP-2、HIF-1α、TGF-β1、bFGF水平降低（P＜0.05）；治疗后，与对照组比较，研究组CD3+、CD4+、CD4+/CD8+水平升高（P＜0.05）；两组不良反应比较无明显差异（P＞0.05）。结论 桑白皮汤加减辅助常规西药治疗PRISm患者的疗效显著，可改善临床症状、肺功能，提高生活质量，降低气道阻力，并可减轻炎症反应，缓解气道重塑，增强机体免疫功能，且具有一定安全性。

目的 比较白内障超声乳化吸除术（Phaco）+房角分离术与Phaco+小梁切除术治疗急性原发性闭角型青光眼（APACG）合并白内障的临床价值。方法 回顾性分析2022年1月至2025年1月我院200例APACG合并白内障患者临床资料，根据手术方式分为小梁切除组（Phaco+小梁切除术）与房角分离组（Phaco+房角分离术），每组100例（200眼）。比较两组眼压、视力[最佳矫正视力（BCVA）]、中央前房深度、视盘血流密度[整体视盘血流密度（wiVD）、视盘内血流密度（diVD）]、生活质量[视功能相关生活质量量表-25（NEI-VFQ-25）]及并发症情况。结论 术后1周、1个月、3个月，房角分离组眼压低于小梁切除组，BCVA、中央前房深度大于小梁切除组，wiVD、diVD高于小梁切除组（P＜0.05）；术后1个月，房角分离组NEI-VFQ-25评分高于小梁切除组（P＜0.05），术后3月两组NEI-VFQ-25评分比较无显著差异（P＞0.05）；房角分离组并发症总发生率（6.50%）低于小梁切除组（13.00%）（P＜0.05）。结论 与Phaco+小梁切除术相比，Phaco+房角分离术治疗APACG合并白内障患者能有效控制眼压，增加前房深度，改善视盘血流循环，恢复患者视力，提高生活质量，减少并发症发生率。

Objective To compare the clinical efficacy of phacoemulsification (Phaco) combined with goniosynechialysis and phacoemulsification combined with trabeculectomy in the treatment of acute primary angle-closure glaucoma (APACG) complicated with cataract. Methods The clinical data of 200 patients with APACG complicated with cataract treated in our hospital from January 2022 to January 2025 were retrospectively analyzed. According to surgical procedures, the patients were divided into trabeculectomy group (Phaco combined with trabeculectomy) and goniosynechialysis group (Phaco combined with goniosynechialysis), with 100 patients (200 eyes) in each group. Intraocular pressure, visual acuity [best corrected visual acuity (BCVA)], central anterior chamber depth, optic disc vessel density [whole-image optic disc vessel density (wiVD), disc-inside vessel density (diVD)], quality of life [25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)] and complications were compared between the two groups. Results At 1 week, 1 month and 3 months after surgery, the goniosynechialysis group had lower intraocular pressure, better BCVA, deeper central anterior chamber depth, and higher wiVD and diVD than the trabeculectomy group (P<0.05). One month postoperatively, the NEI-VFQ-25 score of the goniosynechialysis group was significantly higher than that of the trabeculectomy group (P<0.05), while no significant difference was observed between the two groups at 3 months after surgery (P>0.05). The overall incidence of complications in the goniosynechialysis group was 6.50%, which was lower than 13.00% in the trabeculectomy group (P<0.05). Conclusion Compared with phacoemulsification combined with trabeculectomy, phacoemulsification combined with goniosynechialysis can effectively control intraocular pressure, increase anterior chamber depth, improve optic disc blood circulation, restore visual acuity, enhance quality of life and reduce the incidence of complications in patients with APACG complicated with cataract.

目的 探究复方玄驹胶囊与西地那非联合治疗对轻中度勃起功能障碍（ED）的临床疗效及安全性的影响。方法 前瞻性选取2023-04至2025-04我院98例轻中度ED患者，随机分为2组，各49例。对照组予以西地那非治疗，联合组在对照组基础上予以复方玄驹胶囊，治疗时间均为12周。比较2组临床疗效、治疗前与治疗12周后勃起功能指标[国际勃起功能评分表-5（IIEF-5评分）、勃起硬度量表（EHS评分）、勃起质量量表（QEQ评分）]、阴茎血流动力学[收缩期峰值流速（PSV）、舒张末期流速（EDV）、阻力指数（RI）]、血管内皮功能[一氧化氮（NO）、内皮素（ET）、血管内皮生长因子（VEGF）]及安全性。结果 与对照组相比，联合组有效率较高（P＜0.05）；治疗12周后，与对照组相比，联合组IIEF-5、EHS、QEQ评分较高（P＜0.05）；治疗12周后，与对照组相比，联合组PSV、RI较高，EDV较低（P＜0.05）；治疗12周后，与对照组相比，联合组NO、VEGF水平较高，ET水平较低（P＜0.05）；2组治疗期间不良反应无显著差异（P＞0.05）。结论 复方玄驹胶囊联合西地那非治疗能提高轻中度ED患者疗效，改善血管内皮功能与阴茎血流动力学，恢复勃起功能，且具有一定安全性。

       目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象，根据患者就诊顺序分配为两组。对照组35例，接受常规干预；观察组35例，其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果，以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%，高于对照组的68.57%，差异有统计学意义（P＜0.05）。治疗前，两组各项血脂水平、肝功能、慢性肝病问卷（CLDQ）评分比较，差异无统计学意义（P＞0.05）；治疗后，两组各项血脂水平优于治疗前，各项肝功能低于治疗前，CLDQ评分高于治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组的各项血脂水平优于对照组，各项肝功能低于对照组，CLDQ评分高于对照组，差异有统计学意义（P＜0.05）。结论   对非酒精性脂肪性肝病老年患者而言，中医“治未病”理念下体质辨识干预服务能够提高其治疗效果，调节血脂水平的异常，改善肝功能及生存质量，值得应用。

       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising．Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects．Patients were assigned to two groups，control group（35 cases）received  routine intervention，observation group（35 cases）received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally．The effect of intervention and the changes of blood lipid levels，liver function and quality of life before and after intervention were compared between the two groups．Results  The total effective rate of the observation group was 91.43%，higher than that of the control group（68.57%），the difference was statistically significant（P＜0.05）．Before treatment，there were no significant differences in blood lipid levels，liver function and CLDQ scores between the two groups（P＞0.05）．After treatment，the levels of blood lipids were better than those before treatment，liver function was lower than that before treatment，CLDQ score was higher than that before treatment，the difference was statistically significant（P＜0.05）．After treatment，the blood lipid levels of the observation group was better than that of the control group，the liver function was lower than that of the control group，and the CLDQ score was higher than that of the control group，with statistical significance（P＜0.05）．Conclusions  For elderly patients with nonalcoholic fatty liver disease，the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect，regulate the abnormal blood lipid levels，improve liver function and quality of life，which is worthy of application．

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 探讨影响宫腔修复的因素,为不全流产妇女选择期待治疗提供理论依据。方法 2021年1月—12月在香港大学深圳医院招募早孕药流不全的患者534例,记录其人口学特征以及从排胎到流产后3周到月经复潮后的相关情况,通过多因素Logistic回归分析影响不全流产者宫腔修复的因素。结果 534例药流不全患者中,月经复潮后宫腔残留240例,残留率为44.9%;多因素Logistic回归分析显示,BMI（OR=0.888,95%CI：0.808~0.975）、子宫位置（OR=1.836,95%CI：1.139~2.958）、人工流产次数（OR=2.258,95%CI：1.078~4.728）、阴道流血时长（OR=0.344,95%CI：0.141~0.837）、残留物最大径线（OR=1.061,95%CI：1.031~1.092）、残留物血流信号2级/3级（OR=3.636,95%CI：1.790~7.394;OR=4.001,95%CI：1.561~10.256）是宫腔残留的影响因素。结论 宫腔残留的高危因素有子宫后位、残留物最大径线、1次以上的人工流产、2级及以上的残留物血流信号,且血流信号等级影响最大。BMI和阴道流血时长>3周是宫腔残留的保护因素。

Objective To investigate the factors affecting uterine cavity repair and to provide a theoretical basis for the choice of expectant treatment for women with incomplete abortion．Methods From January to December 2021,534 patients with incomplete abortions were recruited at University of Hong Kong-Shenzhen Hospital,and their demographic characteristics and correlations from expulsion of the gestational sac to 3 weeks after medication abortion and after menstrual resumption were recorded,and the factors affecting uterine cavity repair in incomplete abortions were analyzed by multifactorial logistic regression．Results In 534 women,there were 240 cases of uterine cavity remnants after menstrual return,with a remnant rate of 44.9%;the results of multifactorial logistic regression analysis showed that BMI（OR=0.888,95% CI：0.808-0.975）,uterine position（OR=1.836,95% CI：1.139-2.958）,number of abortions（OR=2.258,95% CI：1.078-4.728）,length of vaginal bleeding（OR=0.344,95% CI：0.141-0.837）,maximum diameter of residuals（OR=1.061,95% CI：1.031-1.092）,and residual blood flow signal grade 2/3（OR=3.636,95% CI：1.790-7.394;OR=4.001,95%CI：1.561-10.256）were influential factors for uterine residuals．Conclusions High-risk factors for uterine residuals are posterior uterus,the maximum diameter of residuals,more than one abortion,grade 2 or higher residual blood flow signal,and the grade of blood flow signal had the greatest effect．BMI and duration of vaginal bleeding >3 weeks are protective factors for uterine residuals．

目的 调查与分析儿童结直肠息肉的临床特征及腹腔镜联合结肠镜下手术对其的治疗效果。方法 选择2019年2月—2021年10月在郑州大学附属儿童医院诊治的98例结直肠息肉患儿,记录患儿的临床特征,根据患儿的手术方法分为腹腔镜组（腹腔镜联合结肠镜下手术治疗,n=40）与结肠镜组（采用结肠镜手术治疗,n=58）,对比不同手术方法的治疗效果、并发症发生率、疼痛视觉模拟评分法（VAS）评分、息肉复发与再手术率。结果 98例患儿中,息肉部位为直肠44例、横直肠38例、其他16例;息肉最大直径（1.65±0.24）cm;息肉单发83例、多发15例。腹腔镜组的围手术期指标比结肠镜组改善（P<0.05）。腹腔镜组术后7 d的感染、出血、肠穿孔、肠梗阻等并发症发生率为5.00%,低于结肠镜组的17.24%（P<0.05）。腹腔镜组术后1个月的总有效率为97.50%,高于结肠镜组的82.76%（P<0.05）。腹腔镜组术后1、3、7 d的疼痛VAS评分低于结肠镜组（P<0.05）。所有患儿术后随访1年,联合的息肉复发率与再次手术率为5.00%、2.50%,均低于结肠镜组的18.97%、13.79%（P<0.05）。结论 儿童结直肠息肉主要位于直肠、横直肠,多为单发,腹腔镜联合结肠镜下手术治疗能促进患儿康复,提高总体治疗效果,也能缓解患儿疼痛,减少并发症的发生,降低随访息肉复发率与再次手术率。

Objective To investigate and analyze the clinical features of children with colorectal polyps and the efficacy of laparoscopic surgery combined with colonoscopy. Methods A total of 98 children with colorectal polyps diagnosed and treated in our hospital from February 2019 to October 2021 were selected as subjects of this study. The clinical characteristics of all children were recorded,and they were divided into the laparoscopic group(laparoscopic surgery combined with colonoscopy,n=40)and the colonoscopy group(colonoscopy,n=58)according to the differences in surgical methods. The therapeutic effect,complication rate,VAS pain score,polyp recurrence and reoperation rate of different surgical methods were compared. Results Among the 98 children,the polyps of 44 cases were in rectum,38 cases in transverse rectum and 16 cases in other sites. The maximum diameter of polyp was(1. 65±0. 24)cm. Polyps were solitary in 83 cases and multiple in 15 cases. The perioperative indexes in the laparoscopic group were significantly improved compared with those in the colonoscopy group(P<0. 05). The incidence of postoperative complications such as infection,bleeding,intestinal perforation and intestinal obstruction was 5. 00% in the laparoscopy group,which was significantly lower than 17. 24% in the colonoscopy group(P<0. 05). The total effective rate of laparoscopic group was 97. 50% one month after operation,which was significantly higher than that of colonoscopy group(82. 76%,P<0. 05). The VAS pain score of the laparoscopic surgery group was significantly lower than that of the colonoscopy group at 1,3 and 7 days after surgery(P<0. 05). After 1 year of follow-up,the combined polyp recurrence rate and reoperation rate were 5. 00% and 2. 50%,which were significantly reduced compared with 18. 97% and 13. 79% in colonoscopy group(P<0. 05). Conclusions The main sites of colorectal polyps in children are rectum and transverse rectum,and most of them are solitary. Laparoscopic and colonoscopic surgery for colorectal polyps in children can promote the recovery of children,improve the overall treatment effect of patients,relieve the pain of children,reduce the occurrence of complications,and reduce the recurrence rate and reoperation rate of follow-up polyps in children.

目的 对本院老年重症肺炎患者的临床资料进行回顾性分析,为老年重症肺炎多药耐药菌感染的临床诊疗提供参考。方法 回顾性分析本院医院76例老年重症肺炎患者的病例信息,将患者随机分为研究组和对照组,每组38例,研究组患者在对照组基础上(头孢哌酮／舒巴坦)联合胸腺肽α1治疗。研究2组患者的痰液致病菌分布及其临床特点,通过对比2组患者治疗前后免疫功能指标T淋巴细胞CD4⁺及炎症因子超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平变化,对头孢哌酮/舒巴坦联合胸腺肽α1治疗老年重症肺炎的临床效果进行分析。结果 76例老年重症肺炎患者中,共检出143株病原菌,以不动杆菌属为主的革兰氏阴性菌(89株)为主要致病菌株,占比64.3%,革兰氏阳性菌(54株)以葡萄球菌属为主,占比35.7%;排名前3位的主要致病菌为:铜绿假单胞菌(33.6%)、金黄色葡萄球菌(22.4%)和大肠埃希菌(14.7%)。痰液分离出的致病菌出现了普遍的严重耐药性,主要以多药耐药铜绿假单胞菌为主。2组治疗前 T 淋巴细胞CD4⁺、hs-CRP、IL-6、TNF-α水平对比无差异(P＞0.05),治疗后观察组CD4⁺水平更高,而 CRP、TNF-α、IL-6水平更低,与对照组有差异(P＜0.05)。结论 老年重症肺炎多药耐药菌重症肺炎检出病原菌主要以铜绿假单胞菌为主,治疗上联合使用胸腺肽α1,能够有效改善患者的免疫抑制状态、减轻老年患者机体炎症反应,对于提高老年患者临床治疗效果及改善患者预后有着重要的临床意义,值得广泛推广。

目的 探究尿毒症继发性甲状旁腺功能亢进经甲状旁腺切除术治疗效果及安全性分析。方法 选取2017年6月—2019年5月于我院就诊的90例尿毒症继发性甲状旁腺功能亢进患者为研究对象,随机分为对照组与观察组,两组各45例。均采取同一药物治疗,对照组行次全切除治疗,观察组行甲状旁腺全切除术+前臂移植术。对比分析两组治疗效果、血生化指标及并发症。结果 观察组疗效优于对照组(P<0.05);观察组术后1周、1个月钙、iPTH、磷、钙磷乘积及ALP水平均低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 甲状旁腺全切除+前臂移植治疗尿毒症继发性甲状旁腺功能亢进疗效显著,并发症风险低,值得推广。

目的 观察实施微信式延续护理干预对真菌性外耳道炎患者心理状态及治疗效果的影响。方法 选取我院2018 年12月—2019年12 月期间门诊治疗的110例真菌性外耳道炎患者为观察对象,将所选患者随机分为常规组和干预组,常规组55例,采取常规护理;干预组55例,在常规护理的基础上实施微信式延续护理干预。观察两组患者的心理状态及治疗依从性、治疗效果的变化。结果 干预组患者心理状态的改善、治疗依从性、治疗效果均优于常规组,差异有统计学意义(P＜0.05)。结论 在给予真菌性外耳道炎患者实施护理干预的过程中,加入微信式延续护理干预,患者的心理状态得到改善、治疗依从率增加及患者治疗的总有效率提高。因此微信式延续护理干预值得在临床护理中进一步推广。

Objective To observe WeChat continuous nursing intervention on mental state and therapeutic efficacy of fungal external auditory meatus. Methods 110 cases of fungal external auditory meatus treated in our hospital from December 2018 to December 2019 were selected as the observation objects,The selected patients were randomly divided into the conventional group and the intervention group,There were 55 cases in the conventional group,taking regular care; there were 55 cases in the intervention group,on the basis of routine nursing,WeChat continuous nursing intervention was implemented. The psychological status and treatment compliance of the two groups were observed,also changes in treatment outcomes. Results The improvement of psychological state,treatment compliance and treatment effect in the intervention group were better than that in the conventional group.The difference was statistically significant(P＜0.05). Conclusion In the course of nursing intervention for patients with fungal external auditory meatus,WeChat continuous nursing intervention was added.The psychological state of the patients has been improved,the rate of treatment compliance is increased and the total effective rate of treatment is increased greatly.Therefore,WeChat continuous nursing intervention is worthy of further promotion in clinical nursing.