目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为（知信行）水平的现状，探究各因素是否对患者的营养风险、营养知信行水平具有影响，并分析两者之间的相关性。方法 选取中山大学附属第八医院（深圳福田）2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象，采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查，数据收集后进行统计分析，从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险，营养风险评分为（2.72±1.42）分。消化系统恶性肿瘤患者营养知识水平得分为（12.30±5.26）分、营养态度水平得分为（14.80±2.68）分、营养行为水平得分为（22.82±4.55）分、营养知信行水平总分为（49.96±9.50）分。家庭经济收入是患者营养风险水平的核心影响因素（P＜0.05），学历水平是患者营养知信行水平的核心影响因素（P＜0.05）。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关（r=-0.143，P＜0.05）。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平，但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要，这将有助于提升患者的营养知识水平，从而整体性改善其营养知信行素养并降低其营养风险，但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。

    Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors，to analyze the influencing factors of nutritional risk，nutritional knowledge-attitude-behavior，and explore the correlation between them．Methods From February 2024 to October 2024，244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects．A general information questionnaire，Nutritional Risk Screening 2002，and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3，and the overall score was（2.72±1.42）．The scores of nutritional knowledge，attitude，behavior and total score of digestive system malignant tumors patients were（12.30±5.26），（14.80±2.68），（22.82±4.55）and（49.96±9.50），respectively．Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors，while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior．Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level，but there is a widespread situation of relatively high nutritional risk．It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period，which will help enhance patients’ nutritional knowledge level，thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks．However，when conducting nutrition education and formulating personalized nutrition plans，the patient’s family economic income，medical payment methods and educational level should be fully considered．

目的 探讨A超和IOL Master测量人工晶状体度数的精确性,为白内障手术提供客观的临床数据。方法 选取300例300眼老年性白内障患者,术前采用A 超和IOL Master测量眼轴长度、自动验光仪测量角膜曲率,A超组利用自动验光仪的角膜曲率数据,IOL Master组利用仪器自带的角膜曲率数据,均使用SRK-T公式计算需要植入的人工晶状体度数,观察术后3 m的屈光状态,使用自动验光仪检测患者屈光状态并分析。结果 所有被列入研究的患眼随机分为A超组和IOL Master组, A超组测得的平均眼轴长度为(23.21±0.59)mm,IOL Master组测得的眼轴长度为(23.22±0.59)mm,两组数据对比差异无统计学意义(P>0.05);利用自动验光仪测量的术前平均角膜曲率为(44.01±1.79)D,利用IOL Master测量的术前平均角膜曲率为(44.13±1.62)D,两者比较差异无统计学意义(P＞0.05);A超组和IOL Master组术后的平均绝对屈光误差(mean absolute refractive error,MAE)分别为(0.43±0.26)D、(0.42±0.17)D,两组比较差异无统计学意义(P>0.05)。结论 IOL Master在操作上略优于A超,但在人工晶体度数测量上与A超比较没有发现明显优势,不能完全取代A超,两者结合更能确保人工晶体度数测量的精确性。

Objective By discussing the accuracy of A-scan and IOL Master in intraocular lens power measurement, to offer Objective clinical data for cataract surgery.Methods Three hundred patients(300 eyes)with age-related cataract were included in the study. Before surgery,axial length was measured by A-scan and IOL Master respectively and corneal curvature was measured by auto refractometer. A-scan group used the corneal curvature data of the auto refractometer. IOL Master group used the corneal curvature data from the instrument. Intraocular lens power was calculated according to the SRK-T formula.We observed the refractive state of 3m after operation, detected and analyzed the patient's refractive data by the auto refractometer.Results All patients who were included in the study were randomly divided into A-scan group and IOL Master group.The mean axial length was (23.21±0.59) mm measured by A-scan, the mean axial length was (23.22±0.59) mm measured by IOL Master. There was no significant difference between them (P>0.05). The preoperative mean corneal curvature measured by the auto refractometer was (44.01±1.79)D. The preoperative mean corneal curvature measured by IOL Master was (44.13±1.62)D. There was no statistically significant difference between them (P＞0.05). The mean absolute refractive error ( MAE) in A－scan group was (0.43±0.26)D and in IOL Master group was (0.42±0.17)D. There was no statistically significant difference between them (P＞0. 05).Conclusion IOL Master group operated slightly better than A-scan group, but we did not find a significant advantage in intraocular lens power measurement with A-scan group. IOL Master may not completely replace A-scan. The combination of the two ensures the accuracy of the measurement in intraocular lens power.

目的 探讨MDS、MDS/AML及原发AML基因突变频谱的异同点及其临床意义。方法 选取98例MDS患者、32例MDS/AML患者及234例原发AML患者为研究对象,利用二代测序技术检测基因突变。结果 MDS组中突变率较高的基因突变为TET2(16.7%,16/96)、U2AF1(12.0%,6/50)、SF3B1(11.8%,9/76);MDS/AML组中突变率较高的基因突变为TP53(33.3%,2/6)、DNMT3A(30%,6/20)、IDH2(21.1%,4/19);原发AML组中突变率较高的基因突变为FLT3-ITD(18.0%,42/233)、NPM1(16.3%,38/233)、DNMT3A(14.9%,14/94)。DNMT3A(P=0.006)、IDH2(P=0.004)及NPM1(P=0.002)等基因突变在MDS与MDS/AML两组间的突变率有统计学差异;FLT3-ITD(P=0.001)、NPM1(P=0.002)、CEBPA(P=0.011)及IDH2(P=0.019)等基因突变在MDS与原发AML两组间的突变率有统计学差异;所有受检基因突变在MDS/AML与原发AML两组间的基因突变的突变率无统计学差异(P＞0.05)。结论 MDS、MDS/AML及原发AML基因突变的突变频谱具有相似性及异质性,从MDS到MDS/AML、原发AML基因突变的变化不仅影响疾病转归及预后而且可帮助鉴别MDS/AML和原发AML。

Objective To explore the similarities and differences of spectrum of gene mutations in patients with myelodysplastic syndrome, MDS/AML and de novo acute myeloid leukemia and their clinical significance. Methods 98 patients with MDS, 32 patients with MDS/AML, 234 patients with de novo AML were selected. Gene mutations were detected by second generation sequencing. Results The most frequent mutations in MDS were as follows:TET2(16.7%, 16/96), U2AF1(12.0%, 6/50), SF3B1(11.8%, 9/76); The most frequent mutations in MDS/AML were TP53(33.3%, 2/6), DNMT3A(30%, 6/20), IDH2 (21.1%, 4/19);The most frequent mutations in de novo AML were FLT3-ITD(18.0%, 42/233), NPM1(16.3%, 38/233), DNMT3A(14.9%, 14/94); DNMT3A(P=0.006),IDH2(P=0.004) and NPM1(P=0.002) were statistical difference between MDS and MDS/AML; FLT3-ITD(P=0.001),NPM1(P=0.002),CEBPA(P=0.011) and IDH2(P=0.019) were statistical difference between MDS and de novo AML;There were no siatistical significance (P>0.05) in the frequency of all detected gene mutations between MDS/AML and AML. Conclusion The spectrum of gene mutation of MDS, MDS/AML and primary AML have similarities and heterogeneity.The changes of gene mutations from MDS to MDS/AML and de novo AML not only affect disease outcome and prognosis, but also help to identify MDS/AML and de novo AML.

目的 探讨Sirius与A超对不同程度近视患者中央角膜厚度(CCT)的测量差异。方法 对225例(450眼)拟行角膜屈光手术的近视患者,按低、中、高度近视分三组,依次用Sirius和A超测量CCT。 测量结果行配对t检验、 Pearson相关及 Bland-Altman分析。结果 低、中、高度近视组中,Sirius所测CCT均数分别为(542.61±29.19)μm、(543.96±27.02)μm、(547.25±22.53)μm;A超CCT均数分别为(538.51±29.12)μm、(540.98±26.56)μm、(542.19±21.64)μm。不同近视组中,Sirius测量值均略大于A超值,且两者高度正相关,差异有统计学意义(P<0.05)。Bland-Altman分析,不同近视组中,两种仪器测量CCT的一致性较好。结论 Sirius在绝大多数情况下能够替代传统的A超角膜测厚仪,但对拟行激光手术的高度近视患者应该综合考虑两种仪器测量结果。

Objective To study the measurement differences of central corneal thickness(CCT) in different degree of myopia by Sirius and ultrasound pachymetry(UP). Methods 225 myopic subjects(450 eyes)were recruited and divided into three groups according to the degree of refractive errors. The CCT were obtained from the eyes for each subjects using the Sirius and UP. Data were compared by using paired t-tests and the Pearson correlations. Bland- Altman analysis of all pairs were determined. Results The mean CCT in low myopic group obtained from Sirius and UP were (542.61±29.19)μm and(538.51±29.12)μm,respectively. The mean CCT in medium myopic group by Sirius and UP were(543.96±27.02)μm and(540.98±26.56)μm.The measured mean CCT in high myopic group were(547.25±22.53)μm and(542.19±21.64)μm by Sirius and UP. The mean CCT measurements between the two instruments were high correlated and statistically different(P<0.05) in the three groups respectively. In different myopia groups Sirius has good coincidence with UP in measuring CCT according to the Bland-Altman plot. Conclusion In vast majority of cases,Sirius can replace traditional UP in measuring CCT. But for the preopreative examination of the high myopia patients, we need to think twice about the difference between the two measurements.

       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例，评估所有患者的应对方式，根据结果分为积极应对组与消极应对组，设计基线资料调查表，详细统计两组患者的基线资料并比较，重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估，78例阴道分娩后尿失禁患者疾病消极应对有40例，占比51.28%；积极应对组与消极应对组患者的产次（χ ² =4.110，P=0.043）、文化水平（Z=2.094，P=0.036）、家庭关怀度（Z=2.069，P=0.040）与自我效能（Z=2.249，P=0.025）比较差异有统计学意义，组间年龄（t=0.096，P=0.924）、孕次（t=1.257，P=0.212）、体质指数（BMI）（t=0.125，P=0.901）、工作（χ ² =0.778，P=0.378）、家庭月人均收入（χ ² =0.044，P=0.834）、漏尿（χ ² =0.040，P=0.842）比较差异无统计学意义；经回归分析发现，家庭关怀度低（OR=1.799，P=0.041）、自我效能低（OR=1.942，P=0.026）、经产妇（OR=2.554，P=0.045）及文化水平低（OR=1.837，P=0.038）均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高，可能与产次、文化水平、家庭关怀度及自我效能有关。

       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery．Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected．The coping strategies of all patients were evaluated，and they were divided into a positive coping group and a negative coping group based on the results．A baseline data questionnaire was designed，and the baseline data of the two groups of patients were compared in detail．The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery．Results After evaluation，40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies，accounting for 51.28%．The parity of patients in the positive and negative coping groups（χ ² =4.110，P=0.043），educational level（Z=2.094，P=0.036），family care（Z=2.069，P=0.040），and self-efficacy（Z=2.249，P=0.025）among the groups were different．Age between groups（t=0.096，P=0.924），gestational age（t=1.257，P=0.212），body mass index（t=0.125，P=0.901），and work experience（χ ² =0.778，P=0.378），monthly per capita income of households（χ ² =0.044，P=0.834），urinary leakage（χ 2 =0.040，P=0.842）had no statistically significant difference in comparison．Through regression analysis，it was found that low family care（OR=1.799，P=0.041），low self-efficacy（OR=1.942，P=0.026），postpartum women（OR=2.554，P=0.045），and low educational level（OR=1.837，P=0.038）were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery．Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease，which may be related to parity，educational level，family care and self-efficacy．