目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义（P<0.05）;Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关（均P<0.05）;Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素（P<0.05）。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。

Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients．Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects．The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients．The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients．Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness．Results There was a statistically significant difference（P<0.05）in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits．Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality（all P<0.05）．Logistic regression analysis showed that the residential style score was an independent influencing factor（P<0.05）for the discharge readiness scale score．Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low．By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness．

目的 探讨氢吗啡酮对大鼠脑缺血再灌注损伤的影响。方法 45只SD雄性大鼠随机分成3组：假手术组（Sham组）、脑缺血再灌注组（I/R组）和氢吗啡酮组（HM组）。采用Zea-Longa改良线拴法构建动物模型,再灌注24 h后,Zea-Longa评分法评价神经功能;TTC染色检测脑梗死体积;苏木精-伊红（HE）和Nissl染色观察海马神经元病理变化,Tunel染色观察细胞凋亡情况,Western blot、qPCR检测凋亡相关因子B淋巴细胞瘤（Bcl）-2、Bcl-2相关X蛋白（Bax）和半胱氨酸蛋白酶（Caspase）-3蛋白和mRNA表达量。结果 与I/R组相比,HM组神经功能评分下降和脑梗死面积减小（P<0.05）,Tunel阳性细胞数量减少（P<0.05）,Bax和Caspase-3蛋白mRNA表达量减少,而Bcl-2表达量显著增加（P<0.05）。结论 氢吗啡酮具有神经保护作用,可减轻大鼠脑缺血再灌注损伤。

Objective To investigate the effect of hydromorphone on cerebral ischemia-reperfusion injury in rats．Methods Forty-five SD male rats were randomly divided into three groups：sham-operated group（Sham group）, cerebral ischemia-reperfusion group（I/R group）and hydromorphone group（HM group）．The animal models were constructed using the Zea-Longa modified line tethering method, and neurological function was evaluated by the Zea-Longa score after 24 h of reperfusion．TTC staining was used to detect the volume of cerebral infarction, hematoxylin-eosin（HE）and Nissl staining were used to observe the pathological changes of hippocampal neurons, and Tunel staining was used to observe apoptosis, Western blot, qPCR were used to detect apoptosis Bcl-2, Bcl-2-associated X protein（Bax）and cysteine protease（Caspase）-3 protein and mRNA expression．Results Compared with the I/R group, the HM group showed lower neurological function scores and cerebral infarct area（P<0.05）, smaller number of Tunel-positive cells（P<0.05）, less mRNA expression of Bax and Caspase-3 proteins and significantly higher expression of Bcl-2（P<0.05）．Conclusions Hydromorphone has neuroprotective effects and can reduce cerebral ischemia-reperfusion injury in rats．