约10%~30%的新发结直肠癌患者会出现急性肠梗阻，传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略，展现出显著优势。肠道支架可迅速解除梗阻，改善患者症状，降低手术风险，为肿瘤微创切除创造条件，同时为新辅助化疗提供可能，但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视，且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展，旨在为临床研究和实践提供参考依据。

    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction．Traditional emergency surgical intervention is characterized by high rates of postoperative complications，elevated mortality，and diminished quality of life．Combined stent and curative elective surgery（CSCES）has emerged as a novel therapeutic strategy，exhibiting significant clinical benefits．Intestinal stenting can rapidly alleviate obstruction，thereby improving patient symptoms，reducing surgical risks，and facilitating minimally invasive tumor resection．Additionally，it provides an opportunity for neoadjuvant chemotherapy．However，potential complications，including bleeding，stent migration，recurrent obstruction，and intestinal perforation，must be carefully considered．Moreover，the long-term safety and impact on oncologic outcomes remain to be elucidated．This review aims to provide a comprehensive overview of the current status，controversies，and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer，with the goalof informing clinical research and practice．

       目的 调查重型β地中海贫血患儿照顾者的负担现状，并分析其影响因素，为医护人员制定干预方案提供依据。方法 采用便利抽样法，于2024年1月—12月选取华南地区5家医院就诊的重型β地中海贫血患儿的主要照顾者作为调查对象，采用一般资料调查表、Zarit照顾者负担量表、中文简化版家庭弹性量表和社会支持评定量表进行调查，并采用单因素分析、相关性分析及多重线性回归探究其影响因素。结果 共发放问卷242份，回收232份，回收率为95.87%。重型β地中海贫血患儿主要照顾者照顾负担的总体平均得分为（36.67±18.63）分。多重线性回归分析结果显示，患儿输血频率、输血相关性皮肤过敏和社会支持是患儿照顾负担的影响因素（P＜0.001），可解释总变异的23.9%。结论 重型β地中海贫血患儿照顾者负担程度以中重度为主。患儿曾出现输血不良反应、输血频率更高，其照顾者负担更重；而主要照顾者具有良好的社会支持水平有助于降低其照顾者负担。医护人员应针对以上因素制定干预方案，以减轻重型β地中海贫血患儿照顾者负担水平。

      Objective To investigate the current burden in caregivers of children with β thalassemia major and analyze its influencing factors，so as to provide a basis for medical staff to formulate intervention plans．Methods By using the convenience sampling method，primary caregivers of children with β thalassemia major from five hospitals in South China from January to December 2024 were selected as the survey subjects．The general information questionnaire，Zarit Caregiver Burden Scale，Simplified Chinese Family Resilience Scale and Social Support Rating Scale were used for the survey．And univariate analysis，correlation analysis and multiple linear regression were adopted to explore its influencing factors．Results A total of 242 questionnaires were distributed and 232 were retrieved，with a recovery rate of 95.87%．The overall average score of care burden for primary caregivers of children with β thalassemia major was（36.67±18.63）．The results of multiple linear regression analysis showed that the frequency of blood transfusion in children，transfusion-related skin allergy and social support were the influencing factors of the care burden（P＜0.001），which could explain 23.9% of the total variation．Conclusions The burden level in caregivers of children with β thalassemia major is mainly moderate to severe．The children with adverse reactions to blood transfusion and higher frequency of blood transfusion impose a heavier burden on its caregivers．The primary caregivers who have good social support can help reduce the burden．Medical staff should formulate intervention plans based on the above factors to reduce the burden level of caregivers of children with β thalassemia major．

       目的 分析药品集中带量采购（集采）政策下医院药品供应保障实况，提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据，描述性统计分析集采药品供应情况。结果 采购的416个中标药品中，69个在购销合同期内短缺，短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关，季节性强，以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力，保障供应。

   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement（hereinafter referred to as “central procurement”），and proposes optimization strategies and suggestions for the policy and guarantee．Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024，descriptive statistical analysis of the drug supply situation through centralized procurement was conducted．Results Among the 416 selected drugs purchased，69 were in short supply during the contract period，with a shortage rate of 16.59%．The reasons for the shortage were related to the production capacity of the enterprise，seasonal demand fluctuations，strong seasonality，and mainly chronic diseases and anti-infective．Conclusions It is suggested to build a monitoring platform，improve the reporting system，formulate emergency plans，and evaluate the supply capacity to ensure supply．

目的：本研究旨在调查广州市重点专科建设背景下护理管理者核心能力的现状，分析其主要影响因素，为护理管理者核心能力提升策略的制定提供参考。方法：采用便利抽样法，选取广州市某区联合申报市级重点专科单位的159名护理管理者作为研究对象。采用一般资料调查表和护士长岗位胜任力问卷进行调查。将搜集的数据使用 SPSS 27.0 软件进行描述性统计、独立样本 t 检验和单因素方差分析以及多元线性回归分析。结果：广州市区联合申报市级重点专科单位护理管理者综合素质总均分为（148.81±26.54）分，各维度得分从高到低依次为：个人性格特质（6.22±1.11）分、临床管理能力（6.20±1.12）分、团队影响能力（6.17±1.14）分。单因素分析显示，职称和工作职务对综合素质得分有显著影响（P＜0.05）。多元线性回归分析进一步表明，在控制其他变量后，年龄30-40岁组对核心能力有显著影响（P＜0.05）。结论：广州市区联合申报市级重点专科单位护理管理者岗位胜任力总体处于中等偏上水平，各维度表现均衡。建议重点专科建设单位重点关注不同职务层次护理管理者的能力发展需求，进一步优化管理体系，促进区域护理管理水平的整体提升。

自2019年2月国务院发布《粤港澳大湾区规划纲要》以来，明确提出推动粤港澳大湾区医疗合作，促进优质医疗卫生资源跨境共享。2020年10月提出并实施港澳药械通工作方案，2021年4月首个试点单位首批药械顺利内地使用，截至2025年12月，港澳药械通指定医疗机构已拓展至71家，实现湾区9地市覆盖，引进使用港澳药品、医疗器械149个品种，惠及患者近2万人次，并获得广东省立法保障。本文以粤港澳三地医疗协同发展背景下，回顾其发展历程，总结部分经验，从实践和执行者的视角透析港澳药械通这一举措的创新性和融合性，实践中的启示，为我国医疗模式的国际接轨，国家医疗改革的相关政策制定，未来国际医疗的“中国服务”提供参考。

目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象，构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分，采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分，高负荷患者约占三分之一；生物、心理、社会因素联合模型可解释68.4%的负荷变异；明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征，应建立多维评估与分层干预机制，以优化资源配置和连续照护。

Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.

       脑卒中后认知障碍（PSCI）是脑卒中患者常见的并发症，严重影响患者的生活质量和社会功能。近年来，随着认知储备理论的发展和早期干预理念的普及，PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展，包括干预的理论基础、具体措施及未来发展方向，以期为临床实践和科研提供参考。

       Post-stroke cognitive impairment（PSCI）is a common complication among stroke patients．It seriously affects the patients’ quality of life and social functions．In recent years，with the development of the cognitive  reserve theory and the popularization of the concept of early intervention，the early intervention model for PSCI has gradually become a research hotspot．This article reviews the current research status and progress of the early intervention model for PSCI，including the theoretical basis of the intervention，specific measures，and future development directions，aiming to provide  references for clinical practice and scientific research．

       目的 调查国内养老机构痴呆照护服务现状,为今后国内进一步推进养老机构痴呆照护服务的发展提供可借鉴的依据。方法 2024年1月1日至3月31日以全国养老机构为研究对象, 采取两阶段分层抽样, 随机抽取国内15个省、自治区、直辖市的养老机构, 采用网络问卷调查方法对抽取的养老机构管理人员进行问卷调查。结果 共回收线上调查问卷443份, 经过去重和排除无效问卷, 最终得到的有效问卷为412份, 有效率为93%。调查发现有313家（76%）机构有收住痴呆患者, 养老床位规模为100~299张的养老机构占比最高。小规模的养老机构中,民办民营机构收住痴呆患者的比例高于公建公营机构。有181家机构设置了痴呆照护专区。床位数在300张以上的养老机构中设立痴呆照护专区的比例高于中、小规模的养老机构。结论 本调查较客观地呈现了我国养老机构痴呆照护服务开展的现状, 大规模的养老机构提供痴呆照护服务的能力更高, 设置痴呆照护专区的机构更能满足痴呆患者多层次、多样化的照护需求。目前国内仍存在专业化的痴呆照护服务供给不足、照护人员短缺等现象,  急需国家加强顶层设计,  促进行业健康发展。

       Objective To explore the current situation of cognitive care services in nursing homes in China, and provide reference for further promoting the development of cognitive care services in nursing homes in China．Methods From January 1 to March 31, 2024, a two-stage stratified sampling was carried out to randomly select pension institutions in 15 provinces, autonomous regions and municipalities directly under the central government across the country, and a questionnaire survey was conducted on the nursing homes．Results A total of 443 online questionnaires were recovered in this survey, and 412 valid questionnaires were obtained after eliminating duplicated and invalid questionnaires, with an effective rate of 93%．In this survey, 76% of the institutions admitted the elderly with dementia, and the nursing homes with 100-299 beds accounted for the highest proportion．Among the small-scale nursing homes, the proportion of the elderly with dementia in private institutions is significantly greater than that in public institutions．There were 181 nursing homes with special cognitive care areas．The proportion of cognitive care area in nursing homes with more than 300 beds was significantly greater than that in medium and small scale nursing homes．Conclusions This survey Objectively presents the current situation of the development of cognitive care services in nursing homes in our country．Large-scale nursing homes have a higher capacity to provide cognitive care services．Nursing homes that set up special areas for cognitive care can better meet the multi-level and diversified care needs of the elderly with dementia．At present, there are still insufficient supply of professional cognitive care services and shortage of nursing personnel in China．It is urgent for the country to strengthen top-level design and promote the healthy development of the industry．

       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄（OR=1.131）、睡眠差（OR=2.557）、合并3种及以上慢性病（OR=3.990）、抑郁（OR=3.296）、营养不良风险（OR=4.005）为老年脆性骨折患者术前衰弱的危险因素,BMI正常（OR=0.206）是保护因素（均P<0.05）。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。

       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures．Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected．Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale（CES-D-10）, the Generalized Anxiety Disorder Scale（GAD-7）, and the Nutritional Risk Screening 2002（NRS-2002）．Logistic regression was used to analyze factors influencing preoperative frailty．Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%．Logistic regression analysis revealed the following risk factors for preoperative frailty：age（OR=1.131）, poor sleep quality（OR=2.557）, multiple chronic comorbidities（OR=3.990）, depression（OR=3.296）, nutritional risk（OR=4.005）．Normal body mass index（OR=0.206）was a protective factor．Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients．Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients．

       克罗恩病肛瘘在解剖结构、诊治措施及疾病预后上具有与普通肛瘘不同的特点, 它是克罗恩病患者常见且严重的并发症及预后不良的征兆,严重影响患者生活质量。文章概述了克罗恩病肛瘘的概念及诊治现状、患者生活质量、相关评估工具及护理措施, 旨在为此类患者的临床管理及相关研究的开展提供参考依据,以提高其生活质量。

       Perianal fistula of Crohn's Disease has different characteristics from common anal fistula in anatomical structure, diagnosis and treatment and prognosis．It is a common and serious complication and a sign of poor prognosis in patients with Crohn's disease, which seriously affects the quality of life of patients．This article summarizes the concept, current status of diagnosis and treatment of perianal fistula in Crohn's Disease, its impact on the quality of life in patients, related assessment tools and nursing measures, so as to provide a reference for the management of such patients and improve their quality of life．