目的 调查住院老年患者因经外周静脉置入中心静脉导管（PICC）而引发的血栓情况，并分析其影响因素，为老年患者置入PICC产生的相关性血栓（PICC-CRT）和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间，选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型，并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例，最终纳入277例患者的完整资料，其中123例患者出现了PICC-CRT，发生率为44.40%（123/277）。血栓分级中，I级78例，Ⅱ级37例，Ⅲ级8例。无症状血栓83例，占67.48%，发生率29.96%（83/277）；症状性血栓40例，占32.52 %，发生率14.44%（40/277）。单因素分析联合多因素Logistic回归显示，卒中史、凝血酶原时间（PT）、导管留置时间是住院老年患者PICC-CRT的关键因素（P＜0.05），预测模型ROC曲线下面积为0.719；置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素（P＜0.05），预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素，基于关键因素构建了预测模型预测其发生，为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter（PICC）placement in hospitalized elderly patients and to analyze its influencing factors，in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis（PICC-CRT）and symptomatic thrombosis in this population．Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled．Comprehensive assessments were conducted using general patient information forms，motor function evaluation，muscle strength testing，Barthel Index，and Padua score．Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis，with variable selection optimized via stepwise regression．Model performance was evaluated using receiver operating characteristic（ROC）curve analysis．Results After excluding 40 patients with incomplete clinical data，277 cases were included in the final analysis．Among them，123 patients developed PICC-CRT，with an incidence rate of 44.40%（123/277）．Thrombosis was graded as Grade I in 78 cases，Grade II in 37 cases，and Grade III in 8 cases．Asymptomatic thrombosis occurred in 83 cases（29.96%），accounting for 67.48% of PICC-CRT；symptomatic thrombosis occurred in 40 cases（14.44%），accounting for 32.52%．Univariate and multivariate Logistic regression analyses identified history of stroke，prothrombin time（PT），and catheter dwell time as key risk factors for PICC-CRT（P＜0.05），with the area under the curve（AUC）of 0.719．History of catheterization，malignancy，catheter dwell time，and number of post-catheterization complications were independent predictors of symptomatic thrombosis（P＜0.05），with an AUC of 0.812．Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients．Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis．

       目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料，按照7︰3比例随机化分为训练列（293例）和验证队列（126例）。统计基于开发队列数据，采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素，并构建风险预测模型。基于开发队列和验证队列数据，采用校准曲线、受试者操作特征（ROC）曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎，发生率为26.97%。美国国立卫生研究院卒中量表（NIHSS）评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值（NPAR）、中性粒细胞计数与淋巴细胞计数比值（NLR）、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素（P＜0.05）。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型，校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近；ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906（95%CI：0.867~0.937）、0.884（95%CI：0.815~0.934）；决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。

      Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage（ICH）and validate the predictive performance of the model．Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022．They were randomly divided into a development cohort（293 cases）and a validation cohort（126 cases）according to a 7∶3 ratio．The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data，and a risk prediction model was constructed．Based on the development cohort data and validation cohort data，the predictive performance of the model was analyzed using calibration curves，receiver operating characteristic（ROC）curve，and decision curve analysis．Results Among 419 patients，113 developed stroke associated pneumonia，with a rate of 26.97%．The National Institutes of Health Stroke Scale（NIHSS）score，swallowing difficulties，initial hematoma volume，neutrophil percentage to albumin ratio（NPAR），neutrophil count to lymphocyte count ratio（NLR），surgical treatment，endotracheal intubation，and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH（P＜0.05）．Based on the above influencing factors，a risk prediction model for stroke associated pneumonia in patients with ICH was constructed．The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence．The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906（95%CI：0.867-0.937）and 0.884（95%CI：0.815-0.934），respectively．The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%，and the threshold probability of the validation cohort was between 2%-76%，the intervention using this model was more clinically valuable than all/no intervention．

Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score，swallowing difficulties，initial hematoma volume，NPAR，NLR，surgical treatment，tracheal intubation，and indwelling gastric tube has good predictive performance and clinical application value．

目的：探究阻塞性冠心病患者中舌象纹理特征与冠周脂肪影像组学的相关性。 方法：收集辽宁中医药大学附属医院131例就诊的疑似冠心病患者，其中阻塞性冠心病63例、非阻塞性冠心病68例，提取临床常规指标、舌象纹理特征及右冠状动脉影像组学参数。独立样本t检验、曼-惠特尼U检验、卡方检验、错误发现率校正用于比较组间差异。使用斯皮尔曼相关性分析舌象纹理特征与冠周脂肪影像组学的相关性。采用弹性网络进行特征筛选,按照7：3的比例随机抽样划分为训练集和测试集，使用BP神经网络模型构建冠周脂肪及冠周脂肪与舌象纹理特征联合模型，使用ROC曲线、准确性、精度、召回率、特异度、F1分数、Kappa系数评估模型。 结果：在疑似冠心病患者中，舌象纹理与冠周脂肪影像组学共检出22组弱负相关、1组中等正相关及23组弱正相关；阻塞性冠心病患者中检出4组中等负相关、4组弱负相关、2组中等正相关及6组弱正相关；非阻塞性冠心病患者中检出1组中等负相关、6组弱负相关、1组中等正相关及10组弱正相关。基于BP神经网络构建诊断模型，联合舌象纹理特征后较单一冠周脂肪影像组学模型测试集AUC有所提升。 结论：舌象纹理特征与冠周脂肪影像组学参数在阻塞性冠心病中存在一定的相关性；舌象纹理信息对冠周脂肪诊断阻塞性冠心病具有增量价值。

Abstract:Objective: To investigate the correlation between tongue image texture features and pericoronary adipose tissue (PCAT) radiomics in patients with obstructive coronary heart disease. Methods: A total of 131 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were enrolled, including 63 cases of obstructive coronary heart disease and 68 cases of non-obstructive coronary heart disease. Clinical routine indicators, tongue image texture features, and right coronary artery radiomics parameters were extracted. Independent sample t-test, Mann-Whitney U test, Chi-square test, and false discovery rate correction were used to compare intergroup differences. Spearman correlation analysis was employed to examine the correlation between tongue image texture features and PCAT radiomics. Elastic net was applied for feature selection. The dataset was randomly split into training and test sets at a 7:3 ratio. BP neural network models were constructed using PCAT features alone and in combination with tongue image texture features. Model performance was evaluated using receiver operating characteristic (ROC) curves, accuracy, precision, recall, specificity, F1 score, and Kappa coefficient. Results: In patients with suspected coronary heart disease, 22 weak negative correlations, 1 moderate positive correlation, and 23 weak positive correlations were identified between tongue image texture features and PCAT radiomics. In patients with obstructive coronary heart disease, 4 moderate negative correlations, 4 weak negative correlations, 2 moderate positive correlations, and 6 weak positive correlations were detected. In patients with non-obstructive coronary heart disease, 1 moderate negative correlation, 6 weak negative correlations, 1 moderate positive correlation, and 10 weak positive correlations were observed. The BP neural network diagnostic model combining tongue image texture features with PCAT radiomics demonstrated improved performance on the test set compared with the PCAT radiomics model alone. Conclusion: Tongue image texture features exhibit certain correlations with PCAT radiomics parameters in obstructive coronary heart disease, and tongue texture information provides incremental value for the diagnosis of obstructive coronary heart disease when combined with PCAT radiomics.

【摘要】目的：探讨营养控制状态（CONUT）评分与急性心肌梗死（AMI）患者长期预后的相关性。方法：纳入90例AMI患者，于2021年1月～2023年12月入院，随访2年，分为主要心血管不良事件（MACEs）组（32例）与非MACEs组（58例），回顾性分析并对比两组基线资料，并分析CONUT评分与MACEs的相关性及MACEs的影响因素，评估CONUT评分对MACEs的预测效能。结果：90例AMI患者2年MACEs发生率为35.56%；相较于非MACEs组，MACEs组年龄、糖尿病、血肌酐、C反应蛋白（CRP）、降钙素原（PCT）、N末端脑钠肽前体（NT-proBNP）、KillipⅢ~Ⅳ级、CONUT评分更高，白蛋白、血钙、左心室射血分数（LVEF）更低（P＜0.05）；CONUT评分与MACEs发生正相关（P＜0.05）；高CONUT评分是MACEs的独立危险因素（P＜0.05）；MACEs预测中，CONUT评分的灵敏度为93.75%，特异度为93.10%，曲线下面积（AUC）为0.854。结论：CONUT评分与AMI患者长期预后密切相关，营养不良程度越重，MACEs发生风险越高。

Abstract Objective: To explore the correlation between nutritional control status (CONUT) score and long-term prognosis of patients with acute myocardial infarction (AMI). Methods: 90 AMI patients were included, admitted to the hospital from January 2021 to December 2023, and followed up for 2 years. They were divided into major adverse cardiovascular events (MACEs) group (32 cases) and non-MACEs group (58 cases). The baseline data of the two groups were retrospectively analyzed and compared, and the correlation between CONUT score and MACEs and influencing factors of MACEs were analyzed to evaluate the predictive efficacy of CONUT score for MACEs. Results: The 2-year incidence rate of MACEs in 90 AMI patients was 35.56%; compared with the non-MACEs group, the MACEs group had higher age, diabetes, serum creatinine, C-reactive protein (CRP), procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), Killip grades III to IV, and CONUT score. Albumin, blood calcium, and left ventricular ejection fraction (LVEF) were lower (P<0.05); CONUT score was positively correlated with the occurrence of MACEs (P<0.05); high CONUT score was an independent risk factor for MACEs (P<0.05); in the prediction of MACEs, the sensitivity of CONUT score was 93.75 %, the specificity was 93.10 %, and the area under the curve ( AUC ) was 0.854. Conclusion: CONUT score is closely related to the long-term prognosis of AMI patients. The more severe the malnutrition, the higher the risk of MACEs.

【摘要】目的 对比舒芬太尼、羟考酮TURP麻醉诱导中的应用效果。方法 按照随机数字表法将2024年4月—2025年12月我院115例TURP患者分为S组（57例，舒芬太尼）与Q组（58例，羟考酮），其余诱导麻醉方案一致。观察两组麻醉恢复相关指标、血流动力学、疼痛评分、CRBD发生率及不良反应发生率。结果 两组瑞芬太尼总用量及苏醒、自主呼吸恢复时间对比无差异（P>0.05），Q组术中体动发生率较S组低（P<0.05）。T0 时两组MAP、HR无差异（P>0.05）；T1、T4均升高，但Q组较S组低（P<0.05）；T2、T3无差异（P>0.05）。Q组T5、T6 VAS评分均较S组低（P<0.05），T7无差异（P>0.05）。Q组CRBD发生率较S组低（P<0.05）。两组无不良反应差异（P>0.05）。结论 舒芬太尼与羟考酮用于TURP麻醉诱导均安全可行，对苏醒进程无明显影响，不良反应少。但与之相比，羟考酮在稳定血流动力学、减轻术后早期疼痛及降低术中体动、CRBD发生率方面优势更显著。

       目的  探讨TAP水平与乳腺癌分子亚型及临床病理参数之间的相关性。方法  以2021年3月—2025年1月期间收治的150例乳腺癌病例为样本，采用静脉采血方式测定TAP凝聚物表面积指标，通过免疫组织化学EnVision双步染色技术，对雌激素受体（ER）、雄激素受体（AR）、孕激素受体（PR）、Ki-67及p53等表达水平进行分析，采用荧光原位杂交（FISH）对人表皮生长因子受体2（HER2）基因扩增状态进行检测。结果  150例患者中，TAP强阳性131例，TAP弱阳性15例，TAP阴性4例，TAP阳性率97.33%。免疫表型：ER阴性43例，ER阳性107例；AR阳性133例，AR阴性17例；PR阴性60例，PR阳性90例；p53阳性73例，p53阴性77例；HER2强阳性41例，HER2弱阳性89例，HER2阴性20例；Ki-67增殖指数≥20% 116例，Ki-67增殖指数＜20% 34例。FISH对65例免疫组织化学检测结果为HER2（2+ ）的乳腺癌病例进行基因扩增状态分析，其中阳性7例，阴性58例。Ki-67高增殖组TAP表达水平显著高于低增殖组（P＜0.05）；不同临床分期患者TAP表达水平存在差异（P＜0.05）；三阴型、HER2阳性型、Luminal A型和Luminal B型的患者之间的TAP表达水平存在差异（P＜0.05），各分子分型（HER2阳性型、三阴型、Luminal A型和Luminal B型）与其对应非分型组的TAP表达均无统计学差异（均P＞0.05）。结论  TAP在乳腺癌中广泛表达，且与Ki-67增殖指数、临床分期呈正相关。虽然不同分子分型间TAP表达存在总体差异，但具体亚型对比未显示显著性，后期需扩大样本量验证。

       Objective  To explore the relationship between tumor abnormal protein（TAP）level and molecular typing and clinicopathological features of breast cancer．Methods  A total of 150 breast cancer cases admitted from March 2021 to January 2025 were enrolled in this study．The surface area of TAP condensates was measured using venous blood samples．The expression levels of estrogen receptor（ER），androgen receptor（AR），progesterone receptor（PR），Ki-67，and P53 were analyzed via immunohistochemistry（IHC）using the EnVision two-step staining technique．The amplification status of the human epidermal growth factor receptor 2（HER2+）gene was determined using fluorescence in situ hybridization（FISH）．Results  Among 150 patients，131 cases were strongly positive，15 cases were weakly positive and 4 cases were negative，with a positive rate of 97.33%．Immunophenotype：ER positive in 107 cases and ER negative in 43 cases，133 cases were  positive for AR and  17 cases were negative，PR was positive in 90 cases and negative in 60 cases，73 cases were positive for p53 and 77 cases were negative．HER2 is strongly positive in 41 cases，weakly positive in 89 cases and negative in 20 cases．There were 116 cases with Ki-67 proliferation index ≥ 20% and 34 cases with Ki-67 proliferation index ＜ 20%．Sixty-five cases of breast cancer HER2（2 ）were detected in the later stage．by FISH，of which 7 cases were positive and 58 cases were negative．The expression level of TAP in patients with high Ki-67 proliferation index was higher than that in patients with low Ki-67 proliferation index（P＜0.05）．The expression level of TAP in patients with different clinical stages was different（P＜0.05）．There were differences in TAP expression levels among patients with triple negative type，HER2 positive type，Luminal A type and Luminal B type（P＜0.05）．There was no statistical difference in TAP expression between each molecular type（triple negative type，HER2 positive type，Luminal A type and Luminal B type）and its corresponding non-typing group（all P＞0.05）．Conclusions  TAP is widely expressed in breast cancer，and it is positively correlated with Ki-67 proliferation index and clinical stage．Although there is a general difference in TAP expression among different molecular typing，the comparison of specific subtypes shows no significance，and it needs to be verified by expanding the sample size 

       目的   探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV1/FVC）、用力肺活量（FVC）的相关性。方法   纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者，以2%作为外周血EOS比例（EOS%）截断值分为两组，研究组（EOS%≥2%）34例，对照组（EOS%＜2%）39例，收集两组患者_{的一般临床资料、实验室检查结果、肺功能检查结果（FEV1}、FVC、FEV₁/FVC），比较组间差异，分析指标间的相关性。结果   对照组与实验组患者EOS%分别为0.5（0.1，0.9）%、5.15（2.60，10.05）%，两组患者EOS%差异有统计学意义（P＜0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56，1.78）ng/L、3.6（1.73，6.77）ng/L，两组IL-5水平差异有统计学意义（P＜0.05）。对照组FEV₁（L）、FVC（L）、FEV₁/FVC水平分别为1.32（1.18，1.58）、2.07（1.92，2.62）、0.62（0.57，0.67）；实验组分别为1.24（1.00，1.52）、2.22（1.94，2.56）、0.58（0.47，0.67），两组FEV₁、FVC、FEV₁/FVC水平差异均无统计学意义（P＞0.05）。Spearman等级相关检验结果显示，EOS%与IL-5水平呈正相关（rs=0.870，P＜0.001）；按组别进行分层后结果显示，对照组、试验组EOS%与IL-5水平均呈正相关（r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）。EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（r_s=0.039，P＞0.05）。对照组EOS%、IL-5水平与FEV₁、FEV₁/FVC、FVC不相关（P＞0.05）；实验组EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（P＞0.05）。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关，外周血EOS%≥2%时血EOS%、血清IL-5与FEV₁、FEV₁/FVC呈负相关，与FVC无关。

       Objective  To explore the correlation among blood eosinophil levels，serum interleukin-5（IL-5）levels，and forced expiratory volume in one second（FEV₁），the ratio of forced expiratory volume in one second to forced vital capacity（FEV₁/FVC），and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods  From March 2023 to March 2024，73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included，and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil（EOS%）．The experimental group（EOS%≥2%）included 34 patients，while the control group（EOS%＜2%）included 39 patients．General clinical data，laboratory test results，and pulmonary function test results（FEV₁，FVC，FEV₁/FVC）were collected from both groups．Results  The median quartiles of EOS% for the control group and experimental group were 0.5（0.10.9）% and 5.15（2.60，10.05）%，respectively．There was a statistically significant difference between the EOS% of two groups（P＜0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56，1.78）ng/L and 3.6（1.73，6.77）ng/L，respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P＜0.05）．For the control group，the median quartiles of FEV₁，FVC，and FEV₁/FVC were 1.32（1.18，1.58），2.07（1.92，2.62）and 0.62（0.57，0.67），respectively．For the experimental group，they were 1.24（1.00，1.52），2.22（1.94，2.56）and 0.58（0.47，0.67）respectively．There was no statistically significant difference between the two groups in FEV₁，FVC and FEV₁/FVC levels（P＜0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （r_s=0.870，P＜0.001）．Stratified by group，both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）．There was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．In the control group，there was no correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC，or FVC（P＞0.05）．In the experimental group，there was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV₁/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．Conclusions  During AECOPD，blood EOS% is positivelycorrelated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%，blood EOS%，serum IL-5，and FEV₁，FEV₁/FVC are negatively correlated，while there is no correlation with FVC．

     目的   探讨2型糖尿病（T2DM）患者葡萄糖目标范围内时间（TIR）与高尿酸血症（HUA）的相关性。方法   纳入2021年10月—2024年10月厦门大学附属第一医院收治的110例T2DM合并HUA的患者，将其分为T2DM并HUA组，另选取同期110例单纯T2DM患者，分为单纯T2DM组，比较两组一般资料及实验室相关指标，采用Logistics回归模型分析T2DM患者HUA发生的影响因素。随后将110例T2DM合并HUA的患者依照其病情严重程度分为轻度组（58例）、中度组（37例）及重度组（15例），比较三组临床相关指标及TIR水平，分析临床相关指标及TIR水平与T2DM患者HUA严重程度的相关性。结果  T2DM并HUA组与单纯T2DM组患者体质指数（BMI）、糖化血红蛋白、总胆固醇、甘油三酯、血肌酐（Scr）、TIR对比差异有统计学意义（P＜0.05）；将具有统计学差异的指标纳入Logistics回归模型，以是否合并HUA作为因变量（合并HUA=1，未合并HUA=0），结果显示，BMI、糖化血红蛋白、总胆固醇、甘油三酯、Scr、TIR为T2DM患者HUA发生的重要影响因素（P＜0.05）；HUA不同严重程度患者临床相关指标及TIR水平对比发现，轻度组、中度组与重度组糖化血红蛋白、总胆固醇、甘油三酯、Scr水平对比差异无统计学意义（P＞0.05），轻度组、中度组与重度组BMI、TIR对比差异显著（P＜0.05），重度组BMI高于轻度组对比差异有统计学意义（P＜0.05），重度组TIR低于轻度组和中度组对比差异有统计学意义（P＜0.05）；Spearman相关分析显示：BMI与HUA严重程度呈正相关，TIR与HUA严重程度呈负相关（P＜0.05）。结论  TIR降低为T2DM患者HUA发生的重要影响因素之一，且TIR水平与HUA严重程度密切相关。

        Objective  To explore the correlation between time in range（TIR）of glucose and hyperuricemia（HUA）in patients with type 2 diabetes mellitus（T2DM）．Methods  From October 2021 to October 2024，110 patients with T2DM complicated with HUA admitted to our hospital were divided into T2DM with HUA group，and 110 patients with T2DM only in the same period were divided into T2DM group．The general data and laboratory related indicators of the two groups were compared，and the influencing factors of the occurrence of HUA in T2DM patients were analyzed by logistic regression model．Subsequently，110 patients with T2DM complicated with HUA were divided into mild group（58 cases），moderate group（37 cases），and severe group（15 cases）according to their severity．The clinical related indicators and TIR levels of the three groups were compared，and the correlation between clinical related indicators and TIR levels and the severity of HUA in T2DM patients was analyzed．Results  Body mass index（BMI），glycosylated hemoglobin，total cholesterol，triglyceride，and blood creatinine（Scr）between T2DM with HUA group and T2DM group were significantly different（P＜0.05）．The indicators with statistical differences were included in the logistics regression model to determine whether to merge HUA as the dependent variable（with HUA=1，without HUA=0）．The results showed that，BMI，glycosylated hemoglobin，total cholesterol，triglycerides，Scr，and TIR were important influencing factors for the occurrence of HUA in T2DM patients（P＜0.05）．Comparison of clinical indicators and TIR levels in patients with different degrees of HUA revealed no significant differences in glycosylated hemoglobin，total cholesterol，triglycerides，and Scr levels among the mild，moderate，and severe groups（P＞0.05），while there were significant differences in BMI and TIR levels among the mild，moderate，and severe groups（P＜0.05）．The difference between the severe group and the mild group was statistically significant（P＜0.05），and the difference between the severe group and the moderate group was statistically significant（P＜0.05）．The Spearman correlation analysis  results showed that BMI was positively correlated with the severity of HUA，while TIR was negatively correlated with the severity of HUA（P＜0.05）．Conclusions  The decrease of TIR is one of the important influencing factors of HUA in T2DM patients，and the level of TIR is closely related to the severity of HUA．

目的 探讨不同类型尿结石患者肠道菌群结构与尿酸代谢的相关性研究。方法 随机选取2022年5月—2023年5月广州市第一人民医院泌尿外科住院的尿结石患者60例为研究组, 选取同期体检中心健康体检人群30名为对照组,按照结石成分将研究组患者分为尿酸组和非尿酸组, 每组各30例, 所有入选患者均接受结石样本、尿样本、大便样本、血样本的采集, 所有样本经光谱、质谱、基因测序、尿常规及血生化检测 , 比较入选对象的肠道菌群及血尿生化指标变化。结果 尿酸组和非尿酸组患者的血磷（SNK-q=7.970、3.542）、血BUN（SNK-q=5.647、4.756）、血SUA（SNK-q=8.178、3.623）、血SCr（SNK-q=7.300、5.553）、血LPS（SNK-q=13.101、9.705）及24h尿酸（SNK-q=4.462、6.426）水平均高于对照组, 具有统计学意义（P<0.05）, 尿酸组和非尿酸组患者的血钙水平低于对照组（SNK-q=3.918/3.047, P<0.05）。非尿酸组患者的血磷、血SUA、血LPS均低于尿酸组, 均有统计学意义（SNK-q=4.428、4.555、3.397, P<0.05）。尿酸组和非尿酸组患者肠道中双歧杆菌数量低于对照组, 差异具有统计学意义（SNK-q=3.754、3.143, P<0.05）。非尿酸组患者肠道中乳酸杆菌数量高于对照组和尿酸组（SNK-q=4.105、3.463, P<0.05）, 尿酸组及非尿酸组患者的血尿酸及24 h尿尿酸水平与肠道双歧杆菌数量呈负相关（P<0.05）。结论 肠道双歧杆菌数量对结石患者血尿酸代谢及尿结石形成具有相关性。

Objective To explore the relationship of intestinal flora and uric acid metabolism in different urinary stones patients．Methods From May 2022 to May 2023, 60 patients with urinary stones patients in Guangzhou First People’s Hospital were selected as the study group, and 30 health check-up people in the same period of the medical examination center were selected as the control group．Study group was divided into the uric acid group and the non-uric acid group, 30 cases each group, all patients received stone samples, urine samples, stool samples,blood samples collection, mass spectrometry, gene sequencing, urine routine, blood biochemical detection were performed．Intestinal flora and blood urinary biochemical indicators of the patients were compared．Results The levels of blood phosphorus（SNK-q=7.970, 3.542）, blood BUN（SNK-q=5.647, 4.756）, blood SUA （SNK-q=8.178, 3.623）, blood SCr（SNK-q=7.300, 5.553）, blood LPS（SNK-q=13.101, 9.705）, and 24-hour urine uric acid （SNK-q=4.462, 6.426）in the uric acid group and the non-uric acid group were all higher than those in the control group,and were statistically significant（P<0.05）．The blood calcium levels of the patients in the uric acid group and the non-uric acid group were lower than those in the control group（SNK-q=3.918/3.047, P<0.05）．The blood phosphorus, blood SUA and blood LPS levels of the non-uric acid group were all lower than those of the uric acid group, and the differences were statistically significant （SNK-q=4.428, 4.555, 3.397, P<0.05）．The number of bifidobacteria in the intestines of patients in the uric acid group and the non-uric acid group was lower than that of the control group,and the differences were statistically significant（SNK-q=3.754, 3.143, P<0.05）．The number of lactobacilli in the intestines of patients in the non-uric acid group was higher than that of the control group and the uric acid group（SNK-q=4.105, 3.463, P<0.05）．The levels of blood uric acid and 24-hour urine uric acid in the uric acid group and the non-uric acid group were negatively correlated with the number of Bifidobacterium in the intestines（P<0.05）．Conclusions The number of intestinal bisidobacteria has a significant correlation with the metabolism of blood uric acid and urinary stones in patients with stones．

目的 分析2型糖尿病患者25-羟维生素D[25（OH）D]、糖化血红蛋白（HbA_1c）水平和外周血管病变（PVD）的相关性,为疾病的预防及早期诊断提供参考。方法 分析于南通市中西医结合医院进行治疗的2型糖尿病患者基本资料,检测其25（OH）D、HbA_1c以及肌酐、血钙等多项实验室指标,按照彩色多普勒超声检查结果将所有82例患者分为PVD阳性和阴性两组,通过样本检测分析PVD的影响因素。结果 经彩色多普勒超声诊断,82例T2DM中PVD阳性50例、阴性32例;PVD阳性患者病程、BMI、LDL-C、HbA_1c、高于阴性组,25（OH）D低于阴性组（P<0.05）;经Logistic回归分析,患者BMI、糖尿病病程、HbA1c以及LDL-C是PVD的影响因素（P<0.05）;82例患者中HbA_1c控制不佳62例,维生素D缺乏者PVD发生率71.43%,明显高于维生素D充足患者的45.00%（χ²=4.055,P=0.044）。结论 患者BMI、糖尿病病程、HbA_1c、LDL-C以及25（OH）D水平均会对PVD的发生起到重要影响作用,且对于HbA_1c控制不佳患者,出现维生素 D 缺乏时发生PVD的概率更高。