因气候与生活习惯影响，广东地区老年性肩周炎临床特点及康复需求具有独特性，亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案，广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起，省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识（2026年版）》。该共识以ICF框架为基础，立足肩周炎康复循证医学证据，结合多学科专家产教研实践经验，对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布，将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。

   Due to climatic and lifestyle influences，the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features，necessitating the development of standardized and locally tailored rehabilitation protocols．To formulate regionally differentiated rehabilitation plans，the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder（2026 Edition）” through collaboration with multiple provincial institutions and experts．Based on the International Classification of Functioning，Disability and Health（ICF）framework and evidence-based rehabilitation medicine for periarthritis of the shoulder，this consensus integrates multidisciplinary expertise from industry，academia，and research to establish unified guidelines on ICF assessment，application of appropriate TCM techniques and rehabilitation therapies，implementation of stepwise intervention measures，and integrated TCM-Western medicine full-cycle rehabilitation approaches．The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder．

       本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题，IMB模型通过向患者提供科学的疾病知识，改变其疾病认知与态度，最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示，IMB模型可显著降低患者术后疼痛发生率，并提高患者参与治疗决策的程度，为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考，以便后期实施相关个性化干预措施，并提供相关理论依据。

       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy．The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge，and ultimately promotes their adoption and maintenance of healthy behaviors．It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy，the research background of this study，the current research status at home and abroad，as well as the future development trends and challenges．The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making．This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model，so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis．

      目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

       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．

乳腺癌化疗后骨髓抑制是临床常见不良反应，严重影响治疗依从性与疗效。中医药已形成系统防治体系，以“脾肾亏虚、气血不足”为核心病机，构建内治外治结合的诊疗模式。内治采用汤剂、中成药等，以健脾补肾、益气养血为法；外治依据经络理论，运用针刺、艾灸等手段，实现协同增效。本文梳理中医药治疗的理论与研究进展，旨在为临床应用与后续研究提供参考。

Bone marrow suppression after chemotherapy for breast cancer is a common clinical adverse reaction, which seriously affects the treatment compliance and efficacy. Traditional Chinese medicine has formed a systematic prevention and treatment system, with "spleen and kidney deficiency, qi and blood deficiency" as the core pathogenesis, and a diagnosis and treatment model that combines internal and external treatment. Internal treatment adopts decoction, traditional Chinese patent medicines and simple preparations, etc., with the method of strengthening spleen and kidney, supplementing qi and nourishing blood; External treatment is based on the theory of meridians, using acupuncture, moxibustion and other methods to achieve synergistic effects. This article reviews the theory and research progress of traditional Chinese medicine treatment, aiming to provide reference for clinical application and subsequent research.

目的 探讨三维能量多普勒超声（3D-PDA）定量评估胎盘血管化参数与胎儿窘迫的相关性。方法 纳入2023年3月-2025年3月于固始县妇幼保健院建档且规律产检的106例孕产妇临床资料，均完善3D-PDA检查，获取胎盘血管化参数：血管化指数（VI）、血流指数（FI）、血管血流指数（VFI）。根据分娩过程中及娩出后是否发生胎儿窘迫分为发生组（n=30）、未发生组（n=76），比较两组孕产妇基线资料、胎盘血管化参数。Pearson相关性分析法评估胎盘血管化参数与胎儿窘迫缺氧评估指标相关性。多因素Logistic回归分析模型分析胎儿窘迫发生的独立影响因素。绘制受试者工作特征曲线（ROC）评估胎盘血管化参数联合对胎儿窘迫的诊断效能。结果 发生组、未发生组年龄、孕前体质指数、孕次等一般资料无明显差异（P＞0.05），胎盘厚度、脐动脉血pH值、新生儿5 min Apgar评分差异有统计学意义（P＜0.05）。发生组VI、FI、VFI值均显著低于未发生组（P＜0.05）。Pearson相关性分析结果显示，VI、FI、VFI与脐动脉血pH值均呈正相关（r=0.562、0.615、0.554，P＜0.05），与新生儿5 min Apgar评分均呈正相关（r=0.522、0.603、0.536，P＜0.05）。多因素Logstic回归分析结果显示，胎盘厚度厚（OR=1.652）、脐带血pH值低（OR=1.792）、新生儿5 min Apgar评分低（OR=1.848）、VI值低（OR=1.892）、FI值低（OR=2.125）、VFI值低（OR=1.885）是胎儿窘迫发生的独立影响因素（P＜0.05）。ROC曲线结果显示，胎盘血管参数（VI、FI、VFI）联合诊断胎儿窘迫的AUC为0.915，高于缺氧评估指标（胎盘厚度、脐动脉血pH值、新生儿5 min Apgar评分）联合（AUC=0.828）诊断效能（Z=2.998，P=0.023）。结论 胎盘血管化参数VI、FI、VFI与胎儿窘迫密切相关，且联合诊断胎儿窘迫的效能高于传统缺氧评估指标联合。

对比微创拔牙与传统拔牙在下颌阻生智齿治疗中的效果及并发症概率。方法：自2023年1月至2025年9月，选取110名下颌阻生智齿患者，采用随机数字列表法，将对象均衡地分为实验组（55人）与对照组（55人）。观察组行微创拔牙术（高速涡轮手机分牙+微创牙挺），对照组行传统拔牙术（骨凿劈冠+锤击增隙）。对比两组手术时间、术后疼痛程度、张口度及术中及术后并发症发生率。结果： 观察组施行手术的时间明显短于对照组[（25.38±5.47）min vs （31.65±6.83）min，P<0.001]；术后24h及7d的VAS评分均低于对照组[（3.52±1.21）分 vs （5.87±1.56）分，（0.89±0.65）分 vs （1.95±0.91）分，均P<0.001]，张口度大于对照组（均P<0.001）。观察组术中并发症总发生率（1.82%）显著低于对照组（14.55%）（P=0.009），术后并发症总发生率（3.64%）亦显著低于对照组（20.00%）（P=0.022）。结论：相较于常规拔牙方式，下颌阻生智齿的微创手术能显著减少治疗时间，减轻术后疼痛与张口受限，并显著降低术中及术后并发症风险，疗效与安全性俱佳，具备临床推广价值。

To compare the efficacy and complication rates of minimally invasive tooth extraction versus traditional extraction in treating impacted lower wisdom teeth. Methods: From January 2023 to September 2025,110 patients with impacted lower wisdom teeth were randomly assigned to an experimental group (55 cases) and a control group (55 cases) using a random number table. The experimental group underwent minimally invasive extraction (high-speed rotary mobile phone tooth splitting + minimally invasive tooth elevator), while the control group received traditional extraction (bone chisel splitting + hammer gap widening). The study compared operative time, postoperative pain (VAS score), mouth opening degree, and intraoperative/operative complications between the two groups. Results: The experimental group showed significantly shorter operative time [(25.38±5.47) min vs (31.65±6.83) min, P<0.001]. Postoperative VAS scores at 24h and 7d were significantly lower in the experimental group [(3.52±1.21) vs (5.87±1.56) points, (0.89±0.65) vs (1.95±0.91) points, both P<0.001], with greater mouth opening degree (P<0.001). The total intraoperative complication rate (1.82%) in the experimental group was significantly lower than the control group (14.55%) (P=0.009), and the postoperative complication rate (3.64%) was also significantly lower than the control group (20.00%) (P=0.022). Conclusion: Compared with traditional tooth extraction, minimally invasive tooth extraction can effectively shorten the operation time, reduce postoperative pain and limited mouth opening, and significantly reduce the risk of intraoperative and postoperative complications. The efficacy and safety are excellent, and it has the value of clinical promotion.

目的?比较经心尖途径与股动脉途径经导管主动脉瓣植入术（TAVI）治疗重度主动脉瓣狭窄的围术期卒中发生率。方法?回顾性分析2024年1月至2026年1月于本院行TAVI治疗的98例重度主动脉瓣狭窄患者，根据手术入路分为经心尖组（n=46）和股动脉组（n=52）。比较两组患者围术期卒中发生率、30天死亡率及术后并发症。结果?经心尖组围术期卒中发生率为6.52%，高于股动脉组的1.92%（P=0.042）。多因素logistic回归分析显示，经心尖入路（OR=3.482，95%CI：1.124～10.786，P=0.030）和主动脉瓣钙化积分（OR=1.156，95%CI：1.023～1.307，P=0.020）是围术期卒中的独立危险因素。经心尖组30天死亡率（4.35% vs. 1.92%，P=0.594）与其他并发症发生率差异无统计学意义。结论?经心尖途径TAVI的围术期卒中发生率显著高于股动脉途径，术前应充分评估手术入路选择，对高危患者采取针对性预防策略。

目的?比较经心尖途径与股动脉途径经导管主动脉瓣植入术（TAVI）治疗重度主动脉瓣狭窄的围术期卒中发生率。方法?回顾性分析2024年1月至2026年1月于本院行TAVI治疗的98例重度主动脉瓣狭窄患者，根据手术入路分为经心尖组（n=46）和股动脉组（n=52）。比较两组患者围术期卒中发生率、30天死亡率及术后并发症。结果?经心尖组围术期卒中发生率为6.52%，高于股动脉组的1.92%（P=0.042）。多因素logistic回归分析显示，经心尖入路（OR=3.482，95%CI：1.124～10.786，P=0.030）和主动脉瓣钙化积分（OR=1.156，95%CI：1.023～1.307，P=0.020）是围术期卒中的独立危险因素。经心尖组30天死亡率（4.35% vs. 1.92%，P=0.594）与其他并发症发生率差异无统计学意义。结论?经心尖途径TAVI的围术期卒中发生率显著高于股动脉途径，术前应充分评估手术入路选择，对高危患者采取针对性预防策略。

目的 探讨胸腔镜辅助下经左胸小切口微创直接冠状动脉旁路移植术（MIDCAB）治疗前降支单支病变的临床效果及安全性。方法 回顾性分析2022年1月至2024年6月收治的86例前降支单支病变患者的临床资料，根据手术方式分为MIDCAB组（n=44）和经皮冠状动脉介入治疗（PCI）组（n=42）。比较两组围术期指标、并发症发生率及随访12个月的主要心脑血管不良事件（MACCE）发生率。结果 MIDCAB组手术时间长于PCI组［（178.35±25.42）min vs （72.18±15.36）min，P<0.001］，但术后靶血管再次血运重建率低于PCI组（2.27% vs 14.29%，P=0.042）。两组术后12个月MACCE发生率差异无统计学意义（4.55% vs 11.90%，P=0.213）。MIDCAB组术后24 h引流量为（285.63±98.47）mL，呼吸机使用时间为（16.35±8.42）h，住院时间为（9.23±3.18）d。结论 MIDCAB治疗前降支单支病变安全有效，具有创伤小、恢复快、远期再血运重建率低的优势，可作为前降支单支病变的优选治疗策略之一。

目的 探讨胸腔镜辅助下经左胸小切口微创直接冠状动脉旁路移植术（MIDCAB）治疗前降支单支病变的临床效果及安全性。方法 回顾性分析2022年1月至2024年6月收治的86例前降支单支病变患者的临床资料，根据手术方式分为MIDCAB组（n=44）和经皮冠状动脉介入治疗（PCI）组（n=42）。比较两组围术期指标、并发症发生率及随访12个月的主要心脑血管不良事件（MACCE）发生率。结果 MIDCAB组手术时间长于PCI组［（178.35±25.42）min vs （72.18±15.36）min，P<0.001］，但术后靶血管再次血运重建率低于PCI组（2.27% vs 14.29%，P=0.042）。两组术后12个月MACCE发生率差异无统计学意义（4.55% vs 11.90%，P=0.213）。MIDCAB组术后24 h引流量为（285.63±98.47）mL，呼吸机使用时间为（16.35±8.42）h，住院时间为（9.23±3.18）d。结论 MIDCAB治疗前降支单支病变安全有效，具有创伤小、恢复快、远期再血运重建率低的优势，可作为前降支单支病变的优选治疗策略之一。

探讨改良拔尿管方法在妇科腹腔镜术后留置尿管患者临床的影响。方法 选取2025年2月7日—2025年10 月10日我院妇科腹腔镜手术术后留置尿管患者60例为研究对象。本研究采用随机数字表法将研究对象分为对照组与观察组，两组各纳入30例。比较两组首次拔管尿路疼痛评价、首次排尿时间、患者尿潴留例数。结果 观察组首次拔尿管尿路疼痛程度显著低于对照组，两组差异有统计学意义（P<0.05）。观察组首次排尿时间显著少于对照组，两组差异有统计学意义（P<0.05）。观察两组尿潴留发生率差异无统计学意义（P>0.05）。结论 本次研究采用改良后的尿管拔除方法，虽未明显降低妇科腹腔镜术后患者的尿潴留发生率，但能有效降低拔尿管时患者的不适感 ，减少尿道损伤，缓解疼痛，加快患者自主排尿，具有积极临床实践意义。