目的   探讨肌骨超声（MSUS）在慢性肌肉骨骼疼痛（CMP）康复精准化教学中的应用效果。方法   选取在广州市第一人民医院南沙医院康复医学科实习的43名大专及本科学生，对照组进行常规CMP康复精准化教学，MSUS组在常规教学基础上增加MSUS辅助教学。实习结束后，通过专业理论考试和实践考核观察教学效果，并以问卷调查学生对教学形式和效果的满意度。结果  MSUS组的理论考核成绩为（84.62±5.14）分，对照组为（81.45±6.21）分，两组间差异无统计学意义（P＞0.05）。MSUS组的实践考核成绩（4.71±1.06）分高于对照组（3.64±1.14）分（P＜0.05）。问卷调查显示，MSUS组学生的总体满意度（35.24±3.43）高于对照组（32.64±3.98），P＜0.05。其中，对于教学方法的满意度，MSUS组（9.81±0.60）高于对照组（8.82±1.18）（P＜0.05）；对于综合分析与实践能力的满意度，MSUS组（7.43±1.91）高于对照组（6.18±1.62）（P＜0.05）。结论  MSUS教学在夯实学生专业基础知识、深化临床实践、提高综合分析能力和学习积极性方面具有显著优势，为精准化康复教学提供了有效手段。

       Objective  To explore the application effect of musculoskeletal ultrasound（MSUS）in the precise teaching of chronic musculoskeletal pain（CMP）rehabilitation．Methods  Forty-three college and undergraduate  students interning in Rehabilitation Medicine Department of Nansha Hospital，Guangzhou First People’s Hospital were selected，control group conducted conventional CMP rehabilitation teaching，and the MSUS group  received additional MSUS-assisted teaching on the basis of the conventional teaching．After the internship，the teaching effectiveness was observed through professional theoretical examinations and practical assessments，and a questionnaire survey was conducted to evaluate students’satisfaction with the teaching methods and outcomes．Results  The theoretical assessment score of the MSUS group were（84.62±5.14）and（81.45±6.21）of the control group，there was no difference between the two groups（P＞0.05）．The practical assessment scores of the MSUS group（4.71±1.06）were higher than those of the control group（3.64±1.14），and a significant difference was found between the two groups（P＜0.05）．The questionnaire survey showed that the overall satisfaction of the MSUS group students（35.24±3.43）was higher than that of the control group（32.64±3.97）（P＜0.05）．Among them，satisfaction with the teaching method was higher in the MSUS group（9.81±0.60）than in the control group（8.82±1.18）（P＜0.05），satisfaction with comprehensive analysis and practical ability was also higher in the MSUS group（7.43±1.91）than in the control group（6.18±1.62）（P＜0.05）．Conclusions  MSUS teaching has significant advantages in consolidating students’basic professional knowledge，deepening clinical practice，improving comprehensive analysis ability and learning enthusiasm．It provides an effective means for precise rehabilitation teaching．

       目的   通过对压疮不同治疗方式的分析，探讨疾病诊断相关分组（DRG）组合的特征，提高核心疾病诊断相关组（ADRG）的入组率和提升相对权重值，从而提升医疗服务效率和水平。方法   使用医院DRGs分析评价系统以及EXCEL软件筛选出2023—2024年广州市第一人民医院主要诊断压疮疾病病例，分析ADRG组合的特征。结果   根据压疮疾病不同治疗方式，主要诊断为压疮（L89）的176病例进入相对的外科治疗组和内科治疗组，ADRG组分别为JD1组合、JJ1组合、JV1组合。JJ1组合治疗方案以创面封闭式负压引流为主；JD1组合的外科治疗方式均是以皮肤和皮下坏死组织的切除清创术+创面封闭式负压引流术（VSD）的手术治疗方案。JD13组、JD15组比JJ13组、JJ15组，相对权重分别高2.35和1.48。26例患者的住院时间均超过60 d，导致进入了QY组合。结论   利用好DRGs工具能有效地提高压疮的入组率，结合精细化的首页质量管理，提升DRGs的组合权重值及医疗服务效率和水平。

       Objective  To analyze  different treatment methods for  pressure  ulcers and explore the characteristics of Diagnosis-Related Groups（DRGs）to improve the admission rate of Adjacent DRGs（ADRGs）and enhance the  relative weight value，thereby improving the efficiency and level of medical services．Methods  Using the DRGs management system and EXCEL software，cases of pressure ulcer disease from Class A tertiary hospital in Guangzhou from 2023 to 2024 were selected，with pressure ulcers as the primary diagnosis，and analyzed the characteristics of ADRG combinations．Results  Based on different treatment methods for pressure ulcers，176 cases primarily diagnosed with pressure ulcers（L89）were categorized into  relative surgical and medical treatment groups，with ADRG groups being JD1，JJ1，and JV1 combinations．The JJ1 group’s treatment plan primarily focused on closed wound negative pressure drainage，the surgical treatment method for JD1 group involved skin and subcutaneous necrotic tissue excision and debridement surgery combined with closed wound negative pressure drainage（VSD）．The  relative weights of JD13 and JD15 groups were 2.35 and 1.48，higher than those of JJ13 and JJ15 groups．Twenty-six cases had an average hospital stay exceeding 60 days，leading to their categorization into the QY group．Conclusions  Utilizing the DRG tool effectively improves the admission rate for pressure ulcer diseases．By combining it with refined quality management on the first page of medical records，the combination weight value of DRGs and the efficiency and level of medical services can be enhanced．

       目的   研究小儿面颈部皮下良性肿物的影像学特点及经头皮区域或腋窝软组织腔镜微创治疗小儿头颈部皮下良性肿物的可行性、临床疗效及安全性。方法   回顾分析2024年1月—2024年8月在广州医科大学附属妇女儿童医疗中心治疗的24例小儿面颈部皮下肿物的病例，患儿年龄为1~5岁，平均年龄1.5岁，其中男15例、女9例；分别为甲状舌管囊肿10例，鳃裂瘘5例，前额皮下肿物5例，颈淋巴结增大3例，颈部皮下肿物1例。分析其影像学特点（超声及CT检查），制定了经头皮区域软组织腔镜微创治疗前额皮下肿物和颈淋巴结活组织检查（活检）或经腋窝软组织腔镜微创治疗甲状舌管囊肿和鳃裂瘘。结果  24例小儿面颈部皮下良性肿物的共同影像学特点是位于浅层，边界清晰，圆形或者椭圆形，对周围组织轻度压迫，无侵犯。所有病例均顺利完成微创手术，出血少，无手术并发症，术后恢复好。术后病理检查均提示良性肿物，面部及颈部均无手术瘢痕。结论   小儿面颈部皮下良性肿瘤的影像学特点是位于浅层，边界清晰。经头皮区域和腋窝软组织腔镜微创治疗小儿面颈部肿物效果确切、安全性高、美观。

       Objective  To  study the imaging characteristics of  subcutaneous  benign tumors in the face and  neck of children，as well as the feasibility，efficacy，and safety of minimally invasive treatment of subcutaneous benign tumors in the head and neck of children through hair area or axillary soft tissue endoscopy．Methods  A  retrospective analysis was conducted on 24 cases of subcutaneous tumors in the face and neck of children treated in our hospital from January to August 2024．Age  range was 1-5 years old，with an average of 1.5 years old．There were 15 boys and 9 girls．There were 10 cases of thyroglossal duct cyst，5 cases of branchial fistula，5 cases of subcutaneous mass on the forehead，3 cases of enlarged cervical lymph nodes，and 1 case of subcutaneous mass on the neck．Imaging characteristics（ultrasound and CT examination）and minimally invasive treatment effects were analyzed，to determine the procedure of minimally invasive treatment of subcutaneous tumors in the forehead and cervical lymph node biopsy by soft tissue endoscopy in the scalp area，and minimally invasive treatment of thyroglossal duct cysts and branchial fistulas through axillary by soft tissue endoscopy．Results  The imaging characteristics of subcutaneous benign tumors in children’s face and neck were located in the shallow layer，with clear boundaries，round or oval shapes，mild compression of surrounding tissues，and no invasion．All cases successfully underwent minimally invasive surgery with minimal bleeding，no  surgical complications，and good postoperative recovery．Postoperative pathological examination confirmed as benign masses．There were no surgical scars on the face and neck．Conclusions  The imaging characteristics of subcutaneous benign tumors in children’s face and neck are located in the shallow layer with clear boundaries．Minimally invasive endoscopic treatment of pediatric face and neck tumors through the scalp area and axillary soft tissue is effective，safe，and aesthetically pleasing．

     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．

       非自杀性自伤行为（NSSI）是指个体在没有自杀意图的情况下，故意对自己身体进行伤害的行为。近年来，NSSI在全球范围内整体呈上升趋势，尤其在青少年群体中日益普遍，这与青少年的年龄特点、心理及生物学特征、社会压力等因素密切相关。有研究表明，NSSI是自杀行为的独立危险因素，不仅对青少年健康造成严重影响，也给家庭和社会带来了沉重的负担。因此，本文通过系统回顾NSSI相关文献，阐述其流行病学现况、影响因素和干预措施，旨在为早期识别高危人群、预防青少年NSSI行为的发生以及制定相应的干预策略提供科学依据。

       Non-suicidal self-injury（NSSI）is the behavior in which an individual intentionally inflicts harm on his or her own body without suicidal intent．In recent years，NSSI has been on the rise globally，especially among adolescents，which is closely related to the age characteristics，psychological and biological characteristics，and social pressure．Some studies have shown that NSSI is an independent risk factor for suicidal behavior，which not only poses a serious impact on the health of adolescents，but also imposes a heavy burden on families and society．Therefore，this article systematically reviews relevant literatures on NSSI，mainly elaborating the epidemiological status，influencing factors and interventions．We aim to provide a scientific basis for the early identification of high-risk populations，the prevention of NSSI in adolescents and the development of corresponding intervention strategies

更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院（广州市第一人民医院）基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。

How to better protect the occupational safety and health of medical personnel is a topic of great concern．This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard．It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital．

目的 探讨长链非编码核糖核酸肺腺癌转移相关转录本 1（LncMALAT1）通过竞争性结合微小RNA-506-3p（miR-506-3p）调控Zeste同源物增强子2（EZH2）影响膀胱癌增殖的机制。方法 收集2023年1月—2024年10月的92例外科手术切除的膀胱癌组织及对应的癌旁组织标本, 利用Western blot和定量实时逆转录聚合酶链式反应（qRT-PCR）方法检测LncMALAT1和EZH2的表达情况。根据患者预后分为不良组（n=34）和良好组（n=58）, 收集患者的性别、年龄、肿瘤直径、血管侵袭情况、TNM分期、远处转移情况等临床指标, 结合临床病理指标分析LncMALAT1和EZH2与膀胱癌患者预后的关系。通过体外实验,包括qRT-PCR、Western blot、平板克隆和EdU实验,验证LncMALAT1对EZH2表达和膀胱癌细胞增殖的影响。利用生物信息学技术预测LncMALAT1与miR-506-3p的相互作用,并通过qRT-PCR验证在膀胱癌细胞中上调LncMALAT1表达后miR-506-3p的表达变化。结果 单因素结果显示, 血管侵袭情况、TNM分期、远处转移情况、LncMALAT1及EZH2表达水平均与膀胱癌患者预后不良有关, 差异有统计学意义（均P<0.05）。分析结果发现LncMALAT1与EZH2在膀胱癌组织中的表达呈正相关。体外实验结果显示, 上调LncMALAT1表达后, EZH2的表达显著上调, 且膀胱癌细胞的增殖能力显著提高（均P<0.05）。qRT-PCR验证表明,上调LncMALAT1表达后,miR-506-3p的表达显著下调（P<0.05）, 提示LncMALAT1通过竞争性结合miR-506-3p调控EZH2,进而影响膀胱癌细胞的增殖进展。结论 LncMALAT1通过竞争性结合miR-506-3p调控EZH2促进膀胱癌增殖功能,进而加快膀胱癌细胞的增殖进展, 可为膀胱癌的治疗提供新的潜在靶点。

Objective To explore the mechanism of long non-coding ribonucleic acid metastasis - associated lung adenocarcinoma transcript 1（LncMALAT1）regulating enhancer of Zeste homolog 2（EZH2）through competitive combination with microRNA-506-3p（miR-506-3p）to affect the proliferation of bladder cancer．Methods A total of 92 pairs of bladder cancer tissues and corresponding adjacent normal tissues were collected from surgical resections between January 2023 and October 2024．The expression levels of LncMALAT1 and EZH2 were detected using Western blot and qRT-PCR．The patients were divided into poor group（n=34）and good group（n=58）according to their prognosis．Clinical data, such as gender, age, tumor diameter, vascular invasion, TNM stage, and distant metastasis were collected, and the relationship between LncMALAT1 and EZH2 and the prognosis of bladder cancer patients was analyzed with clinical pathological indicators．Through in vitro experiments, including qRT-PCR Western blot, plate cloning and EdU experiment were conducted to verify the effect of LncMALAT1 on EZH2 expression and bladder cancer cell proliferation．Bioinformatics technology was used to predict the interaction between LncMALAT1 and miR-506-3p, and qRT-PCR was used to verify the change of miR-506-3p expression after up regulating LncMALAT1 expression in bladder cancer cells．Results The univariate results showed that vascular invasion, TNM stage, distant metastasis, LncMALAT1 and EZH2 expression levels were related to the poor prognosis of bladder cancer patients, and the difference was statistically significant（all P<0.05）．The results showed that the expression of LncMALAT1 and EZH2 in bladder cancer was positively correlated．In vitro experiment results showed that after up regulating LncMALAT1 expression, EZH2 expression was significantly up-regulated, and the proliferation ability of bladder cancer cells was significantly improved（all P<0.05）．QRT-PCR validation showed that the expression of miR-506-3p was significantly down regulated after the expression of LncMALAT1 was up-regulated（P<0.05）, suggesting that LncMALAT1 could regulate EZH2 through competitive combination with miR-506-3p, thereby affecting the proliferation and progression of bladder cancer cells．Conclusions LncMALAT1 can promote the proliferation of bladder cancer cells by competitively combining with miR-506-3p to regulate EZH2, and then accelerate the proliferation of bladder cancer cells, which can provide a new potential target for the treatment of bladder cancer．

目的 研究胸腰椎骨质疏松性椎体压缩性骨折（OVCF）经皮椎体成形术（PVP）后腰背部疼痛缓解情况与骨水泥弥散分布的相关性。方法 选取2021年1月—2023年12月金沙县中医医院和毕节市第三人民医院185例因骨质疏松症导致的胸腰椎OVCF行PVP后的患者,根据术后胸腰椎正侧位X线片显示的骨水泥分布情况分为两组：骨水泥分布充分组（n=101例）和骨水泥分布不良组（n=84）, 两组均行PVP, 均行双侧穿刺入路。统计分析两组患者术前、术后及术后1周、3个月、6个月视觉模拟评分（VAS）、患者起床时间等情况。结果 185例患者术后随访半年, 骨水泥分布充分组101例, 骨水泥分布不良组84 例, 两组术后VAS评分均较前缓解（P<0.05）, 术后及术后1周、3个月、6个月的随访中分布充分组VAS评分分别为（7.17±0.76）（2.11±1.04）（1.4±0.78）（0.36±0.58）（0.05±0.22）分, 优于分布不良组（7.14±0.79）（2.37±0.79）（1.89±0.82）（0.68±0.76）（0.25±0.62）分（P<0.05）。结论 骨水泥的分布在一定程度上决定了PVP后患者腰背部残余痛的程度。尤其是骨水泥在椎体内均匀分布时, 可降低术后腰背疼痛的发生率。

Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty（PVP）of thoracolumbar osteoporotic vertebral compression fracture（OVCF）．Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City．Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation, they were divided into the group with adequate bone cement distribution（n=101 cases）and the group with poor bone cement distribution（n=84）．Both groups underwent PVP and bilateral puncture approaches．The Visual Analogue Scale（VAS）scores of the two groups of patients before the operation, after the operation, 1 week, 3 months, and 6 months after the operation, as well as the leaving bed time of the patients,were statistically analyzed．Results A total of 185 patients were followed up for half a year after the operation．There were 101 cases in the group with adequate bone cement distribution, and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients（P>0.05）, and the postoperative VAS scores of both groups were decreased compared with those before operation（P<0.05）．The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week, 3 months, and 6 months after the operation were（7.17±0.76）,（2.11±1.04）,（1.4±0.78）,（0.36±0.58） ,and（0.05±0.22）, respectively,better than the poor distribution group （7.14±0.79）,（2.37±0.79）,（1.89±0.82）,（0.68±0.76）,（0.25±0.62）, P<0.05．Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP．Especially when the bone cement is evenly distributed within the vertebral body, the incidence of postoperative low back pain can be reduced．

目的 探讨产时超声管理妊娠期糖尿病产妇产程的应用价值。方法 选择2022年1月1日—2023年12月31日在佛山市高明区人民医院妇产科分娩的妊娠期糖尿病初产妇共100例。患者签署知情同意书后, 按照1∶1比例采用随机数字表法分为对照组和研究组各50例。对照组采用阴道指诊检查判断产程和分娩方式。研究组采用经腹联合会阴超声测量检查判断产程及分娩方式。收集两组初产妇血糖、血常规、分娩方式、产后24 h出血量以及切口情况, 新生儿Apgar评分。结果 研究组阴道分娩率高于对照组（88.0% vs 72.0%, P<0.05）, 而阴道检查次数（4.18±0.8 vs 6.82±0.8, P<0.05）少于对照组、不良事件发生率（4% vs 16%, P<0.05）低于对照组。相对于对照组,研究组血红蛋白水平较高（104.10±5.25 vs 100.30±4.78, P<0.05）、而白细胞计数（11.40±1.49 vs 12.04±1.66, P<0.05）以及中性粒细胞百分比较低（72.79±4.04 vs 75.01±5.53, P<0.05）。结论 通过产时超声监测判断妊娠期糖尿病初产妇产程,能够降低阴道操作引起的感染等风险,提高阴道分娩率,有效降低产妇感染,提高产妇分娩满意度以及舒适度,改善母婴结局。

Objective To explore the application value of intrapartum ultrasound for labor management of pregnant women with gestational diabetes mellitus．Methods A total of 100 primiparous women with gestational diabetes mellitus who gave birth in the Obstetrics and Gynecology Department of Foshan Gaoming District People’s Hospital from January 1, 2022 to December 31, 2023 were selected．After signing the informed consent form, the patients were randomly divided into a control group and a study group with 50 cases in each group according to a ratio of 1∶1, using a random number table method．The control group underwent vaginal digital examination to assess the labor process and delivery method．For the study group, the labor process and delivery mode were determined using transabdominal ultrasound measurement．Blood glucose level,routine blood test results, delivery methods, 24-hour postpartum bleeding volume and incision conditions of two groups of primiparas, as well as the Apgar score of newborns were collected．Results The study group demonstrated a significantly higher vaginal delivery rate than the control group（88.0% vs 72.0%, P<0.05）, with fewer vaginal examinations（4.18±0.80 vs 6.82±0.80, P<0.05）and a lower incidence of adverse events（4% vs 16%, P<0.05）．Compared to the control group, the study group exhibited higher hemoglobin levels（[104.10±5.25]g/L vs [100.30±4.78] g/L, P<0.05）, but lower white blood cell counts（[11.40±1.49]×109/L vs [12.04±1.66]×109/L, P<0.05）and reduced neutrophil percentages（[72.79±4.04]% vs [75.01±5.53]%, P<0.05）．Conclusions Intrapartum ultrasound monitoring for assessing labor progression in primiparas with gestational diabetes mellitus reduces infection risks associated with vaginal procedures, increases vaginal delivery rates, effectively decreases maternal infections, enhances maternal satisfaction and comfort during delivery,and improves maternal-neonatal outcomes．

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．