心肌梗死是由冠状动脉阻塞所引起的心肌缺氧坏死,其发病率和病死率居高不下。近年研究发现,利用组织工程手段仿生构建心肌微环境能有效改善心肌梗死区微环境,对心肌的再生能力有着重要的调控作用,能在一定程度上促进心肌再生,有望成为将来治疗心肌梗死的新方向。然而,由于对仿生心肌微环境和机体微环境交互作用、引发的生物学效应及作用机制不清楚,直接影响心肌损伤修复的过程和质量。因此,阐明仿生心肌微环境在心肌损伤修复过程中的交互作用过程及其介导的生物学效应迫在眉睫。该文系统性综述了仿生心肌微环境的构建策略及植入体内后介导的生物学效应,包括免疫调控效应、促血管再生效应以及再生协同效应等,为新型心肌补片的仿生设计和临床应用提供理论支持。

Myocardial infarction（MI）,arising from coronary artery obstruction resulting in hypoxic necrosis of myocardium,remains high morbidity and mortality．Recent studies have revealed that constructing myocardial microenvironment bionically through tissue engineering methods can effectively ameliorate the microenvironment in the infarcted area and exert a crucial regulatory role in myocardial regeneration,which promotes myocardial regeneration to a certain extent and holds promise for the treatment of MI．However,the interaction between biomimetic myocardial microenvironment and host microenvironment,as well as the triggered biological effects and mechanisms are not clear,which directly affects the process and quality of myocardial repair．Therefore,it is urgent to clarify the interaction process and biological effects mediated by the biomimetic myocardial microenvironment during myocardial repair．This review systematically summarizes the construction strategies of biomimetic myocardial microenvironment and their mediated biological effects after implantation,including immunomodulatory effects,pro-vascular regenerative effects,and regenerative synergistic effects,which provides theoretical support for the biomimetic design and clinical application of novel cardiac patches．

本文分析了广州市南沙区某公立医院人力资源管理现状,并基于SWOT分析法探索其发展策略。研究发现,该医院的人力资源管理具有成熟的管理体系和一体化管理的实施优势,但也面临财政支持不足和人才及岗位结构不均衡的劣势。政策支持与区域医疗资源扩展为其提供了重要的机遇,但日益增长的行业竞争和人才吸引与保留的难题构成了威胁。医院应优化管理架构,加强顶层设计,改善学科和人才结构,采取一体化与差异化发展策略,以构建高效的人才队伍,提升医院竞争力。本文通过对优势、劣势、机遇和威胁的综合分析,制定了针对性的管理对策,为同类医疗机构提供了参考。

This paper analyzes the current state of human resource management（HRM）in a public hospital in Nansha District,Guangzhou,and explores development strategies based on a SWOT analysis．The study reveals that the hospital’s HRM benefits from a mature management system and the implementation of integrated management．However,it also faces challenges such as insufficient financial support and an imbalance in the structure of personnel and positions．Policy support and the expansion of regional medical resources present significant opportunities,while increasing industry competition and challenges in attracting and retaining talent pose threats．The hospital should optimize its management structure,enhance top-level design,improve the discipline and personnel structure,and adopt integrated and differentiated development strategies to build an efficient talent team and enhance its competitiveness．Through a comprehensive analysis of strengths,weaknesses,opportunities and threats,this paper formulates targeted management strategies,providing valuable references for similar medical institutions．

目的 研究同轴微导管聚乙烯醇颗粒（PVA）栓塞治疗动脉性下消化道出血患者的应用效果。方法 本研究为前瞻性研究,选择河南科技大学第一附属医院2022年1月—2023年6月收治的118例动脉性下消化道出血患者为研究对象,以计算机随机分组法将其分为常规组和试验组,各59例。两组均行数字减影血管造影检查明确出血情况,常规组予以内镜下注射止血治疗,试验组经同轴微导管PVA栓塞进行止血治疗,比较两组患者的治疗效果及预后情况。结果 在不同治疗方案下,试验组的技术成功率、临床成功率分别为89.83%（53/59）、84.75%（50/59）,均高于常规组[71.19%（42/59）、64.41%（38/59）]（χ²=11.071、10.911,P<0.05）;试验组的止血时间、凝血酶原时间（PT）、凝血酶时间（TT）分别为（50.25±10.37）min、（10.25±2.31）s、（16.33±4.47）s,均低于常规组[（55.36±10.72）min、（12.44±3.61）s、（19.35±4.23）s]（t=2.632、3.925、3.769,P<0.05）;试验组治疗后的动脉搏动指数（PI）、阻力指数（RI）分别为（1.12±0.33）（0.51±0.21）,均低于常规组[（1.65±0.41）（0.73±0.22）]（t=7.735、5.556,P<0.05）;试验组治疗7、14、30 d后的再出血率分别为5.08%（3/59）、8.47%（5/59）、10.17%（6/59）,均低于常规组[20.34%（12/59）、25.42%（15/59）、28.81%（17/59）]（χ²=10.495、10.207、11.071,P<0.05）;试验组的并发症发生率8.47%（5/59）低于常规组22.03%（13/59）,差异均具有统计学意义（χ²=7.113,P<0.05）。结论 与常规内镜下止血相比,同轴微导管PVA栓塞可显著提升动脉性下消化道出血患者的止血成功率,对缩短患者止血时间、促进凝血系统恢复、降低再出血风险及相关并发症发生风险均有积极意义。

Objective To study the effect of coaxial microcatheter PVA embolization in the treatment of patients with arterial lower gastrointestinal bleeding．Methods This study is a prospective study,118 patients with arterial lower gastrointestinal bleeding admitted between January 2022 and June 2023 were selected as the study subjects．They were randomly divided into a conventional group（59 cases）and an experimental group（59 cases）using computer randomization．Both groups underwent digital subtraction angiography examination to determine the bleeding situation．The conventional group received conventional endoscopic hemostasis treatment,while the experimental group received coaxial microcatheter PVA embolization for hemostasis treatment．The treatment efficacy and prognosis were compared between two groups．Results Under different treatment plans,the technical success rate and clinical success rate of the experimental group were 89.83%（53/59）and 84.75%（50/59）,respectively,which were higher than those of the conventional group [71.19%（42/59）and 64.41%（38/59）]（χ²=11.071、10.911,P<0.05）．The hemostatic time,PT,and TT of the experimental group were（50.25±10.37）min,（10.25±2.31）seconds,and（16.33±4.47）seconds,respectively,which were shorter than those of the conventional group [（55.36±10.72）min,（12.44±3.61）seconds,and（19.35±4.23）seconds]（t=2.632、3.925、3.769,P<0.05）．The arterial PI and RI of the experimental group after treatment were（1.12±0.33） and（0.51±0.21）,lower than those of the conventional group [（1.65±0.41）and（0.73±0.22）]（t=7.735、5.556,P<0.05）．The rebleeding rates of the experimental group after 7 days,14 days and 30 days of treatment were 5.08%（3/59）,8.47%（5/59） and 10.17%（6/59）,respectively,which were lower than those of the conventional group [20.34%（12/59）,25.42%（15/59） and 28.81%（17/59）]（χ²=10.495,10.207,11.071,P<0.05）．The incidence of complications in the experimental group was 8.47%（5/59）,which was lower than that in the conventional group 22.03%（13/59）（χ²=7.113,P<0.05）．Conclusions Compared with conventional endoscopic hemostasis,coaxial microcatheter PVA embolization can significantly improve the success rate of hemostasis in patients with arterial lower gastrointestinal bleeding,shorten the hemostasis time,promote coagulation system recovery,reduce the risk of rebleeding and related complications,with a positive significance．

目的 研究靶向NKG2A抑制剂抗头颈部鳞状细胞癌（HNSCC）的作用。方法 应用GEO和TCGA数据库分析NKG2A及其配体HLA-E单细胞表达情况、与患者预后以及免疫微环境的相关性。构建HNSCC皮下抑制瘤模型,流式细胞技术检测化学治疗（化疗）对免疫检测点NKG2A表达的影响。动物实验验证NKG2A抑制剂以及NKG2A抑制剂联合多西他赛化疗的抗肿瘤作用。结果 NKG2A（KLRC1）主要表达在NK细胞,少量表达在T淋巴细胞。HNSCC肿瘤高表达NKG2A/HLA-E（P<0.01）,与患者不良预后密切相关;肿瘤微环境中NKG2A/HLA-E与多个免疫细胞浸润以及免疫检测点表达密切相关（P<0.01）。动物实验显示化疗能上调T、B淋巴细胞表达免疫检查点NKG2A的表达水平（P<0.01）;化疗的基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用（P=0.013）。结论 化疗基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用,为探索HNSCC临床新策略提供实验和理论基础。

Objective To investigate the anti-tumor effects of NKG2A inhibitor on head and neck squamous cell carcinoma（HNSCC）．Methods The single-cell expression of NKG2A ,its ligand HLA-E and their correlations with patient prognosis and immune microenvironment were analyzed in GEO and TCGA databases．The subcutaneous tumor model of HNSCC was constructed,and the effects of chemotherapy on the expression of NKG2A on T and B lymphocytes were detected by flow cytometry．Animal experiments were used to confirmed the anti-tumor effects of NKG2A inhibitor and NKG2A inhibitors combined with docetaxel．Results NKG2A（KLRC1）was mainly expressed in NK cells,and a small amount was expressed in T lymphocytes．The high expression of NKG2A/HLA-E in HNSCC tumors（P<0.01）were closely related to poor prognosis．NKG2A/HLA-E in tumor microenvironment were closely related to the infiltration of multiple immune cells and the expression of immune checkpoints（P<0.01）．Animal experiments showed that chemotherapy could up-regulate the expression of NKG2A in T and B lymphocytes（P<0.01）．Chemotherapy in combination with NKG2A inhibitor could mediate more effective antitumor effects in HNSCC（P=0.013）．Conclusions Combined with NKG2A inhibitor on the basis of chemotherapy can mediate more effective anti-tumor effects,and this study may provide experimental and theoretical basis for exploring new clinical strategies of HNSCC．

目的 研究影响新生儿低血糖的相关危险因素。方法 回顾性分析新生儿科570例新生儿的临床资料,其中新生儿低血糖组190例,正常血糖组新生儿380例,采用Logistic回归分析新生儿低血糖相关危险因素。结果 单因素Logistic回归分析显示,新生儿体质量减轻、早产、新生儿呼吸衰竭、新生儿呼吸窘迫、新生儿感染、母亲分娩年龄增大、经产妇、剖宫产、双胎、妊娠期糖尿病、妊娠期高血压疾病是新生儿低血糖发生的危险因素（均P<0.05）;多因素Logistic回归分析显示,早产（OR=2.115,95%CI：1.186~3.772）、剖宫产（OR=6.92,95%CI：4.202~11.397）是新生儿低血糖发生的危险因素（均P<0.05）。结论 早产、剖宫产是新生儿低血糖发生的危险因素,应根据危险因素及时识别和治疗新生儿低血糖,为新生儿提供及时产后护理指导,以降低新生儿低血糖发生率。

Objective To study the relevant risk factors of neonatal hypoglycemia．Methods A retrospective analysis was conducted on the clinical data of 570 newborns in neonatal pediatrics,including 190 cases in the neonatal hypoglycemia group and 380 cases in the normal blood glucose group．Logistic regression analysis was used to analyze the risk factors related to neonatal hypoglycemia．Results Single factor Logistic regression analysis showed that neonatal weight loss,premature,neonatal respiratory failure,neonatal respiratory distress,neonatal infection,the mother’s age of delivery,multipara,cesarean section,twins,pregnancy diabetes,pregnancy hypertension were the risk factors for neonatal hypoglycemia,all of which had statistical significance（all P<0.05）．In multivariate Logistic regression analysis,premature（OR=2.115,95% CI：1.186-3.772）and cesarean section（OR=6.92,95% CI：4.202-11.397）were risk factors for neonatal hypoglycemia（both P<0.05）．Conclusions Premature and cesarean section are risk factors for the occurrence of neonatal hypoglycemia in the local area．Timely identification and treatment of neonatal hypoglycemia based on risk factors,providing timely postpartum nursing guidance for newborns,can reduce the occurrence of neonatal hypoglycemia．

全膝关节置换术（TKA）是目前治疗终末期膝关节疾病的首选方法,它能够缓解疼痛、改善畸形、恢复力线、增加膝关节活动度及提高患者生活质量。目前,关于胫骨假体旋转对线的方法很多,主要包括胫骨结节、胫骨前后轴、胫骨前皮质、自我形合技术、计算机辅助导航技术、个性化截骨技术等,它们各有优缺点,但在临床上并没有达成共识。该文主要对胫骨近端的解剖学特点和TKA中胫骨假体旋转定位的方法等方面进行综述。旨在为临床骨科医生在行TKA时,选择合适的胫骨假体旋转对线方法提供一些参考。

Total knee replacement（TKA） is currently the preferred treatment for end-stage knee disease,and it can relieve pain,improve deformity,restore strength lines,increase knee range of motion,and improve patients’ quality of life．At present,there are many methods for the rotation of alignment of tibial prosthesis,mainly including tibial tubercles,tibial anteroposterior axes,anterior tibial cortex,self-morphing technology,computer-aided navigation technology,personalized osteotomy technology,etc．Each of the methods above has its advantages and disadvantages,but there is no clinical consensus at present．This article mainly reviews the anatomical characteristics of the proximal tibia and the method of rotational positioning of tibial prosthesis in TKA,which aims to provide some reference for clinical orthopedic surgeons to select the appropriate tibial prosthesis rotation alignment method when performing TKA．

运动捕捉技术已经广泛应用于步态分析、运动康复、动作对比、技战术分析、生物运动力学分析、损伤防护、运动装备设计研发等领域,实现了人机交互的全新体验。而步行是人类运动中最基础的动作,在生物力学研究上对异常步态进行分析能够有效改善患者治疗和康复的效果。本文总结了运动捕捉技术在各种异常步态分析中的应用,并对其优缺点进行了总结与展望。检索PubMed、Embase、EBSCO、Web of Science、中国知网,收集2018年1月至2023年12月公开发表的有关有标记运动捕捉及无标记运动捕捉在异常步态的相关研究,进行系统综述。最终纳入了22篇英文文献,这些文献主要集中在神经科学、生物医学工程和临床医学等领域,特别是在步态分析、运动捕捉技术、神经病理学和康复医学等方面的应用。这些研究为我们理解和改善各种神经系统疾病,如帕金森病、多发性硬化症和脑卒中以及骨关节炎等疾病的步态提供了宝贵的见解。利用运动捕捉来进行异常步态分析能有效地给患者提供准确的康复治疗,将结果用于临床诊断、康复规划或研究目的。异常步态分析在评估肌肉骨骼状况、神经系统疾病或干预措施的有效性方面具有重要价值。

Motion capture technology has been widely used in the fields of gait analysis,sports rehabilitation,action comparison,technical and tactical analysis,biomotor mechanics analysis,injury protection,sports equipment design and development,etc.,which realizes a brand-new experience of human-computer interaction．While walking is the most basic action in human movement,the analysis of abnormal gait on biomechanical research can effectively improve the effect of patient treatment and rehabilitation．This paper summarizes the application of motion capture technology in the analysis of various abnormal gaits,and summarizes and prospects its advantages and disadvantages．PubMed,Embase,EBSCO,Web of Science and China Knowledge Network were searched to collect related studies,openly published from January 2018 to December 2023,about labeled motion capture and unlabeled motion capture in abnormal gait for systematic review．Twenty-two English-language papers were finally included,which focused on the fields of neuroscience,biomedical engineering and clinical medicine,especially in the applications of gait analysis,motion capture technology,neuropathology and rehabilitation medicine．These studies provide valuable insights into understanding and improving gait in various neurological disorders such as Parkinson’s disease,multiple sclerosis and stroke and osteoarthritis．The use of motion capture for abnormal gait analysis can be effective in providing accurate rehabilitation to patients,using the results for clinical diagnosis,rehabilitation planning,or research purposes．Abnormal gait analysis is valuable in assessing musculoskeletal conditions,neurological disorders,or the effectiveness of interventions．

目的 应用FRAX^®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX^®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX^®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX^®工具进行骨折风险评估。

Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.

目的 应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析,提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法 运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别,提取方剂组成,统计并分析方剂中中药的规律并将其结果可视化呈现。结果 最终共纳入62首方剂,包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味,频次频率最高的为桂枝;所用中药四气以温性为主,占56.74%;五味以辛、甘、苦为主,共约占90%,归经以肝肾经为主;药物功效以补虚类为主,占27.13%;关联规则分析显示提升度最高的组合为麻黄-独活,置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝,支持度最高的组合为川芎-当归、川芎-杜仲;通过聚类分析得到3个聚类结果。结论 《圣济总录》治疗腰痛病方面善用通法和补法,强调活血通络,补益肝肾,尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。

Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu,and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain．Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu,extract the composition of the prescription,and analyze the rules of Chinese medicine in the prescription to visually present the results．Results A total of 62 prescriptions were included,including 86 drugs．Among them,with there were 20 kinds of drugs,the frequency of use ≥7 times,the frequency ≥1.6%,and cmnamomi Mmulus highest frequency．Four gas used in traditional Chinese medicine is given priority to with warm,accounted for 56.74%．The five flavors were mainly pungent,sweet and bitter,accounting for about 90%,and the liver and kidney meridians were the main meridians．The drug efficacy was mainly deficiency tonic,accounting for 27.13%．The association rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix,the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix,Pharbitidis Semen- Achyranthis Bidentatae Radix．and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix,Chuanxiong Rhizoma- Eucommiae Cortex．Three clustering result is obtained by cluster analysis．Conclusions In the treatment of low back pain,Shengji Zonglu is good at using both blocking methods and reinforcing methods,emphasizing circulating blood and unblocking meridians supplementing liver and kidney,especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold．

目的 分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法 2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA）,非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果 3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积（AUC）为0.802,优于AL评估（AUC=0.764）。结论 高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。

Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area．Methods In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening．Distance uncorrected visual acuity（UCVA）,astigmatism and its axis position,equivalent spherical（SE）,axial length（AL）,corneal radius（CR）,and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00. Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively．The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation,which had an AUC of 0.764．Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．