比较恩那度司他片与罗沙司他胶囊治疗肾性贫血的临床疗效与安全性。 方法 采用前瞻性队列研究设计，选取2025年1月-2025年12月就诊于我院肾内科使用恩那度司他片与罗沙司他胶囊的非透析肾性贫血患者，比较两者治疗4周后红细胞计数（RBC）、血红蛋白（Hb）、红细胞压积（HCT）水平。通过JADER数据库调取与恩那度司他和罗沙司他相关的药物不良事件（ADE）报告，采用报告比值比法（ROR）和比例报告比值法（PRR）进行信号挖掘，对比分析两者的不良事件信号。 结果 共纳入恩那度司他组18例、罗沙司他组27例。治疗4周后，恩那度司他组Hb、RBC、HCT水平均较治疗前显著升高（P＜0.05），两组间治疗后Hb、RBC、HCT水平比较差异无统计学意义（P＞0.05）。JADER数据库共提取恩那度司他相关ADE报告65例，挖掘得到13个阳性信号；罗沙司他相关ADE报告3542例，挖掘得到135个阳性信号。两组重叠信号11个，主要为血栓栓塞事件（深静脉血栓形成、肺栓塞、分流道阻塞等）和代谢异常（高钾血症）。恩那度司他组检出的高血压（5例，ROR=8.63）未在罗沙司他组中出现。 结论 恩那度司他治疗肾性贫血疗效确切，与罗沙司他疗效相当。安全性方面，恩那度司他相关的血栓事件、高钾血症等信号需引起关注，同时需动态监测血压水平。

To compare the clinical efficacy and safety of Enarodustat Tablets and Roxadustat Capsules in the treatment of renal anemia. METHODS A prospective cohort study design was used to select patients with non-dialysis renal anemia who were treated with Enarodustat Tablets and Roxadustat Capsules in the Department of Nephrology of our hospital from January 2025 to December 2025. The levels of Red Blood Cell count ( RBC ), Hemoglobin ( Hb ) and Hematocrit ( HCT ) were compared between the two groups after 4 weeks of treatment. The adverse drug events ( ADE ) reports related to Enarodustat and Roxadustat were retrieved from the JADER database. The report odds ratio method ( ROR ) and the proportional report ratio method ( PRR ) were used for signal mining, and the adverse event signals of the two were compared and analyzed.RESULTS A total of 18 cases in the Enarodustat group and 27 cases in the Roxadustat group were included. After 4 weeks of treatment, the levels of Hb, RBC and HCT in the Enarodustat group were significantly higher than those before treatment ( P < 0.05 ),and there was no significant difference in Hb, RBC and HCT levels between the two groups after treatment ( P > 0.05 ). A total of 65 ADE reports related to Enarodustat were extracted from JADER database, and 13 positive signals were mined. A total of 3542 cases of Roxadustat-related ADE were reported, and 135 positive signals were mined. There were 11 overlapping signals in the two groups, mainly thromboembolic events ( deep vein thrombosis, pulmonary embolism, shunt obstruction, etc. ) and metabolic abnormalities ( hyperkalemia ). Hypertension ( 5 cases, ROR = 8.63 ) was not detected in the Roxadustat group.CONCLUSION Enarodustat is effective in the treatment of renal anemia, which is equivalent to Roxadustat. In terms of safety, signals such as thrombotic events and hyperkalemia related to Enarodustat need to be paid attention to, and blood pressure levels need to be dynamically monitored.

目的 探讨桑白皮汤加减辅助常规西药治疗痰热郁肺型保留比率的肺功能减损（PRISm）患者的治疗效果，并分析其对中医证候积分、肺功能、气道阻力、免疫功能的影响。方法 选取2024年6月～2025年6月于本院诊治的88例PRISm患者为研究对象，按照随机数字表法将其分为对照组（常规西药治疗）、研究组（桑白皮汤加减联合常规西药治疗），各44例。比较两组临床疗效、不良反应及治疗前后中医证候积分、慢阻肺评估测试（CAT）量表、改良版英国医学研究委员会呼吸困难问卷（mMRC）、吸入支气管扩张剂后检测肺功能、肺弥散功能[一氧化碳弥散量占预计值百分比（DLCO%pred）、残气量/肺总量（RV/TLC）]、气道阻力[抗阻指数（R5-20）、共振频率（Fres）、呼吸总阻抗（Zrs）]、炎症指标[白细胞介素-6（IL-6）、可溶性细胞间黏附分子-1（sICAM-1）、单核细胞趋化蛋白-1（MCP-1）、嗜酸性粒细胞（EOS）、肿瘤坏死因子-α（TNF-α）]、气道重塑[基质金属蛋白酶-2（MMP-2）、缺氧诱导因子-1α（HIF-1α）、转化生长因子-β1（TGF-β1）、碱性成纤维细胞生长因子（bFGF）]、T淋巴细胞亚群水平。结果 研究组总有效率高于对照组（P＜0.05）；治疗后，与对照组比较，研究组中医证候积分、CAT评分、mMRC评分级RV/TLC降低，FEV1、FEV1/FVC、FEV1%pred、VC%pred、DLCO%pred升高（P＜0.05）；治疗后，与对照组比较，研究组R5-20、Fres、Zrs降低（P＜0.05）；治疗后，与对照组比较，研究组血清IL-6、sICAM-1、MCP-1、EOS、TNF-α及MMP-2、HIF-1α、TGF-β1、bFGF水平降低（P＜0.05）；治疗后，与对照组比较，研究组CD3+、CD4+、CD4+/CD8+水平升高（P＜0.05）；两组不良反应比较无明显差异（P＞0.05）。结论 桑白皮汤加减辅助常规西药治疗PRISm患者的疗效显著，可改善临床症状、肺功能，提高生活质量，降低气道阻力，并可减轻炎症反应，缓解气道重塑，增强机体免疫功能，且具有一定安全性。

目的 修订肺癌患者联合药物治疗间歇期症状评估问卷，并评价其信效度。方法 以中文版安德森症状评估量表及肺癌特异性模块为基础，经文献分析、专家会议和认知性访谈形成测试版问卷。于2023年10-12月便利选取福州、莆田2所三级甲等医院278例肺癌患者进行调查，评价其信效度及偏倚风险。结果 修订后问卷含7个症状系统、60个条目，跳转式作答后实际作答21个条目。总问卷Cronbach's α系数为0.856，各维度为0.639～0.747；内容效度指数为0.81。验证性因子分析显示模型拟合尚可（χ2/df=2.366，RMSEA=0.070，CFI=0.858），各维度因子载荷、组合信度及平均方差提取量均达到可接受标准，区分效度良好。COSMIN-RoB评价结果为良好。结论 该问卷信效度良好，可用于评估肺癌患者联合药物治疗间歇期症状严重程度。

Objective To revise the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and evaluate its reliability and validity. Methods Based on the Chinese version of the M. D. Anderson Symptom Inventory and its lung cancer-specific module, a preliminary questionnaire was developed through literature review, expert panel discussions, and cognitive interviews. From October to December 2023, a convenience sample of 278 lung cancer patients was recruited from two tertiary hospitals in Fuzhou and Putian, China. Reliability, validity, and risk of bias were evaluated. Results The revised questionnaire comprised seven symptom-system domains and 60 items, with 21 items completed through a skip-logic design. The overall Cronbach's α coefficient was 0.856, and the coefficients for each domain ranged from 0.639 to 0.747. The content validity index of the questionnaire was 0.81. Confirmatory factor analysis demonstrated an acceptable model fit (χ2/df = 2.366, RMSEA = 0.070, CFI = 0.858). Factor loadings, composite reliability, and average variance extracted of all domains met acceptable standards, indicating good discriminant validity. The overall risk of bias was rated as good according to the COSMIN Risk of Bias checklist. Conclusion The revised questionnaire demonstrated satisfactory reliability and validity and can be used to assess symptom severity in lung cancer patients during combined drug therapy intervals.

目的 探讨改良后本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面的变化。方法 2018年9月-2019年9月选取四川大学华西医院2017级临床医学和口腔医学五年制本科生共30名，以及3名授课教师作为研究对象，将既往版、现行版以及改良版教学质量评价量表应用课堂，并采用问卷调查方法对其进行分析评估。评估经改良后的教学质量评价表在及时性、有效性和易用性方面的变化差异。结果 共计向研究对象发放99份教学质量评价量表和33份调查问卷，回收率为100%。针对授课教师能及时获取教学质量反馈，教师认为课后评教工具的最佳评价时机为课后当天晚上12点前（33.3%）或课后24小时内（66.7%），高于课后立即评价（0%）和期末评价（0%）。对三个版本教学评价表问卷调查结果显示，改良版教学评价量表的时效性、有效性和易用性为优的比例分别为86.67%，60%和76.67%，均高于现行版的43.33%，60%和46.67%，同时均高于既往版的23.33%，23.33%和36.67%，差异有统计学意义（P＜0.05）。结论 改良后的本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面均得以显著提高。通过不断优化量表设计和评价指标，可以提高教学质量评价的科学性和准确性。

Objective: To investigate the changes in timeliness, validity, and usability of the modified classroom teaching evaluation scale for undergraduate clinical medical education. Methods: From September 2018 to September 2019, a cohort comprising 30 fifth-year undergraduate students majoring in clinical medicine and stomatology from West China Hospital, Sichuan University, along with three faculty instructors, was enrolled. Three versions of teaching evaluation scales (historical, current, and modified) were implemented in classroom settings, followed by questionnaire-based comparative analyses. The revised scale was systematically assessed for improvements in feedback timeliness, measurement validity, and operational usability. Results: A total of 99 evaluation forms and 33 questionnaires were distributed, with a 100% response rate. Regarding timely feedback acquisition, faculty preferred receiving evaluations by midnight on the teaching day (33.3%) or within 24 hours post-class (66.7%), outperforming immediate

目的 分析槐花散合桃花汤联合FP（顺铂、5-氟尿嘧啶）化疗方案治疗寒热错杂型晚期食管癌患者的效果。方法 选取我院2023年1月～2024年8月寒热错杂型晚期食管癌患者98例，依照随机数字表法分为两组，各49例。对照组接受FP化疗方案治疗，观察组接受槐花散合桃花汤联合FP化疗方案治疗。比较两组多维度疗效[西医疗效（疾病控制率）、中医疗效]、治疗前后中医证候积分（TCMSS）、肿瘤标志物[鳞状细胞癌抗原（SCC-Ag）、癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）]、生活质量[食管癌生命质量测定量表（QLICP-ES）]、毒副反应、1年生存率。结果 观察组中医疗效（89.80%）较对照组（65.31%）高（P＜0.05），而两组疾病控制率比较无明显差异（P＞0.05）；观察组TCMSS低于对照组（P＜0.05）；治疗后，观察组CEA、CYFRA21-1、SCC-Ag水平低于对照组（P＜0.05）；治疗后，观察组QLICP-ES评分低于对照组（P＜0.05）；观察组恶心呕吐、消化系出血、脱发发生率较对照组低（P＜0.05）；两组1年生存率对比无明显差异（P＞0.05）。结论 槐花散合桃花汤联合FP化疗方案治疗寒热错杂型晚期食管癌，能提高中医疗效，降低患者肿瘤标志物水平，减轻毒副反应，改善中医症状，并有助于减轻化疗对生活质量的负面影响。

Objective To analyze the efficacy of Huaihua San and Taohua Decoction combined with FP (cisplatin, 5-fluorouracil) chemotherapy regimen in the treatment of patients with advanced esophageal cancer of intermingled cold-heat syndrome type. Methods A total of 98 patients with advanced esophageal cancer complicated with intermingled cold-heat syndrome admitted to our hospital from January 2023 to August 2024 were enrolled and divided into two groups by the random number table method, with 49 cases in each group. The control group was treated with FP chemotherapy regimen, and the observation group was treated with Huaihua San and Taohua Decoction combined with FP chemotherapy. Multi-dimensional efficacy indicators [western medicine efficacy (disease control rate) and traditional Chinese medicine (TCM) efficacy], as well as the TCM syndrome score (TCMSS), tumor markers [squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1)], quality of life [quality of life instrument for cancer patients-esophageal cancer scale (QLICP-ES)] before and after treatment, adverse reactions and 1-year survival rate were compared between the two groups. Results The TCM efficacy rate of the observation group was 89.80%, which was significantly higher than 65.31% of the control group (P<0.05), no significant difference was found in disease control rate between the two groups (P>0.05). The TCMSS of the observation group was lower than that of the control group (P<0.05). After treatment, the levels of CEA, CYFRA21-1 and SCC-Ag in the observation group were lower than those in the control group (P<0.05). The QLICP-ES score of the observation group was superior to the control group after treatment (P<0.05). The incidences of nausea and vomiting, digestive tract hemorrhage and alopecia in the observation group were markedly lower (P<0.05). There was no statistical difference in 1-year survival rate between the two groups (P>0.05). Conclusion The regimen of Huaihua San and Taohua Decoction combined with FP chemotherapy for advanced esophageal cancer of intermingled cold-heat syndrome can improve TCM therapeutic efficacy, reduce the levels of tumor markers, alleviate toxic and side effects, ameliorate TCM symptoms, and lessen the negative impact of chemotherapy on patients quality of life.

       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者，随机平均分为两组。行常规对症支持治疗的为对照组；在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组；两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标（CD₃⁺  、CD₄⁺、CD₈⁺  、CD₄⁺ /CD₈⁺ ）较治疗前均有明显改善；干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果，提高生活质量和免疫功能，减少不良反应。

       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy．Methods  From June 2023 to June 2025，80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups．The patients who received routine symptomatic supportive treatment were enrolled as the control group．The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group．The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment．Adverse reactions were detected on the day before treatment，theseventh day and 14th day during treatment．Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment．Adverse  reactions occurred less in the intervention group than in the control group．Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer，improve the quality of life and immune function，reduce adverse reactions．

目的 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系, 并应用于临床,为急诊脑出血患者护理质量管理、监测与评价提供客观、科学的参考依据。方法 通过文献查阅、筛查与评价, 提取可行性资料, 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系的框架, 并采用德尔菲法完成两轮专家函询,确定最终的指标体系。选择2021年1月—2024年1月本院收治的230例急诊脑出血患者为研究对象, 将2021年1月—2022年6月作为干预前监测节点,该阶段的165例患者为传统组, 实施常规的护理质量管理;将2022年7月—2024年1月作为干预后监测节点,该阶段的165例患者为观察组, 实施以急诊脑出血患者护理质量评价指标进行护理质量监测管理。结果 两轮函询中专家积极系数分别为95%和100%, 意见提出率分别为56.25%和35.54%; 两轮函询专家权威系数为0.945、0.893; 第1轮函询中各项指标变异系数（CV）均值为0~0.136, Kendall’s W协调系数为0.065; 第2轮函询中变异系数（CV）均值为0~0.110, Kendall’s W协调系数为0.186。最终形成的急诊脑出血患者护理质量评价体系共涵盖一级指标3个、二级指标11个、三级指标55个。观察组入院-用药时间合格率、吞咽障碍患者动态评估率、气道管理合格率、早期被动/主动活动落实率高于传统组,差异具有统计学意义（χ²=14.850、12.261、8.183、37.420, P<0.05）, 观察组患者满意度明显高于传统组（χ²=14.049, P<0.001）。结论 本研究构建的急诊脑出血患者护理质量评价体系具有一定的科学性、可靠性和实用性, 可作为临床实现护理质量持续改进的重要评价工具。

Objective Based on the Donabedian model,the nursing quality evaluation system of emergency cerebral hemorrhage patients was constructed, and applied to clinical practice, providing an objective and scientific reference basis for realizing the nursing quality management, monitoring and evaluation of emergency cerebral hemorrhage patients．Methods Through literature review, screening and evaluation, the feasibility data was extracted, and the framework of the nursing quality evaluation system for patients with emergency cerebral hemorrhage was constructed based on the Donabedian model, and the Delphi method was adopted to complete two rounds of expert letter inquiry to determine the final index system．The study selected 230 patients with acute cerebral hemorrhage admitted to our hospital from January 2021 to January 2024 as the research subjects．The period from January 2021 to June 2022 was used as the pre-intervention monitoring period, during which 165 patients were in the traditional group, receiving routine nursing quality management．The period from July 2022 to January 2024 was used as the post-intervention monitoring period, during which 165 patients were in the observation group,implementing nursing quality monitoring and management based on evaluation indicators for the care of patients with acute cerebral hemorrhage．Results In the two rounds of letter inquiry, the positive coefficient of experts was 95% and 100%, respectively, and the rate of suggestions was 56.25% and 35.54%, respectively; the authority coefficient of experts in the two rounds of letter inquiry was 0.945 and 0.893．In the first round the mean value of coefficient of variation（CV）of each index was 0~0.136, and the coordination coefficient of Kendall’s W was 0.065; in the second round the mean value of variation coefficient（CV）was 0-0.110, and the coordination coefficient of Kendall's W was 0.186．The final nursing quality evaluation system for emergency cerebral hemorrhage patients covers 11 first-level indicators, 11 second-level indicators and 55 third-level indicators．The results showed that the pass rate of admission-medication time, dynamic assessment rate of dysphagia patients, airway management rate, and early passive / active activity implementation rate of the observation group were statistically significant different from those in the traditional group（χ²=14.850,12.261, 8.183, 37.420, P<0.05）, and the patient satisfaction in the observation group was significantly higher than that in the traditional group（χ²=14.049, P<0.001）．Conclusions The nursing quality evaluation system for emergency cerebral hemorrhage patients constructed in this study is scientific,reliable and practical, and can be used as an important evaluation tool to achieve continuous improvement of nursing quality in clinical practice．

目的 评价早产儿经胃管喂养后采用空气冲管的应用效果。方法 选择2021年1月–2021年12月广州市第一人民医院收治的经胃管喂养后采用温水冲管的60例早产儿为对照组,选择2022年1月–2022年12月收治的经胃管喂养后采用空气冲管的57例早产儿为研究组。喂养1周后,比较两组患儿体质量增加量、血清白蛋白浓度增加量、大便量、喂养不耐受发生率、胃管堵塞率等指标的差异。结果 无患儿发生胃管堵塞。研究组的血清白蛋白浓度增加量[（2.86±5.61）g/L]高于对照组[（0.84±5.27）g/L]（P<0.05）,而两组患儿在体质量增加量、大便量、喂养不耐受发生率等方面比较差异无统计学意义（P>0.05）。多元线性回归分析结果显示空气冲管为血清白蛋白浓度增加量的影响因素（P<0.05）。结论 采用空气进行胃管冲管的方法可改善早产儿的营养状态。

Objective To evaluate the effects of flushing gastric tube by air after feeding in premature infants．Methods A total of 60 premature infants admitted to Guangzhou First People's Hospital from January 2021 to December 2021 whose gastric tube were flushed with water after feeding were selected as the control group,while 57 admitted from January 2022 to December 2022 whose gastric tube were flushed with air after feeding were selected as the study group．After 1 week of feeding,the differences of weight increase,serum albumin concentration increase,stool volume,feeding intolerance incidence and gastric tube blockage rate were compared between the 2 groups．Results No gastric tube blockage occurred．The increase of serum albumin concentration in the study group[（2.86±5.61）g/L] was significantly higher than that in the control group[（0.84±5.27）g/L]（P<0.05）,but there were no significant differences in weight increase,stool volume and feeding intolerance incidence between the 2 groups．Multiple linear regression analysis showed that the flushing gastric tube with air was an independent influencing factor for the increase of serum albumin（P<0.05）．Conclusions Flushing gastric tube with air can improve the nutritional status of premature infants,which is worthy of clinical application．

目的 研究氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2019年2月—2021年1月我院收治的98例NRDS患儿,根据治疗方案不同分为对照组(49例)和观察组(49例)。2组均给予常规治疗,对照组采用氨溴索静脉用药、常规机械通气治疗,观察组采用氨溴索静脉用药、高频振荡通气(HFOV)治疗。比较2组临床疗效、胸部X线评分、新生儿评分(Apgar评分)、不同时间点(治疗前、治疗后2 h、治疗后12 h)动脉血气指标[氧合指数(OI)、动脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)]、呼吸力学指标[呼吸指数(RI)、呼吸道阻力(R)、肺动态顺应性(Crs)]、并发症发生率、死亡率。结果 2组治疗后总有效率比较,观察组93.88%高于对照组77.55%(P＜0.05);治疗后,观察组胸部X线评分、Apgar评分均高于对照组(P＜0.05);治疗后2 h、治疗后12 h时观察组OI、PaCO₂均低于对照组,PaO₂高于对照组(P＜0.05);治疗后,观察组RI、AR水平低于对照组,Crs水平高于对照组(P＜0.05);观察组死亡率2.04%低于对照组14.29%(P＜0.05)。结论 氨溴索静脉用药联合HFOV治疗NRDS的临床疗效显著,可有效促进患儿呼吸功能、动脉血气改善,降低新生儿死亡率。

目的 研究以尼尔·诺丁斯关怀理论为基础的全程护理在病毒性脑炎（VE）患儿中的干预效果。方法 选取我院2020年4月—2022年4月收治的VE患儿88例,以随机抽签法分为对照组（44例）、观察组（44例）,对照组采用常规护理,观察组在此基础上实施以尼尔·诺丁斯关怀理论为基础的全程护理。比较2组治疗依从性、恢复情况、儿童抑郁障碍自评量表（DSRSC）、儿童焦虑性情绪障碍筛查表（SCARED）、生存质量[儿童生存质量普适性核心量表（PedsQLTM4.0）]及家属护理满意度。结果 观察组治疗依从性100.00%（44/44）高于对照组86.36%（38/44）（P<0.05）;干预后,观察组DSRSC、SCARED评分低于对照组,PedsQLTM4.0评分高于对照组（P<0.05）;干预后,观察组FMA、MMSE评分较对照组升高（P<0.05）;观察组家属护理满意度97.93%（43/44）高于对照组81.82%（36/44）（P<0.05）。结论 以尼尔·诺丁斯关怀理论为基础的全程护理可改善VE患儿心理状态,提高治疗依从性,促进身体康复,进而提高患儿生存质量及家属护理满意度。