目的 分析2016—2024年宜春市5岁以下儿童死亡水平、死因构成、县区分布特征及变化趋势，为制定儿童健康干预策略提供依据。方法 回顾性收集2016—2024年宜春市5岁以下儿童死亡监测资料，统计各年度新生儿、婴儿及5岁以下儿童死亡率，分析死因构成比、顺位变化及县区分布特征，采用线性趋势χ2检验分析死亡率年度变化趋势。结果 2016—2024年宜春市各年龄段儿童死亡率均呈下降趋势（均P＜0.05），新生儿、婴儿、5岁以下儿童9年平均死亡率分别为1.35‰、2.62‰、5.02‰，较2016年分别下降26.79%、43.55%、43.06%。死因顺位整体呈现小幅变迁，肺炎占比逐步下降，溺水、意外窒息等意外伤害相关死因顺位持续前移。各县区死亡率存在差异，高死亡率县区集中在袁州区、奉新县，低死亡率县区以铜鼓县为主。结论 2016—2024年宜春市5岁以下儿童死亡率呈下降趋势，但意外伤害已成为主要死因，县区差异客观存在。应重点加强意外伤害预防工作，针对高死亡率县区实施差异化干预。
【摘要】目的：探讨多元化健康宣教在幽门螺旋杆菌（Hp）感染碳13（13C）呼气试验筛查中的应用效果。方法：将2024年5月~2026年4月至我院体检科进行无痛胃肠镜检查后，结果提示Hp阳性的300例患者作为研究对象，开展前瞻性临床试验。经数字表法将入组患者随机列为常规组和试验组，每组150例。两组患者均行13C呼气试验，常规组检查前实施常规健康宣教，试验组检查前实施多元化健康宣教，比较两组患者的心理状态，准备情况，检查情况及整体满意度。结果：试验组的疾病不确定感（MUIS）评分、广泛性焦虑量表-7（GAD-7）评分均低于常规组（t=7.644，10.923；P＜0.05）。试验组的药物停用依从率、饮食依从率、空腹依从率分别92.00%（138/150）、93.33%（140/150）、96.67%（145/150），均高于常规组[80.00%（120/150）、81.33%（122/150）、85.33%（128/150）]（x2=8.970，9.763，11.762；P＜0.05）。试验组的吹气一次成功率、肺泡气样本质量达标率、检查完成率、检查结果准确率分别为94.67%（142/150）、94.00%（141/150）、96.67%（145/150）、96.00%（144/150），均高于常规组[82.67%（124/150）、83.33%（125/150）、84.67%（127/150）、84.00%（126/150），]（x2=10.748，8.492，12.763，12.000；P＜0.05）。试验组的心理舒适、信息获取、检查流畅、结果可靠满意度评分均高于常规组（t=5.279，4.625，4.592，5.729；P＜0.05）。结论：多元化健康宣教可改善Hp感染患者的心理状态，并优化13C呼气试验的准备情况、检查情况，对提升检查结果准确性及患者满意度均有积极影响
[Abstract]Objective:Exploring the application effect of diversified health education in screening for Hp infection with 13C breath test.Methods:A prospective clinical trial will be conducted on 300 patients who were found to be Hp positive after undergoing painless gastroscopy in our hospital from May 2024 to April 2026. The enrolled patients were randomly divided into a control group and an experimental group using a numerical table method, with 150 cases in each group. Both groups of patients underwent 13C breath tests. The routine group received routine health education before the examination, while the experimental group received diversified health education before the examination. The psychological status, preparation, examination results, and overall satisfaction of the two groups of patients were compared.Results:Compare to the control group,the experimental group had lower MUIS scores and GAD-7 scores (t=7.644，10.923; P<0.05). The medication discontinuation compliance rate, dietary compliance rate, and fasting compliance rate of the experimental group were 92.00% (138/150), 93.33% (140/150), and 96.67% (145/150), respectively, all higher than those of the conventional group [80.00% (120/150), 81.33% (122/150), 85.33% (128/150)] (x2=8.970，9.763，11.762; P<0.05). The success rate of one-time blowing, the quality compliance rate of alveolar gas samples, the completion rate of examination, and the accuracy of examination results in the experimental group were 94.67% (142/150), 94.00% (141/150), 96.67% (145/150), and 96.00% (144/150), respectively, which were higher than those in the conventional group [82.67% (124/150), 83.33% (125/150), 84.67% (127/150), 84.00% (126/150)] (x2=10.748，8.492，12.763，12.000; P<0.05). Compare to the control group,the experimental group had higher satisfaction scores of psychological comfort, information acquisition, smooth examination, and reliable results (t=5.279，4.625，4.592，5.729; P<0.05).Conclusion:Diversified health education can improve the psychological state of Hp infected patients, optimize the preparation and examination of 13C breath tests, and have a positive impact on improving the accuracy of examination results and patient satisfaction.
目的: 探讨RNF213基因敲除对hCMEC/D3细胞分泌的外泌体circRNAs表达谱的影响。方法: 采用尺寸排阻法分别从RNF213-/- hCMEC/D3细胞（KO组）和野生型细胞（WT组）培养上清中提取外泌体，用Illumina Novaseq 6000 平台检测外泌体circRNAs表达谱，并用生物信息学方法进行分析。结果: 两组细胞存在134种差异表达的外泌体circRNAs，其中116种上调，18种下调。GO分析结果中，cellular nitrogen compound metabolic process (BP), intracellular anatomical structure (CC), heterocyclic compound binding (MF)和organic cyclic compound binding (MF)是最丰富的术语。Polycomb repressive complex通路是KEGG分析最显著富集的通路。circHIPK3可能通过ceRNA机制和/或与RNA结合蛋白相互作用参与烟雾病的发生发展，并成功构建circRNA-miRNA-mRNA通路。结论: 本研究确定了RNF213-/- hCMEC/D3细胞与野生型细胞外泌体circRNAs的差异表达谱，从外泌体的视角，为烟雾病的发病分子机制提供了新的见解。
