目的 对2014—2023年广西梧州市某三级综合医院法定传染病疫情及流行病学特征进行分析，为地市级医院制定传染病防控策略提供科学依据。方法 采用描述性流行病学方法和Excel软件对该院法定传染病报告数据进行统计分析。结果 2014—2023年该院共报告法定传染病29 569例，其中，无甲类传染病报告，乙类传染病12 375例（41.85%），丙类传染病15 479例（52.35%），其他需监测报告的传染病1 715例（5.80%）。报告病例数排前4位的传染病依次为手足口病6 726例（22.75%）、感染性腹泻病6 451例（21.82%）、病毒性肝炎5 539例（18.73%）、肺结核3 552例（12.01%）。报告病例数在2014—2017年逐年增加，2017—2023年传染病报告病例降升交替，每年发病高峰期主要集中在5—10月；男性报告病例多于女性，男女之比为1.64∶1；0～10岁年龄段病例最多（46.89%），其次为40~60岁（26.91%）；职业分布集中于散居儿童（33.90%）、农民和牧民（18.08%）、工人和民工（9.47%）及幼托儿童（8.48%）；患者主要来自梧州市（79.17%）、广东省（17.34%）。传播途径构成比从高到低依次为肠道传染病（46.38%）、呼吸道传染病（26.03%）、血液及性传播传染病（24.92%）、其他传染病（2.66%）。结论 手足口病、感染性腹泻、病毒性肝炎、肺结核是该院传染病防治工作的重点，其中尤其要注重儿童手足口病和感染性腹泻病的预防，根据不同季节、疾病流行趋势，采取有针对性的传染病防控策略。
Objective To analyzed the epidemic and epidemiological characteristics of notifiable infectious diseases in a class Ⅲ general hospital in Guangxi Wuzhou from 2014 to 2023，to provide scientific basis for municipal hospitals to formulate infectious disease prevention and control strategies．Methods Descriptive epidemiological method and Excel were used to sort out and analyze the data．Results From 2014 to 2023，there were 29 569 cases of notifiable infectious diseases，with category B infectious diseases 12 375 cases（41.85%），category C infectious diseases 15 479 cases（52.35%），and others diseases 1 715 cases（5.80%）．No category A infectious diseases were reported．The top 4 infectious diseases were 6 726 cases of hand-foot-and-mouth disease（HFMD）（22.75%），6 451 cases of infectious diarrhea（21.82%），5 539 cases of viral hepatitis（18.73%）and 3 552 cases of tuberculosis（12.01%）．The number of reported cases increased year by year from 2014 to 2017，and the reported cases of infectious diseases decreased and increased alternately from 2017 to 2023，with the annual peak period mainly presented from May to October．Males reported cases were more than females，the ratio of males to females was 1.64∶1．The number of cases between 0 to 10 years old was the highest（46.89%），followed by 40-60 years old（26.91%）．The occupational distribution was concentrated in scattered children（33.90%），farmers and herdsmen（18.08%），workers and migrant workers（9.47%）and children in childcare（8.48%）．The patients were mainly from Wuzhou City（79.17%）and Guangdong Province（17.34%）．The composition ratio of transmission route from high to low was as follows：intestinal infectious diseases accounted for 46.38%，respiratory tract infectious diseases accounted for 26.03%，blood-borne and sexually transmitted infectious diseases accounted for 24.92%，and other infectious diseases accounted for 2.66%．Conclusions HFMD，infectious diarrhea，viral hepatitis and tuberculosis are the focus of the hospital’s infectious disease prevention and control work，especially the prevention of HFMD and infectious diarrhea in children，and the prevention and control strategies of infectious diseases are adopted according to different seasons and epidemic trends．
目的 调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况，为区域干预提供依据。方法 将江西省南昌市东湖区划分为东、南、西、北、中5个片区，每个片区随机抽取一个街道（管理处），于每年5月份随机抽取各街道（管理处）20名孕妇，每年共抽取100名孕妇，3年共计300名孕妇，采集其尿液样本和家中食用盐样本检测碘含量，以统计学方法进行分析。结果 3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg，碘盐覆盖率为98.67%，碘盐合格率为95.33%，3年的食用盐碘含量比较差异有统计学意义（H=38.545，P＜0.05）。孕妇的尿碘水平中位数为115.15 μg/mL，3年来孕妇的尿碘水平中位数均低于150 μg/mL，有62.67%的孕妇碘缺乏，3年间的尿碘水平比较差异有统计学意义（H=9.392，P＜0.05），其中2024年的尿碘水平中位数为140.00 μg/mL，校正后高于2022年（Z=2.693，P＜0.0167）和2023年（Z=2.590，P＜0.0167）。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇碘营养状况与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇尿碘水平与碘营养状况正相关（rs=0.857，P＜0.05），盐碘含量与碘盐质量正相关（rs=0.314，P＜0.05）。结论 江西省南昌市东湖区2024年孕妇碘缺乏有所改善，但整体形势严峻，超半数的孕妇碘缺乏，食用碘盐基本符合国家消除碘缺乏病标准，但仍需改进。卫生部门要强化孕妇碘营养监测，向孕妇科普碘缺乏病知识，增强补碘意识，促其科学补碘。盐业监管部门需加大监管，严控碘盐质量，确保东湖区居民食盐合格。
Objective To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District，Nanchang City，Jiangxi Province from 2022 to 2024，and provide a basis for regional intervention．Methods Donghu District was divided into five areas：East，South，West，North，and Central．A street（management office）was randomly selected from each area，and 20 pregnant women were randomly selected from each street（management office）in May each year．A total of 100 pregnant women were selected each year，for a total of 300 pregnant women over three years．Urine samples and household salt samples were collected to detect iodine content，and statistical analysis was conducted．Results Over the past three years，the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg，the iodized salt coverage rate was 98.67%，and the iodized salt qualification rate was 95.33%．There were differences in the iodine content of cooking salt in the three years（H=38.545，P＜0.05）．The median urinary iodine level of pregnant women was 115.15 μg/mL．In the past three years，the median urinary iodine levels of pregnant women were all lower than 150 μg/ml，and 62.67% of pregnant women were iodine-deficient．There were differences in the urinary iodine levels in the three years（H=9.392，P＜0.05）．Among them，the median urinary iodine level in 2024 was 140.00 μg/mL，which was significantly higher than that in 2022（Z=2.693，P＜0.0167）and 2023（Z=2.590，P＜0.0167）after correcting the significance level．Spearman correlation analysis results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt（all P＞0.05），and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt（all P＞0.05）．The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status（rs=0.857，P＜0.05），and the iodine content in salt is positively correlated with the quality of iodized salt（rs=0.314，P＜0.05）．Conclusions In 2024，the iodine deficiency among pregnant women in Donghu District，Nanchang City，Jiangxi Province was improved，but the overall situation is still severe．More than half of pregnant women were iodine-deficient．The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders，but still needed to be improved．The health department should strengthen the monitoring of iodine nutrition among pregnant women，popularize knowledge about iodine deficiency disorders to pregnant women，enhance their awareness of iodine supplementation，and promote their scientific iodine supplementation．The salt industry supervision department needs to strengthen supervision，strictly control the quality of iodized salt，and ensure that the cooking salt of residents in Donghu District is qualified．
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．
目的 分析医院职业暴露工作人员特征、发生职业暴露环节、类型及处理方式,为医院制订干预措施提供理论基础。方法 回顾性分析玉溪市人民医院2018—2023年共301例发生职业暴露工作人员资料, 包括职业暴露时间、性别、年龄、科室、岗位类型、在院工作时间、职位、职业暴露发生环节、职业暴露类型、暴露源、职业暴露后是否需要用药等处置信息。结果 301例职业暴露工作人员平均年龄为（28.81±10.92）岁, 女性占比84.7%（255例）; 57.8%（174例）职业暴露发生在检查/穿刺/注射/采血/置管/治疗/手术等操作中, 38.9%（117例）发生在医疗废物处置环节;87.7%（264例）的暴露类型为针刺伤;45.5%（137例）接触暴露源为有血源性传播疾病的患者。发生职业暴露工作人员中, 不同岗位职业暴露者的暴露类型、职位、科室、是否需要药物干预及接触暴露源情况比较差异有统计学意义（P<0.05）。结论 应加强医务工作者职业暴露相关知识及应急处置培训, 对不同工龄、岗位医务工作者制定针对性培训方案, 加强医疗废物处置流程及临床操作技能规范等知识培训,预防医务工作者职业暴露的发生。
Objective To analyze the characteristics,occupational exposure links, types, and treatment methods of occupational exposure among healthcare staff hospital, providing a theoretical basis for the development of related intervention strategies for hospitals．Methods A retrospective study was conducted to explore 301 cases of occupational exposure among healthcare staff in The People’s Hospital of Yuxi City from 2018 to 2023．Data of 301 cases were collected, including information on gender, age,department,personnel category, length of service in the hospital, job title, and the circumstances of occupational exposures, which covered exposure links, type, source, and post-exposure medication treatment measures．Results Among the 301 healthcare staff experiencing occupational exposure, the average age was（28.81±10.92）years, with 84.7%（255 cases）being female．Occupational exposure most frequently occurred during procedures such as examination, puncture, injection, blood collection, catheterization, treatment, and surgery（57.8%,174 cases）, followed by the disposal of medical waste（38.9%, 117 cases）．The primary type of exposure was needle-stick injury（87.7%）．Contact with patients suffering from blood-borne infectious diseases accounted for 45.5%（137 cases）of the occupational exposure incidents．There were significant differences in exposure types, job positions, departments, sources of exposure, and post-exposure medication treatment measures among healthcare staff of different categories（P<0.05）．Conclusions To prevent the occurrence of occupational exposure among healthcare staff, it is necessary to enhance training on occupational exposure knowledge and emergency management, particularly improving the disposal of medical waste and clinical operational skills．Additionally, it is crucial to have personalized training programs tailored to healthcare staff based on their varying lengths of service and positions．
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 观察辅助性T17细胞（Th17）与调节性T细胞（Treg）比值与2型糖尿病（T2DM）患者胰岛素抵抗及胰岛β细胞功能的关系。方法 纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例, 分为糖耐量正常组（NGT组, n=100）和T2DM组（n=100）, 分别测定糖化血红蛋白（HbA1c）、空腹血糖（FPG）、甘油三酯（TG）等生化指标, 电化学发光法测定空腹胰岛素（FINS）, 稳态模型计算胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（HOMA-ISI）。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果 与NGT组相比, T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高（P<0.01）, HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低, 且差异有统计学意义（P<0.01）。Th17与BMI（r=0.251, P<0.001）及HOMA-IR（r=0.305, P<0.001）呈正相关; 与HOMA-β（r=-0.204, P<0.001）及HOMA-ISI（r=-0.359, P<0.001）呈负相关。Treg与HOMA-ISI之间呈正相关（r=0.170, P=0.008）, 而与HOMA-IR呈负相关（r=-0.153, P=0.017）; Th17/Treg与BMI（r=0.332, P<0.001）及HOMA-IR（r=0.374, P<0.001）;与HOMA-β（r=-0.249, P<0.001）及HOMA-ISI（r=-0.427, P<0.001）呈负相关。多元线性回归分析显示, Th17/Treg是HOMA-IR（β=5.915）升高及HOMA-ISI（β=-2.557）下降的影响因素（P<0.01）。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。
Objective To explore the relationship among the proportion of helper T17 cells（Th17）to regulatory T cells（Treg）, insulin resistance, and the function of islet beta cells．Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included．Patients were divided into normal glucose tolerance group（NGT group, n=100）and type 2 diabetes mellitus group（T2DM group, n=100）．The biochemical indexes of HbA1c, fasting blood glucose（FPG）, triglyceride（TG）and fasting insulin（FINS）were determined by electrochemiluminescence．Islet beta cell function index（HOMA-β）, insulin resistance index（HOMA-IR）and insulin sensitivity index（HOMA-ISI）were calculated in homeostasis model．The levels of Th17 and Treg were detected by flow cytometry．Spearman was used to analyze the correlation between indicators, and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR, HOMA-β and HOMA-ISI．Results In contrast to the NGT group, the T2DM group exhibited elevated levels of BMI, FPG, HbA1c, LDL-C, TG, TC, FINS, HOMA-IR, Th17 and Th17/Treg, with these variances being signifincantly different（P<0.01）．There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different（P<0.01）．Th17 was positively correlated with BMI（r=0.251, P<0.001）and HOMA-IR（r=0.305, P<0.001）, it was negatively correlated with HOMA-β（r=-0.204, P<0.001）and HOMA-ISI（r=-0.359, P<0.001）．Treg was positively correlated with HOMA-ISI（r=0.170, P=0.008）, while it was negatively correlated with HOMA-IR（r=-0.153, P=0.017）．The ratio of Th17/Treg was positively correlated with BMI（r=0.332, P<0.001）and HOMA-IR（r=0.374, P<0.001）, it was negatively correlated with HOMA-β（r=-0.249, P<0.001）and HOMA-ISI（r=-0.427, P<0.001）．Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR（β=5.915）and the decrease of HOMA-ISI（β=-2.557）（P<0.01）．Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity．
目的 探讨振幅整合脑电图（aEEG）联合头颅磁共振成像（cMRI）对早产儿矫正12月龄时神经发育的预测价值。方法 选取110例早产儿为研究对象,并在矫正12月龄时采用Gesell 发育量表评估发育商（DQ）,依据DQ分为Gesell 正常组（DQ≥85,n=83）、Gesell 异常组（DQ<85,n=27）。采集早产儿及母亲临床资料,对比两组出生后72 h内aEEG、矫正胎龄37周时cMRI检查指标差异。结果 两组早产儿及母亲基线资料比较差异无统计学意义（P>0.05）。相较于Gesell 正常组,Gesell 异常组双顶径（BPW）降低[（70.68±5.32）mm vs（66.54±3.69）mm],睡眠-觉醒周期（SWC）不成熟率（20.48% vs 85.19%）、aEEG异常率（30.12% vs 70.37%）、两半球间距（IHD）增高[（2.95±0.83） mm vs（3.56±0.72）mm]（P<0.05）。Pearson相关分析结果显示,DQ值与IHD呈负相关,DQ值与BPW呈正相关（r=-0.361、0.598,P<0.05）。二元Logistic回归分析结果显示,BPW增高是Gesell 异常的独立保护因素（P<0.05）,IHD增高、SWC不成熟及aEEG异常是Gesell 异常的独立危险因素（P<0.05）。结论 早产儿出生后72 h内aEEG异常、矫正胎龄37周时cMRI异常可能提示矫正12月龄时不良神经发育结局。
Objective To evaluate the predictive value of amplitude-integrated electroencephalogram combined with cranial magnetic resonance on neurodevelopment for preterm infants at corrected age of 12 months．Methods A total of 110 preterm infants were selected as study subjects,and Gesell developmental scale was used to evaluate developmental quotient（DQ）at corrected age of 12 months．According to DQ,they were divided into normal Gesell group（DQ≥85,n=83）and abnormal Gesell group（DQ<85,n=27）．Clinical data of preterm infants and their mothers were collected,and the differences of amplitude-integrated electroencephalogram and cranial MRI（cMRI）were compared between two groups．Results There was no significant difference in baseline data between two groups（P>0.05）．Compared with the normal Gesell group,the biparirtal width（BPW）in the abnormal Gesell group was decreased（70.68±5.32mm vs 66.54±3.69mm）,the immaturity rate of sleep-wake cycle（SWC）（20.48% vs 85.19%）,the abnormal rate of aEEG（30.12% vs 70.37%）,and（IHD）（2.95±0.83mm vs 3.56±0.72mm）were increased（P<0.05）．The results of Pearson correlation analysis showed that DQ was negatively correlated with IHD,and DQ was positively correlated with BPW（r=-0.361、0.598,P<0.05）．Binary Logistic regression analysis showed that increased BPW was an independent protective factor for abnormal Gesell（P<0.05）,and increased IHD,immature SWC and abnormal aEEG were independent risk factors for abnormal Gesell（P<0.05）．Conclusions Abnormal aEEG within 72h after birth and abnormal cMRI at corrected age of 37 weeks may lead to adverse neurodevelopmental outcomes at corrected age of 12 months．
目的 分析2型糖尿病患者25-羟维生素D[25（OH）D]、糖化血红蛋白（HbA1c）水平和外周血管病变（PVD）的相关性,为疾病的预防及早期诊断提供参考。方法 分析于南通市中西医结合医院进行治疗的2型糖尿病患者基本资料,检测其25（OH）D、HbA1c以及肌酐、血钙等多项实验室指标,按照彩色多普勒超声检查结果将所有82例患者分为PVD阳性和阴性两组,通过样本检测分析PVD的影响因素。结果 经彩色多普勒超声诊断,82例T2DM中PVD阳性50例、阴性32例;PVD阳性患者病程、BMI、LDL-C、HbA1c、高于阴性组,25（OH）D低于阴性组（P<0.05）;经Logistic回归分析,患者BMI、糖尿病病程、HbA1c以及LDL-C是PVD的影响因素（P<0.05）;82例患者中HbA1c控制不佳62例,维生素D缺乏者PVD发生率71.43%,明显高于维生素D充足患者的45.00%（χ2=4.055,P=0.044）。结论 患者BMI、糖尿病病程、HbA1c、LDL-C以及25（OH）D水平均会对PVD的发生起到重要影响作用,且对于HbA1c控制不佳患者,出现维生素 D 缺乏时发生PVD的概率更高。
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 分析共同照护模式联合回授法健康教育在2型糖尿病患者中的应用效果。方法 将2023年1月—2023年12月广州市第一人民医院收治 的114例2型糖尿病患者作为此次研究对象,分为研究组（n=57）和对照组（n=57）,对照组患者给予常规护理结合健康教育,研究组患者给予共同照护模式联合回授法健康教育,评估两组在培训前及培训后1、3个月的血糖控制情况及糖尿病患者自我管理行为量表（SDSCA）等指标。结果 培训1、3个月后,两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均低于培训前,且研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组（P<0.05）。培训1、3个月后,两组患者的糖尿病患者SDSCA评分高于培训前,且研究组各项评分高于对照组（P<0.05）。重复测量方差分析表明随着时间的推移,患者的血糖控制状况随着不同护理培训策略而得到改善。结论 使用共同照护模式联合回授法健康教育对2型糖尿病患者可以更显著改善血糖控制水平、提高自我管理效能。
Objective To analyze the effect of co-care mode and feedback health education on patients with type 2 diabetes．Methods From January 2023 to December 2023,114 patients with type 2 diabetes admitted to Guangzhou First People's Hospital were divided into two groups：experimental group（n=57）and control group（n=57）．Patients in control group were given routine nursing combined with health education．Patients in study group were given co-care and feedback health education． Before intervention and 1,3 months after intervention,patients' blood glucose control and diabetic self-management behavior scale（SDSCA）were evaluated．Results After 1 and 3 months of intervention,the fasting blood glucose,2-hour blood glucose and HbA1c of the two groups were significantly lower than those before intervention,and the fasting blood glucose,2-hour blood glucose and HbA1c of the experimental group were significantly lower than those of the control group（P<0.05）．After 1 month and 3 months of intervention,the SDSCA scores of diabetic patients in both groups were higher than those before intervention,and the scores of study group were higher than those of control group（P<0.05）．Repeated measures analysis of variance indicating that glycemic control improved significantly over time with different nursing training strategies．Conclusions Co-care mode and feedback health education can significantly improve blood glucose control and self-management efficiency in patients with type 2 diabetes．
