目的 探讨优质护理服务对促进心胸外科患者恢复和提高患者护理满意度的效果。方法 将478例患者按时段分为按常规护理的对照组和实施优质护理的实验组,观察患者住院天数、拔除胸腔引流管时间、早期离床活动时间、护患纠纷发生率及满意度。结果 实验组患者住院天数、拔除胸腔引流管时间、早期离床活动时间、护患纠纷发生率明显缩短/降低,满意度显著提高,与对照组比较均差异有统计学意义(P＜0.01)。结论 优质护理服务有利于心胸外科患者术后恢复、减少护患纠纷和提高护理满意度,值得推广。

目的 探讨连续护理在提高乳腺癌保乳患者生存质量中的应用效果,号召我院为病人提供持续性、连续性护理开展APN排班。方法 随机抽取2011年1月—2014年1月我院收治的117例乳腺癌患者的临床资料。观察两组患者术后生存质量、焦虑情况、抑郁情况、术后上肢水肿情况。结果 两组患者术后1周生存质量比较,差异无统计学意义(P＞0.05);观察组术后1个月、3个月、6个月、1年生存质量高于对照组,差异有统计学意义(P＜0.05)。两组患者术后1周焦虑情况比较,差异无统计学意义(P＞0.05);观察组术后1个月、3个月、6个月、1年忧郁情况优于对照组,差异有统计学意义(P＜0.05)。观察组患者术后上肢水肿情况优于对照组,差异有统计学意义(P＜0.05)。结论 连续护理在提高乳腺癌保乳患者生存质量中的应用效果较好,能够改善患者术后生存质量、焦虑抑郁情况、术后上肢水肿情况,值得临床推广。

Objective To explore the effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy. Methods 117 cases of patients with breast cancer were randomly divided into observation group(59 cases) and control group(58 cases). The control group were cared by routine postoperative care, including health education. On the basis of the control group, the observation group were cared by continuous nursing intervention, including cognitive intervention, psychological intervention, social support, life care, functional exercise, the prevention of complications and discharge instruction. The quality of life, anxiety situation, depression amd upper limb edema were compared in the two groups. Results There has no significant difference on the quality of life after 1 week in the two groups(P＞0.05); The quality of life after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). There has no significant difference on the anxiety situation after 1 week in the two groups(P＞0.05); The anxiety situation after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). The depression situation after 1 week, 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). The upper limb edema situation for the observation group were better than the control group(P＜0.05). Conclusion The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy is good. It can improve the quality of life, situations of anxiety, depression and upper limb edema. It is worthy of clinical promotion.

目的 构建抑癌基因SEMA3B真核表达载体pcDNA3.1-SEMA3B,并检测其对肺癌A549细胞恶性生物学行为的影响。方法 应用PCR扩增SEMA3B全长cDNA片段,构建真核表达载体pcDNA3.1-SEMA3B。克隆PCR、双酶切法、基因测序验证过表达载体构建成功。将pcDNA3.1-SEMA3B真核表达载体和空载体pcDNA3.1分别转染入A549细胞中,应用qRT-PCR、Western blot检测SEMA3B mRNA、蛋白表达水平的变化;MTS法检测细胞增殖;流式细胞仪检测细胞凋亡、细胞周期;克隆形成实验检测细胞集落形成能力。结果 SEMA3B基因扩增片段与预测片段一致,克隆成功,且测序鉴定证实真核表达载体构建成功。转染pcDNA3.1-SEMA3B真核表达载体可上调SEMA3B mRNA、蛋白表达水平,且可抑制A549细胞的增殖,诱导凋细胞亡,细胞被阻滞在G1期,抑制细胞集落形成能力。结论 成功构建了SEMA3B基因真核表达载体,抑癌基因SEMA3B在肺癌恶性生物学进程中可能发挥重要作用。

Objective To construct the eukaryotic expression vector of the cancer suppressor gene, SEMA3B, and research the effects on malignant biological behavior of lung cancer A549 cells. Methods By reverse transcriptase-polymerase chain reaction (RT-PCR), the full length SEMA3B gene was amplified and then was inserted into pcDNA3.1. The recombinant plasmid pcDNA3.1-SEMA3B was confirmed correctly through double enzyme digestion and PCR identification, which was transfected into lung cancer A549 cells by lipid media transfection. The untransfected A549 and A549 transfected with pcDNA3.1 were used as controls. SMEA3B gene was detected by qRT-PCR and western blot. MTS assay, flow cytometry, and colony formation test were performed to evaluate the effect of overexpression of SEMA3B gene on A549 cell proliferation, apoptosis, cell cycle, and colony forming ability. Results The amplied fragment of SEMA3B gene by PCR was consistent with the anticipated result, the SEMA3B gene was cloned successfully. And the recombinant plasmid pcDNA3.1-SMEA3B was constructed successfully through gene sequence identification. After transfection of pcDNA3.1-SEMA3B, SEMA3B mRNA and protein expression levels were raised, and overexpression of SEMA3B gene in A549 cells significantly inhibited the proliferation of A549 cells, induced apoptotic cell death, blocked cell cycle in the G1 phase, and suppressed cell colony-forming ability. Conclusion The recombinant pcDNA3.1-SEMA3B is constructed successfully. SEMA3B gene can significantly inhibit the malignant biological behavior of lung cancer A549 cells.

目的 通过构建结构方程模型,分析某三级甲等综合医院腹股沟疝患者住院费用的影响因素,旨在为合理控制腹股沟疝单病种费用提供依据。方法 收集4 328份高州市人民医院2016—2022年主要诊断疾病名称为腹股沟疝且行腹股沟疝手术的患者的病历资料,预分析单个影响因素,采用AMOS28.0拟合构建模型。结果 结构方程模型拟合达到标准。性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝对总费用所产生的总效应数值分别为0.008、-0.044、0.062、0.014、-0.119、0.106、0.236;性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝通过住院时间间接对住院费用产生影响。结论 对住院费用产生的影响因素有性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝、住院时间,建议推行患者预住院模式及日间手术,在正式住院前完成相关检查,优化医疗服务流程,从而合理有效控制单病种住院费用。

Objective By utilizing a structural equation model, to analyze determinants that affect the hospitalization costs for individuals with inguinal hernia at a tertiary-level comprehensive medical center, offering insights for the potential management of costs associated with this specific ailment. Methods This study entailed the compilation of 4 328 patient files from individuals who received surgical treatment for inguinal hernia at a third-level general hospital over the period spanning 2016 to 2022. Preliminary analysis was conducted on isolated variables, followed by the development of a model using AMOS 28. 0 for fit assessment. Results The fitting of structural equation model reached the standard. The total effect values of gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia on the total cost were 0. 008, -0. 044, 0. 062, 0. 014, -0. 119, 0. 106, 0. 236, respectively. Gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia indirectly affected hospitalization expenses through hospitalization days. Conclusions Gender, age, cost, number of hospitalizations, of admission, concomitant diseases, unilateral and bilateral hernia, and length of hospital stay have an impact on hospitalization costs. It is suggested to implement the pre-hospitalization mode and day surgery, complete relevant examinations before formal hospitalization, and optimize the medical service process, so as to reasonably and effectively control the hospitalization cost of single disease.

目的 探讨基于品管圈活动构建健康体检重要异常结果的追踪管理模式对提高电话随访率的影响。方法 选取2022年5月—2023年4月在中山大学孙逸仙纪念医院健康管理中心体检重要异常结果的328例受检者作为研究对象。成立品管圈活动小组,实施追踪管理模式。干预后时间段为2022年11月—2023年4月,期间针对不同样本分别实施了干预措施一至四及全面实施措施,分析随访1个月后成功随访人数。比较干预前后圈员综合能力变化及患者对健康管理中心的满意度。结果 电话随访率在干预措施一实施后为85.02%,干预措施二实施后为88.59%,干预措施三实施后为90.23%,干预措施四实施后为95.27%,全面实施干预措施一至干预措施四后为95.80%,均较干预措施实施前电话随访率（75.91%）有所增长;干预成功随访人数中,复诊率为84.34%（210/249）,全面实施措施后成功随访人数中复诊率为94.74%（216/228）。相较于干预前,干预后,圈员解决问题能力、责任心、沟通协调、团队凝聚力、积极性、品管手法、自信心、和谐感分值均升高（P<0.05）。干预前患者满意度为85.37%,干预后患者满意度为87.80%,干预后满意度有所升高,差异具有统计学意义（P<0.05）。结论 通过开展品管圈活动,使重要异常结果电话随访率明显提高,有利于提升体检机构的服务质量和服务能力,有利于疾病的早发现、早干预。

Objective Exploring the impact of establishing a tracking and management model for important abnormal results of health check ups based on quality control circle activities on improving telephone follow-up rates. Methods A total of 328 subjects with important abnormal results in Health Management Center of Sun Yat-sen Memorial Hospital of Sun Yat sen University from May 2022 to April 2023 were selected. The quality control circle activity group was set and the tracking management mode was carried out. The post intervention period was from November 2022 to April 2023, during which intervention measures 1-4 and comprehensive implementation measures were implemented for different samples. The number of successful follow-up after 1 month of follow-up was analyzed. Changes in the comprehensive ability of the circle staff before and after the intervention and the patients’ satisfaction with the health management center were compared. Results The telephone follow-up rate after intervention 1 was 85. 02%, 88. 59% after intervention 2,90. 23% after intervention 3,95. 27% after intervention 4 and 95. 80% after all intervention,which was higher than 75. 91% before intervention implementation. Among the single intervention individuals, the re-visit rate was 84. 34%（210/249）, and after the comprehensive implementation of measures, the re-visit rate among the successfully intervened individuals was 94. 74%（216/228）. After the intervention,the problem solving ability,responsibility, communication and coordination,team cohesion, enthusiasm,quality control techniques,self-confidence,and sense of harmony all significantly increased（P<0. 05）. The patient satisfaction rate before intervention was 85. 37%, and after intervention it was 87. 80%. The satisfaction rate increased after intervention, and the difference was statistically significant（P<0. 05）. Conclusions Through the quality control circle activities, the telephone follow-up rate of important abnormal results is significantly improved,which is conducive to improving the service quality and service capacity of physical examination institutions,is conducive to the early detection and early intervention of diseases.

股骨转子间骨折是最常见的髋部骨折,内固定手术为其目前治疗的首选方式。头颈钉位置是评估手术效果和判断治疗预后的重要因素,合适的置钉位置有利于稳定骨折、加速康复以及改善预后。目前头颈钉位置最经典的评估方式为尖顶距（TAD）,但TAD至今仍存在较多争议。近年来提出的轴刀角、尖颈距离比、偏心距（ED）以及标准化TAD（STAD）为临床实践拓展了新视野。文章通过对上述头颈钉位置的评估方法及局限性进行文献综述,旨在为临床手术置钉时提供相应的参考。ED和STAD的提出,为未来人工智能评估头颈钉位置提供了可能。

Femoral intertrochanteric fracture is one of the most common hip fractures, and the internal fixation is the preferred treatment. The position of cephalic fixator is an important factor to evaluate the effect of operation and the prognosis of treatment. Tip-apex-distance（TAD）is the most classical method to evaluate the position of cephalic fixator, but it is still controversial. In recent years, the axis-blade angle,tip-neck distance ratio, eccentric distance（ED）and standardized TAD（STAD）have been proposed,though with limitations, they also provide a new perspective for clinical practice. In this study, we reviewed the literature on the evaluation of the position of cephalic fixator in order to provide the corresponding references and guidance for the clinical operation of internal fixation. Both STAD and ED may be the theoretical possibility of artificial intelligence evaluation of the position of cephalic fixator in the future.

       目的   构建并验证主动脉夹层B型（TBAD）患者急性期预后的列线图预测模型，帮助临床医生在急性期内更准确地评估TBAD患者的死亡风险，并制定更合适的治疗策略。方法   回顾性分析从重症监护医学信息数据库v2.2 中提取的399例 TBAD患者的人口学资料和临床资料，结局为TBAD患者急性期（≤14 d）内死亡。先采用最小绝对收缩选择算法回归筛选特征变量，再采用多因素分析确定独立预后因素，并据此构建预测模型。通过受试者工作特征曲线、校准曲线、决策曲线分析（DCA）评价列线图预测模型的性能和临床适用性。结果  APS Ⅲ评分、二氧化碳总量、红细胞分布宽度为TBAD患者14 d内死亡的独立预测因素。列线图预测模型在内部验证中的受试者工作特征曲线下面积为0.776（95% CI：0.691 ~ 0.860），Hosmer-Lemeshow 检验P=0.604，校准曲线和标准曲线高度重合，表明该模型具有良好的区分度和校准度。同时，DCA曲线显示，预测模型在大部分的阈值概率范围内提供了显著的净收益。结论   本研究基于APS Ⅲ评分、二氧化碳总量、红细胞分布宽度构建的列线图预测模型可以较准确地预测TBAD患者14 d内的死亡风险，有助于临床医生制定更合适的个体化治疗策略。

       Objective  To develop and verify a nomogram for predicting acute phase outcomes in patients with type B aortic dissection（TBAD），enabling clinicians to more precisely evaluate mortality  risk in TBAD patients during the acute stage and to devise better treatment plans．Methods  This retrospective study analyzed demographic and clinical data of 399 TBAD patients from the Medical Information Mart for Intensive Care IV v2.2，focusing on mortality within 14 days of the acute phase in TBAD patients．Initially，the Least Absolute Shrinkage and Selection Operator regression was employed for feature variable selection，and then multivariate analysis was used to identify independent prognostic factors for constructing the predictive model．The nomogram predictive model’s effectiveness and clinical applicability were assessed via the Receiver Operating Characteristic curve，calibration curve，and Decision Curve Analysis（DCA）．Results  Acute Physidogy Score Ⅲ score，total carbon dioxide，and red blood cell distribution width emerged as independent predictors of 14-day mortality in TBAD patients．The internal validation of the nomogram predictive model showed an area under the curve of 0.776（95%CI：0.691-0.860），with a Hosmer-Lemeshow test P-value of 0.604．The close alignment of the calibration and standard curves suggested the model’s strong discriminative power and calibration．Furthermore，the DCA curve  revealed that the predictive model offered substantial net benefits within a wide  range of threshold probabilities．Conclusions  This study's nomogram，developed using APS Ⅲ score，total carbon dioxide，and  red blood cell distribution width，accurately predicts the 14-day mortality risk in TBAD patients，assisting clinicians in creating better personalized treatment plans．

       目的   评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1（sICAM-1）的影响。方法   纳入2022年1月—2024年8月的70例正畸拔牙患者，按照治疗方法分组，即对照组（35例，给予固定矫治）、观察组（35例，给予无托槽隐形矫治），评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果   治疗结束时，两组均出现牙根吸收情况，但是观察组无牙根吸收＞3 mm病例，而对照组存在牙根吸收＞3 mm、＞4 mm病例，P＜0.05。治疗前，两组牙周指标［龈沟出血指数（SBI）、牙龈指数（GI）、菌斑指数（PLI）］、炎症因子［白介素-1β（IL-1β）、sICAM-1］比较差异无统计学意义（P＞0.05）。治疗后，两组SBI、GI、PLI、IL-1β、sICAM-1升高，且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组（P＜0.05）。与对照组比较，观察组矫治时间更长（P＜0.05）。结论   对正畸拔牙患者进行无托槽隐形矫治，虽然治疗时间长，但是可以抑制牙根吸收，减轻炎症反应，提高牙周健康水平。

       Objective  To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1（sICAM-1）．Methods  Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods：a control group（35 cases，receiving fixed orthodontic treatment）and an observation group（35 cases，receiving clear aligner treatment）．The root resorption，periodontal indicators，inflammatory factors，and orthodontic treatment time between groups were evaluated．Results  At the end of treatment，both groups showed root resorption，but there were no cases of root resorption＞3 mm in the observation group，while there were cases of root resorption＞3 mm and＞4 mm in the control group，P＜0.05．Before treatment，there was no difference in periodontal indicators（gingival bleeding index［SBI］，gingival index［GI］，plaque index［PLI］），inflammatory factors（interleukin-1 β［IL-1 β］，sICAM-1） between the groups，P＞0.05．After treatment，SBI，GI，PLI，IL-1 β，sICAM-1 increased in both groups，but SBI，GI，PLI，IL-1 β，sICAM-1 were lower in the  observation group，P＜0.05．Compared with the control group，the observation group had a longer orthodontic treatment time，P＜0.05．Conclusions  Although the clear aligner treatment time for orthodontic extraction patients is longer，it can inhibit root resorption，reduce inflammatory reactions，and improve periodontal health．

        目的   分析刃针联合关节错缝术治疗第三腰椎横突综合征（TLVTPS）的疗效。方法   采用视觉模拟评分法、Oswestry功能障碍指数评分以及腰部活动度，分析2023年1月至10月于广州市第一人民医院就诊的274例TLVTPS患者。其中，对照组（137例）采用刃针治疗，观察组（137例）采用刃针联合关节错缝术，比较两组疗效。结果   观察组的视觉模拟评分（0.46分）和Oswestry功能障碍指数评分（10.32分）低于对照组（P＜0.05）；同时，腰部活动差（53.69 cm）高于对照组（P＜0.05）；此外，痊愈及显效率83.93%（115/137）和总有效率93.42%（128/137）高于对照组（P＜0.05）。结论    刃针联合关节错缝术可有效缓解TLVTPS患者疼痛，改善腰部功能，疗效显著。

       Objective  To analyze the therapeutic effect of blade needle combined with joint misalignment therapy in third lumbar verterbrae transverse process syndrome（TLVTPS）．Methods  This study  retrospectively analyzed 274 TLVTPS patients from January 2023 to October 2023 in Guangzhou First People’s Hospital，using the Visual Analogue Score，Oswestry Disability Index scores，and lumbar range of motion．Among them，the control group（137 patients）were treated with blade needle therapy，while the observation group（137 patients）were treated with blade needle therapy combined with joint misalignment therapy．Results  The Visual Analogue Score（0.46）and Oswestry Disability Index scores（10.32）of the observation group were lower than that of the control group（P＜0.05）．Meanwhile，the lumbar range of motion（53.69 cm）was higher than that of the control group（P＜0.05）．Moreover，the recovery and effective rate was 83.93%（115/137）and the total effective rate was 93.42%（128/137），which were higher than that of the control group（P＜0.05）．Conclusions  The combination of blade needle therapy and joint dislocation manipulation alleviate pain effectively，improve lumbar function，and is clinically effective in patients with TLVTPS．

        放射治疗（放疗）可以提高妇科恶性肿瘤患者的总体生存率，降低复发率，增加手术机会。但肿瘤周围的健康组织不可避免地会进入电离辐射区域从而导致阴道狭窄、缩短和失去弹性，文章结合近年来国内外的放疗后阴道损伤治疗方式进行综述，总结分析治疗的优缺点，旨在为放疗后阴道损伤的临床治疗提供帮助。

       Radiotherapy can improve the overall survival rate，reduce the  recurrence  rate and increase the chance of surgery in patients with gynecological malignant tumors．However，the healthy tissue around the tumor can inevitably be included the ionizing radiation area，resulting in vaginal stenosis，shortening and loss of elasticity．This paper reviews the treatment methods of post-radiotherapy vaginal injury at home and abroad in recent years，to summarize and analyze theadvantages and disadvantages of treatment，aiming to provide help for the clinical treatment of post-radiotherapy vaginal injury．