目的 对入住重症监护病房（ICU）重症孕产妇患者的病种特征和住院费用进行分析。方法 从医院信息管理系统中搜索2009—2019年广州市某省级重症孕产妇救治中心ICU的重症孕产妇住院病例,对病例资料进行描述性流行病学分析。结果 2009—2019年该救治中心ICU共收治重症孕产妇1 616例,病种排名前五位依次为心血管疾病430例（26.61%）、血液及造血器官疾病310例（19.18%）、妊娠期特定并发疾病287例（17.76%）、消化系统疾病218例（13.49%）、呼吸系统疾病110例（6.81%）。患者经济负担中位数排名前五位依次为肌肉骨骼系统和结缔组织疾病（62 252.60元）、消化系统疾病（61 684.41元）、感染性疾病（42 945.70元）、血液及造血器官疾病（40 403.52元）、神经系统疾病（40 055.93元）。结论 入住ICU内的重症孕产妇以心血管疾病、血液及造血器官疾病为主,经济学分析表明肌肉骨骼系统和结缔组织疾病造成的经济损失较大。

Objective To analyze the disease characteristics and hospitalization expenses of critically ill maternal patients in intensive care unit（ICU）．Methods Hospitalized cases of severe maternal disease in ICU of a provincial critical care center in Guangzhou from 2009 to 2019 were searched from the hospital information management system,and case data was analyzed by descriptive epidemiology．Results From 2009 to 2019,a total of 1616 critically ill maternal patients received intensive care treatment at this center．The predominant diseases observed were cardiovascular disorders（26.61%）,blood and hematopoietic organ diseases（19.18%）,specific pregnancy-related complications（17.76%）,gastrointestinal ailments（13.49%）,and respiratory disorders（6.81%）．Among the top five patient groups,the median economic burden was the highest in musculoskeletal system and connective tissue diseases（62 252.600 yuan）,followed by digestive system diseases（61 684.410 yuan）,infectious diseases（42 945.700 yuan）,blood and hematopoietic organ diseases（40 403.515 yuan）,and nervous system disorders（40 055.930 yuan）．Furthermore,a discernible correlation between hospitalization cost and length of stay was identified．Conclusions Cardiovascular diseases and disorders of blood and hematopoietic organs are the primary causes for maternal admissions to ICU．Economic analysis shows that musculoskeletal system and connective tissues diseases cause bigger economic loss ．

目的 探讨情景模拟式健康教育对飞秒激光小切口角膜基质透镜取出手术（SMILE）患者的应用效果,提高手术患者术中的配合度。方法 随机选取2020年6月—12月于我院拟进行SMILE手术患者200例,随机分为观察组和对照组,各100例,其中对照组采用常规术前健康教育,观察组采用情景模拟宣教视频的方式实施术前健康教育。比较两组患者围术期依从性、焦虑自评量表（SAS）和SMILE手术知识知晓率。结果 观察组患者围术期依从性和SMILE手术围术期知识知晓率得分高于对照组、患者术前焦虑水平低于对照组,差异均有统计学意义（P<0.05）。结论 情景模拟式健康教育能有效提升SMILE手术患者围术期依从性,减轻患者手术紧张的情绪,提升患者SMILE手术围术期健康知识知晓率,提升就医体验及手术成功率。

Objective To explore the application effect of scenario simulation based health education on patients undergoing small incision lenticule extraction（SMILE）,in order to improve the cooperation of surgical patients．Methods From June to December in 2020,200 patients who were scheduled to undergo SMILE in the hospital were randomly selected and divided into an observation group and a control group,with 100 patients in each group．The control group received routine preoperative health education,while the observation group received preoperative health education through scenario simulation educational videos．The perioperative adherence of patients,Self Rating Anxiety Scale（SAS）,and SMILE surgical knowledge awareness rates were compared between patients of two groups．Results The observation group had higher scores in perioperative adherence of patients and perioperative knowledge awareness of SMILE surgery than the control group,and lower preoperative anxiety levels than the control group,with statistically significant differences（P<0.05）．Conclusions Scenario simulation based health education can effectively improve the adherence of SMILE patients,alleviate their surgical anxiety,enhance their awareness of perioperative health knowledge,improve their medical experience,and increase the success rate of the surgery．

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 本研究以脑卒中患者为研究对象,通过二代Illumina高通量测序平台对患者的粪便标本进行微生物群落多样性测序。选择物种丰度≥30%的24个门类（Phylum）作为肠道菌群的研究指标,进而研究肠道菌群与脑卒后抑郁（PSD）之间的相关关系。方法 以40位脑卒中患者的24个门类作为特征变量,抑郁组和对照组为二分类目标变量,建立以Logistic回归、随机森林、支持向量机和AdaBoost为基模型的Stacking分类模型。主成分分析方法作为该模型的特征选择方法选择恰当的主成分进行模型训练,通过二分类评价报告（precision、recall、f1-score）、ROC曲线和混淆矩阵等评价指标对其性能进行评价。结果 （1）通过差异性检验分析了两组（抑郁组和对照组）的基线一致（P<0.05）;（2）从Stacking模型融合的角度定量分析了影响脑卒中后抑郁情绪的具体肠道菌群。研究结果可知,放线菌门、拟杆菌门、变形菌门和酸杆菌门在PSD患者中均增加（P<0.001）;厚壁菌门,疣微菌门,绿弯菌门和软壁菌门在PSD患者中降低（P<0.001）。结论 以上菌群是影响脑卒中后抑郁患者情绪的主要影响因素,因此,在临床上通过恰当干预肠道菌群的变化来调节脑卒中后抑郁患者的抑郁水平,这为脑卒中后抑郁情绪的诊断和治疗方案提供科学依据。

Objective In this study,patients with stroke were selected as the research object,and the microbial community diversity of patients' stool samples was sequenced by the second-generation Illumina high-throughput sequencing platform． Twenty four phylum species with 30% species abundance were selected as indicators for the study of gut microbiota,and then the correlation between gut microbiota and post-stroke depression（PSD） was studied．Methods Taking 24 categories of 40 stroke patients as characteristic variables,depression group and control group as dichotomous target variables,a stacking classification model based on Logistic regression,random forest,support vector machine and AdaBoost was established．As the feature selection method of the model,principal component analysis selects the appropriate principal components for model training,and evaluates its performance through dichotomous evaluation reports（precision,recall,f1 score）,ROC curve and confusion matrix．Results The baseline of the two groups（depression group and control group）was consistent（P<0.05）through the difference test．From the perspective of stacking model fusion,the specific intestinal flora affecting post-stroke depression was quantitatively analyzed．The results showed that Actinobacteria,Bacteroidetes,Proteobacteria and Acidobacteria were significantly increased in PSD patients（P<0.001）,while Firmicutes,Verrucomicrobia,Chloroflexi and Tenericutes were significantly decreased in PSD patients（P<0.001）．Conclusions The above microbiota are the main factors affecting the mood of patients with post-stroke depression．Therefore,in clinical practice,we can adjust the depression level of patients with post-stroke depression by properly intervening the changes of intestinal microbiota,which provides a scientific basis for the diagnosis and treatment of PSD．

目的 探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势,为本领域研究者提供借鉴。方法 检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量,运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果 共纳入文献395篇,年发文量整体呈现波动上升的趋势;发文量最多的作者为姜之炎;发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队;研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论 AH领域研究内容主要以内治法、外治法、作用机制为主;研究热点逐渐从临床研究转向作用机制等实验研究;应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

Objective To explore the research status,research hotspots,and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children,to provide a reference for researchers in this field．Methods The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1,2005,to January 31,2024．Excel 2019 was applied to analyze the number of published papers,and CiteSpace 6.2.R6 software was applied to analyze its authors,institutions,and keywords．Results A total of 395 papers were included,and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core research teams including JIANG Zhiyan,YU Jingmao,and YAN Zhaojun were initially formed．The research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods,clinical efficacy．Conclusions The research content in this field is mainly based on internal treatment,external treatment,and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．

目的 分析产后出血预测评分与产妇凝血指标的相关性,以及出血预测评分对阴道分娩产后出血的预测效能。方法 采用回顾性研究,纳入2021年1月—2022年12月河南科技大学第二附属医院收治的136例阴道分娩产妇,根据产后出血情况,将合并产后出血的36例患者列为病例组,其余100例列为对照组,比较两组患者的产后出血预测评分及凝血指标,经Spearman相关性系数验证产后出血预测评分结果与凝血指标的相关性,依据实际出血情况,验证产后出血预测评分、各凝血指标对产后出血的预测效能。结果 病例组患者的产后出血预测评分为（7.33±2.46）分,D-二聚体（D-D）为（2.62±0.41）mg/L,均高于对照组[（6.14±2.06）分、（2.17±0.45）mg/L],纤维蛋白原（FIB）为（4.42±1.25）g/L,低于对照组（5.23±1.16）g/L;活化部分凝血活酶时间（APTT）为（37.44±10.25）s,凝血酶原时间（PT）为（15.45±4.12）s,凝血酶时间（TT）为（16.77±4.25）s,均高于对照组[（30.11±10.12）s、（12.49±4.11）s、（13.34±4.18）s],差异具有统计学意义（P<0.05）。经Spearman相关性系数分析,产后出血预测评分与经阴道分娩产妇的D-D、APTT、PT、TT呈正相关,与FIB呈负相关。通过绘制受试者工作特征曲线（ROC）后得知,产后出血预测评分及凝血指标对产后出血均有一定预测价值,但产后出血预测评分的AUC值大于各凝血指标。结论 产后出血预测评分与产妇凝血功能指标呈正相关,将产后出血预测评分与凝血指标检测相结合能实现对产后出血的早期识别及诊断。

Objective To analyze the correlation between postpartum bleeding prediction score and maternal blood coagulation index and the prediction efficiency of postpartum bleeding in vaginal delivery．Methods This is a retrospective study．The cases were included from January 2021 to December 2022．The subjects of the study were 136 vaginal delivery mothers． According to the delivery situation,36 patients with postpartum bleeding were included in the case group,and the rest 100 patients were included in the control group．The postpartum bleeding prediction score and coagulation indicators of the two groups were compared．The correlation between postpartum bleeding prediction score and coagulation indicators was verified by Spearman correlation coefficient．According to the actual bleeding situation,verify the predictive score for postpartum bleeding and the diagnostic efficacy of various coagulation indicators on postpartum bleeding．Results According to the test,the predictive score for postpartum bleeding in the case group was（7.33±2.46）,D-dimer（D-D）was（2.62±0.41）mg/L,which were higher than those in the control group [（6.14±2.06）,（2.17±0.45）mg/L]．Fibrinogen（FIB）was（4.42±1.25）g/L,lower than the control group（5.23±1.16）g/L,activated partial thromboplastin time（APTT）was（37.44±10.25）s,prothrombin time（PT）was（15.45±4.12）s,and thrombin time（TT）was（16.77±4.25）s．Compared with the control group [（30.11±10.12）s,（12.49±4.11）s,and（13.34±4.18）s）],the above indicators were all higher（P<0.05）．Through Spearman correlation coefficient analysis,the predictive score of postpartum bleeding was positively correlated with the D-D,APTT,PT,TT,negatively correlated with the FIB of the parturient who delivered through vagina．After drawing the ROC curve,it was found that both the postpartum hemorrhage prediction score and coagulation indicators had certain predictive value for postpartum hemorrhage,but the AUC value of the postpartum hemorrhage prediction score was greater than each coagulation indicator．Conclusions The prediction score of postpartum bleeding is positively correlated with the coagulation function indicators of the parturient,combining the score and indicators can achieve early identification and diagnosis of postpartum bleeding．

目的 探讨慢性阻塞性肺疾病（COPD）住院患者口腔功能状态现状及影响因素。方法 采用便利抽样法,选择2022年9月—2023年7月在深圳市龙岗区某三甲医院呼吸内科、胸外科的老年COPD住院患者191例作为研究对象。使用一般资料调查表、日常生活自理能力评估量表（BADL）、反复唾液吞咽试验（RSST）、改良版呼吸困难量表（mMRC）、改良版Beck口腔评分量表进行调查及评估。采用单因素分析老年COPD住院患者口腔功能状态的影响因素,采用Logistic回归分析老年COPD住院患者口腔功能状态的影响因素。结果 191例老年COPD患者中,入院时、住院第3天（D3）、住院第5天（D5）、出院的Beck口腔评分分别为（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）分,比较差异无统计学意义（P>0.05）。单因素分析结果显示,COPD患者在D3、D5、出院时,Beck口腔功能状态的影响因素有：年龄、性别、婚姻状况、牙齿缺失情况、抽烟史以及生活自理能力影响,差异具有统计学意义（P<0.05）。二元Logistic回归分析结果显示,年龄、吸烟状况、牙齿缺失数量、生活自理能力是COPD住院患者口腔功能状态的影响因素（P<0.05）。结论 老年COPD患者口腔卫生状况较差,且受到年龄、吸烟情况、牙齿缺失、生活自理能力的影响,应采取针对性预防和干预策略,改善老年COPD住院患者的口腔卫生状况,以降低COPD患者发生并发症的风险。

Objective To investigate the status quo and influencing factors of oral function in hospitalized patients of chronic obstructive pulmonary disease（COPD）．Methods A total of 191 patients with COPD who were hospitalized in the Respiratory Department and Thoracic Surgery Department of a hospital in Longgang,Shenzhen from September 2022 to July 2023 were selected by convenience sampling．The general data questionnaire,the Barthel index of activity of daily living（BADL） the repetitive saliva swallowing test（RSST）,modified Medical Research Council Dyspnea Scale（mMRC）,the Modified Beck Oral Assessment Scale（BOAS）were used for investigation and evaluation．Single factor analysis was used to analyze the influencing factors of oral function status in elderly COPD patients,and logistic regression was used to analyze the independent risk factors affecting oral function status in elderly COPD patients．Results Among 191 elderly patients with COPD,the BOAS scores were（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）at admission,the 3rd day,the 5th day and discharged day,respectively,with no statistical significance．The results of univariate analysis indicated that the independent risk factors of Beck oral function status in COPD patients at D3,D5 and discharge were gender,age,marital status,tooth loss,smoking history and Barthel index score,and the differences were statistically significant（P <0.05）．Binary logistic regression analysis indicated that age,smoking status,tooth loss and Barthel index score were independent risk factors for oral function status in hospitalized patients with COPD（P<0.05）．Conclusions Elderly patients with COPD have poor oral health status,which is affected by patient's age,smoking history,tooth loss and self-care ability．Targeted prevention and intervention strategies should be adopted to improve the oral health status of hospitalized patients with COPD,so as to reduce the COPD patient's risk of complications．

目的 分析长链非编码RNA LINC02038的表达与子宫内膜癌发生、发展的关联性,并探讨其潜在的生物学调控机制,为子宫内膜癌的精准诊治提供科学线索。方法 采用荧光定量PCR技术检测LINC02038 在2019年—2020年期间于我院收集的42例子宫内膜癌标本及相应癌旁正常组织中的表达差异。构建LINC02038过表达载体并转染子宫内膜癌Ishikawa 细胞系,通过CCK-8、Transwell等功能实验验证其对肿瘤细胞增殖、侵袭能力的影响。利用TCGA公共数据库分析LINC02038与子宫内膜癌预后的相关性,并通过基因本体论（GO）、京都基因组百科全书（KEGG）及基因集富集分析（GSEA）等生物信息学方法预测其潜在的下游调控机制。结果 LINC02038在子宫内膜癌组织中的表达高于癌旁正常组织（P<0.001）。过表达LINC02038可促进子宫内膜癌细胞Ishikawa的增殖和迁移。生物信息学分析提示LINC02038可能通过调控细胞分化、激素分泌、细胞外基质重塑等过程,激活NF-κB、细胞外基质受体等信号通路影响子宫内膜癌的发生。结论 LINC02038的异常表达与子宫内膜癌的发生、发展相关联,可作为评估子宫内膜癌发病风险的候选生物标志物。

Objective To analyze the expression of long non-coding RNA LINC02038 and its relationship with the occurrence and development of endometrial carcinoma（EC）,explore its potential biological mechanisms,and provide potential biomarkers for targeted therapy of EC．Methods Quantitative real-time PCR was used to detect the expression levels of LINC02038 in 42 EC tissues and their adjacent tissues．The LINC02038 overexpressin vector was constructed and transfected into EC Ishikawa cells．CCK-8,Transwell migration and invasion assays were performed to examine the effects of LINC02038 overexpression on cancer cell proliferation,migration and invasion．Public TCGA data were analyzed to investigate the associations between LINC02038 and EC pathogenesis and prognosis．GO,KEGG and GSEA enrichment analyses were conducted to elucidate the potential biological mechanisms of LINC02038．Results LINC02038 expression was significantly upregulated in EC tissues compared to adjacent non-tumor tissues（P<0.001）．Overexpression of LINC02038 markedly promoted the proliferation and migration of Ishikawa cells．Bioinformatics analysis suggested that LINC02038 may participate in regulating cell differentiation,hormone secretion,extracellular matrix remodeling and other processes,as well as activating NF-κB,extracellular matrix receptor and other signaling pathways involved in endometrial carcinogenesis．Conclusions The aberrant expression of LINC02038 is associated with EC occurrence and may serve as a potential biomarker for assessing the risk of this cancer．

目的 探讨计划-实施-检查-处理（PDCA）循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）]、肺功能指标[第1秒用力呼气容积（FEV₁）、潮气量（VT）]、炎症免疫指标[单核细胞趋化蛋白-1（MCP-1）、可溶性髓系细胞触发受体-1（sTREM-1）、可溶性细胞间黏附分子-1（sICAM-1）]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义（P<0.05）。干预前,两组患儿PaO₂、SaO₂、PaCO₂、FEV₁、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义（P>0.05）;干预后,两组患儿上述指标水平均有不同程度变化（P<0.05）,观察组PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）、SaO₂（93.58±3.82% vs 86.30±4.21%）、FEV₁（2.66±0.46 L vs 1.97±0.34 L）、VT（11.92±1.89% vs 9.83±1.10%）水平均高于对照组,观察组PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）、MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）、sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）、sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）水平低于对照组,差异均有统计学意义（P<0.05）。观察组患儿家属满意度整体优于对照组（P<0.05）;观察组总满意率（97.5% vs 77.5%）高于对照组,差异有统计学意义（P<0.05）。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。

Objective To explore the application effect of Plan-Do-Check-Action（PDCA）circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation．Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study．Based on the random number table method,they were divided into two groups,with 40 cases in each group．The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention．The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure（PaO₂）,arterial oxygen saturation（SaO₂）,arterial partial pressure of carbon dioxide（PaCO₂）],lung function indicators [（forced expiratory volume in 1 second,FEV₁）,tidal volume（VT）],and inflammatory immune indicators [monocyte chemotactic protein-1（MCP-1）,soluble myeloid cell trigger receptor-1（sTREM-1）,soluble intercellular adhesion molecule-1（sICAM-1）] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared．Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Before intervention,there was no statistically significant difference in the levels of PaO₂,SaO₂,PaCO₂,FEV₁,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children（P>0.05）．After intervention,the levels of the above indicators in both groups of children showed varying degrees of change（P<0.05）．The levels of PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）,SaO₂（93.58±3.82% vs 86.30±4.21%）,FEV₁（2.66±0.46 L vs 1.97±0.34 L）,VT（11.92±1.89% vs 9.83±1.10%）in the observation group were higher than those in the control group．The levels of PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）,MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）,sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）and sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）in the observation group were lower than those of the control group,with statistically significant differences（P<0.05）．The overall satisfaction of the observation group was better than that of the control group（P<0.05）,the total family members’ satisfaction rate of the observation group was higher than that of the control group（97.5% vs 77.5%）,with a statistically significant difference（P<0.05）．Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction．

目的 探讨全身麻醉（全麻）髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为（56.35±5.86）分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室（AICU）住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素（P<0.05）。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。

Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia．Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected．The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated．The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed．Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was（56.35±5.86）,with a moderate level．Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia（P<0.05）．Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles．