胶质瘤是颅内最常见的原发性恶性肿瘤,其分级对患者治疗方式的选择和预后至关重要。尽管目前组织病理学仍是其最为可靠的分级手段,但需通过有创性手术以获取组织样本,存在一定的风险。相较之下,磁共振成像（MRI）作为一种非侵入性影像诊断工具,在胶质瘤分级中发挥着不可或缺的作用。然而,传统MRI评估受限于医师个体主观性强和可重复性差的问题,一定程度上影响了准确的分级结果。近年来,影像组学技术的崭露头角为解决上述难题开辟了新视角,通过高通量提取影像数据特征捕捉并量化肿瘤的影像学表现,避免因主观因素而导致的不确定性,协助医师更准确地评估肿瘤的恶性程度。本文对近五年来MRI影像组学在胶质瘤术前分级预测方面的相关研究进行了简要综述,旨在为相关领域研究者提供有益的参考和借鉴,以推动MRI影像组学在临床实践中的应用。

Glioma is the most common primary malignant brain tumor,and its grading is crucial for treatment decisions and prognosis．Currently,histopathology remains the gold standard for grading,but it requires invasive procedures and carries inherent risks．In contrast,magnetic resonance imaging（MRI）,a non-invasive diagnostic tool,plays an indispensable role in glioma grading．However,traditional MRI assessment is hampered by interobserver subjectivity and limited repeatability,which compromise grading accuracy．In recent years,radiomics,a burgeoning field,has offered a promising solution to address these challenges．By extracting high-dimensional imaging data features,radiomics enables the quantification of tumor radiological characteristics and elimination of subjectivity-related discrepancies．This technology assists clinicians in more precisely assessing the malignancy of gliomas．This article summarizes relevant studies in the past five years on the application of MRI radiomics in preoperative glioma grading,aiming to provide valuable insights and guidance to researchers in the field and promote the clinician implementation of MRI radiomics．

目的 探讨系统化护理流程干预对脑出血患者急救效果及预后的影响。方法 采用回顾性分析的方法,选取2022年2月—2023年2月新乡医学院第三附属医院急诊收治的210例脑出血患者,将2022年2月—2022年8月采取常规护理干预的105例患者作为常规组,将2022年9月—2023年2月采取系统化护理流程干预的105例患者作为研究组。对比两组患者抢救效率、急救效果、并发症发生率、预后水平、护理满意度情况。结果 研究组患者抢救总时间、会诊至确诊、分诊至会诊、接诊至分诊以及出诊反应时间短于常规组（P<0.05）;研究组急救总有效率高于常规组,并发症发生率低于常规组（P<0.05）;出院1个月、3个月后,两组患者神经功能缺损量表（NIHSS）评分均降低,简易智能状态检查量表（MMSE）评分升高,研究组变化幅度更大（P<0.05）;研究组患者护理满意度高于常规组（P<0.05）。结论 针对脑出血患者在急救过程中采取系统化护理流程干预能够提升患者的抢救效率和急救效果,并发症发生率低,改善患者的神经功能缺损情况,提升预后水平,且患者满意度较高。

Objective To explore the impact of systematic nursing process intervention on the emergency response and prognosis of patients with cerebral hemorrhage．Methods By retrospective analysis,210 patients with cerebral hemorrhage admitted to the emergency department of the Third Affiliated Hospital of Xinxiang Medical College from February 2022 to February 2023,105 patients with routine nursing intervention from February 2022 to August 2022 were selected as the routine group,and 105 patients with systematic nursing process intervention from September 2022 to February 2023 were selected as the study group．The rescue efficiency,first aid effect,complication rate,prognosis levels and nursing satisfaction of the two groups were compared．Results The total rescue time,consultation to diagnosis,triage to consultation,reception to triage and the response time to visit in the study group were significantly lower（P<0.05）．The total emergency response rate of the study group was higher than that of the conventional group,and the incidence of complications was significantly lower（P<0.05）．One month and 3 months after discharge,NIHSS score decreased in both groups,MMSE score increased,and the change range was greater in the study group（P<0.05）．The nursing satisfaction of the study group was significantly higher（P<0.05）．Conclusions For patients with cerebral hemorrhage,systematic nursing process intervention in the first aid process can improve the rescue efficiency and first aid effect of patients,reduce the incidence of complications,improve the neurological function defect of patients,improve the prognosis level,and the patient satisfaction is higher．

目的 探讨以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响。方法 选择2021年8月—2022年6月在驻马店市中医院诊治的老年稳定性冠心病患者78例,根据1∶1随机数字表法分为两组,每组各39例。常规组给予常规护理,整合组在常规组护理的基础上给予以整合照护理念为基础的综合干预体系,记录两组患者的预后情况。结果 两组患者在护理3个月后的平衡测试评分、座椅站立测试评分均低于护理前,整合组护理3个月后的平衡测试评分、座椅站立测试评分与常规组相比也降低（P<0.05）。整合组护理3个月后的躯体、心理、社会、精神等维度的生活质量评分均高于常规组（P<0.05）。整合组随访1年的靶血管重建、心肌梗死、心源性死亡、冠状动脉再狭窄等主要心血管事件不良事件发生率为5.13%,常规组为25.64%,整合组低于常规组（P<0.05）。结论 以整合照护理念为基础的综合干预体系能缓解老年稳定性冠心病患者的衰弱状况,改善患者的生活质量,降低主要心血管事件不良事件发生率。

Objective To explore and analyze the effects of a comprehensive intervention based on integrated care on the frailty of elderly stable coronary heart disease（CHD）patients．Methods From August 2021 to June 2022,78 cases of elderly stable CHD patients who were diagnosed and treated in Zhumadian City Hospital of Traditional Chinese Medicine were selected．According to a 1：1 random number table method,78 patients were divided into the integrated group and the traditional group,with 39 cases of each group．The traditional group was given routine care,while the integrated group was given a comprehensive intervention based on integrated care concepts on the basis of the traditional group's care,and the patients' prognosis was recorded．Results The balance test scores and chair stand test scores of both groups after 3 months of nursing care were lower than those before nursing care．The balance test scores and chair stand test scores of the integrated group after 3 months of nursing care were also significantly lower than those of the traditional group（P<0.05）．After 3 months of nursing care,the quality of life scores in physical,psychological,social,and spiritual dimensions in the integrated group were significantly higher than those in the traditional group（P<0.05）．The incidence of major cardiovascular adverse events such as cardiac death,myocardial infarction,target vessel reconstruction,and coronary artery restenosis during a one-year follow-up in the integrated group was 5.13%,compared to 25.64% in the traditional group．The integrated group was significantly lower than the traditional group（P<0.05）．Conclusions The application of a comprehensive intervention based on integrated care concept in elderly stable CHD patients can alleviate frailty,improve quality of life,and reduce the incidence of major cardiovascular adverse events．

目的 分析老年患者腰-硬联合麻醉术中给予不同剂量瑞马唑仑的有效性及安全性。方法 纳入2020年5月—2023年4月在武穴市第一人民医院手术需进行腰-硬联合麻醉的老年患者126例,随机分为低剂量组[42例,术中持续泵注2 μg/（kg·min）瑞马唑仑]、中剂量组[42例,术中持续泵注3 μg/（kg·min）瑞马唑仑]、高剂量组[42例,术中持续泵注4 μg/（kg·min）瑞马唑仑],评估患者麻醉前（T0）、麻醉给药5 min（T1）、15 min（T2）、30 min（T3）时镇静程度并记录生命体征指标,记录患者麻醉起效时间、阻滞完善时间,统计麻醉给药后恶心呕吐、低血压等不良反应发生情况。结果 三组患者T1、T2、T3时Ramsay评分较T0时均升高（P<0.05）,中剂量组、高剂量组T2、T3时Ramsay评分高于低剂量组（P<0.05）,高剂量组T2、T3时Ramsay评分高于中剂量组（P<0.05）,低剂量、中剂量组T2、T3时平均动脉压、心率高于高剂量组（P<0.05）;高剂量组、中剂量组麻醉起效时间、阻滞完善时间均短于低剂量组（P<0.05）;低剂量组、中剂量组低氧血症、低血压等不良反应总发生率低于高剂量组（P<α,α=0.017）。结论 老年患者腰-硬联合麻醉术中给予3 μg/（kg·min）的瑞马唑仑效果较为理想,其镇痛作用优于2 μg/（kg·min）,对生命体征的影响低于4 μg/（kg·min）,不良反应较少,兼顾镇静作用与麻醉安全性。

Objective To analyze the effectiveness and safety of different doses of remimazolam in elderly patients with combined spinal-epidural anesthesia．Methods From May 2020 to April 2023,126 elderly patients who needed combined spinal-epidural anesthesia in Wuxue First People's Hospital were included and randomly divided into low-dose group[42 cases,continuous infusion of 2 μg/（kg·min）reimazolam during operation],medium-dose group[42 cases,continuous infusion of 3 μg/（kg·min）reimazolam during operation],and high-dose group[42 cases,continuous infusion of 4 μg/（kg·min）reimazolam during operation]．The degree of sedation and vital signs were recorded at 5 minutes（T1）,15 minutes（T2）,and 30 minutes（T3）of administration,and the anesthesia effective time and block completion time were recorded,and the incidence of adverse reactions such as nausea,vomiting,and hypotension after anesthesia administration were recorded．Results The Ramsay scores at T1,T2 and T3 of the three groups were significantly higher than those at T0（P<0.05）．The Ramsay scores of the middle-dose group and high-dose group were significantly higher than those of the low-dose group at T2 and T3（P<0.05）．The Ramsay scores of the high-dose group were significantly higher than those of the middle-dose group at T2 and T3（P<0.05）．The mean arterial pressure and heart rate of the low-dose group and the middle-dose group at T2 and T3 were higher than those of the high-dose group（P<0.05）．The effective time of anesthesia and block completion time in the high-dose group and the middle-dose group were significantly shorter than those in the low-dose group（P<0.05）．The total incidences of adverse reactions such as hypoxemia and hypotension in the low-dose group and the middle-dose group were significantly lower than those in the high-dose group（P<α,α=0.017）．Conclusions The effect of 3 μg/（kg·min）remimazolam in elderly patients with spinal-epidural combined anesthesia is ideal,its analgesic effect is better than 2 μg/（kg·min）,the impact on vital signs is less than 4 μg/（kg·min）,with fewer adverse reactions,which is a balance between the sedative effect and the safety of anesthesia．

目的 探讨重复经颅磁刺激应用于帕金森病失眠患者中的效果及对睡眠质量的影响。方法 选取2021年1月—2022年3月南阳南石医院神经内科收治的帕金森病失眠患者100例,按照随机数字表法均分为参照组（n=50）和研究组（n=50）,参照组采用常规西药治疗,研究组在参照组基础上采用重复经颅磁刺激治疗,对比两组治疗效果、神经递质指标水平、帕金森症状表现及睡眠质量评分的差异。结果 研究组治疗总有效率98.00%（49/50）高于参照组82.00%（41/50）,对比差异有统计学意义（P<0.05）。治疗后,研究组神经递质多巴胺及5-羟色胺水平分别为（6.84±0.62）、（22.75±0.59）,均高于参照组,对比差异均有统计学意义（P<0.05）。治疗后,研究组帕金森病症状表现及睡眠质量总评分均低于参照组,对比差异均有统计学意义（P<0.05）。结论 重复经颅磁刺激应用到帕金森病失眠患者的治疗中,能提升疗效,明显改善患者睡眠质量和帕金森病症状。

Objective To investigate the effect of repetitive transcranial magnetic stimulation（rTMS）on Parkinson's insomnia and its influence on sleep quality．Methods A total of 100 Parkinson's patients with insomnia admitted to the Department of Neurology,Nanyang Nanshi Hospital from January 2021 to March 2022 were selected and divided into the reference group（n=50）and the study group（n=50）according to random number table method．The reference group was treated with conventional western medicine,and the study group was treated with rTMS on the basis of the reference group．The levels of neurotransmitters,symptoms of Parkinson's disease and sleep quality were compared．Results The effective rate of the study group was 98.00%（49/50）,which was higher than 82.00%（41/50）of the reference group,with statistical significance（P<0.05）．After treatment,the levels of dopamine and 5-hydroxytryptamine in the study group,（6.84±0.62）and（22.75±0.59）,were higher than those in the reference group,and the comparison was statistically significant（P<0.05）．After treatment,the total score of Parkinson's symptom and sleep quality in the study group were lower than those in the reference group,with statistical significance（P<0.05）．Conclusions The application of rTMS in the treatment of Parkinson's patients with insomnia can improve the curative effect,significantly improve the sleep quality and symptoms of Parkinson's disease,and is worthy of further application and promotion．

目的 探究纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗根管治疗（RCT）后后牙楔状缺损（WSD）的效果。方法 选取2019年8月—2022年8月在新乡市口腔医院治疗的300例（300牙）RCT后后牙WSD患者,按随机数字表法分成A组（n=150）、B组（n=150）。A组接受纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗,B组接受金属烤瓷冠（PFM）联合金属桩核（MPC）修复治疗。对比2组修复成功率、修复效果、修复前后牙周健康指标[牙龈指数（GI）、菌斑指数（PLI）、牙周探诊深度（PD）]、龈沟液炎性因子[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）]水平。结果 A组修复成功率为97.33%（146/150）,高于B组的87.33%（131/150）（P<0.05）;A组边缘密合性、表面质地、颜色匹配均优于B组（P<0.05）;修复6个月后A组GI、PLI、PD较B组低（P<0.05）;修复1个月后A组龈沟液TNF-α、IL-6水平较B组低,IL-10水平较B组高（P<0.05）。结论 与PFM联合MPC修复治疗RCT后后牙WSD患者相比,应用纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗更有助于提升修复成功率及修复效果,改善牙周健康,且对组织产生创伤更小。

Objective To investigate the restorations outcome of fibre post + composite resin + zirconia porcelain crown for patients with wedge-shaped defects（WSD）in posterior teeth after root canal therapy（RCT）．Methods A total of 300 patients（300 teeth）with posterior WSD after RCT in our hospital（from August 2019 to August 2022）were selected and divided into group A（n=150）and group B（n=150）according to random number table method．Group A received composite resin + zirconia porcelain crown + fiber post repair treatment,while group B received porcelain fused to metal（PFM）+ metal post core（MPC）repair treatment．The success rate of repair,the effect of repair,the periodontal health indicators before and after repair[gingival index（GI）,plaque index（PLI）,periodontal probing depth（PD）],and the levels of gingival creval fluid inflammatory factors[interleukin-6（IL-6）,IL-10,tumor necrosis factor-α（TNF-α）] were compared between the two groups．Results The success rate of repair in group A was 97.33%（146/150）,higher than 87.33%（131/150）of group B（P<0.05）．The edge tightness,surface texture and color matching of group A were better than those of group B（P<0.05）．After 6 months of repair,GI,PLI and PD in group A were lower than those in group B（P<0.05）．After one month of repair,the contents of TNF-α and IL-6 in gingival crevicular fluid of group A were lower than those of group B,and the contents of IL-10 were higher than those of group B（P<0.05）．Conclusions Compared with PFM+MPC in the treatment of posterior WSD patients after RCT,the application of composite resin + zirconia porcelain crown + fiber post repair is more helpful to improve the success rate and effect of repair,improve periodontal health,and cause less tissue trauma．

目的 分析早期活动康复对机械通气患儿肌力的影响,探讨影响肌力的相关因素。方法 采取回顾性研究,选择2021年4月—2023年4月医院收治的104例机械通气患儿临床资料,根据康复方法分为两组,其中采取常规康复训练的52例患儿为对照组,采取早期活动康复的52例患儿为观察组。两组均连续干预至出院,比较两组患儿的机械通气、住ICU、总住院时间、不同时点（转出ICU时、出院时、出院1个月）的肌力及Barthel日常生活能力（Barthel）评分;参照《中国重症肌无力诊断和治疗指南（2015年简版）》中诊断标准,评估机械通气患儿获得性肌无力（AW）发生情况。统计并比较两组基线资料,采用二元Logistic回归分析机械通气患儿AW发生的影响因素。结果 观察组的机械通气、住ICU及总住院时间[（7.28±2.47）d、（15.27±3.64）d、（27.08±5.68）d]均短于对照组[（10.64±3.39）d、（17.74±3.55）d、（32.57±6.14）d]（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时英国医学研究委员会（MRC）肌力评定法评分升高,且观察组转出ICU时、出院时MRC评分[（53.57±5.13）分、（56.84±2.16）分]均高于对照组[（50.13±4.57）分、（53.67±2.42）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时Barthel评分升高,且观察组转出ICU时、出院时Barthel评分[（65.03±12.47）分、（90.58±7.59）分]均高于对照组[（55.25±11.12）分、（84.13±9.62）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;住院期间104例机械通气患儿发生AW 31例,发生率29.81%,AW组机械通气时间、营养风险筛查量表2002（NRS）评分[（11.84±4.19）d、（3.07±1.04）分]高于非AW组[（8.18±2.26）d、（1.61±0.75）分],且有创机械通气模式、使用罗库溴铵患儿[77.42%（24/31）、32.26%（10/31）]占比均高于非AW组[53.42%（39/73）、13.70%（10/73）]（P<0.05）;二元Logistic回归分析结果显示,机械通气时间长、有创机械通气模式、使用罗库溴铵、NRS评分高是机械通气患儿AW发生的危险因素（OR>1,P<0.05）。结论 早期活动康复能够有效缩短机械通气患儿患儿通气时间及住院时间,改善肌力,提高生活自理能力,同时机械通气时间、创机械通气模式、使用罗库溴铵、NRS评分与机械通气患儿肌力下降有关。

Objective To analyze the effect of early mobilization and rehabilitation on muscle strength in children with mechanical ventilation and to explore the risk factors affecting muscle strength．Methods A retrospective study was conducted on 104 children with mechanical ventilation admitted to the hospital from April 2021 to April 2023．According to the rehabilitation methods,they were divided into two groups．The clinical data of children with routine rehabilitation training were included in the control group（52 cases）,and the clinical data of children with early mobilization and rehabilitation were included in the observation group（52 cases）．Both groups were continuously intervened until discharged．The mechanical ventilation time,ICU stay and total hospital stay were compared between the two groups．Muscle strength and self-care ability at different time points（transfer out of ICU,discharge,1 month after discharge）,the incidence of acquired weakness（AW）in children with mechanical ventilation were evaluated according to the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis． Baseline data was collected and compared between the two groups．Binary logistic regression was used to analyze the risk factors of AW in children with mechanical ventilation．Results The mechanical ventilation time,ICU and total hospitalization time in the observation group[（7.28±2.47）d,（15.27±3.64）d,（27.08±5.68）d] were shorter than those in the control group[（10.64±3.39）d,（17.74±3.55）d,（32.57±6.14）d]（P<0.05）．Compared with those at the time of transfer out of ICU and discharge,the Medical Research Council（MRC）scores of the two groups increased at 1 month after discharge,and the MRC scores of the observation group at the time of transfer out of ICU and discharge[（53.57±5.13）,（56.84±2.16）] were higher than those of the control group[（50.13±4.57）,（53.67±2.42）]．There were significant differences between the two groups,time points and between groups · time points（P<0.05）．Compared with those at the time of transferring out of ICU and at discharge,the Barthel scores of the two groups increased at 1 month after discharge,and the Barthel scores of the observation group at the time of transferring out of ICU and at discharge[（65.03±12.47）,（90.58±7.59）] were higher than those of the control group[（55.25±11.12）,（84.13±9.62）]．There were significant differences in Barthel scores between the two groups,time points and groups · time points（P<0.05）．AW occurred in 31 of 104 children with mechanical ventilation during hospitalization,with an incidence of 29.81%．The mechanical ventilation time and Nutritional Risk Screening（NRS）score in the AW group[（11.84±4.19）d,（3.07±1.04）] were higher than those in the non-AW group[（8.18±2.26）d,（1.61±0.75）]．The proportion of children with invasive mechanical ventilation mode and the use of rocuronium[77.42%（24/31）,32.26%（10/31）] were higher than those in the non-AW group[53.42%（39/73）,13.70%（10/73）]（P<0.05）．Binary logistic regression analysis showed that long mechanical ventilation time,invasive mechanical ventilation,use of rocuronium and high NRS score were risk factors for AW in children with mechanical ventilation（OR>1,P<0.05）．Conclusions Early mobilization and rehabilitation can effectively shorten the ventilation time and hospitalization time of patients with mechanical ventilation,improve muscle strength and improve the ability of self-reliance．At the same time,mechanical ventilation time,mechanical ventilation mode,use of rocuronium and NRS score are related to the decrease of muscle strength in children with mechanical ventilation．

目的 了解深圳市助产士培训的现况,为今后进一步加强助产士培训工作提供参考依据。方法 利用方便整群抽样法选取2022年在深圳市助产医疗机构工作的助产士,通过问卷调查及数据分析,了解他们在2009—2020年间参加助产士培训的情况以及对临床实操技能掌握的自评现况。结果 本研究共调查481名助产士,大部分来自三级医院,平均拥有9（5,15）年的助产工作经验,根据其工作年限和经验分别参加初级、中级和（或）高级培训,以参加一次初级或中级培训居多。助产士未参加培训的主要原因为医院人员不足和新入职。临床实操技能掌握自评现况分析显示,助产士初、中级母儿急救实操技能亟待加强,中级培训的助产士带教能力需提升。不同职称助产士的实操技能自评分数比较差异有统计学意义（Z=9.23,P=0.026）。结论 深圳市助产士对于初级培训和中级培训的参与度较高,但对部分临床实操技能的掌握仍存在不足,有必要进一步强化助产士临床实操技能培养,以全面满足孕产妇的健康需求。

Objective To understand the current state of midwifery training in Shenzhen,providing insights for the enhancement of future midwifery training programs．Methods Using a convenience cluster sampling method,midwives working in obstetric medical institutions in Shenzhen in 2022 were selected．Through questionnaire surveys and data analysis,the participation in midwifery training from 2009 to 2020 was examined along with their self-assessment of mastery over clinical practical skills．Results A total of 481 midwives,mostly from tertiary hospitals,with an average of 9（5,15）years of midwifery experience,were surveyed in this study and participated in primary,intermediate and/or advanced training according to their years of experience and years of work,with the majority participating in primary or intermediate training once．The main reasons for midwives not attending training were insufficient hospital staff and new recruits．The analysis of the self-assessment of the mastery of clinical practical skills showed that the practical skills of midwives in maternal and pediatric emergencies at the primary and intermediate levels needed to be strengthened,and the teaching ability of midwives with intermediate training needed to be improved．There was a difference in the self-rating of practical skills among midwives of different titles（Z=9.23,P=0.026）．Conclusions Though participation in primary and intermediate midwifery training in Shenzhen City is high,there remains a deficiency in mastering specific clinical practical skills．This research suggests that there’s a pressing need to further enhance the practical clinical skill training for midwives to comprehensively meet the health needs of pregnant and postnatal women．

目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组（P<0.05）。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组（P<0.05）。干预后两组生活质量综合评定量表评分升高,观察组高于对照组（P<0.05）。观察组并发症发生率低于对照组（P<0.05）。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。

Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders．Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases．Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training．The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications．Results The observation group was generally more effective than the control group（P<0.05）．After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group（P<0.05）．After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group（P<0.05）．The complication rate was lower in the observation group（P<0.05）．Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes．

目的 探讨富血小板血浆（PRP）联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为（91.00±9.27）%、（0.29±0.12）%、（29.98±6.68）%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组（P<0.05）。经重复方差测量分析,两组美国特种外科医院膝关节评分系统（HSS）评分、西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟疼痛评分法（VAS）交互（F_交互=1.869、F_交互=1.482、F_交互=2.193）比较差异均有统计学意义（P<0.05）;与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降（P<0.05）;观察组并发症总发生率4.55%低于对照组30.43%（χ²=5.156、P=0.023）。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。

Objective To investigate the clinical effect of platelet rich plasma（PRP）combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function．Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method．Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group．The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared．Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were（91.00±9.27）%,（0.29±0.12）%,and（29.98±6.68）% respectively．The PRP preparation quality is stable and controllable．The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group（P<0.05）．After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery（HSS）Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,and visual analogue pain scales（VAS）interacted(F_Interaction=1.869,F_interaction=1.482,F_interaction=2.193),the differences were statistically significant（P<0.05）．Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased（P<0.05）;the total incidence of complications in the observation group was 4.55%,lower than that in the control group（30.43%,χ²=5.156,P=0.023）．Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time．It has good effects and is relatively safe．