目的 分析常规炎性指标与进展性脑梗死（PCI）患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分（NIHSS）结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表（mRS）评分间的差异,并通过绘制受试者操作特征（ROC）曲线、曲线下面积（AUC）评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）分别为（26.44±5.18）mg/L、（95.28±10.46）ng/L、（45.24±10.31）pg/mL,均高于中度组[（23.12±5.46）mg/L、（90.44±10.17）ng/L、（40.25±10.18）pg/mL],轻度组[（20.28±5.33）mg/L、（84.33±10.27）ng/L、（35.62±8.45）pg/mL],差异具有统计学意义（P<0.05）。重度组的神经元特异性烯醇化酶（NSE）、S100钙结合蛋白β（S100β）分别为（25.45±5.69）μg/L、（60.45±10.31）ng/mL,均高于中度组[（22.18±5.36）μg/L、（55.27±10.46）ng/mL],轻度组[（19.44±5.37）μg/L、（50.49±10.25）ng/mL],差异具有统计学意义（P<0.05）。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关（P<0.05）。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为（26.62±5.31）mg/L、（96.77±10.24）ng/L、（47.25±10.33）pg/mL、（4.24±1.33）分,均高于预后良好组[（23.75±5.44）mg/L、（91.25±10.37）ng/L、（41.12±10.44）pg/mL,（3.36±0.27）分],差异具有统计学意义（P<0.05）。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高（AUC均>0.85）。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。

Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction（PCI） patients,as well as predictive efficacy of indicators on prognosis levels．Methods This is a retrospective study,with case enrollment from June 2021 to February 2023．The study subjects were 100 PCI patients．Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group．The neurological function serological and inflammatory indicators of the three groups of patients were compared．The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient．According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group．The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC．Results After testing,the levels of CRP,IL-6 and TNF in the severe group were（26.44±5.18）mg/L,（95.28±10.46）ng/L and（45.24±10.31）pg/mL,respectively,higher than those in the moderate group[（23.12±5.46）mg/L,（90.44±10.17）ng/L and（40.25±10.18）pg/mL]and the mild group[（20.28±5.33）mg/L,（84.33±10.27）ng/L and（35.62±8.45）pg/mL]（P<0.05）．NSE and S100β in the severe group were（25.45±5.69）μg/L and（60.45±10.31）ng/mL,all higher than those in the moderate group[（22.18±5.36）μg/L,（55.27±10.46）ng/mL]and mild group[（19.44±5.37）μg/L,（50.49±10.25）ng/mL]（P<0.05）．According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β（P<0.05）．After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were（26.62±5.31）mg/L,（96.77±10.24）ng/L,（47.25±10.33）pg/mL and（4.24±1.33）scores,respectively,which were higher than those in the group with good prognosis[（23.75±5.44）mg/L,（91.25±10.37）ng/L,（41.12±10.44）pg/mL and（3.36±0.27）scores]（P<0.05）．Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients（AUC>0.85）．Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage．By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients．

目的 分析流行性感冒（流感）患儿的流行病学特征及病原学分布。方法 纳入2020年3月—2023年2月在开封市祥符区第一人民医院确诊为流感的394例1~10岁患儿的咽拭子标本,通过实时荧光定量聚合酶链式反应完成流感病毒检测,分析此394例流感患儿感染的病毒类型及年龄、季节、性别、年份等分布情况。结果 甲型H1N1流感病毒为本次研究检出占比最高的流感病毒,占36.04%;男女患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）;春季及冬季流感患儿占比最多,分别为41.12%、35.53%,且不同季节之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异有统计学意义（P<0.05）;7~10岁流感患儿占比最高,为42.13%,不同年龄段患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）;2020年流感患儿占比最高,为43.40%,后续依次为2022年的29.70%,2021年的26.90%;不同年份的冬季流感患儿占比比较差异有统计学意义（P<0.05）;不同年份的各年龄段流感患儿占比比较差异无统计学意义（P>0.05）;各年甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）。结论 年龄7~10岁的患儿为流感高危群体,且甲型流感为患儿主要感染类型,而甲型流感病毒多见于春、冬季,新型冠状病毒肺炎疫情期间防控政策变化对流感流行有影响,应加强春、冬季7~10岁年龄段患儿的甲流预防工作。

Objective To analyze the epidemiological characteristics and etiological distribution of children with influenza（flu）．Methods The throat swab specimens of 394 children aged 1 to 10 years old who were diagnosed with influenza at the First People's Hospital of Xiangfu District,Kaifeng City from March 2020 to February 2023 were included．The samples were analyzed by real-time fluorescence quantitative polymerase chain reaction to complete influenza virus detection and analyze the virus types and distribution of age,season,gender,year,etc．among these 394 children with influenza were analyzed．Results Influenza A H1N1 virus was the influenza virus with the highest proportion detected in this study,accounting for 36.04%;there were differences in the proportions of influenza A H3,A H1N1,BV,and B BY influenza viruses between male and female children,with no statistical significance（P>0.05）;the proportion of children with influenza is the largest in spring and winter,41.12% and 35.53% respectively,and proportions of influenza A H3,A H1N1,B BV,and B BY influenza in different seasons were significantly different（P<0.05）．Children aged 7 to 10 accounted for the highest proportion of influenza patients,42.13%．Among children of different ages,the proportion of influenza A H3,A H1N1,B BV,B BY had no statistically significant difference（P>0.05）．The proportion of children with influenza in 2020 was the highest at 43.40%,followed by 29.70% in 2022 and 26.90% in 21;in different years there is a statistically significant difference in the proportion of children with influenza in winter（P<0.05）．There is no statistically significant difference in the proportion of children with influenza of all ages in different years（P>0.05）．The preportions of influenza A H3 and A H1N1,B BV and B BY viruses in each year,had no statistically significant difference（P>0.05）．Conclusions Children aged 7 to 10 years old are a high-risk group for influenza,and influenza A is the main type of infection in children．Influenza A viruses are more common in spring and winter．Changes in prevention and control policies during the new coronavirus pneumonia epidemic have an impact on the epidemic of influenza．Therefore,prevention of influenza A for children aged 7 to 10 years old in spring and winter should be strengthened．

目的 探讨氟哌噻吨美利曲辛联合帕罗西汀对重度抑郁障碍（MDD）患者躯体化症状、睡眠和认知功能的影响分析以及临床应用效果。方法 回顾性分析2020年8月—2023年2月在南昌市某医院接受治疗的120例MDD患者相关资料,按照其治疗方案不同分为帕罗西汀治疗组（常规组,n=55）和氟哌噻吨美利曲辛联合帕罗西汀治疗组（联合组,n=65）。两组患者治疗周期均为4周,比较两组患者治疗前和治疗第2、4周的汉密尔顿抑郁量表（HAMD-17）评分、躯体化症状自评量表（SSS）评分、睡眠质量评分（PSQI）、神经心理状态评定量表（RBANS）;且治疗后对患者进行1个月的随访比较两组患者治疗后总体疗效及不良反应发生情况。结果 经治疗第2、4周联合组RBANS评分高于常规组（P<0.05）,而PSQI评分、SSS评分、HAMD-17评分均低于常规组（P<0.05）。治疗后1个月随访资料显示,两组患者不良反应总发生率比较,差异无统计学意义（P>0.05）,且总有效率高于常规组（P<0.05）。结论 氟哌噻吨美利曲辛联合帕罗西汀对MDD患者临床应用疗效确切,还可以帮助患者减轻躯体化症状,改善患者睡眠质量,并且提高患者认知功能。

Objective To investigate the effect of haloperitoxine melitraxine combined with paroxetine on somatic symptoms,sleep and cognitive function in patients with major depressive disorder（MDD）and its clinical application effects．Methods A retrospective analysis was performed on the relevant data of 120 patients with MDD who received treatment in our hospital from August 2020 to February 2023,and divided into conventional group（treated with paroxetine,55 cases）and combined group（haloperitoxetex melitraxine combined with paroxetine,65 cases）according to their different treatment regimens．The treatment duration of the two groups was 4 weeks,and the Hamilton Rating Scale for Depression（HAMD-17）score,Somatized Symptom Self-rating Scale（SSS）score,Sleep Quality Score（PSQI） and Neuropsychological State Rating Scale（RBANS）scores were compared before treatment and at the 2nd and 4th week of treatment．After treatment,the patients were followed up for 1 month,and the total efficacy and adverse reactions of the two groups of patients after treatment were compared．Results After 2 and 4 weeks of treatment,the combined group showed significantly higher RBANS scores compared to the control group（P<0.05）,while PSQI scores,SSS scores and HAMD-17 scores were significantly lower in the combined group compared to the control group（P<0.05）．One month after treatment,follow-up data showed that there was no statistically significant difference in the overall incidence of adverse reactions between the two groups（P>0.05）．Additionally,the total effective rate was significantly higher in the combined group compared to the control group（P<0.05）．Conclusions Haloperitoxine melitrexine combined with paroxetine has a definite clinical effect in patients with MDD,and can also help patients reduce somatization symptoms,improve patients' sleep quality,and improve patients' cognitive function．

目的 探讨在分化型甲状腺癌（DTC）患者的治疗中,采用早期积极心理进行干预,对患者负性情绪和癌因性疲乏的影响。方法 抽取2021年6月—2023年1月平煤神马医疗集团总医院收治的160例DTC癌患者,随机分为对照组（常规护理）和研究组（常规护理+早期积极心理干预）,每组各80例,评估患者干预前后的心理状态、癌因性疲乏、生活质量、护理工作满意度。结果 护理干预1~4周后,两组患者汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分均降低,并且研究组患者评分更低（P<0.05）;干预后,两组患者的癌因性疲乏评分均升高,但是研究组患者的以上指标升高幅度小于对照组（P<0.05）;此外,两组患者的护士观察量表（NOSIE）评分均明显改善,并且研究组变化幅度大于对照组（P<0.05）;研究组患者的护理满意度高于对照组（95.00% vs 82.50%,P<0.05）。结论 对DTC患者开展早期积极心理干预,能够帮助患者改善负性情绪,减轻癌因性疲乏,提高患者的生活质量和护理满意度。

Objective To investigate the effect of early positive psychological intervention on negative emotions and cancer-related fatigue in the treatment of differentiated thyroid cancer（DTC） patients．Methods From June 2021 to January 2023,160 patients with DTC admitted to General Hospital of Pingmei Shenma Group were randomly divided into the control group（routine nursing）and the research group（routine nursing + early positive psychological intervention）,with 80 patients in each group．The psychological state,cancer-related fatigue,quality of life and nursing satisfaction of patients before and after intervention were evaluated．Results After 1~4 weeks of intervention,the scores of Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）were decreased in both groups,and the scores of research group were lower（P<0.05）．After intervention,the cancer-related fatigue scores of both groups were increased,but the increase of research group were less than that of control group（P<0.05）．Moreover,NOSIE scores of both groups were significantly improved,and the change range of research group was greater than that of control group（P<0.05）．The nursing satisfaction of research group was higher than that of control group（95.00% vs 82.50%,P<0.05）．Conclusions Early positive psychological intervention for patients with DTC can effectively improve negative emotions,reduce cancer-related fatigue,and improve nursing satisfaction of patients．

目的 探讨心理因素对儿童功能性腹泻的影响。方法 选取贵州省人民医院儿科2018年1月—2023年1月收治的200例功能性腹泻患儿,依照患儿年龄进行分组,将3~9岁患儿纳入儿童期观察组（n=116）、将10~14岁纳入青少年期观察组（n=84）,另选取同期体检的200名健康儿童志愿者作为对照组,将3~9岁儿童纳入儿童期对照组（n=110）、10~14岁纳入青少年期对照组（n=90）。对所有3~9岁儿童采用幼儿心理健康评定量表（CMHA-80）评价心理健康水平。对所有10~14岁儿童采用青少年版中国心理健康量表（MSSMHS）评价心理健康水平。心理因素与儿童功能性腹泻的相关性采用Spearman相关性分析,采用Logistic回归分析分析儿童功能性腹泻的影响因素。结果 儿童期观察组与对照组儿童人际关系、意志力、认知、注意力相关CMHA-80评分对比差异无统计学意义（P>0.05）,观察组儿童适应性、社会行为、性格、自我意识、情绪情感、其他相关CMHA-80评分明显低于对照组儿童（P<0.05）;青少年期观察组与对照组儿童环境适应、人际交往相关MSSMHS评分对比差异无统计学意义（P>0.05）,青少年期观察组儿童自我认识、情绪体验、认知效能相关MSSMHS评分低于对照组儿童（P<0.05）。儿童期儿童适应性、社会行为、性格、自我意识、情绪情感与功能性腹泻呈负相关（P<0.05）,青少年期自我认识、情绪体验、认知效能与功能性腹泻负正相关（P<0.05）。Logistic回归分析结果表明,性格、情绪情感、其他为儿童期功能性腹泻的影响因素（P<0.05）,情绪体验、认知效能为青少年期功能性腹泻的影响因素（P<0.05）。结论 心理因素对于儿童功能性腹泻具有较大影响。对于儿童期儿童来说,性格、情绪情感、其他不良习惯、抽动、睡眠、饮食等均是引发功能性腹泻的影响因素,对于青少年期来说,情绪体验、认知效能为引功能性腹泻的影响因素。

Objective To explore the influence of psychological factors on functional diarrhea in children．Methods A total of 200 children with functional diarrhea admitted to Pediatric Department of Guizhou Provincial People's Hospital from January 2018 to January 2023 were selected．They were grouped according to their age．Children aged 3-9 were included in the preschool observation group（n=116）,while those aged 10-14 were included in the adolescent observation group（n=84）．Additionally,200 healthy children volunteers who underwent physical examinations during the same period were selected as the control group．Children aged 3-9 were included in the preschool control group（n=110）,and those aged 10-14 were included in the adolescent control group（n=90）．Use the CMHA-80 Preschool Mental Health Assessment Scale to evaluate the level of mental health for all children aged 3-9．Evaluate the mental health level of all children aged 10-14 using the MSSMHS．The correlation between psychological factors and functional diarrhea in children was analyzed using Spearman correlation analysis,and the influencing factors of functional diarrhea in children were analyzed using logistic regression analysis．Results The results showed that there was no statistically significant difference in the CMHA-80 scores of interpersonal relationships,willpower,cognition and attention between the preschool observation group and control group（P>0.05）．The CMHA-80 scores of adaptability,social behavior,personality,self-awareness,emotions and other factors in the observation group in childhood were significantly lower than those in the control group（P<0.05）．There was no statistically significant difference in the MSSMHS scores of environmental adaptation and interpersonal communication between the adolescent observation group and control group（P>0.05）．The MSSMHS scores of self-awareness,emotional experience and cognitive efficacy in the adolescent observation group were lower than those in the adolescent control group（P<0.05）．There was a negative correlation（P<0.05）between adaptability,social behavior,personality,self-awareness,emotions and functional diarrhea in preschool children．Adolescent self-awareness,emotional experience,cognitive efficacy,and functional diarrhea were negatively and positively correlated（P<0.05）．The results of Logistic regression analysis showed that personality,emotions and other factors were the influencing factors of functional diarrhea in preschool childhood（P<0.05）．Emotional experience and cognitive efficacy were influencing factors for adolescent functional diarrhea（P<0.05）．Conclusions Psychological factors have a significant impact on functional diarrhea in children．For preschool children,personality,emotions,other bad habits,tics,sleep,diet are all factors that can cause functional diarrhea．For adolescents,emotional experience and cognitive efficacy are factors that can cause functional diarrhea．

目的 探究肺炎支原体（MP）感染大叶性肺炎患儿常规通气、脉冲振荡肺功能特点。方法 将2022年5月—2023年5月广州市妇女儿童医疗中心收治的90例MP感染大叶性肺炎患儿为观察组,通气体检健康儿童50例为对照组,依据病变将累及多肺叶作为观察A组（10例）,累及单肺叶作为观察B组（80例）。均接受常规通气与脉冲振荡肺功能测定,观察测定结果,以此为基础,分析肺功能特点。结果 观察组各常规通气肺功能指标测定结果均低于对照组健康儿童,差异有统计学意义（P<0.05）。观察组R5、R20的实测值/预计值高于对照组,X5实测值低于对照组,差异有统计学意义（P<0.05）。气道阻力指标与肺功能呈负相关关系（P<0.05）。观察组两组最大肺活量（VCMAX）、呼气流量峰值（PEF）、用力肺活量（FVC）75%、FVC50%、FVC25%的实测值/预计值差异无统计学意义,观察A组患儿FVC、FEV₁的实测值/预计值低于观察B组患儿,差异有统计学意义（P<0.05）。两组患儿脉冲振荡肺功能对比差异无统计学意义（P>0.05）。90例患儿中,常规通气异常患儿12例,患儿治疗前后VCMAX、FVC75%、FVC50%的实测值/预计值差异无统计学意义,患儿治疗前FVC、FEV₁、PEF、FVC25%的实测值/预计值均低于治疗后,差异有统计学意义（P<0.05）。结论 常规通气与脉冲振荡相关性良好,气道阻力对VCMAX及FVC具有反向作用,MP感染大叶性肺炎主要表现为小气道通气功能受损,气道阻力升高。

Objective To explore the lung function characteristics of routine ventilation and pulse oscillation in children with lobar pneumonia infected with Mycoplasma pneumoniae（MP）．Methods Ninety children with MP infected lobar pneumonia admitted to Guangzhou Women and Children's Medical Center from May 2022 to May 2023 were selected as the observation group,and 50 healthy children undergoing ventilation examination were selected as the control group．Based on the lesion,cases with multi lobar involvement were selected as the observation group A（10 cases）,cases with single lobar involvement were selected as the observation group B（80 cases）．All patients underwent routine ventilation and pulse oscillation received pulmonary function measurement,and the measurement results were observed．Based on this,the characteristics of lung function were analyzed．Results The results of routine ventilation lung function indicators in the observation group were lower than those in the control group,and the difference was statistically significant（P<0.05）．The measured/expected values of R5 and R20 in the observation group were higher than those in the control group,while the measured values of X5 were lower than those in the control group,with statistical significance（P<0.05）．There is a negative correlation between airway resistance indicators and lung function（P<0.05）．The measured/predicted values of vital capacity max（VCMAX）,peak expiratory flow（PEF）,forced vital capacity（FVC）75%,FVC50%,and FVC25% in the observation group were not with statistically significant difference．The measured/predicted values of FVC and FEV₁ in the observation group A were lower than those in the observation group B,and the difference was statistically significant（P<0.05）．There was no statistically significant difference in pulmonary function between the two groups of pediatric patients with pulse oscillation（P>0.05）．Among the 90 patients,12 had abnormal conventional ventilation．The measured/predicted values of VCMAX,FVC75%,and FVC50% before and after treatment were not significantly different．The measured/predicted values of FVC,FEV₁,PEF,and FVC25% before treatment were lower than those after treatment,and the difference was statistically significant（P<0.05）．Conclusions There is good correlation between conventional ventilation and pulse oscillation．Airway resistance has a reverse effect on VCMAX and FVC．MP infected lobar pneumonia is mainly characterized by impaired small airway ventilation function and increased airway resistance．

伴随着对医疗领域人才水平要求的逐步提高,医院人力资源管理尤其是医院人才引进工作正在由规模化发展向精细化发展转变。当前医院人才引进过程中存在缺乏人力资源发展规划、高层次人才引进方法有待完善、人才管理能力亟须提高、科室用人需求脱离实际、忽视对于岗位胜任力的分析等问题。人力资源成熟度模型（People Capability Maturity Model,P-CMM）作为一种系统的管理理论,其具备很强的实践性,文章对人力资源成熟度模型在医院人才引进工作中的本土化应用进行相关讨论与研究,将P-CMM不同成熟度等级、过程域目标与医院人才引进工作相结合,并提出可操作性指导,具有一定的理论与实践价值。

With the gradual improvement of the requirements for talents in the medical field,hospital human resource management,especially the introduction of talents in hospitals,is changing from large-scale development to refined development．At present,there are some problems in the process of hospital talent introduction,such as lack of human resource development plan,improvement of high-level talent introduction method,improvement of talent management ability,separation of department employment demand from reality,neglect of post competency analysis,etc．People Capability Maturity Model（P-CMM）,as a systematic management idea,has strong practicality．This study discusses and studies the localization application of human resource maturity model in hospital talent introduction,combines different maturity levels and process area objectives of P-CMM with hospital talent introduction,and puts forward operational guidance It has certain theoretical and practical value．

目的 针对精神分裂症患者接受喹硫平与帕利哌酮联合治疗对其代谢功能及血清因子的影响。方法 纳入2022年1月—2023年3月驻马店市第二人民医院收治的120例精神分裂症患者,根据住院号进行编号,并通过通过随机抽签方法分为两组,对照组60例应用单一喹硫平治疗,观察组60例应用喹硫平与帕利哌酮联合治疗,对比两组的治疗效果。结果 经治疗,观察组临床总疗效高于对照组（P<0.05）;该组各项代谢功能指标均与对照组比较差异无统计学意义（P>0.05）;该组各项血清因子测定该结果均高于对照组（P<0.05）;该组各项精神症状评分均低于对照组（P<0.05）;该组不良反应发生率与对照组比较差异无统计学意义（P>0.05）。结论 采用喹硫平与帕利哌酮联合的方式治疗精神分裂症患者,可以提升临床疗效,对患者各种精神症状及血清因子改善效果更好,虽然药物会对患者代谢功能产生一定的影响,但是联合用药与单独用药的影响情况无差异,未增加不良反应发生率,安全性良好。

Objective To evaluate the combination of quetiapine and paliperidone on metabolic function and serum factors in schizophrenia．Methods A total of 120 patients with schizophrenia admitted to Zhumadian Second People's Hospital from January 2022 to March 2023 were included,numbered according to the hospitalization number,and divided into two groups by random drawing method．Sixty patients in the control group were treated with quetiapine alone,and 60 patients in the observation group were treated with quetiapine combined with paliperidone,and the therapeutic effects of the two groups were compared．Results After treatment,the total clinical efficacy of the observation group was higher than that of the control group,P<0.05;the metabolic function indexes comparison were P> 0.05;the serum factor of observation group was higher,P<0.05;the scores of psychiatric symptoms in the group were all lower than the control group,P<0.05;the incidence of adverse reactions in the observation improve group was not different from the control group,P>0.05．Conclusions Using quetiapine and schizophrenia,can improve clinical curative effect,various mental symptoms and serum factors,although certain effect on patient metabolic function may occur,but did not significantly increase the incidence of adverse reactions,with high safety．

目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组（n=49）与对照组（n=49）。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮（NO）、内皮素（ET）、血管紧张素Ⅱ（AngⅡ）相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%（χ²=4.356,P=0.037）;治疗后两组AngⅡ、ET水平均降低,且观察组[（13.62±2.24）ng/mL、（68.62±6.66）ng/L]低于对照组[（16.25±4.32）ng/mL、（74.26±9.35）ng/L],对比差异有统计学意义（t₁=3.783,t₂=3.439,P<0.001）;NO水平升高,观察组[（54.26±3.42）μmol/L]高于对照组[（50.51±2.37）μmol/L],对比差异有统计学意义（t=6.309,P<0.001）;治疗后两组血肌酐（Scr）、尿素氮（BUN）、胱抑素C（CysC）水平均降低,且观察组[（404.36±92.12）μmoI/ L、（13.34±4.31）mmol / L、（2.19±0.24）mg / L]低于对照组[（443.49±80.19）μmoI / L、（15.07±4.23）mmol / L、（2.87±0.38）mg / L],对比有统计学意义（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001）;两组不良反应发生率对比差异无统计学意义（10.20% vs 8.16%,P>0.05）。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。

Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment．Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023．Random number table method was used as the grouping method,and they were divided into an observation group（n=49）and a control group（n=49）．The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally．The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared．Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group（χ²=4.356,P=0.037）．Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[（13.62±2.24）ng/mL,（68.62±6.66）ng/L] was lower than the control group[（16.25±4.32）ng/mL,（74.26±9.35）ng/L],the difference was statistically significant（t₁=3.783,t₂=3.439,P<0.001）．Elevated NO levels in the observation group[（54.26±3.42）μmol/L] was higher than the control group[（50.51±2.37）μmol/L],the difference was statistically significant（t=6.309,P<0.001）．Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[（404.36±92.12）μmoI/L,（13.34±4.31）mmol/L,（2.19±0.24）mg/L] were lower than the control group[（443.49±80.19）μmoI/L,（15.07±4.23）mmol/L,（2.87±0.38）mg/L],the differences were statistically significant（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001;P<0.05）．There was no difference in the incidence of adverse effects between the two groups（10.20% vs 8.16%,P>0.05）．Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety．

目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表（GDS）进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例（34.4%）,社会行为发育正常40例（32%）。早产儿语言发育商平均为（67.99±25.75）,社会行为发育商平均为（67.75±23.98）,处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义（P>0.05）。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义（P<0.05）;且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义（P<0.05）;但在社会行为发育方面比较差异无统计学意义（P>0.05）。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义（P<0.05）。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。

Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care．Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale（GDS）was used to assess their language-social behavior and intellectual development．Results Preterm infants had normal language development in 43 cases（34.4%）and normal social behavioral development in 40 cases（32%）．The mean language development quotient of preterm infants was（67.99±25.75）and the mean social behavioral development quotient was（67.75±23.98）,which was at the low developmental level．There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior（P>0.05）．Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior（P<0.05）;and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development．Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development（P<0.05）,but in social behavior there was no significant difference（P>0.05）．The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant（P<0.05）．Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period．It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis．