目的 分析精神分裂症患者体内的肌酸激酶（CK）、肌红蛋白（MYO）、β₂微球蛋白（β₂-MG）、细胞间黏附分子（ICAM）水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤（AKI）可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组（同期我院门诊健康体检者）20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β₂-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β₂-MG值高于健康对照组及肾功能正常组,差异具有统计学意义（F=623.534,30.437,636.776,88.283,P<0.05）,精神分裂症AKI 1期组到AKI 3期组CK、MYO、β₂-MG、ICAM数值均比对照组升高（P<0.05）,3组之间如上指标的比较差异有统计学意义（P<0.05）。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β₂-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。

Objective To study the changes of serum creatine kinase（CK）,myoglobin（MYO）,β₂ microglobulin（β₂-MG）,intercellular adhersion molecule（ICAM）with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury（AKI）in patients with schizophrenia．Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls（who underwent physical examination during the same period）were included．At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β₂-MG level in each group．The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed．Results The serum CK,MYO,ICAM and β₂-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant（F=623.534,30.437,636.776,88.283,P<0.05）,and the comparison of the above indexes among the three groups was statistically significant（P<0.05）．Conclusions The abnormal increase of serum CK,MYO,ICAM and β₂-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis．

目的 调查口腔专科医院门诊不同层级护士急救能力的现状,进一步探讨优化口腔门诊护士急救培训模式。方法 选取2019年1月—2020年1月我院口腔门诊护士97名,采用自设问卷调查及现场操作技能评估对护士进行考核,调查护士的急救能力。结果 口腔科门诊不同层级护士的急救能力(包括相关知识与操作能力)差异有统计学意义(P＜0.05)。其中,N1级(工作1~＜3年)的护理人员急救能力低于N2级(工作3~5年)的护理人员。N3级(工作6~10年)的急救知识考核分、操作考核分略低于工作N2级护士,但差异无统计学意义。而不同年龄、学历、职称、科室的护士急救能力的差异无统计学意义。结论 口腔门诊护士急救培训应分层级进行,特别应加强N1级以下护理人员的急救技能培训,保证护士急救培训效果同质化,对口腔门诊诊疗中提高医疗安全及护理质量具有重要意义。

Objective To investigate the current status of the first-aid ability of nurses at different levels in outpatient clinics of stomatological hospitals, and to further explore the optimization of the training model of first-aid nurses in outpatient clinics. Methods A total of 97 nurses in our outpatient clinic from January 2019 to January 2020 were selected. The nurses were assessed by self-designed questionnaire surveys and on-site operation skills assessment to investigate the nurses' first aid ability. Results The difference in first aid ability (including relevant knowledge and operation ability) of nurses at different levels in the dental clinic was statistically significant (P<0.05). Among them, the first-aid ability of nursing staff of N1 grade (working 1 ~<3 years) is lower than that of nursing staff of N2 grade (working 3 ~ 5 years). The N3 level (working 6～10 years) first aid knowledge assessment and operation assessment scores are slightly lower than those of working N2 nurses, but the difference is not statistically significant. There was no statistically significant difference in the first aid ability in nurses of different ages, educational backgrounds, titles, and departments. Conclusion The first-aid training of nurses in oral clinics should be conducted in different levels, especially the first-aid skills training of nurses below N1 level. We should be strengthened to ensure the homogenization of nurse's first-aid training effect, which is of great significance to improve medical safety and quality of care in oral clinics.