专家述评

血小板药物递送系统的研究进展

Advances in platelet as drug delivery systems

:577-584
 
药物递送系统对于各类疾病意义非凡,但传统药物载体面临细胞毒性强、组织相容性低、半衰期短和靶向性弱等诸多挑战。血小板及其相关衍生物作为新型药物载体具有更为显著的优势。由于血小板自身的生理特点,以及在肿瘤、心血管疾病、血栓性疾病、感染等多种疾病中发挥的病理生理作用,血小板能够弥补传统药物载体的缺陷,具有极大的临床转化意义。该文总结了血小板相关药物递送系统目前的研究进展,以期为新型药物载体研究提供参考。
Drug delivery systems are important for various diseases,but conventional therapeutic drug have many shortcomings,such as high cytotoxicity,low histocompatibility,short half-life and weak targeting.Platelets and their derivatives have more significant advantages as novel drug carriers.Platelets play an important role in the pathophysiology of a wide range of diseases including oncology,cardiovascular diseases,thrombosis and infection.In this paper,we summarized the current research progress of platelet-related drug delivery systems to provide a reference for the research of novel drug delivery systems.
综述

基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究进展

Research about Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway

:1255-1263
 
慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。
Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure.Therefore,it usually leads to decreased patient compliance.It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically.However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment.This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade.It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years.This paper is based on “deficiency in origin” and “excess in superficiality” principle.Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality.By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis.It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices.
护理研究

关节镜下治疗慢性踝关节不稳定的护理与康复

Nursing and rehabilitation of arthroscopic treatment of chronic ankle instability

:1500-1505
 
目的 探讨关节镜下外侧韧带增强固定修复术治疗慢性踝关节不稳定的护理和康复方案。方法 回顾性分析2023年1月–2023年8月广州市正骨医院收治的31例采用关节镜下外侧韧带增强固定修复术治疗的慢性踝关节不稳定患者的围术期护理措施和康复指导措施。结果 31例患者均随访无脱落,于术后3、6、12个月返院复查随访,患者手术后患足美国矫形外科足踝协会(AOFAS)踝-后足评分均较前次随访评分提高(均P<0.05)。患者术后3个月Zung焦虑评分和Zung抑郁评分较术前均明显下降(均P<0.05)。31例患者术后无1例发生踝关节不稳定复发、腓肠神经损伤和感染等并发症。结论 关节镜下外侧韧带增强固定修复术的方法治疗慢性踝关节不稳定患者,加强术前术后的护理措施、康复指导,对恢复踝关节稳定性和灵活性有重要作用,有利于提高患者生活质量和满意度。
Objective To investigate the nursing and rehabilitation of chronic ankle instability with reinforcement fixation and repair of lateral ligament under arthroscopy.Methods The perioperative nursing measures and rehabilitation guidance of 31 patients with chronic ankle instability treated with lateral ligament reinforcement fixation under arthroscopy from January 2023 to August 2023 were analyzed retrospectively.Results None of the 31 patients was disassociated during follow-up.The American Orthopaedic Foot and Ankle Society(AOFAS)scores of the patients were significantly higher and higher at 3,6 and 12 months after surgery(all P<0.05).The Zung anxiety score and Zung depression score at 3 months after operation were significantly lower than those before operation(all P<0.05).None of the 31 patients had postoperative complications such as ankle instability recurrence,sural nerve injury,peroneal tendinitis and infection.Conclusions In arthroscopic reinforcement fixation of lateral ligament in the treatment of patients with chronic ankle instability,strengthening the perioperative nursing measures and rehabilitation guidance,plays an important role in restoring the stability and flexibility of the ankle,and is conducive to improving the quality of life and satisfaction of patients.
论著

某净水公司职工脂肪肝检出情况及影响因素分析

Prevalence of fatty liver disease and influencing factors among employees in a water purification company

:1456-1463
 
目的 了解广州市某净水公司职工脂肪肝检出情况,并分析影响因素。方法 选取2023年广州市某净水公司参加职业健康检查的职工为研究对象,收集研究对象的一般情况、个人史、职业史、身体质量指数(BMI)、血压、血生化指标、肝脏彩超等资料。对该人群脂肪肝的患病情况进行描述性分析,对脂肪肝的影响因素进行单因素及多因素Logistic回归分析。结果 共收集研究对象1 217人,检出脂肪肝543例,检出率为44.62%。单因素分析结果表明,脂肪肝的发生与性别、年龄、体质量指数、高血压相关(P<0.05)。接触硫化氢、氨的职工脂肪肝检出率高于非接触者(P<0.05),且职工工龄越长,脂肪肝检出率越高(P<0.05)。患脂肪肝职工的肝功能、脂代谢、血糖及尿酸水平高于非脂肪肝者(P<0.05)。多因素Logistic回归分析提示,年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸是脂肪肝的影响因素(P<0.05)。结论 广州市某净水公司职工的脂肪肝检出率较高,脂肪肝的发生主要与年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸等因素相关。
Objective To investigate the prevalence of fatty liver disease and influencing factors among employees of a water purification company in Guangzhou.Methods Employees of a water purification company in Guangzhou who participated in occupational health examinations in 2023 were selected as the study subjects.The subjects' general conditions,personal history,occupational history,BMI,blood pressure,blood biochemical indicators,and liver ultrasound images were collected.Descriptive analysis was used to analyze the prevalence of fatty liver disease in this population.The influencing factors of fatty liver were analyzed by single factor and multiple factor Logistic regression.Results A total of 1 217 subjects were included in this study,and 543 were diagnosed as fatty liver disease,with a detection rate of 44.62%.The results of single factor analysis showed that the occurrence of fatty liver was closely related to gender,age,BMI and hypertension(P<0.05).The analysis of occupational hazard factors showed that,the detection rate of fatty liver disease was higher in people exposed to hydrogen sulfide and ammonia compared to non-exposed individuals(P<0.05).The longer the working years,the higher the detection rate of fatty liver(P<0.05).The levels of liver function,lipid metabolism,blood glucose and uric acid in workers with fatty liver were higher than those in workers without fatty liver(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,abnormal liver function,abnormal lipid metabolism,high blood glucose levels and hyperuricemia were independent influencing factors for fatty liver disease(P<0.05).Conclusions The detection rate of fatty liver disease among employees of a water purification company in Guangzhou is high,and the occurrence of fatty liver disease is mainly related to factors such as age,BMI,abnormal liver function,abnormal lipid metabolism,high sugar levels and hyperuricemia.
论著

脐动脉血流动力学指标、血脂、TSH对妊娠期糖尿病患者分娩结局的影响研究

Effects of umbilical artery hemodynamic indexes, blood lipids and TSH on delivery outcomes in patients with gestational diabetes mellitus

:48-51
 
目的 探究脐动脉血流动力学指标、血脂、促甲状腺激素(TSH)对妊娠期糖尿病患者分娩结局的影响研究。方法 选取我院2021年1月—2021年11月收治的妊娠期糖尿病患者138例,采用随机数字表法分为对照组和研究组,每组各69例。比较2组患者体内脐动脉血流动力学指标、血脂指标及TSH相关指标表达水平差异及妊娠结局,并通过多元线性回归分析探究脐动脉血流动力学指标、血脂指标、TSH等相关指标与妊娠期糖尿病患者不良妊娠结局的相关性。结果 研究组孕妇脐动脉峰值流速/舒张末期流速(S/D)、阻力指数(RI)、三酰甘油(TG)、低密度脂蛋白(LDL)、TSH水平高于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组(P<0.05);研究组孕妇巨大儿、剖宫产、新生儿低血糖发生率及新生儿体质量均高于对照组(P<0.05);多元线性回归方程显示:S/D、RI、TG、LDL、TSH水平变化均与不良妊娠结局存在相关性(R2=0.224,调整R2=0.201;F=9.504,P<0. 05),且影响顺序由大到小依次为 TG、TSH、RI、S/D、LDL。结论 妊娠期糖尿病孕妇体内的S/D、RI、TG、LDL、TSH水平异常可能会影响妊娠结局,临床可通过监测上述指标的变化,及时采取干预措施。
Objective To investigate the effects of umbilical artery hemodynamic indexes, blood lipids and thyroid stimulating hormone (TSH) on delivery outcomes in patients with gestational diabetes mellitus. Methods A total of 138 patients with gestational diabetes mellitus who were admitted to our hospital from January 2021 to November 2021 were selected and divided into a control group and a study group by random digital table, with 69 cases in each group. The differences in umbilical artery hemodynamic indexes, blood lipid indexes and TSH-related indexes and pregnancy outcomes were compared between the two groups, and multiple linear regression analysis was used to explore the relationship between umbilical artery hemodynamic indexes, blood lipid indexes, TSH, other related indexes and adverse pregnancy outcomes in patients with gestational diabetes mellitus. Results The systolic and diastolic peak volume ratio (S/D), resistive index (RI) of umbilical artery, triglyceride (TG), low density lipoprotein (LDL) and TSH in the study group were higher than those in the control group, while the levels of free triiodothyronine (FT3) and free thyroxine (FT4) were lower than those in the control group (P<0.05). The incidences of macrosomia, cesarean section, neonatal hypoglycemia and neonatal weight in study group were significantly higher than those in the control group (P<0.05). The multiple linear regression equation showed that the adverse pregnancy outcomes were correlated with changes of TG, TSH, RI, S/D, LDL levels (R2=0.224, adjusted R2=0.201; F=9.504, P<0.05), in descending order. Conclusions Abnormal levels of S/D, RI, TG, LDL, TSH and FT4 in pregnant women with gestational diabetes mellitus may affect the pregnancy outcomes. Clinical intervention measures can be taken by monitoring the changes of the above indicators.
论著

冷敷对前交叉韧带重建术后疼痛肿胀及关节活动度的影响

Effect of cold compress on pain,swelling and range of motion after anterior cruciate ligament reconstruction

:48-51
 
目的 探索冰袋冷敷对膝关节前交叉韧带重建术后关节疼痛肿胀和活动度的影响。方法 回顾性分析自2021年1月—2021年7月在我院因前交叉韧带损伤行前交叉韧带重建术的患者资料,将符合标准的71例行单侧前交叉韧带重建术的患者按住院号的单双号分成2组。其中,对照组38名患者,试验组33名患者。对照组38名患者术后不用冰袋冷敷;试验组33名患者术后采用冰袋冷敷。用视觉模拟评分表评估对照组和试验组患者术前、术后的疼痛,并测量患者的膝关节肿胀程度和活动度。结果 对照组和试验组患者术前视觉模拟评分比较,差异无统计学意义(P>0.05),试验组在术后6、24、48、72小时四个不同的时间点时疼痛视觉模拟评分均明显低于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前关节活动度比较,差异无统计学意义(P>0.05),试验组在术后4、5、6、7天四个不同的时间点时关节活动度优于对照组,差异有统计学意义(P<0.001);对照组和试验组患者术前膝关节肿胀程度比较,差异无统计学意义(P>0.05),试验组在术后1、2、3天三个不同的时间点时膝关节肿胀程度低于对照组,差异有统计学意义(P<0.001)。结论 冰袋冷敷能够有效减轻前交叉韧带重建术后膝关节疼痛肿胀并改善关节活动度。
Objective To explore the effect of ice pack cold compress on joint pain,swelling and motion after anterior cruciate ligament reconstruction. Methods The data of patients undergoing anterior cruciate ligament reconstruction due to anterior cruciate ligament injury in our hospital from January 2021 to July 2021 were retrospectively analyzed,and 71 patients who received unilateral anterior cruciate ligament reconstruction meeting the standards were divided into two groups according to the odd and even numbers of hospital admission. There were 38 patients in the control group and 33 patients in the experimental group. Thirty-eight patients in the control group did not use ice packs after surgery. Thirty-three patients in experimental group were treated with ice pack after operation. Visual analogue scale was used to evaluate the preoperative and postoperative pain of the control group and experimental group,and the degree of knee swelling and range of motion were measured. Results There was no significant difference in preoperative visual analogue scale between control group and experimental group (P>0.05). The scores of pain in the experimental group were significantly lower than that in the control group at 6,24,48 and 72 hours after surgery,with statistical significance (P<0.001). There was no significant difference in preoperative range of motion between control group and experimental group(P>0.05), the range of motion of the experimental group was significantly better than that of the control group at four different time points of 4,5,6 and 7 days after operation,with statistical significance(P<0.001). There was no significant difference in the degree of preoperative knee joint swelling between the control group and the experimental group(P>0.05),and the degree of knee joint swelling in the experimental group was lower than that in the control group on,1,2 and 3 days after surgery,three different time points, with statistically significant difference(P<0.001). Conclusions Ice pack cold compress can effectively reduce the pain and swelling of the knee joint after anterior cruciate ligament reconstruction and improve the range of motion of the joint.
论著

阶梯式呼吸管理护理策略在感染性休克合并急性肺损伤患者中的应用效果

Effect of stepwise respiratory management nursing strategy on patients with septic shock complicated with acute lung injury

:87-90
 
目的 观察阶梯式呼吸管理策略在改善感染性休克伴急性肺损伤(ALI)患者中的价值。方法 纳入我院2019年1月—2020年12月收治的感染性休克伴ALI患者共146例为研究对象,数字表法随机分为观察组(73例)与对照组(73例)。对照组常规护理方案,观察组阶梯式呼吸管理,对比干预前后患者心肺功能的差异。结果 观察组平均动脉压、PaCO2水平低于对照组,心脏指数、中心静脉压、血管外肺水指数、PaO2与氧合指数高于对照组(P<0.05);观察组复苏成功率与临床总有效率高于对照组,复苏时间与呼吸平稳时间低于对照组(P<0.05);观察组气管切开率、有创呼吸机使用率及呼吸机相关性肺炎与气道并发症发生率均低于对照组(P<0.05)。结论 感染性休克并急性肺损伤患者建立阶梯化呼吸管理策略能够显著改善患者的心肺功能,提高临床复苏效果,降低相关并发症风险。
Objective To observe the value of stepwise respiratory management strategy in improving patients with septic shock and acute lung injury(ALI).Methods A total of 146 patients with septic shock and ALI treated in our hospital from January 2019 to December 2020 were included as the research objects.They were randomly divided into observation group(73 cases)and control group(73 cases)by digital table method.The control group received routine nursing plan,and the observation group received stepwise respiratory management.The differences of cardiopulmonary function before and after the intervention were compared.Results The levels of mean arterial pressure,PaCO2 in the observation group were significantly lower than those in the control group,cardiac index,central venous pressure,extravascular lung water index,PaO2 and oxygenation index in the observation group were significantly higher than those in the control group(P<0.05).The success rate of resuscitation and total clinical effective rate in the observation group were significantly higher than those in the control group,and the resuscitation time and respiratory stability time in the observation group were significantly shorter than those in the control group(P<0.05).The tracheotomy rate,the rate of using invasive ventilator and the incidence of ventilator associated pneumonia and airway complications in the observation group were lower than those in the control group(P<0.05).Conclusions The establishment of stepwise respiratory management strategy in patients with septic shock and ALI can significantly improve their cardiopulmonary function,improve the effect of clinical resuscitation and reduce the risk of related complications.
论著

电子束对体外培养的细粒棘球蚴及其p38 mRNA表达的影响

Effects of radiation on Echinococcus granulosus in vitro culture and its mRNA expression of p38 mRNA

:14-20
 
目的 观察电子束照射对体外培养的细粒棘球蚴形态结构、死亡率及其p38 mRNA表达的影响。方法 采集自然感染的绵羊肝中的细粒棘球蚴原头蚴,随机分成3组,分别用0 Gy、30 Gy、60 Gy的不同剂量的6 MeV电子束各照射1次,照射后连续培养3 d、14 d,光镜观察虫体的大体变化及死亡率,qRT-PCR法测定p38基因的表达水平。结果 60 Gy组较0 Gy、30 Gy组原头蚴变性坏死数目明显增多,死亡率有差异(P<0.0125),连续培养天数(3 d、14 d)对虫体死亡率无影响。经电子束照射后,30 Gy、60 Gy组原头蚴p38 mRNA表达水平较0 Gy组升高(P<0.05)。结论 体外培养的原头蚴经电子束照射后大体形态结构发生明显变化、死亡率升高,且与电子束的剂量存在量效关系;p38 mRNA的表达量随着电子束的剂量的增加而升高,p38基因可能参与电子束所致体外杀伤棘球蚴的作用机制。
Objective To observe the effect of 6 MeV electron beam on the morphological structure,mortality rate and expression of p38 mRNA and in Echinococcus granulosus.Methods Einococcus granulosus was collected from natural infected sheep liver and divided into 3 groups randomly,then irradiated by 6 MeV electron beam of 0 Gy,30 Gy and 60 Gy,respectively.After culturing for 3 and 14 days,the gross change and mortality of worms were observed by light microscopy and the expression level of p38 gene was determined by qRT-PCR.Results In 60 Gy group,compared with 0 Gy and 30 Gy group,the gross morphology and structure have changed significantly,the mortality rate was significantly different(P <0.0125).Days of culture(3 days,14 days)had no obvious effect on mortality,and the p38 mRNA expression levels in 30 Gy and 60 Gy group were significantly higher than 0 Gy group(P <0.05).Conclusions The gross morphology,structure changes and mortality of Einococcus granulosus increases significantly after electron beam irradiation and has obvious quantitative and effective relationship with the electron beam dose,the p38 gene may be involved in the mechanism of in vitro killing by electron beam.
论著

“互联网+护理服务”实践与态势分析

Practice and situation analysis of “Internet + Nursing Service”

:45-51
 
目的 探索基于患者居家护理服务需求且以三甲医院为实施主体的“互联网+护理服务”模式,以期为“互联网+护理服务”的开展提供借鉴。方法 成立“互联网+护理服务”小组,基于患者需求进行平台建设,组建“互联网+护理服务”团队,经过同质化培训持证上岗,提供专科护理、母婴护理以及基础护理共25项服务内容。服务结束后,调查患者对“互联网+护理服务”的满意度。结果 截至2022年10月,该平台注册护士438名,注册患者1 000人。共开展“互联网+护理服务”居家护理服务841人次,排名前三位的服务项目是母婴护理、留置/更换鼻饲管护理、留置/更换尿管护理。患者居家服务好评率为100%,对护理服务的整体满意度为(4.86±0.22)分。患者对护士指导居家护理知识的满意度最高,为(4.89±0.33)分,对平台收费的满意度最低,为(4.12±0.78)分。结论 “互联网+护理服务”为居家护理提供了更加方便快捷的渠道,使资源利用更有效,患者认可度高。
Objective To explore the“Internet + Nursing Service”model based on the needs of patients' home care, which the grade A class 3 hospital hospital was the main institution of implementation, and to provide the reference for implementing “Internet + Nursing Service”.Methods We set up a working group, built a platform according to needs, and set up the “Internet + Nursing service”team, who worked with the certificate after homogenization training.The program provided 25 kinds of services, including specialist nursing, maternal and child care, basic nursing, provides high-quality and convenient home care services.After the service, the patients' satisfaction was investigated.Results By October 2021, the platform had 438 registered nurses and 1000 registered patients.A total of 841 people were provided with “Internet + Nursing service”home care services, and the top three services were maternal and infant care, nasal feeding tube care with indentation/replacement, and urinary tube care with indentation/replacement.The favorable rate of home service was 100%, and the overall satisfaction with nursing services was(4.86±0.22)points.Patients had the highest level of satisfaction with nurses' guidance on home nursing knowledge, which was(4.89±0.33)points, and the lowest level of satisfaction with platform fees, which was(4.12±0.78)points.Conclusions “Internet + Nursing Service”provides a more convenient and fast access for home nursing, making resource utilization more effective and with high patient recognition.
论著

2016—2022年广州市某三甲综合医院住院病例疾病谱变化

Changes in disease spectrum of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022

:28-38
 
目的 了解广州市某三甲综合医院2016—2022年住院病例的疾病分布特征,探究新型冠状病毒感染(新冠)疫情对疾病谱的影响,为医院合理配置医疗资源、提高医院医疗水平提供参考。方法 回顾性收集广州市某三甲综合医院2016—2022年间住院病例的病例数据,按照ICD-10国际统计分类标准进行分类,建立Joinpoint回归模型对不同类别疾病构成比的时间变化趋势进行分析。结果 2016—2022年间,前12顺位的疾病种类不变,构成比呈上升趋势的有4种,分别是循环系统疾病、肿瘤、消化系统疾病以及眼和附器疾病,构成比呈下降趋势的有3种,分别是呼吸系统疾病、肌肉骨骼系统和结缔组织疾病以及妊娠、分娩和产褥期。对这7类系统疾病进行不同性别、不同年龄段和不同居住地(广州市内/市外)的亚组分析,结果显示,除眼和附器疾病与妊娠、分娩和产褥期外,其余5种系统疾病在男性和女性中变化趋势比较差异无统计学意义(均P>0.05)。25岁以上人群循环系统疾病、肿瘤和消化系统疾病比例呈上升趋势。45岁以上人群眼和附器疾病的住院比例逐年上升。呼吸系统疾病的下降趋势集中出现在0~5岁和65岁以上人群,肌肉骨骼系统和结缔组织疾病的下降趋势可在45岁以上人群中被观测到,妊娠、分娩和产褥期的下降趋势则可在45岁以下人群中被观测到。总体和市内来源的住院病例的各系统疾病构成比变化趋势均未发现有2019年的连接拐点。但对于居住地在广州市外的病例,有6种系统疾病均存在一个2019年的连接拐点,与2016—2019年相比,2020—2022年增长趋势普遍减弱或者略有降低,但均无统计学意义,2022年市外来源住院病例的多种疾病占比低于2019年。≤24岁年龄组的病例因妊娠、分娩和产褥期住院的比例在2019年以后降低趋势加快,但也无统计学意义,2020—2022年≤24岁人群因妊娠、分娩和产褥期住院的比例低于2019年水平。结论 2016—2022年期间住院病例疾病谱有较大变化,这种变化趋势在不同性别、不同年龄段和居住地间效应存在差异。2020—2022年的新冠疫情流行主要降低了居住地在广州市外的住院病例多个系统疾病的比例以及24岁及以下患者因妊娠、分娩和产褥期住院的比例。
Objective To understand the disease distribution characteristics of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022,to explore the impact of the COVID-19 on the disease spectrum,and to provide reference for hospitals to reasonably allocate medical resources and improve medical level. Methods Inpatient case data of a 3-A-grade general hospital from 2016 to 2022 were retrospectively collected and were classified according to the ICD-10 international statistical classification standard. A Joinpoint regression model was established to analyze the temporal trend of disease composition ratios in different categories. Results From 2016 to 2022,the type of top 12 diseases remained unchanged. There were 4 diseases showing an upward trend in composition,namely circulatory system diseases,tumors,digestive system diseases and eye and accessory organ diseases. There were 3 diseases showing a downward trend in composition,namely respiratory system diseases,musculoskeletal system and connective tissue diseases,as well as pregnancy,childbirth and postpartum period. A subgroup analysis was conducted on these 7 types of systemic diseases by gender,age group and place of residence(within/outside Guangzhou). The results showed that except for eye and accessory organ diseases and pregnancy,childbirth and postpartum period,there was no significant difference in the trend of changes in the other 5 systemic diseases between males and females(all P>0. 05). The upward trend of circulatory system diseases,tumors and digestive system diseases could be observed in people over the age of 25. The hospitalization rate of eye and accessory organ diseases among people over 45 years old was increasing year by year. The downward trend of respiratory diseases was concentrated in people aged 0~5 and over 65 years old,while the downward trend of musculoskeletal and connective tissue diseases could be observed in people aged 45 and above. The downward trend of pregnancy,childbirth and postpartum period could be observed in people under 45 years old. The trend of changes in the proportion of systemic diseases among inpatient cases from both overall and within Guangzhou had not been found to have a joinpoint in 2019. However,for cases residing outside of Guangzhou,there were six systemic diseases that all had a joinpoint in 2019. Compared with the growth trend from 2016 to 2019,the growth trend from 2020 to 2022 generally weakened or showed a slightly downward trend,but none of them were statistically significant. In 2022,the proportion of multiple diseases in hospitalized cases from outside Guangzhou was lower than that in 2019. The proportion of cases in the age group ≤24 years old who are hospitalized due to pregnancy,childbirth and postpartum period has been decreasing rapidly since 2019,but there was no statistical significance. The proportion of cases hospitalized due to pregnancy,childbirth and postpartum period in the population ≤24 years old from 2020 to 2022 was significantly lower than the level in 2019. Conclusions The disease spectrum of inpatients had undergone significant changes between 2016 and 2022,and these trends of changes were different among different genders,age groups and places of residence. The prevalence of the COVID-19 from 2020 to 2022 mainly reduced the proportion of inpatients with multiple systemic diseases living outside Guangzhou,and the proportion of inpatients aged 24 and under hospitalized for pregnancy,childbirth and puerperium.
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