冠状动脉血管成像联合动态心电图与冠心病冠脉狭窄程度及预后的关联研究

Study on the correlation between Coronary CT angiography combined with dynamic electrocardiogram and the degree and prognosis of coronary stenosis in coronary heart disease

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目的:分析冠状动脉CT血管成像(CTA)联合动态心电图(DCG)与冠心病患者冠脉狭窄程度及预后情况的关联。方法:研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者,分别列为病例组和对照组,比较两组CTA参数、DCG参数间差异。依据入院测得(Gensini)评分不同,将入组患者分别列为轻度组(60例,Gensini评分≤30分)、中度组(75例,Gensini评分>30分、≤60分)和重度组(75例,Gensini评分>60分),比较三组CTA参数、DCG参数间差异,分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况,比较不同预后患者CTA参数、DCG参数间差异,归纳冠心病患者预后影响因素,检验CTA参数、DCG参数对患者不良预后的预测效能。结果:病例组的最小管腔直径(MLD)、最小管腔面积(MLA)、血流储备分数(FFR)、正常窦性间期的标准差(SDNN)、每5min平均RR间期的标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)均低于对照组,斑块总体积(TPV)、低频/高频比值(LF/HF)均高于对照组(t=24.128,25.811,15.613,37.636,26.858,9.195,59.862,29.389;P<0.05)。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组,轻度组,TPV、LF-HF均高于中度组,轻度组(F=190.291,51.562,186.482,42.084,44.413,22.541,56.503,109.983;P<0.05)。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关,TPV、LF-HF均与Gensini评分正相关(r=-0.352,-0.377,-0.445,-0.472,-0.332,-0.356,0.401,0.355;P<0.05)。经统计,210例冠心病患者的不良预后发生率为38.10%(80/210)。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组,TPV、LF-HF均高于预后良好组(t=6.827,12.219,19.313,6.097,7.097,5.027,7.088,12.465;P<0.05)。MLA、FFR、SDNN升高为冠心病不良预后的保护因素,LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测(Delong检验,P<0.05)。结论:CTA、DCG能客观评估冠心病患者冠脉狭窄程度,联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。
Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128,25.811,15.613,37.636,26.858,9.195,59.862,29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291,51.562,186.482,42.084,44.413,22.541,56.503,109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352,-0.377,-0.445,-0.472,-0.332,-0.356,0.401,0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827,12.219,19.313,6.097,7.097,5.027,7.088,12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05).Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.

发病48 h内依达拉奉右莰醇注射用浓溶液治疗急性缺血性卒中患者的真实世界用药特征及短期预后分析

Real-World Treatment Characteristics and Short-Term Prognosis of Edaravone Dexborneol in Patients With Acute Ischemic Stroke Treated Within 48 Hours of Onset

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目的:描述发病48 h内急性缺血性卒中(acute ischemic stroke,AIS)患者依达拉奉右莰醇真实世界用药特征,探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法:回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者,药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例,排除35例,纳入112例发病至首次用药时间(onset-to-treatment time,OTT)≤48 h者;按预设24 h界值分为24 h内用药组(n=67)和24~48 h用药组(n=45)。主要结局为住院期间美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)变化值(ΔNIHSS=入院NIHSS评分-出院前NIHSS评分);次要结局包括出院前NIHSS评分、出院改良Rankin量表(modified Rankin Scale,mRS)评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性,并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果:总体OTT为19.65(14.97,34.68)h,疗程12.00(11.00,13.00)d,完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义[8.00(6.00,9.00)分 vs 8.00(6.00,10.00)分,P=0.447];24 h内用药组出院前NIHSS评分更低[5.00(4.00,6.50)分 vs 6.00(5.00,8.00)分,P=0.025],ΔNIHSS更高[3.00(2.00,3.00)分 vs 2.00(1.00,2.00)分,P<0.001],显著神经功能改善率更高(77.6% vs 60.0%,P=0.045)。多因素校正后,24 h内用药仍与更大的ΔNIHSS相关(β=0.768,95%CI:0.377~1.159,P<0.001);Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关(OR=2.475,95%CI:1.047~5.853,P=0.039)。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论:本单中心真实世界队列中,发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低;24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究,结果应解释为关联性证据,需前瞻性、多中心研究及长期功能结局验证。
Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.

动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床症状及社会功能的影响

Effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function of school-age ADHD children

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目的 探讨动态社交行为技巧练习联合生物反馈对学龄注意缺陷多动障碍(ADHD)患儿临床症状和社会功能的影响。方法 回顾性选取我院2021年1月~2024年3月收治的81例学龄ADHD患儿作为研究对象,按照治疗方法不同分为对照组(40例)、观察组(41例),对照组接受生物反馈治疗,观察组接受动态社交行为技巧练习联合生物反馈治疗。比较两组临床疗效、临床症状、社会功能、脑电波频率[β波、θ波、感觉运动节律(SMR)波]。结果 观察组总有效率90.24%较对照组的72.50%高(P<0.05);治疗后观察组对抗性行为、多动-冲动、注意力不集中评分均低于对照组(P<0.05);治疗后观察组家庭、学习与学校、生活技能、自我管理、社交活动及风险活动评分均低于对照组(P<0.05);治疗后观察组β波、SMR波均高于对照组,θ波低于对照组(P<0.05)。结论 动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床疗效确切,可进一步改善患儿临床症状、社会功能。
Objective To explore the effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function in school-age children with attention deficit hyperactivity disorder (ADHD). Methods A total of 81 school-age children with ADHD admitted to our hospital from January 2021 to March 2024 were retrospectively selected as the research objects. According to different treatment methods, they were divided into control group (40 cases) and observation group (41 cases). The control group received biofeedback therapy, and the observation group received dynamic social behavior skills training combined with biofeedback therapy. The clinical efficacy, clinical symptoms, social function, brain wave frequency [β wave, θ wave, sensorimotor rhythm ( SMR ) wave] were compared between the two groups. Results The total effective rate of the observation group was 90.24% higher than that of the control group (72.50%) (P<0.05). After treatment, the scores of antagonistic behavior, hyperactivity-impulsion and inattention in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of family, learning and school, life skills, self-management, social activities and risk activities in the observation group were lower than those in the control group (P<0.05). After treatment, the β wave and SMR wave in the observation group were higher than those in the control group, and the θ wave was lower than that in the control group (P<0.05). Conclusion Dynamic social behavior skill training combined with biofeedback has definite clinical efficacy in school-age children with ADHD, which can further improve their clinical symptoms and social functioning.

阻塞性冠心病舌象纹理特征与冠周脂肪影像组学特征相关性研究

Study on the Correlation between Tongue Texture Features of Obstructive Coronary Heart Disease and Radiomic Indicators of Pericoronary Adipose Tissue

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目的:探究阻塞性冠心病患者中舌象纹理特征与冠周脂肪影像组学的相关性。 方法:收集辽宁中医药大学附属医院131例就诊的疑似冠心病患者,其中阻塞性冠心病63例、非阻塞性冠心病68例,提取临床常规指标、舌象纹理特征及右冠状动脉影像组学参数。独立样本t检验、曼-惠特尼U检验、卡方检验、错误发现率校正用于比较组间差异。使用斯皮尔曼相关性分析舌象纹理特征与冠周脂肪影像组学的相关性。采用弹性网络进行特征筛选,按照7:3的比例随机抽样划分为训练集和测试集,使用BP神经网络模型构建冠周脂肪及冠周脂肪与舌象纹理特征联合模型,使用ROC曲线、准确性、精度、召回率、特异度、F1分数、Kappa系数评估模型。 结果:在疑似冠心病患者中,舌象纹理与冠周脂肪影像组学共检出22组弱负相关、1组中等正相关及23组弱正相关;阻塞性冠心病患者中检出4组中等负相关、4组弱负相关、2组中等正相关及6组弱正相关;非阻塞性冠心病患者中检出1组中等负相关、6组弱负相关、1组中等正相关及10组弱正相关。基于BP神经网络构建诊断模型,联合舌象纹理特征后较单一冠周脂肪影像组学模型测试集AUC有所提升。 结论:舌象纹理特征与冠周脂肪影像组学参数在阻塞性冠心病中存在一定的相关性;舌象纹理信息对冠周脂肪诊断阻塞性冠心病具有增量价值。
Abstract:Objective: To investigate the correlation between tongue image texture features and pericoronary adipose tissue (PCAT) radiomics in patients with obstructive coronary heart disease. Methods: A total of 131 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were enrolled, including 63 cases of obstructive coronary heart disease and 68 cases of non-obstructive coronary heart disease. Clinical routine indicators, tongue image texture features, and right coronary artery radiomics parameters were extracted. Independent sample t-test, Mann-Whitney U test, Chi-square test, and false discovery rate correction were used to compare intergroup differences. Spearman correlation analysis was employed to examine the correlation between tongue image texture features and PCAT radiomics. Elastic net was applied for feature selection. The dataset was randomly split into training and test sets at a 7:3 ratio. BP neural network models were constructed using PCAT features alone and in combination with tongue image texture features. Model performance was evaluated using receiver operating characteristic (ROC) curves, accuracy, precision, recall, specificity, F1 score, and Kappa coefficient. Results: In patients with suspected coronary heart disease, 22 weak negative correlations, 1 moderate positive correlation, and 23 weak positive correlations were identified between tongue image texture features and PCAT radiomics. In patients with obstructive coronary heart disease, 4 moderate negative correlations, 4 weak negative correlations, 2 moderate positive correlations, and 6 weak positive correlations were detected. In patients with non-obstructive coronary heart disease, 1 moderate negative correlation, 6 weak negative correlations, 1 moderate positive correlation, and 10 weak positive correlations were observed. The BP neural network diagnostic model combining tongue image texture features with PCAT radiomics demonstrated improved performance on the test set compared with the PCAT radiomics model alone. Conclusion: Tongue image texture features exhibit certain correlations with PCAT radiomics parameters in obstructive coronary heart disease, and tongue texture information provides incremental value for the diagnosis of obstructive coronary heart disease when combined with PCAT radiomics.

急性中毒导致缺血缺氧性脑病患者预后的影响因素及预测模型研究

Study on the influencing factors and prediction model of prognosis in patients with hypoxic-ischemic encephalopathy caused by acute poisoning

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目的:分析急性有机磷农药中毒(AOPP)引发缺血缺氧性脑病预后相关因素,建立相关的预后预测模型。方法:回顾性分析90例(33例预后不良、57例预后良好)AOPP致HIE患者(2022年3月~2025年8月)的临床资料、中毒指标和血清学指标,独立危险因素用Logistic回顾分析筛选,并构建预后不良预测模型,采用ROC工具对模型效能进行验证。结果:Logistic 回归分析显示,年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素(P<0.05);AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论:高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局,据此构建风险预测模型可有效预测预后不良的发生风险。
To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

基于口腔-肠道微生物轴探讨中医药防治动脉粥样硬化的研究进展

Research Progress on the Prevention and Treatment of Atherosclerosis by Traditional Chinese Medicine Based on the Oral-Gut Microbiota Axis

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动脉粥样硬化(AS)是心血管疾病的病理基础,口腔与肠道通过菌群移位、代谢互作及免疫联动共同构成口腔-肠道微生物轴,其稳态失衡通过菌群易位、代谢紊乱和屏障损伤等促进AS发生发展。中医药以整体观念与辨证论治为指导,多靶点调控口腔-肠道微生物平衡,抑制血管炎症与脂质沉积,发挥抗AS效应。本文系统阐述口腔-肠道微生物与AS的关联,探讨中医药调控微生态防治该病的研究进展,分析当前研究存在的局限并展望未来方向,为中医药防治AS提供新的思路与理论依据。
Atherosclerosis (AS) is the pathological basis of cardiovascular diseases. The oral cavity and the gut together constitute the oral-gut microbial axis through microbial translocation, metabolic interactions, and immune crosstalk. Dysbiosis of this axis promotes the occurrence and development of AS via bacterial translocation, metabolic disorders, and barrier damage. Guided by the holistic concept and syndrome differentiation-based treatment, traditional Chinese medicine (TCM) exerts anti-AS effects by multi-target regulation of the oral-gut microbial balance, inhibiting vascular inflammation and lipid deposition. This article systematically elaborates the association between the oral-gut microbiota and AS, explores the research progress of TCM in modulating microecology for the prevention and treatment of AS, analyzes the limitations of current studies, and prospects future directions, so as to provide new insights and theoretical basis for TCM in preventing and treating AS.

音乐干预对眼科手术焦虑与生理影响的研究进展

Research progress of music intervention for ophthalmic surgery–Related anxiety and physiological responses

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【摘要】 目的 系统分析音乐干预对眼科手术患者围手术期焦虑与生理反应的影响,为其临床应用提供参考。方法 系统检索国内外相关文献,从患者焦虑特征、理论基础、实施方法、干预效果及影响因素等方面进行综合分析。结果 眼科手术患者围术期焦虑发生率较高,焦虑可降低术中配合度、增加麻醉用药等风险。音乐干预通过调节边缘系统及自主神经系统发挥作用,术前、术中持续应用可显著降低焦虑评分,稳定心率、降低血压。听觉敏感性、基线焦虑水平、年龄及干预方案特征是影响干预效果的关键因素。结论 音乐干预能有效缓解眼科手术患者围手术期焦虑,具有良好应用潜力。未来需开展大样本随机对照试验,结合人工智能等技术开发个性化方案,并建立标准化实施方法。
【Abstract】Objective To systematically evaluate the effects of music intervention on perioperative anxiety and physiological responses in ophthalmic surgery patients, and to provide evidence for clinical practice. Methods Domestic and international literature on anxiety characteristics, mechanisms, implementation, efficacy, and influencing factors was systematically searched and reviewed. Results Perioperative anxiety is common in ophthalmic surgery patients and may reduce intraoperative cooperation and increase anesthetic consumption. Music intervention acts on the limbic system and the autonomic nervous system, and can effectively reduce anxiety scores, stabilize heart rate, and lower blood pressure when applied preoperatively and intraoperatively. Key influencing factors include auditory sensitivity, baseline anxiety, age, and intervention features. Conclusions Music intervention safely and effectively relieves perioperative anxiety in ophthalmic surgery patients. Further large-sample randomized controlled trials, AI-based personalized programs, and standardized protocols are needed.
论著

重性抑郁障碍患者肠道菌群特征与SSRIs类抗抑郁药疗效的关联分析

Analysis of the association between gut microbiota characteristics and efficacy of SSRIs antidepressants in patients with major depressive disorder

:233-239
 
      目的 探讨重性抑郁障碍(MDD)患者肠道菌群特征与选择性5-羟色胺再摄取抑制剂(SSRIs)疗效的关联性, 筛选可预测SSRIs疗效的肠道菌群生物标志物。方法 选取2024年5月—2025年5月宁夏回族自治区人民医院收治的90例MDD患者, 根据SSRIs治疗8周后疗效分为应答组56例和无应答组34例, 并选择30例健康对照, 采集基线粪便样本进行16S rRNA基因测序, 分析肠道菌群α多样性、菌属相对丰度差异,并通过相关性分析、多因素Logistic回归及ROC曲线评估菌群标志物对SSRIs疗效的预测价值。结果 MDD患者肠道菌群Chao1指数、Shannon指数低于健康对照(P<0.05), 应答组与无应答组α多样性无差异(P>0.05)。应答组基线Blautia、双歧杆菌属、粪球菌属丰度高于无应答组(P<0.05), 大肠杆菌-志贺菌属丰度低于无应答组(P<0.05)。基线Blautia、双歧杆菌属、粪球菌属丰度与SSRIs治疗8周HAMD-17减分率呈正相关(r分别为0.390、0.420、0.350,均P<0.05), 三者联合预测SSRIs疗效的ROC曲线下面积(AUC)为0.910(灵敏度83.9%,特异度85.3%)。结论 MDD患者存在肠道菌群结构异常, 基线Blautia、双歧杆菌属、粪球菌属丰度可作为SSRIs疗效的潜在预测标志物,为MDD个体化治疗提供实验依据。
       Objective To explore the association between gut microbiota characteristics and the efficacy of selective serotonin reuptake inhibitors(SSRIs)in patients with major depressive disorder(MDD), and to screen gut microbiota biomarkers for predicting SSRIs efficacy.Methods A total of 90 MDD patients(divided into responders[n=56] and non-responders[n=34] based on 8-week SSRIs efficacy)and 30 healthy controls were enrolled from May 2024 to May 2025.Fecal samples were collected for 16S rRNA gene sequencing to analyze gut microbiota α diversity and genus-level relative abundance.Correlation analysis, multivariate logistic regression, and receiver operating characteristic curve were used to evaluate the predictive value of microbiota markers for SSRIs efficacy.Results The Chao1 and Shannon indices of gut microbiota in MDD patients were significantly lower than those in healthy controls(P<0.05), with no difference between responders and non-responders(P>0.05).Responders had higher baseline abundances of Blautia,Bifidobacterium, and Coprococcus(P<0.05), and lower abundance of Escherichia-Shigella compared to non-responders.Baseline abundances of Blautia,Bifidobacterium(P<0.05), and Coprococcus were positively correlated with 8-week HAMD-17 reduction rate(r=0.390, 0.420, 0.350; all P<0.05).The combined prediction of these three genera for SSRIs efficacy showed an area under the curve of 0.910(sensitivity 83.9%, specificity 85.3%).Conclusions MDD patients exhibit abnormal gut microbiota structure.Baseline abundances of Blautia,Bifidobacterium, and Coprococcus may serve as potential predictive biomarkers for SSRIs efficacy, providing experimental basis for personalized treatment of MDD.
论著

微波理疗联合康复训练对断指再植患者手指功能和日常生活能力的影响

Effect of microwave physiotherapy combined with rehabilitation training on finger function and daily living ability of patients with severed finger replantation

:1581-
 
       目的   探讨断指再植患者采用微波理疗联合康复训练的影响。方法   回顾性选取2022年1月—2023年12月于福州市第二总医院进行断指再植的患者,采用康复训练的50例患者纳入对照组,采用微波理疗联合康复训练的51例患者纳入观察组,对比两组干预1个月后的毛细血管反应情况、感知恢复情况、疼痛评分、手指功能及日常生活能力情况。结果   干预1个月后, 观察组患指的温度[(28.43±5.86)℃ vs (26.15±5.39)℃,t=2.025,P<0.001]、毛细血管反应[(9.76±2.63)cm/s vs(7.36±2.23)cm/s,t=4.922,P=0.046,]高于对照组(P<0.05);观察组的英国医学研究委员会感觉评分[(15.79±3.75)分 vs(11.88±3.13)分,t=5.660,P<0.001]高于对照组;观察组第2周[(3.72±0.88)vs(4.39±0.92)分,t=3.721,P<0.001]、4周后[(2.67±0.32)分 vs(3.03±0.52)分,t=4.169,P=0.001]的视觉模拟量表(VAS)评分低于对照组(P<0.05);观察组的密歇根手功能量表(MHQ)评分[(61.05±10.68)分 vs(52.58±10.21)分,t=4.054,P<0.001]高于对照组(P<0.05);观察组的生活质量综合评定表(GQLI-74)评分[(320.16±55.25)分 vs(270.85±50.06)分,t=4.677,P<0.001]高于对照组(P<0.05);观察组的Barthel指数[(75.71±12.84)分 vs(68.58±12.23)分,t=2.843,P=0.005]高于对照组(P<0.05)。结论   微波理疗联合康复训练能够提高断指再植患者的手指功能,减轻患者疼痛,改善日常生活质量。
       Objective  To explore the effect of microwave physiotherapy combined with  rehabilitation training on finger function and daily living ability of patients with severed finger replantation.Methods  Patients who underwent replantation of severed fingers in our hospital from January 2022 to December 2023 were selected retrospectively.Fifty patients who received rehabilitation training were included in the control group,51 patients who were intervened by microwave physiotherapy combined with rehabilitation training were included in the observation group.The blood circulation,sensory recovery,pain score,finger function and daily living ability of the two groups were compared.Results  The temperature([28.43±5.86]℃ vs [26.15±5.39]℃,t=2.025,P<0.001) and capillary reaction([9.76±2.63]cm/s vs [7.36±2.23]cm/s,t=4.922,P=0.046) of the affected fingers in the observation group were higher(P<0.05).The sensory score([15.79±3.75] vs [11.88±3.13],t=5.660,P<0.001)of the observation group was higher than that of the control group(P<0.05).The visual analogue scale(VAS)scores of the observation group at the second week([3.72±0.88] vs [4.39±0.92],t=3.721,P<0.001) and four weeks later([2.67±0.32]vs [3.03±0.52],t=4.169,P=0.001)were lower than those of the control group(P<0.05).The  score of Michigan Hand Outcome Questionnair(MHQ)([61.05±10.68] vs [52.58±10.21],t=4.054,P<0.001) in the observation group was higher(P<0.05).The GQLI-74 score([320.16±55.25] vs [270.85±50.06]) and Barthel index([75.71±12.84] vs[68.58±12.23],t=2.843,P=0.005)in the observation group were higher(P<0.05).Conclusions  Microwave physiotherapy combined with rehabilitation training can improve the finger function,relieve the pain and improve the quality of daily life of patients with severed fingers.
论著

急性缺血性脑卒中介入治疗优化护理路径的构建及应用

Development and application of an optimized nursing pathway for endovascular therapy in acute ischemic stroke

:1563-1568
 
       目的   探讨优化护理路径在急性缺血性脑卒中介入手术中的应用及效果。方法   采用随机对照研究,纳入2024年1月—2025年1月收治的112例急性缺血性脑卒中取栓患者,观察组(56例)实施优化介入护理路径,对照组(56例)采用常规护理。结果   观察组患者的满意度评分、医护满意度评分均优于对照组(P<0.05);观察组的术前等待时间、患者自进入介入室至股动脉穿刺时间、手术时间、住院费用、并发症发生率、差错事故发生率也优于对照组(P<0.05)。结论   通过标准化术前准备、术中多学科协作及术后康复衔接,优化护理路径可显著提升急性缺血性脑卒中治疗时效性(缩短急性脑卒中患者从进入医院到开始静脉溶栓给药的时间至黄金时间窗内),改善患者神经功能预后。
       Objective  To explore the application and efficacy of an optimized nursing pathway in endovascular therapy for acute ischemic stroke(AIS).Methods  A randomized controlled trial was conducted,enrolling 112 AIS patients undergoing mechanical thrombectomy from January 2024 to January 2025.Patients were randomly assigned to either the observation groupn=56),which received the optimized interventional nursing pathway,or the control group(n=56),which  received  routine nursing care.Results  Patient satisfaction score,medical staff satisfaction score,and postoperative favorable  recovery  rate in observation group were better than those of control group(P<0.05).Additionally,the observation group  showed  significant improvements in preoperative waiting time,time from entering the operation room to femoral artery puncture,surgical duration,hospitalization costs,complication incidence rate,and medical error incidence rate(P<0.05).Conclusions  By standardizing preoperative preparations,implementing intraoperative multidisciplinary collaboration,and enhancing postoperative  rehabilitation coordination,the optimized nursing pathway significantly improved the timeliness of thrombectomy treatment(shortening door-to-needle time to reach the golden time window)and enhanced neurological functional prognosis in AIS patients,demonstrating substantial clinical applicability.
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