随着公立医院免陪照护试点推进，家属由床旁陪伴转为院外等待，信息不对称、分离焦虑及信任弱化等问题日益凸显。本文围绕国际免陪照护实践，梳理家属数字化参与从虚拟探视、信息共享到共同决策的演进路径，并总结住院门户、电子日记、代理访问等工具在维系家庭支持、提升照护透明度中的作用。在此基础上，提出我国应依托智慧病房构建医护患属闭环沟通机制，完善授权分级、隐私保护、数字公平与人文支持制度，推动免陪照护兼具效率与温度。

With the advancement of pilot programs for accompaniment-free care in public hospitals, family members have shifted from bedside companionship to waiting outside the ward, giving rise to increasingly prominent problems such as information asymmetry, separation anxiety and weakened trust. Focusing on international practices of accompaniment-free care, this paper reviews the evolutionary path of digital family participation from virtual visits and information sharing to shared decision-making, and summarizes the role of tools such as inpatient portals, electronic diaries and proxy access in maintaining family support and improving care transparency. On this basis, it proposes that hospitals in China should rely on smart ward construction to establish a closed-loop communication mechanism integrating healthcare professionals, patients and family members, and improve institutional arrangements for hierarchical authorization, privacy protection, digital equity and humanistic support, so as to promote accompaniment-free care that combines efficiency with warmth.

目的: 探讨RNF213基因敲除对hCMEC/D3细胞分泌的外泌体circRNAs表达谱的影响。方法: 采用尺寸排阻法分别从RNF213-/- hCMEC/D3细胞（KO组）和野生型细胞（WT组）培养上清中提取外泌体，用Illumina Novaseq 6000 平台检测外泌体circRNAs表达谱，并用生物信息学方法进行分析。结果: 两组细胞存在134种差异表达的外泌体circRNAs，其中116种上调，18种下调。GO分析结果中，cellular nitrogen compound metabolic process (BP), intracellular anatomical structure (CC), heterocyclic compound binding (MF)和organic cyclic compound binding (MF)是最丰富的术语。Polycomb repressive complex通路是KEGG分析最显著富集的通路。circHIPK3可能通过ceRNA机制和/或与RNA结合蛋白相互作用参与烟雾病的发生发展，并成功构建circRNA-miRNA-mRNA通路。结论: 本研究确定了RNF213-/- hCMEC/D3细胞与野生型细胞外泌体circRNAs的差异表达谱，从外泌体的视角，为烟雾病的发病分子机制提供了新的见解。

       泛血管疾病（PVD）是一类以动脉粥样硬化为共同病理基础、累及心、脑、肾及外周血管系统的临床综合征, 具有多血管床共病特征, 发病率高、致残致死率大。非编码RNA（ncRNA）作为基因表达的重要调控因子, 在PVD的发生发展中发挥关键作用。微小RNA（miRNA）、长链非编码RNA（lncRNA）、环状RNA（circRNA）等ncRNA通过调节炎症反应、内皮功能、血管重塑、代谢稳态等多路径参与PVD的病理过程, 并展现出时空特异性和双向调控特征。最新研究揭示ncRNA在临床中的诊断预测及靶向干预潜力, 包括外泌体载体及circRNA递送系统等新策略。此外, 中医药通过调控ncRNA网络, 干预血瘀、痰浊等证型相关通路, 体现中西医结合治疗的系统优势。本文系统综述了ncRNA在PVD中的作用机制与研究进展, 强调其在精准诊疗与转化研究中的应用前景, 并指出未来需加强基础与临床协同、推进个体化干预策略的落地实施。

       Panvascular diseases（PVD）are a group of clinical syndromes characterized by atherosclerosis as a common pathological foundation, involving heart,brain,kidneys,and peripheral vascular systems．These diseases often exhibit multi-vascular bed comorbidities and are associated with high incidence,disability, and mortality rates．Non-coding RNAs（ncRNAs）, as key regulators of gene expression, play a crucial role in the onset and progression of PVD．Various types of ncRNAs—including microRNAs（miRNAs）, long non-coding RNAs（lncRNAs）, and circular RNAs（circRNAs）—are involved in the pathological processes of PVD through multiple pathways, such as modulation of inflammatory responses, endothelial function, vascular remodeling, and metabolic homeostasis, exhibiting spatiotemporal specificity and bidirectional regulatory effects．Recent studies have highlighted the potential of ncRNAs in clinical diagnosis, prognosis, and targeted therapy,with novel strategies including exosome-based delivery and circRNA-targeting systems．In addition, traditional Chinese medicine（TCM）exerts regulatory effects on ncRNA networks to intervene in syndrome-specific pathways, such as those related to blood stasis and phlegm-dampness, reflecting the systemic advantages of integrating TCM with Western medicine．This review systematically summarizes the regulatory mechanisms and research progress of ncRNAs in PVD,emphasizes their potential in precision medicine and translational research, and proposes the need to strengthen collaboration between basic and clinical studies to facilitate the implementation of personalized therapeutic strategies．

更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院（广州市第一人民医院）基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。

How to better protect the occupational safety and health of medical personnel is a topic of great concern．This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard．It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital．

目的 探讨非编码长链 RNA ANRIL（lncRNA-ANRIL）通过调控miR‐181b 介导磷酸酶及张力蛋白同源物基因（PTEN）对冠状动脉粥样硬化性心脏病（冠心病）心肌损伤影响的机制。方法 纳入2023年10月—2024年6月广州市第一人民医院30例确诊为冠心病的患者为观察组, 另选择同期本院体检中心30名健康者为对照组,检测两组研究者血压指标、血脂指标以及血清 lncRNA-ANRIL、miR-181b、PTEN水平, 并比较检测结果。结果 两组的性别、年龄、BMI、吸烟、高血压一般资料对比差异无统计学意义（P>0.05）; 观察组收缩压、舒张压水平以及总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均高于对照组,而高密度脂蛋白胆固醇则低于对照组（P<0.05）; 观察组血清 lncRNA ANRIL Exon 1-2、lncRNA ANRIL Exon 17-18相对表达水平以及PTEN水平低于对照组（t=12.623、7.741、8.231, P=0.001）, 而miR-181b水平则高于对照组（t=37.250, P=0.001）。结论 相较于正常人群, 冠心病患者血清lncRNA-ANRIL和PTEN水平明显降低,而miR-181b水平升高,提示lncRNA-ANRIL可通过调控miR-181b来调节PTEN的表达, 从而影响冠心病心肌损伤的过程。

Objective To explore the mechanism of competitive binding of non coding long stranded RNA ANRIL（lncRNA-ANRIL）to miR-181b to mediate phosphatase and tensin homolog gene（PTEN）on myocardial injury in coronary heart disease．Methods Thirty patients diagnosed with coronary heart disease in our hospital from October 2023 to June 2024 were included as the observation group,and another 30 individuals from physical examination center during the same period were selected as the control group．Blood pressure indicators,blood lipid indicators, and serum levels of lncRNA-ANRIL, miR-181b, and PTEN were measured in the two groups of patients, and the test results were compared．Results There was no significant difference between the two groups in terms of gender, age, BMI, smoking and hypertension（P>0.05）．The levels of systolic blood pressure（SBP）, diastolic blood pressure（DBP）, total cholesterol（TC）, triglycerides（TG）, and low-density lipoprotein cholesterol（LDL-C） in the observation group were higher than those in the control group,while high-density lipoprotein cholesterol（HDL-C） was lower than that in the control group（P<0.05）．The relative expression levels of lncRNA-ANRIL Exon 1-2, Exon 17-18, and PTEN levels in the observation group were lower than those in the control group（t=12.623, 7.741, 8.231, P=0.001）, while the level of miR-181b was higher than that in the control group（t=37.250, P=0.001）．Conclusions Compared with healthy individuals, serum levels of lncRNA-ANRIL and PTEN are significantly reduced in patients with coronary heart disease, while miR-181b levels are elevated, indicating that lncRNA ANRIL can regulate PTEN expression by miR-181b, thereby affecting the process of myocardial injury in coronary heart disease．

长链非编码RNA（lncRNA）是一类长度大于200个核苷酸转录本,通过调控DNA、RNA及蛋白质的表达和功能,参与肿瘤发生、发展并发挥重要作用的RNA,近年来lncRNA成为恶性肿瘤早期诊断和预后标志物研究新的关注方向。Linc-UBC1作为一种新发现的lncRNA,在多种恶性肿瘤如肺癌、胃癌、结直肠癌、宫颈癌、卵巢癌、食管鳞癌等中异常高表达,可通过作为竞争性RNA（ceRNA）、参与信号通路等促进肿瘤细胞的增殖、迁移、侵袭、细胞周期进展、细胞凋亡和上皮间充质转化（EMT）等过程;高表达的linc-UBC1能够增加恶性肿瘤的耐药性,其表达水平与肿瘤分期、淋巴结转移和原发肿瘤远处转移呈正相关;linc-UBC1有望成为许多恶性肿瘤的新型的生物标志物、预后预测因子和治疗靶点,但其具体的调控机制仍处于研究的早期阶段,有待进一步深入研究。文章就目前linc-UBC1在恶性肿瘤发生和发展中的作用研究进展进行综述。

Long non-coding RNA（lncRNA）is a class of transcripts with a length of more than 200 nucleotides．It is involved in the occurrence and development of tumors and plays an important role by regulating the expression and function of DNA,RNA and protein．In recent years,lncRNA has become a new research direction for early diagnosis and prognosis of malignant tumors．As a newly discovered lncRNA,linc-UBC1 is abnormally highly expressed in a variety of malignant tumors such as lung cancer,gastric cancer,colorectal cancer,cervical cancer,ovarian cancer,and esophageal squamous cell carcinoma．It can promote the proliferation,migration,invasion,cell cycle progression,cell apoptosis and EMT of tumor cells by acting as a competing endogenous RNA（ceRNA）and participating in signaling pathways．High expression of linc-UBC1 can increase the drug resistance of malignant tumors,and its expression level is positively correlated with tumor stage,lymph node metastasis and distant metastasis of primary tumors．linc-UBC1 is expected to become a new biomarker,prognostic predictor and therapeutic target for many malignant tumors,while its specific regulatory mechanism is still in the early stage of research and needs further in-depth study．This article reviews the current research progress of linc-UBC1 in the occurrence and development of malignant tumors．

目的 探讨不同清洗方法对聚甲基丙烯酸甲酯（PMMA）骨水泥附着的骨科外来医疗器械清洗效果。方法 以河源地区某三级医院消毒供应中心2023年7—12月同型号PMMA骨水泥术后附着的215件骨科外来医疗器械为研究对象,所有器械均为不锈钢材质,表面光滑,无明显磨损,利用随机数字表将其分为对照组与观察组。对照组（107件）采用常规预处理后清洗消毒器清洗,观察组（108件）预处理采用95%乙醇浸泡15 min后联合快干增亮剂清洗消毒器清洗。比较两种不同清洗方法的清洗效果。结果 观察组的器械清洗消毒后更加光滑且清洁,对照组的器械表面有部分磨损且仍存在一定程度的残留物。采用10倍光源放大镜清洁度检查,对照组清洗合格100件,清洗合格率为93.5%;观察组清洗合格108件,清洗合格率为100%。采用杰力试纸法检测,观察组清洗合格率为100%,对照组清洗合格率为94.4%,采用快速检测三磷酸腺苷（ATP）生物荧光法检查,观察组清洗合格率为99.1%,对照组清洗合格率为93.5%,观察组的清洗合格率高于对照组,差异有统计学意义（P<0.05）。结论 PMMA骨水泥附着的骨科外来医疗器械采用95%乙醇浸泡15 min后联合快干增亮剂和清洗消毒器可以提高清洗合格率以及外来器械再处理技术的安全性,为安全质量管理提供了有利依据。该技术适合推广使用,能有效排除医疗隐患,确保医疗安全。

Objective To compare the cleaning effects of different methods on external orthopedic medical devices contaminated with PMMA bone cement. Methods A total of 215 external orthopedic medical devices contaminated with PMMA bone cement were selected from the disinfection supply center of a tertiary hospital in Heyuan from July to December 2023．All devices were made of stainless steel,with smooth surfaces and no significant abrasion．The devices were randomly divided into control group and observation group using a random number table．The control group（107 devices）was cleaned using conventional pre-treatment followed by a cleaning and disinfection machine．The observation group（108 devices）was pre-treated by soaking in 95% medical ethanol for 15 minutes,followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine．The cleaning effects of the two methods were compared．Results The study showed that the devices in the observation group were smoother and cleaner after cleaning and disinfection,while the devices in the control group had some abrasion and residual contaminants．Using a 10 x magnifying glass to check cleanliness,the control group had 107 devices passed the cleaning test,with a pass rate of 93.5%,while the observation group had 108 devices passed,with a pass rate of 100%．Using the Geri test paper method,the observation group had a cleaning pass rate of 100%,and the control group had a pass rate of 94.4%．Using the ATP bioluminescence method,the observation group had a cleaning pass rate of 99.1%,and the control group had a pass rate of 93.5%．The cleaning pass rate of the observation group was higher than that of the control group,with a statistically significant difference（P<0.05）．Conclusions Soaking external orthopedic medical devices contaminated with PMMA bone cement in 95% medical ethanol for 15 minutes,followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine,can improve the cleaning pass rate and enhance the safety of reprocessing external devices．This technique provides a strong basis for safety and quality management,is suitable for widespread use,which effectively eliminates medical hazards,and ensures medical safety．

目的 对入住重症监护病房（ICU）重症孕产妇患者的病种特征和住院费用进行分析。方法 从医院信息管理系统中搜索2009—2019年广州市某省级重症孕产妇救治中心ICU的重症孕产妇住院病例,对病例资料进行描述性流行病学分析。结果 2009—2019年该救治中心ICU共收治重症孕产妇1 616例,病种排名前五位依次为心血管疾病430例（26.61%）、血液及造血器官疾病310例（19.18%）、妊娠期特定并发疾病287例（17.76%）、消化系统疾病218例（13.49%）、呼吸系统疾病110例（6.81%）。患者经济负担中位数排名前五位依次为肌肉骨骼系统和结缔组织疾病（62 252.60元）、消化系统疾病（61 684.41元）、感染性疾病（42 945.70元）、血液及造血器官疾病（40 403.52元）、神经系统疾病（40 055.93元）。结论 入住ICU内的重症孕产妇以心血管疾病、血液及造血器官疾病为主,经济学分析表明肌肉骨骼系统和结缔组织疾病造成的经济损失较大。

Objective To analyze the disease characteristics and hospitalization expenses of critically ill maternal patients in intensive care unit（ICU）．Methods Hospitalized cases of severe maternal disease in ICU of a provincial critical care center in Guangzhou from 2009 to 2019 were searched from the hospital information management system,and case data was analyzed by descriptive epidemiology．Results From 2009 to 2019,a total of 1616 critically ill maternal patients received intensive care treatment at this center．The predominant diseases observed were cardiovascular disorders（26.61%）,blood and hematopoietic organ diseases（19.18%）,specific pregnancy-related complications（17.76%）,gastrointestinal ailments（13.49%）,and respiratory disorders（6.81%）．Among the top five patient groups,the median economic burden was the highest in musculoskeletal system and connective tissue diseases（62 252.600 yuan）,followed by digestive system diseases（61 684.410 yuan）,infectious diseases（42 945.700 yuan）,blood and hematopoietic organ diseases（40 403.515 yuan）,and nervous system disorders（40 055.930 yuan）．Furthermore,a discernible correlation between hospitalization cost and length of stay was identified．Conclusions Cardiovascular diseases and disorders of blood and hematopoietic organs are the primary causes for maternal admissions to ICU．Economic analysis shows that musculoskeletal system and connective tissues diseases cause bigger economic loss ．

目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/（min·kg）]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/（min·kg）]及并发症比较差异均无统计学意义（P>0.05）。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。

腺苷至肌苷RNA编辑（AIRE）是指转录前体RNA在腺苷酸脱氨酶的作用下,某些位点的腺苷发生脱氨反应转变成肌苷的过程,在碱基配对时,肌苷被识别作鸟苷,导致转录组重编写。随着高通量测序技术的不断进步,大量异常的AIRE被发现可导致氨基酸编码改变、RNA剪切异常以及microRNA-mRNA重定向等过程,从而参与肿瘤的发生发展。绝大部分的AIRE位点均位于基因非编码区,解析它们的生物学功能仍存在一定的挑战。本综述旨在描述AIRE的生物学机制和AIRE位点在不同肿瘤发生发展作用的进展,为AIRE与肿瘤的研究提供思路。

Adenosine-to-inosine RNA editing（AIRE）is catalysed by adenosine deaminases acting on RNA（ADARs）,which converts adenosine to inosine in nascent RNA．Since inosine is recognized as guanosine in post-transcriptional process,AIRE is functionally approximate to an A-to-G mutation and results in transcriptome recoding．With the continuous advancement of high-throughput sequencing technology,a large number of abnormal AIRE events have been found to exert different biological mechanisms such as amino acid changes,RNA splicing abnormalities and microRNA-mRNA redirection,which plays an important role in the development of human tumorigenesis．Most of AIRE sites are located in non-coding region,which brings challenges in analyzing their biological functions．This review aims to describe the biological mechanisms of AIRE and the relationship between AIRE sites and the development of different tumor types,providing ideas for the study of AIRE and tumors．