本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题，IMB模型通过向患者提供科学的疾病知识，改变其疾病认知与态度，最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示，IMB模型可显著降低患者术后疼痛发生率，并提高患者参与治疗决策的程度，为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考，以便后期实施相关个性化干预措施，并提供相关理论依据。

       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy．The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge，and ultimately promotes their adoption and maintenance of healthy behaviors．It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy，the research background of this study，the current research status at home and abroad，as well as the future development trends and challenges．The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making．This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model，so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis．

       目的 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经（PENG）阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例，随机分为两组，A 组（38例）行PENG阻滞联合椎管内麻醉，C 组（38例）行椎管内麻醉。比较两组入室（T0）、摆放体位时（T1）、术后6 h（T2）、术后12 h（T3）、术后24 h（T4）静息和活动状态的数字等级评定量表（NRS）疼痛评分；术后非甾体抗炎药及阿片类药物补救次数；术后 6 h、24 h患侧股四头肌徒手肌力分级（MMT）；首次下床活动时间、住院时间。结果 A组T1～T4时刻静息状态NRS疼痛评分分别为2（1，3）分、1（1，2）分、2（1，2）分、3（2，4）分均低于C组的5（4，7）分、4（3，5）分、5（3，6）分、4（2，6）分，比较差异有统计学意义（均P＜0.001）；A组T1～T4时刻活动状态NRS疼痛评分分别为5（4，7）分、3（2，4）分、4（3，5）分、6（4，7）分均低于C组的10（9，10）分、8（6，9）分、8（7，9）分、9（8，10）分，比较差异有统计学意义（均P＜0.001）。A组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.01）；C组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.05）；A组在T1～T4时的活动状态NRS疼痛评分均低于T0时的（均P＜0.001）；C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的（均P＜0.01）。A组术后非甾体抗炎药及额外阿片类药物补救次数为4（0，8）、2（0，3）次，均低于C组的15（7，19）、5（3，7）次，比较差异有统计学意义（均P＜0.001）。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义（P＞0.05）。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛，不影响其术后下肢肌力。

   Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group（PENG）block combined with spinal-epidural anesthesia in hip joint surgery for frail patients．Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups：Group A（38 cases）received PENG block combined with intraspinal anesthesia，while Group C（38 cases）received only intraspinal anesthesia．The numerical rating scale（NRS）pain scores of resting and active states were compared between the two groups at the time of entering the room（T0），placing the position（T1），6 hours after surgery（T2），12 hours after surgery（T3），and 24 hours after surgery（T4）．Postoperative non-steroidal drugs and opioids remedy times，muscle strength grading（MMT）of quadriceps femoris at 6 hours and 24 hours after operation，and the first time out of bed activity time，hospitalization time were also compared．Results The resting NRS pain scores at T1-T4 in Group A were 2（1，3），1（1，2），2（1，2）and 3（2，4），respectively，which were lower than 5（4，7），4（3，5），5（3，6）and 4（2，6）in Group C，and the difference was statistically significant（all P＜0.001）．The NRS pain scores at T1-T4 in Group A were 5（4，7），3（2，4），4（3，5）and 6（4，7），respectively，which were lower than 10（9，10），8（6，9），8（7，9）and 9（8，10）in Group C，and the difference was statistically significant（all P＜0.001）．The resting NRS pain score of Group A at T1-T4 was lower than that at T0（all P＜0.01）；the resting NRS pain score of Group C at T1-T4 was lower than that at T0（all P＜0.05）．The NRS pain scores at T1-T4 in Group A were lower than those at T0（all P＜0.001）；the NRS pain scores at T1 and T2 in Group C were lower than those at T0（all P＜0.01）．The number of postoperative non-steroidal drugs and additional opioids in group A（4［0，8］，2［0，3］）was lower than that in Group C（15［7，19］，5［3，7］），and the difference was statistically significant（all P＞0.001）．There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation，the first time of getting out of bed and the number of days of hospitalization between the two groups（P＞0.05）．Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength．

       目的 探究肺泡灌洗液靶向高通量测序（tNGS）在鹦鹉热衣原体肺炎中应用效果。方法 选取2021年5月—2025年3月我院收治的35例鹦鹉热衣原体肺炎患者进行研究，患者均接受肺泡灌洗液tNGS检测、肺泡灌洗液常规病原检测，以病原学为金标准，分析肺泡灌洗液tNGS对鹦鹉热衣原体肺炎的诊断效能。结果 金标准对鹦鹉热衣原体阳性检出35例，检出率100.00%，肺泡灌洗液tNGS阳性检出率高于传统病原检测，检测结果回报耗时短于肺泡灌洗液传统病原检测（P＜0.05）。结论 鹦鹉热衣原体肺炎临床症状缺乏特异性，容易转为重症肺炎，肺泡灌洗液tNGS可提高鹦鹉热衣原体肺炎检出率且结果回报较快，采用四环素类、喹诺酮类抗生素有助于改善患者预后。

     Objective To investigate the application effect of targeted next-generation sequencing（tNGS）of bronchoalveolar lavage fluid（BALF）in Chlamydia psittaci pneumonia．Methods Thirty-five patients with Chlamydia psittaci pneumonia admitted to our hospital from May 2021 to March 2025 were selected for the study．All patients underwent BALF tNGS and conventional BALF pathogen detection．With etiology as the gold standard，the diagnostic efficacy of BALF tNGS for Chlamydia psittaci pneumonia was analyzed．Results The gold standard detected 35 cases of Chlamydia psittaci positive，with a detection rate of 100.00%．The positive detection rate of tNGS in alveolar lavage fluid was higher than that of traditional pathogen detection，and the results report time of tNGS was shorter than that of traditional pathogen detection（P＜0.05）．Conclusions Chlamydia psittaci pneumonia lacks specificity in clinical symptoms and is easy to turn into severe pneumonia，bronchoalveolar lavage fluid tNGS can improve the detection rate of Chlamydia psittaci pneumonia and the results return quickly，and the use of tetracyclines and quinolones antibiotics can help improve the prognosis of patients．

      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

目的 评估互联网+多方联动家庭病床模式对老年患者日常生活能力、营养风险及压力性损伤的影响。方法：选取2025年11月—2026年2月深圳市福田区10家社区卫生服务中心的200例家庭病床老年患者为研究对象，采用随机数字表法分为观察组和对照组各100例。观察组接受常规社康医生家庭病床服务，对照组在观察组基础上增加专科医生上门监测及远程会诊。比较两组患者建床90天后的基本生活能力评估表(Barthel指数)、营养风险筛查表(NRS-2002)、压力性损伤风险(Braden量表)评分及满意度。结果：干预后对照组Barthel指数评分显著高于观察组(P<0.05)，NRS-2002营养风险评分和Braden压力性损伤风险评分显著低于观察组(P<0.05)，对照组满意度显著高于观察组(P<0.05)。结论：互联网+多方联动家庭病床模式有利于改善老年患者日常生活能力，降低营养风险与压力性损伤发生率，提高患者满意度，为优化居家养老服务模式提供了实践依据。

Objective: To evaluate the impact of the Internet Plus multi-party collaborative family bed model on activities of daily living, nutritional risk, and pressure injury in elderly patients. Methods: A total of 200 elderly patients with family beds from 8 community health service centers in Futian District, Shenzhen, from January 2025 to October 2025 were selected as study subjects. They were randomly divided into an observation group and a control group (100 cases each) using the random number table method. The observation group received conventional family bed services from community health doctors, while the control group received additional specialist home monitoring and remote consultations based on the observation group. The Barthel Index, Nutritional Risk Screening 2002 (NRS-2002), Braden Scale for pressure injury risk, and satisfaction level were compared between the two groups 90 days after establishing the family bed. Results: After intervention, the control group's Barthel Index score was significantly higher than that of the observation group (P<0.05), while the NRS-2002 nutritional risk score and Braden pressure injury risk score were significantly lower than those of the observation group (P<0.05). The control group's satisfaction level was also significantly higher than that of the observation group (P<0.05). Conclusion: The Internet Plus multi-party collaborative family bed model is beneficial for improving elderly patients' activities of daily living, reducing nutritional risk and pressure injury incidence, and improving patient satisfaction, providing practical evidence for optimizing home-based elderly care service models.

目的：探讨特立帕肽对胸腰椎压缩性骨折（TLCF）患者多模态影像学参数及骨微环境的改善效果。方法：研究对象选择2024年3月~2025年3月至我院行经皮椎体后凸成形术（PKP）治疗的109例TLCF患者，通过随机数字表法将其列为常规组（54例）、试验组（55例）。常规组术后实施常规药物治疗，试验组术后采用特立帕肽联合常规药物治疗，治疗周期为6个月，于治疗1个月后比较两组患者的骨微环境，症状及功能。于治疗6个月后比较两组患者的多模态影像学参数及短期预后情况，于治疗期间统计并对比两组治疗安全性。结果：治疗1个月后，试验组的骨钙素（OC）、骨特异性碱性磷酸酶（BALP）、Ⅰ型原胶原N端前肽（PⅠNP）、Ⅰ型原胶原C端前肽（PⅠCP）分别为（12.42±3.31）ng/mL、（7.02±1.55）μg/L、（25.19±5.46）ng/mL、（68.22±6.47）ng/mL，均高于常规组[（10.39±2.45）ng/mL、（5.77±1.29）μg/L、（21.41±4.33）ng/mL、（63.19±5.27）ng/mL]（t=3.634，4.572，4.000，4.446；P＜0.05）。试验组的视觉模拟疼痛量表（VAS）评分、Oswestry功能障碍指数（ODI）评分均低于常规组（t=6.096，2.754；P＜0.05）。治疗6个月后，试验组的面积骨密度（aBMD）、骨小梁评分（TBS）、预估椎体强度（EVS）分别为（0.75±0.11）g/cm2、（1.29±0.22）、（2.33±0.42）MPa，均高于常规组[（0.51±0.08）g/cm2、（0.82±0.13）、（1.62±0.25）MPa]，骨髓脂肪分数（MFF）（38.48±5.24）%低于常规组（43.19±6.33）%（t=13.007，13.547，10.670，4.235；P＜0.05）。试验组的不良预后发生率10.91%（6/55）低于常规组27.78%（15/54）（x2=4.985；P＜0.05）。试验组治疗期间的药物相关副反应发生率与常规组比较，差异无统计学意义（P＞0.05）。结论：特立帕肽可改善TLCF患者PKP术后骨微环境及疼痛症状、功能障碍，可在避免增加治疗风险同时，有效促进多模态影像学参数恢复，并降低不良预后发生风险。

Objective:To explore the improvement effect of teriparatide on multimodal imaging parameters and bone microenvironment in patients with TLCF.Methods:The research subjects selected 109 patients with TLCF who underwent PKP treatment at our hospital from March 2024 to March 2025. They were randomly divided into a control group (54 cases) and an experimental group (55 cases) using a random number table method. The control group received conventional drug treatment after surgery, while the experimental group received a combination of teriparatide and conventional drug treatment after surgery, with a treatment period of 6 months. After 1 month of treatment, the bone microenvironment, symptoms, and function of the two groups of patients were compared. Compare the multimodal imaging parameters and short-term prognosis of the two groups of patients after 6 months of treatment, and compare the safety of the two groups during the treatment period.Results:After one month of treatment, the levels of OC, BALP, PⅠNP, and PⅠCP in the experimental group were (12.42 ± 3.31) ng/mL, (7.02 ± 1.55) μg/L, (25.19 ± 5.46) ng/mL, and (68.22 ± 6.47) ng/mL, higher than the control group [(10.39 ± 2.45) ng/mL, (5.77 ± 1.29) μg/L, (21.41 ± 4.33) ng/mL, and (63.19 ± 5.27) ng/mL] (t=3.634，4.572，4.000，4.446; P<0.05). The VAS score and ODI score of the experimental group were lower than the control group (t=6.096，2.754; P<0.05). After 6 months of treatment, the aBMD, TBS, and EVS of the experimental group were (0.75 ± 0.11) g/cm2, (1.29 ± 0.22), and (2.33 ± 0.42) MPa, higher than the control group [(0.51 ± 0.08) g/cm2 (0.82 ± 0.13), and (1.62 ± 0.25) MPa], and the MFF was (38.48 ± 5.24)% lower than that of the control group (43.19 ± 6.33)% (t=13.007，13.547，10.670，4.235; P<0.05). The incidence of poor prognosis in the experimental group was 10.91% (6/55) lower than the control group, which was 27.78% (15/54) (x2=4.985; P<0.05). The incidence of drug-related side effects during the treatment period in the experimental group was similar to the control group (P>0.05).Conclusion:Teriparatide can improve the bone microenvironment, pain symptoms, and functional impairment in patients with TLCF after PKP surgery. It can effectively promote the recovery of multimodal imaging parameters while avoiding increased treatment risks, and reduce the risk of adverse prognosis.

对比微创拔牙与传统拔牙在下颌阻生智齿治疗中的效果及并发症概率。方法：自2023年1月至2025年9月，选取110名下颌阻生智齿患者，采用随机数字列表法，将对象均衡地分为实验组（55人）与对照组（55人）。观察组行微创拔牙术（高速涡轮手机分牙+微创牙挺），对照组行传统拔牙术（骨凿劈冠+锤击增隙）。对比两组手术时间、术后疼痛程度、张口度及术中及术后并发症发生率。结果： 观察组施行手术的时间明显短于对照组[（25.38±5.47）min vs （31.65±6.83）min，P<0.001]；术后24h及7d的VAS评分均低于对照组[（3.52±1.21）分 vs （5.87±1.56）分，（0.89±0.65）分 vs （1.95±0.91）分，均P<0.001]，张口度大于对照组（均P<0.001）。观察组术中并发症总发生率（1.82%）显著低于对照组（14.55%）（P=0.009），术后并发症总发生率（3.64%）亦显著低于对照组（20.00%）（P=0.022）。结论：相较于常规拔牙方式，下颌阻生智齿的微创手术能显著减少治疗时间，减轻术后疼痛与张口受限，并显著降低术中及术后并发症风险，疗效与安全性俱佳，具备临床推广价值。

To compare the efficacy and complication rates of minimally invasive tooth extraction versus traditional extraction in treating impacted lower wisdom teeth. Methods: From January 2023 to September 2025,110 patients with impacted lower wisdom teeth were randomly assigned to an experimental group (55 cases) and a control group (55 cases) using a random number table. The experimental group underwent minimally invasive extraction (high-speed rotary mobile phone tooth splitting + minimally invasive tooth elevator), while the control group received traditional extraction (bone chisel splitting + hammer gap widening). The study compared operative time, postoperative pain (VAS score), mouth opening degree, and intraoperative/operative complications between the two groups. Results: The experimental group showed significantly shorter operative time [(25.38±5.47) min vs (31.65±6.83) min, P<0.001]. Postoperative VAS scores at 24h and 7d were significantly lower in the experimental group [(3.52±1.21) vs (5.87±1.56) points, (0.89±0.65) vs (1.95±0.91) points, both P<0.001], with greater mouth opening degree (P<0.001). The total intraoperative complication rate (1.82%) in the experimental group was significantly lower than the control group (14.55%) (P=0.009), and the postoperative complication rate (3.64%) was also significantly lower than the control group (20.00%) (P=0.022). Conclusion: Compared with traditional tooth extraction, minimally invasive tooth extraction can effectively shorten the operation time, reduce postoperative pain and limited mouth opening, and significantly reduce the risk of intraoperative and postoperative complications. The efficacy and safety are excellent, and it has the value of clinical promotion.

肛周脓肿术后防瘘是临床的关注点，本文基于“治未病”思想，提出覆盖肛周脓肿术后防瘘全周期的防治策略，包括未病调体质、调摄饮食、优化手术、加强创面管理降低风险，既发截断病势、辨证防治并发症及局部干预防蔓延，康复期整体调养与随访促愈防复，为中医药在肛周脓肿术后防瘘的临床实践应用方面提供参考。

Prevention of fistula formation after perianal abscess surgery is a clinical concern. Based on the concept of "treating disease before it arises," this paper proposes a comprehensive prevention and treatment strategy covering the entire cycle of fistula prevention after perianal abscess surgery, including regulating constitution before disease onset, adjusting diet, optimizing surgery, strengthening wound management to reduce risk, interrupting disease progression after onset, treating complications based on syndrome differentiation, and local intervention to prevent spread. During the rehabilitation period, holistic recuperation and follow-up are emphasized to promote healing and prevent recurrence, providing a reference for the clinical application of traditional Chinese medicine in preventing fistula after perianal abscess surgery.

【摘要】目的：探讨器械护士术中分区精细化器械管理对心脏瓣膜置换术（HVR）手术效率及安全性的影响。方法：研究对象包括2024年6月~2026年5月至我院行HVR治疗的110例心脏瓣膜病（VHD）患者，以及同期参与手术的22名器械护士，采用随机数字表法将入组患者及护士分别列为常规组（55例患者、11名护士）、试验组（55例患者、11名护士），常规组内护士术中实施常规器械管理，试验组内护士术中实施分区精细化器械管理。比较两组患者的手术效率、围手术期安全事件，以及两组护士所参与手术的工作效率、术中器械管理情况。结果：在不同器械管理模式下，试验组内患者的主动脉阻断时间、体外循环时间、术中非必要等待时间、手术总耗时均低于常规组（t=8.817，5.730，20.609，9.632；P＜0.05）。试验组内患者的围手术期安全事件发生率9.09%（5/55）低于常规组25.45%（14/55）（x2=5.153；P＜0.05）。试验组内护士的器械摆台时间、器械传递反应时间、手术中断次数、器械整理时间、器械移交时间均低于常规组（t=3.347，6.505，5.971，3.795，5.838；P＜0.05）。试验组内护士的器械管理差错率低于常规组（x2=5.238；P＜0.05）。结论：器械护士术中分区精细化器械管理能提高HVR患者的手术效率并降低围手术期安全事件发生风险，对提高器械护士的器械管理质量、预防器械管理差错有积极影响

[Abstract]Objective:To explore the impact of refined intraoperative instrument management by operating room nurses on the efficiency and safety of HVR surgery.Methods:The study subjects included 110 patients with VHD who underwent HVR treatment at our hospital from June 2024 to May 2026, along with 22 instrument nurses who participated in the surgeries synchronously. Using the random number table method, the enrolled patients and nurses were divided into a control group (55 patients, 11 nurses) and an experimental group (55 patients, 11 nurses). Nurses in the conventional group implemented routine instrument management during surgery, while nurses in the experimental group implemented zoned and refined instrument management during surgery. The surgical efficiency, perioperative safety events of the two groups of patients, as well as the work efficiency and intraoperative instrument management of the surgeries participated by the nurses in the two groups were compared.Results:Under different instrument management modes, the aortic occlusion time, extracorporeal circulation time, intraoperative non-essential waiting time, and total surgical time of patients in the experimental group were all lower than the control group (t=8.817，5.730，20.609，9.632; P<0.05). The incidence of perioperative safety events in the experimental group was 9.09% (5/55) lower than that in the control group 25.45% (14/55) (x2=5.153; P<0.05). The instrument placement time, instrument delivery response time, number of surgical interruptions, instrument sorting time, and instrument handover time of nurses in the experimental group were lower than those in the control group (t=3.347，6.505，5.971，3.795，5.838; P<0.05). The error rate of nurses in the experimental group was lower than the control group (x2=5.238; P < 0.05).Conclusion:Refined intraoperative zone-specific instrument management by instrument nurses enhances surgical efficiency for HVR patients and reduces the risk of perioperative safety incidents, thereby positively impacting the quality of instrument care provided by nurses and preventing instrument-related adverse events.

目的 对比三维中等权重压缩感知并行采集序列（3D IW-CS-SENSE）与常规并行采集序列（3D IW-SENSE）在膝关节磁共振成像中的扫描时间、图像质量及诊断效能。方法 前瞻性采集100例膝关节磁共振影像。对比两组三维序列的定量指标、主观评分以及对损伤分级的准确率。结果 IW-CS-SENSE序列扫描时间显著缩短（122.0 ± 28.0 s vs 221.0 ± 49.0 s，P<0.001）。IW-CS-SENSE序列信噪比、对比噪声比及显示效果评分均低于IW-SENSE序列（P＜0.001），但IW-CS-SENSE序列的SENSE伪影评分更优（5.00 ± 0.00 vs 4.59 ± 0.62，P<0.001）。两序列对半月板、韧带及软骨损伤分级的准确率均无统计学差异（P值分别为0.33，0.58和0.15）。 结论 3D IW-CS-SENSE序列可显著缩短扫描时间和消除SENSE伪影，同时保持与4倍加速3D IW-SENSE序列相当的诊断效能。

Objective To compare the imaging times, image quality, and diagnostic performance of three-dimensional (3D) intermediate-weighted compressed sensing sensitivity encoding (IW-CS-SENSE) sequence with conventional 3D IW-SENSE sequence in knee MR imaging. Methods MR images of one hundred knees were obtained prospectively. The quantitative indices, qualitative scores, and grading accuracies between the two 3D sequences were compared. Results Imaging times of IW-CS-SENSE sequences were significantly reduced (122.0 ± 28.0 s vs 221.0 ± 49.0 s, P < 0.001). The signal-to-noise ratios, contrast-to-noise ratios, and visualization scores of IW-CS-SENSE sequences were significantly lower than IW-SENSE sequences (P < 0.001), while scores of SENSE artefact for IW-CS-SENSE sequences were superior (5.00 ± 0.00 vs 4.59 ± 0.62, P < 0.001). The accuracies in grading meniscal, ACL, and cartilage tears were comparable between the two sequences (P = 0.33, P = 0.58 and P = 0.15, respectively). Conclusion 3D IW-CS-SENSE sequences can reduce scanning time significantly and eliminate SENSE artefacts, while maintaining the same diagnostic performance as the 4-fold accelerated 3D IW-SENSE sequences.