目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄（OR=1.131）、睡眠差（OR=2.557）、合并3种及以上慢性病（OR=3.990）、抑郁（OR=3.296）、营养不良风险（OR=4.005）为老年脆性骨折患者术前衰弱的危险因素,BMI正常（OR=0.206）是保护因素（均P<0.05）。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。

       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures．Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected．Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale（CES-D-10）, the Generalized Anxiety Disorder Scale（GAD-7）, and the Nutritional Risk Screening 2002（NRS-2002）．Logistic regression was used to analyze factors influencing preoperative frailty．Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%．Logistic regression analysis revealed the following risk factors for preoperative frailty：age（OR=1.131）, poor sleep quality（OR=2.557）, multiple chronic comorbidities（OR=3.990）, depression（OR=3.296）, nutritional risk（OR=4.005）．Normal body mass index（OR=0.206）was a protective factor．Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients．Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients．

       目的  本研究旨在探讨不同俯卧位通气（PPV）时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法  选择2020年7月—2023年7月在天津市人民医院重症监护病房（MICU）治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组（≥12 h, n=40）和短时组（<12 h, n=40）。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素（GAS）和血管活性肠肽（VIP）]、肠内营养达标率、胃肠并发症率等。结果  短时组治疗后, 1 d、3 d、5 d氧合指数为（189.93±33.72）、（247.53±63.01）、（325.03±58.11）mmHg,高于长时组的（161.63±36.88）、（191.83±57.65）、（267.95±46.25）mmHg,均P<0.05; 胃残留量为（29.00±7.92）、（19.75±4.45）、（11.00±1.87） mL低于长时组的（75.03±23.29）、（53.13±11.99）、（21.70±5.52） mL, 均P<0.05。短时组治疗后腹内压[（8.53±2.05）mmHg vs （9.75±2.05） mmHg]、VIP水平[（61.14±7.63） vs （67.49±4.43） pg/mL]低于长时组,GAS水平[（65.02±8.84） vs （54.22±9.21）pg/mL]升高（均P<0.05）。短时组总胃肠并发症发生率（7.50%）低于长时组（25.00%）, P=0.034。结论  对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。

      Objective To explore the effect of different duration of prone position ventilation（PPV）on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction．Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit（MICU）of a hospital from July 2020 to July 2023, and were selected as the research subjects．They were divided into the long-duration group（≥12 hours, n=40）and the short-duration group（<12 hours, n=40）according to the daily duration of PPV．The general data, oxygenation index, gastrointestinal function indicators（intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]）, enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared．Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment（[189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively）was significantly higher than that of the long-duration group（[161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05）．The gastric residual volume of the short-duration group（[29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively）was significantly lower than that of the long-duration group（[75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05）．The intra-abdominal pressure（[8.53±2.05] vs [9.75±2.05] mmHg）and VIP level（[61.14±7.63] vs [67.49±4.43] pg/mL）of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level（[65.02±8.84] vs [54.22±9.21] pg/mL）was significantly higher（all P<0.05）．The total incidence of gastrointestinal complications in the short-duration group（7.50%）was significantly lower than that in the long-duration group（25.00%, P=0.034）．Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance． 

       文章围绕康复治疗学专业创新创业人才培养模式展开研究，讨论了国内外高校创新创业人才培养现状。从教育理念、课程体系、师资力量、资源配套等方面探讨了人才培养所面临的问题。结合广东药科大学康复治疗学专业培养现状，从管理、教学、平台、服务四大体系明确了具体要求，有望为其他高校康复治疗学专业培养模式改革提供思路。

  The article focuses on innovative and entrepreneurial talent-cultivation models in the Rehabilitation Therapy specialty，discussing the current status of such cultivation in domestic and international universities．It explores challenges in talent development from perspectives including educational philosophy，curriculum system，faculty resources，and resource allocation．Based on the current training status of Guangdong Pharmaceutical University’s Rehabilitation Therapy Program，the study specifies detailed requirements through four major systems：management，teaching，platform，and service．This  research is expected to provide valuable insights for the  reform of talent cultivation models in  rehabilitation therapy programs at other higher education 

institutions．

        目的   探讨临床特征联合外周血血管内皮生长因子（VEGF）与α-羟基丁酸脱氢酶（α-HBDH）对卵巢癌的诊断价值。方法   选取2022年6月—2024年6月在天津市中心妇产科医院妇科接收的84例卵巢癌恶性肿瘤患者纳入观察组，同期选取84例卵巢良性病变患者纳入对照组。对比两组患者临床资料及VEGF、α-HBDH水平的差异，分析VEGF、α-HBDH水平与卵巢癌恶性肿瘤患者临床特征的相关性。采用二元Logistics回归分析卵巢癌恶性肿瘤的独立危险因素，并采用受试者工作特征（ROC）曲线分析VEGF、α-HBDH水平诊断卵巢癌恶性肿瘤的价值。结果   观察组年龄、身体质量指数（BMI）及血清CA125、HE4、VEGF、α-HBDH水平显著高于对照组（P＜0.05），VEGF与α-HBDH水平与国际妇产科联盟（FIGO）分期、分化等级及淋巴结转移均呈正相关关系（P＜0.05）。将年龄、BMI、VEGF、α-HBDH作为自变量纳入二元Logistic回归，结果显示BMI、VEGF、α-HBDH是卵巢癌恶性肿瘤的影响因素（P＜0.05），ROC曲线分析显示，联合检测VEGF和α-HBDH的AUC达0.921，灵敏度和特异度分别为81.0%和91.7%，优于单独检测（VEGF：AUC=0.702；α-HBDH：AUC=0.796）。结论  BMI联合VEGF与α-HBDH检测可为卵巢癌的诊断提供高效、无创的辅助手段，具有重要临床应用潜力。

      Objective  To explore the  diagnostic value of clinical features combined with  peripheral  blood vascular endothelial growth factor（VEGF）and α-hydroxybutyrate dehydrogenase（α-HBDH）levels in ovarian cancer．Methods  A total of 84 patients with malignant ovarian cancer admitted to the gynecology department of Tianjin Central Hospital of Gynecology and Obstetrics from June 2022 to June 2024 were included in the observation group，and 84 patients with benign ovarian lesions during the same period were included in the control group．The clinical data and VEGF，α-HBDH levels of the two groups were compared．Pearson analysis was used to explore the correlation between VEGF，α-HBDH levels，and clinical characteristics of patients with malignant ovarian cancer．Binary Logistic regression analysis was conducted to identify independent risk factors for malignant ovarian cancer，and receiver operating characteristic（ROC） curves were used to analyze the diagnostic value of VEGF and α-HBDH levels for malignant ovarian cancer．Results  The observation group had significantly higher age，BMI，and serum CA125，HE4，VEGF，α-HBDH levels compared to the control group（P＜0.05）．VEGF and α-HBDH levels were significantly positively correlated with FIGO stage，differentiation grade，and lymph node metastasis（P＜0.05）．Age，BMI，VEGF，and α-HBDH were included as independent variables in binary Logistic regression，and the results showed that BMI，VEGF，and α-HBDH levelswere independent risk factors for malignant ovarian cancer（P＜0.05）．ROC curve analysis  revealed that the AUC for combined detection of VEGF and α-HBDH reached 0.921，with sensitivity and specificity of 81.0% and 91.7%，respectively，significantly superior to individual detection（VEGF：AUC=0.702；α-HBDH：AUC=0.796）．Conclusions  The detection of BMI combined with VEGF and α-HBDH levels can provide an efficient and noninvasive auxiliary means for the diagnosis of ovarian cancer，which has important clinical application potential．

      目的   免疫球蛋白A肾病（IgAN）与炎症性肠病（IBD）的相互作用机制尚未阐明。本研究旨在解析IBD与IgAN共病的关键特征基因及核心信号通路，以揭示肠－肾轴的分子调控网络。方法   于GEO数据库获取IBD（GSE75214）和IgAN（GSE93798）基因表达谱，筛选差异表达基因（DEGs）。通过蛋白互作网络（PPI）和拓扑算法（MCC、MNC、Degree、EPC等）识别核心特征基因，并结合公共数据库（CTD、DISEASES和GeneCards）和单细胞转录组测序（GSE171314）进行验证。通过Nephroseq数据库验证基因表达与临床表型的相关性。结果   共筛选出17个IBD-IgAN共病DEGs，PPI网络分析等确定以FOS、EGR1、CXCL2和JUNB为核心特征基因。功能富集分析显示白细胞介素-17（IL-17）信号通路显著激活。单细胞测序验证FOS、EGR1、CXCL2和JUNB基因在IgAN特异性高表达，并通过Nephroseq数据库验证其与尿蛋白和估算的肾小球滤过率下降（eGFR）显著相关。结论  本研究揭示IBD与IgAN共享IL-17通路异常激活及FOS、EGR1、CXCL2和JUNB的基因网络，为开发基于肠－肾轴调控的靶向治疗策略提供理论依据。

       Objective  The complex interplay between immunoglobulin A nephropathy（IgAN）and inflammatory bowel disease（IBD）remains poorly understood．This  study  aimed to identify  key  cross-talk  genes  and  pivotal  signaling pathways shared between IBD and IgAN，thereby elucidating the molecular regulatory network underlying the gut-kidney axis．Methods  Transcriptomic datasets for IBD（GSE75214）and IgAN（GSE93798）were retrieved from the GEO database．Differentially expressed genes（DEGs）were screened，and shared DEGs were intersected．Protein-protein interaction（PPI）networks were constructed using STRING and Cytoscape，with topological algorithms applied to identify hub genes．Gene expression profiles were validated through（CTD，DISEASES and GeneCards）and single-cell RNA sequencing（GSE171314）and the Nephroseq database，focusing on clinical correlations with proteinuria and estimated glomerular filtration rate（eGFR）．Results  Seventeen shared DEGs were identified between IBD and IgAN．PPI network analysis revealed FOS，EGR1，CXCL2 and JUNB as core hub genes．Functional enrichment analysis demonstrated significant activation of the interleukin-17（IL-17）signaling pathway．Single-cell sequencing confirmed the specific upregulation of these genes in renal tubular epithelial cells of IgAN patients，which was further validated to correlate with proteinuria and eGFR decline．Conclusions  IBD and  IgAN share aberrant activation of the IL-17 pathway and a co-regulatory gene network involving FOS，EGR1，CXCL2 and JUNB，providing a theoretical foundation for developing therapeutic strategies centered on the gut-kidney axis．

       目的   针对孤独症多模态证据融合与定量化辨识的关键问题，本研究提出基于图卷积神经网络（GCN）的孤独症谱系障碍（ASD）诊断模型研究思路。方法  通过对来源于ABIDE的ASD儿童脑部fMRI数据进行整理和筛选，提取脑区功能连接矩阵作为图结构的邻接矩阵，并融合临床表型数据，构建了ASD多模态关联网络。通过网络特征比较分析，识别出了ASD与典型发育组的脑功能连接网络组间差异。进一步地构建一个端到端的GCN模型，并尝试引入注意力机制，提高模型决策的可解释性。结果  该模型在诊断性能指标优于传统机器学习方法（准确率=0.710，精确率=0.709，召回率=0.780，F1=0.743，曲线下面积=0.746）。背侧注意网络与边缘系统-颞极枢纽的功能连接减弱是模型做出判断的最主要依据。结论  以异质图为多模态数据整合的基本架构，本模型为ASD的潜在病理机制探索提供了新的方法学范例。

      Objective   To develop a quantitative model for autism spectrum disorder（ASD）integration multimodal evidences．Methods The fMRI  dataset from ABIDE was  used for extracting connectivity function  network of ASD after  data preprocessing．Difference between ASD and typical development about their brain connectivity function was evaluated with t-test．Integrating phenotypic data and fMRI dataset，an graph convolutional neural network （GCN）with attention module was estimated and compared against benchmark models about their efficiency and interpretability．Results  The GCN model was evaluated outperformed other models with better accuracy indices．And regions from Dorsal Attention Network and Limbic-Temporal Pole were ranked as the highest weights for the differentiation in the model．Conclusions  This study provided a novel paradigm for quantitative diagnosis and exploring pathogenesis of ASD．

       目的   探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV1/FVC）、用力肺活量（FVC）的相关性。方法   纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者，以2%作为外周血EOS比例（EOS%）截断值分为两组，研究组（EOS%≥2%）34例，对照组（EOS%＜2%）39例，收集两组患者_{的一般临床资料、实验室检查结果、肺功能检查结果（FEV1}、FVC、FEV₁/FVC），比较组间差异，分析指标间的相关性。结果   对照组与实验组患者EOS%分别为0.5（0.1，0.9）%、5.15（2.60，10.05）%，两组患者EOS%差异有统计学意义（P＜0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56，1.78）ng/L、3.6（1.73，6.77）ng/L，两组IL-5水平差异有统计学意义（P＜0.05）。对照组FEV₁（L）、FVC（L）、FEV₁/FVC水平分别为1.32（1.18，1.58）、2.07（1.92，2.62）、0.62（0.57，0.67）；实验组分别为1.24（1.00，1.52）、2.22（1.94，2.56）、0.58（0.47，0.67），两组FEV₁、FVC、FEV₁/FVC水平差异均无统计学意义（P＞0.05）。Spearman等级相关检验结果显示，EOS%与IL-5水平呈正相关（rs=0.870，P＜0.001）；按组别进行分层后结果显示，对照组、试验组EOS%与IL-5水平均呈正相关（r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）。EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（r_s=0.039，P＞0.05）。对照组EOS%、IL-5水平与FEV₁、FEV₁/FVC、FVC不相关（P＞0.05）；实验组EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（P＞0.05）。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关，外周血EOS%≥2%时血EOS%、血清IL-5与FEV₁、FEV₁/FVC呈负相关，与FVC无关。

       Objective  To explore the correlation among blood eosinophil levels，serum interleukin-5（IL-5）levels，and forced expiratory volume in one second（FEV₁），the ratio of forced expiratory volume in one second to forced vital capacity（FEV₁/FVC），and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods  From March 2023 to March 2024，73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included，and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil（EOS%）．The experimental group（EOS%≥2%）included 34 patients，while the control group（EOS%＜2%）included 39 patients．General clinical data，laboratory test results，and pulmonary function test results（FEV₁，FVC，FEV₁/FVC）were collected from both groups．Results  The median quartiles of EOS% for the control group and experimental group were 0.5（0.10.9）% and 5.15（2.60，10.05）%，respectively．There was a statistically significant difference between the EOS% of two groups（P＜0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56，1.78）ng/L and 3.6（1.73，6.77）ng/L，respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P＜0.05）．For the control group，the median quartiles of FEV₁，FVC，and FEV₁/FVC were 1.32（1.18，1.58），2.07（1.92，2.62）and 0.62（0.57，0.67），respectively．For the experimental group，they were 1.24（1.00，1.52），2.22（1.94，2.56）and 0.58（0.47，0.67）respectively．There was no statistically significant difference between the two groups in FEV₁，FVC and FEV₁/FVC levels（P＜0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （r_s=0.870，P＜0.001）．Stratified by group，both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）．There was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．In the control group，there was no correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC，or FVC（P＞0.05）．In the experimental group，there was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV₁/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．Conclusions  During AECOPD，blood EOS% is positivelycorrelated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%，blood EOS%，serum IL-5，and FEV₁，FEV₁/FVC are negatively correlated，while there is no correlation with FVC．

       目的   探讨基于手术风险模型（RoSCo）评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法   选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者，应用随机数字表法将其分为观察组与对照组，各40例。80例患者均实施腹腔镜肾部分切除术，对照组实施常规干预与术后早期下床活动干预，观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平，疼痛程度与睡眠质量，并发症发生率及生活质量。结果   观察组首次下床活动（19.30±4.17）h、排气（22.03±4.15）h、排便时间（29.93±5.58）h及术后住院时间（5.35±1.33）h短于对照组［（25.08±5.11）、（29.38±5.75）（34.20±5.98）（7.35±2.38）］h，对比差异有统计学意义（t=-5.540、-6.557、-3.308、-4.637，P＜0.05）；手术后，观察组视觉模拟量表（VAS）评分（3.93±0.92）分、PSQI评分（9.13±1.64）分高于对照组［（5.38±1.25）、（12.23±2.40）］分，对比差异有统计学意义（t=-5.902、-6.747，P＜0.05）；观察组并发症发生率7.50%低于对照组27.50%（χ ² =5.541，P=0.019）；手术后观察组SF-36评分相关维度［生理职能（84.45±9.74）、总体健康（60.75±10.65）、躯体疼痛（65.65±8.60）、生理功能（72.98±9.22）、活力（71.95±6.93）、社会功能（75.38±8.33）、精神健康（75.63±8.02）、情感职能（65.43±9.70）］分值高于对照组［生理职能（69.98±10.09）、总体健康（53.58±7.96）、躯体疼痛（58.83±9.35）、生理功能（65.68±7.58）、活力（62.83±12.80）、社会功能（68.98±10.99）、精神健康（71.58±9.69）、情感职能（57.90±6.86）］分值，对比差异有统计学意义（t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004，P＜0.05）。结论   针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复，辅助减轻术后疼痛程度，提升睡眠质量，降低并发症发生率，进一步提升患者生活质量。

      Objective  To explore the application effect of early mobilization timing  based on the Risk of  Surgical Complication（RoSCo）scoring system in renal tumor patients after surgery．Methods  From June 2021 to June 2024，80 patients with renal tumors admitted to the hospital were selected as the research subjects．They were  randomly divided into an observation group and a control group using a random number table method，with 40 patients in each group．All patients underwent laparoscopic partial nephrectomy．The control group received routine care and early postoperative mobilization intervention，while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system．The postoperative rehabilitation level，pain level and sleep quality，incidence of complications，and quality of life between two groups were compared．Results  The first time getting out of bed，exhaust，defecation and postoperative hospitalization time in observation group（［19.30±4.17］h，［22.03±4.15］h，［29.93±5.58］h，［5.35±1.33］h） were shorter than those in control group（［25.08±5.11］h，［29.38±5.75］h，［34.20±5.98］h，［7.35±2.38］h），the  differences  were  statistically significant（t=-5.540，-6.557，-3.308，-4.637，all P＜0.05）．After operation，VAS score（3.93±0.92）and PSQI score（9.13±1.64）in the observation group were higher than those in the control group（［5.38±1.25］and［12.23±2.40］），and the differences were statistically significant（t=-5.902，-6.747，both P＜0.05）．The complication  rate of the observation group （7.50%） was lower than that of the control group（χ ² =5.541，P=0.019）．After operation，SF-36 scores in the observation group were physiological function（84.45±9.74），general health（60.75±10.65），physical pain（65.65±8.60），physiological function（72.98±9.22），vitality（71.95±6.93），social function（75.38±8.33），spiritual health（75.63±8.02）and emotional function（65.43±9.70），which were higher than those of the control group（physiological function［69.98±10.09］，general health［53.58±7.96］，physical pain［58.83±9.35］，physiological function［65.68±7.58］and vitality［62.83±12.80］，social function［68.98±10.99］，mental health［71.58±9.69］，emotional function［57.90±6.86］），and the differences were statistically significant（t=6.530，3.414，3.398，3.870，3.966，2.936，2.037，4.004，all P＜0.05）．Conclusions  Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery，assist in reducing postoperative pain，improve sleep quality，reduce the incidence of complications，and further enhance the quality of life of patients with renal tumors．

       目的   开发一种多功能纳米颗粒输送系统来刺激骨再生和血管形成，用于逆转骨质疏松症。方法   通过制备基于外消旋聚乳酸 Poly（D，L-lactide）即PLA的纳米颗粒来封装淫羊藿苷。随后，通过红细胞膜包被这些纳米颗粒以增强生物相容性。为了提高靶向特异性，进一步合成了由阿仑膦酸盐修饰的聚乙二醇-磷脂酰乙醇胺（PEG-DSPE） 组成的骨靶向聚合物脂质，并将其掺入细胞膜涂层中。结果   多功能纳米颗粒输送系统可通过调节骨髓间充质干细胞 （BMSC）功能，从而增强成骨和血管生成能力。结论   本研究结果表明，多功能纳米颗粒输送系统可以在体外刺激骨形成和血管形成，表明其有成为骨质疏松症先进治疗策略的潜力。

       Objective  To developed a multifunctional nanoparticle system to stimulate bone regeneration and vascularization as a therapeutics strategy for osteopovost．Methods  Poly（D，L-lactide）（PLA）-based nanoparticles were fabricated to encapsulate the icariin，which is renowned for its osteogenic potential．These nanoparticles were then coated with  red blood cell membranes to enhance biocompatibility．To further improve targeting specificity，a bone-targeted polymer-lipid consisting of alendronate-modified PEG-DSPE was synthesized and incorporated into the cell membrane coating．Results  The delivery system was designed to modulate the function of bone marrow mesenchymal stem cells，thereby enhancing both osteogenesis and angiogenesis．Conclusions  Our findings demonstrated that the therapeutic system could enhance bone formation and vascularization in vitro，indicating its potential as an advanced treatment strategy for osteoporosis．

       目的   探讨口服水合氯醛与鼻内给予右美托咪定中深度镇静下行泪道探通术治疗婴幼儿先天性泪道阻塞的疗效、并发症及安全性。方法   随机选择2021年2月—2023年6月在广州医科大学附属妇女儿童医疗中心就诊的先天性泪道阻塞患儿，将其分为观察组和对照组，观察组行中深度镇静后进行泪道探通术，对照组进行表麻下泪道探通术，对比两组的治愈率及并发症发生率。结果   观察组共76例（97眼），总治愈率98.97%，分为3组，6~12月龄组41例（53眼），12~18月龄组14例（15眼），18~36月龄组21例（29眼），对照组共84例（116眼），总治愈率93.10%，6~12月龄组55例（70眼），12~18月龄组15例（24眼），18~36月龄14例（22眼），观察组泪道探通术治愈率高于对照组，差异有统计学意义（χ ² =4.49，P＜0.05）。观察组一次探通的成功率为92.78%，高于对照组61.21%，差异有统计学意义（χ ² =26.86，P＜0.05）。观察组二次探通的成功率为85.71%，高于对照组44.44%，差异有统计学意义（χ ² =4.13，P＜0.05）。发生的并发症主要是出血、皮下水肿、感染、假道形成，观察组并发症的发生率4.12%，低于对照组15.52%，差异有统计学意义（χ ² =7.40，P＜0.05）。观察组中2例患儿口服水合氯醛出现恶心呕吐，改为右美托咪定滴鼻。3例患儿右美托咪定滴鼻后出现口唇苍白，持续10～15 min即可缓解。其余均未有不良反应。结论   中深度镇静下给予婴幼儿泪道阻塞患儿行泪道探通术相比传统表麻下泪道探通术疗效更好，并发症较少，对孩子的心理创伤小，安全且经济实惠。

       Objective  To explore the efficacy，complications and safety of moderate and deep  sedation  under oral administration of chloral hydrate and intranasal administration of dexmedetomidine for the treatment of congenital nasolacrimal duct obstruction（CNLDO） in infants and young children．Methods  Children with CNLDO who visited our hospital from February 2021 to June 2023 were randomly selected and divided into the observation group and the control group．The observation group was performed with lacrimal duct probing after moderate and deep sedation，while the control group was performed with lacrimal duct probing under surface anesthesia．The cure rate and incidence of complications were compared between the two groups．Adverse reactions after using sedatives were observed．Results  The observation group consisted of 76 cases（97 eyes），with a total cure rate of 98.97%．They were divided into three groups：41 cases（53 eyes）in the aged 6-12 months group，14 cases（15 eyes）in the aged 12-18 months group，and 21 cases（29 eyes）in the aged 18-36 months group．The control group consisted of 84 cases（116 eyes），with a total cure rate of 93.10%．There were 55 cases（70 eyes）in the aged 6-12 months group，15 cases（24 eyes）in the aged 12-18 months group，and 14 cases（22 eyes）in the aged 18-36 months group．The cure rate of lacrimal duct probing in the observation group was significantly higher than that in the control group（χ ² =4.49，P＜0.05）．The success  rate of the first probing in the observation group was 92.78%，significantly higher than that in the control group of 61.21%（χ ² =26.86，P＜0.05）．The success rate of the second probing in the observation group was 85.71%，significantly higher than that in the control group of 44.44%（χ ² =4.13，P＜0.05）．The incidence of complications mainly were bleeding，subcutaneous edema，infection，and false passage formation．The incidence of complications in the observation group was 4.12%，lower than that in the control group 15.52%，and the difference was statistically significant（χ ² =7.40，P＜0.05）．Two cases in the observation group experienced nausea and vomiting after taking chloral hydrate orally，and were replaced with dexmedetomidine nasal drops．Three cases of pediatric patients showed pale lips after nasal administration of dexmedetomidine，which lasted for 10-15 minutes and could be relieved．No other adverse reactions were observed．Conclusions  Under moderate and deep sedation，lacrimal duct probing treatment for infants and young children with CNLDO showed better therapeutic effects，fewer complications，less psychological trauma to these patients，which is safe and cost-effective，and is suitable for promotion compared to under traditional surface anesthesia．