目的   探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素，为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法   采用便利抽样法，选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象，采用一般资料调查问卷、疼痛心理僵化量表（PIPS）、简易疾病感知问卷（BIPQ）、家庭功能问卷（APGAR）进行调查，采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果   本次研究共发放问卷152份，回收有效问卷150份，有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为（61.66±2.85）分，回避型经验维度得分为（45.52±1.97）分，认知融合维度得分为（19.74±1.59）分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示：肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系（P＜0.001），与家庭功能得分均呈负相关关系（P＜0.001）。多元线性回归结果显示：文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素（P＜0.05），可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论   肺癌伴癌性疼痛患者心理僵化处于较高水平，且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响，临床医护人员可从疾病感知、家庭支持等角度出发，采用认知干预、同伴支持等方法，加强对患者的健康教育，以缓解其对疾病的负性认知，从而缓解心理僵化，促进身心健康恢复。

       Objective  To explore the status and influencing factors of psychological  rigidity in patients with lung cancer and cancer pain，and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life．Methods  The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object．The general data questionnaire，Psychological Inflexibility in Pain Scale（PIPS），Brief Illness Perception Questionnaire（BIPQ），and family function questionnaire（APGAR）were used to investigate．Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain．Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain．Results  A total of 152 questionnaires were distributed in this study，and 150 valid questionnaires were recovered，with an effective recovery rate of 98.68 %．The total score of PIPS of 150 patients with lung cancer and cancer pain was（61.66±2.85），the score of avoidance experience dimension was（45.52±1.97），and the score of cognitive fusion dimension was（19.74±1.59）．There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels，family per capita monthly income，and pain degree（P＜0.05）．The  results of Pearson correlation analysis showed that the total score of PIPS，the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception（P＜0.001），and negatively correlated with the score of family function（P＜0.001）．The results of multiple linear regression showed that education level，family per capita monthly income，disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain（P＜0.05 ），which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain．Conclusions  The psychological rigidity of lung cancer patients with cancer pain is at a high level，and is affected by education level，family per capita monthly income，disease perception and family function．Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients，so as to alleviate their negative cognition of the disease，to alleviate the psychological rigidity and promote the recovery of physical and mental health．

       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）分 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．

       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．

     目的   探讨2型糖尿病（T2DM）患者葡萄糖目标范围内时间（TIR）与高尿酸血症（HUA）的相关性。方法   纳入2021年10月—2024年10月厦门大学附属第一医院收治的110例T2DM合并HUA的患者，将其分为T2DM并HUA组，另选取同期110例单纯T2DM患者，分为单纯T2DM组，比较两组一般资料及实验室相关指标，采用Logistics回归模型分析T2DM患者HUA发生的影响因素。随后将110例T2DM合并HUA的患者依照其病情严重程度分为轻度组（58例）、中度组（37例）及重度组（15例），比较三组临床相关指标及TIR水平，分析临床相关指标及TIR水平与T2DM患者HUA严重程度的相关性。结果  T2DM并HUA组与单纯T2DM组患者体质指数（BMI）、糖化血红蛋白、总胆固醇、甘油三酯、血肌酐（Scr）、TIR对比差异有统计学意义（P＜0.05）；将具有统计学差异的指标纳入Logistics回归模型，以是否合并HUA作为因变量（合并HUA=1，未合并HUA=0），结果显示，BMI、糖化血红蛋白、总胆固醇、甘油三酯、Scr、TIR为T2DM患者HUA发生的重要影响因素（P＜0.05）；HUA不同严重程度患者临床相关指标及TIR水平对比发现，轻度组、中度组与重度组糖化血红蛋白、总胆固醇、甘油三酯、Scr水平对比差异无统计学意义（P＞0.05），轻度组、中度组与重度组BMI、TIR对比差异显著（P＜0.05），重度组BMI高于轻度组对比差异有统计学意义（P＜0.05），重度组TIR低于轻度组和中度组对比差异有统计学意义（P＜0.05）；Spearman相关分析显示：BMI与HUA严重程度呈正相关，TIR与HUA严重程度呈负相关（P＜0.05）。结论  TIR降低为T2DM患者HUA发生的重要影响因素之一，且TIR水平与HUA严重程度密切相关。

        Objective  To explore the correlation between time in range（TIR）of glucose and hyperuricemia（HUA）in patients with type 2 diabetes mellitus（T2DM）．Methods  From October 2021 to October 2024，110 patients with T2DM complicated with HUA admitted to our hospital were divided into T2DM with HUA group，and 110 patients with T2DM only in the same period were divided into T2DM group．The general data and laboratory related indicators of the two groups were compared，and the influencing factors of the occurrence of HUA in T2DM patients were analyzed by logistic regression model．Subsequently，110 patients with T2DM complicated with HUA were divided into mild group（58 cases），moderate group（37 cases），and severe group（15 cases）according to their severity．The clinical related indicators and TIR levels of the three groups were compared，and the correlation between clinical related indicators and TIR levels and the severity of HUA in T2DM patients was analyzed．Results  Body mass index（BMI），glycosylated hemoglobin，total cholesterol，triglyceride，and blood creatinine（Scr）between T2DM with HUA group and T2DM group were significantly different（P＜0.05）．The indicators with statistical differences were included in the logistics regression model to determine whether to merge HUA as the dependent variable（with HUA=1，without HUA=0）．The results showed that，BMI，glycosylated hemoglobin，total cholesterol，triglycerides，Scr，and TIR were important influencing factors for the occurrence of HUA in T2DM patients（P＜0.05）．Comparison of clinical indicators and TIR levels in patients with different degrees of HUA revealed no significant differences in glycosylated hemoglobin，total cholesterol，triglycerides，and Scr levels among the mild，moderate，and severe groups（P＞0.05），while there were significant differences in BMI and TIR levels among the mild，moderate，and severe groups（P＜0.05）．The difference between the severe group and the mild group was statistically significant（P＜0.05），and the difference between the severe group and the moderate group was statistically significant（P＜0.05）．The Spearman correlation analysis  results showed that BMI was positively correlated with the severity of HUA，while TIR was negatively correlated with the severity of HUA（P＜0.05）．Conclusions  The decrease of TIR is one of the important influencing factors of HUA in T2DM patients，and the level of TIR is closely related to the severity of HUA．

       目的   探讨营养评估及炎症因子水平对非霍奇金淋巴瘤（NHL）患者化学治疗（化疗）后感染及平均住院日的影响。方法   回顾性分析接受R-CHOP治疗的NHL患者95例。通过受试者工作特征（ROC）曲线确定患者主观整体营养评估（PG-SGA）预测患者化疗后感染的界值。将患者分为PG-SGA＜4组与PG-SGA≥4组，比较两组间营养及炎症相关指标的差异。采用单因素与多因素回归分析NHL患者化疗后感染及平均住院日延长的危险因素。结果  ROC曲线显示PG-SGA为3.5时，约登指数最大，预测NHL患者化疗后感染灵敏度为92%，特异度为11.1%。PG-SGA≥4组患者平均年龄、国际预后指数（IPI）及Ann arbor Ⅲ~Ⅳ期比例均高于PG-SGA＜4组（P＜0.05）。与PG-SGA＜4组相比，PG-SGA≥4组患者白介素6（IL-6）及中性粒细胞与淋巴细胞比值（NLR）明显升高，且化疗后感染率及平均住院日≥5 d比例高于对照组（P＜0.05）；与对照组相比，PG-SGA＜4组患者前白蛋白、白蛋白和血红蛋白水平升高（P均＜0.05）。多因素回归分析显示，PG-SGA≥4及合并糖尿病是NHL患者化疗后感染率的独立危险因素（P均＜0.05）。白蛋白低于35 g/L及合并化疗后感染是NHL患者平均住院日延长的独立危险因素（P均＜0.05）。结论   基于PG-SGA的营养评估及炎症因子分析对NHL患者化疗后感染及平均住院日的预测具有临床指导意义。

       Objective  To explore the effects of nutritional assessment and inflammatory factor levels on post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma（NHL）．Methods  A total of 95 NHL patients treated with the R-CHOP regimen were retrospectively analyzed．The  cut-off  value  of  Patient-Generated  Subjective Global Assessment （PG-SGA） for post-chemotherapy infection in NHL patients was evaluated by Receiver Operating Characteristic（ROC）curves．Patients were categorized into PG-SGA＜4 and PG-SGA≥4 groups and compared for differences of nutritional and inflammation-related factors．Univariate and multivariate logistic regression were used to analyze the risk factors for post-chemotherapy infection and length of hospital stay（LHS）．Results  The ROC curve showed that the Youden index was largest at PG-SGA of 3.5，which predicted post-chemotherapy infection in NHL patients with a sensitivity of 92% and a specificity of 11.1%．The mean age，International Prognostic Index（IPI），and Ann Arbor stage Ⅲ~IV proportion in patients with PG-SGA≥4 were higher compared with the control（P＜0.05）．Patients with PG-SGA≥4 had significantly higher interleukin-6 and neutrophil-to-lymphocyte ratio（NLR），and the infection rate and the proportion of LHS≥5 days after chemotherapy were higher than those in the control group（P＜0.05）．Patients in the PG-SGA＜4 group had significantly higher prealbumin，albumin，and hemoglobin levels compared to the PG-SGA≥4 group（P＜0.05）．Multifactorial logistic regression analysis revealed that PG-SGA≥4 and combined diabetes mellitus were independent risk factors for post-chemotherapy infection rate in NHL patients（both P＜0.05）．Albumin less than 35 g/L and combined post-chemotherapy infection were independent risk factors for prolonged LHS in NHL patients（both P＜0.05）．Conclusions  PG-SGA nutritional assessment and inflammatory factor analysis are clinically instructive in predicting post-chemotherapy infections and LHS in NHL patients．

       非自杀性自伤行为（NSSI）是指个体在没有自杀意图的情况下，故意对自己身体进行伤害的行为。近年来，NSSI在全球范围内整体呈上升趋势，尤其在青少年群体中日益普遍，这与青少年的年龄特点、心理及生物学特征、社会压力等因素密切相关。有研究表明，NSSI是自杀行为的独立危险因素，不仅对青少年健康造成严重影响，也给家庭和社会带来了沉重的负担。因此，本文通过系统回顾NSSI相关文献，阐述其流行病学现况、影响因素和干预措施，旨在为早期识别高危人群、预防青少年NSSI行为的发生以及制定相应的干预策略提供科学依据。

       Non-suicidal self-injury（NSSI）is the behavior in which an individual intentionally inflicts harm on his or her own body without suicidal intent．In recent years，NSSI has been on the rise globally，especially among adolescents，which is closely related to the age characteristics，psychological and biological characteristics，and social pressure．Some studies have shown that NSSI is an independent risk factor for suicidal behavior，which not only poses a serious impact on the health of adolescents，but also imposes a heavy burden on families and society．Therefore，this article systematically reviews relevant literatures on NSSI，mainly elaborating the epidemiological status，influencing factors and interventions．We aim to provide a scientific basis for the early identification of high-risk populations，the prevention of NSSI in adolescents and the development of corresponding intervention strategies

目的 探究本体感觉神经肌肉促进疗法（PNF）技术与居家远程康复治疗对缺血性脑卒中患者凝血功能、平衡状态的影响。方法 选择2023年1月—2024年1月在宁乡市中医医院择期治疗的60例缺血性脑卒中患者为研究对象。按照患者选择的治疗方案进行分组, 观察组接受PNF技术联合居家远程康复指导治疗, 对照组接受常规居家远程康复指导治疗。记录疗效、凝血功能、神经功能缺损症状。结果 凝血功能方面,观察组治疗后活化部分凝血酶时间（APTT）、凝血酶原时间（PT）高于治疗前, 二聚体（D-D）、纤维蛋白原（FIB）低于治疗前,组间比较差异有统计学意义（P<0.05）。与对照组相比, 观察组的APTT、PT、D-D、FIB指标相近,组间比较差异无统计意义（P>0.05）。治疗后, 观察组平衡功能（BBS）评分比治疗前高, 组间比较差异有统计学意义（P<0.05）。观察组BBS评分、FMA评分、肌力等级更高, 组间比较差异有统计学意义（P<0.05）。结论 PNF技术+居家远程康复指导治疗可作为缺血性脑卒中患者治疗的有效手段。联合治疗后凝血功能、平衡状态、肢体功能状况、肌力明显改善, 可见联合治疗对于减轻患者病情尤为明显。

Objective To explore the effects of proprioceptive neuromuscular facilitation（PNF）and home-based remote rehabilitation on coagulation function and balance function in patients with ischemic stroke．Methods From January 2023 to January 2024, 60 patients with ischemic stroke were selected from our hospital．The patients were divided into two groups according to the treatment plan chosen by themselves．The patients in the observation group received PNF technology combined with home-based remote rehabilitation guidance, while the patients in the control group received routine home-based remote rehabilitation guidance．The curative effect, coagulation function and neurological deficit were recorded．Results After treatment, activated partial thrombin time（APTT）and prothrombin time（PT）were significantly higher, D-dimer（D-D）and fibrinogen（FIB）were significantly lower in the observation group than those before treatment（P<0.05）．Compared with the control group, the APTT, PT, D-D and FIB of the observation group were similar, and there was no significant difference between the two groups（P>0.05）．After treatment, the Berg Balance Scale score of the observation group was higher than that before treatment, and there was significant difference between the two groups（P<0.05）．The Berg Balance Scale score, Fugl-Meyer Assessment score and muscle strength grade of observation group were higher than those of control group（P<0.05）．Conclusions PNF combined with home-based remote rehabilitation can be used as an effective method for the treatment of patients with ischemic stroke．The coagulation function, balance, extremity function and muscle strength were significantly improved after combined treatment, which indicated that the combined treatment was especially effective in relieving the patients’ symptoms．

目的 探讨不同类型尿结石患者肠道菌群结构与尿酸代谢的相关性研究。方法 随机选取2022年5月—2023年5月广州市第一人民医院泌尿外科住院的尿结石患者60例为研究组, 选取同期体检中心健康体检人群30名为对照组,按照结石成分将研究组患者分为尿酸组和非尿酸组, 每组各30例, 所有入选患者均接受结石样本、尿样本、大便样本、血样本的采集, 所有样本经光谱、质谱、基因测序、尿常规及血生化检测 , 比较入选对象的肠道菌群及血尿生化指标变化。结果 尿酸组和非尿酸组患者的血磷（SNK-q=7.970、3.542）、血BUN（SNK-q=5.647、4.756）、血SUA（SNK-q=8.178、3.623）、血SCr（SNK-q=7.300、5.553）、血LPS（SNK-q=13.101、9.705）及24h尿酸（SNK-q=4.462、6.426）水平均高于对照组, 具有统计学意义（P<0.05）, 尿酸组和非尿酸组患者的血钙水平低于对照组（SNK-q=3.918/3.047, P<0.05）。非尿酸组患者的血磷、血SUA、血LPS均低于尿酸组, 均有统计学意义（SNK-q=4.428、4.555、3.397, P<0.05）。尿酸组和非尿酸组患者肠道中双歧杆菌数量低于对照组, 差异具有统计学意义（SNK-q=3.754、3.143, P<0.05）。非尿酸组患者肠道中乳酸杆菌数量高于对照组和尿酸组（SNK-q=4.105、3.463, P<0.05）, 尿酸组及非尿酸组患者的血尿酸及24 h尿尿酸水平与肠道双歧杆菌数量呈负相关（P<0.05）。结论 肠道双歧杆菌数量对结石患者血尿酸代谢及尿结石形成具有相关性。

Objective To explore the relationship of intestinal flora and uric acid metabolism in different urinary stones patients．Methods From May 2022 to May 2023, 60 patients with urinary stones patients in Guangzhou First People’s Hospital were selected as the study group, and 30 health check-up people in the same period of the medical examination center were selected as the control group．Study group was divided into the uric acid group and the non-uric acid group, 30 cases each group, all patients received stone samples, urine samples, stool samples,blood samples collection, mass spectrometry, gene sequencing, urine routine, blood biochemical detection were performed．Intestinal flora and blood urinary biochemical indicators of the patients were compared．Results The levels of blood phosphorus（SNK-q=7.970, 3.542）, blood BUN（SNK-q=5.647, 4.756）, blood SUA （SNK-q=8.178, 3.623）, blood SCr（SNK-q=7.300, 5.553）, blood LPS（SNK-q=13.101, 9.705）, and 24-hour urine uric acid （SNK-q=4.462, 6.426）in the uric acid group and the non-uric acid group were all higher than those in the control group,and were statistically significant（P<0.05）．The blood calcium levels of the patients in the uric acid group and the non-uric acid group were lower than those in the control group（SNK-q=3.918/3.047, P<0.05）．The blood phosphorus, blood SUA and blood LPS levels of the non-uric acid group were all lower than those of the uric acid group, and the differences were statistically significant （SNK-q=4.428, 4.555, 3.397, P<0.05）．The number of bifidobacteria in the intestines of patients in the uric acid group and the non-uric acid group was lower than that of the control group,and the differences were statistically significant（SNK-q=3.754, 3.143, P<0.05）．The number of lactobacilli in the intestines of patients in the non-uric acid group was higher than that of the control group and the uric acid group（SNK-q=4.105, 3.463, P<0.05）．The levels of blood uric acid and 24-hour urine uric acid in the uric acid group and the non-uric acid group were negatively correlated with the number of Bifidobacterium in the intestines（P<0.05）．Conclusions The number of intestinal bisidobacteria has a significant correlation with the metabolism of blood uric acid and urinary stones in patients with stones．

目的 明确亚甲基四氢叶酸还原酶（MTHFR）C677T、A1298C基因多态性与成人患者使用大剂量甲氨蝶呤（MTX）治疗急性淋巴细胞白血病（ALL）毒性反应和24、48、72 h MTX血药浓度关系。方法 收集2014年6月—2020年6月就诊于新疆医科大学第一附属医院成人急性淋巴细胞白血病75例患者血样检测MTHFR C677T及A1298C基因多态性, 根据抗癌药物常见毒性反应分级标准对毒性反应进行分级,采用非条件Logistic回归分析MTHFR C677T、A1298C基因多态性与HD-MTX毒性反应及血药浓度的关系。结果 MTHFR 677TT型发生贫血风险显著高于CC型（P=0.027, OR=4.694, 95%CI：1.195~18.438）; 未发现MTHFR C677T与白细胞减少、血小板计数减少、中性粒细胞计数减少、淋巴粒细胞计数减少、骨髓抑制、谷丙转氨酶升高、谷草转氨酶升高、肝功能损伤、急性肾损伤及黏膜损伤、24 h、48 h及72 h MTX血药浓度有相关性（P>0.05）; 未发现MTHFR A1298C与HD-MTX毒性反应及血药浓度有相关性（P>0.05）。结论 MTHFR C677T基因多态性与成人急性淋巴细胞白血病患者大剂量MTX化学治疗后血液毒性存在相关性。

Objective To determine the relationship among C677T and A1298C gene polymorphisms of methyltetrahydrofolate reductase（MTHFR）and adult acute lymphocytic leukemia（ALL）, the relationship between the toxicity of high-dose methotrexate（HD-MTX）after chemotherapy and the MTX blood concentration of 24 h, 48 h and 72 h in patients with ALL．Methods Blood samples were collected from 75 adult patients with ALL who were treated at the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2020．The samples were used to detect the genetic polymorphisms of MTHFR C677T and A1298C, and the toxic reactions were graded according to the common toxic reaction classification criteria of anti-cancer drugs．Unconditional Logistic regression was used to analyze the relationship between MTHFR C677T and A1298C gene polymorphisms and HD-MTX toxic reactions and blood drug concentration．Results The risk of anemia in MTHFR 677TT was significantly higher than that in CC type（P=0.027, OR=4.694, 95% CI：1.195-18.438）．No correlation was found between MTHFR C677T and leukopenia, thrombocytopenia, neutropenia, lymphogranulocytopenia, bone marrow suppression, elevated alanine aminotransferase, elevated aspartate aminotransferase, liver function injury, acute kidney injury and mucosal injury, 24 h, 48 h and 72 h MTX plasma concentrations（>0.05）．No correlation was found among MTHFR A1298C and HD-MTX toxicity and blood concentration（P>0.05）．Conclusions MTHFR C677T gene polymorphism is associated with hematotoxicity after HD-MTX chemotherapy in adult patients with ALL．

目的 观察辅助性T17细胞（Th17）与调节性T细胞（Treg）比值与2型糖尿病（T2DM）患者胰岛素抵抗及胰岛β细胞功能的关系。方法 纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例, 分为糖耐量正常组（NGT组, n=100）和T2DM组（n=100）, 分别测定糖化血红蛋白（HbA1c）、空腹血糖（FPG）、甘油三酯（TG）等生化指标, 电化学发光法测定空腹胰岛素（FINS）, 稳态模型计算胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（HOMA-ISI）。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果 与NGT组相比, T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高（P<0.01）, HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低, 且差异有统计学意义（P<0.01）。Th17与BMI（r=0.251, P<0.001）及HOMA-IR（r=0.305, P<0.001）呈正相关; 与HOMA-β（r=-0.204, P<0.001）及HOMA-ISI（r=-0.359, P<0.001）呈负相关。Treg与HOMA-ISI之间呈正相关（r=0.170, P=0.008）, 而与HOMA-IR呈负相关（r=-0.153, P=0.017）; Th17/Treg与BMI（r=0.332, P<0.001）及HOMA-IR（r=0.374, P<0.001）;与HOMA-β（r=-0.249, P<0.001）及HOMA-ISI（r=-0.427, P<0.001）呈负相关。多元线性回归分析显示, Th17/Treg是HOMA-IR（β=5.915）升高及HOMA-ISI（β=-2.557）下降的影响因素（P<0.01）。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。

Objective To explore the relationship among the proportion of helper T17 cells（Th17）to regulatory T cells（Treg）, insulin resistance, and the function of islet beta cells．Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included．Patients were divided into normal glucose tolerance group（NGT group, n=100）and type 2 diabetes mellitus group（T2DM group, n=100）．The biochemical indexes of HbA1c, fasting blood glucose（FPG）, triglyceride（TG）and fasting insulin（FINS）were determined by electrochemiluminescence．Islet beta cell function index（HOMA-β）, insulin resistance index（HOMA-IR）and insulin sensitivity index（HOMA-ISI）were calculated in homeostasis model．The levels of Th17 and Treg were detected by flow cytometry．Spearman was used to analyze the correlation between indicators, and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR, HOMA-β and HOMA-ISI．Results In contrast to the NGT group, the T2DM group exhibited elevated levels of BMI, FPG, HbA1c, LDL-C, TG, TC, FINS, HOMA-IR, Th17 and Th17/Treg, with these variances being signifincantly different（P<0.01）．There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different（P<0.01）．Th17 was positively correlated with BMI（r=0.251, P<0.001）and HOMA-IR（r=0.305, P<0.001）, it was negatively correlated with HOMA-β（r=-0.204, P<0.001）and HOMA-ISI（r=-0.359, P<0.001）．Treg was positively correlated with HOMA-ISI（r=0.170, P=0.008）, while it was negatively correlated with HOMA-IR（r=-0.153, P=0.017）．The ratio of Th17/Treg was positively correlated with BMI（r=0.332, P<0.001）and HOMA-IR（r=0.374, P<0.001）, it was negatively correlated with HOMA-β（r=-0.249, P<0.001）and HOMA-ISI（r=-0.427, P<0.001）．Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR（β=5.915）and the decrease of HOMA-ISI（β=-2.557）（P<0.01）．Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity．