目的 研究靶向NKG2A抑制剂抗头颈部鳞状细胞癌（HNSCC）的作用。方法 应用GEO和TCGA数据库分析NKG2A及其配体HLA-E单细胞表达情况、与患者预后以及免疫微环境的相关性。构建HNSCC皮下抑制瘤模型,流式细胞技术检测化学治疗（化疗）对免疫检测点NKG2A表达的影响。动物实验验证NKG2A抑制剂以及NKG2A抑制剂联合多西他赛化疗的抗肿瘤作用。结果 NKG2A（KLRC1）主要表达在NK细胞,少量表达在T淋巴细胞。HNSCC肿瘤高表达NKG2A/HLA-E（P<0.01）,与患者不良预后密切相关;肿瘤微环境中NKG2A/HLA-E与多个免疫细胞浸润以及免疫检测点表达密切相关（P<0.01）。动物实验显示化疗能上调T、B淋巴细胞表达免疫检查点NKG2A的表达水平（P<0.01）;化疗的基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用（P=0.013）。结论 化疗基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用,为探索HNSCC临床新策略提供实验和理论基础。

Objective To investigate the anti-tumor effects of NKG2A inhibitor on head and neck squamous cell carcinoma（HNSCC）．Methods The single-cell expression of NKG2A ,its ligand HLA-E and their correlations with patient prognosis and immune microenvironment were analyzed in GEO and TCGA databases．The subcutaneous tumor model of HNSCC was constructed,and the effects of chemotherapy on the expression of NKG2A on T and B lymphocytes were detected by flow cytometry．Animal experiments were used to confirmed the anti-tumor effects of NKG2A inhibitor and NKG2A inhibitors combined with docetaxel．Results NKG2A（KLRC1）was mainly expressed in NK cells,and a small amount was expressed in T lymphocytes．The high expression of NKG2A/HLA-E in HNSCC tumors（P<0.01）were closely related to poor prognosis．NKG2A/HLA-E in tumor microenvironment were closely related to the infiltration of multiple immune cells and the expression of immune checkpoints（P<0.01）．Animal experiments showed that chemotherapy could up-regulate the expression of NKG2A in T and B lymphocytes（P<0.01）．Chemotherapy in combination with NKG2A inhibitor could mediate more effective antitumor effects in HNSCC（P=0.013）．Conclusions Combined with NKG2A inhibitor on the basis of chemotherapy can mediate more effective anti-tumor effects,and this study may provide experimental and theoretical basis for exploring new clinical strategies of HNSCC．

目的 研究影响新生儿低血糖的相关危险因素。方法 回顾性分析新生儿科570例新生儿的临床资料,其中新生儿低血糖组190例,正常血糖组新生儿380例,采用Logistic回归分析新生儿低血糖相关危险因素。结果 单因素Logistic回归分析显示,新生儿体质量减轻、早产、新生儿呼吸衰竭、新生儿呼吸窘迫、新生儿感染、母亲分娩年龄增大、经产妇、剖宫产、双胎、妊娠期糖尿病、妊娠期高血压疾病是新生儿低血糖发生的危险因素（均P<0.05）;多因素Logistic回归分析显示,早产（OR=2.115,95%CI：1.186~3.772）、剖宫产（OR=6.92,95%CI：4.202~11.397）是新生儿低血糖发生的危险因素（均P<0.05）。结论 早产、剖宫产是新生儿低血糖发生的危险因素,应根据危险因素及时识别和治疗新生儿低血糖,为新生儿提供及时产后护理指导,以降低新生儿低血糖发生率。

Objective To study the relevant risk factors of neonatal hypoglycemia．Methods A retrospective analysis was conducted on the clinical data of 570 newborns in neonatal pediatrics,including 190 cases in the neonatal hypoglycemia group and 380 cases in the normal blood glucose group．Logistic regression analysis was used to analyze the risk factors related to neonatal hypoglycemia．Results Single factor Logistic regression analysis showed that neonatal weight loss,premature,neonatal respiratory failure,neonatal respiratory distress,neonatal infection,the mother’s age of delivery,multipara,cesarean section,twins,pregnancy diabetes,pregnancy hypertension were the risk factors for neonatal hypoglycemia,all of which had statistical significance（all P<0.05）．In multivariate Logistic regression analysis,premature（OR=2.115,95% CI：1.186-3.772）and cesarean section（OR=6.92,95% CI：4.202-11.397）were risk factors for neonatal hypoglycemia（both P<0.05）．Conclusions Premature and cesarean section are risk factors for the occurrence of neonatal hypoglycemia in the local area．Timely identification and treatment of neonatal hypoglycemia based on risk factors,providing timely postpartum nursing guidance for newborns,can reduce the occurrence of neonatal hypoglycemia．

运动捕捉技术已经广泛应用于步态分析、运动康复、动作对比、技战术分析、生物运动力学分析、损伤防护、运动装备设计研发等领域,实现了人机交互的全新体验。而步行是人类运动中最基础的动作,在生物力学研究上对异常步态进行分析能够有效改善患者治疗和康复的效果。本文总结了运动捕捉技术在各种异常步态分析中的应用,并对其优缺点进行了总结与展望。检索PubMed、Embase、EBSCO、Web of Science、中国知网,收集2018年1月至2023年12月公开发表的有关有标记运动捕捉及无标记运动捕捉在异常步态的相关研究,进行系统综述。最终纳入了22篇英文文献,这些文献主要集中在神经科学、生物医学工程和临床医学等领域,特别是在步态分析、运动捕捉技术、神经病理学和康复医学等方面的应用。这些研究为我们理解和改善各种神经系统疾病,如帕金森病、多发性硬化症和脑卒中以及骨关节炎等疾病的步态提供了宝贵的见解。利用运动捕捉来进行异常步态分析能有效地给患者提供准确的康复治疗,将结果用于临床诊断、康复规划或研究目的。异常步态分析在评估肌肉骨骼状况、神经系统疾病或干预措施的有效性方面具有重要价值。

Motion capture technology has been widely used in the fields of gait analysis,sports rehabilitation,action comparison,technical and tactical analysis,biomotor mechanics analysis,injury protection,sports equipment design and development,etc.,which realizes a brand-new experience of human-computer interaction．While walking is the most basic action in human movement,the analysis of abnormal gait on biomechanical research can effectively improve the effect of patient treatment and rehabilitation．This paper summarizes the application of motion capture technology in the analysis of various abnormal gaits,and summarizes and prospects its advantages and disadvantages．PubMed,Embase,EBSCO,Web of Science and China Knowledge Network were searched to collect related studies,openly published from January 2018 to December 2023,about labeled motion capture and unlabeled motion capture in abnormal gait for systematic review．Twenty-two English-language papers were finally included,which focused on the fields of neuroscience,biomedical engineering and clinical medicine,especially in the applications of gait analysis,motion capture technology,neuropathology and rehabilitation medicine．These studies provide valuable insights into understanding and improving gait in various neurological disorders such as Parkinson’s disease,multiple sclerosis and stroke and osteoarthritis．The use of motion capture for abnormal gait analysis can be effective in providing accurate rehabilitation to patients,using the results for clinical diagnosis,rehabilitation planning,or research purposes．Abnormal gait analysis is valuable in assessing musculoskeletal conditions,neurological disorders,or the effectiveness of interventions．

1994年中国引进患者自控镇痛（PCA）,经过国人改造升级如今已取得了令人瞩目的成绩：2007年《术后患者自控镇痛临床研究与推广应用》获教育部科学技术进步奖二等奖和中华医学科技奖三等奖;2011年具有中国自主专利产权和创新数字医疗的智能化患者自控镇痛（Ai-PCA）诞生,2019年《智能化术后患者自控镇痛管理关键技术及其临床应用》获得中国抗癌协会科技奖二等奖;2023年《中国分娩镇痛规范及推广应用》获得华夏医学科技奖二等奖。笔者撰写述评,提出努力推进Ai-PCA高水平高质量发展的措施,呼吁国内学者重视引领数智镇痛医疗规范化,于2024年在《中华疼痛学杂志》刊出由余守章教授牵头制定的《患者自控镇痛临床应用规范专家共识》,助力中国数智镇痛医疗技术向智慧化前行,为人民群众切实享受到舒适镇痛提供更优质的服务。

Since the introduction of Patient-Controlled Analgesia（PCA）in China in 1994,the domain has witnessed its substantial advancements．The project,Clinical Research and Promotion of Postoperative Patient-Controlled Analgesia,achieved the Ministry of Education’s Second Prize for Scientific and Technological Progress and the Chinese Medical Association’s Third Prize in 2007．The innovation continued in 2011 with the development of an intelligent PCA system（Ai-PCA）endowed with Chinese independent patent rights and innovative digital medical technology．In 2019,the Key Technologies and Clinical Application of Intelligent Postoperative Patient-Controlled Analgesia Management was honored with the second-class Science and Technology Award by the Chinese Anti-Cancer Association．Furthering this trend．In 2023,the Standards and Promotion of Labor Analgesia in China secured the second-class prize in Medical Science and Technology from Huaxia Medical Science and Technology．This commentary suggest strategies for the qualitative enhancement of Ai-PCA and urge domestic scholars to spearhead the standardization of Ai-PCA．Expert Consensus on Clinical Application Standards for Patient-Controlled Analgesia leaded and edited by Pro．She has published,in 2024,which fervently supports the advancement of China’s Ai-PCA technology towards a more intelligent future,to provide the public with higher quality and more comfortable pain management services．

目的 应用FRAX^®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX^®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX^®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX^®工具进行骨折风险评估。

Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.

目的 总结GuideLiner^®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner^®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner^®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。

Objective To evaluate the clinical efficacy and safety of GuideLiner^® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner^® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner^®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner^® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.

目的 对医疗损害责任纠纷案的法庭审理进行分析,探究医疗损害责任纠纷案件的处理现状,对此过程中医疗机构应当关注的问题进行分析总结,以期为医院应对医疗损害鉴定工作和法官审理医疗损害责任纠纷案提供参考。方法 对广州市三所综合医院2015—2021年共93例医疗损害责任纠纷案的判决书进行描述性分析。结果 93例案例中79例进行了医疗损害鉴定。79例进行医疗损害鉴定的案例中,71例鉴定结论被法院采信,采信率达90%。有29例案件鉴定人出庭（占比36.7%）,其中有25例鉴定意见被法院采信,采信率为86.2%,仅有7例案例当事人申请了专家辅助证人出庭。医方大多数最终承担次要及以下责任,占比为73.4%。鉴定结论为责任范围的,法院最后判决偏向于取最高值和中间值（43例出具责任范围的案例中,14例为最高值,13例为中间值）。结论 医疗机构要充分加强对医疗事故技术鉴定和医疗损害鉴定的认识,高度重视医疗损害鉴定工作,尤其加强尸体解剖告知及病历书写管理,充分利用好鉴定人和专家辅助证人出庭两种手段。

Objective To analyze the court trial of medical damage liability disputes,to explore the current situation of medical damage liability disputes,to analyze and summarize the problems encountered in dealing with medical damage disputes,so as to provide some references for hospitals to deal with medical damage disputes．Methods Descriptive statistical analysis performed on the written judgment of 93 cases of medical damage liability disputes in three large comprehensive hospitals in Yuexiu District,Guangzhou from 2015 to 2021．Results In 93 cases,79 cases had expertise of medical malpractice．In 79 expertise,71 of them were adopted,and the acceptance rate was 90%．Among the 29 cases in which the appraisers appeared in court,25 expert opinions were accepted by the court,the acceptance rate was 86.2%．In only 7 cases,the parties applied for expert witnesses to appear in court．In most cases,hospitals ultimately took secondary and lower responsibilities,accounting for 73.4%．If the appraisal conclusion falls within the scope of responsibility,the court's final judgment tends to take the highest and middle values．Conclusions Medical institutions should fully strengthen their understanding of technical identification of medical accidents and medical malpractice identification．Attach great importance to the identification of medical malpractice,especially strengthen the management of autopsy notification and medical record writing,make full use of two methods：appraisers and experts witnesses appearing in court．

目的 挖掘使用美托洛尔后的药物不良事件（ADE）,为临床合理用药提供参考意见。方法 对美国食品药品管理局（FDA）FDA药物ADE报告系统（FAERS）数据库进行信号挖掘,采用报告比值比法和比例报告比值法,分析FAERS数据库中2004年第1季度至2023年第2季度关于美托洛尔的ADE报告。结果 在FAERS数据库中收集到美托洛尔相关ADE共24 184例、667个阳性信号,共涉及27个系统器官分类。ADE严重报告共16 766（占69.33%）,ADE报告频次排名前3的分别是头晕、心动过缓、呼吸困难。结论 美托洛尔的不良反应主要集中在全身性疾病及给药部位各种反应、心脏器官疾病和各类损伤。在使用美托洛尔过程中发生ADE时,应该及时采取相应的干预措施。

Objective To explore the adverse drug events（ADEs）after the use of metoprolol and provide reference opinions for clinical rational drug use．Methods Signal mining was conducted on the FDA Adverse Event Reporting System（FAERS）database in the United States．The reporting ratio method and proportional reporting ratio method were used to analyze ADEs reports related to metoprolol in the FAERS database from the first quarter of 2019 to the second quarter of 2023．Results A total of 24 184 cases of metoprolol related ADEs were collected in the FAERS database,with 667 positive signals and a total of 27 system organ class involved．Conclusions The adverse reactions of metoprolol mainly focus on systemic diseases,various reactions at the administration site,heart organ diseases,and various injuries．It is recommended that timely intervention measures should be taken when ADE occurs during the use of metoprolol．

目的 应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析,提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法 运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别,提取方剂组成,统计并分析方剂中中药的规律并将其结果可视化呈现。结果 最终共纳入62首方剂,包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味,频次频率最高的为桂枝;所用中药四气以温性为主,占56.74%;五味以辛、甘、苦为主,共约占90%,归经以肝肾经为主;药物功效以补虚类为主,占27.13%;关联规则分析显示提升度最高的组合为麻黄-独活,置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝,支持度最高的组合为川芎-当归、川芎-杜仲;通过聚类分析得到3个聚类结果。结论 《圣济总录》治疗腰痛病方面善用通法和补法,强调活血通络,补益肝肾,尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。

Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu,and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain．Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu,extract the composition of the prescription,and analyze the rules of Chinese medicine in the prescription to visually present the results．Results A total of 62 prescriptions were included,including 86 drugs．Among them,with there were 20 kinds of drugs,the frequency of use ≥7 times,the frequency ≥1.6%,and cmnamomi Mmulus highest frequency．Four gas used in traditional Chinese medicine is given priority to with warm,accounted for 56.74%．The five flavors were mainly pungent,sweet and bitter,accounting for about 90%,and the liver and kidney meridians were the main meridians．The drug efficacy was mainly deficiency tonic,accounting for 27.13%．The association rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix,the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix,Pharbitidis Semen- Achyranthis Bidentatae Radix．and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix,Chuanxiong Rhizoma- Eucommiae Cortex．Three clustering result is obtained by cluster analysis．Conclusions In the treatment of low back pain,Shengji Zonglu is good at using both blocking methods and reinforcing methods,emphasizing circulating blood and unblocking meridians supplementing liver and kidney,especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold．

目的 开发适合中国肾癌患者的生命质量测定量表的特异模块。方法 采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果 经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。

Objective To develop the specific module of the quality of life instruments for patients with renal cancer（QLICP-RE）．Methods With the structured group（nominal group and focus group）methods,the item pool was put forward and a preliminary instrument was formed．The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures．Doctors and patients' importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach's α．Results By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally．Conclusions The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness．