目的 研究磁共振成像（MRI）、经直肠超声（TRUS）结合血清前列腺特异性抗原（PSA）诊断前列腺癌诊断的应用价值。方法 收集2020年1月—2023年1月前在武穴市第一人民医院检查的疑似前列腺癌患者140例,均给予MRI、TRUS检查,并进行血清PSA水平检测,以患者手术病理结果为金标准,观察单一MRI、TRUS、血清PSA及联合诊断时漏诊、误诊情况,进行一致性分析,计算各项单一诊断及联合诊断的诊断灵敏度、特异度、准确率。结果 经手术病理结果证实为前列腺癌81例,非前列腺癌59例,前列腺癌患者血清PSA水平高于非前列腺癌患者（P<0.05）;单一MRI、TRUS或PSA诊断前列腺癌与手术病理结果的一致性一般（Kappa=0.641、0.624、0.536,均P<0.001）,联合诊断与手术病理结果的一致性较好（Kappa=0.906,P<0.001）;联合诊断的灵敏度、特异度、准确率为高于单一MRI、TRUS、血清PSA及各诊断方式两两联合（P<α,α=0.007）。结论 前列腺癌诊断中单一MRI、TRUS、血清PSA诊断均存在漏诊、误诊风险,联合诊断可弥补单一诊断的不足,提高前列腺癌患者的诊断准确率。

Objective To study the application value of magnetic resonance imaging（MRI）,transrectal ultrasound（TRUS）combined with serum prostate-specific antigen（PSA）in the diagnosis of prostate cancer．Methods A total of 140 patients with suspected prostate cancer who were examined at Wuxue First People's Hospital from January 2020 to January 2023 were enrolled．MRI and TRUS examinations were performed,and serum PSA levels were tested．The surgical pathology results of the patients were used as the gold standard．The missed diagnosis and misdiagnosis in single MRI,TRUS,serum PSA and combined diagnosis were observed,consistency was analyzed,and the diagnostic sensitivity,specificity,and accuracy of each single diagnosis and combined diagnosis were calculated．Results There were 81 cases of prostate cancer and 59 cases of non-prostate cancer confirmed by surgical pathology results．The serum PSA level of prostate cancer patients was higher than that of non-prostate cancer patients（P<0.05）．The difference between the diagnosis of prostate cancer by single MRI,TRUS or PSA and the results of surgical pathology was with general consistency（Kappa=0.641,0.624,0.536,all P<0.001）,and the consistency of combined diagnosis and surgical pathology results was good（Kappa=0.906,P<0.001）．The sensitivity,specificity,and accuracy of combined diagnosis were higher than single MRI,TRUS,serum PSA and the combination of two diagnostic methods（P<α,α=0.007）．Conclusions In the diagnosis of prostate cancer,single MRI,TRUS and serum PSA diagnosis all have risks of missed diagnosis and misdiagnosis．Combined diagnosis can make up for the shortcomings of single diagnosis and improve the diagnostic accuracy of prostate cancer．

目的 检验婴儿孤独症观察量表中文版（AOSI）临床应用的灵敏度与特异度,评价其临床应用效果。方法 随机抽取1岁时曾在清远市妇幼保健院行AOSI评估,于2~3岁时诊断为孤独症谱系障碍（ASD）的48例患儿为ASD组,诊断为正常发展的46例幼儿作为对照组。比较两组患儿的18个条目得分和总分,采用受试者操作特征（ROC）曲线计算AOSI的特异度、灵敏度、阳性预测值与阴性预测值,并判断AOSI的最佳诊断（阳性）分界值;分析AOSI评估结果与《精神障碍诊断与统计手册（第5版）》（DSM-5）中ASD诊断标准的一致性。结果 两组研究对象性别、年龄比较差异无统计学意义（P>0.05）。ASD组各条目得分和总分均高于对照组,且差异具有统计学意义（P<0.01）。AOSI的曲线下面积（AUC）为1.00（P<0.01）,95%置信区间为（1.00,1.00）。不同阳性分界线的灵敏度、特异度、阳性预测值、阴性预测值及一致性相比较,当约登指数等于1.00时AOSI的最佳诊断（阳性截断值）界线为9分时,其上述值均为1.00。AOSI评估结果与DSM-5中ASD的诊断标准完全相一致（Kappa=1,P<0.01）。结论 AOSI应用于评估1岁的婴儿,当取9分为诊断界值时,具有高度的灵敏度与特异度,能较好地预测该婴儿在2~3岁时是否患ASD;AOSI是婴儿期ASD筛查的重要工具,其评估结果可作为ASD高危儿早期干预的证据和ASD的辅助诊断工具,适合于临床推广应用。

Objective To test the sensitivity and specificity of the Chinese version of the Autism Observation Scale for Infants（AOSI）in clinical application and evaluate its clinical application effect．Methods Forty-eight children with autism spectrum disorder（ASD）diagnosed at the age of 2 to 3 years who had undergone AOSI evaluation in Qingyuan Maternal and Child Health Hospital at the age of 1 year（2021）were randomly selected as the ASD group,and 46 children with normal development were randomly selected as the control group．The scores of 18 items and total scores of the two groups of subjects were compared．The specificity,sensitivity,positive predictive value and negative predictive value of AOSI were calculated using the receiver operating characteristic curve（ROC）,and the best diagnostic（positive）cut-off value of AOSI was confirmed．The consistency of AOSI evaluation results with the ASD diagnostic criteria in DSM-5 were compared．Results There was no statistically significant difference in genders or age between two groups（P>0.05）．The scores of each item and total scores in the ASD group were significantly higher than those in the control group,and the difference was statistically significant（P<0.01）．The area under the curve of AOSI（AUC=1.00,P<0.01）had a 95% confidence interval of（1.00,1.00）．Comparing the sensitivity,specificity,positive predictive value,negative predictive value and consistency of different positive boundary points,when the Youden index was equal to 1.00,the optimal diagnostic（positive cut-off value）boundary for AOSI was 9 points,and all of the above values were 1.00． The AOSI evaluation results were completely consistent with the diagnostic criteria for ASD in DSM-5（Kappa=1,P<0.01）．Conclusions AOSI has high sensitivity and specificity when it is used to evaluate the 1-year-old infant．When “9 points” is taken as the diagnostic threshold,it can better predict whether the infant has ASD at the age of 2~3 years．AOSI is an important tool for screening ASD in infancy．Its evaluation results can be used as evidence for early intervention of high-risk infants with ASD and as a assisting tool to diagnosis ASD,which is suitable for clinical application．

目的 探讨骨肉瘤（OS）和软组织肉瘤（STS）的关键核心基因（Hub基因）及其潜在作用,为肿瘤诊断和预后提供新依据。方法 从基因表达综合数据库（GEO）获得OS数据集GSE16088及STS数据集GSE21122,采用GEO2R在线工具筛选GSE16088和GSE21122数据集的差异表达基因（DEGs）。通过韦恩图获得2个数据集共同DEGs。选取2个数据集中差异表达最显著的上调和下调基因各20个,分别绘制聚类热图。通过使用注释、可视化和综合发现数据库（DAVID）对2个数据集的共同DEGs进行功能（GO）和通路（KEGG）富集分析。构建蛋白互作网络并使用最大中心度（MCC）算法筛选排名最前的10个基因作为潜在的关键Hub基因。采用受试者工作特征（ROC）曲线探讨关键Hub基因对肉瘤患者的诊断价值。通过Kaplan-Meier Plotter进行生存期分析。通过实时荧光定量PCR技术对得分靠前的5个Hub基因进行验证。结果 GSE16088数据集筛选出5 210个DEGs,其中上调和下调的DEGs分别为1 028、4 182个;GSE21122数据集共筛选出1 224个DEGs,其中上调和下调的DEGs分别为451、773个;2个数据集共获得498个共同DEGs。共同DEGs参与到多个生物学过程和信号通路。基于PPI网络和MCC算法最终获得10个关键Hub基因,ROC曲线验证结果符合预期,且生存期分析10个关键Hub基因与肉瘤预后显著相关（P<0.05）。Hub基因在mRNA表达水平和生物信息学分析结果一致（P<0.05）。结论 10个关键Hub基因可用于肉瘤的诊断和预后,为后续免疫治疗提供新视野。

Objective To explore the Hub genes of osteosarcoma（OS）and soft tissue sarcoma（STS）and their potential roles,and to provide evidence for tumor diagnosis and prognosis．Methods The GSE16088 dataset and the GSE21122 dataset were screened in the Gene Expression Omnibus database of the National Center for Biotechnology Information in the United States．The online editing tool GEO2R was used to screen the DEGs of the GSE16088 dataset and the GSE21122 dataset and the Veen map was drawn to find the common DEGs of the GSE16088 dataset and the GSE21122 dataset．20 up-regulated and 20 down-regulated genes with the most significant differential expression were selected from 2 datasets,and heatmaps were drawn for each．The Database for Annotation,Visualization and Integrated Discovery was used to perform GO function enrichment analysis and KEGG pathway enrichment analysis on DEGs of GSE16088 dataset and GSE21122 dataset．PPI network of DEGs was constructed by STRING．PPI sub-modules and Hub genes with high connectivity were screened．Maximal clique centrality（MCC）score was used to select the Hub genes in the protein interaction network．The predictive value of 10 Hub genes in sarcoma patients was analyzed by receiver operating characteristic（ROC）curve．Survival analysis was performed by means of the Kaplan-Meier Plotter．The top five core genes were verified by real-time fluorescence quantitative PCR．Results A total of 5 210 genes were screened in GSE16088 dataset,including 1 028 and 4 182 genes with upregulated and downregulated expression．A total of 1 224 genes were selected from the GSE21122 dataset,including 451 and 773 genes with upregulated and downregulated expression．The cluster heatmap was used to show the top 20 DEGs with high and low expression in GSE16088 and GSE21122 datasets．By differential analysis of gene expression between the two datasets,498 co-DEGs were obtained．GO and KEGG enrichment showed that common DEGs were associated．Ten Hub genes were obtained by PPI and MCC algorithm,the ROC curve verification results were as expected．Survival analysis showed that 10 Hub genes were significantly associated with the prognosis of sarcoma（P<0.05）．The mRNA expression level of Hub genes was the same as the results of bioinformatics analysis（P<0.05）．Conclusions The 10 Hub genes can be used for the diagnosis and prognosis of osteosarcoma,and provide a new vision for subsequent immunotherapy．

血友病是一种由于X染色体上凝血因子基因突变所致的遗传性出血性疾病,目前主要的治疗方法是凝血因子替代疗法。但长期频繁的注射用药往往导致患者依从性差,容易产生抑制性抗体,从而影响治疗效果。虽然现在延长半衰期的新型凝血因子药物、人源化双特异性抗体以及抗组织因子途径抑制剂单克隆抗体等用于疾病治疗,在给药方式和作用持续时间上已有很大进步,但它们仍无法治愈血友病。因此,以疾病根治为重要目标的基因治疗被设计出来,近年来受到了广泛的关注。该文介绍了血友病基因治疗的原理、基因治疗载体的选择、基因治疗预处理方案,总结了现阶段基因治疗临床应用的安全性和有效性;最后讨论基因治疗目前存在的问题以及未来发展方向。

Hemophilia is a genetic bleeding disorder resulting from mutations in coagulation factor genes on the X chromosome．The mainstay of current treatment is coagulation factor replacement therapy．However,frequent and long-term injections often lead to poor patient compliance,easy inhibitor development,and compromised therapeutic efficacy．Despite advancements in delivery methods and prolonged action of novel agents such as extended half-life coagulation factor concentrates,humanized bispecific antibodies,and anti-tissue factor pathway inhibitor monoclonal antibodies,these approaches still fall short of curing hemophilia．Consequently,gene therapy,aiming for disease eradication,has garnered significant attention in recent years．This review delves into the principles of gene therapy,the selection of gene therapy vectors,and gene therapy preconditioning regimens．It summarizes the safety and efficacy of gene therapy in current clinical applications and discusses challenges and future directions in this field．

目的 探讨以多媒体教学法、标准患者教学法、案例教学法、手术观摩教学法等多种教学方法相结合的多样化教学,在小儿外科临床见习的教学实施效果评价。方法 以2022年、2023年参加小儿外科临床见习的儿科学生为研究对象,随机分为试验组和对照组,每组分别45人。试验组采用多样化教学进行临床带教,对照组采用传统教学法进行带教。对比两组儿科学生的理论知识分数、技能操作分数、临床知识评分及总成绩,师生满意度及家属对儿科学生的满意度。结果 试验组的理论知识分数（85.69±4.59）、技能操作分数（86.36±4.35）、临床知识评分（87.71±4.01）及总成绩（86.59±2.85）均高于对照组,差异有统计学意义（P<0.05）。在满意度评价中,试验组在教学方式、学习兴趣、自我评价、团队协作能力及对小儿外科的专业认可度分别为（4.84±0.37）（4.87±0.34）（4.89±0.32）（4.84±0.37）（4.91±0.29）,均高于对照组,差异有统计学意义（P<0.01）;而试验组及对照组对带教教师的理论知识水平分别为（4.80±0.46）（4.64±0.53）,带教教师的积极性评分分别为（4.89±0.32、4.75±0.43）,比较差异无统计学意义（P>0.05）;带教教师在试验组专业知识掌握情况、临床实践操作能力、学生学习积极性及团队协作能力评分分别为（4.82±0.39）（4.87±0.34）（4.91±0.29）（4.93±0.25）,均高于对照组,差异有统计学意义（P>0.05）。患儿家属对试验组在医师尊重孩子、医师非常关注孩子及医师鼓励孩子提问并积极解决问题方面评分分别为（4.91±0.29）（4.93±0.25）（4.91±0.29）,均高于对照组,差异有统计学意义（P<0.05）。结论 在小儿外科临床见习采用多样化教学不仅能提高儿科学生的理论、技能、临床知识水平,还能提高师生满意度及儿科学生对小儿外科的专业认可度。

Objective To assess the impact of multimedia teaching methods,standard patient teaching methods,case teaching methods,and surgical observation teaching methods on clinical probation in pediatric surgery．Methods Pediatric students participating in clinical probation in pediatric surgery in 2022 and 2023 were randomly assigned to either the experimental group or the control group,with 45 students in each group．The experimental group received diversified teaching methods,while the control group received traditional teaching methods．A comparison was made between the two groups regarding theoretical knowledge scores,skill operation scores,clinical knowledge scores,total scores,teacher-student satisfaction levels,and family satisfaction levels of pediatric students．Results The experimental group demonstrated significantly higher theoretical knowledge scores（P<0.05）,skill operation scores（P<0.05）,clinical knowledge scores（P<0.05）,and total scores compared to the control group．In terms of satisfaction evaluation criteria such as teaching style,learning interest,self-evaluation ability,teamwork skills and professional recognition of pediatric surgery（P<0.01）,the experimental group showed significantly higher levels than the control group．There was no significant difference between the two groups regarding teachers’ theoretical knowledge level and enthusiasm score（P>0.05）．However,the teachers in the experimental group scored significantly higher than those in the control group when it came to professional knowledge mastery,clinical practice ability,student learning enthusiasm,and teamwork skills（P>0.05）．Conclusions Implementing diversified teaching approaches during pediatric surgery clinical probation not only enhances theoretical understanding,skills development,and clinical expertise among pediatric students,but also improves overall satisfaction levels for both teachers and students as well as enhances professional recognition of pediatric surgery students．

目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组（P<0.05）。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组（P<0.05）。干预后两组生活质量综合评定量表评分升高,观察组高于对照组（P<0.05）。观察组并发症发生率低于对照组（P<0.05）。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。

Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders．Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases．Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training．The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications．Results The observation group was generally more effective than the control group（P<0.05）．After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group（P<0.05）．After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group（P<0.05）．The complication rate was lower in the observation group（P<0.05）．Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes．

目的 探讨特发性间质性肺炎（IIPs）[非特发性肺间质性纤维化（IPF）型]合并弥漫性肺部出血综合征患者治疗方案以及应用价值。方法 报道1例IIPs（非IPF型）合并弥漫性肺部出血综合征患者的治疗经过以及结果,结合文献分析治疗IIPs（非IPF型）合并弥漫性肺部出血综合症临床应用价值。结果 该文报道 l 例特发性肺间质肺炎（非IPF型）伴弥漫性肺泡出血综合征的老年男性患者,合并呼吸、循环衰竭,启用静脉-静脉体外膜肺氧合（VV-ECMO）抢救并成功撤机,病情好转出院。结论 IIPs作为病因以及发病机制未明、临床表现多样的一类肺间质性疾病,需临床多学科协作,及早诊断、治疗,才能成功挽救患者。

Objective To explore the treatment plan and application value of idiopathic interstitial pneumonia（non IPF）complicated with diffuse alveolar hemorrhage syndrome．Methods A case of idiopathic interstitial pneumonia（non IPF）complicated with diffuse alveolar hemorrhage syndrome was reported．The clinical application value of treatment of idiopathic interstitial pneumonia（non IPF）complicated with diffuse alveolar hemorrhage syndrome was analyzed combined with the literature．Results A case of idiopathic interstitial pneumonia（non IPF type）with diffuse alveolar hemorrhage syndrome was reported in this paper． Combined with respiratory and circulatory failure,veno-venous extracorporeal membrane oxygenation was used to rescue and successfully wean,and the condition improved and discharged．Conclusions Through the curative effect evaluation of this patient,it is believed that idiopathic interstitial pneumonia,as a kind of pulmonary interstitial disease with unknown etiology and pathogenesis and diverse clinical manifestations,need clinical multidisciplinary cooperation,early diagnosis and treatment,in order to successfully save the patient．

目的 探讨产科监护室妊娠期糖尿病产妇泌乳启动延迟及影响因素,以期作为预防泌乳启动延迟的参考依据。方法 选择2021年1月—2023年5月期间医院产科监护室接收的妊娠期糖尿病产妇80例为研究对象,采用单因素和多因素分析产妇的年龄、体质指数、产次、定期复查血糖、妊娠期高血压、分娩方式、开奶时间、新生儿体质量、产后焦虑、产后抑郁、产后疲乏、吸吮次数等对泌乳启动延迟的影响。结果 妊娠期糖尿病产妇泌乳启动延迟33例,发生率41.25%;泌乳启动延迟产妇的年龄≥35岁者占51.52%、未定期复查血糖者占39.39%、合并妊娠期高血压者占54.55%、开奶时间≥6 h者占57.58%、产后焦虑者占30.0%、产后抑郁者占36.36%、产后疲乏者占36.36%、吸吮次数<6次者占60.61%,与非泌乳启动延迟产妇比较差异均有统计学意义（P<0.05）。两组孕前体质指数、产次、分娩方式、新生儿出生体质量比较差异无统计学意义（P>0.05）。年龄≥35岁、未定期复查血糖、合并妊娠期高血压、开奶时间≥6 h、产后焦虑、产后抑郁、产后疲乏、吸吮次数<6次为妊娠期糖尿病产妇泌乳启动延迟的危险因素（P<0.05）。结论 产科监护室妊娠期糖尿病产妇泌乳启动延迟发生率较高,主要受到年龄、未定期复查血糖、合并妊娠期高血压、开奶时间、产后心理状态、吸吮次数等因素影响,应重视健康教育和早期辅助干预,降低泌乳启动延迟发生率。

Objective To explore the delayed lactation initiation and its influencing factors of pregnant women with diabetes in the obstetric care unit,so as to provide a reference for preventing delayed lactation initiation．Methods A total of 80 pregnant women with diabetes who were received by the hospital obstetric care unit from January 2021 to May 2023 were selected as the research objects．The age,body mass index,parity,regular blood glucose recheck,pregnancy hypertension,delivery mode,starting time,neonatal weight,postpartum anxiety,postpartum depression,postpartum fatigue,sucking times and other factors that led to the delay of lactation initiation were analyzed by single factor and multi factor analysis．Results The onset of lactation was delayed in 33 pregnant women with diabetes,with an incidence of 41.25%．The age of postpartum women with delayed lactation initiation over 35 years old accounted for 51.52%,blood sugar was not regularly rechecked accounted for 39.39%,pregnancy induced hypertension accounted for 54.55%,lactation time over 6 hours accounted for 57.58%,postpartum anxiety accounted for 30.0%,postpartum depression accounted for 36.36%,postpartum fatigue accounted for 36.36%,and sucking frequency <6 times accounted for 60.61%,which were higher than that of non-delayed lactation initiation women（P<0.05）．There was no statistically significant difference between the two groups in terms of pre pre-pregnancy body mass index,parity,delivery method and newborn birth weight（P>0.05）．The risk factors of delayed lactation initiation in pregnant women with diabetes were age ≥ 35 years,no regular blood glucose review,hypertension during pregnancy,≥ 6 h of first milk expression time,postpartum anxiety,postpartum depression,postpartum fatigue and sucking times<6（P<0.05）．Conclusions The incidence of delayed lactation initiation in pregnant women with diabetes in the obstetric care unit is high,which is mainly affected by age,pregnancy induced hypertension,time of starting breast feeding,postpartum psychological state and sucking times．Health education and early auxiliary intervention should be emphasized to reduce the incidence of delayed lactation initiation．

目的 探讨综合呼吸康复训练对老年慢性阻塞性肺疾病急性期（AECOPD）患者的临床症状、生活质量、活动能力、肺功能、肺康复依从性的影响。方法 纳入70 例AECOPD 患者,随机数字分为对照组（n=35）和干预组（n=35）,对照组在常规治疗基础上予缩唇腹式呼吸功能锻炼,干预组在常规治疗基础上进行综合呼吸康复训练,干预前后采用慢性阻塞性肺疾病评估测试（CAT）调查问卷、改良版英国医学研究委员会呼吸问卷（mMRC）、肺功能第一秒用力呼气容积（FEV1）预计值进行评估。结果 对照组呼吸康复训练前后CAT评分、mMRC量表呼吸困难评级比较差异均有统计学意义（t=16.781,t=8.103,均P<0.001）;干预组呼吸康复训练前后CAT评分、mMRC呼吸困难评级比较差异也均有统计学意义（t=24.035,t=15.938,均P<0.001）;干预组患者的CAT评分、mMRC量表呼吸困难评级较对照组下降明显。结论 综合呼吸康复训练能有效改善 AECOPD 患者临床症状、增强患者活动能力、提高生活质量、提高肺康复依从性。

Objective To investigate the effects of comprehensive respiratory rehabilitation training on clinical symptoms,quality of life,activity ability,lung function and compliance of elderly patients with acute exacerbation of obstructive pulmonary disease（AECOPD）．Methods Seventy patients with AECOPD were included and randomly divided into control group（n=35）and intervention group（n=35）．The control group was given routine treatment and respiratory muscle function exercise．The intervention group was given routine treatment and comprehensive respiratory rehabilitation training．COPD Assessment Test（CAT）,modified Medical Research Council Scale（mMRC）and FEV1 predicted value of lung function were used to evaluate before and after intervention．Results In the control group,differences of CAT score and mMRC score were significant（t=16.781,t=8.103,P<0.001）before and after respiratory rehabilitation training．In the intervention group,the CAT score before and after respiratory rehabilitation training showed a 0.01 level of significance（t=24.035,P<0.001）,and the mMRC score before and after training showed a 0.01 level of significance（t=15.938,P<0.001）．There were significant differences between control group and intervention group（P<0.01）．Compared with the control group,CAT score and mMRC score were significantly lower in the intervention group．Conclusions Comprehensive respiratory rehabilitation training can effectively improve the clinical symptoms of AECOPD patients,enhance the activity ability of patients,improve the quality of life,and improve the compliance of patients to perform pulmonary rehabilitation．

肝癌患者因食欲降低、进食减少导致不同程度的营养不良,引发厌食症,甚至恶病质,严重影响患者生存质量。食欲评估是降低营养风险的基础,医护人员可通过食欲症状的评估调整患者饮食及营养指导措施,以改善患者营养状态,提高生存质量。该文对食欲的评估工具、方法及干预在肝癌营养不良患者中的应用现状进行阐述,为肝癌患者的食欲干预提供科学依据。

Hepatocellular carcinoma patients suffer from different degrees of malnutrition due to decreased appetite and eating,which triggers anorexia and even cachexia,seriously affecting the quality of patient survival．Appetite assessment is the basis for reducing nutritional risk,and healthcare professionals can adjust patients’ diet and nutritional guidance measures through the assessment of appetite symptoms in order to improve patients’ nutritional status and survival quality．In this paper,the current status of the assessment tools,methods and interventions of appetite in malnutrition patients with hepatocellular carcinoma are described to provide a scientific basis for appetite interventions．