目的 探讨癫痫患者疾病进展恐惧水平的影响因素。方法 选取2021年1月—2022年8月本院收治的82例癫痫患者,评估所有患者的疾病进展恐惧水平,设计基线资料调查表,详细统计所有患者的基线资料,比较不同资料特征癫痫患者的恐惧疾病进展简化量表（FoP-Q-SF）评分,重点分析癫痫患者疾病进展恐惧水平的影响因素。结果 经评估,82例癫痫患者的FoP-Q-SF评分为（34.73±5.16）分;不同年龄、社会支持、希望水平、发作频率及受教育程度癫痫患者的FoP-Q-SF评分比较差异有统计学意义（均P<0.05）,其他不同资料特征癫痫患者的FoP-Q-SF评分比较,差异无统计学意义（P>0.05）;多元线性回归分析结果显示,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素（P<0.05）。结论 癫痫患者疾病进展恐惧呈中高水平,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素。

目的 了解越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况,为更好地贯彻落实消除艾滋病母婴传播工作提供下一步工作策略和措施依据。方法 于2022年7月—8月,对广州市越秀区5家助产机构妇产科、保健科和医务科的医务人员进行艾滋病母婴阻断知识政策及HIV感染孕产妇相关权益知识的问卷调查。结果 465名医务人员对个别艾滋病母婴阻断政策了解不足,包括“人类免疫缺陷病毒（HIV）感染孕产妇到定点医疗机构终止妊娠或住院分娩时可以获得一定的减免”（知晓率79.78%）、“HIV感染孕产妇的宝宝可以免费领取一定数量的奶粉”（知晓率66.88%）;医务人员对HIV感染孕产妇的生育相关权益认识严重不足,对HIV感染孕产妇生育权益认识正确的仅有45.59%。临床护士群体对上述艾滋病母婴阻断政策及HIV感染孕产妇相关权益的知晓率低于临床医生及其他医务人员,组间比较差异有统计学意义（P<0.05）。结论 越秀区助产机构医务人员对艾滋病母婴阻断知识有一定的了解,但掌握不够完整、全面,对HIV感染患者的生育权认识严重不足,应进一步加强对助产机构医务人员、尤其是护士群体关于艾滋病母婴阻断政策知识及患者相关权益的培训,以更好地贯彻落实消除艾滋病母婴传播工作,保障HIV感染患者的权益。

Objective To understand the knowledge of medical staff of midwifery institutions in Yuexiu District about AIDS prevention of mother-to-children transmission（PMTCT）and patients' rights and interests,in order to provide the basis for the following work strategy and measures for better implementation of the elimination of mother-to-child transmission of HIV．Methods From July to August in 2022,a questionnaire survey about knowledge and policies of AIDS PMTCT and rights of HIV infected pregnant women was conducted among the medical staff of obstetrics and gynecology department,health care department and medical department in five midwifery institutions in Yuexiu District of Guangzhou City．Results A total of 465 medical workers had insufficient understanding of some policies on PMTCT of AIDS,including HIV-infected pregnant women can obtain certain fee waiver when they go to designated medical institutions to terminate pregnancy or hospitalized deliver（awareness rate of 79.78%）,HIV-infected pregnant women's babies can receive a certain amount of free milk powder（awareness rate of 66.88%）．There was a serious lack of awareness of reproductive rights of HIV-infected pregnant women among medical staff,and only 45.59% of them had correct understanding．The awareness rate of the PMTCT and the rights and interests of HIV-infected pregnant women among clinical nurses was significantly lower than that among clinicians and other medical staff．Conclusions The medical staff of midwifery institutions in Yuexiu District have some knowledge about the PMTCT of AIDS,but their knowledge is not complete and comprehensive,and their understanding of the reproductive rights of HIV-infected patients is seriously inadequate,so it is necessary to further strengthen the training of medical staff in midwifery institutions,especially nurses,on the policy knowledge of PMTCT of AIDS and the related rights and interests of patients,in order to better implement the elimination of mother-to-child transmission of AIDS and protect the rights and interests of infected patients．

目的 了解广州市社区居民对中医“治未病”的认知现状,分析其影响因素,并为中医“治未病”的进一步发展提出可行建议。方法 采用多阶段整群抽样法,对广州市不同区域的652名居民进行问卷调查,通过描述性分析和χ²检验分别对基本认知情况与影响因素进行阐述。结果 广州市居民对“治未病”服务了解情况不太理想（67.80%）,接受“治未病”服务的意愿情况较好（77.91%）,对于中医“治未病”服务的认知还比较片面,主要通过手机、网络、社区等方式了解相关内容。影响居民接受意愿的因素主要是年龄、学历、户口、职业类型等。结论 目前广州市社区中医“治未病”服务具有一定群众基础和发展潜力,但是还存在居民认知不足、宣传力度不够、服务能力不足等问题,应当着重从这些方面进行改进。

Objective To understand the current cognitive status of community residents in Guangzhou regarding traditional Chinese medicine（TCM）pre-treatment,analyze its influencing factors,and provide feasible suggestions for the further development of TCM pre-treatment．Methods By multi-stage cluster sampling method,a questionnaire survey was conducted on 652 residents in different regions of Guangzhou．Descriptive analysis and chi-square test were used to elucidate the basic cognitive situation and influencing factors．Results The understanding of TCM pre-treatment services among residents in Guangzhou was not ideal（67.8%）,and their willingness to receive TCM pre-treatment services was good（77.91%）．Their understanding of TCM pre-treatment services was quite one-sided,mainly through mobile phones,internet,communities and other means．The main factors affecting residents' willingness to accept this service were age,education level,household registration and occupation．Conclusions At present,the TCM pre-treatment service in the community of Guangzhou has a certain mass basis and development potential．However,there are still problems such as insufficient residents' awareness,insufficient publicity,and insufficient service capabilities,which should be improved in the future．

目的 分析医用几丁糖治疗不可复性关节盘前移位患者的临床疗效及其对患者生活质量、恐惧疾病进展的影响。方法 将200例确诊为不可复性关节盘前移位患者分为2组,实验组以颞下颌关节微创灌洗术联合几丁糖治疗,对照组采用单一颞下颌关节微创灌洗术治疗,分别于治疗前和治疗后1、3、6、12个月采用一般资料调查表、口腔健康影响程度量表（OHIP）-14中文版、恐惧疾病进展简化量表（FoP-Q-SF）、视觉疼痛模拟量表等进行问卷调查并进行统计学分析。结果 治疗后,2组患者最大张口度、疼痛评分、生活质量及恐惧疾病进展水平较治疗前明显改善（P>0.05）,且2组间比较,颞下颌关节微创灌洗术联合医用几丁糖在临床效果、生活质量及恐惧疾病进展水平长期效果明显优于单一颞下颌关节微创灌洗术（P>0.05）。结论 颞下颌关节微创灌洗术单一应用或联合医用几丁糖均对不可复性关节盘前移位患者疗效良好,对提升患者生活质量和缓解恐惧心理方面也有着重要意义,其中不可复性关节盘前移位联合应用几丁糖的长期疗效优于其单一应用。

Objective To analyze the efficacy of medical chitosan and its effect on the quality of life and fear of disease progression of patients with anterior disc displacement without reduction．Methods A total of 200 patients with anterior disc displacement without reduction were selected and divided into two groups,the experimental group was treated with temporomandibular joint lavage and medical chitosan,the control group was treated with temporomandibular joint lavage only．Before and after treatment with 1 month,3 months,6 months and 12 months,general data questionnaire,OHIP-14 Chinese version,FoP-Q-SF and visual analogue scale were used to investigate and the data were analyzed statistically．Results After treatment,the maximum mouth opening degree,pain score,quality of life and fear of disease progression were significantly improved compared with those before treatment,the differences were statistically significant（P>0.05）．The long-term curative effect of the temporomandibular joint lavage and medical chitosan was better than that of the temporomandibular joint lavage only in clinical outcome,quality of life and fear of disease progression（P>0.05）．Conclusions Temporomandibular joint lavage combined with medical chitosan and temporomandibular joint lavage only are effective in the treating anterior disc displacement without reduction,and can improve the quality of life and fear of disease progression,while the combined treatment has better long-term effect．

目的 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为（30.69±8.98）分,口腔健康评估平均为（8.59±3.68）分,口腔健康相关生活质量GOHAI总分为（25.65±8.10）分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关（P<0.05）。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素（P<0.05或P<0.01）。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。

Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people．Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people．Results The 266 middle-aged and elderly people had a mean score of（30.69±8.98）for general knowledge and behavioral scores of oral health,a mean score of（8.59±3.68）for oral health assessment,a total score of（25.65±8.10）for oral health-related quality of life GOHAI．The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people（P<0.05）．The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly（P<0.05）．Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents．

受试者招募工作关乎临床研究质量与进度。无法按计划招募到合适的受试者,一直是研究者发起的临床研究（IIT）开展过程中面临的主要挑战之一。本文分析影响IIT项目受试者招募进度的常见因素,并借鉴国内外经验,从提高受试者认知度与信任度、拓宽招募渠道、加强人文关怀、建立多中心伦理协作审查机制等方面探讨推进受试者招募的具体措施,以期为IIT研究者及科研管理部门提供参考。

Recruitment of subjects is crucial to the quality and progress of clinical research．However,the inability to recruit suitable subjects according to the plan has been one of the major challenges faced by investigators in the process of conducting investigator-initiated trial（IIT）．This article analyzes the common factors that affect the recruitment progress of IIT projects,draws on domestic and international experiences,and explores specific measures to promote subject recruitment,including improving subject awareness and trust,expanding recruitment channels,enhancing humanistic care and establishing a multi-center ethical collaboration review mechanism,in order to provide reference for IIT researchers and research management departments．

嵌合基因是指由两个或多个原本不连续的基因片段重组而成的新基因,它们可以通过基因组重排、转录诱导等机制产生。嵌合基因在正常生理和发育过程中具有重要的功能和调控作用。嵌合基因可以改变原有基因的表达水平、编码蛋白质的结构和功能、信号通路的激活和抑制等,从而促进肿瘤细胞的增殖、侵袭、转移和耐药性。近年来,随着高通量测序技术的发展和应用,越来越多的嵌合基因被发现和鉴定,它们在不同类型的肿瘤中具有不同的表达模式和功能作用,为肿瘤的分子诊断、预后评估和靶向治疗提供了新的机会和挑战。本文旨在对嵌合基因产生的机制、检测方法和在肿瘤中的功能和应用等方面进行综述,为进一步认识嵌合基因在肿瘤进展中的功能机制及其精准化治疗提供参考。

Chimeric genes refer to novel genes formed by the recombination of two or more originally non-contiguous gene fragments through mechanisms like genomic rearrangement and transcriptional induction．They play important roles in physiological and developmental regulation．Chimeric genes can alter the expression,structure and function of original genes,modulate signaling pathway activation and inhibition,and thereby promote tumor cell proliferation,invasion,metastasis and drug resistance．In recent years,with the development and application of high-throughput sequencing technologies,increasing numbers of chimeric genes have been discovered and identified．They demonstrate different expression patterns and functional roles in various tumor types,providing new opportunities and challenges for molecular diagnosis,prognostic assessment and targeted therapy of cancers．This review summarizes the mechanisms of chimeric gene formation,detection methods and their functions and applications in tumors,to provide insights into the functional mechanisms of chimeric genes in tumor progression and their implications for precision treatment．

目的 研究高胆红素血症新生儿溶血三项及抗体效价的相关影响因素。方法 采用回顾性分析,选取我院2022年7月—2023年3月期间收治的新生儿高胆红素血症85例,所有患儿均接受溶血三项检查及母亲IgG 抗体效价检测,其中溶血三项包括直接抗人球蛋白试验、抗体释放试验、血清游离抗体试验。记录患儿出生孕周、性别、日龄、母亲怀孕次数、母亲分娩方式、母亲IgG 抗体效价及血红蛋白水平、总胆红素水平指标,观察上述因素对溶血三项检测阳性有无影响,并开展影响溶血三项检测阳性的多因素Logistic回归分析。结果 85例高胆红素血症患儿中,高胆红素血症阳性63例（74.12%）;其中男婴32例（50.79%）、女婴31例（49.21%）,A型30例（47.62%）、B型31例（49.21%）、O型2例（3.17%）、AB型0例（0.00%）。不同血型高胆红素血症患儿溶血三项阳性率比较差异无统计学意义（χ²=0.857,P=0.652）,不同母亲IgG 抗体效价高胆红素血症患儿溶血三项阳性率比较差异有统计学意义（χ²=19.807,P<0.001）。结论 新生儿溶血阳性可能与母体中血型抗体效价密切相关,可随其升高而升高,应针对特定人群开展针对性干预,改善新生儿结局。

目的 对比磁敏感加权成像（SWI）、磁共振成像（MRI）、第3代双源电子计算机断层扫描（CT）三种方式在急性缺血性脑卒中（AIS）患者血管内治疗后诊断出血灶以及碘对比剂外渗中的临床价值。方法 选取2022年1月—2023年2月在新乡医学院第一附属医院接受血管内治疗的80例AIS患者作为研究对象,所有患者均接受MRI、SWI、第3代双源CT检查,经综合分析后确定诊断结果,对比三种检查方法对治疗后早期出血灶的鉴别效能,同时以治疗72 h后的常规CT结果作为诊断金标准,评价三种检查方法诊断早期出血灶与碘对比剂外渗的效能。结果 MRI的阳性预测价值为90.32%、阴性预测价值为88.00%,SWI的阳性预测价值为93.55%、阴性预测价值为92.00%,第3代双源CT的阳性预测价值为93.75%、阴性预测价值为95.83%,其中第3代双源CT与金标准的一致性更高（Kappa=0.891）。与治疗72 h后的常规CT结果对比,MRI的曲线下面积（AUC）为0.907,诊断灵敏度为90.32%、特异度为88.00%、准确度为89.29%;SWI的AUC为0.937,诊断灵敏度为93.55%、特异度为92.00%、准确度为92.86%;第3代双源CT的AUC为0.971,诊断灵敏度为96.77%、特异度为92.00%、准确度为94.64%,第3代双源CT的诊断效能最高。结论 AIS血管内治疗后,采用SWI、MRI、第3代双源CT三种检查方式均能有效区分出血灶与碘对比剂外渗情况,且临床诊断价值较好。

目的 探讨烧伤后瘢痕整形患者康复期创伤后成长及情绪调节策略及干预效果。方法 选择2021年10月—2023年6月期间我院接收的55例烧伤后瘢痕整形患者作为研究对象,采用随机数字表法分为2组,对照组27例采取常规康复护理干预,观察组28例实施针对性评估及护理干预,评价2组创伤后成长特征、情绪调节策略、应对方式。结果 干预后,观察组自我转变、个人力量、人生感悟、新的可能性和与他人关系等评分均高于对照组（均P<0.05）。护理干预后观察组情绪调节评分（ERQ）优于对照组,其中认知重评评分更高、表达抑制评分更低,组间比较差异有统计学意义（均P<0.05）。护理干预后应对方式评分优于对照组,其中回避、屈服评分更低,面对评分更高（均P<0.05）。结论 基于康复期创伤后成长及情绪调节现状实施针对性护理干预可促进烧伤后瘢痕整形患者减轻创伤感受,能够以积极的情绪应对康复期,改善情绪状态。