目的 研究分析牙髓血管再生术治疗年轻恒牙的临床应用疗效。方法 选取本院2012年1月—2013年12月间年轻恒牙牙髓血管再生治疗的60例患者为研究对象,按随机数方式分成两组,每组30例。对照组患者应用根尖诱导成形手术治疗,观察组患者应用牙髓血管再生术进行治疗,统计比较两组患者术后VAS评分及临床疗效。结果 观察组患者治疗总有效率为93.3%,相较于对照组患者的90.0%差异无统计学意义(P＞0.05);治疗前,两组患者VAS疼痛等级评分差异无统计学意义(P＞0.05);治疗后,患者VAS评分降低明显,且观察组显著低于对照组,差异有统计学意义(P＜0.05)。结论 临床中应用内封氢氧化钙糊剂血管再生术在年轻恒牙治疗中具有较好的应用效果,提高有效率,减轻疼痛,值得临床中应用与推广。

目的 探讨脉管炎围手术期出现焦虑症状及影响因素和护理以提高在围手术期的生活质量。方法 通过对脉管炎患者进行问卷调查焦虑发生及影响因素。结果 脉管炎围手术期患者出现焦虑是十分常见的,生活质量下降直接或间接影响手术的成功率。结论 有效的护理干预能改善各方面的焦虑因素,使患者在围手术期保持心情舒畅,从而适应截肢形象的改变,提高生活质量。

目的 通过开展QC活动降低PICU患儿补液外渗发生率。减轻患儿不适,强化护士主动服务的意识,提高护理质量,提升管理效果。方法 成立QC小组,按照PDCA循环法,调查PICU患儿补液外渗情况及存在问题,制定对策,组织实施,定期对效果进行评价、总结。结果 外渗发生率由活动前的15.48%下降至活动后的10.44%,严重外渗发生率由活动前的2.38%下降至活动后的0.55%,P<0.05,差异有统计学意义。结论 QC活动有效降低PICU患者补液外渗发生率。

Objective To conduct QC activities to reduce the incidence of fluid extravasation in PICU patients. Relieve discomfort in PICU patients,and strengthen the awareness of nurses active service,improve quality of care and management effectiveness. Methods Establishing QC circle,applying the method of PDCA cycle,investigating fluid extravasation in PICU patients,analyzing the main reasons for fluid extravasation,developing countermeasures,Implementing strategies,summarizing and evaluating the effects regularly.Comparing the incidence of fluid extravasation in PICU patients before and after the activity. Results After the activity,the incidence of fluid extravasation decreased from 15.48% to10.44%,the incidence of severe fluid extravasation decreased from 2.38% to 0.55%,P<0.05,the difference was statistically significant. Conclusion The QC activity effectivelycan reduce the incidence of severe fluid extravasation in PICU patients.

目的 探究酒石酸美托洛尔联合辛伐他汀治疗的临床疗效。方法 对我院2013年2月—2014年5月间收治的80例心律失常患者的临床资料进行回顾性分析,将80例患者随机划分为研究组与对照组,两组各40例;对照组40例心律失常患者给予酒石酸美托洛尔治疗,研究组在对照组的治疗基础上给予辛伐他汀治疗,比较研究组患者与对照组患者的临床治疗效果。结果 研究组患者临床治疗总有效率高于对照组,两组差异有统计学意义(P＜0.05);研究组患者室性期前收缩次数、房性期前收缩次数低于对照组,两组差异有统计学意义(P＜0.05);研究组患者与对照组患者不良反应发生例数无统计学意义(P＞0.05)。结论 心律失常行辛伐他汀治疗的临床疗效显著,值得临床推广应用。

目的 探讨中青年医护人员血尿酸(UA)水平与心血管危险因素的关系。方法 利用国人缺血性心血管疾病发病危险的评估方法及简易评估工具“心血管危险积分”评价982名中青年医护人员的心血管危险因素,计算其危险评分积分值,用四分位法根据UA值将研究对象分为四组,比较不同分组间的临床资料,分析UA水平与心血管危险因素的关系。结果 UA水平与心血管危险因素存在正相关(P＜0.01);Ⅲ、Ⅳ组心血管危险积分均高于Ⅰ、Ⅱ组,差异有统计学意义(P＜0.01)。结论 UA增高是心血管疾病的一个重要危险因素,重视高尿酸血症的防治,对预防中青年医护人员的心血管疾病的发生具有重要意义。

Objective To study the relationship between serum uric acid levels and risk factor of cardiovascular disease in young and middle-aged medical staff. Methods Using of risk assessment method and simple assessment tools of cardiovascular risk score of Chinese ischemic cardiovascular disease, the study appraised risk factors of cardiovascular disease about 982 young and middle-aged medical staffs, calculated the risk score integral value. The study divided objects of study into four groups with quartile's method according to serum uric acid levels, compared clinical data between different groups, analyzed the correlation between uric acid level and cardiovascular risk factors. Results Serum uric acid level and cardiovascular risk factors had positive correlation(P<0.01); Ⅲ,Ⅳ group's cardiovascular risk score were higher than Ⅰ, Ⅱ group; the difference had statistics significance(P<0.01). Conclusion Hyperuricemia is an important risk factors in cardiovascular disease. Paying attention to hyperuricemia prevention has important significance to prevention of cardiovascular disease in young and middle-aged medical staff.

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.

       无创正压通气的使用是患者发生鼻面部压力性损伤的重要原因之一，随着我国防控政策的放开，新增老年新冠感染患者急剧增加。文章对使用无创正压通气发生相关压力性损伤现状进行综述，介绍老年患者使用无创正压通气发生鼻面部压力性损伤的主要影响因素、评估方法以及预防措施现状，旨在为临床医务人员预防其相关压力性损伤提供参考。

       The use of non-invasive positive pressure ventilation is one of the important reasons for nasal and facial pressure injuries in patients．With the release of China's epidemic prevention policy，the number of new elderly patients with COVID-19 has increased dramatically．This paper summarizes the current situation of stress injuries caused by noninvasive positive pressure ventilation，introduces the main influencing factors，evaluation methods and prevention measures of nasal and facial stress injuries in elderly patients with noninvasive positive pressure ventilation，aiming to provide a reference for clinical medical personnel to prevent their related stress injuries．

       运动可以调节机体代谢，预防和治疗由糖脂代谢紊乱所引发的心血管疾病。运动因子是在运动过程中，由肌肉、脂肪以及肝脏等多个组织合成和分泌的一系列生物活性物质，包括蛋白质和多肽类分子、小分子代谢物以及核酸等。诸多研究证实，运动因子是运动调节机体代谢的重要因素之一，也是机体从运动中获益的关键分子机制。近年来，随着蛋白质组学、代谢组学以及高通量测序等相关技术的飞速发展，越来越多的运动因子被陆续发现和证实。这不仅拓宽了人们对机体从运动中获益相关机制的认知，还激发了人们对运动因子在健康领域应用前景的浓厚兴趣。文章系统地阐述了运动因子对机体心血管系统的影响，旨在揭示运动因子在促进心血管健康以及治疗心血管疾病等方面的积极效用。

       Exercise can prevent and treat cardiovascular diseases resulting from the metabolic disorders of glucose and lipid．Exerkines are defined as a series of bioactive substances in response to exercise including proteins，peptides，small molecular metabolites and nucleic acids．Multiple tissues can produce exerkines，such as skeletal muscle，adipose tissue，and liver．Many studies indicate that exerkines play essential roles in improving glucose and lipid metabolism，which are crucial to harness the health-related benefits mediated by exercise．In recent years，with the progression of proteomics，metabolomics and high-throughput sequencings，an increasing number of exerkines are discovered．These findings expand the research on beneficial effects of exercise and draw attention to the clinical implications of exerkines．This review aims to explore the influence of exerkines on cardiovascular system and reveal their potential roles in the prevention and treatment of cardiovascular disease．

       目的   探讨CT、MRI影像学表现对原发性肝细胞癌（HCC）微血管侵犯（MVI）的诊断价值。方法   选取2018年1月—2024年7月江门市第二人民医院（江门市中心医院蓬江分院）和江门市中心医院120例（共158个病灶）HCC患者，均行上腹部CT、MRI平扫+增强及弥散加权成像（DWI）检查；以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能；分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性；比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数（ADC）值。结果    DWI检查对HCC MVI的诊断效能（灵敏度、特异度、准确度、阳性预测值、阴性预测值）均显著性高于CT、MRI平扫+增强（P＜0.05）；CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较，差异均无统计学意义（P＞0.05）。在HCC MVI诊断效能中，CT、MRI影像学表现与术后病理确诊结果之间为中度一致性；DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者（P＜0.05）。在不同b值（400、800、1 000、1 500 s/mm² ）下，HCC MVI患者的ADC值均显著性高于无HCC MVI患者（P＜0.05）。结论    CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能，而MRI诊断结果与病理诊断一致性更佳，尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯，有助于指导临床医生建立“个体化”精准诊疗策略。

       Objective  To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion（MVI）in primary hepatocellular carcinoma（HCC）．Methods  A total of 120 patients（158 lesions in total）with HCC in the Second People’s Hospital of Jiangmen（Pengjiang Branch of Jiangmen Central Hospital）and Jiangmen Central Hospital were selected from January 2018 to July 2024，all underwent CT and MRI plain + enhanced and diffusion-weighted imaging（DWI）of the upper abdomen；postoperative pathology results was used as the diagnostic gold standard．The diagnostic efficacy of CT，MRI plain + enhanced and DWI for HCC MVI was compared．The concordance among CT，MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI．Imaging manifestations and apparent diffusion coefficient（ADC）values in patients with and without HCC MVI were compared．Results  Diagnostic effectiveness of DWI examination for HCC MVI（sensitivity，specificity，accuracy，positive predictive value，negative predictive value）were all significantly higher than those of CT and MRI plain + enhanced（P＜0.05）；none of the differences were statistically significant（P＞0.05）in the comparison of diagnostic effectiveness of CT，MRI，and DWI for the diagnosis of MVI in patients with primary HCC．In HCC MVI diagnostic effectiveness，moderate concordance was found among CT，MRI imaging phenotypes and postoperative pathology results；high concordance was found between DWI and postoperative pathology results．In HCC MVI patients，the proportion of non-marginal arterial reinforcement，enhanced envelope，halo reinforcement，nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI（P＜0.05）．At different b-values（400，800，1 000，1 500 s/mm² ），ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI（P＜0.05）．Conclusions  CT，MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI，while MRI diagnostic results are in better concordance with pathologic diagnosis．In particular，ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC，which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies．