目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病（CSR）患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者（154例）为研究对象进行回顾性分析，根据干预方案分为参照组（77例，采取颈椎功能康复训练）、研究组（77例，采取子午流注穴位按摩联合颈椎功能康复训练）。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分（VAS）与颈椎功能障碍指数量表评分（NDI）、颈椎功能活动度、血液流变学指标［血浆黏度（PV）、全血低切黏度（LSWBV）、纤维蛋白原（FIB）、全血高切黏度（HSWBV）］。结果 与参照组总有效率（83.12%）相比，研究组（96.10%）明显升高（P＜0.05）；研究组干预后各中医证候积分均较参照组低（P＜0.05）；干预后，研究组VAS、NDI评分均低于参照组（P＜0.05）；研究组干预后颈椎活动度高于参照组（P＜0.05）；干预后，研究组LSWBV、PV、FIB、HSWBV水平均较参照组低（P＜0.05）；研究组干预后3个月复发率为2.72%（2/74），低于参照组的14.06%（9/64）（χ2=4.588，P＜0.05）。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果，改善临床症状、颈椎功能、颈椎活动度，调节血液流变学，降低颈椎疼痛程度、复发率。

Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病（CSR）患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者（154例）为研究对象进行回顾性分析，根据干预方案分为参照组（77例，采取颈椎功能康复训练）、研究组（77例，采取子午流注穴位按摩联合颈椎功能康复训练）。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分（VAS）与颈椎功能障碍指数量表评分（NDI）、颈椎功能活动度、血液流变学指标［血浆黏度（PV）、全血低切黏度（LSWBV）、纤维蛋白原（FIB）、全血高切黏度（HSWBV）］。结果 与参照组总有效率（83.12%）相比，研究组（96.10%）明显升高（P＜0.05）；研究组干预后各中医证候积分均较参照组低（P＜0.05）；干预后，研究组VAS、NDI评分均低于参照组（P＜0.05）；研究组干预后颈椎活动度高于参照组（P＜0.05）；干预后，研究组LSWBV、PV、FIB、HSWBV水平均较参照组低（P＜0.05）；研究组干预后3个月复发率为2.72%（2/74），低于参照组的14.06%（9/64）（χ2=4.588，P＜0.05）。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果，改善临床症状、颈椎功能、颈椎活动度，调节血液流变学，降低颈椎疼痛程度、复发率。

Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

    目的   探讨放血疗法对小儿发热的疗效。方法   检索包括中国生物医学文献数据库（CBM）、CNKI、万方、维普、PubMed、Embase、Web of Science、Cochrane Library等8个中、英文数据库自建库至2025年5月所发表的放血疗法治疗小儿发热的随机对照试验研究（RCT），2名研究人员根据Cochrane系统评价手册（5.1.0版）推荐的偏倚风险评估表对所纳入文献进行质量评估，采用RevMan 5.4软件对纳入文献质量进行系统分析。结果  纳入19项RCT，共2 224例患儿，其中观察组1 118例、对照组1 106例。放血疗法能够提高小儿发热的临床疗效［OR=4.18，95% CI（3.00，5.38），P＜0.001］；降低患儿24 h内高热复发率［OR=0.12，95% CI（0.05，0.34），P＜0.001］；缩短平均退热时间［MD=-1.78，95% CI（-2.56，-1.00），P＜0.001］。结论  放血疗法能够提高小儿发热的临床疗效，降低复发率，缩短退热时间，可作为小儿发热的辅助治疗方法。

       Objective  To explore the efficacy of bloodletting therapy treatment on pediatric fever by meta-analysis．Methods  The randomised controlled trials（RCTs）examining bloodletting therapy for paediatric fever were  retrieved from eight Chinese and English databases—China Biomedical Literature Database（CBM），CNKI，Wanfang，VIP，PubMed，Embase，Web of Science，and Cochrane Library—covering publications from the establishment of each database up to May 2025．Two researchers assessed study quality using the risk of bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews（version 5.1.0）．RevMan 5.4 software was employed for systematic analysis of included studies．Results  Nineteen RCTs involving 2 224 patients were ultimately included，comprising 1 118 patients in the observation group and 1 106 in the control group．Results indicated that bloodletting therapy significantly improved clinical efficacy in paediatric fever（OR=4.18，95% CI［3.00，5.38］，P＜0.001），reduced the recurrence rate of high fever within 24 hours（OR=0.12，95% CI［0.05，0.34］，P＜0.001），and shortened the average time to fever resolution（MD=-1.78，95% CI［-2.56，-1.00］，P＜0.001）．Conclusions  Bloodletting therapy can improve the clinical efficacy of pediatric fever，reduce the recurrence rate and shorten the time of fever reduction，and can be used as an adjunctive treatment for pediatric fever．

       目的 了解《医疗保障基金使用监督管理条例》（以下简称《条例》）在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。

        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”（hereinafter referred to as the “Regulations”）in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions．Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff．Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations．” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization．However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities．Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision．

      目的 探讨重性抑郁障碍（MDD）患者肠道菌群特征与选择性5-羟色胺再摄取抑制剂（SSRIs）疗效的关联性, 筛选可预测SSRIs疗效的肠道菌群生物标志物。方法 选取2024年5月—2025年5月宁夏回族自治区人民医院收治的90例MDD患者, 根据SSRIs治疗8周后疗效分为应答组56例和无应答组34例, 并选择30例健康对照, 采集基线粪便样本进行16S rRNA基因测序, 分析肠道菌群α多样性、菌属相对丰度差异,并通过相关性分析、多因素Logistic回归及ROC曲线评估菌群标志物对SSRIs疗效的预测价值。结果 MDD患者肠道菌群Chao1指数、Shannon指数低于健康对照（P<0.05）, 应答组与无应答组α多样性无差异（P>0.05）。应答组基线Blautia、双歧杆菌属、粪球菌属丰度高于无应答组（P<0.05）, 大肠杆菌-志贺菌属丰度低于无应答组（P<0.05）。基线Blautia、双歧杆菌属、粪球菌属丰度与SSRIs治疗8周HAMD-17减分率呈正相关（r分别为0.390、0.420、0.350,均P<0.05）, 三者联合预测SSRIs疗效的ROC曲线下面积（AUC）为0.910（灵敏度83.9%,特异度85.3%）。结论 MDD患者存在肠道菌群结构异常, 基线Blautia、双歧杆菌属、粪球菌属丰度可作为SSRIs疗效的潜在预测标志物,为MDD个体化治疗提供实验依据。

       Objective To explore the association between gut microbiota characteristics and the efficacy of selective serotonin reuptake inhibitors（SSRIs）in patients with major depressive disorder（MDD）, and to screen gut microbiota biomarkers for predicting SSRIs efficacy．Methods A total of 90 MDD patients（divided into responders[n=56] and non-responders[n=34] based on 8-week SSRIs efficacy）and 30 healthy controls were enrolled from May 2024 to May 2025．Fecal samples were collected for 16S rRNA gene sequencing to analyze gut microbiota α diversity and genus-level relative abundance．Correlation analysis, multivariate logistic regression, and receiver operating characteristic curve were used to evaluate the predictive value of microbiota markers for SSRIs efficacy．Results The Chao1 and Shannon indices of gut microbiota in MDD patients were significantly lower than those in healthy controls（P<0.05）, with no difference between responders and non-responders（P>0.05）．Responders had higher baseline abundances of Blautia,Bifidobacterium, and Coprococcus（P<0.05）, and lower abundance of Escherichia-Shigella compared to non-responders．Baseline abundances of Blautia,Bifidobacterium（P<0.05）, and Coprococcus were positively correlated with 8-week HAMD-17 reduction rate（r=0.390, 0.420, 0.350; all P<0.05）．The combined prediction of these three genera for SSRIs efficacy showed an area under the curve of 0.910（sensitivity 83.9%, specificity 85.3%）．Conclusions MDD patients exhibit abnormal gut microbiota structure．Baseline abundances of Blautia,Bifidobacterium, and Coprococcus may serve as potential predictive biomarkers for SSRIs efficacy, providing experimental basis for personalized treatment of MDD．

       目的   探讨溶酶体相关膜蛋白3（LAMP3）与肾癌发病风险之间的因果关系，为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究（GWAS）数据，采用孟德尔随机化分析方法，评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期（OS）及无病生存期（DFS）的关系。结果  LAMP3基因变异与肾癌风险呈正相关，提示LAMP3的表达可能增加肾癌的发病风险。此外，GEPIA2分析进一步显示，LAMP3的高表达与肾癌患者的低总体生存期（OS）及无病生存期（DFS）显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系，结果表明LAMP3可能是肾癌的潜在致病因子，并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据，并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。

        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis，providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer．Methods  This study utilized data from genome-wide association studies（GWAS）and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer．Additionally，GEPIA2 was used to examine the association between LAMP3 expression and overall survival（OS）and disease-free survival（DFS）in renal cancer patients．Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk，suggesting that LAMP3 expression may increase the likelihood of developing renal cancer．Furthermore，GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients．Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis．The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis．These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future．

       目的   系统评价护士的护理伦理敏感性现状及影响因素，为针对性干预提供参考。方法   检索国内外相关数据库，检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果   纳入16篇文献，包括4 961例研究对象。Meta分析结果显示，护士的护理伦理敏感性处于中等偏高水平，总分为［OR=67.29，95%CI（53.24，81.34）］分。年龄［OR=2.78，95%CI（1.45，5.33），P=0.002］、工作年限［OR=3.55，95%CI（1.35，9.33），P=0.001］、伦理知识教育［OR=14.60，95%CI（4.24，50.32），P＜0.001］、共情能力［OR=1.35，95%CI（1.01，1.80），P＜0.001］、工作场所氛围［OR=1.85，95%CI（0.42，4.51），P＜0.001］、工作嵌入量［OR=3.60，95%CI（0.40，32.84），P=0.001］是护士护理伦理敏感性的主要影响因素。结论   当前证据表明，护士的护理伦理敏感性处于中等偏高水平，影响因素较多，管理者需结合人群特征实施干预，以提高护士护理伦理敏感性水平。

   Objective  To systematically evaluate the current status of nurses’  ethical  sensitivity in  nursing  and influencing factors that influence it，in order to inform targeted interventions．Methods  Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024．Meta-analysis was performed by two analysts independently screening the literature，extracting information，and quality evaluation using Stata 15.0 and RevMan 5.3 software．Results  Sixteen papers including 4 961 study subjects were included．Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29（95%CI［53.24，81.34］）．Age（OR=2.78，95%CI［1.45，5.33］，P=0.002），years of experience（OR=3.55，95%CI［1.35，9.33］，P=0.001），education on ethical knowledge（OR=14.60，95%CI［4.24，50.32］，P＜0.001），and empathic ability（OR=1.35，95%CI［1.01，1.80］，P＜0.001），workplace atmosphere（OR=1.85，95%CI［0.42，4.51］，P＜0.001），and the amount of job embeddedness（OR=3.60，95%CI［0.40，32.84］，P=0.001） were the main influences on nurses’ ethical sensitivity in nursing．Conclusions  The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity，with a high number of influencing factors，and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses．

      目的   免疫球蛋白A肾病（IgAN）与炎症性肠病（IBD）的相互作用机制尚未阐明。本研究旨在解析IBD与IgAN共病的关键特征基因及核心信号通路，以揭示肠－肾轴的分子调控网络。方法   于GEO数据库获取IBD（GSE75214）和IgAN（GSE93798）基因表达谱，筛选差异表达基因（DEGs）。通过蛋白互作网络（PPI）和拓扑算法（MCC、MNC、Degree、EPC等）识别核心特征基因，并结合公共数据库（CTD、DISEASES和GeneCards）和单细胞转录组测序（GSE171314）进行验证。通过Nephroseq数据库验证基因表达与临床表型的相关性。结果   共筛选出17个IBD-IgAN共病DEGs，PPI网络分析等确定以FOS、EGR1、CXCL2和JUNB为核心特征基因。功能富集分析显示白细胞介素-17（IL-17）信号通路显著激活。单细胞测序验证FOS、EGR1、CXCL2和JUNB基因在IgAN特异性高表达，并通过Nephroseq数据库验证其与尿蛋白和估算的肾小球滤过率下降（eGFR）显著相关。结论  本研究揭示IBD与IgAN共享IL-17通路异常激活及FOS、EGR1、CXCL2和JUNB的基因网络，为开发基于肠－肾轴调控的靶向治疗策略提供理论依据。

       Objective  The complex interplay between immunoglobulin A nephropathy（IgAN）and inflammatory bowel disease（IBD）remains poorly understood．This  study  aimed to identify  key  cross-talk  genes  and  pivotal  signaling pathways shared between IBD and IgAN，thereby elucidating the molecular regulatory network underlying the gut-kidney axis．Methods  Transcriptomic datasets for IBD（GSE75214）and IgAN（GSE93798）were retrieved from the GEO database．Differentially expressed genes（DEGs）were screened，and shared DEGs were intersected．Protein-protein interaction（PPI）networks were constructed using STRING and Cytoscape，with topological algorithms applied to identify hub genes．Gene expression profiles were validated through（CTD，DISEASES and GeneCards）and single-cell RNA sequencing（GSE171314）and the Nephroseq database，focusing on clinical correlations with proteinuria and estimated glomerular filtration rate（eGFR）．Results  Seventeen shared DEGs were identified between IBD and IgAN．PPI network analysis revealed FOS，EGR1，CXCL2 and JUNB as core hub genes．Functional enrichment analysis demonstrated significant activation of the interleukin-17（IL-17）signaling pathway．Single-cell sequencing confirmed the specific upregulation of these genes in renal tubular epithelial cells of IgAN patients，which was further validated to correlate with proteinuria and eGFR decline．Conclusions  IBD and  IgAN share aberrant activation of the IL-17 pathway and a co-regulatory gene network involving FOS，EGR1，CXCL2 and JUNB，providing a theoretical foundation for developing therapeutic strategies centered on the gut-kidney axis．

       目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

       目的   通过对急性深静脉血栓形成（DVT）患者经导管接触性溶栓治疗（CDT）中，影响血管导管相关感染（VCAI）危险因素及病原菌分析，为VCAI的预防提供合理、有效的措施。方法   收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料，回顾性调查患者诊疗相关资料及血培养结果，并对发生VCAI和病原菌情况进行分析。结果   本研究共调查急性DVT行CDT治疗的患者437例，发生VCAI的患者共21例，千日感染率为0.543‰。多因素Logistic回归分析结果显示：溶栓频率＞3次/天［OR=3.49（95%CI：1.86~6.45）］、导管留置时间＞7 d［OR=3.86（95%CI：1.26~10.18）］和有导管回送［OR=8.67（95%CI：4.83~12.65）］是患者发生VCAI的危险因素（P＜0.05）。发生VCAI的21例患者，血培养共培养出24株病原菌，有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见，共培养出13株，占比54.17%，革兰阴性菌9株，占比37.5 %。结论   导管留置时间＞7 d、溶栓频率＞3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主，可合并其他病原菌感染，其中以革兰阳性球菌为主。

        Objective  By analyzing the risk factors and pathogens of vessel catheter associated infection（VCAI）in patients with acute deep vein thrombosis（DVT）undergoing catheter directed thrombolysis（CDT），to provide  reasonable and effective measures for the prevention and treatment of VCAI ．Methods  Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected，patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized，and the occurrence of VCAI and pathogenic bacteria was statistically analyzed．Results  This study investigated 437 patients undergoing CDT treatment for acute DVT，and a total of 21 patients developed VCAI，with an infection rate of 0.543‰．The  results of multiple Logistic  regression analysis show that thrombolysis frequency＞3 times/day（OR=3.49［95%CI：1.86-6.45］），catheter retention days＞7 days（OR=3.86［95%CI：1.26-10.18］），and the presence of catheter return（OR=8.67［95%CI：4.83-12.65］） were risk factors for the occurrence of VCAI in patients．Among the 21 patients with VCAI，a total of 24 strains of pathogenic bacteria were discoveredin blood culture，and 3 patients developed composite pathogen infections．Among them，Gram  positive cocci were the most common，with a total of 13 strains cultured，accounting for 54.17%，9 strains of Gram negative bacteria，accounting for 37.5%．Conclusions  The duration of catheter retention＞7 days，thrombolysis frequency＞3 times/day，and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment．The pathogen of VCAI is mainly single pathogen，which can be combined with other pathogens，among which Gram positive cocci are the main pathogen．