目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组（n=49）与对照组（n=49）。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮（NO）、内皮素（ET）、血管紧张素Ⅱ（AngⅡ）相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%（χ²=4.356,P=0.037）;治疗后两组AngⅡ、ET水平均降低,且观察组[（13.62±2.24）ng/mL、（68.62±6.66）ng/L]低于对照组[（16.25±4.32）ng/mL、（74.26±9.35）ng/L],对比差异有统计学意义（t₁=3.783,t₂=3.439,P<0.001）;NO水平升高,观察组[（54.26±3.42）μmol/L]高于对照组[（50.51±2.37）μmol/L],对比差异有统计学意义（t=6.309,P<0.001）;治疗后两组血肌酐（Scr）、尿素氮（BUN）、胱抑素C（CysC）水平均降低,且观察组[（404.36±92.12）μmoI/ L、（13.34±4.31）mmol / L、（2.19±0.24）mg / L]低于对照组[（443.49±80.19）μmoI / L、（15.07±4.23）mmol / L、（2.87±0.38）mg / L],对比有统计学意义（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001）;两组不良反应发生率对比差异无统计学意义（10.20% vs 8.16%,P>0.05）。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。

Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment．Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023．Random number table method was used as the grouping method,and they were divided into an observation group（n=49）and a control group（n=49）．The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally．The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared．Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group（χ²=4.356,P=0.037）．Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[（13.62±2.24）ng/mL,（68.62±6.66）ng/L] was lower than the control group[（16.25±4.32）ng/mL,（74.26±9.35）ng/L],the difference was statistically significant（t₁=3.783,t₂=3.439,P<0.001）．Elevated NO levels in the observation group[（54.26±3.42）μmol/L] was higher than the control group[（50.51±2.37）μmol/L],the difference was statistically significant（t=6.309,P<0.001）．Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[（404.36±92.12）μmoI/L,（13.34±4.31）mmol/L,（2.19±0.24）mg/L] were lower than the control group[（443.49±80.19）μmoI/L,（15.07±4.23）mmol/L,（2.87±0.38）mg/L],the differences were statistically significant（t₁=2.243,P₁=0.027;t₂=2.005,P₂=0.048;t₃=10.591,P₃<0.001;P<0.05）．There was no difference in the incidence of adverse effects between the two groups（10.20% vs 8.16%,P>0.05）．Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety．

目的 探讨右美托咪定（Dex）分别联合丙泊酚或依托咪酯在颅内动脉瘤介入术中的镇静效果及对患者血流动力学的影响。方法 将60例颅内动脉瘤介入术患者按照随机数表法分为A组（Dex+丙泊酚,n=30）、B组（Dex+依托咪酯,n=30）。记录两组不同时间点的平均动脉压（MAP）、心率（HR）,比较苏醒期的镇静效果、呛咳程度、拔管时间、苏醒时间、清醒时间及术后不良反应。结果 A组患者T₁MAP、HR为（84.56±5.13）mmHg、（65.87±5.14）次/分和T₂（83.29±5.47）mmHg、（65.87±5.14）次/分均低于B组T₁（87.89±3.88）mmHg、（70.22±5.67）次/分和T₂（86.71±3.75）mmHg、（69.97±5.87）次/分（t分别为2.836、2.825、3.113、3.391,均P<0.001）。两组苏醒期各项指标和躁动（10.00% vs 0%,P=0.757）、呼吸抑制发生率（3.33% vs 0%,P=0.313）比较差异均无统计学意义（均P>0.05）,A组恶心、呕吐发生率（3.33%）较B组（20.00%）更低（χ²=4.043,P=0.044）。结论 Dex联合丙泊酚、依托咪酯麻醉在颅内动脉瘤介入术中均可发挥良好安全的麻醉作用,降低患者术后躁动和呼吸抑制的发生率,使用Dex联合依托咪酯在患者围插管期的血流动力学的稳定性效果更好,但在降低患者术后恶心呕吐的风险方面效果较差。

Objective To evaluate the sedative effect of dexmedetomidine（Dex）combined with propofol or etomidate during cerebral aneurysm intervention and its effect on patient hemodynamics．Methods A total of 60 cerebral aneurysm patients were randomly divided into two groups：Group A（Dex + propofol,n=30）and Group B（Dex + etomidate,n=30）．Mean arterial pressure（MAP）and heart rate（HR）were recorded at different time points in the two groups,and the sedation effect,choking degree,extubation time,waking up time,waking time and postoperative side effects were compared．Results T₁ MAP,HR of（84.56±5.13）mmHg,（65.87±5.14）times / min and T₂（83.29±5.47）mmHg,（65.87±5.14）times / min in group A were lower than those in group B T₁（87.89±3.88）mmHg,（70.22±5.67）times / min and T₂（86.71±3.75）mmHg,（69.97±5.87）times / min（t=2.836,2.825,3.113,3.391,all P<0.001）．There was no significant difference in the incidence of emergence agitation（10.00 % vs 0.00 %,P=0.757）and respiratory depression（3.33 % vs 0.00 %,P=0.313）between the two groups（P>0.05）．The incidence of nausea and vomiting in group A（3.33 %）was lower than that in group B（20.00 %）（χ²=4.043,P=0.044）．Conclusions Dex combined with propofol and etomidate anesthesia can have a good and safe anesthesia effect in intracranial aneurysm intervention,and reduce the incidence of postoperative agitation and respiratory depression in patients．Hemodynamic stabilization during the tube phase is more effective,but less effective in reducing the risk of postoperative nausea and vomiting in patients．

目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组（n=43,予以常规护理）与观察组（n=42,实施常规护理基础上给予基于时机理论的护理干预）,通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表（NRS）、抑郁自评量表（SDS）、焦虑自评量表（SAS）评分分别为（2.13±0.57）（42.45±3.17）（42.45±3.17）分,低于对照组的（3.23±0.78）（52.34±4.45）（48.23±3.23）分（P<0.05）;观察组术后1个月简明健康状况调查表（SF-36）生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为（38.12±8.27）（42.22±9.12）（52.34±8.23）（64.11±8.92）（70.12±9.03）（34.46±6.18）（71.34±8.17）（75.24±8.46）分,高于对照组的（35.23±8.13）（38.56±9.23）（45.03±8.11）（60.57±8.23）（65.23±8.78）（30.14±6.13）（66.23±8.08）（72.12±8.35）分（P<0.05）。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。

Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia．Methods The research period was from July 2020 to June 2023．The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery．They were divided into a control group（n=43,receiving routine care）and an observation group（n=42,receiving timing based nursing intervention on the basis of routine care）through odd and even number drawing．A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire．Results The scores of NRS,SDS and SAS in the observation group at discharge were（2.13±0.57）,（42.45±3.17）and（42.45±3.17）respectively,which were significantly lower than those in the control group（3.23±0.78）, （52.34±4.45）and（48.23±3.23）．The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were（38.12±8.27）,（42.22±9.12）,（52.34±8.23）, （64.11±8.92）, （70.12±9.03）, （34.46±6.18）, （71.34±8.17） and（75.24±8.46）, which were significantly higher than those of the control group（35.23±8.13）, （38.56±9.23）, （45.03±8.11）, （60.57±8.23）, （65.23±8.78）, （30.14±6.13）, （66.23±8.08）and（72.12±8.35）（P<0.05）．Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life．

目的 探讨微RNA-29b（miR-29b）对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组（MM组）、miR-29b阻遏物组（MR组）和阴性对照物组（MNC组）,分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑（WST-1）检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物（PTEN）-蛋白激酶 B（AKT）通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为（2 032.1±873.4）、（19 272.8±2 087.9）、（472.7±105.6）,组间比较差异有统计学意义（P<0.05）。MM组0、3、5、7 d时OD值分别为（0.32±0.06）、（0.53±0.08）、（1.13±0.12）和（1.92±0.14）,MNC组0、3、5、7 d时OD值分别为（0.34±0.09）、（0.71±0.08）、（1.67±0.21）和（3.49±0.24）,MR组0、3、5、7 d时OD值分别为（0.38±0.09）、（0.84±0.18）、（2.43±0.24）和（5.67±0.15）,3组0 d时OD值比较差异无统计学意义（P=0.216）,三组3 d、5 d、7 d时OD值比较差异存在统计学意义（P<0.001）。MNC组、MM组和MR组迁移细胞数分别为（403.9±23.8）（102.6±15.7）和（685.7±46.8）个,上述3组侵袭细胞数分别为（82.1±12.7）（38.2±10.6）和（124.6±21.6）个,MM组和MNC组上述指标比较差异均有统计学意义（P<0.05）,MR组和MM组上述指标比较差异均有统计学意义（P<0.05）。MNC组、MM组、MR组PTEN蛋白相对表达量分别为（0.25±0.08）、（0.69±0.11）、（0.11±0.05）,上述3组p-AKT蛋白相对表达量分别为（0.58±0.10）、（0.13±0.06）和（0.79±0.08）,上述3组AKT蛋白相对表达量分别为（0.38±0.09）、（0.37±0.11）和（0.37±0.08）,MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义（P<0.05）,AKT水平比较差异无统计学意义（P>0.05）;MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义（P<0.05）,AKT水平比较差异无统计学意义（P>0.05）。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。

Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells．Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group（MM group）,micro29b repressor group（MR group）and negative control group（MNC group）,and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group．The real-time quantitative reverse transcription polymerase chain reaction（RT-PCR）was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein．Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were（2 032.1±873.4）,（19 272.8±2 087.9）and（472.7±105.6）,respectively,and there were significant differences between groups（P<0.05）．OD values of MM group at 0 d,3 d,5 d and 7 d were（0.32±0.06）,（0.53±0.08）,（1.13±0.12）and（1.92±0.14）respectively．The OD values of MNC group at 0,3,5 and 7 days were（0.34±0.09）,（0.71±0.08）,（1.67±0.21）and（3.49±0.24）respectively．The OD values of MR group at 0 d,3 d,5 d and 7 d were（0.38±0.09）,（0.84±0.18）,（2.43±0.24）and（5.67±0.15）respectively．There was no significant difference in OD value between the three groups on day 0 （P=0.216）．There were significant differences in OD value between the three groups on day 3,day 5 and day 7（P<0.001）．The number of migrating cells in MNC group,MM group and MR group were（403.9±23.8）cells,（102.6±15.7）cells and（685.7±46.8）cells,respectively．The number of invasive cells in the above three groups were（82.1±12.7）cells,（38.2±10.6）cells and（124.6±21.6）cells．There were significant differences in the above indexes between MM group and MNC group（P<0.05）,also between MR group and MM group（P<0.05）．The relative expression levels of PTEN protein in MNC group,MM group and MR group were（0.25±0.08）,（0.69±0.11）and（0.11±0.05）．The relative expression levels of p-AKT protein in the above three groups were（0.58±0.10）,（0.13±0.06）and（0.79±0.08）．The relative expression levels of AKT protein in the above three groups were（0.38±0.09）,（0.37±0.11）and（0.37±0.08）,respectively．Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance（P<0.05）,but there was no statistical difference in AKT level（P>0.05）．Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance（P<0.05）,and there was no statistical difference in AKT level（P>0.05）．Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway．

目的 探讨理论授课后续以问题为基础的学习（PBL）的阶梯教学法在临床技能混合教学中的效果。方法 选择福建医科大学附属南平第一医院2019级临床医学专业58名见习生为研究对象,将其通过单双号抽签的方式分为两组,即研究组与对照组各29例,研究组基于理论授课后续PBL的阶梯教学法,以“一对一”方式进行线上线下混合教学,对照组开展常规线下教学,对两组见习生教学效果进行比较。结果 研究组见习生参与消毒铺巾、气管插管、胸腔穿刺、腰椎穿刺及小儿腰椎穿刺等5项临床技能考核分别为（95.23±3.18）（95.19±3.26）（95.15±3.35）（95.28±3.17）（95.11±3.45）分,优于对照组（88.23±4.01）（87.89±4.59）（86.23±3.78）（87.22±3.89）（86.23±3.67）分（t=7.366、6.983、9.510、8.650、9.494,P<0.05）;研究组见习生综合能力提升情况优于对照组（χ²=6.444,5.497、5.497、6.444、7.733,P<0.05）;从教师培训态度（7项）、培训方法（15项）、培训时间（3项）、培训效果（11项）等方面进行评价,研究组临床技能培训教学效果各项评分及总分分别为（6.67±0.35）（12.23±2.23）（2.44±0.29）（9.23±2.56）（30.34±4.45）分,高于对照组的（4.12±1.45）（10.12±2.17）（9.23±2.56）（1.68±0.56）（7.23±2.12）分（24.34±3.45）分,（t=9.206、3.652、6.490、3.240、5.738,P<0.05）。结论 基于理论授课后续PBL的阶梯教学法,以“一对一”线上线下混合教学建立医学生临床技能的培训方法,见习生的综合能力明显提升,教学效果更好。

Objective To explore the effect of Problen-Based Learning（PBL）step-by-step teaching method in the online and offline mixed teaching of clinical skills for medical students. Methods Fifty-eight interns majoring in clinical medicine of grade 2019 in Nanping First Hospital affiliated to Fujian Medical University were selected as the research object,they were divided into two groups by drawing lots with even and odd numbers,namely,the study group and the control group,with 29 cases in each group．The study group conducted online and offline mixed teaching in a “one-on-one” way based on the step-by-step PBL teaching method after theoretical teaching,while the control group received regular offline teaching,and the teaching effects of the two groups were compared. Results The students of the study group participated in 5 clinical skills assessment,including disinfection towel（95.23±3.18）,tracheal intubation（95.19±3.26）,chest puncture（95.15±3.35）,lumbar puncture（95.28±3.17）and pediatric lumbar puncture（95.11±3.45）,were significantly better than those of control group（88.23±4.01）,（87.89±4.59）,（86.23±3.78）,（87.22±3.89）,（86.23±3.67）（t=7.366,6.983,9.510,8.650,9.494,P<0.05）．The comprehensive ability improvement of students in study group was better than that in control group（χ²=6.444,5.497,5.497,6.444,7.733,P<0.05）．The evaluation was made from the aspects of teacher training attitude（7 items）,training method（15 items）,training time（3 items）and training effect（11 items）．The clinical skill training teaching effect scores of study group（6.67±0.35）,（12.23±2.23）,（2.44±0.29）,（9.23±2.56）,（30.34±4.45）were significantly higher than those of control group（4.12±1.45）,（10.12±2.17）,（9.23±2.56）,（1.68±0.56）,（7.23±2.12）,（24.34±3.45）（t=9.206,3.652,6.490,3.240,5.738,P<0.05）. Conclusions Based on PBL step-by-step teaching method after theoretical teaching,the training method of clinical skills for medical students is established by “one-to-one” online and offline mixed teaching,can improve the clinical skills and comprehensive ability of interns and get high evaluation from students．

目的 探讨与分析基于信息-动机-行为（IMB）模型的护理干预对造口患者并发症及生活质量的影响。方法 选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果 IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多（P<0.05）。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多（P<0.05）。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多（P<0.05）。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低（P<0.05）,护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低（P<0.05）。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高（P<0.05）。结论 基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。

Objective To explore and analysis the effects of nursing intervention based on Information-Motivation-Behavioral（IMB）model on complications and quality of life of patients with stoma. Methods Eighty-four cases of patients with colorectal cancer undergoing enterostomy in our hospital from May 2021 to Aprilt 2023 were selected as the study subjects．According to the principle of 1∶1 random computer lottery,the patients were divided into IMB group（42 cases）and traditional group（42 cases）．The traditional group were given routine nursing intervention,and the IMB group were given nursing intervention based on the IMB model on the basis of the traditional group．The nursing observation time of the traditional group and IMB group were 3 months,the changes in complications,quality of life,psychological status,and self-management ability scores of patients were observed and recorded. Results The incidence of complications such as abdominal abscess,intestinal obstruction,pulmonary infection and stoma infection in IMB group during nursing were 4.8%,which were significantly lower than 19.0% in the traditional group（P<0.05）．The compliance of IMB group during nursing were 100.0%,which were significantly higher than 90.5% in the traditional group（P<0.05）．After nursing of 3 months,the scores of self-management ability such as symptom recognition,symptom treatment and post-treatment evaluation in IMB group were significantly higher than those in the traditional group（P<0.05）．The scores of anxiety and depression in the traditional group and IMB group after nursing of 3 months were significantly lower than those before nursing（P<0.05）,and the scores of anxiety and depression in the IMB group after nursing of 3 months were also significantly lower than those in the traditional group（P<0.05）．After nursing of 3 months,the scores of IMB group on function scale,symptom scale,symptom subscale and total quality of life scale were significantly higher than those of the traditional group（P<0.05）. Conclusions The application of nursing intervention based on the IMB model in patients with stoma can improve the compliance with medical treatment,reduce the occurrence of complications,improve the self-management ability of patients,relieve anxiety and depression,and continue to improve the prognosis and quality of life of patients．

目的 探讨标准化沟通（SBAR）模式交接班联合护理质量指标管理在胆管结石患者中的应用效果及护理质量、不良事件及并发症影响。方法 选取天津市人民医院2021年1月—2022年12月收治的80例胆管结石患者,应用抽签法分为观察组与对照组,每组各40例。所有患者均采取手术治疗,其中对照组患者实施常规护理,观察组患者在对照组基础上增加SBAR沟通模式交接班联合护理质量指标管理。对比两组患者的护理质量、护理不良事件发生率、护理满意度及术后并发症发生率。结果 观察组基础护理、护理态度、护理责任心、风险识别能力、风险防范能力护理质量评分高于对照组（P<0.05）;两组注射、口服给药差错、换药、抽血差错、病例书写错误以及执行医嘱不及时等护理不良事件发生率对比差异无统计学意义（P>0.05）,观察组患者护理满意度高于对照组（P<0.05）;观察组患者压疮、感染、静脉血栓等并发症发生率均低于对照组（P<0.05）。结论 SBAR沟通模式交接班联合护理质量指标管理针对胆管结石患者应用效果显著,可改善临床护理质量,同时患者护理满意度较高,进一步降低患者术后并发症发生率。

Objective To investigate the application effect of SBAR communication mode shift combined with the management of care quality indicators on patients with bile duct stones and their influence on postoperative complications. Methods Eighty patients with bile duct stones admitted to our hospital from January 2021 to December 2022 were selected,and divided into observation group and control group by drawing lots,40 cases each．All the patients were treated by surgery,and the control group patients received routine care,and the observation group patients added the SBAR communication mode．The quality of care,incidence of adverse events,satisfaction with care and incidence of postoperative complications of the two groups were compared. Results The quality of care values of basic care,nursing care,nursing responsibility,risk identification and risk prevention in the observation group were significantly higher than in the control group（P<0.05）．There was no difference in the incidence of nursing side effects such as injection and oral administration errors,dressing changes,blood sampling errors,case clerk errors and delayed execution of medical orders between the two groups（P>0.05）．Patient satisfaction in the observation group was significantly higher than that in the control group（P<0.05）．The incidence of complications such as pressure ulcers,infections and venous thrombosis in the observation group was significantly lower than that in the control group（P<0.05）. Conclusions SBAR communication mode and combined nursing quality index management for patients with bile duct stones,which can improve the quality of clinical nursing and patient nursing satisfaction,and further reduce the incidence of postoperative complications in patients．

目的 探讨Nolla分期对青少年拔牙正畸患者下颌第三磨牙倾斜角的影响。方法 选择2018年10月—2022年10月收治的100例拔牙正畸青少年患者。100例患者均拔除了4颗前磨牙,共有100颗下颌第三磨牙,通过Nolla分期,可将100例患者分成四组,每组25例。Ⅰ组：牙冠正在形成,Ⅱ组：牙冠基本形成,Ⅲ组：牙根形成在1/2以下,Ⅳ组：牙根形成在1/2以上。在治疗前后,测量下颌第三磨牙倾斜角,对角度α的变化进行分析。结果 第三磨牙牙胚倾斜角、MP-SN、MP-FH在不同组间比较差异无统计学意义（F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994）;治疗前组间下颌第三磨牙角度比较差异无统计学意义（P>0.05）,治疗后不同组间下颌第三磨牙角比较差异有统计学意义（F=13.376,P<0.001）,治疗前后Ⅰ组、Ⅱ组、Ⅳ组第三磨牙的角度无差异（t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399）,Ⅲ组治疗后角度变化减少（t=3.697,P<0.001）。结论 青少年正畸拔牙后,下颌第三磨牙处于牙根形成阶段的一半以下可能会导致第三磨牙近中倾斜加重。当下颌第三磨牙处于牙冠形成阶段,牙冠形成超过一半时,第三磨牙角度变化较小。在治疗前应根据Nolla分期评估下颌第三磨牙的预后情况,并及时制定相应的干预策略。

Objective To explore the effect of Nolla staging on the inclination angle of mandibular third molars in adolescent orthodontic patients undergoing tooth extraction. Methods A total of 100 adolescent patients who underwent tooth extraction orthodontic treatment from October 2018 to October 2022 were included．All 100 patients had 4 premolars extracted,with a total of 100 mandibular third molars．According to Nolla staging,the 100 patients can be divided into 4 groups,with 25 cases in each group．Group I：The crown was forming,Group II：The crown was basically formed,Group III：The root formation was below 1/2,Group IV：The root formation was above 1/2．The inclination angle of the mandibular third molar was measured before and after treatment,and the angle α changes will be analyzed. Results There was no difference in the inclination angle,MP-SN,and MP-FH of the third molar tooth germ among different groups（F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994）．There was no difference in the angle of mandibular third molar teeth between groups before treatment（P>0.05）,the contrast of mandibular third molar angles between different groups after treatment was signifiant（F=13.376,P<0.001）,while the angles in Group I,Group and Group Ⅳ were not slgnificantly different（t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399）,and the angle change decreased after treatment in Group Ⅲ（t=3.697,P<0.001）. Conclusions After orthodontic extraction in adolescents,if the mandibular third molar is less than half of the root formation stage,it may lead to increased mesial inclination of the third molar．However,when the mandibular third molar is in the stage of crown formation and the crown is more than half formed,the angle change of the third molar is relatively small．Therefore,in clinical practice,Nolla staging should be evaluated in the prognosis of mandibular third molars before treatment and develop corresponding intervention strategies in a timely manner．

目的 探讨福莫特罗联合格隆溴铵对慢性阻塞性肺疾病急性加重期（AECOPD）患者的疗效。方法 选择2021年1月—2023年6月廉江市人民医院收治的97例AECOPD患者进行研究,在双方知情基础上,通过单双号抽签方式分组,抽取单号纳入对照组（n=48,予以福莫特罗治疗）,抽取双号纳入观察组（n=48,予以福莫特罗联合格隆溴铵治疗）,对比两组肺功能指标、血气指标、症状改善情况及出现的不良反应。结果 治疗后两组的肺功能指标均高于治疗前,而观察组各指标高于对照组（P<0.05）;治疗后两组PaO₂高于治疗前,PaCO₂低于治疗前,且观察组上述血气指标与对照组比较差异有统计学意义（P<0.05）;治疗后两组的CAT及SGRQ评分均低于治疗前,其中观察组评分低于对照组（P<0.05）;观察组（8.33%）与对照组（12.24%）不良反应率比较,差异不显著（P>0.05）。结论 采用福莫特罗联合格隆溴铵治疗AECOPD患者,有助于改善患者肺功能,使其血气指标得到改善,还可有效缓解其呼吸道症状,且安全性得到保障。

Objective To explore the curative effect of formoterol combined with glycopyrronium bromide on patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods The research cut-off period was from January 2021 to June 2023．A total of 97 patients with AECOPD were selected from Lianjiang People's Hospital for research．On the basis of mutual knowledge,they were divided into groups by odd and even numbers．The odd numbers were drawn into the control group（n=48,treated with formoterol）and the odd numbers were drawn into the observation group（n=48,treated with formoterol+glycopyrronium bromide）,the pulmonary function index,blood gas index,symptom improvement and adverse reactions were compared between the two groups. Results After treatment,the lung function indexes of the two groups were higher than those before treatment,while the indexes of the observation group were higher than those of the control group（P<0.05）．PaO₂ was higher and PaCO₂ was lower in the two groups after treatment,and the blood gas indexes in the observation group were different from those in the control group（P<0.05）．The scores of COPD assessment test and St. George's Respiratory Questionaire in the two groups after treatment were lower than those before treatment,while the scores in the observation group were lower than those in the control group（P<0.05）;There was no significant difference between the observation group（8.33%）and the control group（12.24%）（P>0.05）. Conclusions The choice of formoterol and qualified ammonium bromide for AECOPD is helpful to improve the lung function,blood gas index and respiratory symptoms,And the security is guaranteed．

目的 探讨复方甘草酸苷联合卡泊三醇乳膏治疗寻常型银屑病的效果观察。方法 选取辽健集团阜新矿总医院2019年12月—2022年12月收治的96例寻常型银屑病患者,分为联合组与对照组,每组48例。对照组使用卡泊三醇乳膏治疗,联合组在对照组基础上联用复方甘草酸苷治疗,对比临床疗效,以皮质含量、经表皮水分流失（TEWL）、角质层水含量变化评价患者的皮肤屏障功能,并对比两组患者治疗前后T细胞相关炎症因子表达水平。结果 联合组治疗总有效率较对照组高[93.75% vs 77.08%,χ²=5.352,P=0.021];治疗后两组皮质含量、角质层水含量升高,联合组高于对照组,TEWL降低,联合组低于对照组[皮质含量：（73.59±7.24）μg/cm² vs（110.12±13.64）μg/cm²,t=16.389,P<0.001;角质层水含量：（25.28±3.25）% vs（16.24±2.14）%,t=16.095,P<0.001;TEWL：（8.06±1.44）g/（h·m²）vs（11.71±2.68）g/（h·m²）,t=8.312,P<0.001];治疗后两组患者白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、γ干扰素（IFN-γ）表达水平均降低,且联合组低于对照组[IL-2：（22.25±3.32）vs（26.62±3.24）pg/mL,t=6.661,P<0.001;IL-6：（80.46±5.11）vs（112.62±12.16）pg/mL,t=16.892,P<0.001;IFN-γ：（68.62±10.73）vs（51.26±6.37）ng/L,t=9.639,P<0.001]。结论 复方甘草酸苷联合卡泊三醇乳膏可改善寻常型银屑病皮肤屏障功能,降低炎症因子,改善Th1/Th2细胞因子失衡情况。

Objective To investigate the effect of compound glycyrrhizin and caspotriol cream in psoriasis vulgaris. Methods The 96 psoriasis patients admitted to Fuxin Mine General Hospital from December 2019 to December 2022 were selected and divided into combined group and control group,with 48 patients in each group．The control group was treated with caspotriol cream,the combined group treated with compound glycyrrhizin treatment,the clinical efficacy was compared,and the skin barrier function of patients was evaluated by cortical content,transepidermal water loss（TEWL）,and changes in stratum corneum water content．The expression levels of T cell related inflammatory factors before and after treatment were compared between the two groups. Results The overall effective treatment rate in the combined group was higher than in the control group[93.75% vs 77.08%,χ²=5.352,P=0.021]．After treatment,cortical and stratum corneum water levels increased in both groups,with the combined group being higher than the control group．TEWL decreased and the combined group was lower than the control group[cortical content：（73.59±7.24）μg/cm² vs（110.12±13.64）μg/cm²,t=16.389,P<0.001;water content in the stratum corneum：（25.28±3.25）% vs（16.24±2.14）%,t=16.095,P<0.001;TEWL：（8.06±1.44）g/（h·m²）vs（11.71±2.68）g/（h·m²）,t=8.312,P<0.001]．After treatment,two groups of patients were treated with interleukin-2（IL-2）,interleukin-6（IL-6） and interferon（IFN）-γ,and the combined group was lower than the control group[IL-2：（22.25±3.32）pg/mL vs（26.62±3.24）pg/mL,t=6.661,P<0.001;IL-6：（80.46±5.11）pg/mL vs（112.62±12.16）pg/mL,t=16.892,P<0.001;IFN-γ：（68.62±10.73）ng/L vs（51.26±6.37）ng/L,t=9.639,P<0.001]. Conclusions The combination of compound glycyrrhizin and carpotriol cream can improve the skin barrier function of psoriasis vulgaris,reduce inflammatory factors,and improve the imbalance of Th1/Th2 cytokines．