目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者（均行无痛胃肠镜检查）为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义（t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05）;重复测量方差分析结果显示,分组因素间收缩压（SBP）（F=30.019,P<0.001）、心率（HR）（F=282.057,P<0.001）、SpO₂（F=64.518,P<0.001）、;时间因素SBP（F=21.780,P<0.001）、HR（F=345.118,P<0.001）、SpO₂（F=41.762,P<0.001）;分组与时间交互时间因素SBP（F=12.941,P<0.001）、HR（F=193.295,P<0.001）、SpO₂（F=13.546,P<0.001）,差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO₂、较B组低。;A组患者围术期不良反应发生率（20.00%）低于B组患者（56.67%）（χ²=25.593,P<0.001）。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。

Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients（all underwent painless gastroscopy）admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects．They were randomly divided into groups using a random number table method．Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol．Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups．There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients（t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05）．The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP（F=30.019,P<0.001）,HR（F=282.057,P<0.001）,SpO₂（F=64.518,P<0.001）,time factors SBP（F=21.780,P<0.001）,HR（F=345．118,P<0.001）,SpO₂（F=41.762,P<0.001）,and interaction factors SBP（F=12.941,P<0.001）,HR（F=193.295,P<0.001）,and SpO₂（F=13.546,P<0.001）．The line chart visually shows that the SBP,HR,SpO₂ of Group A patients were lower than those of Group B．The incidence of perioperative adverse reactions in Group A patients（20.00%）was lower than that in Group B patients（56.67%）（χ²=25.593,P<0.001）. Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions．

目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%（χ²=3.887,P<0.05）,观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为（3.09±1.25）（4.17±2.24）（3.95±1.53）（4.05±1.77）d,均低于对照组（5.14±2.43）（7.03±3.23）（6.40±2.62）（6.32±1.81）d（t=5.143、4.988、5.536、6.147,P<0.05）,观察组的 C 反应性蛋白（C-reactive protein,CRP）、白细胞介素-6（Interleukin-6,IL-6）以及Toll样受体4（Toll-like receptor 4,TLR-4）水平分别为（3.64±0.87）mg/L、（54.59±10.65）ng/mL、（7.94±1.57）%,均低于对照组（7.51±1.43）mg/L、（87.66±11.17）ng/mL、（12.11±2.48）%（t=15.850、14.690、9.740,P<0.05）,观察组的气道压力、动脉血二氧化碳分压（partial pressure of carbon dioxide in artery,PaCO₂）水平分别为（6.92±3.60）cmH₂O、（43.19±6.29）mmHg,低于对照组（8.68±2.98）cmH₂O、（55.43±5.95）mmHg,观察组动脉氧分压（Partial arterial oxygen pressure,PaO₂）（86.06±5.31）mmHg、血氧饱和度（oxyhemoglobin saturation,SpO₂）（98.03±6.63）%高于对照组（68.04±5.19）mmHg、（90.22±5.51）%要高（t=2.582、9.692、16.638、6.221,P<0.05）,观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义（χ²=2.849,P>0.05）。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。

Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group．The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration．The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group（χ²=3．887,P<0.05）．The relief time of fever,pulmonary rale,cough and sputum in observation group was（3.09±1.25）d,（4.17±2.24）d,（3.95±1.53）d,and（4.05±1.77）d,respectively,which were significantly lower than the control group[（5.14±2.43）d,（7.03±3.23）d,（6.40±2.62）d and（6.32±1.81）d]（t=5.143,4.988,5.536,6.147,P<0.05）．The levels of CRP,IL-6 and TLR-4 in the observation group were（3.64±0.87）mg/L,（54.59±10.65）ng/mL and（7.94±1.57）%,respectively．They were significantly lower than（7.51±1.43）mg/L,（87.66±11.17）ng/mL and（12.11±2.48）% in the control group（t=15.850,14.690,9.740,P<0.05）．The airway pressure and PaCO₂ levels of the observation group were（6.92±3.60）cmH₂O and（43.19±6.29）mmHg,respectively,which were significantly lower than those of the control group[（8.68±2.98）cmH₂O and（55.43±5.95）mmHg]．The levels of PaO₂[（86.06±5.31）mmHg] and SpO₂[（98.03±6.63）%] in the observation group were higher than those in the control group[（68.04±5.19）mmHg and（90.22±5.51）%],and there were statistically significant differences（t=2.582,9.692,16.638,6.221,P<0.05）．The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference（χ²=2.849,P>0.05）. Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients．

目的 探讨依奇珠单抗对中重度斑块型银屑病的治疗效果。方法 选取厦门大学附属第一医院2022年1月—2023年8月收治的75例中重度斑块型银屑病患者,应用抽签法进行分组,分为试验组（n=35）与对照组（n=40）。对照组采取常规外用药物治疗,试验组采取依奇珠单抗治疗。对比两组临床疗效,治疗前后外周血调节性T细胞（Treg）和辅助性T细胞17（Th17/Treg）细胞水平变化,并对所有患者进行6个月门诊复查随访,对比复发率及不良反应。结果 试验组总有效率88.57%,高于对照组的67.50%（χ²=4.730,P=0.028）;治疗后两组患者Treg细胞升高,试验组（5.59±1.24）%高于对照组（4.12±1.13）%,对比差异有统计学意义（t=5.371,P<0.001）,Th17细胞、Th17/Treg细胞降低,试验组[（1.06±0.14）%、0.19±0.05]低于对照组[（1.71±0.28）%、0.42±0.14],对比差异有统计学意义（t=12.434、9.212,P<0.001）;试验组停药后6个月复发率低于对照组（5.71% vs 27.50%,χ²=6.180,P=0.013）;试验组不良反应发生率略高于对照组,组间对比差异无统计学意义（14.29% vs 5.00%,χ²=1.900,P=0.168）。结论 依奇珠单抗治疗中重度斑块型银屑病疗效显著,可调节Th17/Treg平衡,降低停药后复发率,且安全性较高。

Objective To explore the therapeutic effect of Ixekizumab on moderate to severe plaque psoriasis. Methods Seventy-five patients with moderate to severe plaque psoriasis who were admitted to the First Affiliated Hospital of Xiamen University from January 2022 to August 2023 were selected and allocated by lottery into an experimental group（n=35）and a control group（n=40）．The control group received routine external medication while the experimental group received Ixekizumab treatment．The clinical efficacy of two groups,changes in Th17/Treg cell values before and after treatment were compared,and a 6-month outpatient follow-up for all patients was conducted to compare recurrence rates and incidence of adverse reactions. Results The total response rate in the experimental group was 88.57%,which was higher than the 67.50% in the control group（χ²=4.730,P=0.028）．After treatment,the level of Treg cell in the two groups was significantly higher,and the level of Treg cell experimental in the group was higher than that in the control group[（5.59±1.24）% vs （4.12±1.13）%,t=5.371,P<0.001]．After treatment,the level of Th17 and Th17/Treg cell in the two groups were lower,and the level of Th17 cell and Th17/Treg in the experimental group[（1.06±0.14）%,0.19±0.05] were significantly lower than those in the control group[（1.71±0.28）%,0.42±0.14],which was statistically significant（t=12.434、9.212,P<0.001）．The relapse rate at 6 months after drug withdrawal in the experimental group was significantly lower than that in the control group（5.71% vs 27.50,χ²=6.180,P=0.013）．The incidence of adverse reactions in the experimental group was higher than that in the control group,but with no statistical significance（14.29% vs 5.00%,χ²=1.900,P=0.168）. Conclusions Ixekizumab has a significant therapeutic effect on moderate to severe plaque psoriasis．It can regulate the Th17/Treg balance and reduce the recurrence rate after discontinuation,and with high safety．

目的 探讨责任制助产护理模式配合体位管理对高龄产妇分娩方式及产程的影响。方法 选择2023年6月—12月医院接收的高龄产妇68例进行研究，按照护理方式分为两组各34例，对照组为常规助产护理，观察组为责任制助产护理模式配合体位管理，比较两组分娩方式、产程、疼痛程度及护理满意度。结果 观察组阴道分娩率为76.47%（26例），高于对照组52.94%（18例），剖宫产率为8.82%（3例），低于对照组29.41%（10例）（χ2分别为4.121、4.660，均P＜0.05）。观察组第一产程（6.25±0.50）h、第二产程（0.79±0.21）h、总产程（7.15±0.63）h、宫口开大3 cm、10 cm时的疼痛程度（4.12±1.08）分、（6.29±1.25）分明显低于对照组（7.01±0.62）h、（0.96±0.30）h、（8.11±1.07）h、（7.84±1.45）分、（9.09±0.74）分（t分别为5.563、2.706、4.508、11.997、11.239，均P＜0.05）。观察组的护理满意度为97.06%（33例），比对照组的76.47%（26例）高（χ2=4.610，P=0.031）。结论 高龄产妇展开责任制助产护理模式配合体位管理可促进自然分娩，并缩短产程，减轻产时疼痛程度，降低剖宫产率，提高护理满意度。

Objective To explore the effect of responsibility midwifery nursing model combined with position management on delivery mode and labor process of elderly parturient．Methods A total of 68 cases of elderly pregnant women admitted to the hospital from June to December 2023 were selected,and they were divided into two groups according to the nursing mode,34 cases in each group．The control group was given routine midwifery nursing,and the observation group was given responsible midwifery nursing mode combined with position management．The methods of delivery,labor process,pain degree and nursing satisfaction of the two groups were compared．Results The vaginal delivery rate was 76.47%（26 cases）in the observation group,which was higher than 52.94%（18 cases）in the control group,and the cesarean section rate was 8.82%（3 cases）in the observation group,which was lower than 29.41%（10 cases）in the control group（χ²=4.121 and 4.660,P=0.042 and 0.030）．The pain degree of the first stage of labor（6.25±0.50）h,the second stage of labor（0.79±0.21）h,the total stage of labor（7.15±0.63）h,the pain degree of the cervical dilation 3 cm,10 cm in the observation group were significantly lower than those in the control group[（7.01±0.62）h,（4.12±1.08）points,（6.29±1.25）points vs （0.96±0.30）h,（8.11±1.07）h,（7.84±1.45）score,（9.09±0.74）score（t=5.563,2.706,4.508,11.997,11.239,P<0.05）．The nursing satisfaction of the observation group was 97.06%（33 cases）,which was higher than 76.47%（26 cases）of the control group（χ²=4.610,P=0.031）．Conclusion sResponsibility midwifery nursing mode combined with position management can promote natural childbirth,shorten the labor process,reduce the pain during labor,reduce the rate of cesarean section,and improve nursing satisfaction in elderly women,which is worthy of promotion．

目的 探讨风险防范护理干预对颅内动脉瘤介入术后患者血管并发症的应用。方法 选取天津市人民医院2020年6月—2023年10月收治的80例颅内动脉瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。所有患者均采取血管内介入栓塞术治疗,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风险防范护理干预。对比两组患者干预前后负面情绪变化、术后并发症发生率、干预前后生活质量变化以及护理满意度。结果 干预后,两组焦虑、抑郁评分降低,观察组分别为（39.78±1.80）（44.73±3.78）分,低于对照组的（54.63±3.91）（49.23±4.14）分,对比差异有统计学意义（t=21.823、5.078,P<0.05）;观察组术后并发症发生率低于对照组（7.50% vs 27.50%,χ²=5.541,P=0.019）;干预后两组中文版明尼苏达心功能不全生命质量（MLHFQ）相关维度评分均升高,且观察组分别为（30.73±3.82]（21.13±2.70）（27.08±4.28）分,高于对照组的（26.20±3.50）（17.20±2.79）（23.20±2.35）分,对比差异有统计学意义（t=5.530、6.389、5.021,P<0.05）;观察组护理满意度高于对照组（92.50% vs 72.50%,χ²=5.541,P=0.019）。结论 颅内动脉瘤介入术后采取风险防范护理干预可改善患者焦虑、抑郁情绪,降低术后并发症,改善患者术后生活质量,患者护理满意度较高。

Objective To investigate the application effect of risk prevention nursing intervention on vascular complications in patients with intracranial aneurysms after interventional surgery．Methods Eighty patients with intracranial aneurysm admitted in Tianjin People’s Hospital from June 2020 to October 2023 were selected and divided into observation group and control group with 40 cases each．All the patients were treated with endovascular interventional embolization,the control group patients underwent routine care,and the observation group patients added risk prevention nursing intervention on the basis of the control group．The negative mood changes before and after the intervention,the incidence of postoperative complications,the quality of life before and after the intervention,and nursing satisfaction were compared between the two groups．Results After the intervention,the anxiety and depression scores in both groups decreased,and the observation group[（39.78±1.80）and （44.73±3.78）] scores were lower than the control group[（54.63±3.91）and（49.23±4.14）] scores,significantly（t=21.823,5.078,P<0.05）．The postoperative complication rate was significantly lower than the control group（7.50% vs 27.50%,χ²=5.541,P=0.019）．After the intervention,MLHFQ related dimension scores were increased in both groups,and the observation group（30.73±3.82,21.13±2.70 and 27.08±4.28）scores were higher than the control group（26.20±2.50,17.20±2.79 and 23.20±2.35）scores,statistically significant（t=5.530,6.389,5.021,P<0.05）．The nursing satisfaction was higher than the control group（92.50% vs 72.50%,χ²=5.541,P=0.019）．Conclusion sRisk prevention nursing intervention after intracranial aneurysm intervention can improve patient anxiety and depression,assist in reducing the incidence of postoperative complications,improve patient quality of life,and increase patient satisfaction with nursing．

目的 探讨本体感觉训练联合等速肌力训练对早期膝骨关节炎（KOA）患者的应用效果。方法 选择郑州市骨科医院2022年5月—2023年5月收治的120例早期膝骨关节炎患者为研究对象,将所有对象进行编号,采用简单随机方法分成研究组和对照组,每组各60例,两组均接受常规治疗,对照组在此基础上接受等速肌力训练,研究组在对照组基础上联合应用本体感觉训练,比较两组治疗前和治疗6周后疼痛视觉模拟量表（VAS）评分、膝关节伸屈肌群峰力矩（PT）、关节功能以及本体感觉。结果 治疗后研究组VAS评分为（1.33±0.31）分,对照组为（2.05±0.34）分,研究组低于对照组（t=12.121,P<0.05）;治疗后两组膝关节伸、屈肌群PT均较治疗前明显增加（P<0.05）,研究组大于对照组（t₁=2.696,t₂=3.360,P<0.05）;治疗后研究组WOMAC评分为（24.58±5.14）分,对照组为（26.85±5.11）分,研究组低于对照组（t=2.426,P<0.001）,研究组Lequesne指数为（6.55±1.21）分,对照组为（7.02±1.25）分,研究组低于对照组（t=2.093,P<0.001）;治疗后研究组平均轨迹误差为（21.35±5.96）%,对照组为（24.06±5.88）%,研究组改善程度优于对照组（t=2.507,P<0.001）,研究组平均负重力量差为（0.77±0.22）kg,对照组为（1.01±0.24）kg,研究组改善程度明显优于对照组（t=5.710,P<0.001）。结论 本体感觉训练联合等速肌力训练可以显著提升早期膝骨关节炎患者肌力,改善关节功能和本体感觉作用明显,适合推广。

Objective To explore the application effect of proprioceptive training combined with isokinetic muscle strength training on early knee osteoarthritis（KOA）patients．Methods A total of 120 patients with early knee osteoarthritis admitted to a hospital from May 2022 to May 2023 were selected as the study subjects．All subjects were numbered and randomly divided into an experimental group and a control group,with 60 cases in each group．Both groups received routine treatment,while the control group received isokinetic muscle strength training additionally．The experimental group received proprioceptive training in addition to the control group treatment．After 6 weeks of treatment,compare the pain situation,peak torque（PT）of knee extensor and flexor muscles,joint function,and proprioception before and after treatment between two groups were compared．Results After treatment,the VAS scores of both groups were lower than those before treatment（P<0.05）,and the experimental group was lower than the control group（t=12.121,P<0.05）．After treatment,the PT of the knee joint extensor and flexor muscle groups in both groups significantly increased compared to before treatment（P<0.05）,and the experimental group was significantly larger than the control group（P<0.05）．After treatment,the WOMAC score and Lequesne index of the two groups significantly decreased compared to those before treatment（P<0.05）,and the experimental group was smaller than the control group（P<0.05）．After treatment,the average trajectory error and average weight difference between the two groups were significantly smaller than those before treatment（P<0.05）,while the experimental group was smaller than the control group（P<0.05）．Conclusion sThe combination of proprioceptive training and isokinetic muscle strength training can significantly improve muscle strength,joint function,and proprioceptive sensation in patients with early knee osteoarthritis,making it suitable for promotion．

目的 探究应用高频振荡通气（HFOV）模式下早期肺表面活性物质干预对呼吸窘迫综合征致重度呼吸衰竭患儿转归的影响。方法 选取南阳医学高等专科学校第一附属医院2020年6月—2022年12月收治的120例呼吸窘迫综合征致重度呼吸衰竭患儿作为研究对象,按照随机数字表法将其分为对照组与研究组各60例,对照组行常规通气联合早期肺表面活性物质干预,研究组行HFOV联合早期肺表面活性物质干预,对比两组患儿临床症状、血气指标、肺功能指标、患儿转归分析、并发症以及临床疗效。结果 研究组患儿症状消失时间为（31.28±10.24）h、呼吸机辅助通气时间为（50.13±15.81）h以及住院天数为（12.47±5.48）d,对照组患儿症状消失时间为（59.91±11.56）h,呼吸机辅助通气时间为（91.17±25.47）h及住院天数为（20.11±9.45）d,研究组低于对照组（P<0.05）;治疗后,研究组患儿PaO₂为（77.89±9.10）mmHg,PaCO₂为（41.09±8.25）mmHg,氧合指数为（432.18±37.81）mmHg,对照组患儿PaO₂为（65.28±8.16）mmHg,PaCO₂为（49.71±8.91）mmHg,氧合指数为（258.64±56.74）mmHg,研究组PaO₂、氧合指数高于对照组,且PaCO₂低于对照组（P<0.05）;治疗后,研究组患儿体重潮气量（TV）为（7.68±2.16）mL/kg,达峰容积比（TPEF/TE）为（34.19±4.06）%,达峰时间比（VPEF/VE）为（33.47±3.42）%,对照组患儿TV为（6.64±2.01）mL/kg,TPEF/TE为（28.66±3.81）%,VPEF/VE为（28.95±3.10）%,研究组高于对照组（P<0.05）;研究组患儿支气管肺发育不良（BPD）为11.66%,对照组为13.33%,两组患儿BPD发生率比较差异无统计学意义（P>0.05）;研究组IVH为3.33%、ROP为5.00,对照组脑室内出血（IVH）为8.33%,早产儿视网膜病（ROP）为11.66%,研究组低于对照组（P<0.05）;研究组患儿并发症发生率为6.66%,对照组患儿并发症发生率为20.00%,研究组低于对照组（P<0.05）;研究组患儿总有效率为96.66%,对照组患儿总有效率为83.33%,研究组高于对照组（P<0.05）。结论 HFOV模式下早期肺表面活性物质干预呼吸窘迫综合征致重度呼吸衰竭患儿效果显著,改善患儿呼吸功能与血气指标,并发症较少。

Objective To investigate the effect of early intervention with pulmonary surfactant under HFOV mode on the outcome of severe respiratory failure in children with respiratory distress syndrome．Methods A total of 120 children with severe respiratory failure caused by respiratory distress syndrome admitted to our hospital from June 2020 to December 2022 were selected as the study subjects．They were randomly divided into a control group and a study group of 60 cases each using a random number table method．The control group received routine ventilation combined with early pulmonary surfactant intervention,while the study group received HFOV combined with early pulmonary surfactant intervention．Symptom disappearance,ventilator-assisted ventilation,hospital stay,blood gas indicators,lung function indicators,analysis of pediatric outcomes,complications,and clinical efficacy were compared between the two groups．Results The time of symptom disappearance was（31.28±10.24）h,the duration of ventilator assisted ventilation was（50.13±15.81）h and the number of days in hospital was（12.47±5.48）d in the study group,while the time of symptom disappearance was（59.91±11.56）h,the duration of ventilator assisted ventilation was（91.17±25.47）h and the number of days in hospital was（20.11±9.45）d in the control group,which were higher than those in the study group（P<0.05）．After treatment,PaO₂ was （77.89±9.10）mmHg,PaCO₂ was （41.09±8.25）mmHg and oxygenation index was （432.18±37.81）mmHg in the study group,while PaO₂ was （65.28±8.16）mmHg,PaCO₂ was （49.71±8.91）mmHg and oxygenation index was （258.64±56.74）mmHg in the control group．The PaO₂ and oxygenation index of the study group were higher than those of the control group,and the PaCO₂ was lower than that of the control group（P<0.05）．After treatment,TV in the study group was （7.68±2.16）mL/kg,TPEF/TE was （34.19±4.06）%,VPEF/VE was （33.47±3.42）%,and TV in the control group was （6.64±2.01）mL/kg,TPEF/TE was （28.66±3.81）%,VPEF/VE was （28.95±3.10）%．The study group was higher than the control group（P<0.05）．BPD was 11.66% in the study group and 13.33% in the control group．There was no significant difference in the incidence of BPD between the two groups（P>0.05）．The IVH and ROP of the study group were 3.33% and 5.00 respectively,while those of the control group were 8.33% and 11.66% respectively,which were lower in the study group（P<0.05）．The incidence of complications was 6.66% in the study group and 20.00% in the control group,which was lower in the control group（P<0.05）．The total effective rate was 96.66% in the study group and 83.33% in the control group,which was higher in the control group（P<0.05）．Conclusion sEarly intervention of pulmonary surfactant in children with severe respiratory failure caused by respiratory distress syndrome under HFOV mode has a significant effect,improving respiratory function and blood gas indicators,and reducing complications．

目的 探讨无痛消化内镜下高频电刀治疗对胃癌前病变的应用效果及复发率的影响。方法 选取甘肃医学院附属医院2017年1月—2020年1月收治的120例胃癌前病变患者进行回顾性分析,依照其手术治疗方案将其分为两组,各60例。对照组采取常规内镜黏膜下剥离术,观察组患者采取无痛消化内镜下高频电刀剥离治疗。对比两组的切除速度、切除面积、治愈性切除率、完全及整块切除率,对患者进行3年随访,记录其复发情况,并对比两组患者并发症情况。结果 两组的切除面积、治愈性切除率、完全切除率及整块切除率对比差异无统计学意义（P>0.05）,观察组切除速度为（27.34±8.58）mm²/min,高于对照组的（15.54±4.52）mm²/min,差异有统计学意义（P<0.05）。两组患者术后3年的总复发率（28.33% vs 30.00%）对比差异无统计学意义（P>0.05）。观察组感染、穿孔等相关并发症发生率为3.33%,低于对照组的15.00%（P<0.05）。结论 无痛消化内镜下高频电刀与常规内镜黏膜下剥离术治疗胃癌前病变相比具有显著疗效。但无痛消化内镜下高频电刀治疗可提升切除速度,降低并发症发生率。

Objective To explore the application effect and recurrence rate of painless endoscopic high-frequency electrocautery on gastric precancerous lesions．Methods A total of 120 patients with precancerous gastric cancer admitted to the Affiliated Hospital of Gansu Medical College from January 2017 to January 2020 were selected for retrospective analysis and divided into two groups according to their surgical treatment plan,with 60 patients in each group．The control group underwent conventional endoscopic submucosal dissection,and the patients in the observation group received painless digestive endoscopic high-frequency electric knife dissection．The resection speed,resection area,curative resection rate,complete and bulk resection rate were compared of the two groups,the patients were followed up for 3 years to record the recurrence rate,and the complications of the two groups of patients were also compared．Results There were no differences in resection area,curative resection rate,complete resection rate and total resection rate between the two groups（P>0.05）．The resection speed in the observation group was（27.34±8.58）mm²/min,which was higher than that in the control group（15.54±4.52）mm²/min（P<0.05）．There was no difference in the total recurrence rate（28.33% vs 30.00%）at 3 years after surgery between the two groups（P>0.05）．The incidence of infection,perforation and other related complications in the observation group was 3.33%,lower than that in the control group（15.00%）（P<0.05）．Conclusion sCompared with conventional endoscopic submucosal dissection,high-frequency electric knife under painless digestive endoscopy has significant efficacy in the treatment of gastric precancerous lesions．However,painless endoscopic high-frequency electrosurgical treatment can improve the resection speed and reduce the incidence of complications such as infection,perforation and bleeding．

目的 探讨手术室环境对人工股骨头置换术患者等待期应激反应的影响。方法 回顾性选取2021年1月1日—2023年7月31日入院的84例患者,患者均需要接受人工股骨头置换术治疗。根据患者接受治疗时手术室的环境将患者分为两组,对照组42例患者,其接受手术治疗时手术室环境未改造升级;观察组42例患者,其接受手术治疗时手术室环境已改造升级。对比两组应激反应（肾上腺素、皮质醇水平）、情绪状态[汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分]、血压（收缩压、舒张压、心率）、生活质量评分、患者对手术室环境的满意度。结果 T₁时刻,两组肾上腺素、皮质醇水平均升高,但对照组升高幅度[（43.48±4.59）pg/L、（268.48±13.55）ng/L]大于观察组[（38.15±5.28）pg/L、（240.15±12.48）ng/L],对比差异有统计学意义（t=4.937、9.967,P<0.05）。T₁时刻,两组HAMD、HAMA评分均升高,对照组水平[（22.84±3.26）（24.03±3.47）分]大于观察组[（19.75±3.73）（20.76±3.36）分],对比差异有统计学意义（t=4.042、4.387,P<0.05）。T₁时刻,两组收缩压、舒张压、心率水平均显著升高,但对照组升高幅度[（129.34±7.25）mmHg、（94.25±6.62）mmHg、（88.58±3.27）次/分]大于观察组[（117.62±8.13）mmHg、（85.63±5.38）mmHg、（82.16±3.66）次/分],对比有统计学意义（t=6.973、6.549,8.477,P<0.05）。术后5 d,两组各维度评分均显著升高,观察组各维度评分高于对照组（P<0.05）。观察组患者对手术室环境的满意率高于对照组（97.62% vs 85.71%,χ²=3.896,P=0.048）。结论 手术室环境改造升级对人工股骨头置换术患者具有积极作用,可有效降低患者等待期应激反应,减轻患者等待期焦虑、抑郁情绪,降低患者等待期血压、心率上升幅度,有利于提升患者术后生活质量,提高患者对手术室环境的满意度。

Objective To investigate the effect of operating room environment on stress response during the waiting period in patients with artificial femoral head replacement．Methods Eighty-four patients admitted between January 1,2021 to July 31,2023 required artificial femoral head replacement．According to the operating room environment during treatment,the patients were divided into two groups．Forty-two patients in the control group received the surgical treatment in the original operating room environment and 42 patients received surgical treatment in upgraded environment．Comparing two groups of stress response（adrenaline,cortisol）,emotional status[HAMD score,HAMA score],blood pressure（systolic blood pressure,diastolic blood pressure,heart rate）,quality of life,patient satisfaction with the operating room environment of two groups were compared．Results At time T₁,epinephrine and cortisol levels were significantly increased in the two groups,but the control group increased[（43.48±4.59）pg/L,（268.48±13.55）ng/L] greater than the observation group[（38.15±5.28）pg/L,（240.15±12.48）ng/L],which were statistically significant（t=4.937,9.967,P<0.05）．At time T₁,the HAMD and HAMA scores were significantly higher in both groups,but the increase[（22.84±3.26）and（24.03±3.47）] was greater than the observation group[（19.75±3.73）and（20.76±3.36）],which showed statistical significance（t=4.042,4.387,P<0.05）． At time T₁,SBP,DBP and heart rate increased significantly in both groups,but the control group increased[（129.34±7.25）mmHg,（94.25±6.62）mmHg,（88.58±3.27）][（117.62±8.13）mmHg,（85.63±5.38）mmHg,（82.16±3.66）/min] grater than the observation group（t=6.973,6.549,8.477,P<0.05）．Five days after surgery,the scores of each dimension increased significantly in both groups,but the observation group increased more than the control group（P<0.05）．The observation group patients showed a higher satisfaction rate of the operating room environment than the control group（97.62% vs 85.71%,χ²=3.896,P=0.048）．Conclusion sThe transformation and upgrading of the operating room environment has a positive effect on the patients with artificial femoral head replacement,which can effectively reduce the stress response of patients during the waiting period,reduce the anxiety and depression of patients during the waiting period,and reduce the rise in blood pressure and heart rate of patients during the waiting period,which is conducive to improving the quality of life of patients after surgery and improving the satisfaction of patients with the operating room environment．

目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病（冠心病）患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效（P=0.023）和中医证候积分（P<0.001）均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量（Peak VO₂,P=0.005）、最大摄氧量（VO₂max,P=0.001）、氧脉搏（VO₂/HR,P=0.002）和无氧阈值时最大代谢当量（MET,P=0.001）,以及降低无氧阈值（AT,P<0.001）和二氧化碳通气当量（VE/VCO₂,P=0.020）方面比对照组更明显。两组患者在36项简明健康状态调查表（SF-36）评分的8个维度中评分均有所升高,其中在生理机能（P=0.001）、生理职能（P<0.001）、一般健康状况（P=0.018）、精力（P=0.007）、社会职能（P=0.010）、精神健康（P=0.004）方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义（P>0.05）。两组患者的匹兹堡睡眠质量指数（PSQI）均有所改善,且干预组效果优于对照组（P<0.001）。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO₂、VO₂max、VO₂/HR、MET、AT、VE/VCO₂等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。

Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease（CHD）．Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group．Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment．Results After treatment,both groups showed improvement in the traditional Chinese medicine（TCM）clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index（PSQI）scores;increase in Peak VO₂,VO₂max,VO₂/HR,and metabolic equivalent（MET）;and decrease in AT and VE/VCO₂．However,the treatment group had a more pronounced improvement in the TCM clinical efficacy（P=0.023）,TCM syndrome（P<0.001）,PSQI scores（P<0.001）,and cardiopulmonary exercise testing（CPET）indicators including Peak VO₂（P=0.005）,VO₂max（P=0.001）,VO₂/HR（P=0.002）,MET（P=0.001）,AT（P<0.001）and VE/VCO₂（P=0.020）,compared to their control counterparts． For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning（P=0.001）,role limitations due to physical health（P<0.001）,general health（P=0.018）,vitality（P=0.007）,social functioning（P=0.010）and mental health（P=0.004）,but not in pain or role limitations due to emotional problems．Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO₂、VO₂max、VO₂/HR、MET、AT and VE/VCO₂,and elevate both quality of life and sleep quality among older adults with CHD．