目的 探讨吲哚布芬联合智能抗阻训练对急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后血小板功能及心功能的影响。方法 选取2024年1月至2025年12月在本院接受PCI支架植入术的60例ACS患者，随机分为观察组和对照组，每组30例。对照组给予常规治疗联合氯吡格雷75 mg/d治疗，观察组给予常规治疗联合吲哚布芬（100mg/次，2次/d）+智能抗阻训练干预，两组均连续干预3个月。比较两组患者干预前、干预1个月、3个月时花生四烯酸（AA）诱导和二磷酸腺苷（ADP）诱导的血小板聚集率，随访3个月不良心血管事件（MACE）发生率，以及干预前后心功能指标[左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）]。结果 干预前两组血小板聚集率、LVEF、LVEDD比较差异无统计学意义（P＞0.05）；干预1个月、3个月时，观察组AA诱导和ADP诱导的血小板聚集率降低幅度均显著大于对照组（P＜0.05）；干预3个月后，观察组LVEF显著高于对照组，LVEDD显著低于对照组（P＜0.05）；随访3个月，两组MACE发生率比较差异无统计学意义（P＞0.05）。结论 吲哚布芬联合智能抗阻训练可更显著地抑制ACS患者PCI术后血小板聚集，更有效地改善心功能指标，且安全性良好。
Objective To explore the effect of indobufen combined with intelligent resistance training on platelet function and cardiac function in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 60 ACS patients who underwent PCI stent implantation in our hospital from January 2024 to December 2025 were selected and randomly divided into an observation group and a control group, with 30 patients in each group. The control group was given conventional treatment combined with clopidogrel 75 mg/d, while the observation group was given conventional treatment combined with indobufen (100 mg/time, twice a day) + intelligent resistance training intervention. Both groups received continuous intervention for 3 months. The arachidonic acid (AA)-induced and adenosine diphosphate (ADP)-induced platelet aggregation rates were compared between the two groups before intervention, 1 month and 3 months after intervention. The incidence of major adverse cardiovascular events (MACE) was followed up for 3 months, and the cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)] were compared before and after intervention. Results Before intervention, there were no significant differences in platelet aggregation rates, LVEF and LVEDD between the two groups (P > 0.05); at 1 month and 3 months after intervention, the reduction amplitudes of AA-induced and ADP-induced platelet aggregation rates in the observation group were significantly greater than those in the control group (P < 0.05); after 3 months of intervention, LVEF in the observation group was significantly higher than that in the control group, and LVEDD was significantly lower than that in the control group (P < 0.05); after 3 months of follow-up, there was no significant difference in the incidence of MACE between the two groups (P > 0.05). Conclusion Indobufen combined with intelligent resistance training can more significantly inhibit platelet aggregation, more effectively improve cardiac function indexes in ACS patients after PCI, and has good safety.
目的 分析改良经脊柱内椎间孔镜系统技术（TESSYS）对腰椎间盘突出症患者疼痛及功能的影响，以期分析该术式优劣，丰富该研究领域。方法 回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象，根据治疗方式的不同划分为观察组（TESSYS技术治疗）和对照组（经皮椎间孔镜髓核摘除术治疗），每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况，比较两组患者术前及术后1个月腰椎功能情况，包括Oswestry功能障碍指数（ODI）、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平。结果 观察组患者疗效优于对照组（Z=-3.737，P＜0.001）。交互效应下，两组疼痛因不同术式而随着时间增加而有所不同（P＜0.05）；时点效应下，观察组、对照组各组均随着时点增加疼痛随之减少（P＜0.05）；组间效应下，干预前、干预后1个月两组差异不明显，但是观察组疼痛干预后6 h（Z=-2.831，P=0.005）、干预后1天（Z=-3.253，P=0.001）低于对照组。术后1个月，观察组患者的ODI（Z=-4.804，P＜0.001）低于对照组，而腰椎曲度（Z=-6.218，P＜0.001）、腰背肌后伸活动度（Z=-7.014，P=0.001）高于对照组。术后24 h后，观察组患者的hs-CRP（Z=-5.671，P＜0.001）、IL-6（Z=-3.262，P＜0.001）低于对照组。结论 TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势，可提高疗效，减少出血量，减轻疼痛，减少炎症反应，加快腰椎功能康复，缩短住院时间。
Objective The effect of modified transforaminal endoscopic spine system（TESSYS） on pain and function in patients with lumbar disc herniation was analyzed，so as to analyze the advantages and disadvantages of this procedure and enrich the research field．Methods Retrospectively，80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects．These patients were divided into two groups based on their treatment methods：the observation group（treated with TESSYS technology）and the control group（treated with percutaneous endoscopic discectomy）．Each group consisted of 40 patients．The study evaluated the treatment efficacy，surgical duration，intraoperative bleeding volume，hospital stay fluoroscopy frequency，and incision length for both groups．Additionally，we compared the VAS scores of both groups before surgery，six hours post-surgery，one day post-surgery，one week post-surgery，and one month post-surgery．We also compared the lumbar function of both groups before surgery and 1 month post-surgery，including the Oswestry Functional Index（ODI），lumbar lordosis，and lumbar back muscle extension activity．Furthermore，we compared the serum levels of high-sensitivity C-reactive protein（hs-CRP）and interleukin-6（IL-6）in both groups before and 24 hours after surgery．Results The therapeutic effect of the observation group was better than that of the control group（Z=-3.737，P＜0.001）．Under the interaction effect，the pain of the two groups varied with time due to different surgical procedures（P＜0.05）．Under the time effect，both the observation group and the control group showed a decrease trend in pain as the time to treatment increased（P＜0.05）．Under the inter group effect，there was no significant difference between the two groups before and 1 month after intervention，but the pain in the observation group was less than that in the control group at 6 hours after intervention（Z=-2.831，P=0.005）and 1 day after intervention（Z=-3.253，P=0.001）．One month after surgery，the ODI（Z=-4.804，P＜0.001）of the observation group patients was lower than that of the control group，while the lumbar curvature（Z=-6.218，P＜0.001）and lumbar back muscle extension activity（Z=-7.014，P=0.001）were higher than those of the control group．Twenty-four hours after surgery，the hs-CRP（Z=-5.671，P＜0.001）and IL-6（Z=-3.262，P＜0.001）levels in the observation group were lower than those in the control group．Conclusions The improved percutaneous transforaminal endoscopic technique has significant advantages over percutaneous transforaminal discectomy in the treatment of lumbar disc herniation．It can improve efficacy，reduce bleeding，alleviate pain，reduce inflammatory reactions，accelerate lumbar functional recovery，and shorten hospitalization time．
目的 探讨多组分运动训练对老年慢性阻塞性肺疾病（COPD）稳定期病人骨骼肌功能的影响。方法 前瞻性选择2022年10月—2024年10月90例COPD稳定期患者，采用抽签法随机分为观察组与对照组，对照组45例采取常规运动干预，观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量，四肢肌群力量，运动耐力与肺功能，生活质量。结果 干预后，两组上肢、下肢骨骼肌含量均略增加，观察组高于对照组（P＜0.05）；干预后，两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加，观察组高于对照组（P＜0.05）；干预后，两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高，观察组高于对照组（P＜0.05）；干预后，两组圣乔治呼吸问卷各维度分数及总分均降低，观察组低于对照组（P＜0.05）。结论 针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量，改善患者运动耐力与肺功能，减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
Objective To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease（COPD）．Methods From October 2022 to October 2024，90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method．The control group consisted of 45 patients who received routine exercise care，while the observation group consisted of 45 patients who received multi-component exercise training in addition to the routine care．Skeletal muscle content，muscle group strength，exercise endurance，lung function，and quality of life between two groups of patients were compared before and three months after intervention．Results After intervention，the skeletal muscle content of both upper and lower extremities slightly increased in both groups，with the observation group being higher than the control group（P＜0.05）．After intervention，the strength of the knee extensor，knee flexor，elbow extensor，and elbow flexor muscle groups increased in both groups，with the observation group had better results than the control group（P＜0.05）．After intervention，both groups showed an increase in six-minute walking test，forced vital capacity，and forced expiratory volume in first second，with the observation group had better results than the control group（P＜0.05）．After intervention，the scores of each dimension and total score of the SGRQ in both groups decreased，and the observation group had lower scores than the control group（P＜0.05）．Conclusions Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities，enhance exercise endurance and lung function，and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life．
目的 本研究旨在探讨不同俯卧位通气（PPV）时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法 选择2020年7月—2023年7月在天津市人民医院重症监护病房（MICU）治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组（≥12 h, n=40）和短时组（<12 h, n=40）。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素（GAS）和血管活性肠肽（VIP）]、肠内营养达标率、胃肠并发症率等。结果 短时组治疗后, 1 d、3 d、5 d氧合指数为（189.93±33.72）、（247.53±63.01）、（325.03±58.11）mmHg,高于长时组的（161.63±36.88）、（191.83±57.65）、（267.95±46.25）mmHg,均P<0.05; 胃残留量为（29.00±7.92）、（19.75±4.45）、（11.00±1.87） mL低于长时组的（75.03±23.29）、（53.13±11.99）、（21.70±5.52） mL, 均P<0.05。短时组治疗后腹内压[（8.53±2.05）mmHg vs （9.75±2.05） mmHg]、VIP水平[（61.14±7.63） vs （67.49±4.43） pg/mL]低于长时组,GAS水平[（65.02±8.84） vs （54.22±9.21）pg/mL]升高（均P<0.05）。短时组总胃肠并发症发生率（7.50%）低于长时组（25.00%）, P=0.034。结论 对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。
Objective To explore the effect of different duration of prone position ventilation（PPV）on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction．Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit（MICU）of a hospital from July 2020 to July 2023, and were selected as the research subjects．They were divided into the long-duration group（≥12 hours, n=40）and the short-duration group（<12 hours, n=40）according to the daily duration of PPV．The general data, oxygenation index, gastrointestinal function indicators（intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]）, enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared．Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment（[189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively）was significantly higher than that of the long-duration group（[161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05）．The gastric residual volume of the short-duration group（[29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively）was significantly lower than that of the long-duration group（[75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05）．The intra-abdominal pressure（[8.53±2.05] vs [9.75±2.05] mmHg）and VIP level（[61.14±7.63] vs [67.49±4.43] pg/mL）of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level（[65.02±8.84] vs [54.22±9.21] pg/mL）was significantly higher（all P<0.05）．The total incidence of gastrointestinal complications in the short-duration group（7.50%）was significantly lower than that in the long-duration group（25.00%, P=0.034）．Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance．
目的 观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法 选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组，益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果 益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降，中医临床症状评分的有效率优于益生菌组。结论 桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。
Objective To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders（FAPDs）．Methods A total of 100 children diagnosed with FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected．These children were randomly divided into two groups：the probiotics group（50 cases）and the probiotics+traditional Chinese medicine individualized intervention group（50 cases）．Both groups received continuous treatment for 1 week．Parameters including supine/upright heart rates，supine/upright blood pressure，Rutter Children’s Behavior Questionnaire，and improvements in traditional Chinese clinical symptom scores were recorded．Results The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group．The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group．Conclusions Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children．
目的 探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV1/FVC）、用力肺活量（FVC）的相关性。方法 纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者，以2%作为外周血EOS比例（EOS%）截断值分为两组，研究组（EOS%≥2%）34例，对照组（EOS%＜2%）39例，收集两组患者的一般临床资料、实验室检查结果、肺功能检查结果（FEV1、FVC、FEV1/FVC），比较组间差异，分析指标间的相关性。结果 对照组与实验组患者EOS%分别为0.5（0.1，0.9）%、5.15（2.60，10.05）%，两组患者EOS%差异有统计学意义（P＜0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56，1.78）ng/L、3.6（1.73，6.77）ng/L，两组IL-5水平差异有统计学意义（P＜0.05）。对照组FEV1（L）、FVC（L）、FEV1/FVC水平分别为1.32（1.18，1.58）、2.07（1.92，2.62）、0.62（0.57，0.67）；实验组分别为1.24（1.00，1.52）、2.22（1.94，2.56）、0.58（0.47，0.67），两组FEV1、FVC、FEV1/FVC水平差异均无统计学意义（P＞0.05）。Spearman等级相关检验结果显示，EOS%与IL-5水平呈正相关（rs=0.870，P＜0.001）；按组别进行分层后结果显示，对照组、试验组EOS%与IL-5水平均呈正相关（rs=0.820，P＜0.001；rs=0.938，P＜0.001）。EOS%、IL-5水平与FEV1、FEV1/FVC呈负相关（P＜0.05），与FVC不相关（rs=0.039，P＞0.05）。对照组EOS%、IL-5水平与FEV1、FEV1/FVC、FVC不相关（P＞0.05）；实验组EOS%、IL-5水平与FEV1、FEV1/FVC呈负相关（P＜0.05），与FVC不相关（P＞0.05）。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关，外周血EOS%≥2%时血EOS%、血清IL-5与FEV1、FEV1/FVC呈负相关，与FVC无关。
Objective To explore the correlation among blood eosinophil levels，serum interleukin-5（IL-5）levels，and forced expiratory volume in one second（FEV1），the ratio of forced expiratory volume in one second to forced vital capacity（FEV1/FVC），and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods From March 2023 to March 2024，73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included，and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil（EOS%）．The experimental group（EOS%≥2%）included 34 patients，while the control group（EOS%＜2%）included 39 patients．General clinical data，laboratory test results，and pulmonary function test results（FEV1，FVC，FEV1/FVC）were collected from both groups．Results The median quartiles of EOS% for the control group and experimental group were 0.5（0.10.9）% and 5.15（2.60，10.05）%，respectively．There was a statistically significant difference between the EOS% of two groups（P＜0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56，1.78）ng/L and 3.6（1.73，6.77）ng/L，respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P＜0.05）．For the control group，the median quartiles of FEV1，FVC，and FEV1/FVC were 1.32（1.18，1.58），2.07（1.92，2.62）and 0.62（0.57，0.67），respectively．For the experimental group，they were 1.24（1.00，1.52），2.22（1.94，2.56）and 0.58（0.47，0.67）respectively．There was no statistically significant difference between the two groups in FEV1，FVC and FEV1/FVC levels（P＜0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （rs=0.870，P＜0.001）．Stratified by group，both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （rs=0.820，P＜0.001；rs=0.938，P＜0.001）．There was a negative correlation between EOS%，IL-5 level，and FEV1，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．In the control group，there was no correlation between EOS%，IL-5 level，and FEV1，FEV1/FVC，or FVC（P＞0.05）．In the experimental group，there was a negative correlation between EOS%，IL-5 level，and FEV1，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．Conclusions During AECOPD，blood EOS% is positivelycorrelated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%，blood EOS%，serum IL-5，and FEV1，FEV1/FVC are negatively correlated，while there is no correlation with FVC．
目的 探讨断指再植患者采用微波理疗联合康复训练的影响。方法 回顾性选取2022年1月—2023年12月于福州市第二总医院进行断指再植的患者，采用康复训练的50例患者纳入对照组，采用微波理疗联合康复训练的51例患者纳入观察组，对比两组干预1个月后的毛细血管反应情况、感知恢复情况、疼痛评分、手指功能及日常生活能力情况。结果 干预1个月后， 观察组患指的温度［（28.43±5.86）℃ vs （26.15±5.39）℃，t=2.025，P＜0.001］、毛细血管反应［（9.76±2.63）cm/s vs（7.36±2.23）cm/s，t=4.922，P=0.046，］高于对照组（P＜0.05）；观察组的英国医学研究委员会感觉评分［（15.79±3.75）分 vs（11.88±3.13）分，t=5.660，P＜0.001］高于对照组；观察组第2周［（3.72±0.88）分 vs（4.39±0.92）分，t=3.721，P＜0.001］、4周后［（2.67±0.32）分 vs（3.03±0.52）分，t=4.169，P=0.001］的视觉模拟量表（VAS）评分低于对照组（P＜0.05）；观察组的密歇根手功能量表（MHQ）评分［（61.05±10.68）分 vs（52.58±10.21）分，t=4.054，P＜0.001］高于对照组（P＜0.05）；观察组的生活质量综合评定表（GQLI-74）评分［（320.16±55.25）分 vs（270.85±50.06）分，t=4.677，P＜0.001］高于对照组（P＜0.05）；观察组的Barthel指数［（75.71±12.84）分 vs（68.58±12.23）分，t=2.843，P=0.005］高于对照组（P＜0.05）。结论 微波理疗联合康复训练能够提高断指再植患者的手指功能，减轻患者疼痛，改善日常生活质量。
Objective To explore the effect of microwave physiotherapy combined with rehabilitation training on finger function and daily living ability of patients with severed finger replantation．Methods Patients who underwent replantation of severed fingers in our hospital from January 2022 to December 2023 were selected retrospectively．Fifty patients who received rehabilitation training were included in the control group，51 patients who were intervened by microwave physiotherapy combined with rehabilitation training were included in the observation group．The blood circulation，sensory recovery，pain score，finger function and daily living ability of the two groups were compared．Results The temperature（［28.43±5.86］℃ vs ［26.15±5.39］℃，t=2.025，P＜0.001） and capillary reaction（［9.76±2.63］cm/s vs ［7.36±2.23］cm/s，t=4.922，P=0.046） of the affected fingers in the observation group were higher（P＜0.05）．The sensory score（［15.79±3.75］ vs ［11.88±3.13］，t=5.660，P＜0.001）of the observation group was higher than that of the control group（P＜0.05）．The visual analogue scale（VAS）scores of the observation group at the second week（［3.72±0.88］ vs ［4.39±0.92］，t=3.721，P＜0.001） and four weeks later（［2.67±0.32］vs ［3.03±0.52］，t=4.169，P=0.001）were lower than those of the control group（P＜0.05）．The score of Michigan Hand Outcome Questionnair（MHQ）（［61.05±10.68］ vs ［52.58±10.21］，t=4.054，P＜0.001） in the observation group was higher（P＜0.05）．The GQLI-74 score（［320.16±55.25］ vs ［270.85±50.06］） and Barthel index（［75.71±12.84］ vs［68.58±12.23］，t=2.843，P=0.005）in the observation group were higher（P＜0.05）．Conclusions Microwave physiotherapy combined with rehabilitation training can improve the finger function，relieve the pain and improve the quality of daily life of patients with severed fingers．
目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。
Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice．Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study．This led to the integration of a preliminary evaluation framework．Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project．Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals．This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023．Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application．Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%．Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process．Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors．This system holds considerable potential for widespread clinical adoption and application．
目的 观察辅助性T17细胞（Th17）与调节性T细胞（Treg）比值与2型糖尿病（T2DM）患者胰岛素抵抗及胰岛β细胞功能的关系。方法 纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例, 分为糖耐量正常组（NGT组, n=100）和T2DM组（n=100）, 分别测定糖化血红蛋白（HbA1c）、空腹血糖（FPG）、甘油三酯（TG）等生化指标, 电化学发光法测定空腹胰岛素（FINS）, 稳态模型计算胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（HOMA-ISI）。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果 与NGT组相比, T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高（P<0.01）, HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低, 且差异有统计学意义（P<0.01）。Th17与BMI（r=0.251, P<0.001）及HOMA-IR（r=0.305, P<0.001）呈正相关; 与HOMA-β（r=-0.204, P<0.001）及HOMA-ISI（r=-0.359, P<0.001）呈负相关。Treg与HOMA-ISI之间呈正相关（r=0.170, P=0.008）, 而与HOMA-IR呈负相关（r=-0.153, P=0.017）; Th17/Treg与BMI（r=0.332, P<0.001）及HOMA-IR（r=0.374, P<0.001）;与HOMA-β（r=-0.249, P<0.001）及HOMA-ISI（r=-0.427, P<0.001）呈负相关。多元线性回归分析显示, Th17/Treg是HOMA-IR（β=5.915）升高及HOMA-ISI（β=-2.557）下降的影响因素（P<0.01）。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。
Objective To explore the relationship among the proportion of helper T17 cells（Th17）to regulatory T cells（Treg）, insulin resistance, and the function of islet beta cells．Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included．Patients were divided into normal glucose tolerance group（NGT group, n=100）and type 2 diabetes mellitus group（T2DM group, n=100）．The biochemical indexes of HbA1c, fasting blood glucose（FPG）, triglyceride（TG）and fasting insulin（FINS）were determined by electrochemiluminescence．Islet beta cell function index（HOMA-β）, insulin resistance index（HOMA-IR）and insulin sensitivity index（HOMA-ISI）were calculated in homeostasis model．The levels of Th17 and Treg were detected by flow cytometry．Spearman was used to analyze the correlation between indicators, and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR, HOMA-β and HOMA-ISI．Results In contrast to the NGT group, the T2DM group exhibited elevated levels of BMI, FPG, HbA1c, LDL-C, TG, TC, FINS, HOMA-IR, Th17 and Th17/Treg, with these variances being signifincantly different（P<0.01）．There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different（P<0.01）．Th17 was positively correlated with BMI（r=0.251, P<0.001）and HOMA-IR（r=0.305, P<0.001）, it was negatively correlated with HOMA-β（r=-0.204, P<0.001）and HOMA-ISI（r=-0.359, P<0.001）．Treg was positively correlated with HOMA-ISI（r=0.170, P=0.008）, while it was negatively correlated with HOMA-IR（r=-0.153, P=0.017）．The ratio of Th17/Treg was positively correlated with BMI（r=0.332, P<0.001）and HOMA-IR（r=0.374, P<0.001）, it was negatively correlated with HOMA-β（r=-0.249, P<0.001）and HOMA-ISI（r=-0.427, P<0.001）．Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR（β=5.915）and the decrease of HOMA-ISI（β=-2.557）（P<0.01）．Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity．
目的 研究基于儿童早期预警评分（PEWS）的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组（n=50）及对照组（n=50）。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程（相关指标涵盖症状持续时长及住院天数）、呼吸功能（涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量）、并发症发生情况（涵盖呼吸机相关性肺炎、肺大疱及胸膜炎）、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组（均P<0.05）。研究组各项呼吸功能指标水平均高于对照组（均P<0.05）。两组各项并发症发生率对比差异无统计学意义（P>0.05）。研究组患儿家属满意度高于对照组（96.00% vs 82.00%,P<0.05）。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。
Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score（PEWS）on the recovery process and respiratory function of children with severe pneumonia．Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed．Those children were divided into study group（n=50）and control group（n=50）according to the difference of intervention methods．Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group．The two groups were compared with each other in terms of recovery process（including duration of symptoms and length of stay）,respiratory function（including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity）,complications（including ventilators associated pneumonia,bullosa and pleurisy）,and family member satisfaction．Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group（all P<0.05）．The levels of respiratory function indexes in study group were higher than those in control group（all P<0.05）．There was no significant difference in the incidence of complications between the two groups（P>0.05）．The satisfaction of family member in the study group was higher than that in the control group（96.00% vs 82.00%）（P<0.05）．Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia．
