目的 探讨延续性护理干预对癌痛患者服药依从性及疼痛治疗效果的影响。方法 选取105例住院治疗的中度至重度癌痛患者,均需服用阿片类药物止痛治疗,单日出院的患者(48例)设为对照组,双日出院的患者(57例)设为干预组。对照组在出院前由责任护士给予常规的用药指导;实验组则在此基础上,于出院后提供延续性护理干预,对患者每周进行电话回访1次,每个出院患者至少回访4次,比较两组患者出院4周后服药依从性及疼痛治疗效果的差异。结果 实验组服药依从性、疼痛治疗效果高于对照组(P＜0.05)。结论 延续性护理干预能提高出院癌痛患者服药依从性及疼痛治疗效果,改善患者的生存质量。

Objective To investigate the impact of continuing nursing on the medication compliance and effect of pain treatment in patients with cancer pain. Methods 105 cases of hospitalized patients with medium to severe cancer pain were selected,need to take opioid analgesic therapy,they were divided into the control group who were single-day discharged(n=48)and intervention group who were double-day discharged(n=57),when discharged,the control group was received conventional health education of medication by the specialized nurses;on this basis,the experimental group was received continuing nursing after discharge,the patients had a return visit by telephone once a week,each patient were visited 4 times at least. After 4 weeks,the medication compliance and effect of pain treatment in the two groups were compared. Results In the experimental group,the medication compliance of patients and effect of pain treatment were significantly higher than those of the control group(P＜0.05). Conclusion The continuing nursing intervention can significantly improve the medication compliance and effect of pain treatment for discharged patients with cancer pain,and improve the quality of life.

目的 通过建立急性心力衰竭（AHF）患者服药依从性预测模型,提高AHF患者的服药依从性和临床管理效果。方法 纳入2021年1月—2023年12月在广州市番禺区何贤纪念医院住院治疗的580例AHF患者,通过收集患者的一般人口学资料、疾病相关资料及出院后6个月的服药依从性数据,应用Logistic回归模型分析患者服药依从性的影响因素,并基于影响因素建立预测模型。结果 患者服药依从性总体良好（75%）。依从性良好组与依从性差组的年龄、独居情况、合并基础病、服药种类、疾病了解评分、治疗信心评分和自我控制信心评分比较差异有统计学意义（P<0.05）。Logistic 回归分析显示危险因素包括年龄≥60岁（OR=1.774）、独居（OR=1.871）、合并基础病≥2种（OR=1.719）和服药种类≥7种（OR=1.456）。而疾病了解评分（OR=0.923）、治疗信心评分（OR=0.946）和自我控制信心评分（OR=0.901）是保护因素（P<0.05）。基于上述因素建立的预测模型,通过ROC曲线验证,曲线下面积为0.815（95%CI：0.780~0.850）,提示所构建的模型具有良好的区分度。对该模型的校准度进行评价,P=0.528,提示该预测模型拟合度良好。此外,该预测模型的一致性指数为0.738,说明模型的预测性能良好。绘制的决策曲线中,曲线位于极端线之上,当阈概率取值在9%~59%时,对应的净获益率为0~27%,提示建立的模型具有优秀的临床有效性。结论 AHF患者的服药依从性受到多种因素的影响,包括年龄、居住状态、合并基础病种类及服药种类等。

Objective To establish a predictive model for medication compliance among acute heart failure（AHF）patients in order to enhance their therapeutic compliance and optimize clinical outcomes. Methods A total of 580 AHF inpatients at He Xian Memorial Hospital in Panyu District, Guangzhou between January 2021 and December 2023 were enrolled. Demographic information, disease-specific data,as well as post-discharge medication compliance records within six-month were collected by investigators. Utilizing logistic regression analysis revealed several influential determinants affecting medication compliance which formed the basis for constructing our predictive model. Results Generally,patient compliance was good（75%）. The comparison between the good compliance group and the poor compliance group showed that there were significant differences in age, living alone,combined with underlying diseases, types of medication, disease understanding score, treatment confidence score and self-control confidence score（P<0. 05）. Logistic regression analysis showed that independent risk indicators including individuals aged ≥60 years（odds ratio[OR]=1. 774）, those living alone（OR=1. 871）, presence of two or more underlying diseases（OR=1. 719）, along with consumption of seven or more medications daily（OR=1. 456）. Conversely,disease awareness score（OR=0. 923）, treatment confidence score（OR=0. 946）, and self-control confidence score（OR=0. 901）were identified as independent protective factors. Validation using receiver operating characteristic curves demonstrated robust predictive performance with an area under curve value of 0. 815（95%CI：0. 780-0. 850）, affirming its efficacy. The calibration of the model was evaluated, with a P-value of 0. 528, indicating good fit of the predictive model. Additionally, the concordance index（C-index）of the model was 0. 738, suggesting its excellent predictive performance. The decision curve analysis revealed that the curve was above the extreme lines, with a net benefit rate ranging from 0 to 27% when the threshold probability falls between. Conclusions The medication compliance of AHF patients is influenced by various factors, including age, living arrangement, the number of underlying diseases, and the number of medications taken. Targeted interventions such as enhancing patient education, simplifying treatment regimens, and improving social support can effectively improve the medication compliance of AHF patients. The predictive model established in this study provides a scientific basis for clinicians to develop more precise and effective individualized intervention measures,thereby improving the prognosis and quality of life.

        目的   探究支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况。方法   选取94例肺炎支原体肺炎患儿为研究对象，以随机数字表法分为A组、B组，各47例，分别实施布地奈德雾化吸入治疗、支气管镜肺泡灌洗联合布地奈德雾化吸入治疗，比较两组症状持续时间、治疗后肺部影像改善情况、炎症指标水平及不良反应发生率。结果  B组体温恢复时间（2.73±0.51）d、咳嗽消失时间（5.98±1.24）d、住院时间（10.96±3.36）d，A组分别为（3.14±0.83）（7.06±2.33）（13.27±3.18）d，B组较A组短（t=2.885、2.809、3.423，均P＜0.05）；治疗后B组40.43%阴影完全消失、34.04%阴影显著缩小、23.40%阴影有所缩小、2.13%阴影改善不明显，A组分别为21.28%、36.17%、25.53%、17.02%，B组肺部阴影改善情况优于A组（Z=8.311，P＜0.05）；治疗前B组白细胞计数（WBC）、超敏C-反应蛋白（hs-CRP）、降钙素原（PCT）水平与A组相近（P＞0.05）；治疗后B组WBC（7.71±1.94）×109 /L、hs-CRP（4.96±1.44）mg/L、PCT（84.32±21.40）pg/mL，A组分别为（9.05±2.48）×109 /L、（6.17±1.85）mg/L、（105.46±34.02）pg/mL，B组水平较A组低（t=2.918、3.538、3.606，均P＜0.05）；B组不良反应发生率为8.52%，A组为4.26%，B与A组相近（χ ² =0.178，P＞0.05）。结论   对肺炎支原体肺炎患儿实施支气管镜联合雾化吸入药物治疗，可缩短康复时间，促进肺部阴影消退，降低其炎症指标水平，且未增加不良反应发生率。

     Objective  To investigate the effect of bronchoscopy combined with nebulized inhalation of medication on the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia（MPP）．Methods  A total of 94 children with MPP were selected as the research subjects and randomly divided into Group A and Group B using a random number table，with 47 cases in each group．They were treated with budesonide nebulization inhalation therapy and bronchoalveolar lavage combined with budesonide nebulization inhalation therapy，respectively．The duration of symptoms，improvement of lung imaging before and after treatment，levels of inflammatory indicators，and incidence of adverse  reactions were compared between the two groups．The results showed that the temperature recovery time was（2.73±0.51）days，cough disappearance time was（5.98±1.24）days，and hospitalization time was（10.96±3.36）days in Group B，（3.14±0.83）days，（7.06±2.33）days，and（13.27±3.18）days in Group A，respectively．Durpation in Group B was shorter than Group A（t=2.885，2.809，3.423，all P＜0.05）． After treatment，40.43% of the shadows in Group B completely disappeared，34.04% of the shadows significantly reduced，23.40% of the shadows reduced，and 2.13% of the shadows showed no significant improvement，better than 21.28%，36.17%，25.53%，and 17.02% in Group A（Z=8.311，P＜0.05）． Before treatment，the white blood cell count（WBC），high-sensitivity C-reactive protein（hs CRP），and procalcitonin（PCT）levels in group B were similar to those in Group A（P＞0.05）．After treatment，the WBC（7.71±1.94）×109 /L，hs CRP（4.96±1.44）mg/L，and PCT（84.32±21.40）pg/mL in Group B were lower than those in Group A（9.05±2.48）×109 /L，（6.17±1.85）mg/L，and（105.46±34.02）pg/mL，respectively（t=2.918，3.538，3.606，all P＜0.05）．The incidence of adverse reactions in Group B was 8.52%，while in Group A it was 4.26%．The incidence of adverse reactions in group B was similar to that in group A（χ ² =0.178，P＞0.05）．Conclusions  Bronchoscopy combined with nebulized inhalation therapy for children with MPP can shorten the recovery time，promote the disappearance of lung shadows，reduce their inflammatory index levels，and without increasing the incidence of adverse reactions．

      目的   应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析，提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法   运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别，提取方剂组成，统计并分析方剂中中药的规律并将其结果可视化呈现。结果   最终共纳入62首方剂，包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味，频次频率最高的为桂枝；所用中药四气以温性为主，占56.74%；五味以辛、甘、苦为主，共约占90%，归经以肝肾经为主；药物功效以补虚类为主，占27.13%；关联规则分析显示提升度最高的组合为麻黄-独活，置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝，支持度最高的组合为川芎-当归、川芎-杜仲；通过聚类分析得到3个聚类结果。结论   《圣济总录》治疗腰痛病方面善用通法和补法，强调活血通络，补益肝肾，尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。

       Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu，and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain．Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu，extract the composition of the prescription，and analyze the rules of Chinese medicine in the prescription to visually present the results．Results A total of 62 prescriptions were included，including 86 drugs．Among them，with there were 20 kinds of drugs，the frequency of use ≥7 times，the frequency ≥1.6%，and cmnamomi Mmulus highest frequency．Four gas used in traditional Chinese medicine is given priority to with warm，accounted for 56.74%．The five flavors were mainly pungent，sweet and bitter，accounting for about 90%，and the liver and kidney meridians were the main meridians．The drug efficacy was mainly deficiency tonic，accounting for 27.13%．The association  rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix，the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix，Pharbitidis Semen- Achyranthis Bidentatae Radix．and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix，Chuanxiong Rhizoma- Eucommiae Cortex．Three clustering result is obtained by cluster analysis．Conclusions In the treatment of low back pain，Shengji Zonglu is good at using both blocking methods and reinforcing methods，emphasizing circulating blood and unblocking meridians supplementing liver and kidney，especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold．