目的 调查南宁市2022—2024年食源性疾病的发生情况,并分析该地食源性疾病的流行病学特征,为防控食源性疾病提供依据。方法 在2022年1月—2024年12月统计南宁市多中心上报的食源性疾病发生情况,并分析食源性疾病的分布特征。结果 2022年1月—2024年12月在南宁市共计调查21 712例食源性疾病患者,其中男性占49.25%,女性占50.75%;食源性疾病以18~59岁、4~17岁年龄段占比相对较高,在季节方面2022年以秋季占比较高,2023—2024年以夏季占比较高;散居儿童、学生和农民是食源性疾病的主要人群,混合食品、水果及其制品、粮食类及其制品、肉类及其制品为前四位暴露食品;包装方面以散装占比最高、进食场所则以家庭占比最高;食源性疾病患者3年间不同性别、年龄段、发病季节、人群类型、暴露食品、包装形式及进食场所比较差异均有统计学意义（P<0.05）。症状主要以消化道症状、其他/全身症状为主。结论 南宁市2022—2024年食源性疾病发生例数有所增长,多发于夏秋季节,散居儿童、学生、农民是食源性疾病的高风险群体,同时针对散装食品,尤其混合食品、水果及其制品、粮食类及其制品、肉类及其制品等主要暴露食品应做好重点防控监测,可根据本地食源性疾病发生的流行病学特征进行对应的宣传教育,以确保食品安全。

Objective To explore the occurrence of foodborne diseases in Nanning City from 2022 to 2024,and analyze the epidemiological characteristics of foodborne diseases in the area,providing a basis for the prevention and control of foodborne diseases．Methods From January 2022 to December 2024,the incidence of foodborne diseases reported by multiple centers in Nanning City was statistically analyzed,and the distribution characteristics of foodborne diseases were analyzed．Results From January 2022 to December 2024,a total of 21 712 foodborne disease patients were analyzed in Nanning City,among them,males account for 49.25% and females account for 50.75%．Foodborne diseases had a relatively high proportion in the age groups of 18-59 and 4-17 years old．In terms of seasons,the proportion was higher in autumn 2022 and in summer 2023-2024．Scattered children,students,and farmers were the main populations of foodborne diseases,with mixed foods,fruits and their products,grains and their products,and meat and its products being the top four exposed foods．In terms of packaging,bulk packaging had the highest proportion,while in terms of eating places,household packaging has the highest proportion．There were statistically significant differences in the gender,age group,onset season,population type,exposed food,packaging form,and eating location of foodborne disease patients over a three-year period．Conclusions The number of foodborne diseases in Nanning City has increased from 2022 to 2024,mostly occurring in summer and autumn seasons．Scattered children,students,and farmers are high-risk groups for foodborne diseases．At the same time,key prevention and control monitoring should be carried out for bulk foods,especially mixed foods,fruits and their products,grains and their products,meat and their products,and corresponding publicity and education can be carried out according to the epidemiological characteristics of local foodborne diseases to ensure food safety．

目的 探讨单次根管疏通填充对牙体牙髓病患者的填充效果及龈沟液炎症指标的影响。方法 选择2023年8月—2024年2月天津市人民医院接收的牙体牙髓病患者84例进行研究,采用随机数字表法分为两组,各42例。对照组采取多次根管疏通填充,观察组采取单次根管疏通填充,比较2组填充效果、治疗效果、龈沟液炎症指标、口腔健康和功能指标、并发症情况。结果 观察组欠填、恰填、超填比例与对照组比较无统计学意义（χ²分别为0.262、1.615、0.512,P分别为0.608、0.203、0.474）。观察组的总有效率为97.62%,高于对照组80.95%（χ²=6.098,P=0.014）。治疗后,观察组龈沟液白细胞介素IL-1β、IL-17A、IL-35、肿瘤坏死因子-α水平低于对照组（t分别为3.271、3.028、2.699、2.968,P分别为0.002、0.003、0.008、0.004）。治疗后,观察组龈沟出血指数、牙龈指数低于对照组,咬合力、咀嚼效率高于对照组（t分别为2.311、2.686、2.262、2.776,P分别为0.023、0.009、0.026、0.007）。观察组并发症发生率4.76%低于对照组21.43%（χ²=5.126,P=0.024）。结论 牙体牙髓病采取单次根管疏通填充治疗可保证恰当的填充效果,取得良好的治疗效果,而且减轻龈沟液炎症反应,促进口腔健康和功能改善,并发症较少,安全性高,值得推广。

Objective To explore the effects of one-time root canal dredging and filling on the filling effect and gingival crevicular fluid inflammation indexes in patients with endodontic disease．Methods A total of 84 cases of endodontic patients admitted to the Tianjin People's Hospital from August 2023 to February 2024 were chosen and separated into the control group（n=42,multiple-time root canal dredging and filling）and the observation group（n=42,one-time root canal dredging and filling）by random number table method．The filling effect,therapeutic effect,gingival creval fluid inflammation indicators,oral health and function indicators,and complications were compared．Results The underfilling,accurate filling and overfilling showed no significant difference between the two groups（χ²=0.262,1.615,0.512,P=0.608,0.203,0.474）．The total effective rate of observation group was 97.62%,higher than that of control group 80.95%（χ²=6.098,P=0.014）．After treatment,levels of interleukin（IL）-1β,IL-17A,IL-35 and tumor necrosis factor-α in gingival crevicular fluid of observation group were lower（t=3.271、3.028、2.699、2.968,P=0.002、0.003、0.008、0.004）．After treatment,the sulcus bleeding index and gingival index of the observation group were lower,and the biting force and mastication efficiency were higher（t=2.311、2.686、2.262、2.776,P=0.023、0.009、0.026、0.007）．The complication rate in the observation group was 4.76%,lower than that in the control group 21.43%（χ²=5.126,P=0.024）．Conclusions A one-time root canal dredging and filling treatment for endodontic diseases can ensure proper filling effect,achieve good therapeutic effect,reduce gingival crevicular fluid inflammation,promote oral health and function improvement,with fewer complications,high safety,which is worthy of promotion．

随着中西医结合的不断深入,医学工作者在临床工作中发现,西药因囿于西医体系,很难在中医药理论体系指导下的临床诊疗上发挥作用,极有必要走西药中药化之路,以弥补这一方面的不足。本文以阿司匹林为主要范例,从推测西药的中药性质入手,总结归纳几种研究方法及注意事项,并大致总结目前研究西药中药化上的诸多不足,同时收集汇总目前相关文献中提到的西药的中药性质,以抛砖引玉,供后续研究者参考。

With the continuous deepening of Chinese medicalization of western medicine,it is not difficult to find that western medicine is limited to the western medicine system,which is hard to play a role in clinical diagnosis and treatment under the guidance of traditional Chinese medicine（TCM）system．It is extremely necessary to take the road of TCM of western medicines to make up for the deficiencies．In this paper,we take aspirin as the main example,start from the speculation of the nature of western medicines,summarize several research methods and notes,and generally summarize the many shortcomings of the current research on the Chinese medicalization of western medicines,and at the same time,collect and summarize the TLM nature of western medicines mentioned in the relevant literature,to provide a reference for the subsequent researchers．

Wnt/β-catenin信号通路是一种在胚胎发育,细胞增殖分化、迁移,干细胞更新等中起关键作用的蛋白质家族。Wnt/β-catenin信号通路的失调常常会导致各种严重的疾病,例如肿瘤、心脏疾病、肺部疾病、肝脏疾病、骨骼疾病、神经疾病等。大量研究表明,Wnt/β-catenin信号通路在心肌纤维化发病机制中起重要作用,本文结合最新研究成果,从心肌纤维化相关疾病的角度对Wnt/β-catenin通路进行综述,为预防心肌纤维化提供新的思路,进一步达到防治心血管疾病的目的。

The Wnt/β-catenin signaling pathway is a family of proteins that play a key role in embryonic development,cell proliferation and differentiation,migration,stem cell renewal,etc．Dysfunctions of Wnt/β-catenin signaling pathway often lead to various serious diseases,such as tumor,heart,lung,liver,bone and neurological diseases,etc．Numerous studies have shown that the Wnt/β-catenin signaling pathway plays an important role in the pathogenesis of cardiac fibrosis．This article,in combination with the latest research findings,presents a review of the Wnt/β-catenin pathway from the perspective of myocardial fibrosis-related diseases,in order to provide new ideas for preventing myocardial fibrosis and achieving the goal of combating cardiovascular disease．

目的 探讨慢性阻塞性肺疾病（COPD）住院患者口腔功能状态现状及影响因素。方法 采用便利抽样法,选择2022年9月—2023年7月在深圳市龙岗区某三甲医院呼吸内科、胸外科的老年COPD住院患者191例作为研究对象。使用一般资料调查表、日常生活自理能力评估量表（BADL）、反复唾液吞咽试验（RSST）、改良版呼吸困难量表（mMRC）、改良版Beck口腔评分量表进行调查及评估。采用单因素分析老年COPD住院患者口腔功能状态的影响因素,采用Logistic回归分析老年COPD住院患者口腔功能状态的影响因素。结果 191例老年COPD患者中,入院时、住院第3天（D3）、住院第5天（D5）、出院的Beck口腔评分分别为（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）分,比较差异无统计学意义（P>0.05）。单因素分析结果显示,COPD患者在D3、D5、出院时,Beck口腔功能状态的影响因素有：年龄、性别、婚姻状况、牙齿缺失情况、抽烟史以及生活自理能力影响,差异具有统计学意义（P<0.05）。二元Logistic回归分析结果显示,年龄、吸烟状况、牙齿缺失数量、生活自理能力是COPD住院患者口腔功能状态的影响因素（P<0.05）。结论 老年COPD患者口腔卫生状况较差,且受到年龄、吸烟情况、牙齿缺失、生活自理能力的影响,应采取针对性预防和干预策略,改善老年COPD住院患者的口腔卫生状况,以降低COPD患者发生并发症的风险。

Objective To investigate the status quo and influencing factors of oral function in hospitalized patients of chronic obstructive pulmonary disease（COPD）．Methods A total of 191 patients with COPD who were hospitalized in the Respiratory Department and Thoracic Surgery Department of a hospital in Longgang,Shenzhen from September 2022 to July 2023 were selected by convenience sampling．The general data questionnaire,the Barthel index of activity of daily living（BADL） the repetitive saliva swallowing test（RSST）,modified Medical Research Council Dyspnea Scale（mMRC）,the Modified Beck Oral Assessment Scale（BOAS）were used for investigation and evaluation．Single factor analysis was used to analyze the influencing factors of oral function status in elderly COPD patients,and logistic regression was used to analyze the independent risk factors affecting oral function status in elderly COPD patients．Results Among 191 elderly patients with COPD,the BOAS scores were（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）at admission,the 3rd day,the 5th day and discharged day,respectively,with no statistical significance．The results of univariate analysis indicated that the independent risk factors of Beck oral function status in COPD patients at D3,D5 and discharge were gender,age,marital status,tooth loss,smoking history and Barthel index score,and the differences were statistically significant（P <0.05）．Binary logistic regression analysis indicated that age,smoking status,tooth loss and Barthel index score were independent risk factors for oral function status in hospitalized patients with COPD（P<0.05）．Conclusions Elderly patients with COPD have poor oral health status,which is affected by patient's age,smoking history,tooth loss and self-care ability．Targeted prevention and intervention strategies should be adopted to improve the oral health status of hospitalized patients with COPD,so as to reduce the COPD patient's risk of complications．

目的 探讨痰涂片找抗酸杆菌、痰利福平耐药实时荧光定量核酸扩增检测技术（Xpert MTB/RIF）、分枝杆菌菌种鉴定、痰抗酸杆菌培养和血γ-干扰素释放检测技术（TB-IGRA）5种检测技术在尘肺合并肺结核临床诊断中的应用价值。方法 纳入2016年7月—2021年5月在厦门大学附属第一医院住院治疗的尘肺合并肺结核患者,按照尘肺患者是否合并肺结核,将患者分为尘肺组（156例）和尘肺合并肺结核组（111例）;比较两组患者的性别、年龄、接尘时间等一般资料,以及患者痰涂片、Xpert MTB/RIF、分枝杆菌菌种鉴定、痰培养和TB-IGRA的检测结果,分析尘肺合并肺结核患者5种检测技术阳性检出率的差异及其诊断价值。结果 在尘肺合并肺结核组中,TB-IGRA检测方法的阳性检出率最高（81.1%）,高于其他4种检测方法（P<0.01）;两两联合检测,以Xpert MTB/RIF+TB-IGRA组合的检测方式检出率最高（96.4%）,高于其他9种组合（P<0.01）。结论 TB-IGRA检测方法对尘肺合并肺结核患者的阳性检出率较高,联合Xpert MTB/RIF检测后可进一步提高诊断效率,对早期诊断尘肺是否合并结核具有重要的临床诊断价值。

Objective To investigate the value of five testing techniques in the clinical diagnosis of pneumoconiosis combined pulmonary tuberculosis,including sputum smear,Xpert Mycobacterium tuberculosis/rifampicin（Xpert MTB/RIF）,identification of Mycobacterium species,sputum acid-fast bacilli culture and tuberculosis-interferon-gamma release assays（TB-IGRA）．Methods Patients with pneumoconiosis combined with tuberculosis who were hospitalized in the First Hospital of Xiamen University from July 2016 to May 2021 were included in the study．The patients were divided into the pneumoconiosis group（156 cases）and pneumoconiosis combined with tuberculosis group（111 cases）according to whether the pneumoconiosis patients were combined with tuberculosis or not．The general data of the patients in the two groups were compared with respect to gender,age,and dust exposure time,and the results of sputum smears,Xpert MTB/RIF,identification of Mycobacterium species,sputum acid-fast bacilli culture and TB-IGRA were collected to analyze the differences and the diagnostic value in the five testing techniques of the positivity rates for patients who have pneumoconiosis combined with pulmonary tuberculosis．Results In the group with pneumoconiosis combined with tuberculosis,the positive detection rate of TB-IGRA was the highest（81.1%）,which was higher than other 4 testing methods（P<0.01）．Combined testing in pairs suggested that the testing method of Xpert MTB/RIF and TB-IGRA combination was the highest（96.4%）,significantly higher than the other 9 combinations（P<0.01）．Conclusions TB-IGRA has higher positive detection rate for patients with pneumoconiosis combined with tuberculosis,and diagnostic efficiency can be further improved by combining Xpert MTB/RIF assay testing,which is of great clinical diagnostic value for the early diagnosis of pneumoconiosis combined with tuberculosis．

目的 探讨宣清导浊汤加减方联合血液透析治疗对老年慢性肾衰竭（CRF）患者肾功能、微炎症状态和毒素清除率的影响。方法 回顾性选取2019年10月—2022年10月我院收治的82例老年CRF患者,将其根据治疗方法分为联合组与单一组,每组41例。单一组仅采取血液透析治疗,联合组联合宣清导浊汤加减方治疗,对比两组患者治疗前后中医证候积分、毒素清除率、炎症因子变化。结果 治疗后,两组患者口淡不渴、肢体麻木、腰膝酸软、倦怠乏力、食少纳呆以及面色晦暗相关中医证候积分均降低,且联合组低于单一组（P<0.05）;治疗后两组患者血肌酐、尿素氮、血β₂-微球蛋白均降低,联合组低于单一组（P<0.05）;治疗后两组患者白细胞介素-6、C-反应蛋白、肿瘤坏死因子-α炎性因子水平明显降低,且联合组更低（P<0.05）。两组在治疗期间均无不良反应。结论 宣清导浊汤加减方联合血液透析治疗老年CRF患者效果较佳,可通过降低机体炎症因子表达水平、提高毒素清除率来改善患者临床症状,且不会增加不良反应。

Objective To explore the effect of Xuanqing Daozhuo Decoction modified formula combined with hemodialysis treatment on renal function,micro inflammatory status,and toxin clearance rate in elderly patients with chronic renal failure（CRF）．Methods Retrospectively,82 elderly CRF patients admitted to our hospital from October 2019 to October 2022 were selected and divided into a combination group and a single group according to the treatment methods,with 41 cases in each group． The single group was treated with hemodialysis only,and the combined group was treated with Xuanqing Daozhuo Decoction modified formula additionally．The changes of TCM syndrome scores,toxin clearance rate and inflammatory factors before and after treatment were compared between the two groups．Results After treatment,the scores of TCM syndroms including tasteless mouth and no thirst,numbness of limbs,soreness and weakness of waist and knee,fatigue,poor appetite and sluggish stomach were all decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,serum creatinine,blood urea nitrogen and β₂-microglobulin were decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,the levels of interleukin-6,C-reactive protein and tumor necrosis factor-α inflammatory factors were significantly decreased in 2 groups,which were lower in combination group（P<0.05）．The two groups had no adverse effects during the treatment period．Conclusions Xuanqing Daozhuo Decoction modified formula and hemodialysis can improve the clinical symptoms of elderly patients with CRF,reduce the expression level of inflammatory factors in patients,and increase the clearance rate of toxins in patients,and does not increase the adverse effects．

通过筛查和早期发现,可以降低结直肠癌（CRC）的发病率,有效切除肿瘤病变可以降低CRC的病死率。虽然对CRC的危险因素、发病机制和前体病变的了解已经取得进展,但最近年轻人群CRC发病率升高,原因尚不清楚。在过去十年中,出现了多种侵入性、半侵入性和非侵入性筛查方式。目前对结肠镜检查质量的重视提高了筛查的有效性,人工智能等影像新技术在肿瘤检测中的作用正在迅速显现。而且,CRC有效干预措施,如保肛治疗新术式、靶向治疗及免疫治疗领域的新进展,被证明可以提高CRC患者的生存率。该文旨在总结目前国内外CRC筛查方式和指南的证据,并综述CRC治疗领域的进展。

The incidence of colorectal cancer（CRC）can be reduced through screening and early detection．Effective resection of tumor lesions reduces mortality from CRC．Although progress has been made in understanding the risk factors,pathogenesis and precursor lesions of CRC,the reasons for the recent increase in the incidence of CRC in young adults are largely unknown．A variety of invasive,semi-invasive and non-invasive screening modalities have emerged in the last decade．The current emphasis on the quality of colonoscopy has improved the effectiveness of screening,and the role of new imaging technologies such as artificial intelligence in tumor detection is rapidly emerging．Moreover,there are effective interventions for CRC,such as new surgical modalities for anal preservation therapy,and new advances in the field of targeted therapy and immunotherapy,which have been shown to improve the survival rate of CRC．The aim of this article is to summarize the current evidence on CRC screening modalities and guidelines both nationally and internationally,and to provide an overview of advances in the field of CRC treatment．

目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/（min·kg）]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/（min·kg）]及并发症比较差异均无统计学意义（P>0.05）。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。

目的 探讨多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓发生率的影响。方法 选择2021年1月—2022年10月我院收治的70例下肢骨折患者,随机分为联合组与常规组,每组各35例。常规组患者实施常规护理,联合组患者实施多学科整合护理路径联合手术室优质护理,对比两组患者护理效果。结果 联合组患者首次下床活动时间、术后视觉模拟量表（VAS）评分低于常规组（P<0.05）,二者住院时间以及引流管拔除时间比较差异无统计学意义（P>0.05）;经过护理干预后,两组的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）均延长,血浆纤维蛋白原（FIB）降低,联合组优于常规组（P<0.05）,且联合组下肢静脉血栓发生率低于常规组（0% vs 17.14%,P<0.05）;联合组患者护理满意度更高（P<0.05）;术后1个月两组患者日常生活活动能力（ADL）评分、Fugl-Meyer评分均升高,联合组高于常规组（P<0.05）。结论 多学科整合护理路径联合手术室优质护理可改善下肢骨折患者围术期指标和血液高凝状态,降低患者下肢静脉血栓发生率,提升护理满意度及患者远期日常生活能力、肢体运动功能。

Objective To explore the application effect of multidisciplinary integrated nursing path combined with high-quality nursing in operating room on patients with lower limb fracture and the effect on postoperative lower limb venous thrombosis．Methods From January 2021 to October 2022,70 patients with lower limb fracture admitted to our hospital were randomly divided into combination group and conventional group,with 35 cases in each group．Patients in the conventional group received routine nursing,and patients in the combined group received multidisciplinary integrated nursing path combined with high-quality nursing in the operating room．The nursing effect of the two groups was compared．Results The first time of getting out of bed in the combined group was earlier and postoperative VAS score was lower than those in the conventional group（P<0.05）,and the length of hospital stay and drainage tube removal time were not significantly different between the two groups（P>0.05）．After nursing intervention,the prothrombin time（PT）and activated partial thromboplastin time（APTT）of the two groups were prolonged,and the plasma fibrinogen（FIB）decreased,and the change range of the combined group was greater（P<0.05）．The incidence of venous thrombosis in the combined group was significantly lower than that in the conventional group（0.00% vs 17.14%,P<0.05）．The nursing satisfaction of patients in combination group was higher（P<0.05）．The activities of daily living score and Fugl-Meyer score of both groups increased one month after surgery,and the combined group was higher than the conventional group（P<0.05）．Conclusions Multidisciplinary integrated nursing path combined with high-quality nursing in operating room can improve perioperative indicators and blood hypercoagulability of patients with lower limb fractures,reduce the incidence of lower limb venous thrombosis,improve nursing satisfaction,long-term daily living ability and limb motor function of patients．