目的 观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法 收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者,随机平均分为两组。行常规对症支持治疗的为对照组;在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组;两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标(CD3+ 、CD4+、CD8+ 、CD4+ /CD8+ )较治疗前均有明显改善;干预组发生不良反应少于对照组。结论 补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果,提高生活质量和免疫功能,减少不良反应。
Objective To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy.Methods From June 2023 to June 2025,80 inpatients and outpatients of colorectal cancer in the recovery period were collected and randomly divided into two groups.The patients who received routine symptomatic supportive treatment were enrolled as the control group.The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group.The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment.Adverse reactions were detected on the day before treatment,theseventh day and 14th day during treatment.Results The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment.Adverse reactions occurred less in the intervention group than in the control group.Conclusions Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer,improve the quality of life and immune function,reduce adverse reactions.
目的 调查国内养老机构痴呆照护服务现状,为今后国内进一步推进养老机构痴呆照护服务的发展提供可借鉴的依据。方法 2024年1月1日至3月31日以全国养老机构为研究对象, 采取两阶段分层抽样, 随机抽取国内15个省、自治区、直辖市的养老机构, 采用网络问卷调查方法对抽取的养老机构管理人员进行问卷调查。结果 共回收线上调查问卷443份, 经过去重和排除无效问卷, 最终得到的有效问卷为412份, 有效率为93%。调查发现有313家(76%)机构有收住痴呆患者, 养老床位规模为100~299张的养老机构占比最高。小规模的养老机构中,民办民营机构收住痴呆患者的比例高于公建公营机构。有181家机构设置了痴呆照护专区。床位数在300张以上的养老机构中设立痴呆照护专区的比例高于中、小规模的养老机构。结论 本调查较客观地呈现了我国养老机构痴呆照护服务开展的现状, 大规模的养老机构提供痴呆照护服务的能力更高, 设置痴呆照护专区的机构更能满足痴呆患者多层次、多样化的照护需求。目前国内仍存在专业化的痴呆照护服务供给不足、照护人员短缺等现象, 急需国家加强顶层设计, 促进行业健康发展。
Objective To explore the current situation of cognitive care services in nursing homes in China, and provide reference for further promoting the development of cognitive care services in nursing homes in China.Methods From January 1 to March 31, 2024, a two-stage stratified sampling was carried out to randomly select pension institutions in 15 provinces, autonomous regions and municipalities directly under the central government across the country, and a questionnaire survey was conducted on the nursing homes.Results A total of 443 online questionnaires were recovered in this survey, and 412 valid questionnaires were obtained after eliminating duplicated and invalid questionnaires, with an effective rate of 93%.In this survey, 76% of the institutions admitted the elderly with dementia, and the nursing homes with 100-299 beds accounted for the highest proportion.Among the small-scale nursing homes, the proportion of the elderly with dementia in private institutions is significantly greater than that in public institutions.There were 181 nursing homes with special cognitive care areas.The proportion of cognitive care area in nursing homes with more than 300 beds was significantly greater than that in medium and small scale nursing homes.Conclusions This survey Objectively presents the current situation of the development of cognitive care services in nursing homes in our country.Large-scale nursing homes have a higher capacity to provide cognitive care services.Nursing homes that set up special areas for cognitive care can better meet the multi-level and diversified care needs of the elderly with dementia.At present, there are still insufficient supply of professional cognitive care services and shortage of nursing personnel in China.It is urgent for the country to strengthen top-level design and promote the healthy development of the industry.
目的 通过戴明循环管理法的品管圈(QCC)活动, 提升内镜中心病理标本标识的正确率与病理标本管理安全性。方法 采用基于戴明循环管理法的QCC活动, 对内镜中心病理标本标识质量进行现状把握、原因分析并制定对策, 比较QCC活动开展前后内镜病理标本标识的正确率。结果 QCC活动后, 内镜中心病理标本标识的正确率从99.8%提高至100%(P<0.05)。结论 内镜中心通过开展基于戴明循环管理法的QCC活动, 显著提升了内镜病理标本管理安全性与工作效率。
Objective To improve the accuracy of pathological specimen identification and the safety of pathological specimen management in endoscopy center through quality control circle(QCC)activity based on Deming cycle management.Methods QCC activity based on Deming cycle management was used to summarize the status quo,analyze the causes and formulate countermeasures for the quality control of pathological specimen identification in endoscopy center.The accuracy rate of endoscopic pathological specimen identification before and after QCC activity was compared.Results After QCC activity, the accuracy of pathological specimen identification in endoscope center increased from 99.8% to 100%.Conclusions QCC activities based on Deming cycle management can greatly improve the safety and efficiency of endoscopic pathological specimen management.
目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
目的 探索α-突触核蛋白(α-Syn)干预对人单核细胞白血病细胞系(THP-1)巨噬细胞源性泡沫细胞的影响。方法 通过佛波酯(PMA)和氧化型低密度脂蛋白(ox-LDL)构建THP-1巨噬细胞源性泡沫细胞模型,使用不同浓度(33、66、100、133 nmol/L)α-Syn处理泡沫细胞,随后检测细胞胆固醇含量和炎症因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)的mRNA表达以及核因子κB(NF-κB)和凝集素样氧化低密度脂蛋白受体-1(LOX-1)的蛋白表达变化。结果 高剂量(100和133 nmol/L)α-Syn处理可以减少THP-1巨噬细胞源性泡沫细胞内胆固醇的含量(P<0.05),并且减少IL-1β、IL-6和IL-8的mRNA表达(P<0.05)。进一步发现(100 nmol/L和133 nmol/L)α-Syn可以降低THP-1巨噬细胞源性泡沫细胞p-NF-κB和LOX-1的蛋白表达(P<0.05)。结论 α-Syn可以降低THP-1源性巨噬细胞泡沫细胞胆固醇蓄积和炎症反应,可能是通过下调p-NF-κB和LOX-1蛋白表达。
Objective To explore the effects of α-synuclein(α-Syn)intervention on human monocytic leukemia cell(THP-1)macrophage-derived foam cells.Methods The THP-1 macrophage-derived foam cell model was constructed by phorbol 12-myristate 13-acetate(PMA)and oxidized low-density lipoprotein(ox-LDL).Foam cells were treated with different concentrations(33, 66, 100, and 133 nmol/L)of α-Syn, and the cellular cholesterol contents, as well as the mRNA expression of IL-1β、IL-6 and IL-8 were detected.Subsequently,alternation in protein expression of NF-κB and LOX-1 was measured.Results High-dose(100 and 133nmol/L)α-Syn treatment significantly reduced the levels of intracellular cholesterol in THP-1-derived macrophage foam cells(P<0.05)and decreased the mRNA expression of IL-1β、IL-6 and IL-8(P<0.05).It was further found that(100 nmol/L and 133 nmol/L)α-Syn decreased the protein expression of p-NF-κB and LOX-1 in THP-1 macrophage-derived foam cells(P<0.05).Conclusions The results of the present study suggest that α-Syn reduces cholesterol accumulation and inflammatory response in THP-1-derived macrophage foam cells, possibly by down-regulating p-NF-κB and LOX-1 protein expression.
目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题:多重躯体症状负担持续存在(术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感); 负性心理情绪困扰(病耻感、疾病不确定感与复发恐惧); 心理调适过程(诊断冲击与认知失调、角色适应与主动应对); 创伤后成长与健康行为转变(生命意义感提升、健康促进行为强化); 强烈的康复信息支持需求(自我保健知识需求、结构化康复锻炼指导需求)。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。
Objective To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions.Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer.Colaizzi's 7-step analysis method was used to summarize and extract themes.Results Five themes and 12 sub-themes were summarized:Persistent burden of multiple physical symptoms(postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue); negative emotional experiences(stigma of illness, illness uncertainty and fear of recurrence); psychological adjustment processes(diagnostic shock and denial, role acceptance and active coping); post-traumatic growth and health behavior transformation(enhanced sense of meaning in life, strengthened health-promoting behaviors); strong demand for rehabilitation information support(self-care knowledge, rehabilitation exercise knowledge).Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life.
目的 针对孤独症多模态证据融合与定量化辨识的关键问题,本研究提出基于图卷积神经网络(GCN)的孤独症谱系障碍(ASD)诊断模型研究思路。方法 通过对来源于ABIDE的ASD儿童脑部fMRI数据进行整理和筛选,提取脑区功能连接矩阵作为图结构的邻接矩阵,并融合临床表型数据,构建了ASD多模态关联网络。通过网络特征比较分析,识别出了ASD与典型发育组的脑功能连接网络组间差异。进一步地构建一个端到端的GCN模型,并尝试引入注意力机制,提高模型决策的可解释性。结果 该模型在诊断性能指标优于传统机器学习方法(准确率=0.710,精确率=0.709,召回率=0.780,F1=0.743,曲线下面积=0.746)。背侧注意网络与边缘系统-颞极枢纽的功能连接减弱是模型做出判断的最主要依据。结论 以异质图为多模态数据整合的基本架构,本模型为ASD的潜在病理机制探索提供了新的方法学范例。
Objective To develop a quantitative model for autism spectrum disorder(ASD)integration multimodal evidences.Methods The fMRI dataset from ABIDE was used for extracting connectivity function network of ASD after data preprocessing.Difference between ASD and typical development about their brain connectivity function was evaluated with t-test.Integrating phenotypic data and fMRI dataset,an graph convolutional neural network (GCN)with attention module was estimated and compared against benchmark models about their efficiency and interpretability.Results The GCN model was evaluated outperformed other models with better accuracy indices.And regions from Dorsal Attention Network and Limbic-Temporal Pole were ranked as the highest weights for the differentiation in the model.Conclusions This study provided a novel paradigm for quantitative diagnosis and exploring pathogenesis of ASD.
目的 探讨医院药房外包代煎代送服务的质量管理。方法 成立中药代煎质量控制管理小组,研究给出完善质量控制体系的策略,涉及建立标准化操作流程、加强人员培训、优化信息化管理系统以及健全监督评估机制。结果 通过对中药库房的采购、入库验收、在库管理、调剂环节的审方、调剂、煎药质量管理以及物流、发药人员全流程管理,提高了患者的满意度,更多的患者选择了中药代煎服务。结论 实施有效的质量控制措施可提高代煎代送服务的质量,为医院药房提升服务质量给予理论依据与实践指导。
Objective To explore quality management of outsourced decoction preparation and delivery services in hospital pharmacies.Methods A quality control management team for traditional Chinese medicine(TCM)decoction preparation was established to develop strategies for improving the quality control system.These strategies involved establishing standardized operating procedures,strengthening personnel training,optimizing the information management system,and improving the supervision and evaluation mechanism.Results Through comprehensive process management,covering procurement,warehouse acceptance,inventory management,prescription review in the dispensing stage,dispensing itself,quality control of decoction preparation,logistics,and management of dispensing personnel,patient satisfaction was enhanced,leading more patients to opt for the TCM decoction service.Conclusions Implementing effective quality control measures can improve the quality of decoction preparation and delivery services,providing a theoretical basis and practical guidance for hospital pharmacies to enhance their service quality.
目的 调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法 采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果 老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。结论 老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
Objective To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.
目的 评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法 将156例脑梗死患者随机分为对照组和试验组,各78例。试验组使用新型穿戴式气压治疗仪(邦普医疗/VW100)进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d,观察临床疗效及安全性,比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果 治疗10 d后,试验组与对照组深静脉血栓未发生率差值为1.2%,相应的95%置信区间为–5.3%~7.9%,下限高于–10%,医护人员和患者对试验组的评价优于对照组(P<0.001)。结论 新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪,治疗过程中未见明显不良反应,临床使用安全有效。
Objective To evaluate the effectiveness and safety of new wearable pneumatic compression pump in preventing deep vein thrombosis.Methods One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group.Study group was treated with the new wearable pneumatic compression pump(Bangpu Medical / VW100).Control group was treated with pneumatic compression pump(Wonjin-POWER).The course of both groups was 10 days,comparing the deep vein thrombosis rate and useage satisfaction of patients and staffs between the two groups.Results After 10 days of treatment,the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%.The corresponding 95% confidence interval was(-5.3%,7.9%),and the lower limit was greater than -10%.The appraisal from medical staffs and the patients of study group was better than that of the control group(P<0.001).Conclusions The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump,which clinical practice experience is better.There is no obvious adverse reactions in the treatment process,and the clinical practice is also safe and effective.