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 探讨软组织重建治疗儿童蟹钳指畸形的临床效果。方法 2019年1月—2022年12月对25例蟹钳指畸形或蟹钳指畸形术后出现“Z”形畸形患儿进行软组织重建治疗,观察术后1年Tada评分、并发症发生情况。结果 术后1年,25例患儿的Tada评分优16例（64%）,良8例（32%）,差1例（4%）。术后1年Peds QL评分（92.74±9.52）高于术前（79.25±7.43）,比较差异有统计学意义（P<0.001）。指间关节伸直障碍、骨折愈合延迟各发生1例,并发症总发生率8%。结论 软组织重建治疗儿童蟹钳指畸形,患儿无需经历一期切除重复拇指,二期行截骨矫形手术或者切除多指的多次手术,只需一次手术就完成蟹钳指截骨矫形,具有治疗周期短、患儿痛苦少、家庭经济成本低,且能显著提升患儿生存质量,临床效果满意等优点。

Objective To investigate the clinical effect of soft tissue reconstruction in the treatment of crab-claw finger deformity in children．Methods From January 2019 to December 2022,soft tissue reconstruction was performed in 25 patients with crab-claw finger deformity or “Z-shaped” deformity after surgery,and Tada score and complications were observed one year after surgery．Results One year after surgery,16 of 25 children had excellent Tada scores（64%）,8 of 25 had good scores（32%）,and 1 had poor score（4%）．The Peds QL score 1 year after operation（92.74±9.52）was significantly higher than that before operation（79.25±7.43）,and the difference was statistically significant（P<0.001）．Dysextension of interphalangeal joint and delayed fracture healing occurred in 1 case,the total complication rate was 8%．Conclusions In the treatment of crab-claw finger deformity and soft tissue reconstruction,children do not need to undergo one-stage resection of the repetitive thumb,second-stage osteotomy and orthopedic surgery or multiple operations to remove extra fingers,and just only one operation is needed to complete the osteotomy and orthopedic surgery of crab-claw finger,which has the advantages of short treatment cycle,less pain for children and low economic cost for families．It significantly improves the quality of life of children and has satisfactory clinical effects．

目的 探讨对分课堂对《老年人健康照护技术》实训教学效果的影响,为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。方法 以广州卫生职业技术学院2022级智慧健康养老服务与管理专业学生为研究对象,设定其中一班为观察组,另一班为对照组,在《老年人健康照护技术》实训教学过程中,观察组采用对分课堂的实训教学模式,对照组采用传统实训教学模式;实训结束后对两组均进行理论和技能考核,并在教学前后均采用《一般自我效能感量表》对两组学生进行测评。结果 试验开始之前,对两组学生一般自我效能感测评得分进行比较,差异无统计学意义（P>0.05）;试验结束后,将观察组与对照组的理论和技能考核成绩、一般自我效能感得分进行比较,观察组均明显高于对照组,差异有统计学意义（P<0.01）;且观察组一般自我效能感得分优于本组试验前,差异有统计学意义（P<0.01）。结论 对分课堂有利于提高学生的一般自我效能感,有助于改善《老年人健康照护技术》的实训教学效果,能够为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。

Objective To explore the impact of split courses on the practical training and teaching effectiveness of “Elderly Health Care Technology”,and to provide reference for further improving the practical training and teaching plan of smart health and elderly care services and management．Methods A study was conducted on students majoring in Intelligent Health and Elderly Care Services and Management from Guangzhou Health Vocational and Technical College in 2022．One class was set as the observation group and the other as the control group．During the training and teaching process of “Elderly Health Care Technology”,the observation group adopted a split courses training teaching mode,while the control group adopted a traditional training teaching mode．After the practical training,theoretical and skill assessments were conducted on both groups,and the General Self Efficacy Scale was used to evaluate both groups of students before and after teaching．Results Before the start of the experiment,there was no statistically significant difference in the general self-efficacy evaluation scores between the two groups of students（P>0.05）．After the experiment,the theoretical and skill assessment scores, general self-efficacy scores of the observation group, and the control group were compared．The observation group was significantly higher than the control group,with a significant statistical difference（P<0.01）,and the general self-efficacy score of the observation group was better than before the experiment,with a statistically significant difference as well（P<0.01）．Conclusions split courses were beneficial for improving students’ general self-efficacy,enhancing teaching effectiveness,and providing reference basis for further improving the practical training teaching plan for smart health and elderly care services and management．

心血管疾病是导致我国居民死亡的首要原因。在2006—2019年间,我国每年因心血管疾病死亡的人数从215万人增加到328万人。斑马鱼因个体小、成本低廉、体外发育、身体透明、基因组与人类高度同源等特点,近年来被广泛应用于医学研究。斑马鱼模型有利于推动心血管疾病领域的基础性研究。该文通过对前期研究进行综述,重点介绍了斑马鱼模型在心血管疾病中基因筛选、心脏再生、药物筛选、毒性评估等方面的研究进展。

Cardiovascular disease is the leading cause of death in China．Between 2006 and 2019,the annual number of deaths due to cardiovascular diseases increased from 2.15 million to 3.28 million．Zebrafish has been widely used in medical research in recent years because of its small individual size,low cost,in vitro development,transparent body and high homology of genome with human．The zebrafish model is conducive to promoting basic research in the field of cardiovascular disease．Based on the review of previous studies,this paper focuses on the research progress of zebrafish model in gene screening,cardiac regeneration,drug screening,toxicity assessment and other aspects of cardiovascular diseases．

价值医疗下公立医院需转变运营管理模式,建设专门运营管理部门对满足外部政策要求和改善内部运营管理十分必要。通过梳理公立医院开展运营管理的主要任务,确定公立医院专门运营管理部门的职责,设计与承担职责相适应的组织架构,保证专门运营管理部门的职能充分发挥。

Public hospitals need to change the operation management mode under value-based healthcare．It is necessary to build a special operation management department to meet the requirements of external policies and improve internal operation management．By sorting out the operation and management tasks of public hospitals,the responsibilities of the operation management department are determined,and the organizational structure suitable for the responsibilities is designed,so that the construction of specialized operation management department can be effectively implemented．

目的 分析音乐治疗焦虑领域研究热点的演变与趋势。方法 利用文献计量学方法对近20年（2003——2023）发表音乐治疗焦虑方面的研究与文献进行了可视化分析：对中国知网（CNKI）及Web of Science（WOS）文献库中收录的文献进行关键词（中文关键词：音乐治疗、焦虑;英文关键词：Music therapy、Anxiety）检索,利用CiteSpace 6.3 R2软件绘制知识图谱进行可视化分析。结果 通过文献的检索与筛选最终纳入中文文献506篇及英文文献1 782篇,其中国内外主要发文者为刘月芳、刘春艳、Bradt、Cold、Silverman等研究者团队,国内外主要研究机构均为高校,但国内高校相对于国外相关研究开展较为独立且合作联系较少;发文国家主要为美国、中国以及土耳其,西方国家之间的合作联系较为密切,我国开展相关跨地域研究主要是与亚洲国家进行多中心合作。国内研究热点为“音乐疗法”“心理干预”“五行音乐”等,国外研究热点为“Pain”“Depression”“Quality of life”等。结论 本文通过CiteSpace软件进行文献计量学分析发现,音乐治疗与焦虑结合是国内外研究的热点,国内研究聚焦于焦虑,而国外研究更关注音乐治疗在广泛心理问题中的应用。尽管该研究领域发展迅速,但国内外合作交流较少,国际研究团队间合作不够紧密。未来研究需进一步探索音乐治疗的机制和最佳实践方法,加强跨学科合作,利用科技创新,结合中国文化特色,以期实现音乐治疗在焦虑治疗中的更广泛应用,并提升患者的生活质量。同时,未来相关研究方法需多样化,以全面掌握研究趋势,为音乐治疗焦虑提供更有力的证据支持。

Objective To explore the evolution and trends of research hotspots in the field of music therapy for anxiety and provide reference and basis for related research．Methods Bibliometric analysis method was used to visualize and analyze the research and literature on music therapy for anxiety in the past 20 years（2003-2023）．Keyword searches were conducted in Chinese National Knowledge Infrastructure（CNKI）and Web of Science（WOS）databases,and a knowledge map was drawn using CiteSpace 6.3 R2 software for visualization analysis．Results Through the literature search and screening,506 Chinese and 1782 English literatures were included,and the main authors at home and abroad were researcher teams such as Liu Yuefang,Liu Chunyan,Bradt,Cold and Silverman．The main research institutions at home and abroad were universities,but domestic universities were more independent and had fewer collaborative relationships than foreign ones．The main publishing countries were the United States,China and Turkey,and there was closer cooperation between western countries．Multicenter cooperation with Asian countries was the main form of cross-region research in China．The research hotspots at home were “music therapy”,“psychological intervention”,“five elements music”,while the foreign research hotspots were “pain”,“depression”,and “quality of life”．Conclusions The combination of “music therapy” and “anxiety” is the main research hotspot at home and abroad in recent years．Among them,foreign scholars mainly use anxiety and other psychological problems as research topics to explore the application of music therapy to these issues,while domestic scholars focus on the research of anxiety and propose many music therapy programs for anxiety．In addition,there is relatively little cooperation and communication between domestic and foreign research sectors,and the degree of coincidence among international research teams is not high．Therefore,research teams at home and abroad should strengthen cooperation and communication．Based on the analysis of research hotspots in music therapy for anxiety in the past 20 years,this field has received considerable attention and has developed rapidly,but there are still many aspects that need to be explored and improved through continuous efforts and innovation．

脊髓损伤是一种高致残性中枢神经系统疾病,目前缺乏有效的治疗措施。干细胞组织工程兴起和神经调控技术的发展,给脊髓损伤的治疗带来新的希望。目前,多项针对脊髓损伤的干细胞相关治疗项目的临床研究已在全球注册,干细胞疗法是脊髓损伤领域的研究热点,具有良好的应用前景。而神经调控技术一直在临床上脊髓损伤后的康复治疗中发挥着重要作用,特别是靶向神经调控技术近年在脊髓损伤治疗方面取得突破性进展。有研究尝试联合干细胞疗法和神经调控技术应用治疗脊髓损伤,试图取得更好的效果。本文综述了干细胞疗法和神经调控技术在脊髓损伤治疗中的研究进展,旨在探讨其作用效果、修复机制、应用前景以及面临的问题,进一步为脊髓损伤的基础研究和临床转化提供参考。

Spinal cord injury is a highly disabling disease of the central nervous system without effective treatment to date．With the rise of stem cell and tissue engineering,and the breakthrough of neuromodulation technology,it brings new hope to the treatment of spinal cord injury．At present,a number of clinical studies on stem cell-related treatment projects for spinal cord injury have been registered worldwide,which has become a research hotspot．Neuromodulation technology has been playing an important role in the clinical rehabilitation of spinal cord injury．Especially,breakthroughs have been made in the treatment of spinal cord injury by targeted neuromodulation technology in recent years,which is encouraging．Some studies have attempted to combine stem cell therapy and neuromodulation technology to treat spinal cord injuries in an attempt to achieve better effect．This review summarizes the research progress of stem cell therapy and neuromodulation technology in the treatment of spinal cord injury,with the aim of discussing their effect,repair mechanisms,application prospect and various problems to face,and providing further reference for the basic research and clinical transformation of spinal cord injury．

在“放管服”改革的背景下,基于业财融合管理理念对医院科研物资进行一体化管理是发展趋势。但由于科研项目管理涉及众多部门,流程繁杂,致使医院科研物资管理面临诸多问题。为了改变现状,广州市某三甲医院探索构建基于业财融合的医院科研物资一体化信息系统,分别上线了科研物资采购平台和经费管理系统,并在实践中对信息系统进行了优化与设计。实践证明,该系统具有创新性和应用价值,对医院的财务管理和科研项目管理具有重要的参考意义。

Under the background of streamlining administration and delegating power,the integrated management of hospital scientific research materials based on the concept of integrating industry and finance is a development trend．However,due to the involvement of multiple departments and complicated processes in scientific research project management,the management of hospital scientific research materials faces many problems．In order to change the current situation,a Tertiary Grade A Hospital in Guangzhou explored the construction of an integrated information system for hospital scientific research materials based on the integration of industry and finance．They launched a scientific research material procurement platform and a funding management system,and optimized and designed the information system in practice．Practice has proven that the system is innovative and valuable,and it has important reference significance for the financial management and scientific research project management of hospitals．

目的 以临床二级学院附属医院的管理为例,对当下医科类高校研究生校院二级管理存在问题进行探讨。方法 对某医科高校附属医院474名临床医学研究生及9名辅导员进行调查。结果 55.56%的研究生表示导师的约束力最大,但42.56%的学生与导师是不定期沟通;39.83%的学生不认可在培养方式上严格区分培养,其中学术型硕士二年级学生中44.3%认为有一定区别,但区别不大;学院配备的学生工作管理专职人员不足、学院层级的管理制度和机制不健全和二级学院权责不清运行机制不顺畅。结论 明确医科类高校与二级附属医院之间的关系、提高治理效能激活医科类高校二级附属医院人才培养的自主性和内生动力、医科类高校二级附属医院研究生施行差异化培养和整合资源,共同提升医科高校与附属医学院的整体水平。

Objective To discuss the existing problems of secondary management in medical colleges and universities,taking the management of secondary college of affiliated hospital as an example．Methods Through the investigation of 474 clinical medical graduate students and 9 counselors in the affiliated hospital of a medical university．Results There was 55.56% of the graduate students said that the supervisor was the most binding force,but 42.56% of the students communicated with the supervisor irregularly;39.83% of the students do not recognize the strict differentiation of training methods,44.3% of the students in the second year of study believed that there was a certain difference,but the difference was not big．The college was equipped with insufficient full-time staff for student work management,the management system and mechanism at the college level were not perfect,and the power and responsibility of the second-level college were not clear and the operation mechanism is not smooth．Conclusions Clarify the relationship between medical colleges and secondary affiliated hospitals,improve governance efficiency and activate the autonomy and endogenous motivation of talent training in secondary affiliated hospitals of medical colleges and universities,implement differentiated training the graduates of secondary affiliated hospitals of medical colleges and universities,integrate resources,so as to jointly improve the overall level of medical colleges and universities and affiliated medical schools．

慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数（SII）作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。

Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis．As a new type of inflammatory index,the systemic immune inflammatory index（SII）was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields．SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development．