目的 通过静脉输液批次决策的自动化、标准化以及个体化,实现静脉用药调配中心（PIVAS）工作同质化和高效化,进而促进临床安全合理用药。方法 根据药物使用的时辰药理学,调查分析人工决策输液批次存在的问题,建立批次时间划分表和制定批次决策规则,基于医院信息系统构建自动输液批次决策系统。由药师维护自动输液批次决策系统,针对该系统的应用效果评价分析。结果 应用自动批次决策软件后,PIVAS 批次不合格率下降,输液时间合理性提高。审方药师用于决策输液批次的时间减少,大幅度提高 PIVAS 和病区护士工作效率,同时降低 PIVAS输液配送出错频率。结论 自动输液批次决策系统构建完成之后,用药时间更合理,提高药物治疗效果;PIVAS工作效率明显提高,工作质量显著提升,输液批次不合格率降低,患者输液批次真正做到编排一致性,提高用药时间合理性,进而使临床用药更合理、更安全,实现个体化治疗。

ObjectiveThrough the automation, standardization and individualization of intravenous（IV）fluid batch decision-making, to realize the homogenization and high efficiency of Pharmacy Intravenous Admixture Services（PIVAS）, to promot safe and rational clinical drug use．Methods According to the pharmacology of drug use, the problems existing in manual IV fluid batch decision were investigated and analyzed, and an automatic IV fluid batch decision system was constructed based on hospital information system．Batch time division table and batch decision rules were established, automatic IV fluid batch decision system was maintained by pharmacists, the application effect of the system were evaluated and analyzed．Results The unqualified rate of PIVAS batch decreased, and the rationality of IV transfusion time increased．The time for prescription checking pharmacists to make IV fluid batch decisions was shortened, which greatly improved the work efficiency of PIVAS and nurses, and reduced the error frequency of PIVAS IV fluid distribution．Conclusions After the completion of the automatic IV fluid batch decision system, the medication time is more reasonable and the drug treatment effect is improved．The work efficiency and quality of PIVAS are significantly improved, and the unqualified rate of IV fluid batches is reduced．The IV fluid batches of patients are really arranged in a consistent way, and the rationality of medication time is improved, so that clinical medication is more reasonable and safer, and individualized treatment is realized．

直肠癌是全球常见的消化道恶性肿瘤之一,准确的影像学评估对直肠癌的诊断和治疗决策至关重要。在各种影像学检查中,磁共振成像已逐渐成为直肠癌不可或缺的检查手段,其中酰胺质子转移加权（APTw）成像是当前直肠癌磁共振成像中的一种极具发展前景的成像技术,其是通过检测病灶中内源性可移动蛋白的酰胺质子与水质子之间的交换,可以更好地在分子水平评估直肠癌病灶的蛋白质浓度、pH值、温度和代谢状态等,在直肠癌中有极大的应用潜能,有助于实现精准医疗。本文主要综述APTw成像在直肠癌中的研究进展、发展前景及尚存在的问题。

Rectal cancer is one of the most common gastrointestinal malignancies worldwide, and accurate imaging evaluation is essential for the diagnosis and treatment of rectal cancer．In various imaging examinations, magnetic resonance imaging（MRI）has gradually become an indispensable means of rectal cancer, among which amide proton transfer-weighted（APTw）imaging is a promising imaging technology．APTw imaging is to detect the exchange between amide protons of endogenous mobile proteins in lesions and water quality particles, which can better assess the protein concentration, pH, temperature, and metabolic status of rectal cancer at the molecular level．It has great application potential in rectal cancer and contributes to precision medicine．This article mainly reviews the research progress, development prospect and remaining problems of APTw imaging in rectal cancer．

融合基因是指两个独立基因的编码区首尾相连所形成的且置于同一套调控序列控制的产物,研究表明许多癌症的发生与融合基因存在密切的联系。融合基因可作为癌症治疗的靶点,在癌症诊断及治疗领域中融合基因的研究具有重要意义。部分融合基因驱动癌症的机制已被初步揭示,但是有些真实存在的在肿瘤发生发展过程中有重要意义的融合基因由于工具和实验技术限制还未被发现。因此,对融合基因的分析预测研究方法逐渐成为关注的热点之一。本文探讨了目前常用的关于融合基因的分析工具及方法,为融合基因在癌症中的研究提供思路。

Fusion genes are the products of two independent genes whose coding regions are linked and controlled by the same set of regulatory sequences．Studies have shown that many cancers are closely linked to gene fusions．Fusion genes can be used as targets for cancer therapy,and the study of fusion genes is of great importance in cancer diagnosis and treatment．Some of the mechanisms of fusion genes driving cancer have been initially revealed,but there are more fusion genes which are important in the process of tumor development have not been discovered due to the limitation of tools and experimental techniques．Therefore,the analysis and prediction methods of fusion genes are becoming a hot topic of interest．In this paper,we discuss the commonly used analytical tools and methods on fusion genes to provide ideas for the study of fusion genes in cancer．

高压氧治疗是在高于当地压力的环境下,吸入高于当地大气氧浓度的氧来治疗疾病的方法,主要用于缺氧缺血性疾病或与缺氧缺血有关的疾病的治疗。炎症作为机体对刺激的一种防御机制,是感染、损伤、中毒等疾病共同的病理生理基础,在疾病的发生发展中扮演重要角色。高压氧与炎症的关系密切,围绕高压氧与炎症调节相关的研究进行综述,对深入认识高压氧的作用机制具有重要的意义。

Hyperbaric oxygen therapy is the treatment of diseases by inhaling oxygen at a concentration higher than the local atmospheric oxygen concentration in an environment that higher than the local pressure．It is mainly used in the treatment of hypoxic-ischemic diseases or diseases related to hypoxia-ischemia．As a defense mechanism against stimulation,inflammation is the common pathophysiological basis of infection,injury,poisoning and other diseases,which plays an important role in the occurrence and development of diseases．Hyperbaric oxygen is closely related to inflammation．The review on hyperbaric oxygen and inflammation regulation is of great significance to further understand the mechanism of hyperbaric oxygen．

目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。

Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions．Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method．Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation．Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods．The conclusion part of the article proposes directions and challenges for future research．

糖尿病已成为全球最严重的健康问题之一。需要白内障手术的糖尿病患者也日益增多,虽然糖尿病的眼表并发症很常见,但由于糖尿病患者全身和眼部疾病十分复杂,使得眼前段如角结膜和泪腺的糖尿病并发症往往被忽视。糖尿病患者白内障超声乳化术有引发或加重眼前节疾病的风险,包括干眼病（DED）、角膜上皮糜烂、上皮缺损迁延不愈,甚至威胁视力的角膜溃疡。这些风险里最为常见的是DED,并且可能因白内障超声乳化手术而加重。眼科医生需要在手术前预先评估已存在的DED是否需要术前治疗,并且需要注意在已存在 DED 的情况下,各项术前检查数据测量的准确性会降低,以及尽可能减少对眼表造成损害的各种手术因素;并考虑通过管理减少术后 DED。本综述就评估白内障超声乳化术对合并糖尿病的老年性白内障患者的眼表术中的影响因素进行分析。

Diabetes mellitus(DM)has become one of the most serious health problems in the world. The number of diabetic patients requiring cataract surgery is also increasing. Although ocular surface complications of DM are common,the complexity of systemic and ocular disease in diabetic patients makes diabetic complications in the anterior segment,such as the cornea and lacrimal gland,often be overlooked. Phacoemulsification in diabetic patients carries the risk of triggering or exacerbating ocular segment disease,including dry eye disease,corneal epithelial erosion,persistent epithelial defects and even vision-threatening corneal ulcers. The most common of these risks is dry eye disease,and it can be exacerbated by cataract phacoemulsification. Ophthalmologists need to preemptively assess the need for preoperative treatment of pre-existing dry eye disease(DED),be aware of the reduced accuracy of preoperative data measurements in the presence of DED,and minimize surgical factors that can damage the ocular surface;and consider management to reduce postoperative DED. In this review,we analyze the factors that influence phacoemulsification in ocular surface surgery for senile cataract patients with diabetes.

严重烧伤后患者免疫功能的失调,易导致创面感染、全身炎症反应综合征、脓毒症、感染性休克等并发症,增加患者病死率。免疫细胞功能适度的活化将有助于烧伤患者抵御外界病原体的侵袭、促进创面的愈合,但功能过度激活或者功能低下,则会引发一系列严重的后果。本文旨在归纳严重烧伤后中性粒细胞、单核/巨噬细胞、肥大细胞、NK细胞及T淋巴细胞等免疫细胞的功能变化与炎症反应之间的关系,为完善烧伤患者诊疗、减少并发症、改善预后提供新的思路。

The imbalance of immune function in severely burned patients can easily lead to wound infection,systemic inflammatory response syndrome,sepsis,septic shock and other complications,which increase the mortality of patients. Moderate activation of immune cell function will help burned patients to resist the invasion of external pathogens and promote wound healing,but excessive activation or low function can lead to a series of serious consequences. The purpose of this paper is to summarize the relationship between the functional changes of immune cells such as neutrophils,monocytes/macrophages,mast cells,NK cells,T lymphocytes and inflammatory reaction after severe burns,and to provide new ideas for improving the diagnosis and treatment of burned patients,reducing complications and improving the prognosis.

目的 了解高职医学生职业决策困难现状及其主要影响因素,提出改善对策。方法 采用分层整群抽样方法,选取广州市某职业院校740名全日制医学生进行问卷调查。结果 被调查高职医学生职业决策困难总平均分值为(3.55±0.647),其中职业规划探索维度均分最低为(3.42±0.797),其它维度均分从低到高分别是职业目标探索(3.49±0.766)、职业信息探索(3.58±0.678)和职业自我探索(3.69±0.659);单因素方差分析结果显示,不同专业、所在专业是否为第一志愿、不同家庭所在地的高职医学生职业决策困难分值均存在差异(P<0.05);多元逐步回归分析结果显示,家庭所在地、学校职业规划指导课程、兼职或见习的经历、学校活动(就业指导讲座、职业规划大赛等)、对所学专业的就业前景很乐观、学校提供了充足的就业信息、曾参加过创新创业大赛,是医学生职业决策困难的预测因素(P<0.05)。结论 高职医学生职业决策困难程度处于中等水平,学校可通过开展有针对性的职业指导,建立系统的职业决策困难测评与干预体系,搭建实践、就业服务平台等方法改善高职医学生职业决策困难状况,为学生提供强有力的支持与保障;政府可加大政策导向,引导高职医学生面向基层就业。

Objective To understand the current situation and main influencing factors of career decision-making difficulties of higher vocational medical students, and put forward improvement countermeasures. Methods The method of stratified cluster sampling was adopted, with 740 full-time medical students from a vocational college in Guangzhou being investigated. Results The average score of career decision-making difficulty of medical students surveyed in higher vocational colleges was (3.55±0.647), in which the average score of the career planning exploration was the lowest (3.42±0.797), and the average scores of other dimensions from low to high were career goal exploration (3.49±0.766), career information exploration (3.58±0.678) and career self-exploration (3.69±0.659). The results of one-way analysis of variance (ANOVA) showed that there were significant differences in the scores of career decision-making difficulties of medical students in higher vocational colleges among different majors, the major being the first choice or not, and different living places (P<0.05). The results of multiple stepwise regression analysis showed that family location, school guidance courses for career planning, part-time or trainee experience, school activities (employment guidance lectures, career planning competitions, etc.), being optimistic about the employment prospects of their majors, schools providing sufficient employment information, and having participated in innovation and entrepreneurship competitions were predictors of difficulties in career decision-making for medical students (P<0.05). Conclusions The difficulty of career decision-making of medical students in higher vocational colleges was in the middle level. Schools can establish a systematic evaluation and intervention system aiming at career decision-making difficulties by carrying out targeted career guidance, and build practice and employment service platform to improve the career decision-making difficulties of medical students in higher vocational colleges, and to provide strong support and security for students. The government can enhance policy guidance for medical students in higher vocational colleges to apply for primary hospital.

前列腺癌作为最常见的男性泌尿系统恶性肿瘤之一,目前常规治疗手段主要为手术、放化疗、内分泌治疗等,但后期并发症、治疗副作用等问题突出,且多转化为去势抵抗性前列腺癌,预后极差。既往研究已然证实,中医药在前列腺癌的治疗中可有效减少复发、减轻症状,提高患者生活质量。本文旨在总结近几年中医药对前列腺癌的研究,为往后的研究与临床治疗提供一些新的思路。

Prostate cancer(PCa) is one of the most common male urinary system malignancies.At present,conventional treatment methods are mainly surgery, radiotherapy and chemotherapy, endocrine therapy,etc.However, late complications, treatment side effects and other problems are prominent, and prostate cancer tends to develop as castration-resistant prostate cancer (CRPC), and the prognosis is very poor. Previous studies have confirmed that Chinese medicine can effectively reduce recurrence incidence, relieve symptoms and improve the quality of life of patients in the treatment of prostate cancer. This article summarizes the research of traditional Chinese medicine on prostate cancer in recent years, and provides some new ideas for future research and clinical treatment.

目的 分析广州血液中心以“生日献血纪念章”(下称生日纪念章)个性化专属纪念品对献血者的招募保留效果进行分析和研究。方法 2017年—2019年期间,广州血液中心生日当天献血者共11 790名,每半年生日当天献血的献血者人数,绘制折线图,分析2018年7月起“生日纪念章”活动前后,生日当天献血的献血者人数变化;卡方检验对比2组献血人群特征差异,分析该活动敏感人群。结果 2017年—2019年每半年生日当天献血人数总体持续增长,其中2018年7—12月较2018年1—6月,生日当天献血人数增长了406%,增长比例最大。活动前后2组人群性别、年龄、职业及既往献血次数分布差异均有统计学意义(P<0.05)。活动后男性、35岁及以上献血者、工人/职员及其他职业,固定献血者比例增加。结论 广州血液中心的“生日纪念章”活动对生日当天献血有明显的促进效果,其中,男性,年龄35岁及以上,工人/职业/其他职业及固定献血者对该活动更敏感,更可能选择生日当天献血。今后针对女性、25岁以下、学生及初次献血者,注意增加其他招募保留措施。

Objective To analyze the effect of the “Birthday Blood Donation Medal” (hereinafter referred to as the Birthday Medal) personalized souvenir to the blood donor recruitment and retention effect of blood donors in Guangzhou Blood Center. Methods From 2017 to 2019, there were a total of 11 790 blood donors donated blood on their birthday in Guangzhou Blood Center. Aline chart was drawn of the number of blood donors who donated blood on birthday to observe the trends every half a year from 2017 to 2019; Chi-square test was used to compare the characteristics of blood donors in two groups (before and after the “Birthday Blood Donation Medal” activity) and we analyzed the sensitive population of the activity. Results The number of blood donors on the birthday every half year from 2017 to 2019 continued to increase. Among them, the number of blood donors donated on birthday on July-December 2018 increased by 406% compared to the first six months of 2018, which was the largest increase. The differences in gender, age, occupation, and previous blood donation times between the two groups were statistically significant (P<0.05). After the activity, the percentage of male, 35-year-old and above blood donors, workers/clerks and other occupations, and regular blood donors increased. Conclusion The “Birthday Blood Donation Medal” activity in Guangzhou Blood Center has a significant promotion effect on blood donation on birthday. Among them, males, aged 35 and above, workers/occupations/other occupations and regular blood donors are more sensitive to this activity and are more likely to donate blood on birthday. In the future, other recruitment and retention measures should be taken to pay attention to women, under 25 years old, students and first-time blood donors.