目的 对入住重症监护病房（ICU）重症孕产妇患者的病种特征和住院费用进行分析。方法 从医院信息管理系统中搜索2009—2019年广州市某省级重症孕产妇救治中心ICU的重症孕产妇住院病例，对病例资料进行描述性流行病学分析。结果 2009—2019年该救治中心ICU共收治重症孕产妇1 616例，病种排名前五位依次为心血管疾病430例（26.61%）、血液及造血器官疾病310例（19.18%）、妊娠期特定并发疾病287例（17.76%）、消化系统疾病218例（13.49%）、呼吸系统疾病110例（6.81%）。患者经济负担中位数排名前五位依次为肌肉骨骼系统和结缔组织疾病（62 252.60元）、消化系统疾病（61 684.41元）、感染性疾病（42 945.70元）、血液及造血器官疾病（40 403.52元）、神经系统疾病（40 055.93元）。结论 入住ICU内的重症孕产妇以心血管疾病、血液及造血器官疾病为主，经济学分析表明肌肉骨骼系统和结缔组织疾病造成的经济损失较大。
Objective To analyze the disease characteristics and hospitalization expenses of severe maternal patients in intensive care unit（ICU）．Methods Hospitalized cases of severe maternal disease in ICU of a provincial critical care center in Guangzhou from 2009 to 2019 were searched from the hospital information management system，and case data was analyzed by descriptive epidemiology．Results From 2009 to 2019，a total of 1616 critically ill maternal patients received intensive care treatment at this center．The predominant diseases observed were cardiovascular disorders（26.61%），blood and hematopoietic organ diseases（19.18%），specific pregnancy-related complications（17.76%），gastrointestinal ailments（13.49%），and respiratory disorders（6.81%）．Among the top five patient groups，the median economic burden was the highest in musculoskeletal system and connective tissue diseases（62 252.600 yuan），followed by digestive system diseases（61 684.410 yuan），infectious diseases（42 945.700 yuan），blood and hematopoietic organ diseases（40 403.515 yuan），and nervous system disorders（40 055.930 yuan）Furthermore，a discernible correlation between hospitalization cost and length of stay was identified．Conclusions Cardiovascular diseases and disorders of blood and hematopoietic organs are the primary causes for maternal admissions to ICU．Economic analysis shows that musculoskeletal system and connective tissues diseases cause bigger economic loss ．
目的 探讨情景模拟式健康教育对飞秒激光小切口角膜基质透镜取出手术（SMILE）患者的应用效果，提高手术患者术中的配合度。方法 随机选取2020年6月—12月于我院拟进行SMILE手术患者200例，随机分为观察组和对照组，各100例，其中对照组采用常规术前健康教育，观察组采用情景模拟宣教视频的方式实施术前健康教育。比较两组患者围术期依从性、焦虑自评量表（SAS）和SMILE手术知识知晓率。结果 观察组患者围术期依从性和SMILE手术围术期知识知晓率得分高于对照组、患者术前焦虑水平低于对照组，差异均有统计学意义（P＜0.05）。结论 情景模拟式健康教育能有效提升SMILE手术患者围术期依从性，减轻患者手术紧张的情绪，提升患者SMILE手术围术期健康知识知晓率，提升就医体验及手术成功率。
Objective To explore the application effect of scenario simulation based health education on patients undergoing small incision lenticule extraction（SMILE），in order to improve the cooperation of surgical patients．Methods From June to December in 2020，200 patients who were scheduled to undergo SMILE in the hospital were randomly selected and divided into an observation group and a control group，with 100 patients in each group．The control group received routine preoperative health education，while the observation group received preoperative health education through scenario simulation educational videos．The perioperative adherence of patients，Self Rating Anxiety Scale（SAS），and SMILE surgical knowledge awareness rates were compared between patients of two groups．Results The observation group had higher scores in perioperative adherence of patients and perioperative knowledge awareness of SMILE surgery than the control group，and lower preoperative anxiety levels than the control group，with statistically significant differences（P＜0.05）．Conclusions Scenario simulation based health education can effectively improve the adherence of SMILE patients，alleviate their surgical anxiety，enhance their awareness of perioperative health knowledge，improve their medical experience，and increase the success rate of the surgery．
目的 探讨出生胎龄＜37周早产儿发生败血症时的临床特征及其不良结局的危险因素。方法 收集2020年1月—2023年12月安徽医科大学第一附属医院本部新生儿科收治出生胎龄＜37周且发生败血症早产儿的临床资料；根据败血症发生时间分为早发型败血症（EOS）49例，晚发型败血症（LOS）150例；根据是否出现不良结局，分为结局不良组90例，结局良好组109例。分析EOS和LOS败血症的临床特征，并采用多因素Logistic回归分析早产儿败血症出现不良结局的危险因素。结果 早产儿败血症中EOS患儿出生胎龄更小，生后1 min Apgar评分更低，孕母羊水污染、胎膜早破≥18 h发生率较LOS更高（P＜0.05）；早产儿败血症临床表现无特异性，但LOS患儿休克发生率更高（P＜0.05）；早产儿易发生革兰阴性菌感染，合并先天性心脏病（OR=2.490，P＜0.05）、出生胎龄＜30周（OR=4.851，P＜0.05）、出生体质量小于1 500 g（OR=4.169，P＜0.05）是早产儿败血症发生不良结局的危险因素。结论 早产儿败血症临床表现无特异性，更易发生革兰阴性菌感染，出生胎龄越小、体质量越低发生不良结局的风险更高。
Objective To analyze the clinical characteristics and risk factors of adverse outcomes of sepsis in premature infants with gestational age ＜ 37 weeks．Methods Clinical data of preterm infants ＜ 37 weeksof gestational age admitted to the Department of Neonatology of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2023 were collected．According to the timing of sepsis，49 cases with early-onset sepsis（EOS）and 150 cases with late-onset sepsis（LOS）were diagnosed．According to the outcome，90 cases were divided into the adverse outcome group and 109 cases were good outcome group．The clinical characteristics of EOS and LOS were analyzed，and the risk factors of adverse outcomes were analyzed by multivariate logistic regression．Results The gestational age of EOS infants was smaller at birth，the 1 minute Apgar score was lower ，and the incidence of amniotic fluid contamination and premature rupture of membranes ≥18h were higher than those in LOS infants（P＜0.05）．The clinical manifestations of sepsis in premature infants were not specific，but the incidence of shock was higher in LOS children（P＜0.05）．Preterm infants were more likely to develop gram-negative bacterial infection，congenital heart disease（OR=2.490，P＜0.05），gestational age ＜30 weeks（OR=4.851，P＜0.05），and birth weight ＜ 1 500 g（OR=4.169，P＜0.05）were identified as significant risk factors for adverse sepsis outcomes in preterm infants．Conclusions The clinical manifestations of septicemia in preterm infants are non-specific，and they are more likely to suffer from gram-negative bacterial infection．The younger the gestational age and lower the birth weight of preterm infants，the higher the risk of adverse outcomes after sepsis．
目的 回顾分析高原地区儿童阑尾炎术后早期炎性肠梗阻的临床特征，总结治疗经验。方法 回顾分析青海省妇女儿童医院2019—2023年收治的49例儿童阑尾炎术后早期炎性肠梗阻病例资料。结果 纳入研究的49例患儿，阑尾炎发病时间3～8 d，平均（5.38±1.25）d，术后出现肠梗阻时间3~11 d，平均时间（4.81±1.70）d，其中48例经过保守治疗后梗阻解除，恢复排气、排便，肠功能恢复时间4~13 d，平均（5.93±2.49）d，1例经积极保守治疗后病情进展，最终经手术治愈。49例患儿均顺利治愈出院，住院时间10～26 d，平均（15.69±3.79）d。术后随访1～2年，患儿饮食、排便均无异常。结论 高原地区儿童阑尾炎术后早期粘连性肠梗阻预防是关键，采取保守治疗同样可获得较高的治愈率，若保守治疗无效或病情进展应及时积极采取手术治疗。
Objective To review the clinical characteristics of early postoperative inflammatory small bowel obstruction（EPISBO） in children with appendicitis in plateau area and summarize the treatment experience．Methods The data of 49 cases of appendicitis EPISBO in children admitted to Qinghai Women and Children’s Hospital from 2019 to 2023 were retrospectively analyzed．Results The onset time of appendicitis was 3-8 days，with an average of（5.38±1.25）days，and the time of intestinal obstruction was 3-11 days after surgery，with an average of（4.81±1.70）days．After conservative treatment，48 cases were relieved of obstruction，resumed exhaust and defecation，and intestinal function recovered in 4-13 day，average（5.93±2.49）d，1 case had progression after conservative treatment，and was cured by surgery．All the 49 children were successfully cured and discharged．The length of hospital stay was 10-26 days，with an average of（15.69±3.79）days．Postoperative follow-up of 1 to 2 years showed normal eating and bowel movements．Conclusions The prevention of EPISBO in children with appendicitis in plateau area is the key．Conservative treatment can also achieve a higher cure rate．If conservative treatment is ineffective or the disease progresses，timely surgical treatment should be provided．
无创正压通气的使用是患者发生鼻面部压力性损伤的重要原因之一，随着我国防控政策的放开，新增老年新冠感染患者急剧增加。文章对使用无创正压通气发生相关压力性损伤现状进行综述，介绍老年患者使用无创正压通气发生鼻面部压力性损伤的主要影响因素、评估方法以及预防措施现状，旨在为临床医务人员预防其相关压力性损伤提供参考。
The use of non-invasive positive pressure ventilation is one of the important reasons for nasal and facial pressure injuries in patients．With the release of China's epidemic prevention policy，the number of new elderly patients with COVID-19 has increased dramatically．This paper summarizes the current situation of stress injuries caused by noninvasive positive pressure ventilation，introduces the main influencing factors，evaluation methods and prevention measures of nasal and facial stress injuries in elderly patients with noninvasive positive pressure ventilation，aiming to provide a reference for clinical medical personnel to prevent their related stress injuries．
放射治疗（放疗）可以提高妇科恶性肿瘤患者的总体生存率，降低复发率，增加手术机会。但肿瘤周围的健康组织不可避免地会进入电离辐射区域从而导致阴道狭窄、缩短和失去弹性，文章结合近年来国内外的放疗后阴道损伤治疗方式进行综述，总结分析治疗的优缺点，旨在为放疗后阴道损伤的临床治疗提供帮助。
Radiotherapy can improve the overall survival rate，reduce the recurrence rate and increase the chance of surgery in patients with gynecological malignant tumors．However，the healthy tissue around the tumor can inevitably be included the ionizing radiation area，resulting in vaginal stenosis，shortening and loss of elasticity．This paper reviews the treatment methods of post-radiotherapy vaginal injury at home and abroad in recent years，to summarize and analyze theadvantages and disadvantages of treatment，aiming to provide help for the clinical treatment of post-radiotherapy vaginal injury．
运动可以调节机体代谢，预防和治疗由糖脂代谢紊乱所引发的心血管疾病。运动因子是在运动过程中，由肌肉、脂肪以及肝脏等多个组织合成和分泌的一系列生物活性物质，包括蛋白质和多肽类分子、小分子代谢物以及核酸等。诸多研究证实，运动因子是运动调节机体代谢的重要因素之一，也是机体从运动中获益的关键分子机制。近年来，随着蛋白质组学、代谢组学以及高通量测序等相关技术的飞速发展，越来越多的运动因子被陆续发现和证实。这不仅拓宽了人们对机体从运动中获益相关机制的认知，还激发了人们对运动因子在健康领域应用前景的浓厚兴趣。文章系统地阐述了运动因子对机体心血管系统的影响，旨在揭示运动因子在促进心血管健康以及治疗心血管疾病等方面的积极效用。
Exercise can prevent and treat cardiovascular diseases resulting from the metabolic disorders of glucose and lipid．Exerkines are defined as a series of bioactive substances in response to exercise including proteins，peptides，small molecular metabolites and nucleic acids．Multiple tissues can produce exerkines，such as skeletal muscle，adipose tissue，and liver．Many studies indicate that exerkines play essential roles in improving glucose and lipid metabolism，which are crucial to harness the health-related benefits mediated by exercise．In recent years，with the progression of proteomics，metabolomics and high-throughput sequencings，an increasing number of exerkines are discovered．These findings expand the research on beneficial effects of exercise and draw attention to the clinical implications of exerkines．This review aims to explore the influence of exerkines on cardiovascular system and reveal their potential roles in the prevention and treatment of cardiovascular disease．
目的 通过对广东省下的卫生资源配置的公平性进行分析，找出当前卫生资源配置存在的问题并提出优化建议，以进一步减少健康不平等的现象，为实现广东省均衡化配置卫生资源的“十四五”目标提供实践参考依据。方法 收集整理《广东省统计年鉴》中2018—2022年相关数据，采用集聚度法、空间自相关分析，从人口、地理、空间三个纬度对卫生资源分布的公平性进行分析。结果 珠三角、粤东地区的卫生资源配置公平性，在地理维度上较高，人口维度上较低；粤西、粤北地区的卫生资源配置的公平性与之相反。在空间分布上，2018年部分城市的卫生资源分布呈现出一定的空间集聚特征，但到2022年这种空间集聚特征均弱化，空间自相关性消失。结论 广东省卫生资源在地域之间存在分布不均衡情况，其配置公平性有待提升。尽管空间自相关消失可能意味着资源不再集中在某些特定区域，但政策制定者在未来进行卫生资源规划时，要考虑如人口密度、经济发展水平等因素给各地区带来的影响，以进一步促进资源的均等化配置。
Objective By analyzing the equity of health resource allocation in Guangdong Province，to identify the current problems in health resource allocation and put forward optimization suggestions to further reduce health inequalities and provide practical references for achieving the “14th Five-Year Plan” goal of balanced allocation of health resources in Guangdong Province．Methods Relevant data from 2018-2022 in the Guangdong Provincial Statistical Yearbook were collected and organized，and the equity of health resource distribution was analyzed in three dimensions：demographic，geographic and spatial，by using the agglomeration method and spatial auto-correlation analysis．Results The equity of health resource allocation in the Pearl River Delta and Guangdong East regions was higher in geographical dimension and lower in population dimension；the equity of health resource allocation in Guangdong West and Guangdong North regions was the opposite．In terms of spatial distribution，the distribution of health resources in some cities showed some spatial clustering characteristics in 2018，but all such spatial clustering characteristics weakened and spatial auto-correlation disappeared by 2022．Conclusions Health resources in Guangdong Province were unbalanced in terms of their geographic distribution，and the equity of their allocation needs to be improved．Although the disappearance of spatial auto-correlation may mean that resources are no longer concentrated in certain regions，policymakers should consider the impact of factors such as population density and level of economic development on regions when planning health resources in the future to further promote the equalization of resource allocation．
