随着糖尿病发病率不断攀升，人们逐渐聚焦于糖尿病合并骨质疏松。围绕此疾病，国内外学者开展了广泛而深入的研究，临床实践聚焦于两点：糖尿病的精准治疗和骨质疏松的有效干预。在确保血糖稳定的基础上，致力于抑制骨吸收、促进骨形成。在此治疗理念指导下，临床医生应当更加全面了解血糖管理与抗骨质疏松药物的作用机制并合理应用，更大程度改善患者的临床症状及预后。然而，药物作用机制复杂，联合应用存在潜在药物相互作用问题。未来研究方向包括探索更安全有效的联合治疗方案，更加精确化地治疗以提高临床疗效。文章分析了降糖药物及抗骨质疏松药物对疾病的疗效，并展望未来的研究方向，旨在为临床实践提供更为深刻与全面的指导。
As the incidence of diabetes mellitus continues to rise，people are also gradually focusing on diabetes mellitus combined with osteoporosis，which puts patients at a higher risk of fragility fracture．Scholars at home and abroad have conducted extensive and in-depth research around this condition，and clinical practice has focused on two points：first，the precise treatment of diabetes，and second，the effective intervention of osteoporosis．On the basis of ensuring blood glucose stabilization，we are committed to inhibiting bone resorption and promoting bone formation．Under the guidance of this therapeutic concept，we should have a more comprehensive understanding of the mechanism of action of blood glucose management and anti-osteoporosis drugs and apply them rationally，aiming to improve the clinical symptoms and prognosis of patients to a greater extent through dual intervention．However，the mechanism of action of different drugs is complex，and there are potential drug-drug interactions and safety issues associated with their combined use．Future research directions should include exploring safer and more effective combination therapies，developing novel drugs，and more precise and individualized treatments to improve clinical efficacy．This article analyzes the efficacy of glucose-lowering drugs and anti-osteoporosis drugs on the disease and looks forward to future research directions，aiming to provide more profound and comprehensive guidance for clinical practice．
根据美国国家胆固醇教育计划成人组第三次报告NECP-ATPⅢ会议定义，当男性年龄＜55岁，女性年龄＜65岁诊断为冠状动脉粥样硬化性心脏病（冠心病）时即为早发冠心病（pCAD）。作为冠心病的特殊类型之一，pCAD发生多伴明显家族史。近年来随着早发冠心病患者人数呈明显上升趋势，且单核苷酸多态性（SNP）研究和全基因组关联研究的迅速发展，与早发冠心病相关的基因多态性研究成为热点。笔者利用多个文献数据库检索国内外相关文献，对近年早发冠心病的基因多态性研究进展予以综述，并尝试归纳总结出新的重点研究方向。
According to the third meeting of the Adult Education Group of the Cholesterol Education Program of the United States（NECP-ATPⅢ），premature coronary artery disease（pCAD）is a disease diagnosed in men ＜55 years old and women ＜65 years old，which is a special form of CAD with multiple obvious family history．In recent years，with the increasing number of patients with pCAD，and the rapid development of single nucleotide polymorphism（SNP）and genome-wide association studies，the study of gene polymorphism related to premature coronary artery disease has become a hot topic．Several database were searched to collect relevant literature at home and abroad，and the research progress of gene polymorphism of premature coronary artery disease in recent years was summarized，and tried to provide new key research directions．
炎症性肠病（IBD）是一种以反复腹痛、腹泻、血便和体重降低为主要表现的慢性特发性性疾病，主要分为溃疡性结肠炎与克罗恩病两种类型。近年来，IBD的患病率随着城市化和工业化进展迅速升高，给中国和全球的公共健康带来沉重的负担。随着人类基因组技术的发展，越来越多的证据表明，遗传学因素在IBD发病过程中起着不可或缺的作用。在亚欧人群中，通过大规模全基因组关联研究现已明确了320个IBD易感基因位点。IBD易感基因在影响机体的细胞代谢、免疫功能调节、肠道上皮屏障和微生物清除等多个方面发挥着重要作用。本文就IBD相关易感基因及其多态性的研究进展进行综述，从基因层面揭示IBD发病的分子机制，并对探索IBD因人而异的个性化治疗方案提供帮助。
Inflammatory bowel disease（IBD）is a chronic idiopathic disease characterized by recurrent abdominal pain，diarrhea，bloody stools，and weight loss．Ulcerative colitis and Crohn’s disease represent the two main types of IBD．In recent years，the prevalence of IBD has increased rapidly with the advancement of industrialization，imposing a heavy burden on public health in China and globally．Currently，with the development of genomics，a growing body of evidence suggests that genetic factors play an indispensable role in the pathogenesis of IBD．In the Eurasian population，320 IBD susceptibility gene loci have been identified through large-scale genome-wide association studies．IBD susceptibility genes play a crucial role in various aspects affecting cellular metabolism，immune function regulation，intestinal epithelial barrier，and microbial clearance．This article reviews the susceptibility genes and their polymorphisms associated with IBD，revealing the molecule mechanisms of IBD from gene perspectives and contributing to the development of personalized treatment strategies tailored to individual IBD patients．
结直肠癌（CRC）是全球第三大最常见的癌症，也是癌症相关死亡的第二大常见原因。结直肠癌肝转移（CRLM）是导致CRC患者死亡的主要原因，根治性肝切除术是目前有望治愈CRLM的唯一途径，但大部分患者不能进行根治性肝切除术。通过早期发现并进行针对性干预，能够改善患者的治疗效果及预后。文章通过综述CRLM的发病机制、诊疗现状及最新纳米诊疗方法，为深入探索高效诊疗方法提供思路。
Colorectal cancer（CRC）is the third most common cancer and the second most common cause of cancer-related death worldwide．Colorectal cancer liver metastases（CRLM）are the leading cause of death in patients with CRC．Radical hepatectomy is the only way to cure CRLM so far，while most patients cannot undergo radical hepatectomy．CRLM treatment efficacy and prognosis can be improved by early diagnosis and specialized intervention．This paper reviews the pathogenesis，diagnosis，and treatment status of CRLM and the latest nano-diagnosis and treatment methods so as to provide ideas for in-depth exploration of efficient diagnosis and treatment methods．
目的 探讨导言-目标-前测-对照-后测-总结（BOPPPS）教学模式在基层护理培训中的应用效果。方法 采用类实验研究方法，将2021年5月—2021年12月参加培训的96名护士设为对照组，使用传统教学模式，将2022年1月—2022年12月参加培训的325名护士设为研究组，使用BOPPPS教学模式。对两组学员的教学效果通过理论、操作考核及问卷调查进行比较。结果 对照组学员理论知识、技能操作以及培训满意度均高于对照组，差异均有统计学意义（均P＜0.05）。结论 BOPPPS教学模式在基层护理实训课中具有重要意义，可提高学员理论和技能操作能力，提升学员满意度。
Objective To explore the application effect of BOPPPS teaching mode in nursing primary training．Methods Adopting class experimental research method，96 nurses who participated in the training from May 2021 to December 2021 were the control group，using the traditional teaching method．The 325 nurses who participated in the training from January 2022 to December 2022 were set up as a study group using the BOPPPS teaching model．The teaching effectiveness of the two groups of nurses was compared through theoretical and operative examinations and questionnaires．Results The theoretical knowledge，skill operation and training satisfaction of the trainees in the experimental group were higher than those in the control group，and the differences were statistically significant（P＜0.05）．Conclusions BOPPPS teaching mode is of great significance in nursing primary practical training course，which can improve the theory and skill operation ability of trainees and enhance the satisfaction of trainees．
目的 旨在通过实证了解广东省青年中医人才岗位胜任力现状，探讨青年中医人才岗位胜任力素质特征，为青年中医人才培养提供策略。方法 通过专家咨询制定《青年中医人才岗位胜任力评价框架》并开展问卷调查，采用SPSS 26.0进行数据分析。结果 构建了包含8个一级指标、76个二级指标的《青年中医人才岗位胜任力评价框架》；广东省青年中医人才岗位胜任力自评总分整体处于及格以上水平。女性在职业价值和职业素养、临床技能、交流与沟通技能、管理能力和团队合作、批判性思维与学术科研能力的评分高于男性；不同职称在其他附加维度的评分比较具有统计学差异（P＜0.05）。结论 构建的评价框架能够有效评估青年中医人才岗位胜任力；广东省青年中医人才岗位胜任力整体处于及格水平，需重视补强短板；女性青年中医人才岗位胜任力多个维度的得分优于男性，着重提升各人群的弱项维度岗位胜任力；进一步建立健全职称评聘制度，以破五唯为导向构建符合不同级别职称的青年中医人才评价机制。
Objective To understand the current job competence status of young TCM talents in Guangdong Province through empirical research，to explore the characteristics of job competence and quality of young TCM talents，providing strategy for cultivating young talents in TCM．Methods The “Competency Evaluation Framework for Young TCM Talents” was developed through expert consultation and a questionnaire survey was conducted．SPSS 26.0 was used for data analysis．Results “Job Competency Evaluation Framework for Young TCM Talents” was constructed，which included 8 primary indicator items and 76 secondary indicator items．The overall self-evaluation score of the overall job competence of young TCM talents in this study was above the passing level．Female score was higher than male in terms of professional value and professional ethics，clinical skills，communication and interpersonal skills，management ability and teamwork，critical thinking and academic research ability．There were statistically significant differences in the scores of different job titles in other additional dimensions（P＜0.05）．Conclusions The constructed evaluation framework can effectively assess the job competence of young TCM talents．The overall competence of young TCM talents in Guangdong Province is at a passing level，and attention should paid to strengthening their weaknesses．Female young TCM talents have better multidimensional scores in job competence than males，and efforts should be made to focus on improving the weak dimensional job competence of various groups of people．The professional title evaluation and appointment system needs to be established and improved．A talent evaluation mechanism should be built for young TCM talents that meets different levels of professional titles，guided by the principle of breaking the five criteria．
目的 提示临床在使用解郁化痰安神颗粒过程中，予以关注其发生的药物不良反应，同时进一步重视中成药及中药制剂带来的药物不良反应，并与中医药当中的瞑眩反应予以区分。方法 通过分析1例解郁化痰安神颗粒致失眠不良反应，基于中国知网、万方数据知识服务平台等国内数据库，对不良反应发生机制予以分析、讨论。结果 本次解郁化痰安神颗粒致失眠不良反应1例，不良反应相关性评价为“可能”，根据临床观察，可能为中药中典型的“瞑眩反应”。结论 临床当发现基于中成药的不良反应，应予以分析辨别，及时处置药物不良反应，进一步观察研究瞑眩反应。
Objective To suggest that during the clinical use of Jieyu Huatan Anshen Granules，attention should be paid to its adverse drug reactions，and further attention should be paid to the adverse drug reactions caused by traditional Chinese patent medicines and simple preparations and traditional Chinese medicine preparations，and it should be distinguished from the insomnia and dizziness reactions in traditional Chinese medicine．Methods A case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was analyzed based on domestic databases such as CNKI and Wanfang data to investigate and discuss the mechanism of adverse reactions．Results One case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was reported，and the correlation evaluation of the adverse reaction was “possible”．According to clinical observations，it may be a typical “dizziness reaction” in traditional Chinese medicine．Conclusions When adverse reactions based on traditional Chinese medicine decoction，traditional Chinese patent medicines and simple preparations and other traditional Chinese medicine preparations are found in clinical practice，they should be analyzed and identified，and the adverse reactions should be handled in time and be further observed and studied．
目的 分析现代文献中穴位贴敷疗法干预矮小症研究现状，为临床治疗该病提供依据。方法 整理近2018年1月—2023年12月6年间国内医学期刊上公开发表的关于穴位贴敷疗法治疗矮小症的中文文献，对文献年代分布、发表期刊、研究内容、贴敷穴位、贴敷药物、贴敷的时间、频次、治疗时间、观察指标、中西医结合治疗矮小症、不良反应等进行统计分析。结果 最终纳入的文献共10篇，近6年间均有相关文献发表；发表期刊《中医儿科杂志》《新中医》《中国现代医生》《中医外治杂志》《中国中西医结合儿科学》；研究内容涉及矮小症分型、穴位贴敷联合重组人生长激素法、畲医法、中药内服法、拉伸操法、营养干预指导、推拿等方法治疗矮小症。结论 穴位贴敷疗法联合其他疗法在临床上对儿童矮小症的改善效果显著，不良反应轻微，相信随着矮小症成因的进一步明确，穴位贴敷疗法治疗矮小症的机制会更加清晰，为改善矮小症提供科学理论依据，同时，为矮小症等相关疾病的治疗提供新思路。
Objective To analyze the research status of acupoint application therapy in short stature from January 2018 to December 2023，and to provide basis for clinical treatment of the disease．Methods To review the Chinese literature published in domestic medical journals in recent 6 years on the treatment of short stature by acupoint application therapy，including the distribution of time and journals，the research contents，the acupoint application，the drug application，the application time，the treatment frequency and duration，the observation index，treatment of short stature with integrated traditional，Chinese and Western medicine and adverse reactions were statistically analyzed．Results There were 10 articles in this review，and all of them were published in the past 6 years，published journal were Pediatrics of Traditional Chinese medicine，new Traditional Chinese medicine，modern Chinese doctor，Journal of external treatment of traditional Chinese medicine，Pediatrics of integrated traditional Chinese and Western medicine in China．The research content involved the short stature classification，acupoint application combined with recombinant human growth hormone therapy，the She medical therapy，traditional Chinese medicine，stretching manipulation，nutrition intervention guidance，massage and other methods．Conclusions The combination of acupoint application therapy and other therapies has a significant clinical effect on the improvement of short stature in children，with slight adverse reactions．It is believed that with the further clarification of the causes of short stature，the mechanism of point application therapy for short stature will be more clear and provide scientific basis for improving short stature．At the same time，it may provide a new idea for the treatment of dwarfism and other related diseases．
急性胰腺炎（AP）是一种常见的消化系统急症。随着生活水平的提高，其重症发病率也逐年增加。中西医结合治疗急性胰腺炎在临床实践中展现出优势。近年来，大柴胡汤合大承气汤在治疗急性胰腺炎方面药理机制的研究不断延伸，同时对方药中的药理活性成分也在不断深入研究。该文旨在整理相关研究，综述大柴胡汤合大承气汤治疗急性胰腺炎的理论基础、临床应用、药物活性成分、药理机制等，以期为临床实践和进一步深入研究提供参考。
Acute pancreatitis（AP）is a common gastrointestinal emergency．With the improvement of living standards，the incidence of severe AP has been increasing year by year．The combined treatment of traditional Chinese and Western medicine has shown advantages in the clinical practice of acute pancreatitis．In recent years，the pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis has been continuously studied，and the pharmacological active components in the prescription are also being explored．This article aims to summarize relevant research on the theoretical basis，clinical application，active ingredients and pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis，providing reference for clinical practice and further research．
胰源性门静脉高压（PSPH）是由脾静脉（SV）流通受阻引起的一种临床综合征，在临床较为罕见且对患者造成生命威胁，但却为门静脉高压唯一可治愈的类型。其主要发病诱因是胰腺原发疾病，通常为胰腺急（慢）性炎症、胰腺占位性病变和胰腺手术操作导致。1型孤立性食管胃底静脉曲张、脾大、脾功能亢进是PSPH的主要临床表现特征，其中食管胃底曲张静脉破裂出血是PSPH最为严重的并发症；患者若表现为肝功能正常但出现原因不明脾肿大并伴有消化道出血症状，应考虑可能出现了PSPH。PSPH的治疗可分为胰腺原发病、门静脉高压及并发症的综合性诊治。本文旨在回顾PSPH的相关文献，对其有关临床诊断与治疗现状进行综述，以期指导医务工作者在临床中尽早发现PSPH并对患者及时有效治疗。
Pancreatic segmental portal hypertension（PSPH）is a clinical syndrome caused by spleen vein（SV）occlusion or stenosis．It is a rare and life-threatening hemorrhagic disease of the upper digestive tract，but it is the only curable type of portal hypertension．The main cause is primary pancreatic disease，which is usually due to acute or chronic pancreatic inflammation，pancreatic space-occupying lesions and pancreatic surgery．Type 1 isolated esophagogastric varices，splenomegaly and hypersplenism are the main clinical features of PSPH，and esophagogastric variceal bleeding is the most serious complication of PSPH．PSPH should be considered in patients with normal liver function but unexplained splenomegaly accompanied by gastrointestinal bleeding．The treatment of PSPH can be divided into a comprehensive diagnosis and treatment of primary pancreatic disease，portal hypertension and complications．Therefore，the purpose of this paper is to review relevant literature of PSPH，the relevant clinical diagnosis and treatment status quo were summerized，in order to guide the medical workers in clinical PSPH，early detection and timely and effective treatment for patients．
