目的 分析长链非编码RNA LINC02038的表达与子宫内膜癌发生、发展的关联性,并探讨其潜在的生物学调控机制,为子宫内膜癌的精准诊治提供科学线索。方法 采用荧光定量PCR技术检测LINC02038 在2019年—2020年期间于我院收集的42例子宫内膜癌标本及相应癌旁正常组织中的表达差异。构建LINC02038过表达载体并转染子宫内膜癌Ishikawa 细胞系,通过CCK-8、Transwell等功能实验验证其对肿瘤细胞增殖、侵袭能力的影响。利用TCGA公共数据库分析LINC02038与子宫内膜癌预后的相关性,并通过基因本体论（GO）、京都基因组百科全书（KEGG）及基因集富集分析（GSEA）等生物信息学方法预测其潜在的下游调控机制。结果 LINC02038在子宫内膜癌组织中的表达高于癌旁正常组织（P<0.001）。过表达LINC02038可促进子宫内膜癌细胞Ishikawa的增殖和迁移。生物信息学分析提示LINC02038可能通过调控细胞分化、激素分泌、细胞外基质重塑等过程,激活NF-κB、细胞外基质受体等信号通路影响子宫内膜癌的发生。结论 LINC02038的异常表达与子宫内膜癌的发生、发展相关联,可作为评估子宫内膜癌发病风险的候选生物标志物。

Objective To analyze the expression of long non-coding RNA LINC02038 and its relationship with the occurrence and development of endometrial carcinoma（EC）,explore its potential biological mechanisms,and provide potential biomarkers for targeted therapy of EC．Methods Quantitative real-time PCR was used to detect the expression levels of LINC02038 in 42 EC tissues and their adjacent tissues．The LINC02038 overexpressin vector was constructed and transfected into EC Ishikawa cells．CCK-8,Transwell migration and invasion assays were performed to examine the effects of LINC02038 overexpression on cancer cell proliferation,migration and invasion．Public TCGA data were analyzed to investigate the associations between LINC02038 and EC pathogenesis and prognosis．GO,KEGG and GSEA enrichment analyses were conducted to elucidate the potential biological mechanisms of LINC02038．Results LINC02038 expression was significantly upregulated in EC tissues compared to adjacent non-tumor tissues（P<0.001）．Overexpression of LINC02038 markedly promoted the proliferation and migration of Ishikawa cells．Bioinformatics analysis suggested that LINC02038 may participate in regulating cell differentiation,hormone secretion,extracellular matrix remodeling and other processes,as well as activating NF-κB,extracellular matrix receptor and other signaling pathways involved in endometrial carcinogenesis．Conclusions The aberrant expression of LINC02038 is associated with EC occurrence and may serve as a potential biomarker for assessing the risk of this cancer．

如何降低急性胰腺炎的病死率是一项意义重大的课题。日本2021版诊疗指南提出了对急性胰腺炎患者的“集束化管理措施”,在此指导下,日本急性胰腺炎总体病死率下降至2.6%,重症急性胰腺炎病死率下降至6.1%,远低于全球各国报道的病死率。本文对该指南之诊疗方案进行分析,并与我国现行指南进行对比,以期对AP患者的临床诊治提供指导意义,并期待日后有更多更深入的该领域相关研究。

It is a significant problem that how to reduce the mortality rate of acute pancreatitis．However,under the guidance of the Pancreatitis Bundles from the 2021 Edition of the Japanese Guidelines for Acute Pancreatitis of patients with acute pancreatitis,the overall fatality rate of acute pancreatitis in Japan has decreased to 2.6%,and the fatality rate of severe acute pancreatitis has decreased to 6.1%,which is much lower than the fatality rate reported around the world．We analyze the diagnosis and treatment methods of this guideline and compare it with the current guideline in China,in order to have more relevant studies in the future．

通过筛查和早期发现,可以降低结直肠癌（CRC）的发病率,有效切除肿瘤病变可以降低CRC的病死率。虽然对CRC的危险因素、发病机制和前体病变的了解已经取得进展,但最近年轻人群CRC发病率升高,原因尚不清楚。在过去十年中,出现了多种侵入性、半侵入性和非侵入性筛查方式。目前对结肠镜检查质量的重视提高了筛查的有效性,人工智能等影像新技术在肿瘤检测中的作用正在迅速显现。而且,CRC有效干预措施,如保肛治疗新术式、靶向治疗及免疫治疗领域的新进展,被证明可以提高CRC患者的生存率。该文旨在总结目前国内外CRC筛查方式和指南的证据,并综述CRC治疗领域的进展。

The incidence of colorectal cancer（CRC）can be reduced through screening and early detection．Effective resection of tumor lesions reduces mortality from CRC．Although progress has been made in understanding the risk factors,pathogenesis and precursor lesions of CRC,the reasons for the recent increase in the incidence of CRC in young adults are largely unknown．A variety of invasive,semi-invasive and non-invasive screening modalities have emerged in the last decade．The current emphasis on the quality of colonoscopy has improved the effectiveness of screening,and the role of new imaging technologies such as artificial intelligence in tumor detection is rapidly emerging．Moreover,there are effective interventions for CRC,such as new surgical modalities for anal preservation therapy,and new advances in the field of targeted therapy and immunotherapy,which have been shown to improve the survival rate of CRC．The aim of this article is to summarize the current evidence on CRC screening modalities and guidelines both nationally and internationally,and to provide an overview of advances in the field of CRC treatment．

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．

目的 分析医院门诊西药房“分-全带教”模式的应用效果,为提高药房实习生的教学质量提供参考价值。方法 选取广州市番禺区中心医院药学部门诊西药房2020年9月—2022年7月的48例实习生（包含进修生、研究生）作为研究对象,对所有实习生实施“分阶段、分层级、分诊断单元窗口学习、全面能力培养”的“分-全带教”模式。观察所有实习生入科实习前后的考核成绩。结果 通过“分-全带教”实施后,实习生的理论知识（94.15±3.38）分、药学服务技能评分（90.56±3.99）分均比实习前有所提升,且实习生的学习兴趣（94.21±3.70）分、巩固知识点（91.98±3.56）分、提高医患沟通（92.73±3.81）分、认识自身技能不足（92.06±3.50）分同时提升（P<0.05）。结论 采用“分-全带教”模式明显提升对医院门诊西药房的实习生中的教学效果,实习生的理论和实践技能均有所提高,其药学服务能力同时得到提高。

Objective To analyze the application effectiveness of the “divided-comprehensive precepting” model in the hospital outpatient pharmacy and provide reference value for improving the teaching quality of pharmacy interns．Methods Forty-eight interns（including visiting scholars and graduate students）from the Pharmacy Department of Panyu Central Hospital in Guangzhou,China,from September 2020 to July 2022 were selected as the research subjects．The “divided-comprehensive precepting” model,characterized by “staged,tiered,diagnosis unit-specific window learning,and comprehensive competency development” was implemented for all interns．The scores of all interns before and after entering the internship were observed．Results After the implementation of the“divided-comprehensive precepting”model,the scores of interns in theoretical knowledge（94.15±3.38）and pharmaceutical service skills（90.56±3.99）were improved compared to those before the internship．Moreover,interns’scores in learning interest（94.21±3.70）,consolidating knowledge（91.98±3.56）,enhancing doctor-patient communication（92.73±3.81）and recognizing their own skill deficiencies（92.06±3.50）were also improved．Conclusions The “divided-comprehensive precepting” precepting model significantly enhances the teaching effectiveness in the internship of hospital outpatient pharmacy．Interns’ theoretical and practical skills are improved,enhancing their pharmaceutical service capabilities．

目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/（min·kg）]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/（min·kg）]及并发症比较差异均无统计学意义（P>0.05）。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。

目的 探讨基于态度-定义-开放思维-计划-实施（ADOPT）模式的健康教育联合情绪引导对消化内镜诊疗患者配合度的影响。方法 选取2020年1月—2023年1月在我院准备行消化内镜诊疗的80例住院患者,随机分为观察组与对照组各40例。对照组患者在检查前采取常规护理,观察组患者在常规护理基础上增加基于ADOPT模式的健康教育联合情绪引导,在护理前后应用简明心境量表（POMS-SF）分别评估两组患者负面情绪、诊疗配合度、基础值（T₁）、入镜时（T₂）、检查开始后5 min（T₃）、检查结束时（T₄）的Ramsay镇静评分和舒适度评分,并对比两组患者的护理满意度。结果 护理后两组患者的困惑、活力、疲劳、抑郁、生气和紧张方面的POMS-SF评分降低,且观察组低于对照组（P<0.05）;观察组患者配合度为95.00%,高于对照组75.00%（P<0.05）;两组患者T1时间Ramsay镇静评分与舒适度评分比较差异无统计学意义（P>0.05）,观察组T₂、T₃、T₄时间Ramsay镇静评分高于对照组,舒适度评分优于对照组（P<0.05）;观察组患者的总满意度高于对照组（P<0.05）。结论 对消化内镜诊疗患者采取基于ADOPT模式的健康教育联合情绪引导可改善患者内镜诊疗过程前的负面情绪,提升患者配合度,同时能够改善患者诊疗过程中的镇静程度和舒适度,患者护理满意度较高。

Objective To explore the value of health education based on the ADOPT model combined with emotional guidance on the cooperation of patients undergoing digestive endoscopy diagnosis and treatment．Methods From January 2020 to January 2023,80 hospitalized patients who were going to have digestive endoscopy diagnosis and treatment in our hospital were selected as the research subjects．All patients were divided into observation group and control group,with 40 patients in each group．The control group patients received routine care before the examination,while the observation group patients added ADOPT based health education combined with emotional guidance on the basis of routine care．The Profile of Mood States-Short Form（POMS-SF）was used to evaluate the negative emotions of the two groups of patients before and after the examination．The diagnostic and treatment cooperation,basic value（T₁）,at the time of endoscopy（T₂）,and 5 minutes after the examination（T₃）,at the end of the examination（T₄）,the Ramsay sedation score and comfort score were compared between the two groups,and the nursing satisfaction of the two groups of patients was compared．Results After nursing,the POMS-SF scores of confusion,vitality,fatigue,depression,anger,and tension in the two groups of patients were significantly reduced,and the observation group was lower（P<0.05）．The cooperation rate of 95.00% in the observation group was significantly higher than that of 75.00% in the control group（P<0.05）．There was no significant difference in the Ramsay sedation score and comfort score between the two groups of patients at T₁ time（P>0.05）．The Ramsay sedation scores of the observation group at T₂,T₃,and T₄ time were higher,while the comfort score was lower（P<0.05）．The overall satisfaction of the observation group patients was higher（P<0.05）．Conclusions Adopting ADOPT based health education combined with emotional guidance for patients undergoing endoscopic diagnosis and treatment can improve their negative emotions before the endoscopic diagnosis and treatment process,enhance their cooperation level,and improve their level of sedation and comfort during the process．Patients have a high level of nursing satisfaction．

目的 探讨多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓发生率的影响。方法 选择2021年1月—2022年10月我院收治的70例下肢骨折患者,随机分为联合组与常规组,每组各35例。常规组患者实施常规护理,联合组患者实施多学科整合护理路径联合手术室优质护理,对比两组患者护理效果。结果 联合组患者首次下床活动时间、术后视觉模拟量表（VAS）评分低于常规组（P<0.05）,二者住院时间以及引流管拔除时间比较差异无统计学意义（P>0.05）;经过护理干预后,两组的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）均延长,血浆纤维蛋白原（FIB）降低,联合组优于常规组（P<0.05）,且联合组下肢静脉血栓发生率低于常规组（0% vs 17.14%,P<0.05）;联合组患者护理满意度更高（P<0.05）;术后1个月两组患者日常生活活动能力（ADL）评分、Fugl-Meyer评分均升高,联合组高于常规组（P<0.05）。结论 多学科整合护理路径联合手术室优质护理可改善下肢骨折患者围术期指标和血液高凝状态,降低患者下肢静脉血栓发生率,提升护理满意度及患者远期日常生活能力、肢体运动功能。

Objective To explore the application effect of multidisciplinary integrated nursing path combined with high-quality nursing in operating room on patients with lower limb fracture and the effect on postoperative lower limb venous thrombosis．Methods From January 2021 to October 2022,70 patients with lower limb fracture admitted to our hospital were randomly divided into combination group and conventional group,with 35 cases in each group．Patients in the conventional group received routine nursing,and patients in the combined group received multidisciplinary integrated nursing path combined with high-quality nursing in the operating room．The nursing effect of the two groups was compared．Results The first time of getting out of bed in the combined group was earlier and postoperative VAS score was lower than those in the conventional group（P<0.05）,and the length of hospital stay and drainage tube removal time were not significantly different between the two groups（P>0.05）．After nursing intervention,the prothrombin time（PT）and activated partial thromboplastin time（APTT）of the two groups were prolonged,and the plasma fibrinogen（FIB）decreased,and the change range of the combined group was greater（P<0.05）．The incidence of venous thrombosis in the combined group was significantly lower than that in the conventional group（0.00% vs 17.14%,P<0.05）．The nursing satisfaction of patients in combination group was higher（P<0.05）．The activities of daily living score and Fugl-Meyer score of both groups increased one month after surgery,and the combined group was higher than the conventional group（P<0.05）．Conclusions Multidisciplinary integrated nursing path combined with high-quality nursing in operating room can improve perioperative indicators and blood hypercoagulability of patients with lower limb fractures,reduce the incidence of lower limb venous thrombosis,improve nursing satisfaction,long-term daily living ability and limb motor function of patients．

目的 探讨头位分娩评分法在孕妇分娩过程中的应用价值。方法 选取2020年1月—2022年12月于郑州市妇幼保健院进行建档住院的4 000例待产分娩孕妇作为研究对象,所有孕妇在宫口已开时都给予头位分娩评分,观察与记录所有孕妇的分娩方式与头位分娩评分法状况,记录新生儿出生1 min与出生5 min的Apgar评分,记录所有孕妇的产后并发症发生情况。结果 在4 000例孕妇中,Apgar评分≤8分者156例、9~10分者894例、≥11分者2 950例。不同头位分娩评分法孕妇的年龄、孕周、孕次、产次对比差异无统计学意义（P>0.05）。≤8分者的剖宫产率为100.0%,9~10分者、≥11分者分别为35.3%、5.7%,对比差异有统计学意义（P<0.05）。≤8分者、9~10分者、≥11分者的新生儿出生1 min与出生5 min的Apgar评分对比差异无统计学意义（P>0.05）。≤8分者、9~10分者、≥11分者的产后发热、产后出血、产后血肿、产后尿潴留等并发症发生率为分别为13.5%、2.0%、0.2%,对比差异有统计学意义（P<0.05）。结论 头位分娩评分法在产科中处理头位分娩时具有指导价值,值得推广应用。

Objective To explore and analyze the application values of the head position delivery scoring method in the delivery process of 4 000 pregnant women．Methods Selected 4 000 cases of pregnant women as the study object,all pregnant women gave head delivery score,observed and recorded the delivery mode and head delivery scoring method,recorded the Apgar score of 1 min and 5 min,and recorded the occurrence of postpartum complications of all pregnant women．Results Among the 4 000 pregnant women,156 scored ≤8,894 scored 9-10,and 2 950 scored ≥11．There was no significant difference in the age,gestational age,pregnancy time and delivery status of pregnant women in different head delivery scoring methods（P>0.05）．The cesarean section of patients with ≤8 score was 100.0%,those with 9-10 score and those with ≥11 score were 35.3% and 5.7%,respectively,and there were significant differences（P<0.05）．There was no significant difference in Apgar score between newborns with ≤8 scores,9-10 scores and ≥11 scores at 1 min and 5 min after birth（P>0.05）．The incidence rates of puerperal fever,postpartum hemorrhage,postpartum hematoma and postpartum urinary retention were 13.5%,2.0% and 0.2% in patients with ≤8 score,9~10 score and ≥11 score,respectively,and there were significant differences（P<0.05）．Conclusions The head delivery scoring method has guiding value in handling head delivery in obstetrics and is worth promoting and applying．

目的 分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法 选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组（n=50）及参照组（n=50）。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果 治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义（P>0.05）,治疗后两组患儿的降钙素原（procalcitonin,PCT）、C-反应蛋白（C-reactive protein,CRP）、白细胞计数（white blood cell count,WBC）、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善（P<0.05）,其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率（94.00%）与参照组的临床有效率（86.00%）比较差异无统计学意义（P>0.05）;两组患儿的不良反应发生率比较差异无统计学意义（P>0.05）,但其中研究组腹泻的发生率高于参照组（P<0.05）。结论 在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药（头孢他啶）的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。

Objective To analyze the application effect of amoxicillin clavulanate potassium combined with third-generation cephalosporin antibiotics in children with neonatal pneumonia and its impact on the intestinal microbiota．Methods From February 2021 to November 2022,100 newborns with pneumonia who received relevant treatment in the Department of Neonatology at the First People’s Hospital of Shangqiu City were randomly divided into a study group（n=50）and a reference group（n=50）using a simple randomization method．Routine treatment was provided for neonatal pneumonia in the reference group,and on this basis,a combination treatment of amoxicillin,clavulanate potassium,and third-generation cephalosporin antibiotics was applied on the study group patients．After treatment,the serum factor levels,intestinal colony status,clinical efficacy,and incidence of adverse reactions were compared between the two groups of children．Results Before treatment,there were no statistically significant differences in serum factor levels and intestinal microbiota between the two groups of children（P>0.05）．After treatment,the levels of procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell count（WBC）,Enterococcus,Enterobacter,Bifidobacterium,and Lactobacillus in the two groups of children improved（P<0.05）,with the levels of PCT,CRP,WBC,the number of Enterococcus,Bifidobacterium,and Lactobacillus in the study group was lower than that in the reference group,while the number of Enterobacter in the study group was higher．There was no statistically significant difference（P>0.05）in the clinical response rate between the study group（94.00%）and the reference group（86.00%）．There was no statistically significant difference in the incidence of adverse reactions between the two groups of children（P>0.05）,but the incidence of diarrhea in the study group was higher than that in the reference group（P<0.05）．Conclusions The clinical efficacy of amoxicillin clavulanate potassium alone and amoxicillin clavulanate potassium+third-generation cephalosporin antibiotics（ceftazidime）in the treatment of newborns with pneumonia is comparable．Although the combination therapy can significantly reduce the number of bacteria in the body of children and improve serum factor levels,it is more prone to complications of diarrhea．In order to reduce drug resistance,separate medication should be appropriately used．