【摘要】目的:探讨器械护士术中分区精细化器械管理对心脏瓣膜置换术(HVR)手术效率及安全性的影响。方法:研究对象包括2024年6月~2026年5月至我院行HVR治疗的110例心脏瓣膜病(VHD)患者,以及同期参与手术的22名器械护士,采用随机数字表法将入组患者及护士分别列为常规组(55例患者、11名护士)、试验组(55例患者、11名护士),常规组内护士术中实施常规器械管理,试验组内护士术中实施分区精细化器械管理。比较两组患者的手术效率、围手术期安全事件,以及两组护士所参与手术的工作效率、术中器械管理情况。结果:在不同器械管理模式下,试验组内患者的主动脉阻断时间、体外循环时间、术中非必要等待时间、手术总耗时均低于常规组(t=8.817,5.730,20.609,9.632;P<0.05)。试验组内患者的围手术期安全事件发生率9.09%(5/55)低于常规组25.45%(14/55)(x2=5.153;P<0.05)。试验组内护士的器械摆台时间、器械传递反应时间、手术中断次数、器械整理时间、器械移交时间均低于常规组(t=3.347,6.505,5.971,3.795,5.838;P<0.05)。试验组内护士的器械管理差错率低于常规组(x2=5.238;P<0.05)。结论:器械护士术中分区精细化器械管理能提高HVR患者的手术效率并降低围手术期安全事件发生风险,对提高器械护士的器械管理质量、预防器械管理差错有积极影响
[Abstract]Objective:To explore the impact of refined intraoperative instrument management by operating room nurses on the efficiency and safety of HVR surgery.Methods:The study subjects included 110 patients with VHD who underwent HVR treatment at our hospital from June 2024 to May 2026, along with 22 instrument nurses who participated in the surgeries synchronously. Using the random number table method, the enrolled patients and nurses were divided into a control group (55 patients, 11 nurses) and an experimental group (55 patients, 11 nurses). Nurses in the conventional group implemented routine instrument management during surgery, while nurses in the experimental group implemented zoned and refined instrument management during surgery. The surgical efficiency, perioperative safety events of the two groups of patients, as well as the work efficiency and intraoperative instrument management of the surgeries participated by the nurses in the two groups were compared.Results:Under different instrument management modes, the aortic occlusion time, extracorporeal circulation time, intraoperative non-essential waiting time, and total surgical time of patients in the experimental group were all lower than the control group (t=8.817,5.730,20.609,9.632; P<0.05). The incidence of perioperative safety events in the experimental group was 9.09% (5/55) lower than that in the control group 25.45% (14/55) (x2=5.153; P<0.05). The instrument placement time, instrument delivery response time, number of surgical interruptions, instrument sorting time, and instrument handover time of nurses in the experimental group were lower than those in the control group (t=3.347,6.505,5.971,3.795,5.838; P<0.05). The error rate of nurses in the experimental group was lower than the control group (x2=5.238; P < 0.05).Conclusion:Refined intraoperative zone-specific instrument management by instrument nurses enhances surgical efficiency for HVR patients and reduces the risk of perioperative safety incidents, thereby positively impacting the quality of instrument care provided by nurses and preventing instrument-related adverse events.
目的 对比三维中等权重压缩感知并行采集序列(3D IW-CS-SENSE)与常规并行采集序列(3D IW-SENSE)在膝关节磁共振成像中的扫描时间、图像质量及诊断效能。方法 前瞻性采集100例膝关节磁共振影像。对比两组三维序列的定量指标、主观评分以及对损伤分级的准确率。结果 IW-CS-SENSE序列扫描时间显著缩短(122.0 ± 28.0 s vs. 221.0 ± 49.0 s,p<0.001)。IW-CS-SENSE序列信噪比、对比噪声比及显示效果评分均低于IW-SENSE序列(p<0.001),但IW-CS-SENSE序列的SENSE伪影评分更优(5.00 ± 0.00 vs. 4.59 ± 0.62,p<0.001)。两序列对半月板、韧带及软骨损伤分级的准确率均无统计学差异(p值分别为0.33,0.58和0.15)。 结论 3D IW-CS-SENSE序列可显著缩短扫描时间和消除SENSE伪影,同时保持与4倍加速3D IW-SENSE序列相当的诊断效能。
Objective To compare the imaging times, image quality, and diagnostic performance of three-dimensional (3D) intermediate-weighted compressed sensing sensitivity encoding (IW-CS-SENSE) sequence with conventional 3D IW-SENSE sequence in knee MR imaging. Methods MR images of one hundred knees were obtained prospectively. The quantitative indices, qualitative scores, and grading accuracies between the two 3D sequences were compared. Results Imaging times of IW-CS-SENSE sequences were significantly reduced (122.0 ± 28.0 s vs. 221.0 ± 49.0 s, p < 0.001). The signal-to-noise ratios, contrast-to-noise ratios, and visualization scores of IW-CS-SENSE sequences were significantly lower than IW-SENSE sequences (p < 0.001), while scores of SENSE artefact for IW-CS-SENSE sequences were superior (5.00 ± 0.00 vs. 4.59 ± 0.62, p < 0.001). The accuracies in grading meniscal, ACL, and cartilage tears were comparable between the two sequences (p = 0.33, p = 0.58 and p = 0.15, respectively). Conclusion 3D IW-CS-SENSE sequences can reduce scanning time significantly and eliminate SENSE artefacts, while maintaining the same diagnostic performance as the 4-fold accelerated 3D IW-SENSE sequences.
目的 修订肺癌患者联合药物治疗间歇期症状评估问卷,并评价其信效度。方法 以中文版安德森症状评估量表及肺癌特异性模块为基础,经文献分析、专家会议和认知性访谈形成测试版问卷。于2023年10-12月便利选取福州、莆田2所三级甲等医院278例肺癌患者进行调查,评价其信效度及偏倚风险。结果 修订后问卷含7个症状系统、60个条目,跳转式作答后实际作答21个条目。总问卷Cronbach's α系数为0.856,各维度为0.639~0.747;内容效度指数为0.81。验证性因子分析显示模型拟合尚可(χ2/df=2.366,RMSEA=0.070,CFI=0.858),各维度因子载荷、组合信度及平均方差提取量均达到可接受标准,区分效度良好。COSMIN-RoB评价结果为良好。结论 该问卷信效度良好,可用于评估肺癌患者联合药物治疗间歇期症状严重程度。
Objective To revise the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and evaluate its reliability and validity. Methods Based on the Chinese version of the M. D. Anderson Symptom Inventory and its lung cancer-specific module, a preliminary questionnaire was developed through literature review, expert panel discussions, and cognitive interviews. From October to December 2023, a convenience sample of 278 lung cancer patients was recruited from two tertiary hospitals in Fuzhou and Putian, China. Reliability, validity, and risk of bias were evaluated. Results The revised questionnaire comprised seven symptom-system domains and 60 items, with 21 items completed through a skip-logic design. The overall Cronbach's α coefficient was 0.856, and the coefficients for each domain ranged from 0.639 to 0.747. The content validity index of the questionnaire was 0.81. Confirmatory factor analysis demonstrated an acceptable model fit (χ2/df = 2.366, RMSEA = 0.070, CFI = 0.858). Factor loadings, composite reliability, and average variance extracted of all domains met acceptable standards, indicating good discriminant validity. The overall risk of bias was rated as good according to the COSMIN Risk of Bias checklist. Conclusion The revised questionnaire demonstrated satisfactory reliability and validity and can be used to assess symptom severity in lung cancer patients during combined drug therapy intervals.
摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练(ACBT)在非小细胞肺癌(NSCLC)化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者,采用随机数字表法将所有研究对象分为联合组和常规组,每组49例。常规组给予常规干预,联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后,两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组(P<0.05);联合组FVC、FEV1、MVV及6MWT均显著高于常规组(P<0.05);干预前两组6MWT组间对比差异无统计学意义(P>0.05),干预4周、6周、8周、12周后,两组6MWT均较干预前增加,且联合组远于常规组(P<0.05);干预12周后,两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升,且联合组高于常规组(P<0.05)。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能,提高生活质量和运动耐力。
Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.
目的 编制适用于老年人群的衰弱综合征中医评估量表并检验其信度与效度。方法 通过文献研究及《中华医典》检索构建条目池,采用4轮德尔菲专家咨询及预调查筛选条目形成初量表;便利抽取300例老年患者行横断面调查,以Fried表型衰弱量表为校标,进行项目分析、Cronbach’s α系数、探索性因子分析及ROC曲线分析。 结果 经条目筛选最终形成含5个核心症状条目(表A)及38个证候条目(表B)的量表。表A校标关联效度r=0.929(P<0.05),AUC=0.957,灵敏度0.949,特异度0.859;表A+B校标关联效度r=0.648(P<0.05),AUC=0.827,灵敏度0.606,特异度0.911;总量表Cronbach's α=0.872。结论 所研制的衰弱综合征中医量表信效度良好,可用于老年人衰弱状态筛查及中医证型判别。
Objective: To develop a Traditional Chinese Medicine (TCM) assessment scale for frailty syndrome in the elderly and to evaluate its reliability and validity. Methods: An item pool was constructed through literature review and searches of the *Chinese Medical Canon*. A preliminary scale was developed through four rounds of Delphi expert consultation and a pilot survey. A cross-sectional survey was conducted using a convenience sample of 300 elderly patients. Using the Fried Phenotypic Frailty Scale as the gold standard, item analysis, Cronbach’s α coefficient, exploratory factor analysis, and ROC curve analysis were performed. Results: After item screening, the final scale comprised 5 core symptom items (Table A) and 38 syndrome items (Table B). For Table A, the criterion-related validity was r = 0.929 (P < 0.05), AUC = 0.957, sensitivity = 0.949, and specificity = 0.859; Table A+B showed a test-retest reliability of r = 0.648 (P < 0.05), an AUC of 0.827, a sensitivity of 0.606, and a specificity of 0.911; the total scale had a Cronbach’s α of 0.872. Conclusion: The developed Traditional Chinese Medicine (TCM) frailty syndrome scale demonstrates good reliability and validity and can be used for screening frailty in the elderly and for distinguishing TCM syndrome patterns.
目的:探讨维生素B2(VB2)联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法:选取2024年5月—2025年10月收治的150例黄疸患儿,应用随机数字表法分为常规组和试验组,每组75例。常规组接受蓝光照射治疗,试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶(GSH-Px),8羟基脱氧鸟苷(8-OHdG)、晚期蛋白氧化产物(AOPP)、超氧阴离子(O2-)]、肝脏微循环[血管性血友病因子(vWF)、可溶性血栓调节蛋白(sTM)、肝动脉阻力指数(HA-RI)、门静脉血流速度(PVV)]、胆红素排泄[总胆红素(TBil)、间接胆红素(IBil)]、肝脏功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果:治疗后,试验组的GSH-Px高于常规组,8-OHdG、AOPP、O2-均低于常规组(P<0.05);试验组的vWF、sTM、HA-RI均低于常规组,PVV高于常规组(P<0.05)。试验组的TBil、IBil、ALT、AST分别为(80.52±5.47)μmol/L、(68.52±5.49)μmol/L、(30.25±5.48)U/L、(32.14±5.22)U/L,均低于常规组[(85.19±6.44)μmol/L、(74.37±6.52)μmol/L、(35.29±6.17)U/L、(38.55±6.48)U/L],差异有统计学意义(P<0.05)。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为(3.05±0.33)d、(4.22±1.39)d、(5.41±1.27)d、(5.12±0.49)d,均低于常规组[(3.68±0.36)d、(5.36±1.45)d、(6.28±1.33)d、(6.51±0.54)d],差异有统计学意义(P<0.05)。试验组的不良反应发生率与常规组比较,差异无统计学意义(P>0.05)。结论:VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环,对促进胆红素排泄、改善肝脏功能均有积极影响,在促进患儿康复同时未显著增加治疗风险。其安全性较高,可进一步推广。
Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.
目的:描述发病48 h内急性缺血性卒中(acute ischemic stroke,AIS)患者依达拉奉右莰醇真实世界用药特征,探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法:回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者,药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例,排除35例,纳入112例发病至首次用药时间(onset-to-treatment time,OTT)≤48 h者;按预设24 h界值分为24 h内用药组(n=67)和24~48 h用药组(n=45)。主要结局为住院期间美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)变化值(ΔNIHSS=入院NIHSS评分-出院前NIHSS评分);次要结局包括出院前NIHSS评分、出院改良Rankin量表(modified Rankin Scale,mRS)评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性,并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果:总体OTT为19.65(14.97,34.68)h,疗程12.00(11.00,13.00)d,完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义[8.00(6.00,9.00)分 vs 8.00(6.00,10.00)分,P=0.447];24 h内用药组出院前NIHSS评分更低[5.00(4.00,6.50)分 vs 6.00(5.00,8.00)分,P=0.025],ΔNIHSS更高[3.00(2.00,3.00)分 vs 2.00(1.00,2.00)分,P<0.001],显著神经功能改善率更高(77.6% vs 60.0%,P=0.045)。多因素校正后,24 h内用药仍与更大的ΔNIHSS相关(β=0.768,95%CI:0.377~1.159,P<0.001);Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关(OR=2.475,95%CI:1.047~5.853,P=0.039)。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论:本单中心真实世界队列中,发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低;24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究,结果应解释为关联性证据,需前瞻性、多中心研究及长期功能结局验证。
Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.
目的 探讨数字减影血管造影(DSA)在冠状动脉病变诊断中的应用价值,并评估血清学参数相对于DSA金标准的诊断效能。方法 本研究纳入100名确诊为冠心病的患者。病例组为100例DSA确诊的冠心病患者,对照组按1:1比例匹配100例同期接受DSA检查排除冠心病的患者。应用DSA技术分别评估冠心病的狭窄程度及部位等指征。回顾性收集并对比分析两组患者的各项血清学参数(cTnI、CK-MB、hs-CRP、LDL-C、TC),计算血清学指标诊断冠心病的效能,并进一步探究以上评估于入组患者性别亚组间的统计学差异。结果 病例组与对照组在性别、年龄、BMI等基线资料上均衡可比(P > 0.05)。以DSA为金标准,cTnI诊断冠心病的灵敏度为82.0%,特异度为85.0%;hs-CRP的灵敏度为85.0%,特异度为75.0%。 cTnI、hs-CRP水平随冠状动脉狭窄程度加重而显著升高(P < 0.05)。且以上冠心病评价指征于患者性别亚组间均无统计学差异( P <0.05)。结论 DSA技术可用于冠状动脉病变发生的部位、形态、数目等指征的明确评估,且于不同性别亚组间无统计学差异。血清学参数,尤其是cTnI和hs-CRP,对冠心病具有良好的辅助诊断价值,其水平与病变严重程度相关,可作为DSA检查前的有效筛查工具,为后续的治疗提供重要的参考依据。
Objective: To investigate the clinical value of digital subtraction angiography (DSA) in the diagnosis of coronary artery disease (CAD) and to evaluate the diagnostic performance of serological parameters relative to the DSA gold standard. Methods: A total of 100 patients with confirmed CAD were included in this study. The case group comprised 100 patients with CAD confirmed by DSA, while the control group consisted of 100 age- and sex-matched individuals who underwent DSA during the same period and were excluded from CAD. DSA was employed to assess the degree and location of coronary artery stenosis. Retrospective collection and comparative analysis of serological parameters (cTnI, CK-MB, hs-CRP, LDL-C, TC) were performed between the two groups. The diagnostic efficacy of these serological indicators for CAD was calculated, and subgroup analyses were conducted to explore potential sex-related differences. Results: The case and control groups were comparable in baseline characteristics such as sex, age, and BMI (P > 0.05). Using DSA as the gold standard, the sensitivity and specificity of cTnI for diagnosing CAD were 82.0% and 85.0%, respectively; hs-CRP demonstrated a sensitivity of 85.0% and specificity of 75.0%. Levels of cTnI and hs-CRP increased significantly with the severity of coronary stenosis (P < 0.05). No statistically significant differences were observed between male and female subgroups (P > 0.05). Conclusion: DSA provides definitive assessment of lesion location, morphology, and number in coronary artery disease, with no significant sex-related differences. Serological markers, particularly cTnI and hs-CRP, demonstrate good auxiliary diagnostic value for CAD. Their levels correlate with disease severity and may serve as effective screening tools prior to DSA, offering important reference value for subsequent clinical management.
目的 分析布地格福吸入、无创正压通气(NIPPV)联合治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的效果。方法 本研究采用回顾性对照研究。选取2024-06—2025-05我院96例AECOPD合并呼吸衰竭者,根据治疗方案不同分组,每组48例。对照组接受NIPPV治疗,研究组接布地格福吸入、NIPPV联合治疗,持续治疗1周。观察并对比两组疗效、病情程度、血气指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]、肺功能[最大呼气压(MEP)、一秒率(FEV1/FVC)]、炎性因子指标[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂质(LPO)]及不良反应。结果 研究组治疗有效率为91.67%(44/48),高于对照组75.00%(36/48)(P<0.05);治疗1周后与对照组相比,研究组mMRC分值、CAT分值均较低(P<0.05);治疗1周后,与对照组相比,研究组MEP、FEV1/FVC、PaO2较高,PaCO2较低(P<0.05);治疗1周后与对照组相比,研究组CRP、TNF-α、IL-6较低(P<0.05);治疗1周后与对照组相比,研究组SOD、GSH-Px较高,LPO较低(P<0.05);两组不良反应无明显差异(P>0.05)。结论 布地格福吸入、NIPPV联合治疗AECOPD合并呼吸衰竭,可明显减轻症状,改善血气指标与肺功能,抑制炎症反应,调节氧化应激,且保障安全性。
分析经开窗减压+二期刮治术治疗巨大型颌骨囊肿的效果。方法:回顾性采集100例巨大型颌骨囊肿的临床资料(2020年1月至2024年12月),按手术方法分组(传统刮治组、开窗减压+二期刮治术组),各50例,观察两组治疗有效率、炎症因子水平、并发症、华盛顿大学生活质量问卷(UW-QOL)评分及疾病复发情况。结果:总有效率比较,开窗减压+二期刮治术组(96.00%)比传统刮治组(82.00%)高(P<0.05);与传统刮治组比较,术后1周开窗减压+二期刮治术组白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平更低(P<0.05);开窗减压+二期刮治术组并发症总发生率为 6.00%,低于传统刮治组的22.00%(P<0.05);UW-QOL各维度(情绪、外貌、疼痛、咀嚼、味觉、唾液)评分比较,术后6个月开窗减压+二期刮治术组比传统刮治组高(P<0.05);开窗减压+二期刮治术组复发率(2.00%)比传统刮治组(16.00%)低(P<0.05)。结论:对巨大型颌骨囊肿患者开展开窗减压+二期刮治术,有利于抑制炎症反应,改善临床结局,提升生活质量。
To analyze the effect of fenestrated decompression + two-stage curettage in the treatment of giant mandibular cysts. Methods: The clinical data of 100 cases of giant jaw cysts (from January 2020 to December 2024) were retrospectively collected and divided into groups according to surgical methods (traditional curettage group, fenestrated decompression + two-stage curettage group), 50 cases in each group, and the treatment effectiveness, inflammatory factor levels, complications, University of Washington Quality of Life Questionnaire (UW-QOL) scores and disease recurrence were observed in the two groups. Results: Comparing the total effective rate, the window decompression + second-stage curettage group (96.00%) was higher than the traditional curettage group (82.00%) (P<0.05); compared with the traditional curettage group, the window decompression + second-stage curettage group 1 week after surgery The levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) in the surgery group were lower (P<0.05); the total incidence of complications in the window decompression + second-stage curettage group was 6.00%, lower than 22.00% in the traditional scaling group (P<0.05); comparison of UW-QOL scores in each dimension (emotion, appearance, pain, chewing, taste, saliva), window opening 6 months after surgery The decompression + two-stage curettage group was higher than the traditional curettage group (P<0.05); the recurrence rate of the window decompression + two-stage curettage group (2.00%) was lower than the traditional curettage group (16.00%) (P<0.05). Conclusion: Carrying out fenestration decompression + two-stage curettage for patients with giant jaw cysts can help suppress the inflammatory reaction, improve clinical outcomes, and enhance the quality of life.