目的 探究前瞻性护理对老年吸入性肺炎的影响和作用。方法 选择2017年8月—2018年12月住院采取常规护理的94例老年患者作为对照组,选择2019年1月—2020年10月住院的114例老年患者作为观察组进行前瞻性护理,比较对照组和观察组吸入性肺炎的发病率。结果 观察组吸入性肺炎发病率低于对照组（P<0.05）。结论 前瞻性护理可及早筛选并识别老年患者发生吸入性肺炎的危险因素,依此采取相应的护理措施,降低吸入性肺炎的发病率。

Objective To explore the effect of prospective nursing on preventing aspiration pneumonia in elderly patients．Methods A total of 94 elderly patients who were hospitalized from August 2017 to December 2018 and received routine care were selected as the control group,and 114 elderly patients who were hospitalized from January 2019 to October 2020 were selected as the observation group for prospective care,and the incidence of aspiration pneumonia in the control group and the observation group were compared．Results The incidence of aspiration pneumonia in the observation group was lower than that in the control group（P<0.05）．Conclusions Prospective nursing can identify risk factors of aspiration pneumonia in elderly patients,and take appropriate nursing measures to reduce the incidence of aspiration pneumonia．

目的 分析华北地区某医院院前急救医疗服务的资源利用状况,并依据相关影响因素针对院前急救医疗服务过程中存在问题提出相应对策。方法 收集2021年3月—2022年4月期间就诊于华北地区某医院急诊科患者的一般资料、就诊过程、症状特征。依据是否接受过院前急救服务、是否为疾病急性发作的危重症患者将患者分为4组,分析比较4组患者在一般资料、疾病病症特点两个方面是否存在统计学差异,探索影响院前急救医疗资源合理利用的相关因素。结果 本研究总计收纳患者病例5 800例,其中接受院前急救医疗服务的患者共840例占总调查人数的14.5%,其中危重症患者530例（63.1%）,非危重症患者310例（36.9%）;未接受院前急救医疗服务的患者为4 960例占总调查人数的85.5%,其中危重症患者803例（16.2%）。对所得数据采用多因素回归方法分析得知,在急诊科接受的危重症患者中急性胸痛与突发性头痛是选择不使用院前急救医疗措施的独立影响因素。在非危重症患者中发热、外伤、腹痛是非急重症患者接受院前急救医疗服务的独立影响因素。结论 院前急救医疗服务资源的提供与利用在实际应用的过程中存在资源闲置与服务空缺的问题。危重症患者在入院前仍有较大比例的患者没有选择接受院前急救医疗服务。该情况表明当前居民对危重症患者危重症状及院前急救医疗服务了解与认知不足,对此有必要加强对居民关于院前急救服务的科普宣教工作,并借助现有医疗服务力量支持院前急救医疗服务的规范与准则,这对保障患者生命安全,争取危重症患者存活机会,促进急救资源合理利用具有重要意义。

Objective To analyze the resource utilization status of pre-hospital emergency medical services in a hospital in North China,and to propose corresponding countermeasures for problems in the process of pre-hospital emergency medical services according to relevant influencing factors．Methods From March 2021 to April 2022,the general data,treatment process and symptom characteristics of patients who were treated in the emergency department of a hospital in North China were collected．According to whether they had received pre-hospital emergency services and whether they were critically ill patients with acute onset of disease,the patients were divided into four groups．Whether there were statistical differences in the general data and disease characteristics of the four groups of patients,and the relevant factors affecting the rational utilization of pre-hospital emergency medical resources were explored．Results This study included 5 800 patients,of which 840 patients receiving pre-hospital emergency medical services,accounted for 14.5% of the total survey,including 530（63.1%）and 310 non-critically ill patients（36.9%）;4 960 patients not receiving pre-hospital emergency medical services accounted for 85.5% of the total survey,including 803（16.2%）of critically ill patients．Analysis by multivariate regression methods on the obtained data showed that acute chest pain and sudden headache in critically ill patients in the emergency department were independent influencing factors in choosing not to use pre-hospital emergency medical measures．Fever,trauma,and abdominal pain in non-critically ill patients were independent factors influencing the reception of pre-hospital emergency medical services．Conclusions The provision and utilization of pre-hospital emergency medical service resources have the problem of idle resources and service vacancies in the process of practical application．A significant proportion of critically ill patients still do not choose to receive pre-hospital emergency medical services before admission．This situation shows that the current residents have insufficient understanding and cognition of critical symptoms and pre-hospital emergency medical services,and it is necessary to strengthen the scientific popularization and education of residents on pre-hospital emergency services,and support the norms and guidelines of pre-hospital emergency medical services with the help of existed medical services,which is of great significance for ensuring the safety of patients' lives,striving for the survival opportunities of critically ill patients,and promoting the rational use of emergency resources．

目的 探究麦默通（Mammotome）微创旋切术加置引流对乳腺良性肿物患者术后疼痛、炎性应激指标及并发症的影响。方法 选取本院2020年1月—2022年1月收治的100例乳腺良性肿物患者,简单随机法进行分组,每位患者赋予1位随机数,1~51号为实验组,采用Mammotome微创旋切术加置引流,52~100号为对照组,实施Mammotome微创旋切术。对比2组治疗效果、围术期指标、术前及术后1 d、3 d疼痛程度（NRS评分）、术前及术后3 d炎性应激指标及并发症情况。结果 2组病灶清除率（100.00%、97.96%）、并发症发生率（3.92%、16.32%）间无差异（P>0.05）;相较于对照组,实验组手术时间较长,残腔积液较少,住院时间较短（P<0.05）;术后1 d、3 d实验组NRS评分低于对照组（P<0.05）;术后3 d 2组C反应蛋白、白介素-6、白介素-1β、降钙素原水平较术前上升,且实验组上升幅度小于对照组（P<0.05）。结论 Mammotome微创旋切术加置引流治疗乳腺良性肿物能减少残腔积液,降低炎症反应程度,有助于术后切口愈合,缓解术后疼痛,且不增加并发症风险。

Objective To investigate the effect of Mammotome minimally invasive excision with drainage on postoperative pain,inflammatory stress indexes and complications in patients with benign breast tumors．Methods A total of 100 patients with benign breast tumors admitted to our hospital from January 2020 to January 2022 were selected and grouped by simple random method,each patient was assigned a random number．Patients No.1 to No.51 were included in the experimental group,treated with Mammotome minimally invasive excision with drainage．Patients No.52 to No.100 were included in the control group,treated with Mammotome minimally invasive excision．The treatment effect,perioperative indicators,pain level（NRS score）and inflammatory stress indexes before and 1st and 3rd days after operation and complications were compared between the two groups．Results There were no significant differences in the lesion clearance rate（100.00% vs 97.96%）and the complication rate（3.92% vs 16.32%）between the two groups（P>0.05）．Compared with the control group,the experimental group had longer operation time,less residual cavity liquid and shorter hospital stay（P<0.05）．The NRS score of the experimental group was lower than that of the control group at 1st and 3rd days after operation（P<0.05）．On the third day after operation,the levels of C-reactive protein,interleukin- 6,interleukin-1β and procalcitonin in the two groups were increased compared with those before operation,and the increase in the experimental group was smaller than that in the observation group（P<0.05）．Conclusions Mammotome minimally invasive excision with drainage in the treatment of benign breast tumors can reduce residual cavity fluid accumulation,reduce the degree of inflammatory response,help postoperative incision healing,relieve postoperative pain,and without increasing the risk of complications．

目的 探讨桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响,以便临床寻找出更有效的治疗方案,进而改善患者预后。方法 本次研究对象为赣州市人民医院2017年6月—2022年1月收治的82例桥小脑角肿瘤患者,用随机数字表法将其分为对照组（41例）和实验组（41例）。对照组患者给予常规显微手术治疗,实验组患者给予神经内镜辅助常规显微手术治疗,2组患者均于术后观察8周。比较2组患者肿瘤全切率,手术时间、住院时间及住院费用,术前及术后2、4、8周格拉斯哥预后量表（GOS）评分,以及术后8周内并发症发生情况。结果 肿瘤全切率：实验组患者术后8周（90.24%）与对照组（73.17%）相比,处于更高水平;手术时间、住院时间：实验组患者与对照组相比,处于更短水平;GOS评分：术前至术后2周,2组患者评分均呈下降趋势,术后2周至8周,2组患者评分呈升高趋势,其中实验组术后2、4、8周与对照组相比,处于更高水平,差异有统计学意义（P<0.05）;并发症总发生率：术后8周内,实验组患者（4.88%）与对照组（17.07%）相比,差异无统计学意义（P>0.05）。结论 桥小脑角肿瘤微创切除术中应用神经内镜,可有效缓解患者的临床症状,优化手术相关指标,减轻神经功能受损,提高肿瘤全切率,改善预后,且安全性高。

Objective To investigate the effect of neuroendoscope on functional recovery and prognosis of patients with cerebellopontine angle tumor after microinvasive resection,so as to find out more effective treatment and improve the prognosis of patients．Methods The subjects were 82 patients with cerebellopontine angle tumors admitted to Ganzhou People's Hospital from June 2017 to January 2022．They were divided into control group（n = 41）and experimental group（n = 41）by random number table method．Patients in the control group were treated with conventional microsurgery,while patients in the experimental group were treated with neuroendoscope assisted conventional microsurgery．All patients were observed for 8 weeks after operation．The total tumor resection rate,operation time,hospitalization time,hospitalization expense,Glasgow Outcome Scale（GOS）score before and 2,4,8 weeks after operation,and complications within 8 weeks after operation were compared between the two groups．Results Compared with the control group（73.17%）,the patients in the experimental group had a higher resection removal rate of tumor after 8 weeks of operation（90.24%）．Patients in the experimental group had a shorter operation time and hospital stay than those in the control group．From pre-operation to 2 weeks after operation,the GOS scores of patients in both groups showed a downward trend,and from 2 weeks to 8 weeks after operation,the scores of patients in both groups showed an upward trend,and the patients in the experimental group were at a higher level than those in the control group at 2,4,8 weeks after operation,the difference were statistically significant（P < 0.05）．Within 8 weeks after surgery,there was no significant difference in total incidence of complications between the experimental group（4.88%）and the control group（17.07%,P > 0.05）．Conclusions The application of neuroendoscope in the minimally invasive surgery of cerebellopontine angle tumor can effectively relieve the clinical symptoms of patients,optimize the operation-related indexes,reduce the damage of nerve function,increase the total resection rate of tumor,improve the prognosis,and with high safety．

目的 分析精神分裂症患者体内的肌酸激酶（CK）、肌红蛋白（MYO）、β₂微球蛋白（β₂-MG）、细胞间黏附分子（ICAM）水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤（AKI）可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组（同期我院门诊健康体检者）20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β₂-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β₂-MG值高于健康对照组及肾功能正常组,差异具有统计学意义（F=623.534,30.437,636.776,88.283,P<0.05）,精神分裂症AKI 1期组到AKI 3期组CK、MYO、β₂-MG、ICAM数值均比对照组升高（P<0.05）,3组之间如上指标的比较差异有统计学意义（P<0.05）。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β₂-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。

Objective To study the changes of serum creatine kinase（CK）,myoglobin（MYO）,β₂ microglobulin（β₂-MG）,intercellular adhersion molecule（ICAM）with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury（AKI）in patients with schizophrenia．Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls（who underwent physical examination during the same period）were included．At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β₂-MG level in each group．The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed．Results The serum CK,MYO,ICAM and β₂-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant（F=623.534,30.437,636.776,88.283,P<0.05）,and the comparison of the above indexes among the three groups was statistically significant（P<0.05）．Conclusions The abnormal increase of serum CK,MYO,ICAM and β₂-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis．

目的 分析艾司氯胺酮对剖宫产术后镇痛及肾素-血管紧张素-醛固酮系统（RAAS）、产后抑郁情况发生的影响。方法 研究对象为2020年5月—2021年6月在我院行剖宫产的96例孕产妇,根据麻醉药物的不同分为研究组50例和对照组46例,2组孕产妇均给予腰硬联合麻醉行剖宫产术,研究组于手术切皮前5 min静脉注射艾司氯胺酮0.2 mg/kg,对照组静脉注射等量生理盐水。比较2组孕产妇术后疼痛评分（VAS评分）、肾素活性（PRA）、血管紧张素-II（AT-II）、醛固酮（ALD）、爱丁堡产后抑郁量表（EPDS）、不良反应的发生情况。结果 与对照组比较,术后各时间点研究组孕产妇VAS评分均明显较低,差异具有统计学意义（P<0.01）。2组T1、T2、T3各时间点RAAS各指标均明显低于T0时间点（P<0.05）;研究组在T1、T2时间点RAAS各指标均明显低于对照组,差异具有统计学意义（P<0.05）。研究组术后3 d、术后6周EPDS评分均明显低于对照组（P<0.01）。2组不良反应总发生率比较无差异（P>0.05）。结论 艾司氯胺酮用于剖宫产术后镇痛效果显著,对产妇RAAS影响较小,并可缓解产妇抑郁症状,且不良反应发生率较低。

Objective To analyze the effect of esketamine on analgesia and renin angiotensin aldosterone system（RAAS）and the occurrence of postpartum depression after cesarean delivery．Methods The subjects were 96 pregnant women who underwent cesarean section in our hospital from May 2020 to June 2021,they were divided into 50 cases in the study group and 46 cases in the control group．Both groups of pregnant women were given combined spinal epidural anesthesia for cesarean section．The patients in study group were injected with esmketamine 0.2 mg/kg intravenously 5 minutes before skin incision,and those in control group were injected with the same amount of saline intravenously．The postoperative pain scores（VAS score）,plasma renin activity（PRA）,angiotensin-II（AT-II）,aldosterone（ALD）,Edinburgh Postpartum Depression Scale（EPDS）,and the occurrence of adverse effects were compared between the two groups．Results Compared with the control group,maternal VAS scores were significantly lower in the study group at all postoperative time points,and the differences were statistically significant（P<0.01）．The indexes of RAAS were significantly lower in both groups at T1,T2 and T3 time points than at T0 time point（P<0.05）;the indexes of RAAS were significantly lower in the study group at T1 and T2 time points than in the control group,and the differences were statistically significant（P<0.05）．The postoperative EPDS scores in the study group were significantly lower than those in the control group at 3 d and 6 weeks（P<0.01）．There was no difference in the overall incidence of adverse reactions between the two groups（P>0.05）．Conclusions Esketamine is effective for postoperative analgesia after cesarean section,with less effect on maternal RAAS,and can relieve maternal depressive symptoms,and has a low incidence of adverse reactions．

目的 调查眼科患者对荧光素眼底血管造影认知情况及健康教育需求,为眼底造影医护人员实施高效、个性化健康教育提供依据。方法 采用自制眼底造影认知及健康教育需求问卷,对本院2021年6月—8月的123例眼底血管造影患者进行问卷调查,使用Spearman相关性分析、非参数秩和检验及多元线性逐步回归分析患者眼底血管造影认知的影响因素。结果 患者荧光素眼底血管造影认知得分为（33.77±8.09）分,其中,患者对于检查中的相关知识认知最低,相对得分为0.59;患者健康教育需求的得分为（43.95±7.63）分,其中,检查后的相关知识需求度最高,相对得分为0.77;不同年龄、文化程度、主要照顾者、眼造影检查次数及是否合并全身病的患者的认知水平差异有统计学意义（P<0.05）。多元线性逐步回归分析表明,眼造影检查史是患者眼底血管造影认知的独立影响因素。结论 眼科患者对荧光素眼底血管造影认知水平较低,健康教育需求高,医护人员应重视健康教育的实施,结合FFA操作流程及患者特点,制定标准化健康教育流程,探索有效的线上+线下的健康教育模式,以提高造影患者认知水平,保障患者安全。

Objective To investigate fundus fluorescein angiography（FFA）cognition and health education needs in ophthalmic patients,and to provide basis for efficient and personalized health education for FFA medical staff．Methods A self-made questionnaire was used in a survey of 123 patients from June to August 2021．The influencing factors of FFA cognition were analyzed by Spearman correlation analysis,non parametric rank sum test and multiple linear stepwise regression．Results The score of FFA cognition was（33.77 ± 8.09）．Patients had the lowest cognition of relevant knowledge during the examination,with a relative score of 0.59．The score of patient's health education needs was（43.95 ± 7.63）,while the score of relevant knowledge needs after examination was the highest,with a relative score of 0.77．There were significant differences in cognitive level among patients with different ages,educational levels,main caregivers,angiographic times,and complication of systemic diseases（P<0.05）．Multiple linear stepwise regression analysis showed that the number of ocular angiography was an independent factor affecting the cognition of FFA．Conclusions Patients with FFA have low cognitive level and high demand for health education．Medical staff should pay attention to the implementation of health education,formulate a standardized health education process with the combination of operation process and patient characteristics,and explore an effective online-to-offline health education mode,so as to improve the cognitive level of angiography patients and ensure the safety of patients．

目的 基于影像组学方法,探讨多层螺旋CT（MSCT）四期增强扫描单一/不同期相及不同容积感兴趣区（VOI）的选择,在术前预测原发性肝细胞癌（HCC）微血管侵犯（MVI）中的价值。方法 回顾性收集88例经手术病理证实为HCC并行术前MSCT四期增强扫描的患者,其中包括47例MVI阳性患者和41例MVI阴性患者。在MSCT增强扫描的动脉早期、动脉晚期、门静脉期及延迟期图像中手动逐层勾画肿瘤ROI,获得瘤体容积感兴趣区VOI（Vt）,然后基于计算机自动膨胀算法将Vt外扩10 mm获得瘤体及瘤周VOI（Vt+Vp）。使用Pyradiomics软件分别从Vt和Vt+Vp中提取影像组学特征,随后采用15种特征选择方法和10种分类器构建150个预测模型,并通过十折交叉检验以验证模型的效能。使用准确度、敏感度、特异度、受试者工作特性曲线下面积（AUC）评估模型的效能,并比较性能最优的前三个预测模型。结果 MSCT四期增强扫描图像中预测HCC MVI状态的影像组学模型在门静脉期的表现优于其它期相及各期相的不同组合,其中最大的AUC值在Vt和Vt+Vp两种ROI中分别为0.768和0.782。此外,基于Vt+Vp的影像组学模型对MVI的预测效能优于基于Vt的影像组学模型,基于Vt+Vp性能最优的预测模型的AUC值、准确度、敏感度和特异度分别0.782、0.728、0.745和0.705。结论 采用影像组学方法术前无创性预测HCC MVI状态首选增强扫描的门静脉期,ROI首选瘤体联合瘤周10 mm区域。

Objective To investigate the value of single or different phases of contrast-enhanced multi-slice spiral CT（MSCT）in different volumetric regions of interest（ROI）to preoperatively predict the state of microvascular invasion in primary hepatocellular carcinoma（HCC）based on radiomics methods．Methods A total of 88 patients with HCC confirmed by surgical pathology who underwent preoperative MSCT quadruple-enhanced scan were retrospectively recruited,including 47 MVI-positive patients and 41 MVI-negative patients．The ROI was manually delineated slice-by-slice in the early arterial phase,late arterial phase,portal venous phase,and equilibrium phase of enhanced MSCT images to obtain the volume of tumor VOI（Vt）,and then Vt was expanded by 10 mm through the computer expansion algorithm automatically to obtain the volume of tumor and peritumor（Vt+Vp）．Pyradiomics software was used to extract radiomic features from Vt and Vt+Vp,followed by 150 discriminant models constructed with 150 feature selection methods and 10 classifiers,and then 10-fold cross-validation was used to evaluate the performance of these models．Using accuracy,sensitivity,specificity,area under the receiver operating characteristic curve（AUC）to assess model performance．The top three predictive models with the best performance were also compared．Results The radiomics model for predicting HCC MVI status in portal venous phase among quadruple-enhanced MSCT images outperformed other phases and different combinations of phases,achieving the highest AUC values of 0.768 and 0.782 in Vt and Vt+Vp respectively．In addition,the prediction performance of the radiomics model based on Vt+Vp was superior to models based on Vt．AUC value,accuracy,sensitivity,and specificity of the model with the best performance based on Vt+Vp were 0.782,0.728,0.745 and 0.705 respectively．Conclusions Radiomics models based on the portal venous phase of contrast-enhanced MSCT and tumor combined with the 10mm peritumoral area were more recommended to be employed to preoperative non-invasively predict the state of HCC MVI．

目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况（CONUT）评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组（P=0.005 3）,且2组性别构成存在差异,男性患者多于女性（P=0.037 0）。CONUT评分>2.5组患者的肿瘤直径较大（P=0.039 4）。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组（P=0.008 3）。单因素Logistic回归分析,年龄（OR=1.127;95%CI：1.028~1.236;P=0.011）、CONUT评分（OR=0.339;95%CI：0.151~0.764;P=0.009）是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄（OR=1.115;95%CI：1.008~1.233;P=0.035）、CONUT评分（OR=0.414;95%CI：0.175~0.982;P=0.045）是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。

Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer．Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed．Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status（CONUT）score was calculated．The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated．Results A total of 223 patients were included in this study．The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter．The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5（P=0.005 3）．Moreover,there was significant difference between the sex ratio of the two groups,with male more than female（P=0.037 0）．The tumor diameter was significantly larger in the group with CONUT score > 2.5（P=0.039 4）．In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5（P=0.008 3）．Univariate logistic regression analysis showed that age（OR=1.127;95% CI：1.028-1.236;P=0.011）and CONUT score（OR=0.339;95% CI：0.151-0.764;P=0.009）were the risk factors for short-term complications．Multivariate logistic regression analysis showed that age（OR=1.115;95% CI：1.008-1.233;P=0.035）and CONUT score（OR=0.414;95% CI：0.175-0.982;P=0.045）were the risk factors for short-term complications．Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications．

目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组（NC组,n=10）与2型糖尿病组（T2DM组,n=20）,检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数（HOMA-IR）;HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高（P<0.05）,HDL-C降低（P<0.05）。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义（P<0.05）。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关（P<0.05）。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。

Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus （T2DM）rats and to explore its relationship with diabetes．Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group（NC group,n=10）and T2DM group（n=20）,and fasting plasma glucose（FPG）,fasting insulins（FINS）,glycated hemoglobin（HbA1c）,total cholesterol（TC）,triglyceride (TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）levels were detected．Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index（HOMA-IR）,HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR．Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C（P<0.05）and decreased HDL-C（P<0.05）．The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference（P<0.05）．Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC（P<0.05）．Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM．