目的 探索实体肿瘤内部不同区域的间质液压（IFP）分布的异质性。方法 通过建立新西兰大白兔的皮下浅肌层VX2移植瘤模型,通过超声造影观察肿瘤的大小、形状、血流灌注等成瘤情况,并在超声引导下通过针芯法（WIN法）测量41只荷瘤兔VX2移植瘤内部不同区域的IFP。结果 41只荷瘤兔的VX2移植瘤的中央IFP为（23.79±8.07） mmHg、肿瘤外周1/2IFP为（15.58±5.22）mmHg、肿瘤外周1/4IFP为（8.29±5.47）mmHg,IFP从中央到外周逐步降低（F=70.85,P<0.001）。结论 VX2移植瘤内不同区域的IFP存在异质性,即从中央到外周IFP呈梯度显著降低。

Objective To explore the heterogeneity of interstitial fluid pressure（IFP）distribution in different regions of solid tumors．Methods The model of VX2 tumor was established in New Zealand white rabbits．The size,shape and blood perfusion of the tumor were observed by contrast-enhanced ultrasound,the IFP of VX2 tumor in 41 rabbits was measured by the wick-in-needle method（WIN method）under the guidance of ultrasound．Results The mean values of central IFP,peripheral 1/2 IFP and peripheral 1/4 IFP were（23.79±8.07） mmHg,（15.58±5.22 ）mmHg and （8.29±5.47） mmHg,respectively by statistical analysis,the IFP values changed significantly with different regions（F=70.85,P<0.001）．Conclusions There is heterogeneity of IFP in different regions of VX2 xenografts,that is,from the center to the periphery,the IFP decreased significantly．

目的 探索整体针联合运动处方应用于伴骨质疏松症（OP）的膝骨关节炎（KOA）患者全膝关节置换术（TKA）术前预康复的可行性、有效性及其对Wnt/β-catenin通路的影响。方法 2021年5月—2022年4月在广州市第一人民医院南沙医院骨科住院治疗的伴OP的KOA患者随机入组,分3组：A组予常规术前宣教和准备;B组在A组基础上,术前应用标准化运动处方3周;C组在A组基础上,术前联合应用整体针和运动处方3周。比较术前3周、术前1天、术后8周视觉模拟疼痛评分（VAS）、关节活动度（ROM）、膝关节功能评分（HSS）的组间差异,并比较术中关节液β连环蛋白（β-catenin）、基质金属蛋白酶-13（MMP-13）、重组人Dickkopf相关蛋白-1（DKK-1）含量的组间差异。结果 共纳入50例受试者,A组15例,B组18例,C组17例。术前1天组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术后8周组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术中关节液标志物含量组间方差分析显示：B、C组β-catenin、MMP-13含量均低于A组（P<0.05）,C组β-catenin、MMP-13含量均低于B组（均P<0.05）;B、C组DKK-1含量均高于A组（均P<0.05）,C组DKK-1含量高于B组（P<0.05）。结论 整体针联合运动处方在OP患者TKA术前应用切实可行,可有效缓解疼痛、改善功能。整体针可增强运动处方的正向预康复作用,其作用机制可能与Wnt/β-catenin通路调节有关。

Objective To explore the feasibility,effectiveness and impact on the Wnt/β-catenin pathway of combined holistic acupuncture and exercise prescription for preoperative rehabilitation in knee osteoarthritis（KOA）patients with osteoporosis（OP）undergoing total knee arthroplasty（TKA）．Methods KOA patients with OP were divided into three groups randomly：Group A received conventional preoperative education and preparation,Group B received standardized exercise prescription for three weeks additionally,Group C received combined holistic acupuncture and exercise prescription for three weeks additionally．Between-group differences in visual analogue scale（VAS）pain scores,range of motion（ROM）and knee joint function scores（HSS）were compared at 3 weeks preoperatively,1 day preoperatively and 8 weeks postoperatively．Differences in intraoperative joint fluid levels of β-catenin,MMP-13 and DKK-1 were also compared．Results A total of 50 participants were included,with 15 in Group A,18 in Group B and 17 in Group C．Baseline conditions were comparable among the three groups．One-day preoperative analysis showed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM was higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Groups B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Eight-week postoperative analysis revealed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM were higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Group B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Intraoperative joint fluid biomarker analysis showed that β-catenin and MMP-13 levels were lower in Groups B and C compared to Group A（P<0.05）,and β-catenin and MMP-13 levels were lower in Group C compared to Group B（P<0.05）．DKK-1 levels were higher in Groups B and C compared to Group A（P<0.05）,and DKK-1 level was higher in Group C compared to Group B（P<0.05）．Conclusions Combined holistic acupuncture and exercise prescription is feasible and effective for preoperative rehabilitation in TKA for KOA patients with OP．Holistic acupuncture enhances the positive pre-rehabilitation effect of exercise prescription,and its mechanism may be related to the regulation of the Wnt/β-catenin pathway．

目的 研究抗体筛查阳性输血患者的抗体与Rh抗原分布情况。方法 收集2019年10月1日—2022年12月31日中山大学孙逸仙纪念医院34 796例患者的不规则抗体筛查结果,以及抗体筛查阳性患者的抗体鉴定与Rh抗原分型结果,记录34 796例患者的年龄、性别、妊娠史、输血史等基本资料,分析各血型系统不规则抗体产生的阳性率及相关影响因素。结果 34 796例患者中,不规则抗体筛查阳性的患者237例,抗体筛查阳性率为0.68%。共检出不规则抗体260例,其中MNS系统83例（占31.93%）,Rh血型系统抗体70例（占26.93%）,Lewis血型系统14例（占比5.39%）。同种非特异性抗体79例,阳性率30.38%。同种特异性抗体中抗-E的占比最高,为20.77%;其次是抗-Mia,为20.39%。对237例抗体筛查阳性患者进行Rh抗原分型,CCDee抗原表型占比最高,为52.74%,其次是CcDEe占比29.16%。抗体筛查阳性率与性别、输血史、妊娠史有关,女性、有输血史、有妊娠史者的抗体筛查阳性率较高（P>0.05）。不同科室间抗体筛查阳性率比较差异有统计学意义（P>0.05）,其中风湿免疫科与血液科患者阳性率最高。结论 抗-E、抗-Mia为主要的红细胞不规则抗体,不规则抗体的产生与性别、输血史、妊娠史有关,输血前进行不规则抗体筛查、鉴定及Rh抗原分型,有利于提高输血安全。

Objective To explore the distribution of antibodies and Rh antigens in transfusion patients with positive antibodies screened in our hospital．Methods From October 1,2019 to December 31,2022,there were 34,796 patients undergoing irregular antibody screening in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,antibody identification and Rh blood typing results of positive patients were collected．Meanwhile,the age,sex,pregnancy history,blood transfusion history and other basic data of 34 796 patients were collected,and the positive rate of irregular antibody production and related influencing factors of blood group system were analyzed．Results Among the 34,796 patients,237 patients were screened positive for irregular antibodies,and the antibody screening positivity rate was 0.68%．A total of 260 cases of irregular antibodies were detected,83 cases of MNS system,accounting for 31.93%;70 cases of Rh blood group system,accounting for 26.93%;14 cases of Lewis blood group system,accounting for 5.39%．There were 79 cases of homozygous non-specific antibodies,with a detection rate of 30.38%．The highest percentage of homo-specific antibodies was anti-E,accounting for 20.77%,followed by anti-Mia,accounting for 20.39%．Rh antigen typing was performed in 237 antibody-screening positive patients,and the highest percentage of CCDee antigen phenotype was 52.74%,followed by CcDEe with 29.16%．Antibody screening positive rate was correlated with gender,blood transfusion history and pregnancy history,and the positive rate was higher in female,patients with blood transfusion history and pregnancy history,and the difference was statistically significant（P>0.05）．There were differences in the positive detection rate of antibody-screening in different departments,and the differences were statistically significant（P>0.05）,and the highest positive rates were in Department of Rheumatology and Immunology and Hematology．Conclusions Anti-E,anti-Mia are the main erythrocyte irregular antibodies,and the production of irregular antibodies is related to gender,transfusion history and pregnancy history,and irregular antibody screening,identification and Rh antigen typing before transfusion are beneficial to improve transfusion safety．

帕金森病（PD）是一种常见的与年龄相关的神经退行性疾病,其特点是黑质致密部内多巴胺能神经元的进行性丢失以及路易小体的积累。多巴胺能神经元的退化导致纹状体的多巴胺水平降低,最终出现静息性震颤、运动迟缓、肌肉僵硬和姿势不稳等运动症状,以及认知能力下降、嗅觉功能受损、精神异常和睡眠障碍等非运动症状。由于人口结构转变和全球老龄化,PD的不断增加对患者、家庭和社会构成重大负担。尽管广泛的研究已阐明了PD的病因学和潜在机制,但现有治疗主要集中在症状管理,无法阻止疾病的进展。小胶质细胞作为脑内重要的免疫细胞,对维持中枢神经系统的稳态具有关键作用。本文综述了PD研究,包括其病因学因素、分子机制和现有治疗策略。此外,审视了在PD样模型中涉及小胶质细胞的研究,深入探讨了小胶质细胞在疾病进展中的动态,并探究了小胶质细胞在促进或减轻疾病进展方面所扮演的错综角色。通过这样的探讨,本综述旨在为PD复杂的发病机制提供新的洞见和观点,激发出针对性治疗干预的创新思路。

Parkinson's disease（PD）,a prevalent age-related neurodegenerative disorder,is characterized by the progressive loss of dopaminergic neurons within the substantia nigra compacta（SNc）and the accumulation of Lewy bodies．The degeneration of dopaminergic neurons leads to diminished striatal dopamine levels,culminating in motor symptoms such as resting tremors,bradykinesia,muscle rigidity and postural instability,alongside non-motor manifestations encompassing cognitive decline,impaired olfactory function,psychological abnormalities and sleep disturbances．The escalating incidence of PD due to shifting demographics and global aging poses substantial burdens on patients,families and society．Although extensive research has elucidated the etiology and underlying mechanisms of PD,available treatments largely focus on symptom management and lack the capacity to halt disease progression．Microglia,as integral immune cells within the brain,wield pivotal influence over central nervous system homeostasis．This review presents a comprehensive synthesis of PD,encompassing its etiological factors,molecular mechanisms,and existing therapeutic strategies．Furthermore,we scrutinized research involving microglia in PD-like models,delving into the dynamics of microglia in disease progression and probing into the intricate roles that microglia assume in either fostering or mitigating disease advancement．By doing so,this review aims to furnish novel insights and perspectives that shed light on the intricate pathogenesis of PD,potentially sparking innovative concepts for targeted therapeutic interventions．

目的 本文旨在对全流程的生物安全管理问题进行梳理,为未来出现的大规模核酸筛查提供参考。方法 我们参考技术规范及其他医疗机构的实践总结,结合自身实际经验,梳理了核酸采集场所、个人防护、标本采集转运检测流程共3个方面的生物安全管理需注意的问题及解决措施。严格要求采样队伍按标准要求执行,以达到保质保量完成筛查任务的目的。结果 新冠核酸筛查期间我院共外派采集标本361 841人次。标本零污染零丢失,未发生一例生物安全事件,圆满完成采样任务。结论 大规模新冠核酸筛查是查清疫情源头、抑制疫情蔓延的重要手段。为了保证全流程的生物安全,应做好充足准备,严格落实各项生物安全措施。

Objective This article aims to sort out the problems in the whole process of biosafety management and provide reference for large-scale nucleic acid screening in the future. Methods We refer to the technical guidelines and the practice of other medical institutions, combined with our practical experience, summarized the problems and solutions needing attention in biosafety management in three aspects: nucleic acid sampling place, personal protection and the process from sample collection to detection. The sampling team was strictly required to implement the standard requirements, so as to complete the screening task with quality and quantity. Results A total of 361 841 samples were collected during SARS-CoV-2 nucleic acid screening. No samples were contaminated or lost, and no biosafety accident occurred. The sampling task were successfully completed. Conclusion Large-scale SARS-CoV-2 nucleic acid screening is an important method to find out the source of the epidemic and curb the spread of the SARS-CoV-2 pandemic. In order to ensure the biosafety of the whole process, sufficient preparations should be made and biosafety measures should be strictly implemented.

目的 探索老龄化形势下广州市白云区西部卒中防治工作的新模式。方法 通过完善组织结构、管理架构、建立稳定高效运行的(1+1+N)紧密型医联体模式,创建优质高效的卒中救治区域联盟,实现高质量的基层首诊,双向转诊,快速响应的卒中绿道急救和全程管理。结果 初步完成构建广州市白云区西部区域性卒中救治中心,区域内卒中患者及时救治,溶栓效率,血管再通等均有显著提升,整体提升白云区西部医疗机构的卒中救治水平。结论 区域性的协同救治是提高卒中救治水平的重要举措。(1+1+N)紧密型医联体模式能提高卒中患者救治率,具有可行性和必要性。

Objective To explore the effectiveness of a new stroke prevention and treatment pattern in the western part of Baiyun District, Guangzhou city, under an aging situation. Method We aim to build a high-quality and efficient stroke treatment regional alliance based on a (1+1+N) compact medical consortium, expecting to improve the overall abilities of stroke treatment in the western part of Baiyun District through high-quality primary care, two-way referrals, rapid response to stroke greenway emergency and full-process management. Results We have initially established a regional stroke treatment center in the western part of Baiyun District, Guangzhou. Stroke patients in that region can be treated in time, and the efficiency of thrombolysis and vascular recanalization have been significantly improved. Conclusion Regional coordinated treatment is an effective measure to reduce the disability and fatality rate of stroke. The (1+1+N) compact medical consortium model can improve the treatment effect in stroke patients, which is feasible and necessary.

目的 探讨孕期盆底肌锻炼联合产后盆底功能康复治疗对产后女性盆底功能障碍的防治效果。方法 选取2019年1月—2020年6月在我院产科门诊定期产检,B超确认为单胎足月顺产,剔除妊娠合并症及并发症,符合入组标准病例共316例,随机分成观察组和对照组,观察组131例,对照组185例,观察组在孕12周开始宣教孕期定期行盆底肌Kegel运动,并在产后42天开始行盆底康复治疗仪治疗6周,统计临床疗效,2组均在产后42天、3个月、6个月统计2组盆底功能检测、盆底器官脱垂(pelvic organ prolapse,POP)和压力性尿失禁(stress urinary incorrtinence,SUI)发生情况。结果 观察组和对照组一般资料,2组在年龄、分娩孕周、新生儿平均体重无统计学差异(P＞0.05),2组盆底功能进行检测比较,产后42天观察组阴道收缩持续时间、Ⅱ类肌纤维强度(85.24±22.19 cmH₂O)高于对照组(74.14±19.94 cmH₂O),差异具有统计学意义(P＜0.05),产后3月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(76.41±16.42 cmH₂O;4.35±1.78 s;94.15±18.25 cmH₂O)高于对照组(62.45±17.55 cmH₂O;3.89±1.52 s;88.55±18.36 cmH₂O),差异具有统计学意义(P＜0.05),产后6月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(79.56±15.78 cmH₂O;5.46±2.01 s;99.78±23.47 cmH₂O)明显高于对照组(67.63±14.45 cmH₂O;4.13±1.45 s;90.16±18.75 cmH₂O),差异具有统计学意义(P＜0.05)。对比2组POP和SUI发生率情况,产后42天观察组SUI发生率(28.24%)低于对照组(35.14%),差异具有统计学意义(P＜0.05);产后3月观察组POP和SUI发生率(18.32%;13.74%)低于对照组(22.70%;17.83%),差异具有统计学意义(P＜0.05),产后6月观察组POP和SUI发生率(0.00%;0.07%)明显低于对照组(8.10%;11.89%),差异具有统计学意义(P＜0.05)。 结论 孕期行盆底肌锻炼联合产后盆底功能康复治疗能明显改善产后盆底功能状态,显著降低产后盆底功能障碍性疾病的发生率。

Objective To explore the prevention and treatment effect of pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy on postpartum pelvic floor dysfunction in women. Methods From January 2019 to June 2020, women in our hospital's obstetrics outpatient department for regular obstetric checkups were selected, which ultrasound confirmed it was a singleton full-term delivery. The cases of stillbirth, fetal malformation and placenta previa were excluded. A total of 316 cases met the inclusion criteria and were randomly divided into the observation group and the control group, with 131 cases in the observation group and 185 cases in the control group. Observation group started regular pelvic floor muscle Kegel exercises from 12 weeks of gestation,and accepted pelvic floor rehabilitation therapeutic treatment from 42 days to six weeks postpartum. We summerized the pelvic floor function tests results, pelvic organ prolapse (POP) and stress urinary incontinence (SUI) situation of both groups in 42 days, 3 months and 6 months postpartum. Results The general information of the observation group and the control group showed that there were no statistical differences in age, gestational age of delivery and average weight of newborn (P>0.05). The pelvic floor function 42 days after delivery of the two groups was tested and compared, duration of vaginal contraction and class Ⅱ muscle fiber strength of the observation group [(85.24±22.19) cmH₂O] was significantly higher than that of the control group [(74.14±19.94) cmH₂O], and the difference was statistically significant (P＜0.05). Class I muscle fiber strength, duration of vaginal contraction and class Ⅱ muscle fiber strength were observed at 3 months postpartum, those of observation group[(76.41±16.42) cmH₂O; (4.35±1.78) s; (94.15±18.25) cmH₂O] were significantly higher than that in the control group [(62.45± 17.55) cmH₂O; (3.89±1.52) s; (88.55±18.36) cmH₂O], and the difference were statistically significant (P<0.05). At 6 months postpartum, class I muscle fiber strength, vaginal contraction duration and class Ⅱ muscle fiber strength in observation group [(79.56±15.78) cmH₂O; (5.46±2.01) s; (99.78±23.47) cmH₂O] were significantly higher than that of the control group [(67.63±14.45) cmH₂O; (4.13± 1.45) s; (90.16±18.75) cmH₂O], and the difference were statistically significant (P<0.05). Comparison of the incidence of POP and SUI between the two groups showed that the incidence of SUI in the observation group at 42 days postpartum (28.24%) was significantly lower than that in the control group (35.14%), the difference was statistically significant (P＜0.05). The incidences of POP and SUI in the observation group at 3 months postpartum (18.32%; 13.74%) were significantly lower than that of the control group (22.70%; 17.83%), the difference were statistically significant (P＜0.05). The incidences of POP and SUI in the observation group at 6 months postpartum (0.00%; 0.07%) were significantly lower than that of the control group (8.10%; 11.89%), the difference were statistically significant (P＜0.05). Conclusion Pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy can significantly improve postpartum pelvic floor function and significantly reduce the incidence of postpartum pelvic floor dysfunction diseases.

目的 上消化道出血发作急、变化快,具有较高的危险性,本研究目的在于分析急性上消化道出血患者的临床特征及危险因素,为临床诊治提供参考。方法 将2019年1月—2021年2月年我院的242例疑似急性上消化道出血患者作为研究对象,收集患者的年龄、性别、是否有长期抽烟史、饮酒史,是否有合并症以及并发症等一般资料,运用单因素分析其临床特征,运用多因素Logistic回归分析其独立危险因素。结果 患者年龄、长期饮酒史、消化性溃疡、门脉高压、急性胃黏膜病变、服用阿司匹林(ASA药物)、Hp感染等临床特征与急性上消化道出血具有相关性,与患者的性别、长期抽烟史不具有相关性;年龄、消化性溃疡、门脉高压、服用ASA药物、Hp感染是急性上消化道出血的危险性因素。结论 急性上消化道出血病势程度较重,死亡率高,出血需及时针对性治疗;对于急性上消化道出血高危患者,严密监测病情变化,评估其风险系数。

Objective Upper gastrointestinal bleeding has a high risk because of its rapid change. The purpose of this study is to analyze the clinical characteristics and risk factors of patients with acute upper gastrointestinal bleeding, so as to provide reference for clinical diagnosis and treatment. Methods A total of 242 patients with suspected acute upper gastrointestinal bleeding in our hospital from January 2019 to February 2021 were selected as the research objects. The general data such as patients' age, gender, whether they had a long-term history of smoking or drinking, whether they had complications and data of complications were collected. The clinical characteristics were analyzed by univariate analysis, and the independent risk factors were analyzed by multivariate Logistic regression analysis. Results Age, long-term drinking history, peptic ulcer, portal hypertension, acute gastric mucosal lesions, taking aspirin (ASA drugs), Hp infection and other clinical characteristics were correlated with acute upper gastrointestinal bleeding, but gender and long-term smoking history were not. Age, peptic ulcer, portal hypertension, taking ASA drugs and Hp infection were the risk factors of acute upper gastrointestinal bleeding. Conclusion The acute upper gastrointestinal bleeding is a serious disease, with high mortality, and the bleeding needs timely targeted treatment. For patients with high-risk acute upper gastrointestinal bleeding, closely monitor the changes of the disease and evaluate the risk coefficient are needed.

目的 探讨肠道菌群多样性及丰度在抗结核治疗强化期的变化。方法 收集广州市胸科医院20例初治菌阳肺结核患者使用强化方案治疗1周及强化期结束的粪便标本,所有标本进行16S rDNA测序,进行生物信息学分析。结果 强化期结束治疗组的Alpha多样性指标Chao1和observed_otus指数分别为(97.8±28.3)和(97.6±28.2),高于治疗1周组的(81±34.7)和(81±34.7),差异有统计学意义(P=0.04;P=0.038)。基于加权和未加权Unifrac距离的PCoA分析显示两组整体菌群结构无明显差异。在相对丰度较高的菌科中,强化期结束治疗组的拟杆菌科、肠球菌科、肠杆菌科、丹毒菌科、卟啉单胞菌科、双歧杆菌科等相对丰度下降,毛螺菌科、梭杆菌科、普氏菌科、瘤胃球菌科、韦氏菌科等相对丰度增加。通过线性判别分析效应量LEfse分析两组数据,发现在属水平上,厚壁菌门的瘤胃球菌、乳杆菌及放线菌门的柯林氏菌为组间显著差异菌种。结论 强化期治疗结束与治疗1周相比,肠道菌群多样性增加,但肠道菌群结构无明显差异。肠道拟杆菌科丰度减少,毛螺菌科丰度增加。

Objective To investigate the changes in the diversity and abundance of intestinal flora during the intensive period of anti-tuberculosis treatment. Methods Stool specimens from 20 patients with newly treated bacteria-positive pulmonary tuberculosis in Guangzhou Chest Hospital, which were treated with the intensive treatment for 1 week and whole intensive treatment, were collected. All the specimens were subjected to 16S rDNA sequencing and bioinformatics analysis. Results The Alpha diversity index Chao1 and observed_otus index of the treatment group with whole process were (97.8±28.3) and (97.6±28.2) respectively, which were higher than (81±34.7) and (81±34.7) of the 1-week treatment group, which had statistical differences (P=0.04;P=0.038). PCoA analysis based on weighted and unweighted Unifrac distance showed that there was no significant difference in the overall flora community structure between the two groups. Among the bacteria families with higher relative abundance, the relative abundance of Bacteroidaceae,Enterococcaceae,Enterobacteriaceae,Erysipelotrichaceae,Porphyromonadaceae and Bifidobacteriaceae in the treatment group with whole process decreased, the relative abundance content of Lachnodoiraceae,Fusobacteriaceae,Prevotellaceae, Rumincoccaceae, and Veillonellaceae increased. By using linear discriminant analysis effect size (LEfse) to analyze the two sets of data, it was found that at the genus level,Rumincoccaceae of Firmicutes and Lactobacillus;Collinsella of Actinobacteria were significantly different species between the groups. Conclusion Compared with 1 week of treatment, the diversity of intestinal flora increased at the end of intensive treatment, but there was no significant difference in the community structure of intestinal flora. The abundance of intestinal Bacteroidaceae decreased, and the abundance of Lachnodoiraceae increased.

目的 分析CT+MRI在原发性肝癌诊断与介入治疗预后评估中的临床意义。方法 选定本院2019年1月—2021年1月住院治疗的150例原发性肝癌患者,入院后均接受介入治疗,分别予以CT、MRI检查,将手术病理检查结果作为本次研究的金标准,比较CT、MRI、CT+MRI诊断效能,Kappa检验CT、MRI、CT+MRI与金标准的一致性,比较CT、MRI、CT+MRI介入术后病灶检出率。结果 CT+MRI诊断准确率(98.67%)、特异度(75.00%)、灵敏度(99.32%)均高于CT(86.00%、25.00%、87.67%)、MRI(90.67%、91.78%、50.00%),P＜0.05(差异均有统计学意义),CT+MRI与金标准的一致性较好(Kappa值为0.779),CT、MRI与金标准的一致性一般(Kappa值为0.527、0.596)。CT+MRI介入术后病灶总检出率(12.00%)高于CT(2.00%)、MRI(4.00%),P＜0.05(差异有统计学意义)。结论 CT+MRI可提高原发性肝癌患者介入术后病灶检出率,弥补了单一CT、MRI检查的不足。

Objective To evaluate the clinical significance of CT + MRI scans in diagnosis of primary liver cancer and prognosis evaluation after interventional therapy. Methods A total of 150 cases of patients with primary liver cancer admitted to our hospital from January 2019 to January 2021 were selected. They all received interventional treatment, and were examined by CT and MRI. The results of pathological examination were taken as the gold standard in this study to compare the diagnostic efficacy of CT, MRI and CT+MRI.Kappa value was used to compare the consistency of CT, MRI, CT+MRI scans with gold standard, and compared the detection rate of lesions after CT, MRI and CT+MRI interventional surgery. Results The diagnostic accuracy (98.67%), specificity (75.00%) and sensitivity (99.32%) of CT + MRI scans were higher than those of CT (86.00%, 25.00%, 87.67%) and MRI scans (90.67%, 91.78%, 50.00%),P<0.05 (which differences were statistically significant). The consistency of CT + MRI scans with gold standard was good (kappa value was 0.779), but the consistency of CT/MRI scans with gold standard were not satisfying (kappa value were 0.527, 0.596). The total detection rate of lesions after CT + MRI interventional surgery (12.00%) was higher than that of CT (2.00%) and MRI (4.00%, which P<0.05). Conclusion CT + MRI scans can improve the detection rate of lesions in patients with primary liver cancer after interventional therapy, and make up for the deficiency of only CT or MRI scans.