目的 探讨经阴道超声多参数联合血清孕酮在先兆流产妊娠结局中的临床意义，以期为临床制定相应干预方案提供参考。 方法 回顾性选取我院2022年8月~2024年8月就诊的152例早期先兆流产（孕5~8周）患者作为研究对象，均随访至孕12周，根据妊娠结局分为继续妊娠组（n=64）、难免流产组（n=88），比较两组临床资料及入院时经阴道超声多参数[收缩期峰值流速（S）/舒张末期流速（D）、阻力指数（RI）、搏动指数（PI）、孕囊大小]、血清孕酮水平，Logistic回归方程分析入院时经阴道超声多参数及血清孕酮水平对先兆流产患者妊娠结局的影响，受试者工作特征（ROC）曲线分析其对先兆流产患者难免流产的预测价值。 结果 两组年龄、流产史、S/D、RI、PI、孕囊大小、血清孕酮水平比较，差异具有统计学意义（P＜0.05）；经Logistic回归方程分析结果显示，在校正年龄、流产史潜在混杂因素后，S/D、RI、PI、孕囊大小、血清孕酮水平仍与先兆流产患者妊娠结局显著相关，均为其独立影响因素（P＜0.05）；绘制ROC曲线结果显示，S/D、RI、PI、孕囊大小、血清孕酮对于先兆流产患者难免流产的预测AUC分别为0.749、0.764、0.743、0.774、0.793，具有一定预测价值；基于S/D、RI、PI、孕囊大小、血清孕酮水平建立Logistic回归方程模型，经Hosmer-Lemeshow拟合优度检验显示，构建的模型χ2=2.249，P=0.117，说明该模型构建的预测结果与实际结果一致；绘制ROC分析该模型对先兆流产患者难免流产的预测价值，结果显示AUC为0.894（95%CI：0.834~0.938），敏感度为81.82%，特异度为87.50%。结论 经阴道超声多参数联合血清孕酮对于先兆流产患者妊娠结局具有较高预测价值，临床可通过早期联合检测评估患者难免流产发生风险，以针对性制定相应干预方案。

摘要 目的 分析固定（FB）和活动平台（MB）单髁置换术（UKA）在膝关节内侧间室骨关节炎早期阶段的临床效果与影像学差异，以指导临床假体选择。 方法 本研究回顾性纳入41例确诊为单侧膝关节内侧间室骨关节炎的患者，按照假体类型分为两组：FB组（20例，使用春立XG假体）和MB组（21例，使用春立XK假体）。分别在术前、术后及随访终点统计膝关节屈伸活动范围（ROM）、VAS 疼痛评分、美国特种外科医院膝关节评分（HSS ）；测量并比较股胫角（FTA）、胫骨假体内外翻角（TCVA）、胫骨假体后倾角（TCPSA）；记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善（P均<0.0001）；末次随访时固定平台组 VAS 评分显著低于活动平台组（P<0.05），而两组间的ROM、HSS 评分无统计学差异（均 P>0.05）。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围，组间均无统计学差异（均 P>0.05）。固定平台组手术时间更短（P<0.05），两组均无严重并发症，假体生存率均为 100%。 结论 活动平台与固定平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能，下肢力线恢复效果相当；固定平台假体在疼痛控制与手术便捷性方面更具优势，临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术；活动平台假体；固定平台假体；骨关节炎；并发症

Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications

【摘要】目的：探讨营养控制状态（CONUT）评分与急性心肌梗死（AMI）患者长期预后的相关性。方法：纳入90例AMI患者，于2021年1月～2023年12月入院，随访2年，分为主要心血管不良事件（MACEs）组（32例）与非MACEs组（58例），回顾性分析并对比两组基线资料，并分析CONUT评分与MACEs的相关性及MACEs的影响因素，评估CONUT评分对MACEs的预测效能。结果：90例AMI患者2年MACEs发生率为35.56%；相较于非MACEs组，MACEs组年龄、糖尿病、血肌酐、C反应蛋白（CRP）、降钙素原（PCT）、N末端脑钠肽前体（NT-proBNP）、KillipⅢ~Ⅳ级、CONUT评分更高，白蛋白、血钙、左心室射血分数（LVEF）更低（P＜0.05）；CONUT评分与MACEs发生正相关（P＜0.05）；高CONUT评分是MACEs的独立危险因素（P＜0.05）；MACEs预测中，CONUT评分的灵敏度为93.75%，特异度为93.10%，曲线下面积（AUC）为0.854。结论：CONUT评分与AMI患者长期预后密切相关，营养不良程度越重，MACEs发生风险越高。

Abstract Objective: To explore the correlation between nutritional control status (CONUT) score and long-term prognosis of patients with acute myocardial infarction (AMI). Methods: 90 AMI patients were included, admitted to the hospital from January 2021 to December 2023, and followed up for 2 years. They were divided into major adverse cardiovascular events (MACEs) group (32 cases) and non-MACEs group (58 cases). The baseline data of the two groups were retrospectively analyzed and compared, and the correlation between CONUT score and MACEs and influencing factors of MACEs were analyzed to evaluate the predictive efficacy of CONUT score for MACEs. Results: The 2-year incidence rate of MACEs in 90 AMI patients was 35.56%; compared with the non-MACEs group, the MACEs group had higher age, diabetes, serum creatinine, C-reactive protein (CRP), procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), Killip grades III to IV, and CONUT score. Albumin, blood calcium, and left ventricular ejection fraction (LVEF) were lower (P<0.05); CONUT score was positively correlated with the occurrence of MACEs (P<0.05); high CONUT score was an independent risk factor for MACEs (P<0.05); in the prediction of MACEs, the sensitivity of CONUT score was 93.75 %, the specificity was 93.10 %, and the area under the curve ( AUC ) was 0.854. Conclusion: CONUT score is closely related to the long-term prognosis of AMI patients. The more severe the malnutrition, the higher the risk of MACEs.

目的 探讨血清白蛋白（ALB）、纤维蛋白原（FIB）、乳酸脱氢酶（LDH）水平联合检测对急性心肌梗死患者短期预后的预测价值，以期为临床早期制定相应干预方案、改善患者预后提供参考。 方法 回顾性选取我院2023年1月~2025年1月收治的132例急性心肌梗死患者，入院后均接受经皮冠脉介入术（PCI）术治疗，根据术后6个月是否发生心血管主要不良事件（MACE）分为预后不良组（n=34）、预后良好组（n=98），比较两组临床资料及入院时血清ALB、FIB、LDH水平，Logistic回归方程分析血清ALB、FIB、LDH水平与急性心肌梗死患者PCI术后预后的关系，受试者工作特征（ROC）曲线分析其预测价值。 结果 两组病变血管支数、Killip分级及入院时血清ALB、FIB、LDH水平比较，差异具有统计学意义（P＜0.05）；入院时血清ALB、FIB、LDH水平与PCI术后预后显著相关，均为其独立影响因素（P＜0.05）；绘制ROC曲线结果显示，入院时血清ALB、FIB、LDH对于PCI术后预后不良的预测AUC分别为0.795、0.856、0.832，联合预测预后不良的AUC为0.927（95%CI：0.892~0.963），大于各方案单独预测，敏感度为91.18%，特异度为89.80%；危险度分析显示，血清ALB低水平患者预后不良风险是高水平患者的6.127倍，血清FIB、LDH高水平患者预后不良风险是低水平患者的10.493、8.170倍（P＜0.05）。 结论 血清ALB、FIB、LDH水平联合检测对急性心肌梗死患者PCI术后预后具有较高预测价值，临床可根据其早期评估患者预后不良风险，以制定个体化干预方案，改善患者预后。

摘要：目的 探讨心力衰竭患者住院期间容量管理成效及影响因素。方法 选取2024年1月—2025年12月我院收治的666例心力衰竭患者为调查对象，根据其成效将其分为有效组（n=612）和无效组（n=54）。统计两组患者临床资料及监测指标，采用单/多因素Logistic分析心力衰竭患者住院期间容量管理成效的影响因素。结果 本研究中，心力衰竭患者住院期间容量管理的有效率为91.89%（612/666）。两组年龄、病程、心功能分级及下肢水肿发生率比较（P＜0.05）；性别、体重指数、文化程度、吸烟史、饮酒史、基础疾病比较无明显差异（P＞0.05）。干预前及干预后，两组左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽比较（P＜0.05）。自变量设置为一般资料中对比有差异的指标包括年龄、病程、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽，因变量为心力衰竭患者住院期间容量管理成效，进行单因素Logistic回归分析，结果显示，心力衰竭患者住院期间容量管理成效的影响因素是年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽。校正年龄、性别等混杂因子，将单因素方差中对比有差异的数据纳入多因素Logistic回归分析，结果显示，心力衰竭患者住院期间容量管理成效的影响因素是年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、心输出量及脑钠肽。结论 心力衰竭患者住院期间容量管理成效较好，心力衰竭患者住院期间容量管理成效的影响因素为年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、心输出量及脑钠肽。

目的 探讨固定平台（FB）与活动平台（MB）单髁置换术（UKA）治疗膝关节内侧间室骨关节炎（OA）的早期临床疗效及影像学差异，为临床假体选择提供依据。 方法 回顾性分析41 例单侧膝关节内侧间室骨关节炎患者临床资料，其中 FB 组 20例（采用春立XG假体），MB 组 21 例（采用春立XK假体）。比较两组患者术前、术后和末次随访的膝关节活动度（ROM）、疼痛视觉模拟评分（VAS）、美国特种外科医院膝关节评分（HSS）；测量并比较股胫角（FTA）、胫骨假体内外翻角（TCVA）、胫骨假体后倾角（TCPSA）；记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善（P均<0.0001）；末次随访时固定平台组 VAS 评分显著低于活动平台组（P<0.05），ROM、HSS 评分两组差异无统计学意义（均 P>0.05）。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围，组间差异均无统计学意义（均 P>0.05）。固定平台组手术时间更短（P<0.05），两组均无严重并发症，假体生存率均为 100%。 结论 固定平台与活动平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能，下肢力线恢复效果相当；固定平台假体在疼痛控制与手术便捷性方面更具优势，临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术；活动平台假体；固定平台假体；骨关节炎；并发症

Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications

目的 探讨将 Root Cause Analysis（RCA）质量管理模式与心理资本理论相结合应用于手术核查团队，对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名，按手术间编号分为对照组与实验组，各 40 名。对照组实施常规手术核查流程；实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后，比较两组沟通中断发生率、核查流程执行质量、沟通效率，以及心理资本量表（PCQ-24）和团队协作量表（T-TPQ）得分。结果 实验组沟通中断发生率显著低于对照组（P＜0.05），核查流程执行质量和沟通效率均显著优于对照组（P＜0.001）。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组（均 P＜0.001）。结论 将 RCA 流程分析与心理资本理论干预相结合，可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平，具有良好的临床应用价值与推广潜力。

Objective: To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P＜0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P＜0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P＜0.001), as were T-TPQ total and subscale scores (P＜0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

【摘要】 目的 探讨多模态影像定量参数联合血小板与淋巴细胞比值（PLR）对上皮性卵巢癌（EOC）的诊断价值及其对良恶性卵巢病变的鉴别意义。方法 选取2023年6月至2024年12月本院收治的84例卵巢占位性病变患者作为研究对象，其中EOC患者46例纳入EOC组，良性卵巢病变患者38例纳入非EOC组。比较两组CT动脉期碘浓度、CT能谱曲线斜率及ADC值多模态影像定量参数，同时检测外周血指标并计算PLR，分析各指标在EOC诊断中的应用价值。采用受试者工作特征（ROC）曲线评价各指标单独及联合诊断效能。结果 两组年龄、体重指数及绝经情况比较差异均无统计学意义（P＞0.05）。EOC组形态不规则、边界模糊、实性成分为主、壁结节形成、明显不均匀强化、中大量腹腔积液及腹膜、淋巴结转移发生率均高于非EOC组（P＜0.05）。EOC组PLR、CT动脉期碘浓度及CT能谱曲线斜率均高于非EOC组，而ADC值低于非EOC组（P＜0.05）。ROC曲线分析显示，CT动脉期碘浓度、CT能谱曲线斜率、ADC值及PLR诊断EOC的AUC分别为0.801、0.819、0.828及0.867；联合预测模型AUC为0.975，敏感度为94.7%，特异度为91.3%，诊断效能优于各单项指标。结论 EOC患者多模态影像定量参数及PLR均存在明显异常改变，多模态影像参数联合PLR可进一步提高EOC的诊断效能，对良恶性卵巢病变的鉴别具有一定临床应用价值。

目的 探讨将 Root Cause Analysis（RCA）质量管理模式与心理资本理论相结合应用于手术核查团队，对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名，按手术间编号分为对照组与实验组，各 40 名。对照组实施常规手术核查流程；实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后，比较两组沟通中断发生率、核查流程执行质量、沟通效率，以及心理资本量表（PCQ-24）和团队协作量表（T-TPQ）得分。结果 实验组沟通中断发生率显著低于对照组（P＜0.05），核查流程执行质量和沟通效率均显著优于对照组（P＜0.001）。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组（均 P＜0.001）。结论 将 RCA 流程分析与心理资本理论干预相结合，可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平，具有良好的临床应用价值与推广潜力。

Objective: To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P＜0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P＜0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P＜0.001), as were T-TPQ total and subscale scores (P＜0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

【摘要】 目的 探讨多模态影像定量参数联合血小板与淋巴细胞比值（PLR）对上皮性卵巢癌（EOC）的诊断价值及其对良恶性卵巢病变的鉴别意义。方法 选取2023年6月至2024年12月本院收治的84例卵巢占位性病变患者作为研究对象，其中EOC患者46例纳入EOC组，良性卵巢病变患者38例纳入非EOC组。比较两组CT动脉期碘浓度、CT能谱曲线斜率及ADC值多模态影像定量参数，同时检测外周血指标并计算PLR，分析各指标在EOC诊断中的应用价值。采用受试者工作特征（ROC）曲线评价各指标单独及联合诊断效能。结果 两组年龄、体重指数及绝经情况比较差异均无统计学意义（P＞0.05）。EOC组形态不规则、边界模糊、实性成分为主、壁结节形成、明显不均匀强化、中大量腹腔积液及腹膜、淋巴结转移发生率均高于非EOC组（P＜0.05）。EOC组PLR、CT动脉期碘浓度及CT能谱曲线斜率均高于非EOC组，而ADC值低于非EOC组（P＜0.05）。ROC曲线分析显示，CT动脉期碘浓度、CT能谱曲线斜率、ADC值及PLR诊断EOC的AUC分别为0.801、0.819、0.828及0.867；联合预测模型AUC为0.975，敏感度为94.7%，特异度为91.3%，诊断效能优于各单项指标。结论 EOC患者多模态影像定量参数及PLR均存在明显异常改变，多模态影像参数联合PLR可进一步提高EOC的诊断效能，对良恶性卵巢病变的鉴别具有一定临床应用价值。