摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

目的 探讨婴儿胆汁淤积症为表现的钠牛磺胆酸共转运多肽（NTCP）缺陷病临床特点，提高临床医生对疾病的认识。方法：回顾总结分析12例因婴儿胆汁淤积症于2018年1月-2024年12月广州医科大学附属妇女儿童医疗中心就诊并经基因检测确诊为NTCP基因缺陷病患儿的临床特征、肝功能特点、基因结果及预后转归。结果：12例患儿基因组测序结果均存在SLC10A1基因纯合突变：c.800C>T(p.Ser267Phe)，就诊中位年龄2.1月，临床表现为黄疸伴大便颜色浅；肝功能表现为顽固的高胆汁酸血症及以直接胆红素升高为主的高胆红素血症,ALT、AST水平升高者10例，伴肝肿大者5例，脾肿大者4例，经治疗后黄疸消退中位时间5个月，3例患儿行胆道冲洗及肝活检，所有患儿生长发育均无异常。 结论 NTCP 缺陷病在婴儿期可表现为胆汁淤积症，肝功能异常除高胆汁酸血症外，以直接胆红素升高为主的高胆红素血症为典型表现；本病预后良好，早期行基因检测可避免有创或过度检查

To explore the clinical features of sodium taurocholate cotransporting polypeptide (NTCP) defective disease manifested by infantile cholestasis and to improve clinicians' understanding of the disease.Methods A retrospective summary and analysis were conducted of the clinical features, liver function features, genetic findings, and prognosis of 12 children who were diagnosed with NTCP gene deficiency disease by genetic testing at The Women's and Children's Medical Center Affiliated to Guangzhou Medical University between January 2018 and December 2024 as a result of infantile cholestasis. Results 12 children were diagnosed with NTCP gene defects at a median age of 2.1 months, and all of them had a pure mutation in the SLC10A1 gene (c.800C>T(p.Ser267Phe)) by genome sequencing. Intractable hyperbilirubinemia and hyperbilirubinemia with primarily elevated direct bilirubin, elevated ALT and AST levels in 10 cases, hepatomegaly in 5 cases, splenomegaly in 5 cases, and elevated bile levels in the liver were among th

目的 分析2021-2025年某社区卫生服务中心失眠患者用药趋势，为社区失眠规范化管理提供参考。方法 回顾性收集某社区卫生服务中心2021年1月至2025年12月失眠相关药物处方数据，共纳入处方18,042张，涉及患者3,805人。统计处方量、药物种类、患者年龄、性别、伴随疾病等信息。根据处方次数及平均处方间隔天数将患者分为三类：偶发就诊型（1次）、短期治疗型（2~10次且平均间隔≥60天）和长期用药型（>10次或平均间隔<60天），分析各类患者的用药特征及伴随疾病分布。结果 处方量从2021年2,688张增至2025年5,734张，增长2.1倍，就诊人数增长1.6倍。艾司唑仑占比从66.22%降至41.75%，右佐匹克隆从13.28%升至54.99%，2024年为关键转折点；各年龄组右佐匹克隆使用均呈上升趋势，2025年组间差异趋于消失（48%~61%）。患者平均年龄从73.2岁降至69.5岁（Tukey HSD，P<0.05），≥80岁组占比从29.36%降至14.28%。偶发就诊型占42.6%，短期治疗型占25.9%，长期用药型占31.6%。长期用药型消耗全部处方的68.2%，平均处方间隔37.3 d（中位34 d），右佐匹克隆占比43.2%。高血压是最常见伴随疾病，患病率随年龄升高（28.17%~68.17%）；高血脂和焦虑呈倒U型分布。结论 社区失眠就诊需求快速增长，药物结构向新型非苯二氮?类药物明显转变。失眠患者呈年轻化趋势。长期用药型患者消耗了大部分处方资源，其用药管理模式需结合处方间隔特征进行精准分层，并重视老年患者心血管代谢共病的综合管理。

To analyze the medication trends and characteristics of insomnia patients in a community health service center from 2021 to 2025, and to provide evidence for standardized community-based insomnia management. METHODS A retrospective analysis was conducted on insomnia-related prescription data from a community health service center between January 2021 and December 2025. A total of 18,042 prescriptions involving 3,805 patients were included. Prescription volume, drug types, patient age, sex, and comorbidities were analyzed. Patients were classified into three types based on prescription count and average prescription interval: episodic consultation type (1 prescription), short-term treatment type (2–10 prescriptions with interval ≥60 days), and long-term medication type (>10 prescriptions or interval <60 days). RESULTS Prescriptions increased from 2,688 in 2021 to 5,734 in 2025 (2.1-fold), with a 1.6-fold increase in patient visits. Estazolam decreased from 66.22% to 41.75%, while eszopiclone increased from 13.28% to 54.99%, with 2024 as the turning point. Eszopiclone usage increased across all age groups, converging to 48%–61% by 2025. Mean age decreased from 73.2 to 69.5 years (Tukey HSD, P<0.05), and the proportion of patients aged ≥80 years dropped from 29.36% to 14.28%. Episodic consultation type accounted for 42.6%, short-term treatment type 25.9%, and long-term medication type 31.6%. The long-term type consumed 68.2% of all prescriptions, with an average prescription interval of 37.3 days (median 34 days) and eszopiclone accounting for 43.2%. Hypertension was the most common comorbidity, increasing with age (28.17%–68.17%). Hyperlipidemia and anxiety showed an inverted U-shaped distribution. CONCLUSION Community insomnia treatment demand is growing rapidly, with a significant shift toward newer non-benzodiazepines and a trend toward younger patient demographics. Long-term medication patients consume the majority of prescription resources and require precise stratification based on prescription interval patterns, along with integrated management of cardiometabolic comorbidities in older adults.

摘要：探讨 高蛋白饮食干预成人非酒精性脂肪肝的效果及受控衰减指数的评估效能。方法 选取2024年3月—2025年6月右江民族医学院附属医院感染性疾病科、内分泌科门诊及住院的NAFLD患者120例。按照随机数字表法分为2组，观察组（采用高蛋白饮食）和对照组（采用限能量平衡膳食），每组各 60 例。结果 两组患者干预后BMI、WC、WHR、WHtR、BFR、VAI、CAP、UA、ALT、AST、TC、TG、LDL水平均较本组干预前显著降低，HDL较本组干预前显著升高（P＜0.001）。组间比较显示，干预后观察组BMI、WC、WHR、WHtR、BFR、VAI、CAP、Scr、UA、TC、TG、LDL、AST、ALT水平均显著降低，HDL显著升高（P＜0.001），组间差值及干预后组间比较，观察组上述指标改善幅度及最终指标水平均显著优于对照组（P＜0.001）。CAP与人体成分分析指标（BMI、WC、WHR、WHtR、VAI）呈正相关（P＜0.05）。观察组总体有效占比为93.3%，对照组总体有效占比为42%。CAP、BMI是脂肪肝治疗后是否消退的独立影响因素。CAP、ALT、WHtR三个指标联合检测AUC升高至0.947(95%CI 0.892～1.00)，灵敏度92.9%，特异性93.6%，约登指数0.878，显著高于各指标单独检测。结论 高蛋白饮食可以显著改善成人NAFLD患者的CAP、BMI、WC、WHR、BFR、WHtR、肝功能、血脂，对改善和减缓NAFLD的进展具有重要的临床意义，CAP 值可客观评估脂肪肝干预效果，值得临床推广。

目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病（CSR）患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者（154例）为研究对象进行回顾性分析，根据干预方案分为参照组（77例，采取颈椎功能康复训练）、研究组（77例，采取子午流注穴位按摩联合颈椎功能康复训练）。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分（VAS）与颈椎功能障碍指数量表评分（NDI）、颈椎功能活动度、血液流变学指标［血浆黏度（PV）、全血低切黏度（LSWBV）、纤维蛋白原（FIB）、全血高切黏度（HSWBV）］。结果 与参照组总有效率（83.12%）相比，研究组（96.10%）明显升高（P＜0.05）；研究组干预后各中医证候积分均较参照组低（P＜0.05）；干预后，研究组VAS、NDI评分均低于参照组（P＜0.05）；研究组干预后颈椎活动度高于参照组（P＜0.05）；干预后，研究组LSWBV、PV、FIB、HSWBV水平均较参照组低（P＜0.05）；研究组干预后3个月复发率为2.72%（2/74），低于参照组的14.06%（9/64）（χ2=4.588，P＜0.05）。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果，改善临床症状、颈椎功能、颈椎活动度，调节血液流变学，降低颈椎疼痛程度、复发率。

Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

【摘要】目的 对比舒芬太尼、羟考酮TURP麻醉诱导中的应用效果。方法 按照随机数字表法将2024年4月—2025年12月我院115例TURP患者分为S组（57例，舒芬太尼）与Q组（58例，羟考酮），其余诱导麻醉方案一致。观察两组麻醉恢复相关指标、血流动力学、疼痛评分、CRBD发生率及不良反应发生率。结果 两组瑞芬太尼总用量及苏醒、自主呼吸恢复时间对比无差异（P>0.05），Q组术中体动发生率较S组低（P<0.05）。T0 时两组MAP、HR无差异（P>0.05）；T1、T4均升高，但Q组较S组低（P<0.05）；T2、T3无差异（P>0.05）。Q组T5、T6 VAS评分均较S组低（P<0.05），T7无差异（P>0.05）。Q组CRBD发生率较S组低（P<0.05）。两组无不良反应差异（P>0.05）。结论 舒芬太尼与羟考酮用于TURP麻醉诱导均安全可行，对苏醒进程无明显影响，不良反应少。但与之相比，羟考酮在稳定血流动力学、减轻术后早期疼痛及降低术中体动、CRBD发生率方面优势更显著。

目的：探讨闭合复位弹性髓内钉固定术（CR-ESIN）对股骨骨折患儿康复进程及关节功能的影响。方法：回顾性选取2024年4月~2025年6月至我院行内固定术治疗的102例股骨骨折患儿为研究对象，依据手术方案不同，将行CR-ESIN治疗的51例患儿列为CR-ESIN组，将剩余51例行传统切开复位接骨板内固定术（ORIF）治疗的患儿列为ORIF组，比较两组患儿的治疗情况、康复进程，手术并发症发生情况，关节功能恢复情况及内固定物取出阶段负担。结果：在不同手术方案下，CR-ESIN组的手术耗时、术中出血量、术后住院时间、支具使用时间、完全负重时间分别为（60.29±5.44）min、（50.52±5.49）mL、（6.22±1.34）d、（4.15±1.33）周、（6.81±1.34）周，均低于ORIF组[（76.33±8.29）min、（190.48±20.51）mL、（8.17±1.65）d、（6.32±1.48）周、（7.82±2.17）周]（t=11.552，47.076，6.552，8.322，2.828；P＜0.05）。CR-ESIN组的手术并发症发生率5.88%（3/51）低于ORIF组19.61%（10/51）（x2=4.320；P＜0.05）。CR-ESIN组的髋关节前屈活动度、后伸活动度、儿童下肢功能量表（PODCI）评分分别为（132.44±22.52）°、（20.39±4.47）°、（75.14±6.29）分，均高于ORIF组[（120.28±20.37）°、（17.55±3.12）°、（70.31±5.36）分]，术后双侧股骨长度差（1.52±0.39）cm低于ORIF组（3.08±0.44）cm（t=2.860，3.721，4.174，18.948；P＜0.05）。CR-ESIN组的取出手术切口长度、取出手术耗时、取出手术出血量、再骨折率均低于ORIF组（t/x2=31.706，8.298，38.448，4.883；P＜0.05）。结论：CR-ESIN能提高股骨骨折患儿手术效率并降低出血风险，与传统ORIF相比，此术式有利于加快患儿康复进程、降低术后并发症发生率、促进关节功能恢复并减轻内固定物取出阶段负担。

Objective:To explore the effects of closed reduction elastic intramedullary nail fixation (CR-ESIN) on the rehabilitation process and joint function of children with femoral fractures.Methods:A retrospective study was conducted on 102 children with femoral fractures who underwent internal fixation surgery in our hospital from April 2024 to June 2025. Based on different surgical plans, 51 children who underwent CR-ESIN treatment were included in the CR-ESIN group, and the remaining 51 children who underwent traditional open reduction plate internal fixation (ORIF) treatment were included in the ORIF group. The treatment status, rehabilitation process, incidence of surgical complications, joint function recovery, and burden during the removal of internal fixation materials were compared between the two groups of children.Results:Under different surgical plans, the surgical time, intraoperative blood loss, postoperative hospitalization time, brace use time, and complete weight-bearing time of the CR-ESIN group were (60.29 ± 5.44) min, (50.52 ± 5.49) mL, (6.22 ± 1.34) d, (4.15 ± 1.33) weeks, and (6.81 ± 1.34) weeks, lower than the ORIF group [(76.33 ± 8.29) min, (190.48 ± 20.51) mL, (8.17 ± 1.65) d, (6.32 ± 1.48) weeks, and (7.82 ± 2.17) weeks] (t=11.552，47.076，6.552，8.322，2.828; P<0.05). The incidence of surgical complications in the CR-ESIN group was 5.88% (3/51) lower than the ORIF group 19.61% (10/51) (x2=4.320; P<0.05). The hip flexion range of motion, extension range of motion, and PODCI scores of the CR-ESIN group were (132.44 ± 22.52) °, (20.39 ± 4.47) °, and (75.14 ± 6.29) points, higher than the ORIF group [(120.28 ± 20.37) °, (17.55 ± 3.12) °, and (70.31 ± 5.36) points]. The length difference between the bilateral femurs was (1.52 ± 0.39) cm, which was lower than the ORIF group (3.08 ± 0.44) cm (t=2.860，3.721，4.174，18.948; P<0.05). The length of the surgical incision, the duration of the extraction surgery, the amount of bleeding during the extraction surgery, and the rate of re fracture in the CR-ESIN group were all lower than the ORIF group (t/x2=31.706，8.298，38.448，4.883; P<0.05).Conclusion:CR-ESIN can improve the surgical efficiency and reduce the risk of bleeding in children with femoral fractures. Compared with traditional ORIF, this procedure is beneficial for accelerating the recovery process of children, reducing the incidence of postoperative complications, promoting joint function recovery, and reducing the burden of internal fixation removal stage.

b

扩张型心肌病（DCM）以左心室或双心室扩大并伴心肌收缩功能下降为主要特征，左心室逆重构（LVRR）可反映治疗后心室结构和功能恢复，并与患者预后改善相关。近年来，中医药联合常规西医治疗DCM的研究逐渐增多，部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示，中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复，从而促进LVRR。然而，现有研究对LVRR的判定标准尚未统一，相关临床证据仍需进一步规范和验证。鉴于此，本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述，以期为DCM的中西医结合治疗及后续临床研究设计提供参考。

Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.