目的 了解行角膜胶原交联术患者围术期的体验感受,为角膜胶原交联术的顺利进行及术后康复提供参考依据。方法 采用目的抽样法,于2023年8月—2023年10月在中山大学中山眼科中心选取12例行角膜交联术的患者进行半结构式访谈,采取Colaizzi七步法进行整理分析资料。结果 通过分析得出患者在围手术期的5种感受：焦虑、疼痛、恐惧、紧张、盲目乐观。结论 分析角膜交联手术患者在围术期不同感受,做好围术期护理,希望有利于提高手术效果。

Objective To understand the perioperative experience of patients undergoing corneal collagen cross-linking surgery,and provide reference for the smooth progress of corneal collagen cross-linking surgery and postoperative rehabilitation．Methods Using purposive sampling method,12 patients who underwent corneal cross-linking surgery were selected from the Sun Yat-sen Ophthalmology Center of Sun Yat-sen University from August 2023 to October 2023 for semi-structured interviews．The data were analyzed using the Colaizzi seven step method．Results Through analysis,five feelings of patients during the perioperative period were identified：anxiety,pain,fear,tension and blind optimism．Conclusion sAnalyzing the different feelings of patients undergoing corneal cross-linking surgery during the perioperative period and providing good perioperative care can help achieve satisfactory results in the surgery．

慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。

Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure．Therefore,it usually leads to decreased patient compliance．It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically．However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment．This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade．It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years．This paper is based on “deficiency in origin” and “excess in superficiality” principle．Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality．By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis．It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices．

炎症性肠病（IBD）作为一种慢性、易复发的炎症性疾病,被世界卫生组织归类为现代医疗领域的难治性疾病之一。其确切发病机制尚不清晰,目前主要认为与肠菌失衡触发宿主过度的肠黏膜免疫反应,进而在遗传易感性的个体中引发肠黏膜的损伤有关。目前,尚无特效的靶点能治愈IBD。过氧化物酶体增殖物激活受体（PPARs）作为核受体超家族的一员,在机体的生长发育、炎症调控以及代谢过程中扮演着重要角色,且被视为治疗包括IBD在内的多种疾病的重要潜在靶点,并被认为与肠道菌群关系密切。文章旨在探讨PPARs与肠道菌群的关系在IBD中的作用,从而挖掘IBD新的潜在诊疗靶点,开发新的治疗策略,为临床上IBD的诊断和治疗提供新的思路和方法。

Inflammatory bowel disease（IBD）,characterized as a chronic and recurrent inflammatory condition,is classified by the World Health Organization as one of the intractable diseases in modern medicine．The precise pathogenesis of IBD remains unclear,but current research widely believes that it is closely related to dysbiosis of the gut microbiota．Imbalance in the gut flora triggers an excessive immune response in the host’s intestinal mucosa,leading to mucosal damage in genetically susceptible individuals．To date,no specific targets have been identified that can cure IBD．Peroxisome proliferator-activated receptors（PPARs）,as members of the nuclear receptor superfamily,play significant roles in growth and development,inflammation regulation,and metabolic processes．They are regarded as potential effective targets for treating various diseases,including IBD,and are closely related to the gut microbiota．This review aims to discuss the progress in understanding the role of the relationship between PPARs and gut microbiota in IBD,so as to find new potential targets for the diagnosis and treatment of IBD,develop new treatment strategies,provide new ideas and methods for the diagnosis and treatment of IBD in clinical practice．

《流行病学》作为公共卫生与预防医学的主干课程,对于培养高质量公共卫生人才至关重要。在大数据、人工智能和互联网技术迅猛发展的时代背景下,传统的单一教学模式已无法满足现代医学教育的需求。线上线下混合教学模式逐渐成为高等医学教育的主要教学方式。这种模式结合了线上资源的丰富性和线下课堂的互动性,能够拓展教学内容,提高学生的自主学习能力。通过大数据分析和人工智能技术,可以提供个性化学习体验和实时反馈,优化教学效果。然而,这一模式在实际应用中仍面临诸如资源整合不够、师生互动不足等挑战。文章以广州医科大学为例,分析了《流行病学》课程中混合教学模式的优势与不足,并提出了针对性的改进建议。通过这些建议,旨在提升混合教学模式的有效性,为未来教学改革提供新的思路和参考。

Epidemiology,as a core course in public health and preventive medicine,is crucial for training high-quality public health professionals．With the rapid development of big data,artificial intelligence,and internet technologies,traditional single-mode teaching methods no longer meet the demands of modern education．The blended learning model,combining online and offline teaching,has gradually become a primary method in higher medical education．This model integrates the richness of online resources with the interactivity of offline classes,expanding instructional content and enhancing students' self-directed learning abilities．By leveraging big data analysis and artificial intelligence,personalized learning experiences and real-time feedback can be provided to optimize teaching effectiveness．However,this model still faces challenges such as inadequate resource integration and insufficient teacher-student interaction in practical application．This study uses a medical university as a case study to analyze the advantages and limitations of the blended learning model in epidemiology courses and proposes targeted improvement suggestions．The aim is to enhance the effectiveness of blended learning and provide new insights and references for future teaching reforms．

随着新医改全面深化、医保基金支付方式改革、国家公立医院绩效考核持续推进等新业态,医院靠粗放式规模扩张的收入模式不再适应新时期的发展。大多数基层公立医院不重视运营管理,存在收不抵支的财务风险与压力,导致医院面临巨大的良性运营挑战。探究基层公立医院的运营管理现状,普遍存在运营定位不清晰、运营组织体系不完善、运营意识薄弱、业财融合理念不强、专业人才少、信息系统功能不完善等诸多问题。如何有效应对潜在运营风险,推动转变管理模式并向高质量发展成为基层公立医院面临的重要课题。为此,基层公立医院迫切需要加强运营管理,对人、财、物、技术、空间等核心资源进行评估和流程管理,多管齐下,提高运营效率和社会经济效益,实现向管理要效益,解决收不抵支问题,推动医院可持续和高质量发展。

目的 探讨关节镜下外侧韧带增强固定修复术治疗慢性踝关节不稳定的护理和康复方案。方法 回顾性分析2023年1月–2023年8月广州市正骨医院收治的31例采用关节镜下外侧韧带增强固定修复术治疗的慢性踝关节不稳定患者的围术期护理措施和康复指导措施。结果 31例患者均随访无脱落,于术后3、6、12个月返院复查随访,患者手术后患足美国矫形外科足踝协会（AOFAS）踝-后足评分均较前次随访评分提高（均P<0.05）。患者术后3个月Zung焦虑评分和Zung抑郁评分较术前均明显下降（均P<0.05）。31例患者术后无1例发生踝关节不稳定复发、腓肠神经损伤和感染等并发症。结论 关节镜下外侧韧带增强固定修复术的方法治疗慢性踝关节不稳定患者,加强术前术后的护理措施、康复指导,对恢复踝关节稳定性和灵活性有重要作用,有利于提高患者生活质量和满意度。

Objective To investigate the nursing and rehabilitation of chronic ankle instability with reinforcement fixation and repair of lateral ligament under arthroscopy．Methods The perioperative nursing measures and rehabilitation guidance of 31 patients with chronic ankle instability treated with lateral ligament reinforcement fixation under arthroscopy from January 2023 to August 2023 were analyzed retrospectively．Results None of the 31 patients was disassociated during follow-up．The American Orthopaedic Foot and Ankle Society（AOFAS）scores of the patients were significantly higher and higher at 3,6 and 12 months after surgery（all P<0.05）．The Zung anxiety score and Zung depression score at 3 months after operation were significantly lower than those before operation（all P<0.05）．None of the 31 patients had postoperative complications such as ankle instability recurrence,sural nerve injury,peroneal tendinitis and infection．Conclusions In arthroscopic reinforcement fixation of lateral ligament in the treatment of patients with chronic ankle instability,strengthening the perioperative nursing measures and rehabilitation guidance,plays an important role in restoring the stability and flexibility of the ankle,and is conducive to improving the quality of life and satisfaction of patients．

目的 分析基于叙事护理理论的心理干预在突发创伤下肢骨折患者中的应用价值。方法 选择南方医科大学深圳医院2023年4月—2023年10月收治的100例突发创伤下肢骨折患者,根据随机数字表法将患者分为研究组和对照组,各50例。对照组提供常规心理护理和健康教育,研究组在对照组的基础上增加基于叙事护理理论的心理干预。对比两情绪压力量表和创伤后成长情况、康复依从性。结果 研究组的情绪压力评分维度中抑郁和焦虑及压力评分明显低于对照组（P<0.05）;研究组的创伤相关评分维度中与他人的关系、新的可能性和个人力量、生活的欣赏和精神变化评分高于对照组,康复依从性高于对照组（P<0.05）。结论 基于叙事护理理论的心理干预,可缓解突发创伤下肢骨折患者的心理压力,提高康复依从性,促进早日康复。

Objective To analyze the application value of psychological intervention based on narrative nursing theory in patients with sudden traumatic lower extremity fracture．Methods A total of 100 patients with sudden traumatic lower extremity fracture admitted to Shenzhen Hospital of Southern Medical University from April 2023 to October 2023 were selected and divided into study group and control group with 50 cases in each group by random number table method．The control group received routine psychological nursing and health education,and the study group was added psychological intervention based on narrative nursing theory．The two emotional stress scales were compared with post-traumatic growth and rehabilitation compliance．Results The scores of depression,anxiety and stress in the study group were significantly lower than those in the control group（P<0.05）．The trauma-related scores of the study group were significantly higher than those of the control group in relation to others,new possibilities and personal strength,appreciation of life and spiritual changes,and the rehabilitation compliance was significantly higher than that of the control group（P<0.05）．Conclusions Psychological intervention based on narrative nursing theory can relieve psychological pressure of patients with sudden traumatic lower extremity fracture,improve rehabilitation compliance,and promote early recovery．

目的 探讨血清胱抑素C（Cys-C）联合β₂-微球蛋白（β₂-MG）早期诊断糖尿病肾病的应用价值。方法 选择2021年4月—2023年4月医院接收的100例糖尿病患者为对象,根据其有无合并肾脏疾病,将其分为糖尿病组及糖尿病肾病组,各50例,同比例选取同期到我院体检的健康人群50名进行对照研究,检测比较其Cys-C及β₂-MG水平,对比其Cys-C阳性率、β2-MG阳性率及联合检测阳性率,并对比不同疾病分期糖尿病肾病患者的Cys-C、β₂-MG水平。结果 糖尿病肾病患者Cys-C、β₂-MG水平高于糖尿病患者与健康者（P<0.05）。糖尿病患者Cys-C、β₂-MG水平高于健康者（P<0.05）。糖尿病肾病患者Cys-C阳性率64.00%、β₂-MG阳性率72.00%、Cys-C+β₂-MG联合检测阳性率96.00%高于糖尿病6.00%、10.00%、12.00%及健康者0.00%、0.00%、0.00%（P<0.05）;糖尿病Cys-C+β₂-MG联合检测阳性率12.00%高于健康者0.00%（P<0.05）;糖尿病肾病中Cys-C+β₂-MG联合检测阳性率96.00%高于CysC 64.00%、β₂-MG 72.00%（P<0.05）。糖尿病肾病不同分期患者Cys-C、β₂-MG水平比较,Ⅳ期>Ⅲ期>Ⅰ~Ⅱ期（P<0.05）。结论 糖尿病肾病患者Cys-C、β₂-MG水平明显升高,Cys-C、β₂-MG联合诊断更具有优势,而且肾损害越严重,Cys-C、β₂-MG异常程度越高,作为临床诊治的参考依据的价值较高。

Objective To investigate the application value of serum cystatin C（Cys-C）combined with β₂-microglobulin（β₂-MG）in the early diagnosis of diabetic nephropathy．Methods A total of 100 diabetic patients admitted to our hospital from April 2021 to April 2023 were selected as subjects,and divided into diabetes group and diabetic nephropathy group according to whether they have renal diseases or not,with 50 cases in each group．Then,50 healthy people who came to our hospital for physical examination in the same period were selected for comparative study,and their Cys-C and β₂-MG levels were detected and compared,and their Cys-C positive rate,β₂-MG positive rate and combined detection positive rate were compared．Results The levels of Cys-C and β₂-MG in patients with diabetic nephropathy were higher than those in patients with diabetes and healthy controls（P<0.05）．The levels of Cys-C and β₂-MG in diabetic patients were higher than those in healthy controls（P<0.05）．The positive rates of Cys-C（64.00%）,β₂-MG（72.00%）and Cys-C+β₂-MG（96.00%）in patients with diabetic nephropathy were higher than those in patients with diabetes（6.00%,10.00%,12.00%）and healthy subjects（0.00%,0.00%,0.00%）（P<0.05）．The positive rate of combined detection of Cys-C and β₂-MG in diabetic patients（12.00%）was higher than that in healthy subjects（0.00%）（P<0.05）．The positive rate of Cys-C combined with β₂-MG in diabetic nephropathy was 96.00%,which was higher than that of Cys-C 64.00% and β₂-MG 72.00%（P<0.05）．The levels of Cys-C and β₂-MG in patients with stage Ⅳ diabetic nephropathy were higher than those in patients with stage Ⅲ and Ⅰ-Ⅱ diabetic nephropathy（P<0.05）．The levels of Cys-C and β₂-MG in stage Ⅲ patients were higher than those in stage Ⅰ-Ⅱ patients（P<0.05）．Conclusions The levels of Cys-C and β₂-MG are significantly increased in patients with diabetic nephropathy,and the combination of Cys-C and β₂-MG has more advantages．The greater serious renal damage,the greater abnormal degree of Cys-C and β₂-MG,which has a higher value as a reference for clinical diagnosis and treatment．

目的 研究单核细胞/高密度脂蛋白比值（MHR）对免疫球蛋白A肾病（IgAN）患者肾小球硬化严重程度的预测价值。方法 回顾性分析2016年1月—2022年6月龙岩人民医院收治的296例IgAN患者的临床和肾脏病理资料,参照牛津分型将患者分为无肾小球节段性硬化组（S0组）、有肾小球节段性硬化组（S1组）及球性硬化组;根据Katafuchi肾小球积分将患者分为低三分位组、中三分位组及高三分位组。比较不同肾小球硬化程度和不同Katafuchi肾小球积分患者的MHR水平,对MHR与Katafuchi肾小球积分的关系进行相关性分析,绘制受试者操作特征（ROC）曲线分析MHR对肾小球硬化程度的预测效能。结果 S1组和球性硬化组的单核细胞计数分别为（0.41±0.11）×10⁹ /L、（0.45±0.10）×10⁹ /L,均高于S0组的（0.30±0.06）×10⁹ /L,对比差异有统计学意义（t₁=10.381,P₁<0.001;t₂=12.169,P₂<0.001）,球性硬化组的HDL水平为（1.14±0.16）mmoL/L,低于S0组（1.26±0.24）mmoL/L（t₂=2.992,P₂=0.003）。S1组和球性硬化组的MHR为（0.36±0.04）、（0.44±0.05）,大于S0组的（0.24±0.02）,对比差异有统计学意义（t₁=37.852,P₁<0.001;t₂=42.037,P₂<0.001）,球性硬化组的MHR大于S1组（t₃=9.673,P₃<0.001）。中三分位组和高三分位组的单核细胞计数为（0.34±0.06）×10⁹ /L、（0.48±0.10）×10⁹ /L,高于低三分位组的（0.27±0.05）×10⁹ /L,对比差异有统计学意义（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）,高三分位组的单核细胞计数高于中三分位组（t₃=8.855,P₃<0.001）。高三分位组的HDL水平为（0.96±0.12）mmoL/L,低于低三分位组的（1.23±0.21）mmoL/L和中三分位组的（1.19±0.16）mmoL/L,对比差异有统计学意义（t₂=8.132,P₂<0.001;t₃=7.954,P₃<0.001）。高三分位组的MHR为（0.49±0.07）,大于低三分位组的（0.25±0.03）和中三分位组（0.26±0.08）,对比差异有统计学意义（t₂=35.382,P₂<0.001;t₃=15.146,P₃<0.001）。相关性分析显示,单核细胞与Katafuchi肾小球积分呈正相关（r=0.58,P<0.05）,HDL与Katafuchi肾小球积分呈负相关（r=-0.52,P<0.05）,MHR与Katafuchi肾小球积分呈正相关（r=0.66,P<0.05）。MHR预测肾小球节段性硬化的曲线下面积（AUC）为0.609（95%CI：0.325~0.917）,此时截断值为0.29,灵敏度为68.42%,特异度为65.45%。MHR预测球性硬化的AUC为0.735（95%CI：0.527~1.001）,此时截断值为0.40,灵敏度为73.08%,特异度为66.14%。结论 MHR在预测IgAN患者肾小球硬化程度方面具有潜能。

Objective To explore predictive value of the monocyte / high-density lipoprotein ratio（MHR）on the severity of glomerulosclerosis in patients with immunoglobulin A nephropathy（IgAN）．Methods The clinical and renal pathological data of 296 IgAN patients admitted to Longyan People's Hospital from January 2016 to June 2022 were analyzed retrospectively,and the patients were divided into no segmental sclerosis group（S0）,segment sclerosis group（S1）and glomerular sclerosis group according to Oxford classification;the patients were divided into low group,middle group and high group according to Katafuchi score．MHR levels in patients with different degrees of glomerular sclerosis and different Katafuchi score were compared,the relationship between MHR and Katafuchi glomerular integration was analyzed,and ROC curves were drawn to analyze the predictive efficacy of MHR on the degree of glomerular sclerosis．Results Monocyte counts in the S1 and glomerular sclerosis groups [（0.41±0.11）10⁹ /L,（0.45±0.10）10⁹ /L] were all significantly higher than the S0 group（0.30±0.06）10⁹ /L,with statistically significant difference（t₁=10.381,P₁<0.001,t₂=12.169,P₂<0.001）．The HDL level（1.14±0.16）mmoL / L was significantly lower than that in the S0 group（1.26±0.24）mmoL / L（t₂=2.992,P₂=0.003）．The MHR in S1 and glomerular sclerosis group[（0.36±0.04）,（0.44±0.05）] were significantly greater than S0（0.24±0.02）（t₁=37.852,P₁<0.001,t₂=42.037,P₂<0.001）,and the MHR in glomerular sclerosis group was significantly greater than that of S1（t₃=9.673,P₃<0.001）．The monocyte counts of middle and high group[（0.34±0.06）10⁹ /L,（0.48±0.10）10⁹ /L] were significantly higher than the low group（0.27±0.05）10⁹ /L（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）and high group was significantly higher than middle group（t₃=8.855,P₃<0.001）．The HDL level of high group（0.96±0.12）mmoL/L was significantly lower than the low group（1.23±0.21）mmoL/L and middle group（1.19±0.16）mmoL/L,with statistically significance（t₂=8.132,P₂<0.001,t₃=7.954,P₃<0.001）．The MHR（0.49±0.07）in the high group was significantly greater than the low group（0.25±0.03）and middle group（0.26±0.08）,with statistically significance（t₂=35.382,P₂<0.001,t₃=15.146,P₃<0.001）．Correlation analysis showed that monocytes were positively correlated with Katafuchi score（r=0.58,P<0.05）,HDL negatively with Katafuchi score（r=-0.52,P<0.05）,and MHR positively with Katafuchi score（r=0.66,P<0.05）．The AUC of MHR predicting segmental sclerosis was 0.609（95%CI：0.325~0.917）,when the cut-off was 0.29,sensitivity was 68.42% and specificity of 65.45%．The AUC of MHR predicting glomerulosclerosis was 0.735（95%CI：0.527~1.001）,when the cut-off was 0.40,sensitivity was 73.08% and specificity was 66.14%．Conclusions MHR has the potential in predicting the degree of glomerulosclerosis in IgAN patients．

目的 探讨超声监测导向下早期肠内营养（EEN）在重症脓毒血症（SS）有创通气（IV）患者中的应用效果。方法 选取2021年2月—2023年11月连州市人民医院收入的115例SS-IV患者,依据随机数字表法分为对照组（n=57）、超声监测组（n=58）。所有患者均予重症监护病房（ICU）综合治疗,在此基础上对照组实施临床经验的传统肠内营养（EN）干预,超声监测组实施超声监测导向下EEN干预,均监测至治疗结束。统计两组IV时间、ICU停留时间、EN达标时间、EN不耐受发生率、相关并发症发生率,比较干预前、EN结束时营养状况[白蛋白（ALB）、总蛋白（TP）、前白蛋白（PA）]、序贯器官衰竭评分（SOFA）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。结果 对照组剔除放弃治疗1例,死亡2例,纳入54例;超声监测组剔除放弃治疗1例,死亡1例,纳入56例。超声监测组EN达标时间[（40.18±8.46）h]、IV时间[（7.12±1.44）d]、ICU停留时间[（9.21±1.63）d]短于对照组[（46.03±10.15）h、（8.02±1.62）d、（10.18±1.54）d]（t=3.288、3.082、3.206,均P<0.05）。EN结束时超声监测组SS-IV患者血清ALB[（32.05±3.13）g/L]、TP[（65.36±3.62）g/L]、PA[（0.24±0.06）g/L]高于对照组[（30.28±2.24）g/L、（63.28±4.24）g/L、（0.21±0.05）g/L]（t=3.400、2.770、2.843,均P<0.05）。EN结束时超声监测组APACHEⅡ评分[（15.85±1.93）分]、SOFA评分[（7.42±1.64）分]低于对照组[（17.02±2.04）分、（8.35±2.03）分]（t=3.091、2.648,均P<0.05）。超声监测组EN不耐受发生率[12.50%（7/56）]低于对照组[29.63%（16/54）],超声监测组相关并发症发生率[8.93%（5/56）]低于对照组[24.07%（13/54）]（χ²=4.878、4.608,均P<0.05）。结论 超声监测导向下EEN干预应用于SS-IV患者,可改善患者病情与营养状况,降低EN不耐受及相关并发症发生风险,缩短恢复时间。

Objective To investigate the effect of ultrasound monitoring guided early enteral nutrition（EEN）in patients with severe sepsis（SS）and invasive mechanical ventilation（IV）．Methods A total of 115 SS-IV patients admitted to Lianzhou People's Hospital from February 2021 to November 2023 were randomly divided into control group（n=57）and ultrasound monitoring group（n=58）．All patients were given comprehensive treatment in intensive care unit（ICU）．On this basis,traditional enteral nutrition（EN）intervention with clinical experience was implemented in control group,and EEN intervention guided by ultrasonic monitoring was implemented in ultrasound monitoring group．All patients were monitored until the end of treatment．IV time,ICU stay time,EN compliance time,incidence of EN intolerance,and incidence of related complications were analyzed in the 2 groups．Nutritional status [albumin（ALB）,total protein（TP）,prealbumin（PA）],sequential organ failure assessment（SOFA）,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）were compared before intervention and at the end of EN．Results In control group,1 cases gave up,2 cases died,and 54 cases were included．In ultrasound monitoring group,1 case gave up,1 case died,and 56 cases were included．The EN compliance time [（40.18±8.46）h],IV time [（7.12±1.44）d] and ICU stay time [（9.21±1.63）d] of ultrasound monitoring group were shorter than those of control group [（46.03±10.15）h,（8.02±1.62）d,（10.18±1.54）d]（t=3.288,3.082,3.206,all P<0.05）．At the end of EN,serum ALB[（32.05±3.13）g/L],TP[（65.36±3.62）g/L],PA[（0.24±0.06）g/L] of SS-IV patients in ultrasound monitoring group were higher than those in control group [（30.28±2.24）g/L,（63.28±4.24）g/L,（0.21±0.05）g/L]（t=3.400,2.770,2.843,all P<0.05）．At the end of EN,APACHEⅡ scores [（15.85±1.93）points] and SOFA scores [（7.42±1.64）points] of ultrasound monitoring group were lower than those of control group [（17.02±2.04）points and（8.35±2.03）points]（t=3.091,2.648,all P<0.05）．The incidence of EN intolerance in ultrasound monitoring group [12.50%（7/56）] was lower than that in control group [29.63%（16/54）],and the incidence of related complications in ultrasound monitoring group [8.93%（5/56）] was lower than that in control group [24.07%（13/54）]（χ²=4.878,4.608,all P<0.05）．Conclusions EEN intervention guided by ultrasonic monitoring in SS-IV patients can improve the nutritional status of patients,reduce the risk of EN intolerance and related complications,shorten the recovery time,and reduce the progression of patients' disease．