泛血管疾病（PVD）是一类以动脉粥样硬化为共同病理基础、累及心、脑、肾及外周血管系统的临床综合征, 具有多血管床共病特征, 发病率高、致残致死率大。非编码RNA（ncRNA）作为基因表达的重要调控因子, 在PVD的发生发展中发挥关键作用。微小RNA（miRNA）、长链非编码RNA（lncRNA）、环状RNA（circRNA）等ncRNA通过调节炎症反应、内皮功能、血管重塑、代谢稳态等多路径参与PVD的病理过程, 并展现出时空特异性和双向调控特征。最新研究揭示ncRNA在临床中的诊断预测及靶向干预潜力, 包括外泌体载体及circRNA递送系统等新策略。此外, 中医药通过调控ncRNA网络, 干预血瘀、痰浊等证型相关通路, 体现中西医结合治疗的系统优势。本文系统综述了ncRNA在PVD中的作用机制与研究进展, 强调其在精准诊疗与转化研究中的应用前景, 并指出未来需加强基础与临床协同、推进个体化干预策略的落地实施。

       Panvascular diseases（PVD）are a group of clinical syndromes characterized by atherosclerosis as a common pathological foundation, involving heart,brain,kidneys,and peripheral vascular systems．These diseases often exhibit multi-vascular bed comorbidities and are associated with high incidence,disability, and mortality rates．Non-coding RNAs（ncRNAs）, as key regulators of gene expression, play a crucial role in the onset and progression of PVD．Various types of ncRNAs—including microRNAs（miRNAs）, long non-coding RNAs（lncRNAs）, and circular RNAs（circRNAs）—are involved in the pathological processes of PVD through multiple pathways, such as modulation of inflammatory responses, endothelial function, vascular remodeling, and metabolic homeostasis, exhibiting spatiotemporal specificity and bidirectional regulatory effects．Recent studies have highlighted the potential of ncRNAs in clinical diagnosis, prognosis, and targeted therapy,with novel strategies including exosome-based delivery and circRNA-targeting systems．In addition, traditional Chinese medicine（TCM）exerts regulatory effects on ncRNA networks to intervene in syndrome-specific pathways, such as those related to blood stasis and phlegm-dampness, reflecting the systemic advantages of integrating TCM with Western medicine．This review systematically summarizes the regulatory mechanisms and research progress of ncRNAs in PVD,emphasizes their potential in precision medicine and translational research, and proposes the need to strengthen collaboration between basic and clinical studies to facilitate the implementation of personalized therapeutic strategies．

        吲哚菁绿（ICG）荧光成像技术基于ICG独特的代谢特性及近红外光激发特性, 通过动态荧光显影成像为手术提供精准导航, 其在肝胆胰外科领域展现出重要的应用价值。随着多版国内外指南的迭代更新, ICG荧光导航技术已被确立为肝胆胰外科手术的重要辅助手段, 其安全性和有效性得到充分验证。文章就ICG荧光成像技术的原理、在肝胆胰外科应用中的现状、在临床应用中面临的问题以及其应用展望展开综述。

       Based on the unique metabolic properties and near-infrared light excitation characteristics of indocyanine green（ICG）, the ICG fluorescence imaging technology provides dynamic fluorescence imaging for precise surgical navigation．This technology has demonstrated significant value in hepatobiliary and pancreatic surgery．With iterative updates to international and domestic guidelines, ICG-based fluorescence navigation has been established as an essential adjunctive tool in hepatopancreaticobiliary procedures, with its safety and efficacy validated through extensive clinical research．This review systematically explores the underlying principles of ICG fluorescence imaging, its current applications in liver, biliary, and pancreatic surgeries, the challenges encountered in clinical practice, and future directions for technological optimization and clinical translation

       克罗恩病肛瘘在解剖结构、诊治措施及疾病预后上具有与普通肛瘘不同的特点, 它是克罗恩病患者常见且严重的并发症及预后不良的征兆,严重影响患者生活质量。文章概述了克罗恩病肛瘘的概念及诊治现状、患者生活质量、相关评估工具及护理措施, 旨在为此类患者的临床管理及相关研究的开展提供参考依据,以提高其生活质量。

       Perianal fistula of Crohn's Disease has different characteristics from common anal fistula in anatomical structure, diagnosis and treatment and prognosis．It is a common and serious complication and a sign of poor prognosis in patients with Crohn's disease, which seriously affects the quality of life of patients．This article summarizes the concept, current status of diagnosis and treatment of perianal fistula in Crohn's Disease, its impact on the quality of life in patients, related assessment tools and nursing measures, so as to provide a reference for the management of such patients and improve their quality of life．

       炎症性肠病是一种慢性复发性疾病, 患者希望水平较低, 可能加剧疾病活动度、降低治疗依从性并降低其生活质量。文章从炎症性肠病患者希望水平的现状、评估工具、影响因素及干预方法四方面进行综述, 剖析现存挑战并提出未来研究方向, 旨在提升医护人员对希望水平管理的重视,为进一步构建科学、合理的炎症性肠病患者希望水平规范化管理方案提供参考。

        Inflammatory bowel disease（IBD）is a chronic and frequently recurring disease, and low level of hope in patients may exacerbate disease activity, reduce treatment adherence,and lower their quality of life．This article reviews the current situation of hope level, assessment tools, influencing factors and intervention methods, to analyze the existing challenges and proposes future research directions, aiming to raise the attention of hope level management among healthcare professionals, and to provide reference for the construction of a scientific, reasonable and standardized management plan for hope level of patients with inflammatory bowel disease．

      目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题：多重躯体症状负担持续存在（术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感）; 负性心理情绪困扰（病耻感、疾病不确定感与复发恐惧）; 心理调适过程（诊断冲击与认知失调、角色适应与主动应对）; 创伤后成长与健康行为转变（生命意义感提升、健康促进行为强化）; 强烈的康复信息支持需求（自我保健知识需求、结构化康复锻炼指导需求）。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。

       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions．Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer．Colaizzi's 7-step analysis method was used to summarize and extract themes．Results Five themes and 12 sub-themes were summarized：Persistent burden of multiple physical symptoms（postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue）; negative emotional experiences（stigma of illness, illness uncertainty and fear of recurrence）; psychological adjustment processes（diagnostic shock and denial, role acceptance and active coping）; post-traumatic growth and health behavior transformation（enhanced sense of meaning in life, strengthened health-promoting behaviors）; strong demand for rehabilitation information support（self-care knowledge, rehabilitation exercise knowledge）．Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life．

      目的 分析儿童大环内酯类耐药重症肺炎支原体肺炎（SMPP）的危险因素,构建列线图预测模型。 方法 回顾性收集2023年1月—2024年9月在广州医科大学附属番禺中心医院儿科住院治疗的1 121例大环内酯类耐药肺炎支原体肺炎患儿入院初期的临床资料。按7∶3比例将患儿资料随机分为训练集（784例）和验证集（337例）。采用R4.4.1软件使用10重交叉验证最小绝对收缩与选择算法（LASSO）回归分析进行单因素变量筛选,采用Logistics回归分析建立预测模型, 绘制可视化列线图。使用受试者操作特征曲线（ROC）, 校准曲线、Hosmer-Lemeshow（HL）检验及临床决策曲线（DCA）分别评估模型的区分度、校准度和临床使用价值。 结果 在训练集中, LASSO回归结合Logistics回归分析结果显示,院前发热时间>5.5 d、谷丙转氨酶>14.5 U/L、乳酸脱氢酶>287.5 U/L、C反应蛋白>18.65 mg/L、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的危险因素（P<0.05）, 根据上述危险因素构建列线图预测模型。训练集和验证集ROC曲线下面积分别为0.847和0.822; 校准曲线和HL检验显示模型具有良好的校准度; DCA显示预测模型在风险阈值为0.05~0.95时预测性能最优。 结论 院前发热时间、谷丙转氨酶、乳酸脱氢酶、C反应蛋白、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的影响因素, 基于以上因素构建的列线图模型具有较好的预测效能, 有利于早期识别耐药重症病例, 及早采取有效干预,改善患者预后。

      Objective To explore the risk factors and to construct a nomogram prediction model for severe macrolide-resistant Mycoplasma pneumoniae pneumonia（MPP）in children．Methods The clinical data during the initial admission period of 1 121 children with macrolide-resistant MPP who were hospitalized in the Department of Pediatrics of the Affiliated Panyu Central Hospital of Guangzhou Medical University from January 2023 to September 2024 were retrospectively collected．The children data were randomly divided into a training set（n=784）and a validation set（n=337）at a ratio of 7∶3．With R language software（version 4.4.1）, least absolute shrinkage and selection operator（LASSO）regression analysis with tenfold cross-validation was used to screen risk factors, Logistics regression analysis was used to establish prediction model, and a visualization of the risk variables was created using a nomogram．The receiver operating characteristic（ROC）curves, calibration curves, Hosmer-Lemeshow（HL）test and clinical decision curve analysis（DCA）were used to evaluate the discrimination, calibration and clinical application value of the model．Results In the training set, LASSO regression analysis combined with Logistics regression analysis showed that prehospital fever duration > 5.5 days, alanine aminotransferase level> 14.5 U/L, lactate dehydrogenase level> 287.5 U/L, C-reactive protein > 18.65 mg/L, lung consolidation, and co-infection with virus were risk factors for severe macrolide-resistant MPP（P<0.05）．A nomogram prediction model was constructed based on the above risk factors．The area under the ROC curves of the training set and the validation set were 0.847 and 0.822, respectively．The calibration curves and HL test showed that the model had good calibration． The DCA curves showed that the prediction model had the best prediction performance when the risk threshold was between 0.05-0.95．Conclusions Prehospital fever duration, alanine aminotransferase level, lactate dehydrogenase level, C-reactive protein level, lung consolidation and co-infection with virus were risk factors for prediction of severe macrolide-resistant MPP．The nomogram model based on the above factors had a good prediction efficiency, which was conducive to early identification of severe cases with macrolide-resistant, and taking early effective interventions to improve the prognosis．

       目的 探索α-突触核蛋白（α-Syn）干预对人单核细胞白血病细胞系（THP-1）巨噬细胞源性泡沫细胞的影响。方法 通过佛波酯（PMA）和氧化型低密度脂蛋白（ox-LDL）构建THP-1巨噬细胞源性泡沫细胞模型,使用不同浓度（33、66、100、133 nmol/L）α-Syn处理泡沫细胞,随后检测细胞胆固醇含量和炎症因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）及白细胞介素-8（IL-8）的mRNA表达以及核因子κB（NF-κB）和凝集素样氧化低密度脂蛋白受体-1（LOX-1）的蛋白表达变化。结果 高剂量（100和133 nmol/L）α-Syn处理可以减少THP-1巨噬细胞源性泡沫细胞内胆固醇的含量（P<0.05）,并且减少IL-1β、IL-6和IL-8的mRNA表达（P<0.05）。进一步发现（100 nmol/L和133 nmol/L）α-Syn可以降低THP-1巨噬细胞源性泡沫细胞p-NF-κB和LOX-1的蛋白表达（P<0.05）。结论 α-Syn可以降低THP-1源性巨噬细胞泡沫细胞胆固醇蓄积和炎症反应,可能是通过下调p-NF-κB和LOX-1蛋白表达。

      Objective To explore the effects of α-synuclein（α-Syn）intervention on human monocytic leukemia cell（THP-1）macrophage-derived foam cells．Methods The THP-1 macrophage-derived foam cell model was constructed by phorbol 12-myristate 13-acetate（PMA）and oxidized low-density lipoprotein（ox-LDL）．Foam cells were treated with different concentrations（33, 66, 100, and 133 nmol/L）of α-Syn, and the cellular cholesterol contents, as well as the mRNA expression of IL-1β、IL-6 and IL-8 were detected．Subsequently,alternation in protein expression of NF-κB and LOX-1 was measured．Results High-dose（100 and 133nmol/L）α-Syn treatment significantly reduced the levels of intracellular cholesterol in THP-1-derived macrophage foam cells（P<0.05）and decreased the mRNA expression of IL-1β、IL-6 and IL-8（P<0.05）．It was further found that（100 nmol/L and 133 nmol/L）α-Syn decreased the protein expression of p-NF-κB and LOX-1 in THP-1 macrophage-derived foam cells（P<0.05）．Conclusions The results of the present study suggest that α-Syn reduces cholesterol accumulation and inflammatory response in THP-1-derived macrophage foam cells, possibly by down-regulating p-NF-κB and LOX-1 protein expression．

       目的  本研究旨在探讨不同俯卧位通气（PPV）时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法  选择2020年7月—2023年7月在天津市人民医院重症监护病房（MICU）治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组（≥12 h, n=40）和短时组（<12 h, n=40）。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素（GAS）和血管活性肠肽（VIP）]、肠内营养达标率、胃肠并发症率等。结果  短时组治疗后, 1 d、3 d、5 d氧合指数为（189.93±33.72）、（247.53±63.01）、（325.03±58.11）mmHg,高于长时组的（161.63±36.88）、（191.83±57.65）、（267.95±46.25）mmHg,均P<0.05; 胃残留量为（29.00±7.92）、（19.75±4.45）、（11.00±1.87） mL低于长时组的（75.03±23.29）、（53.13±11.99）、（21.70±5.52） mL, 均P<0.05。短时组治疗后腹内压[（8.53±2.05）mmHg vs （9.75±2.05） mmHg]、VIP水平[（61.14±7.63） vs （67.49±4.43） pg/mL]低于长时组,GAS水平[（65.02±8.84） vs （54.22±9.21）pg/mL]升高（均P<0.05）。短时组总胃肠并发症发生率（7.50%）低于长时组（25.00%）, P=0.034。结论  对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。

      Objective To explore the effect of different duration of prone position ventilation（PPV）on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction．Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit（MICU）of a hospital from July 2020 to July 2023, and were selected as the research subjects．They were divided into the long-duration group（≥12 hours, n=40）and the short-duration group（<12 hours, n=40）according to the daily duration of PPV．The general data, oxygenation index, gastrointestinal function indicators（intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]）, enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared．Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment（[189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively）was significantly higher than that of the long-duration group（[161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05）．The gastric residual volume of the short-duration group（[29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively）was significantly lower than that of the long-duration group（[75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05）．The intra-abdominal pressure（[8.53±2.05] vs [9.75±2.05] mmHg）and VIP level（[61.14±7.63] vs [67.49±4.43] pg/mL）of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level（[65.02±8.84] vs [54.22±9.21] pg/mL）was significantly higher（all P<0.05）．The total incidence of gastrointestinal complications in the short-duration group（7.50%）was significantly lower than that in the long-duration group（25.00%, P=0.034）．Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance． 

       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄（OR=1.131）、睡眠差（OR=2.557）、合并3种及以上慢性病（OR=3.990）、抑郁（OR=3.296）、营养不良风险（OR=4.005）为老年脆性骨折患者术前衰弱的危险因素,BMI正常（OR=0.206）是保护因素（均P<0.05）。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。

       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures．Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected．Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale（CES-D-10）, the Generalized Anxiety Disorder Scale（GAD-7）, and the Nutritional Risk Screening 2002（NRS-2002）．Logistic regression was used to analyze factors influencing preoperative frailty．Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%．Logistic regression analysis revealed the following risk factors for preoperative frailty：age（OR=1.131）, poor sleep quality（OR=2.557）, multiple chronic comorbidities（OR=3.990）, depression（OR=3.296）, nutritional risk（OR=4.005）．Normal body mass index（OR=0.206）was a protective factor．Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients．Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients．

       目的 探究强化肢体沟通联合心理引导在肱骨髁上骨折患儿围术期照护中的应用。方法 选取2023年1月—2024年1月河南省儿童医院收治的84例肱骨髁上骨折患儿为研究对象。根据随机数字表法分为常规组和干预组, 每组各42例。对照组采用常规护理, 干预组采用强化肢体沟通联合心理引导的护理。比较两组肘关节功能疗效、疼痛程度、康复锻炼依从性、生活质量等。结果 两组优良率比较差异无统计学意义（P>0.05）; 干预后,两组视觉模拟评分法（VAS）评分和儿童疼痛行为量表（FLACC）评分均降低,且干预组低于常规组（P<0.05）; 干预组康复锻炼依从性为97.62%高于常规组的76.19%（P<0.05）; 干预后, 两组生活质量均升高,且干预组高于常规组（P<0.05）。结论 强化肢体沟通联合心理引导对肱骨髁上骨折患儿护理效果显著, 可降低患者的疼痛程度,提高康复锻炼依从性,提高生活质量。

       Objective To explore the application of strengthening physical communication combined with psychological guidance in perioperative care of children with supracondylar fracture of humerus．Methods From January 2023 to January 2024, 84 children with supracondylar fracture of humerus in Henan Children's Hospital were selected as the research objects．By the random number table method, these patients were evenly divided into the routine group and the observation group, with 42 patients each．The routine group received standard nursing care, while the observation group was provided with enhanced nursing interventions that incorporated physical communication and psychological guidance．A comparative analysis was conducted between the two groups in terms of elbow joint function recovery, pain intensity levels, compliance to rehabilitation exercises, and overall quality of life improvements．Results No statistically significant difference was observed in the proportion of excellent and good outcomes between the two groups（P>0.05）．Following the implementation of the interventions, both the Visual Analog Scale（VAS）score and the Faces, Legs, Activity, Cry, Consolability（FLACC）score decreased in both groups,with the observation group demonstrating a more pronounced reduction compared to the routine group（P<0.05）．The compliance rate for rehabilitation exercises in the observation group was notably higher, reaching 97.62%, in contrast to 76.19% of the routine group,with difference being statistically significant（P<0.05）．Post-intervention, an improvement in the quality of life was noted in both groups,however,the observation group exhibited a superior increase compared to the routine group, with this superiority being statistically significant（P<0.05）．Conclusions Strengthening physical communication combined with psychological guidance has obvious nursing effect on children with supracondylar fracture of humerus, which can reduce the pain degree of patients, improve the compliance of rehabilitation exercise and the quality of life．

       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。

       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．

       目的 通过戴明循环管理法的品管圈（QCC）活动, 提升内镜中心病理标本标识的正确率与病理标本管理安全性。方法 采用基于戴明循环管理法的QCC活动, 对内镜中心病理标本标识质量进行现状把握、原因分析并制定对策, 比较QCC活动开展前后内镜病理标本标识的正确率。结果 QCC活动后, 内镜中心病理标本标识的正确率从99.8%提高至100%（P<0.05）。结论 内镜中心通过开展基于戴明循环管理法的QCC活动, 显著提升了内镜病理标本管理安全性与工作效率。

       Objective To improve the accuracy of pathological specimen identification and the safety of pathological specimen management in endoscopy center through quality control circle（QCC）activity based on Deming cycle management．Methods QCC activity based on Deming cycle management was used to summarize the status quo,analyze the causes and formulate countermeasures for the quality control of pathological specimen identification in endoscopy center．The accuracy rate of endoscopic pathological specimen identification before and after QCC activity was compared．Results After QCC activity, the accuracy of pathological specimen identification in endoscope center increased from 99.8% to 100%．Conclusions QCC activities based on Deming cycle management can greatly improve the safety and efficiency of endoscopic pathological specimen management．

       目的 探讨自发性脑出血（SICH）患者静脉血栓栓塞症（VTE）的独立危险因素,并评估针对性分层预防措施的有效性及安全性, 为临床优化防治策略提供依据。方法 回顾性纳入2022年1月—2025年1月收治的86例SICH患者, 根据下肢深静脉超声结果分为深静脉血栓（DVT）组（n=16）与非DVT组（n=70）。采集患者基线资料、临床特征及实验室指标, 采用单因素及多因素Logistic回归分析VTE危险因素, 并基于独立危险因素制定分层预防方案。结果 多因素分析显示, 体质指数（BMI）升高（OR=1.22, 95%CI：1.06~1.41）、中心静脉置管（OR=5.23, 95%CI：1.37~19.95）、止血药物使用（OR=4.80, 95%CI：1.21~19.01）及NIHSS评分升高（OR=1.20, 95%CI：1.02~1.42）是VTE的独立危险因素（均P<0.05）。因此需针对SICH患者进行针对性干预, 包括基于BMI的个体化干预、中心静脉置管的精细化管控、止血药物的动态调控及神经功能保护与早期康复。结论 SICH患者VTE发生与代谢、医源性及神经功能损伤多因素交互作用密切相关, 应针对患者构建基于BMI、中心静脉管理及凝血监测的分层预防策略。

       Objective To explore the independent risk factors for venous thromboembolism（VTE）in patients with spontaneous intracerebral hemorrhage（SICH）and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic．Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025．Based on lower-extremity venous ultrasound findings, patients were divided into a deep venous thrombosis（DVT）group（n=16）and a non-DVT group（n=70）．Baseline characteristics, clinical features, and laboratory indicators were collected．Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors, and a stratified prevention protocol was developed based on independent risk factors．Results Multivariate analysis revealed that elevated body mass index（BMI）（OR=1.22, 95%CI：1.06-1.41）, central venous catheterization（OR=5.23, 95%CI：1.37-19.95）, hemostatic drug use（OR=4.80, 95%CI：1.21-19.01）, and higher NIHSS scores（OR=1.20, 95%CI：1.02-1.42）were independent risk factors for VTE（all P<0.05）．Consequently, targeted nursing interventions should be implemented for SICH patients, including BMI-based personalized care, refined management of central venous catheters, dynamic regulation of hemostatic drugs, and neuroprotective early rehabilitation．Conclusions VTE in SICH patients is closely associated with the interplay of metabolic, iatrogenic,and neurological injury factors．A stratified prevention strategy incorporating BMI monitoring, central venous catheter management, and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety．

        目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组（30例,常规治疗+四子散中药封包药熨）与对照组（30例,常规治疗）。比较两组治疗前后疼痛评分（NRS-11）、肿胀程度评分、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义（P>0.05）; 治疗1周后,观察组疼痛评分为（2.11±0.48）分、肿胀程度为（0.35±0.43）度、CRP为（12.23±3.12）mg/L、IL-6为（16.03±4.01）ng/L,均低于对照组的（3.54±0.56）分、（1.04±0.58）度、（24.31±4.51）mg/L、（23.19±6.75）ng/L,差异有统计学意义（P<0.001）。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。

       Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery．Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group（30 cases, conventional treatment+Sizi power pack hot compress）and control group（30 cases, conventional treatment）． The pain score（NRS-11）, swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups．Results There was no significant difference in pain and swelling scores between the two groups before treatment（P>0.05）．After 1 week of treatment, the pain score（2.11±0.48）, swelling score（0.35±0.43）, CRP（12.23±3.12 mg/L）, IL-6（16.03±4.01 ng/L）levels in the observation group were significantly lower than those in the control group（3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L）, and the difference was statistically significant（P<0.001）．There were no adverse events in the observation group or the control group．Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety．

       目的 调查国内养老机构痴呆照护服务现状,为今后国内进一步推进养老机构痴呆照护服务的发展提供可借鉴的依据。方法 2024年1月1日至3月31日以全国养老机构为研究对象, 采取两阶段分层抽样, 随机抽取国内15个省、自治区、直辖市的养老机构, 采用网络问卷调查方法对抽取的养老机构管理人员进行问卷调查。结果 共回收线上调查问卷443份, 经过去重和排除无效问卷, 最终得到的有效问卷为412份, 有效率为93%。调查发现有313家（76%）机构有收住痴呆患者, 养老床位规模为100~299张的养老机构占比最高。小规模的养老机构中,民办民营机构收住痴呆患者的比例高于公建公营机构。有181家机构设置了痴呆照护专区。床位数在300张以上的养老机构中设立痴呆照护专区的比例高于中、小规模的养老机构。结论 本调查较客观地呈现了我国养老机构痴呆照护服务开展的现状, 大规模的养老机构提供痴呆照护服务的能力更高, 设置痴呆照护专区的机构更能满足痴呆患者多层次、多样化的照护需求。目前国内仍存在专业化的痴呆照护服务供给不足、照护人员短缺等现象,  急需国家加强顶层设计,  促进行业健康发展。

       Objective To explore the current situation of cognitive care services in nursing homes in China, and provide reference for further promoting the development of cognitive care services in nursing homes in China．Methods From January 1 to March 31, 2024, a two-stage stratified sampling was carried out to randomly select pension institutions in 15 provinces, autonomous regions and municipalities directly under the central government across the country, and a questionnaire survey was conducted on the nursing homes．Results A total of 443 online questionnaires were recovered in this survey, and 412 valid questionnaires were obtained after eliminating duplicated and invalid questionnaires, with an effective rate of 93%．In this survey, 76% of the institutions admitted the elderly with dementia, and the nursing homes with 100-299 beds accounted for the highest proportion．Among the small-scale nursing homes, the proportion of the elderly with dementia in private institutions is significantly greater than that in public institutions．There were 181 nursing homes with special cognitive care areas．The proportion of cognitive care area in nursing homes with more than 300 beds was significantly greater than that in medium and small scale nursing homes．Conclusions This survey Objectively presents the current situation of the development of cognitive care services in nursing homes in our country．Large-scale nursing homes have a higher capacity to provide cognitive care services．Nursing homes that set up special areas for cognitive care can better meet the multi-level and diversified care needs of the elderly with dementia．At present, there are still insufficient supply of professional cognitive care services and shortage of nursing personnel in China．It is urgent for the country to strengthen top-level design and promote the healthy development of the industry．

      目的 探讨重性抑郁障碍（MDD）患者肠道菌群特征与选择性5-羟色胺再摄取抑制剂（SSRIs）疗效的关联性, 筛选可预测SSRIs疗效的肠道菌群生物标志物。方法 选取2024年5月—2025年5月宁夏回族自治区人民医院收治的90例MDD患者, 根据SSRIs治疗8周后疗效分为应答组56例和无应答组34例, 并选择30例健康对照, 采集基线粪便样本进行16S rRNA基因测序, 分析肠道菌群α多样性、菌属相对丰度差异,并通过相关性分析、多因素Logistic回归及ROC曲线评估菌群标志物对SSRIs疗效的预测价值。结果 MDD患者肠道菌群Chao1指数、Shannon指数低于健康对照（P<0.05）, 应答组与无应答组α多样性无差异（P>0.05）。应答组基线Blautia、双歧杆菌属、粪球菌属丰度高于无应答组（P<0.05）, 大肠杆菌-志贺菌属丰度低于无应答组（P<0.05）。基线Blautia、双歧杆菌属、粪球菌属丰度与SSRIs治疗8周HAMD-17减分率呈正相关（r分别为0.390、0.420、0.350,均P<0.05）, 三者联合预测SSRIs疗效的ROC曲线下面积（AUC）为0.910（灵敏度83.9%,特异度85.3%）。结论 MDD患者存在肠道菌群结构异常, 基线Blautia、双歧杆菌属、粪球菌属丰度可作为SSRIs疗效的潜在预测标志物,为MDD个体化治疗提供实验依据。

       Objective To explore the association between gut microbiota characteristics and the efficacy of selective serotonin reuptake inhibitors（SSRIs）in patients with major depressive disorder（MDD）, and to screen gut microbiota biomarkers for predicting SSRIs efficacy．Methods A total of 90 MDD patients（divided into responders[n=56] and non-responders[n=34] based on 8-week SSRIs efficacy）and 30 healthy controls were enrolled from May 2024 to May 2025．Fecal samples were collected for 16S rRNA gene sequencing to analyze gut microbiota α diversity and genus-level relative abundance．Correlation analysis, multivariate logistic regression, and receiver operating characteristic curve were used to evaluate the predictive value of microbiota markers for SSRIs efficacy．Results The Chao1 and Shannon indices of gut microbiota in MDD patients were significantly lower than those in healthy controls（P<0.05）, with no difference between responders and non-responders（P>0.05）．Responders had higher baseline abundances of Blautia,Bifidobacterium, and Coprococcus（P<0.05）, and lower abundance of Escherichia-Shigella compared to non-responders．Baseline abundances of Blautia,Bifidobacterium（P<0.05）, and Coprococcus were positively correlated with 8-week HAMD-17 reduction rate（r=0.390, 0.420, 0.350; all P<0.05）．The combined prediction of these three genera for SSRIs efficacy showed an area under the curve of 0.910（sensitivity 83.9%, specificity 85.3%）．Conclusions MDD patients exhibit abnormal gut microbiota structure．Baseline abundances of Blautia,Bifidobacterium, and Coprococcus may serve as potential predictive biomarkers for SSRIs efficacy, providing experimental basis for personalized treatment of MDD．

       目的 分析广东省卒中中心建设现状及存在的问题,提出切实可行的改善建议。方法 基于广泛的文献调研, 通过问卷对广东省护士协会卒中中心建设与管理分会相关单位开展问卷调查, 统计分析其在医院管理制度、医护人员卒中救治水平及健康宣教等方面的现状与问题。结果 广东省卒中中心建设与管理委员会相关单位在卒中救治中基本实现跨学科合作, 院前评估制度基本满足卒中判断需求, 在提高卒中救治效率方面已基本形成共识, 卒中健康宣教基本满足患者需求, 但方式有待改进, 卒中随访制度和个案管理制度基本符合要求; 存在的问题包括卒中中心一线救治人员外出交流学习机会较少; 院前评估数据采集的便利性有待提高; 卒中康复需求仍难以满足; 健康宣教工作仍需加强。结论 广东省卒中中心建设与管理委员会相关单位在卒中院前评估、院内救治、出院随访和健康宣教方面能够满足患者需求, 但仍存在不足。建议相关单位为一线工作人员提供更多外出交流学习机会, 充分应用互联网和物联网技术提高院前卒中数据采集共享便利性; 加强多种形式的科普宣教, 继续完善拓展卒中康复治疗和护理服务并完善相关制度。

       Objective To understand the current situation of construction and existing problems of Stroke Center in Guangdong Province．Put forward feasible suggestions for improvement．Methods Based on extensive literature research, a questionnaire was designed to investigate the relevant organizations of Stroke Center Construction and Management Branch of Guangdong Nurses Association．The status quo and existing problems in hospital management system, stroke treatment level of medical staff, health education and other aspects were statistically analyzed．Results The relevant organizations of the Guangdong Stroke Center Construction and Management Committee could basically achieve interdisciplinary cooperation in stroke treatment, the pre-hospital assessment system basically met the needs of stroke judgment, and a consensus was basically reached on how to improve the efficiency of stroke treatment．Stroke health education basically met the needs of patients but the methods need to be improved．The stroke follow-up system and case management system basically met the requirements,but there were not many opportunities for first-line treatment personnel in stroke centers to exchange and study abroad．The convenience of data collection for pre-hospital assessment needed to be improved．Stroke rehabilitation needs were still difficult to meet．Health education still needs to be strengthened．Conclusions The relevant units of Guangdong Stroke Center Construction and Management Committee can meet the needs of patients in the aspects of pre-hospital assessment, in-hospital treatment,discharge follow-up and health education, but there are still shortcomings．It is suggested that relevant organizations provide more opportunities for front-line staff to exchange and study abroad, make full use of Internet and Internet of Things technology to improve the convenience of pre-hospital stroke data collection and sharing．Strengthen various forms of science popularization and education, and continue to improve and expand stroke rehabilitation treatment and nursing services, improve relevant systems．

       目的 了解《医疗保障基金使用监督管理条例》（以下简称《条例》）在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。

        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”（hereinafter referred to as the “Regulations”）in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions．Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff．Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations．” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization．However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities．Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision．

       本文系统探讨了人工智能（AI）技术在模拟医学培训中的应用现状、优势与挑战。AI通过虚拟患者系统、手术模拟评估、医学影像诊断培训及结构化报告优化四大核心场景,显著提升培训的智能化与个性化水平。研究表明,AI驱动的实时反馈机制（如手术技能评估系统）在随机对照试验中表现优于传统专家指导, 并具备大规模推广潜力, 可降低人力成本。然而,技术仍面临算法透明性、数据隐私伦理及临床转化效果验证等挑战。未来需深化跨学科合作, 结合增强现实（AR）等技术创新, 构建全球资源共享的智能认证体系, 推动医学教育范式转型。

       This review summarizes and discusses the application status, advantages,and challenges of artificial intelligence（AI）technology in simulated medical training．AI significantly enhances the intelligence and personalization of training through four core scenarios：virtual patient systems, surgical simulation assessment, medical imaging diagnosis training, and structured reporting optimization．Researches demonstrates that AI-driven real-time feedback mechanisms（e.g., surgical skill assessment systems）outperform traditional expert guidance in randomized controlled trials（P<0.001）and exhibit potential for large-scale implementation to reduce labor costs．However, challenges remain regarding algorithmic transparency, data privacy ethics, and clinical translation validation．Future efforts require deepened interdisciplinary collaboration, integration with innovations like augmented reality, and the establishment of a globally shared intelligent certification system to advance the transformation of medical education paradigms．