目的   调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况，为区域干预提供依据。方法   将江西省南昌市东湖区划分为东、南、西、北、中5个片区，每个片区随机抽取一个街道（管理处），于每年5月份随机抽取各街道（管理处）20名孕妇，每年共抽取100名孕妇，3年共计300名孕妇，采集其尿液样本和家中食用盐样本检测碘含量，以统计学方法进行分析。结果  3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg，碘盐覆盖率为98.67%，碘盐合格率为95.33%，3年的食用盐碘含量比较差异有统计学意义（H=38.545，P＜0.05）。孕妇的尿碘水平中位数为115.15 μg/mL，3年来孕妇的尿碘水平中位数均低于150 μg/mL，有62.67%的孕妇碘缺乏，3年间的尿碘水平比较差异有统计学意义（H=9.392，P＜0.05），其中2024年的尿碘水平中位数为140.00 μg/mL，校正后高于2022年（Z=2.693，P＜0.0167）和2023年（Z=2.590，P＜0.0167）。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇碘营养状况与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇尿碘水平与碘营养状况正相关（r_s=0.857，P＜0.05），盐碘含量与碘盐质量正相关（r_s=0.314，P＜0.05）。结论   江西省南昌市东湖区2024年孕妇碘缺乏有所改善，但整体形势严峻，超半数的孕妇碘缺乏，食用碘盐基本符合国家消除碘缺乏病标准，但仍需改进。卫生部门要强化孕妇碘营养监测，向孕妇科普碘缺乏病知识，增强补碘意识，促其科学补碘。盐业监管部门需加大监管，严控碘盐质量，确保东湖区居民食盐合格。

       Objective  To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District，Nanchang City，Jiangxi Province from 2022 to 2024，and provide a basis for regional intervention．Methods  Donghu District was divided into five areas：East，South，West，North，and Central．A street（management office）was randomly selected from each area，and 20 pregnant women were randomly selected from each street（management office）in May each year．A total of 100 pregnant women were selected each year，for a total of 300 pregnant women over three years．Urine samples and household salt samples were collected to detect iodine content，and statistical analysis was conducted．Results  Over the past three years，the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg，the iodized salt coverage rate was 98.67%，and the iodized salt qualification rate was 95.33%．There were differences in the iodine content of cooking salt in the three years（H=38.545，P＜0.05）．The median urinary iodine level of pregnant women was 115.15 μg/mL．In the past three years，the median urinary iodine levels of pregnant women were all lower than 150 μg/ml，and 62.67% of pregnant women were iodine-deficient．There were differences in the urinary iodine levels in the three years（H=9.392，P＜0.05）．Among them，the median urinary iodine level in 2024 was 140.00 μg/mL，which was significantly higher than that in 2022（Z=2.693，P＜0.0167）and 2023（Z=2.590，P＜0.0167）after correcting the significance level．Spearman correlation analysis  results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt（all P＞0.05），and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt（all P＞0.05）．The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status（r_s=0.857，P＜0.05），and the iodine content in salt is positively correlated with the quality of iodized salt（r_s=0.314，P＜0.05）．Conclusions  In 2024，the iodine deficiency among pregnant women in Donghu District，Nanchang City，Jiangxi Province was improved，but the overall situation is still severe．More than half of pregnant women were iodine-deficient．The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders，but still needed to be improved．The health department should strengthen the monitoring of iodine nutrition among pregnant women，popularize knowledge about iodine deficiency disorders to pregnant women，enhance their awareness of iodine supplementation，and promote their scientific iodine supplementation．The salt industry supervision department needs to strengthen supervision，strictly control the quality of iodized salt，and ensure that the cooking salt of residents in Donghu District is qualified．

更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院（广州市第一人民医院）基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。

How to better protect the occupational safety and health of medical personnel is a topic of great concern．This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard．It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital．

目的 分析医院职业暴露工作人员特征、发生职业暴露环节、类型及处理方式,为医院制订干预措施提供理论基础。方法 回顾性分析玉溪市人民医院2018—2023年共301例发生职业暴露工作人员资料, 包括职业暴露时间、性别、年龄、科室、岗位类型、在院工作时间、职位、职业暴露发生环节、职业暴露类型、暴露源、职业暴露后是否需要用药等处置信息。结果 301例职业暴露工作人员平均年龄为（28.81±10.92）岁, 女性占比84.7%（255例）; 57.8%（174例）职业暴露发生在检查/穿刺/注射/采血/置管/治疗/手术等操作中, 38.9%（117例）发生在医疗废物处置环节;87.7%（264例）的暴露类型为针刺伤;45.5%（137例）接触暴露源为有血源性传播疾病的患者。发生职业暴露工作人员中, 不同岗位职业暴露者的暴露类型、职位、科室、是否需要药物干预及接触暴露源情况比较差异有统计学意义（P<0.05）。结论 应加强医务工作者职业暴露相关知识及应急处置培训, 对不同工龄、岗位医务工作者制定针对性培训方案, 加强医疗废物处置流程及临床操作技能规范等知识培训,预防医务工作者职业暴露的发生。

Objective To analyze the characteristics,occupational exposure links, types, and treatment methods of occupational exposure among healthcare staff hospital, providing a theoretical basis for the development of related intervention strategies for hospitals．Methods A retrospective study was conducted to explore 301 cases of occupational exposure among healthcare staff in The People’s Hospital of Yuxi City from 2018 to 2023．Data of 301 cases were collected, including information on gender, age,department,personnel category, length of service in the hospital, job title, and the circumstances of occupational exposures, which covered exposure links, type, source, and post-exposure medication treatment measures．Results Among the 301 healthcare staff experiencing occupational exposure, the average age was（28.81±10.92）years, with 84.7%（255 cases）being female．Occupational exposure most frequently occurred during procedures such as examination, puncture, injection, blood collection, catheterization, treatment, and surgery（57.8%,174 cases）, followed by the disposal of medical waste（38.9%, 117 cases）．The primary type of exposure was needle-stick injury（87.7%）．Contact with patients suffering from blood-borne infectious diseases accounted for 45.5%（137 cases）of the occupational exposure incidents．There were significant differences in exposure types, job positions, departments, sources of exposure, and post-exposure medication treatment measures among healthcare staff of different categories（P<0.05）．Conclusions To prevent the occurrence of occupational exposure among healthcare staff, it is necessary to enhance training on occupational exposure knowledge and emergency management, particularly improving the disposal of medical waste and clinical operational skills．Additionally, it is crucial to have personalized training programs tailored to healthcare staff based on their varying lengths of service and positions．

目的 探讨基于区域专科联盟模式,在联盟医院内建立淋巴水肿专科干预小组的有效策略及其对患者干预效果的影响。方法 对区域医联体内7家联盟医院（包括德阳市人民医院、广汉市人民医院、罗江区人民医院、广汉妇幼保健院、德阳肿瘤医院、中江妇幼保健院、什邡市妇幼保健院）20名医护人员进行淋巴水肿知识及干预技能培训,建立区域性淋巴水肿专科干预小组,制定小组工作职责、实施专科质量控制。选取2024年5—8月淋巴水肿专科干预小组干预模式开展期间作为观察组, 选取2024年1—4月淋巴水肿专科干预小组干预模式开展前作为对照组。对比两组医护人员淋巴水肿相关知识掌握合格率、住院患者淋巴水肿风险筛查率、淋巴水肿高风险患者措施落实率、出院随访患者上肢功能评定评分及患者就医满意度。结果 干预后,护理人员淋巴水肿知识各维度得分[基础知识（17.36±2.54）、诊断与评估（25.66±4.34）、治疗与管理（25.08±4.73）、预防与康复（15.36±2.53）、总分（85.36±8.52）]均高于干预前[基础知识（11.35±2.29）、诊断与评估（17.87±3.18）、治疗与管理（18.28±3.85）、预防与康复（10.39±2.24）、总分（55.35±7.56）]（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）; 观察组住院患者淋巴水肿风险筛查率高于对照组（80.72% vs 61.24%）, 对比差异有统计学意义（χ²=31.454, P<0.001）; 观察组患者出院时及出院后1月上肢功能评定（DASH）量表评分[（23.36±8.63）（20.16±7.34）分]低于对照组[（25.32±9.16）（22.25±7.67）分], 对比差异有统计学意义（t=2.884, P=0.004; t=3.646, P=0.001）; 观察组患者出院时患者就医满意度评分（83.36±8.63）高于对照组（71.37±10.33）, 对比差异有统计学意义（t=16.460, P<0.001）。结论 基于区域专科联盟体的联盟医院淋巴水肿专科干预小组能够有效地实现三级医院优质干预资源下沉, 在联盟内可实现淋巴水肿防治同质化、专科人才培训基地建设,整体提升区域内淋巴水肿防控效果,提高患者就医满意度。

Objective To explore effective strategies for establishing a lymphoedema specialty nursing team within alliance hospitals based on a regional specialty alliance and assess its impact on patient care outcomes．Methods A regional lymphedema specialty nursing team was established by training 20 healthcare professionals from 7 hospitals（Deyang City People’s Hospital,Guanghan People’s Hospital, Luojiang People’s Hospital, Guanghan Maternal and Child Health Hospital, Deyang Tumor Hospital, Zhongjiang Maternal and Child Health Hospital, and Shifang Maternal and Child Health Hospital）in a regional medical consortium, focusing on lymphedema knowledge and intervention skills．The team’s responsibilities and nursing quality control protocols were standardized．The observation group included data from May to August in 2024（post-intervention period）, while the control group comprised data from January to April in 2024（pre-intervention period）．Comparisons were made between the two groups regarding healthcare professionals’qualification rate in lymphedema knowledge,inpatients’ lymphedema risk screening rate, implementation rate of preventive measures for high-risk patients, upper extremity function assessment scores（using the Disabilities of the Arm,Shoulder and Hand [DASH] scale）at discharge and 1-month post-discharge, and patient satisfaction．Results After the intervention, healthcare professionals’ lymphedema knowledge scores significantly improved across all domains：basic knowledge（17.36±2.54 vs 11.35±2.29）, diagnosis/assessment（25.66±4.34 vs 17.87±3.18）, treatment/management（25.08±4.73 vs 18.28±3.85）,prevention/rehabilitation（15.36±2.53 vs 10.39±2.24）,and total score（85.36±8.52 vs 55.35±7.56）（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）．The observation group demonstrated a higher lymphedema risk screening rate（80.72% vs 61.24%,χ2=31.454,P<0.001）．DASH scores in the observation group were significantly lower than the control group at discharge（23.36±8.63 vs 25.32±9.16）and 1-month post-discharge（20.16±7.34 vs 22.25±7.67）（t=2.884, P=0.004; t=3.646, P=0.001）．Patient satisfaction scores at discharge were higher in the observation group（83.36±8.63 vs 71.37±10.33, t=16.460, P<0.001）．Conclusions The lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance effectively facilitates the high-quality nursing resources homogenization in primary hospitals．Within the alliance, it achieves homogenization of lymphoedema prevention and treatment, establishes a training base for specialty talents, and overall enhances lymphoedema prevention and control within the region, thereby improving patient satisfaction with healthcare．

目的 探讨基于健康意识理论（HEC）的健康管理联合早期活动护理干预应用于急性胰腺炎（AP）患者的效果。方法 将南阳市第一人民医院2020年1月—2023年1月期间收治的80例AP患者作为研究对象,按照随机数字表法分为对照组（n=40）和观察组（n=40）。两组患者均按照AP护理常规进行护理,对照组予早期活动护理干预,观察组予早期活动护理和基于HEC的健康管理,观察两组健康行为能力、健康促进行为和并发症发生情况。结果 干预后,两组患者健康行为能力自评量表得分均高于干预前,且观察组得分高于对照组（P<0.05）;两组患者健康促进生活方式量表Ⅱ得分均高于干预前,且观察组得分高于对照组（P<0.05）;观察组并发症发生率（5.00%）低于对照组（20.00%）。结论 基于HEC的健康管理联合早期活动护理可以有效改善AP患者的健康行为能力、健康促进行为减少并发症的发生。

Objective To explore the effect of health management combined with early activity nursing intervention based on health as expanding consciousness（HEC）on patients with acute pancreatitis（AP）．Methods Eighty patients with AP admitted to the First People’s Hospital of Nanyang City from January 2020 to January 2023 were selected as the study subjects．They were randomly divided into a control group（n=40）and an observation group（n=40）using a random number table method．Both groups of patients received routine AP nursing care．The control group received early activity nursing intervention,while the observation group received early activity nursing and HEC based health management．The health behavior ability,health promotion behavior,and incidence of complications were observed in both groups．Results After the intervention,both groups of patients had higher scores on the Self Rating Health Behavioral Ability Scale than before the intervention,and the observation group had higher scores than the control group（P<0.05）．The scores of the Health Promotion Lifestyle Scale II for both groups of patients were higher than before intervention,and the scores of the observation group were higher than those of the control group（P<0.05）．The incidence of complications in the observation group（5.00%）was lower than that in the control group（20.00%）．Conclusions Health management based on HEC combined with early activity nursing can effectively improve the health behavior ability of AP patients,promote health behavior,and reduce the occurrence of complications．

目的 探讨大一护理系学生（护生）心理健康素养、心理健康与心理弹性的现状以及三者之间的关系。方法 采用方便抽样法选取大一护生202人作为研究对象,采用一般资料问卷、青少年心理健康素养评定量表（AMHLAQ）、心理健康量表（K10）,心理弹性量表（CD-RISC）进行调查。结果 （1）城市大一护生心理健康素养（t=-2.832,P<0.01）、心理健康水平（t=3.052,P<0.001）和心理弹性水平（t=-2.521,P<0.05）高于农村大一护生;独生子女的心理健康素养（t=2.098,P<0.05）和心理健康水平（t=-2.684,P<0.01）高于非独生;父亲学历为高中及以上的心理健康素养（t=-2.543,P<0.05）和心理健康水平（t=3.082,P<0.01）高于父亲学历为初中及以下;母亲学历为高中及以上的心理健康素养（t=-2.052,P<0.05）和心理健康水平（t=2.595,P<0.01）高于父亲学历为初中及以下;（2）心理健康得分越高,心理问题越严重,心理健康素养与心理弹性呈正相关（r=0.340,P<0.01）,心理健康得分与心理健康素养、心理弹性呈负相关（r=-0.651,-0.384,P<0.01）。（3）心理弹性在心理健康素养与心理健康中存在部分中介效应,中介效应值为-0.190,中介效应占比15.68%。结论 山西医科大学汾阳学院大一护生心理健康存在一定问题,要多注重农村地区、非独生子女以及父母学历较低的人群心理健康和心理健康素养的培养,大一护生心理健康素养越高,心理弹性水平越高,心理健康得分越低,心理健康水平越高。心理弹性在心理健康素养与心理健康中起中介作用,可以提升大一护生的心理弹性水平,培养其坚韧性、自强性和乐观性,从而降低心理健康得分,提高心理健康水平。

Objective To explore the current status of mental health literacy,mental health,and psychological resilience among first-year nursing students,as well as the relationship among the three．Methods A total of 202 freshmen were selected as the research subjects using convenience sampling method．The survey was conducted using a general information questionnaire,the Adolescent Mental Health Literacy Assessment Scale（AMHLAQ）,the Mental Health Scale（K10）,and the Psychological Resilience Scale（CD-RISC）．Results （1）The mental health literacy（t=-2.832,P<0.01）,mental health level（t=3.052,P<0.001）,and psychological resilience level（t=-2.521,P<0.05）of urban freshmen were significantly higher than those of rural freshmen．The mental health literacy（t=2.098,P<0.05）and mental health level（t=-2.684,P<0.01）of only-child were higher than those of non-only-child．The mental health literacy（t=-2.543,P<0.05）and mental health level（t=3.082,P<0.01）of the father with a high school education or above were higher than those of the father with a middle school education or below．The mental health literacy（t=-2.052,P<0.05）and mental health level（t=2.595,P<0.01）of the mother with a high school education or above were higher than those of the father with a middle school education or below．（2）The higher the mental health score,the more serious the psychological problem．There was a significant positive correlation between mental health literacy and psychological resilience（r=0.340,P<0.01）,while there was a significant negative correlation among mental health score and mental health literacy and psychological resilience（r=-0.651,-0.384,P<0.01）．（3）Psychological resilience had a partial mediating effect between mental health literacy and mental health,with a mediating effect value of -0.190,accounting for 15.68% of the total．Conclusions There are certain problems with the mental health of freshmen nursing students in Shanxi Medical University．It is necessary to pay more attention to the cultivation of mental health and mental health literacy in rural areas,non-only-child,and those whose parents with lower educational level．The higher the mental health literacy and resilience level of freshmen nursing students,the lower their mental health scores,and the higher their mental health level．Psychological resilience plays a mediating role in the relationship between mental health literacy and mental health．It can cultivate the level of psychological resilience,resilience,self-improvement and optimism of first-year nursing students,thereby reducing their mental health scores and improving their mental health level．

目的 探讨对分课堂对《老年人健康照护技术》实训教学效果的影响,为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。方法 以广州卫生职业技术学院2022级智慧健康养老服务与管理专业学生为研究对象,设定其中一班为观察组,另一班为对照组,在《老年人健康照护技术》实训教学过程中,观察组采用对分课堂的实训教学模式,对照组采用传统实训教学模式;实训结束后对两组均进行理论和技能考核,并在教学前后均采用《一般自我效能感量表》对两组学生进行测评。结果 试验开始之前,对两组学生一般自我效能感测评得分进行比较,差异无统计学意义（P>0.05）;试验结束后,将观察组与对照组的理论和技能考核成绩、一般自我效能感得分进行比较,观察组均明显高于对照组,差异有统计学意义（P<0.01）;且观察组一般自我效能感得分优于本组试验前,差异有统计学意义（P<0.01）。结论 对分课堂有利于提高学生的一般自我效能感,有助于改善《老年人健康照护技术》的实训教学效果,能够为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。

Objective To explore the impact of split courses on the practical training and teaching effectiveness of “Elderly Health Care Technology”,and to provide reference for further improving the practical training and teaching plan of smart health and elderly care services and management．Methods A study was conducted on students majoring in Intelligent Health and Elderly Care Services and Management from Guangzhou Health Vocational and Technical College in 2022．One class was set as the observation group and the other as the control group．During the training and teaching process of “Elderly Health Care Technology”,the observation group adopted a split courses training teaching mode,while the control group adopted a traditional training teaching mode．After the practical training,theoretical and skill assessments were conducted on both groups,and the General Self Efficacy Scale was used to evaluate both groups of students before and after teaching．Results Before the start of the experiment,there was no statistically significant difference in the general self-efficacy evaluation scores between the two groups of students（P>0.05）．After the experiment,the theoretical and skill assessment scores, general self-efficacy scores of the observation group, and the control group were compared．The observation group was significantly higher than the control group,with a significant statistical difference（P<0.01）,and the general self-efficacy score of the observation group was better than before the experiment,with a statistically significant difference as well（P<0.01）．Conclusions split courses were beneficial for improving students’ general self-efficacy,enhancing teaching effectiveness,and providing reference basis for further improving the practical training teaching plan for smart health and elderly care services and management．

目的 探讨基于态度-定义-开放思维-计划-实施（ADOPT）模式的健康教育联合情绪引导对消化内镜诊疗患者配合度的影响。方法 选取2020年1月—2023年1月在我院准备行消化内镜诊疗的80例住院患者,随机分为观察组与对照组各40例。对照组患者在检查前采取常规护理,观察组患者在常规护理基础上增加基于ADOPT模式的健康教育联合情绪引导,在护理前后应用简明心境量表（POMS-SF）分别评估两组患者负面情绪、诊疗配合度、基础值（T₁）、入镜时（T₂）、检查开始后5 min（T₃）、检查结束时（T₄）的Ramsay镇静评分和舒适度评分,并对比两组患者的护理满意度。结果 护理后两组患者的困惑、活力、疲劳、抑郁、生气和紧张方面的POMS-SF评分降低,且观察组低于对照组（P<0.05）;观察组患者配合度为95.00%,高于对照组75.00%（P<0.05）;两组患者T1时间Ramsay镇静评分与舒适度评分比较差异无统计学意义（P>0.05）,观察组T₂、T₃、T₄时间Ramsay镇静评分高于对照组,舒适度评分优于对照组（P<0.05）;观察组患者的总满意度高于对照组（P<0.05）。结论 对消化内镜诊疗患者采取基于ADOPT模式的健康教育联合情绪引导可改善患者内镜诊疗过程前的负面情绪,提升患者配合度,同时能够改善患者诊疗过程中的镇静程度和舒适度,患者护理满意度较高。

Objective To explore the value of health education based on the ADOPT model combined with emotional guidance on the cooperation of patients undergoing digestive endoscopy diagnosis and treatment．Methods From January 2020 to January 2023,80 hospitalized patients who were going to have digestive endoscopy diagnosis and treatment in our hospital were selected as the research subjects．All patients were divided into observation group and control group,with 40 patients in each group．The control group patients received routine care before the examination,while the observation group patients added ADOPT based health education combined with emotional guidance on the basis of routine care．The Profile of Mood States-Short Form（POMS-SF）was used to evaluate the negative emotions of the two groups of patients before and after the examination．The diagnostic and treatment cooperation,basic value（T₁）,at the time of endoscopy（T₂）,and 5 minutes after the examination（T₃）,at the end of the examination（T₄）,the Ramsay sedation score and comfort score were compared between the two groups,and the nursing satisfaction of the two groups of patients was compared．Results After nursing,the POMS-SF scores of confusion,vitality,fatigue,depression,anger,and tension in the two groups of patients were significantly reduced,and the observation group was lower（P<0.05）．The cooperation rate of 95.00% in the observation group was significantly higher than that of 75.00% in the control group（P<0.05）．There was no significant difference in the Ramsay sedation score and comfort score between the two groups of patients at T₁ time（P>0.05）．The Ramsay sedation scores of the observation group at T₂,T₃,and T₄ time were higher,while the comfort score was lower（P<0.05）．The overall satisfaction of the observation group patients was higher（P<0.05）．Conclusions Adopting ADOPT based health education combined with emotional guidance for patients undergoing endoscopic diagnosis and treatment can improve their negative emotions before the endoscopic diagnosis and treatment process,enhance their cooperation level,and improve their level of sedation and comfort during the process．Patients have a high level of nursing satisfaction．

目的 探讨复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选择2019年6月—2023年1月在河南省许昌中医院诊治的79例缺血性脑卒中患者,按照入院就诊顺序采用奇偶法把患者分为联合组40例与传统组39例。传统组给予阿替普酶静脉溶栓治疗,联合组给予复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗,评价与记录联合组与传统组的疗效与安全性及治疗前、治疗14 d后Fugl-Meyer评定量表（FMA）与改良版Banhel评价指数（MBI）、血清β-内啡肽、前列腺素E2（PGE2）水平变化。结果 治疗14 d后联合组的总有效率更高（97.5% vs 82.1%,P<0.05）,并发症发生率更低（5.0% vs 20.5%,P<0.05）。联合组与传统组治疗14 d后的FMA与MBI评分高于治疗前（P<0.05）,联合组治疗14 d后的FMA评分、MBI评分比传统组提高（P<0.05）。联合组与传统组治疗14 d后的血清β-内啡肽、PGE2水平低于治疗前（P<0.05）,联合组治疗14 d后的血清β-内啡肽、PGE2水平低于传统组（P<0.05）。结论 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中能提高效果,降低患者的肺部感染、尿路感染、静脉血栓、褥疮等并发症发生率,改善患者的运动与日常生活功能,还可降低患者血清β-内啡肽、PGE2水平。

Objective To explore and analysis the efficacy and safety of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods From June 2019 to January 2023,79 patients with ischemic stroke who were diagnosed and treated at Henan Xuchang Traditional Chinese Medicine Hospital were selected as the research subjects．According to the order of admission,the patients were divided into the combination group of 40 cases and the traditional group of 39 cases．The traditional group received intravenous thrombolytic therapy with alteplase,while the combination group received treatment with compound brain peptide ganglioside injection on the basis of the traditional group．The efficacy and safety and changes of the Fugl-Meyer rating Scale（FMA）and modified Banhel Evaluation Index（MBI）,serum β-endorphin,and PGE 2 levels in the combined and traditional groups were evaluated and recorded. Results After 14 days of treatment,the combined group had a higher overall response rate（97.5% vs 82.1%,P<0.05）and a lower complication rate（5.0% vs 20.5%,P<0.05）．FMA scores and MBI scores of the two groups after 14 days of treatment were higher than those before treatment（P<0.05）,and FMA scores and MBI scores of the combined group after 14 days of treatment were higher than those of the traditional group（P<0.05）．The contents of β-endorphin and prostaglandin E2 in two groups after 14 days of treatment were lower than those before treatment（P<0.05）,and the contents of β-endorphin and prostaglandin E2 in combination group after 14 days of treatment were lower than those in traditional group（P<0.05）. Conclusions The combination of compound brain peptide ganglioside injection and alteplase intravenous thrombolysis in the treatment of acute ischemic stroke can improve the treatment effect,reduce the incidence of complications such as pulmonary infections,urinary tract infections,venous thrombosis and bedsores in patients,improve patients' motor and daily life functions,and also reduce patients' serum levels of β-endorphins and prostaglandin E2．

价值医疗下公立医院需转变运营管理模式,建设专门运营管理部门对满足外部政策要求和改善内部运营管理十分必要。通过梳理公立医院开展运营管理的主要任务,确定公立医院专门运营管理部门的职责,设计与承担职责相适应的组织架构,保证专门运营管理部门的职能充分发挥。

Public hospitals need to change the operation management mode under value-based healthcare．It is necessary to build a special operation management department to meet the requirements of external policies and improve internal operation management．By sorting out the operation and management tasks of public hospitals,the responsibilities of the operation management department are determined,and the organizational structure suitable for the responsibilities is designed,so that the construction of specialized operation management department can be effectively implemented．