目的 探讨64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。方法 选择2023年7月—2024年5月在潜江市中心医院诊治的主动脉夹层疑似患者96例为研究对象,所有患者均进行64层螺旋CT三维重建技术检查, 记录成像参数。所有患者在64层螺旋CT三维重建后进行介入治疗, 以介入检查结果为金标准, 判断64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。结果 在96例患者中, 64层螺旋CT三维重建联合判断为主动脉夹层60例, 其中Ⅰ型32例、Ⅱ型20例、Ⅲ型8例,其中再现（VR）、最大密度投影（MIP）及多平面重建（MPR）分别判断为主动脉夹层56例、54例、56例。在96例患者中, 64层螺旋CT三维重建检查的破口层面主动脉平均直径（3.08±0.25）cm、破口至左锁骨下平均距离（4.05±0.26）cm, 与介入治疗检查（3.05±0.36）cm、（4.06±0.14）cm, 对比差异无统计学意义（t=0.671, P=0.503; t=0.332, P=0.740）。64层螺旋CT三维重建联合、VR、MIP、MPR对主动脉夹层的诊断灵敏度分别为98.33%、93.22%、89.83%、94.92%, 特异度分别为97.30%、97.30%、97.30%、100.00%, 准确率分别为98.96%、94.79%、92.71%、96.88%。结论 64层螺旋CT三维重建技术在主动脉夹层介入术前评估中具有很高的灵敏度、特异度与准确率。

Objective To explore and analyze the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection（AD）intervention．Methods From July 2023 to May 2024, 96 cases of patients suspected of aortic dissection treated in our hospital were selected as the research subjects．All patients underwent 64-slice spiral CT three-dimensional reconstruction technology examination, and imaging parameters were recorded．After the 64-slice spiral CT three-dimensional reconstruction, all patients were given interventional treatment, and the results of the interventional examination were used as the “gold standard” to evaluate the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection intervention．Results Among the 96 patients,64-slice spiral CT three-dimensional reconstruction combined diagnosis identified 60 cases of aortic dissection,including 32 type I, 20 type II, and 8 type III cases．volume rendering（VR）, maximum intensity projection（MIP）, and muhiplanar reconstrudion（MPR） identified 56, 54, and 56 cases of aortic dissection,respectively．In 96 patients, the mean aortic diameter at the lacerated level and the mean distance from the lacerated to the left subclavicular level were（3.08±0.25）cm and（4.05±0.26）cm respectively in 64-slice spiral CT three-dimensional reconstruction examination, compared with（3.05±0.36）cm and（4.06±0.14）cm in interventional examination．There was no difference in comparison（t=0.671, P=0.503; t=0.332, P=0.740）．The sensitivity, specificity, and accuracy of the 64-slice spiral CT three-dimensional reconstruction combined, VR, MIP, and MPR for the diagnosis of aortic dissection were 98.33%, 93.22%, 89.83%, 94.92%, specificity were 97.30%, 97.30%, 97.30%, 100%, accuracy were 98.96%, 94.79%, 92.71%, 96.88%．Conclusions Technology of 64-slice spiral CT three-dimensional reconstruction has high sensitivity, specificity, and accuracy in the preoperative assessment of aortic dissection intervention and is worth promoting and applying clinically．

目的 观察辅助性T17细胞（Th17）与调节性T细胞（Treg）比值与2型糖尿病（T2DM）患者胰岛素抵抗及胰岛β细胞功能的关系。方法 纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例, 分为糖耐量正常组（NGT组, n=100）和T2DM组（n=100）, 分别测定糖化血红蛋白（HbA1c）、空腹血糖（FPG）、甘油三酯（TG）等生化指标, 电化学发光法测定空腹胰岛素（FINS）, 稳态模型计算胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（HOMA-ISI）。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果 与NGT组相比, T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高（P<0.01）, HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低, 且差异有统计学意义（P<0.01）。Th17与BMI（r=0.251, P<0.001）及HOMA-IR（r=0.305, P<0.001）呈正相关; 与HOMA-β（r=-0.204, P<0.001）及HOMA-ISI（r=-0.359, P<0.001）呈负相关。Treg与HOMA-ISI之间呈正相关（r=0.170, P=0.008）, 而与HOMA-IR呈负相关（r=-0.153, P=0.017）; Th17/Treg与BMI（r=0.332, P<0.001）及HOMA-IR（r=0.374, P<0.001）;与HOMA-β（r=-0.249, P<0.001）及HOMA-ISI（r=-0.427, P<0.001）呈负相关。多元线性回归分析显示, Th17/Treg是HOMA-IR（β=5.915）升高及HOMA-ISI（β=-2.557）下降的影响因素（P<0.01）。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。

Objective To explore the relationship among the proportion of helper T17 cells（Th17）to regulatory T cells（Treg）, insulin resistance, and the function of islet beta cells．Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included．Patients were divided into normal glucose tolerance group（NGT group, n=100）and type 2 diabetes mellitus group（T2DM group, n=100）．The biochemical indexes of HbA1c, fasting blood glucose（FPG）, triglyceride（TG）and fasting insulin（FINS）were determined by electrochemiluminescence．Islet beta cell function index（HOMA-β）, insulin resistance index（HOMA-IR）and insulin sensitivity index（HOMA-ISI）were calculated in homeostasis model．The levels of Th17 and Treg were detected by flow cytometry．Spearman was used to analyze the correlation between indicators, and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR, HOMA-β and HOMA-ISI．Results In contrast to the NGT group, the T2DM group exhibited elevated levels of BMI, FPG, HbA1c, LDL-C, TG, TC, FINS, HOMA-IR, Th17 and Th17/Treg, with these variances being signifincantly different（P<0.01）．There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different（P<0.01）．Th17 was positively correlated with BMI（r=0.251, P<0.001）and HOMA-IR（r=0.305, P<0.001）, it was negatively correlated with HOMA-β（r=-0.204, P<0.001）and HOMA-ISI（r=-0.359, P<0.001）．Treg was positively correlated with HOMA-ISI（r=0.170, P=0.008）, while it was negatively correlated with HOMA-IR（r=-0.153, P=0.017）．The ratio of Th17/Treg was positively correlated with BMI（r=0.332, P<0.001）and HOMA-IR（r=0.374, P<0.001）, it was negatively correlated with HOMA-β（r=-0.249, P<0.001）and HOMA-ISI（r=-0.427, P<0.001）．Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR（β=5.915）and the decrease of HOMA-ISI（β=-2.557）（P<0.01）．Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity．

目的 探讨卵巢癌化学治疗（化疗）耐药与焦孔素E（GSDME）基因的甲基化是否有关, 以及地西他滨是否可以通过去甲基化使GSDME蛋白表达水平升高从而逆转卵巢癌化疗耐药。方法 顺铂逆浓度梯度构建SKOV-3卵巢癌耐顺铂细胞株（SKOV-3/DDP）; CCK8法检测耐药前后细胞株的半抑制浓度（IC₅₀）; 实时荧光定量甲基化特异性PCR法检测两组细胞中GSDME基因的甲基化水平; Wetern Blot检测两组细胞中GSDME的表达水平。将耐药细胞株用不同质量浓度的地西他滨处理,重复上述实验, 检测地西他滨处理前后细胞的IC₅₀、GSDME基因的甲基化水平及GSDME蛋白的表达程度。结果 与SKOV-3细胞相比, SKOV-3/DDP中GSDME基因的甲基化水平升高（P<0.01）, 同时GSDME蛋白的表达水平降低（P<0.001）; 随着地西他滨作用浓度的升高, 耐药细胞中GSDME基因的甲基化程度逐渐降低, 蛋白的表达水平逐渐升高, 细胞的IC₅₀逐渐降低：在用0.5 μg/mL地西他滨处理耐药细胞后GSDME基因的甲基化水平虽然降低（P<0.01）, 但是此时蛋白的表达水平及耐药细胞的IC₅₀均无明显改变（P>0.05）; 当地西他滨的浓度增加到1.0 μg/mL时蛋白的表达水平才明显升高（P<0.05）, 而此时细胞的IC₅₀仍未见明显降低（P>0.05）; 待药物浓度达到1.5 μg/mL时, 细胞的IC₅₀才表现出明显的下降趋势（P<0.05）。结论 GSDME的表达与卵巢癌的化疗耐药密切相关, GSDME的高甲基化水平致使其低表达可促进卵巢癌的化疗耐药。但地西他滨可以通过去甲基化使卵巢癌耐药细胞中GSDME的表达水平升高, 从而增加卵巢癌细胞对化疗药物的敏感性, 进而逆转卵巢癌化疗耐药。

Objective To explore whether drug resistance in ovarian cancer is associated with gasdermin E（GSDME） methylation, and to explore whether decitabine can reverse ovarian cancer chemoresistance by increasing GSDME protein expression levels through demethylation．Methods The cisplatin-resistant cell line（SKOV-3/DDP）was constructed by inverse concentration gradient of cisplatin．Semi-inhibitory concentration（IC₅₀）of cell lines after drug resistance was detected using the CCK8 assay．Real-time fluorescence quantitative methylation-specific PCR was used to detect the methylation level of GSDME gene in the two groups of cells．Wetern Blot was used to detect the expression level of GSDME in the two groups of cells．Drug-resistant cell lines were treated with different concentrations of the demethylating drug decitabine．Experiments above were repeated to detect the methylation degree of IC₅₀ and GSDME genes and the expression level of GSDME protein in drug-resistant cells before and after decitabine treatment．Results Compared with SKOV-3 cells, the methylation level of GSDME gene in SKOV-3/DDP was significantly increased（P<0.01）, while the expression level of GSDME protein was significantly decreased（P<0.001）．With the increase of decitabine concentration, the methylation degree of GSDME gene in drug-resistant cells was gradually decreased, the expression level of protein was gradually increased, and the IC₅₀ of cells was gradually decreased：the methylation level of GSDME gene was decreased after 0.05 μg/mL decitabine treatment（P<0.01）, but there were no significant changes in protein expression level and IC₅₀ of drug-resistant cells（P>0.05）．The protein expression level was significantly increased when the concentration of local citabine was increased to 0.10 μg/mL（P<0.05）, while the IC50 of the cells was not significantly decreased（P>0.05）．When the drug concentration reached 0.15 μg/mL, he IC₅₀ of the cells showed a significant downward trend（P<0.05）．Conclusions The expression of GSDME is closely related to chemoresistance in ovarian cancer, and the low expression of GSDME due to its high methylation level can promote chemoresistance in ovarian cancer．However, decitabine can increase the expression level of GSDME in drug-resistant ovarian cancer cells through demethylation,thereby increasing the sensitivity of ovarian cancer cells to chemotherapeutic drugs, and then reversing the chemoresistance of ovarian cancer．

目的 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系, 并应用于临床,为急诊脑出血患者护理质量管理、监测与评价提供客观、科学的参考依据。方法 通过文献查阅、筛查与评价, 提取可行性资料, 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系的框架, 并采用德尔菲法完成两轮专家函询,确定最终的指标体系。选择2021年1月—2024年1月本院收治的230例急诊脑出血患者为研究对象, 将2021年1月—2022年6月作为干预前监测节点,该阶段的165例患者为传统组, 实施常规的护理质量管理;将2022年7月—2024年1月作为干预后监测节点,该阶段的165例患者为观察组, 实施以急诊脑出血患者护理质量评价指标进行护理质量监测管理。结果 两轮函询中专家积极系数分别为95%和100%, 意见提出率分别为56.25%和35.54%; 两轮函询专家权威系数为0.945、0.893; 第1轮函询中各项指标变异系数（CV）均值为0~0.136, Kendall’s W协调系数为0.065; 第2轮函询中变异系数（CV）均值为0~0.110, Kendall’s W协调系数为0.186。最终形成的急诊脑出血患者护理质量评价体系共涵盖一级指标3个、二级指标11个、三级指标55个。观察组入院-用药时间合格率、吞咽障碍患者动态评估率、气道管理合格率、早期被动/主动活动落实率高于传统组,差异具有统计学意义（χ²=14.850、12.261、8.183、37.420, P<0.05）, 观察组患者满意度明显高于传统组（χ²=14.049, P<0.001）。结论 本研究构建的急诊脑出血患者护理质量评价体系具有一定的科学性、可靠性和实用性, 可作为临床实现护理质量持续改进的重要评价工具。

Objective Based on the Donabedian model,the nursing quality evaluation system of emergency cerebral hemorrhage patients was constructed, and applied to clinical practice, providing an objective and scientific reference basis for realizing the nursing quality management, monitoring and evaluation of emergency cerebral hemorrhage patients．Methods Through literature review, screening and evaluation, the feasibility data was extracted, and the framework of the nursing quality evaluation system for patients with emergency cerebral hemorrhage was constructed based on the Donabedian model, and the Delphi method was adopted to complete two rounds of expert letter inquiry to determine the final index system．The study selected 230 patients with acute cerebral hemorrhage admitted to our hospital from January 2021 to January 2024 as the research subjects．The period from January 2021 to June 2022 was used as the pre-intervention monitoring period, during which 165 patients were in the traditional group, receiving routine nursing quality management．The period from July 2022 to January 2024 was used as the post-intervention monitoring period, during which 165 patients were in the observation group,implementing nursing quality monitoring and management based on evaluation indicators for the care of patients with acute cerebral hemorrhage．Results In the two rounds of letter inquiry, the positive coefficient of experts was 95% and 100%, respectively, and the rate of suggestions was 56.25% and 35.54%, respectively; the authority coefficient of experts in the two rounds of letter inquiry was 0.945 and 0.893．In the first round the mean value of coefficient of variation（CV）of each index was 0~0.136, and the coordination coefficient of Kendall’s W was 0.065; in the second round the mean value of variation coefficient（CV）was 0-0.110, and the coordination coefficient of Kendall's W was 0.186．The final nursing quality evaluation system for emergency cerebral hemorrhage patients covers 11 first-level indicators, 11 second-level indicators and 55 third-level indicators．The results showed that the pass rate of admission-medication time, dynamic assessment rate of dysphagia patients, airway management rate, and early passive / active activity implementation rate of the observation group were statistically significant different from those in the traditional group（χ²=14.850,12.261, 8.183, 37.420, P<0.05）, and the patient satisfaction in the observation group was significantly higher than that in the traditional group（χ²=14.049, P<0.001）．Conclusions The nursing quality evaluation system for emergency cerebral hemorrhage patients constructed in this study is scientific,reliable and practical, and can be used as an important evaluation tool to achieve continuous improvement of nursing quality in clinical practice．

脓毒症当前仍然是全球范围内重要的医疗卫生问题,其对世界公共卫生及患者安全带来重大威胁。脓毒症是指宿主对感染反应失调引起的危及生命的器官功能障碍, 其发病率和病死率均极高,是临床重症医学中的重大挑战。在脓毒症病情的进展过程中, 可出现组织灌注不足、血流动力学不稳定等变化, 从而导致多器官功能受损,而心脏是常见的被累及的重要靶器官之一, 这种由脓毒症所导致的不同程度的心肌损伤, 被称为“脓毒性心肌病”, 其发生和发展机制复杂多样, 涉及循环心肌抑制因素、心肌自身因素及自主神经失调等多个方面。文章综述了脓毒症患者发生心肌损伤的高危因素, 以期为临床治疗和预防提供参考。

Sepsis currently remains an important global healthcare issue, and a major threat to world public health and patient safety．Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection, with extremely high morbidity and mortality,which is a major challenge in clinical critical care medicine．During the progression of sepsis, changes such as inadequate tissue perfusion and haemodynamic instability may occur, leading to impairment of multiple organ functions, while the heart is one of the commonly involved vital target organs, and the varying degree of myocardial damage caused by sepsis is known as “septic cardiomyopathy”．The mechanisms of its occurrence and development are complex and diverse, involving circulating myocardial inhibitory factors, myocardial auto-factors, and autonomic dysregulation．In this paper, we review the high-risk factors for myocardial injury in septic patients, providing a reference for clinical treatment and prevention.

医联体是分级诊疗制度建设的重要抓手,对“健康中国”战略目标的实现具有重要作用。在当前医疗改革背景下,探究医联体建设模式具有重要意义。文章介绍了广州市属A医院和区属B医院探索的非托管紧密型医联体实践举措、成效、创新与不足,总结了该模式对我国医联体建设的启示：一是政府层面要做好顶层设计,给与政策支持;二是网顶医院要下沉优质资源,因地制宜帮扶;三是成员单位要主动参与建设,抓住发展机遇。

The establishment of medical unions is a crucial step in the development of a hierarchical diagnosis and treatment system and plays a significant role in achieving the strategic goal of “Healthy China．”Given the current context of healthcare reform,it is highly important to explore effective models for constructing medical unions．This paper introduces the practical measures taken by Guangzhou Hospital A and Hospital B to establish a non-trustee-close medical commonwealth．It discusses the effects achieved as well as innovations made through this approach while also highlighting its limitations．Furthermore,this study summarizes key insights that can be drawn from this model for building medical commonwealths in China：firstly,governments should focus on top-level design and provide policy support;secondly,leading hospitals should allocate high-quality resources based on local conditions;thirdly,member units should actively participate in construction efforts and seize development opportunities．

值班和交接班制度是医疗质量安全管理核心制度之一,是医院 “8 h”以外医疗质量安全连续性的重要保障。华西天府医院以往依托纸质排班进行医师值班工作管理,容易造成值班信息不透明、手工报送信息繁琐等弊端。利用值班排班系统对医师值班工作进行科学管理,不仅使值班排班及值班费报送工作便捷、及时、规范,还有利于提升临床医师和行政管理人员的工作效率和满意度。

The doctor duty arrangements system is one of the core systems of medical quality and safety management．It is an important guarantee for the continuity of medical quality and safety beyond “eight hours”．In the past,a tertiary hospital relied on paper scheduling to manage doctors’ on-duty work,which was easy to cause defects such as opaque on-duty information and complicated manual information submission．The scientific management of doctors’ on-duty work by using the on-duty scheduling system not only makes the on-duty scheduling and on-duty fee reporting to be convenient,timely and standard,but also helps to improve the work efficiency and satisfaction of clinicians and administrative staffs．

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 探讨广州市越秀区青少年近视特点和危险因素,为降低青少年近视发病率提供参考依据。方法 本项目采用分层随机整群抽样的研究方法,抽取分布于广州市越秀区2 774名青少年作为研究对象,根据近视检查情况将其分为近视组（n=1 657）与非近视组（n=1 117）,通过问卷调查的方式,分析青少年近视整体现况、流行病学特征以及影响青少年近视发生、发展的相关行为和因素。结果 2 774名青少年中,1 657名近视,检出率为59.73%;其中女生为872名,多于男生的785名;幼儿园、小学生、初中生、高中生近视人数分别为20名、446名、484名、707名,呈升高趋势。学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的影响因素（P<0.05）。广州市越秀区青少年近视程度均与学段、校外用眼环境、电子屏幕使用情况、户外活动及睡眠情况、近距离用眼情况呈正相关（P<0.05）,与校内用眼环境、读写姿势、近视检查及矫治情况呈负相关（P<0.05）。对不同预后组间存在统计学差异的因素进行Logistic多因素分析后得到,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的相关影响因素（P<0.05）。结论 广州市越秀区青少年近视发生人群呈现高龄化,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是青少年近视的相关影响因素,建议加强组织学生到户外进行多种课间户外体育活动,同时鼓励家长在校外从自身做起,树立爱眼护眼好榜样,与学校共同保护孩子的视力。

Objective To explore the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou,and to provide reference for reducing the incidence of myopia among adolescents．Methods This project adopted stratified random cluster sampling to select 2 774 adolescents distributed in Yuexu District,Guangzhou as the research objects,which were divided into myopia group（n=1 657）and non-myopia group（n=1 117）according to the myopic examination．Through questionnaire survey,the overall situation and epidemiological characteristics of myopia among adolescents in our district were comprehensively known,in order to explore the related behaviors and factors affecting the occurrence and development of myopia among adolescents in our district,explore reasonable intervention measures,and put forward scientific and effective myopia prevention and control technical means and strategies．Results Among 2 774 adolescents,1 657 were nearsighted（59.73%）．Among them,872 were female and 785 were male．The number of myopia in kindergarten,primary school,middle school and high school students were 20,446,484 and 707 respectively,showing an increasing trend．School period,eyes use environment in school and outside school,reading and writing posture,situations of electronic screen use,close distance eye use,outdoor activities and sleep,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou（P<0.05）．The myopia degree of adolescents in Yuexiu District of Guangzhou was positively correlated with school period,out-of-school eyes use environment,electronic screen use,outdoor activities and sleep conditions,and close distance eyes use（P<0.05）,and negatively correlated with in-school eyes use environment,reading and writing posture,myopia examination and correction conditions（P<0.05）．After Logistic multivariate analysis of the factors with statistical difference between different prognostic groups,school period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep conditions,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou（P<0.05）．Conclusions In Yuexiu District,Guangzhou,the population with myopia is gradually moving to a younger age．School period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep condition,myopia examination and correction are the relevant influencing factors．It is recommended to strengthen the organization of students to go outdoors for a variety of outdoor sports activities between classes,while encouraging parents to set a good example of eye care outside the school and work with the school to protect their children’s eyesight．

目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为（48.58±6.34）分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素（F=30.872,P<0.001）,解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。