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 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 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 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  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． 

       文章围绕康复治疗学专业创新创业人才培养模式展开研究，讨论了国内外高校创新创业人才培养现状。从教育理念、课程体系、师资力量、资源配套等方面探讨了人才培养所面临的问题。结合广东药科大学康复治疗学专业培养现状，从管理、教学、平台、服务四大体系明确了具体要求，有望为其他高校康复治疗学专业培养模式改革提供思路。

  The article focuses on innovative and entrepreneurial talent-cultivation models in the Rehabilitation Therapy specialty，discussing the current status of such cultivation in domestic and international universities．It explores challenges in talent development from perspectives including educational philosophy，curriculum system，faculty resources，and resource allocation．Based on the current training status of Guangdong Pharmaceutical University’s Rehabilitation Therapy Program，the study specifies detailed requirements through four major systems：management，teaching，platform，and service．This  research is expected to provide valuable insights for the  reform of talent cultivation models in  rehabilitation therapy programs at other higher education 

institutions．

        目的   探讨临床特征联合外周血血管内皮生长因子（VEGF）与α-羟基丁酸脱氢酶（α-HBDH）对卵巢癌的诊断价值。方法   选取2022年6月—2024年6月在天津市中心妇产科医院妇科接收的84例卵巢癌恶性肿瘤患者纳入观察组，同期选取84例卵巢良性病变患者纳入对照组。对比两组患者临床资料及VEGF、α-HBDH水平的差异，分析VEGF、α-HBDH水平与卵巢癌恶性肿瘤患者临床特征的相关性。采用二元Logistics回归分析卵巢癌恶性肿瘤的独立危险因素，并采用受试者工作特征（ROC）曲线分析VEGF、α-HBDH水平诊断卵巢癌恶性肿瘤的价值。结果   观察组年龄、身体质量指数（BMI）及血清CA125、HE4、VEGF、α-HBDH水平显著高于对照组（P＜0.05），VEGF与α-HBDH水平与国际妇产科联盟（FIGO）分期、分化等级及淋巴结转移均呈正相关关系（P＜0.05）。将年龄、BMI、VEGF、α-HBDH作为自变量纳入二元Logistic回归，结果显示BMI、VEGF、α-HBDH是卵巢癌恶性肿瘤的影响因素（P＜0.05），ROC曲线分析显示，联合检测VEGF和α-HBDH的AUC达0.921，灵敏度和特异度分别为81.0%和91.7%，优于单独检测（VEGF：AUC=0.702；α-HBDH：AUC=0.796）。结论  BMI联合VEGF与α-HBDH检测可为卵巢癌的诊断提供高效、无创的辅助手段，具有重要临床应用潜力。

      Objective  To explore the  diagnostic value of clinical features combined with  peripheral  blood vascular endothelial growth factor（VEGF）and α-hydroxybutyrate dehydrogenase（α-HBDH）levels in ovarian cancer．Methods  A total of 84 patients with malignant ovarian cancer admitted to the gynecology department of Tianjin Central Hospital of Gynecology and Obstetrics from June 2022 to June 2024 were included in the observation group，and 84 patients with benign ovarian lesions during the same period were included in the control group．The clinical data and VEGF，α-HBDH levels of the two groups were compared．Pearson analysis was used to explore the correlation between VEGF，α-HBDH levels，and clinical characteristics of patients with malignant ovarian cancer．Binary Logistic regression analysis was conducted to identify independent risk factors for malignant ovarian cancer，and receiver operating characteristic（ROC） curves were used to analyze the diagnostic value of VEGF and α-HBDH levels for malignant ovarian cancer．Results  The observation group had significantly higher age，BMI，and serum CA125，HE4，VEGF，α-HBDH levels compared to the control group（P＜0.05）．VEGF and α-HBDH levels were significantly positively correlated with FIGO stage，differentiation grade，and lymph node metastasis（P＜0.05）．Age，BMI，VEGF，and α-HBDH were included as independent variables in binary Logistic regression，and the results showed that BMI，VEGF，and α-HBDH levelswere independent risk factors for malignant ovarian cancer（P＜0.05）．ROC curve analysis  revealed that the AUC for combined detection of VEGF and α-HBDH reached 0.921，with sensitivity and specificity of 81.0% and 91.7%，respectively，significantly superior to individual detection（VEGF：AUC=0.702；α-HBDH：AUC=0.796）．Conclusions  The detection of BMI combined with VEGF and α-HBDH levels can provide an efficient and noninvasive auxiliary means for the diagnosis of ovarian cancer，which has important clinical application potential．

      目的   免疫球蛋白A肾病（IgAN）与炎症性肠病（IBD）的相互作用机制尚未阐明。本研究旨在解析IBD与IgAN共病的关键特征基因及核心信号通路，以揭示肠－肾轴的分子调控网络。方法   于GEO数据库获取IBD（GSE75214）和IgAN（GSE93798）基因表达谱，筛选差异表达基因（DEGs）。通过蛋白互作网络（PPI）和拓扑算法（MCC、MNC、Degree、EPC等）识别核心特征基因，并结合公共数据库（CTD、DISEASES和GeneCards）和单细胞转录组测序（GSE171314）进行验证。通过Nephroseq数据库验证基因表达与临床表型的相关性。结果   共筛选出17个IBD-IgAN共病DEGs，PPI网络分析等确定以FOS、EGR1、CXCL2和JUNB为核心特征基因。功能富集分析显示白细胞介素-17（IL-17）信号通路显著激活。单细胞测序验证FOS、EGR1、CXCL2和JUNB基因在IgAN特异性高表达，并通过Nephroseq数据库验证其与尿蛋白和估算的肾小球滤过率下降（eGFR）显著相关。结论  本研究揭示IBD与IgAN共享IL-17通路异常激活及FOS、EGR1、CXCL2和JUNB的基因网络，为开发基于肠－肾轴调控的靶向治疗策略提供理论依据。

       Objective  The complex interplay between immunoglobulin A nephropathy（IgAN）and inflammatory bowel disease（IBD）remains poorly understood．This  study  aimed to identify  key  cross-talk  genes  and  pivotal  signaling pathways shared between IBD and IgAN，thereby elucidating the molecular regulatory network underlying the gut-kidney axis．Methods  Transcriptomic datasets for IBD（GSE75214）and IgAN（GSE93798）were retrieved from the GEO database．Differentially expressed genes（DEGs）were screened，and shared DEGs were intersected．Protein-protein interaction（PPI）networks were constructed using STRING and Cytoscape，with topological algorithms applied to identify hub genes．Gene expression profiles were validated through（CTD，DISEASES and GeneCards）and single-cell RNA sequencing（GSE171314）and the Nephroseq database，focusing on clinical correlations with proteinuria and estimated glomerular filtration rate（eGFR）．Results  Seventeen shared DEGs were identified between IBD and IgAN．PPI network analysis revealed FOS，EGR1，CXCL2 and JUNB as core hub genes．Functional enrichment analysis demonstrated significant activation of the interleukin-17（IL-17）signaling pathway．Single-cell sequencing confirmed the specific upregulation of these genes in renal tubular epithelial cells of IgAN patients，which was further validated to correlate with proteinuria and eGFR decline．Conclusions  IBD and  IgAN share aberrant activation of the IL-17 pathway and a co-regulatory gene network involving FOS，EGR1，CXCL2 and JUNB，providing a theoretical foundation for developing therapeutic strategies centered on the gut-kidney axis．

       目的   针对孤独症多模态证据融合与定量化辨识的关键问题，本研究提出基于图卷积神经网络（GCN）的孤独症谱系障碍（ASD）诊断模型研究思路。方法  通过对来源于ABIDE的ASD儿童脑部fMRI数据进行整理和筛选，提取脑区功能连接矩阵作为图结构的邻接矩阵，并融合临床表型数据，构建了ASD多模态关联网络。通过网络特征比较分析，识别出了ASD与典型发育组的脑功能连接网络组间差异。进一步地构建一个端到端的GCN模型，并尝试引入注意力机制，提高模型决策的可解释性。结果  该模型在诊断性能指标优于传统机器学习方法（准确率=0.710，精确率=0.709，召回率=0.780，F1=0.743，曲线下面积=0.746）。背侧注意网络与边缘系统-颞极枢纽的功能连接减弱是模型做出判断的最主要依据。结论  以异质图为多模态数据整合的基本架构，本模型为ASD的潜在病理机制探索提供了新的方法学范例。

      Objective   To develop a quantitative model for autism spectrum disorder（ASD）integration multimodal evidences．Methods The fMRI  dataset from ABIDE was  used for extracting connectivity function  network of ASD after  data preprocessing．Difference between ASD and typical development about their brain connectivity function was evaluated with t-test．Integrating phenotypic data and fMRI dataset，an graph convolutional neural network （GCN）with attention module was estimated and compared against benchmark models about their efficiency and interpretability．Results  The GCN model was evaluated outperformed other models with better accuracy indices．And regions from Dorsal Attention Network and Limbic-Temporal Pole were ranked as the highest weights for the differentiation in the model．Conclusions  This study provided a novel paradigm for quantitative diagnosis and exploring pathogenesis of ASD．