约10%~30%的新发结直肠癌患者会出现急性肠梗阻，传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略，展现出显著优势。肠道支架可迅速解除梗阻，改善患者症状，降低手术风险，为肿瘤微创切除创造条件，同时为新辅助化疗提供可能，但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视，且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展，旨在为临床研究和实践提供参考依据。

    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction．Traditional emergency surgical intervention is characterized by high rates of postoperative complications，elevated mortality，and diminished quality of life．Combined stent and curative elective surgery（CSCES）has emerged as a novel therapeutic strategy，exhibiting significant clinical benefits．Intestinal stenting can rapidly alleviate obstruction，thereby improving patient symptoms，reducing surgical risks，and facilitating minimally invasive tumor resection．Additionally，it provides an opportunity for neoadjuvant chemotherapy．However，potential complications，including bleeding，stent migration，recurrent obstruction，and intestinal perforation，must be carefully considered．Moreover，the long-term safety and impact on oncologic outcomes remain to be elucidated．This review aims to provide a comprehensive overview of the current status，controversies，and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer，with the goalof informing clinical research and practice．

       目的 探讨营养风险管理结合分期饮食指导对溃疡性结肠炎（UC）患者营养状况的影响。方法 选择郑州市大肠肛门病医院收治的90例UC患者，纳入时间为2024年1月—2025年1月，按照计算机分组法分为对照组（45例），给予分期饮食指导，观察组（45例），在对照组的基础上增加营养风险管理，观察两组患者症状改善情况、营养状况、生活质量。结果 干预后，观察组Mayo评分（4.30±1.14）分、主观整体营养状况评价表（PG-SGA）评分（1.74±0.38）分低于对照组（5.48±1.33、2.28±0.43）分（P＜0.05）；观察组血红蛋白（HB）、前白蛋白（PA）、白蛋白（ALB）水平高于对照组（P＜0.05），IBDQ各维度评分及总分更高（P＜0.05）。结论 对UC患者应用营养风险管理结合分期饮食指导，能够减轻临床症状，改善营养状况，促进生活质量的提升。

       Objective To explore the influence of nutritional risk management combined with staged dietary guidance on the nutritional status of ulcerative colitis（UC）patients．Methods A total of 90 UC patients admitted to our hospital were selected and included from January 2024 to January 2025．According to the computer grouping method，45 cases were divided into control group with staged dietary guidance，and 45 cases were divided into observation group with nutritional risk management．The symptoms improvement，nutritional status，and quality of life of the two groups were observed．Results After intervention，the observation group had lower Mayo score（4.30±1.14）and Patient?Generated Subjective Global Assessment（PG-SGA）score（1.74±0.38）than the control group（5.48±1.33 and 2.28±0.43，respectively）（P＜0.05）；the observation group had higher levels of hemoglobin（HB），prealbumin（PA），and albumin（ALB）than the control group（P＜0.05），and also had higher scores in all dimensions and total score of the Inflammatory Bowel Disease Questionnaire（IBDQ）（P＜0.05）．Conclusions The application of nutrition risk management combined with staged dietary guidance in UC patients can reduce clinical symptoms，improve nutritional status，promote the improvement of life quality．

       脑卒中后认知障碍（PSCI）是脑卒中患者常见的并发症，严重影响患者的生活质量和社会功能。近年来，随着认知储备理论的发展和早期干预理念的普及，PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展，包括干预的理论基础、具体措施及未来发展方向，以期为临床实践和科研提供参考。

       Post-stroke cognitive impairment（PSCI）is a common complication among stroke patients．It seriously affects the patients’ quality of life and social functions．In recent years，with the development of the cognitive  reserve theory and the popularization of the concept of early intervention，the early intervention model for PSCI has gradually become a research hotspot．This article reviews the current research status and progress of the early intervention model for PSCI，including the theoretical basis of the intervention，specific measures，and future development directions，aiming to provide  references for clinical practice and scientific research．

       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 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．

       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．

       目的   系统评价护士的护理伦理敏感性现状及影响因素，为针对性干预提供参考。方法   检索国内外相关数据库，检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果   纳入16篇文献，包括4 961例研究对象。Meta分析结果显示，护士的护理伦理敏感性处于中等偏高水平，总分为［OR=67.29，95%CI（53.24，81.34）］分。年龄［OR=2.78，95%CI（1.45，5.33），P=0.002］、工作年限［OR=3.55，95%CI（1.35，9.33），P=0.001］、伦理知识教育［OR=14.60，95%CI（4.24，50.32），P＜0.001］、共情能力［OR=1.35，95%CI（1.01，1.80），P＜0.001］、工作场所氛围［OR=1.85，95%CI（0.42，4.51），P＜0.001］、工作嵌入量［OR=3.60，95%CI（0.40，32.84），P=0.001］是护士护理伦理敏感性的主要影响因素。结论   当前证据表明，护士的护理伦理敏感性处于中等偏高水平，影响因素较多，管理者需结合人群特征实施干预，以提高护士护理伦理敏感性水平。

   Objective  To systematically evaluate the current status of nurses’  ethical  sensitivity in  nursing  and influencing factors that influence it，in order to inform targeted interventions．Methods  Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024．Meta-analysis was performed by two analysts independently screening the literature，extracting information，and quality evaluation using Stata 15.0 and RevMan 5.3 software．Results  Sixteen papers including 4 961 study subjects were included．Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29（95%CI［53.24，81.34］）．Age（OR=2.78，95%CI［1.45，5.33］，P=0.002），years of experience（OR=3.55，95%CI［1.35，9.33］，P=0.001），education on ethical knowledge（OR=14.60，95%CI［4.24，50.32］，P＜0.001），and empathic ability（OR=1.35，95%CI［1.01，1.80］，P＜0.001），workplace atmosphere（OR=1.85，95%CI［0.42，4.51］，P＜0.001），and the amount of job embeddedness（OR=3.60，95%CI［0.40，32.84］，P=0.001） were the main influences on nurses’ ethical sensitivity in nursing．Conclusions  The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity，with a high number of influencing factors，and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses．

       目的   调查老年人照护服务需求现状并分析其影响因素，为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法，选取广州市某三甲医院212名老年人作为调查对象，采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养（1.96±0.90分）、心理慰藉（2.63±0.85分）、安宁服务（2.73±1.07分）的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素（P均＜0.05），可解释61.5%的变异量。结论   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征，构建供需匹配的多元化，多层次照护体系。

       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors，so as to provide a reference for the construction of a needs-oriented care service system for the elderly．Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale，Fried frailty scale and the self-designed elderly needs assessment questionnaire．Results  Elderly patients had higher demands for exercise，nutrition，psychological comfort and hospice services．The results of multivariate analysis showed that the influencing factors of care service demand included pension style，activities of daily living，number of hobbies，gender，frailty level，and having main caregivers（all P＜0.05），which could explain 61.5% of the variation．Conclusions  The care needs of elderly patients are affected by many factors．A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly．

       目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

       帕金森病是全球第二大神经退行性疾病，其根本病理特征为中脑黑质多巴胺能神经元的退变死亡。目前临床一线治疗主要采用左旋多巴替代疗法，然而疗效有限且副作用显著。以补充多巴胺能神经元为基础的细胞替代疗法，能够从根本上解决神经元丢失的问题，具有长远的临床意义。细胞替代治疗的细胞最早来自于胎儿腹侧中脑组织，随着重编程技术的不断发展，已逐步转向人类胚胎干细胞和诱导多能干细胞体外分化的前体细胞。同时，直接在体内重编程，将胶质细胞转分化为多巴胺能神经元，也是一种具有应用潜力的策略。本文系统总结了近年来帕金森病细胞替代疗法的进展和面临的挑战，旨在为该疾病治疗新策略的研究提供参考和启示。

       Parkinson’s disease（PD）is the second most prevalent neurodegenerative disorder worldwide，characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta．Traditional treatments，primarily involving levodopa for dopamine replacement，offer limited efficacy and associated with significant side effects．Cell  replacement therapies aimed at replenishing dopaminergic neurons provide a promising long-term solution to neuronal loss，with  substantial clinical significance．The initial successful cellular source for transplantation in PD research was fetal ventral mesencephalic tissue．Nevertheless，advancements in  reprogramming technologies have increasingly favored the use of human embryonic stem cells and induced pluripotent stem cells．Additionally，direct in vivo reprogramming，converting glial cells into dopaminergic neurons，has emerged as an alternative strategy for cell replacement therapy．This  review  systematically  summarizes the  recent advances and challenges in cell replacement therapies for PD，with the aim of providing insights and guidance for the development of novel therapeutic strategies for the PD．