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目的探讨嗜粘蛋白阿克曼氏菌在新生期母婴分离（MS）和避水应激（WAS）肠易激综合征（IBS）大鼠模型的内脏高敏发生中的作用。方法将SD雄性大鼠在新生期随机分为3组：sham WAS（空白组），MS+WAS组（IBS模型组）及阿克曼氏菌组（Akkermansia muciniphila， A. muciniphila组），IBS模型组及阿克曼氏菌组采用母婴分离联合避水应激方法（MS+WAS）建立内脏高敏感模型。母婴分离刺激结束后，阿克曼氏菌组每天避水应激处理同时灌胃1 mL 1×109 CFU/mL A. muciniphila连续10 d。再用行为学观察和腹部回缩反射评分来检测内脏痛反应。结果经阿克曼氏菌干预后，实验组大鼠与模型组相比，体质量显著增加；粪便颗粒数及其不成形率显著下降；内脏疼痛阈值则显著上升。阿克曼氏菌组大鼠结肠黏膜内2型大麻素受体（CB2R）mRNA表达相比模型组显著上升。结论阿克曼氏菌可能通过调控结肠的CB2RmRNA表达来缓解IBS大鼠的内脏高敏。

Objective To observe the early rehabilitation outcomes of the first-time artificial total hip arthroplasty (THA) using the direct anterior approach (DAA). Methods Sixty patients who underwent unilateral THA for the first time at Huangshan People's Hospital from 2020 to 2021 were selected, including 30 cases of THA using the direct anterior approach (DAA group) and 30 cases of THA using the posterior-lateral approach (PLA group). The surgical incision length, intraoperative blood loss, duration of drainage tube placement, time to first ambulation after surgery, quality of life, complications, pain, and joint function recovery were compared between the two groups. Pain was assessed using the Visual Analog Scale (VAS) at 1 week, 4 weeks, and 12 weeks postoperatively. Hip joint function was evaluated using the Harris Hip Score (HHS) scoring system, and quality of life was assessed using the S-36 questionnaire. Results The DAA group had a shorter incision length and less intraoperative blood loss compared to the PLA group, and time to first ambulation was earlier and duration of drainage tube placement was shorter in the DAA group compared to the PLA group, with a significant difference (P＜0. 05). At 4 and 12 weeks postoperatively, pain VAS scores, Harris scores, and quality of life were higher in the DAA group compared to the PLA group, with a significant difference (P＜0. 05). There was a case of dislocation of hip prosthesis and a cased of periprosthesis infection in the PLA group, and no postoperative complications reported in the DAA group. Conclusion Compared with PLA approach, THA using the DAA approach results in smaller trauma and faster recovery, aligning with the concept of rapid rehabilitation and showing better clinical efficacy. (目的 探讨首次人工全髋关节置换术(THA)直接前方入路(DAA)的早期临床康复效果。方法 选取2020年1月—2021年12月在黄山市人民医院首次接受单侧THA的患者60例, 其中直接前方入路(DAA)THA 30例(DAA组), 后外侧入路(PLA)THA 30例(PLA组)。比较两组患者手术切口长度、术中出血、引流管留置时间、术后首次下床时间、生活质量、并发症、疼痛及关节功能恢复情况, 在术后1周、术后4周、术后12周应用视觉模拟量表(VAS)评价疼痛, 应用Harris髋关节评分系统(HHS)评价髋关节功能, 应用健康调查简易量表(SF-36)评价生活质量。结果 DAA组切口长度、术中出血量少于PLA组, 首次下床时间早于PLA 组, 引流管留置时间短于PLA 组, 差异有统计学意义(P＜0. 05)。DAA组患者术后4周、术后12周疼VAS评分、Harris评分、SF-36量表评分均高于PLA组, 差异有统计学意义(P＜0. 05); PLA组术后出现1例髋关节假体脱位, 1例出现假体周围感染; DAA组无并发症发生。结论 与PLA比较, DAA入路行THA创伤更小, 恢复更快, 符合快速康复理念, 早期临床康复效果更佳。)

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This study analyzed the transitional care work system and evaluation system in China from the perspectives of current situation, potential problems and improvement strategies, and provided a reference for the development of standardization and integration of the transitional care work system and the evaluation system. (本分析了目前国内延续性护理工作体系和评价体系的现况, 包括延续护理的发展、发展中面临的问题以及相关的改善方案, 为延续性护理工作体系和评价体系的标准化和一体化提供参考依据。)

The transitional care is mainly used in the care of chronic diseases management, but in recent years, transitional care has also been extended to postoperative surgery, PICC tube placement, puerperium care and other aspects. There is no specific requirement for nursing staff, and most of them have not received professional training. Transitional care in China is rapidly popularizing and developing, but there are also problems that cannot be ignored in the development process. When the hospital vigorously promotes transitional care, it should focus on solving the existing problems in order to better implement transitional care, and then provide better medical care services for the current situation of China's aging population. (延续性护理主要运用于慢性疾病护理, 近年来在外科术后、PICC置管后、产褥期等方面应用广泛。国内延续性护理对护理人员尚未有明确要求, 大多未经过专业培训, 多为临床各科室护士担任。虽然国内延续性护理正在快速普及和发展, 但发展过程中也存在不可忽视的问题。医院在大力推行延续性护理时, 要着重解决目前存在的问题, 以便更好地实施延续性护理, 进而为国内人口老龄化的现状提供更好的医疗护理服务。)