葛根芩连汤作为一种传统中药复方，在治疗代谢性疾病方面展现出显著的疗效。随着中草药现代研究方法的进步，逐渐揭示了葛根芩连汤在代谢性疾病中的治疗作用及其分子机制，包括葛根素、黄芩苷、小檗碱等活性成分的抗炎作用。然而，中草药研究领域的新理论和新机制被不断发现，如影响肠道菌群、产生植物外囊泡、中药汤剂成分自组装等，使得对葛根芩连汤作用机制的理解亟待更新。本文旨在综述葛根芩连汤在代谢性疾病中的作用及机制，并结合最新的研究成果，重点分析其在肠道菌群、植物外囊泡和中药自组装领域的相关发现，探讨其潜在的治疗靶点和未来研究方向，为临床应用和基础研究提供指导。

      Gegen Qinlian decoction（GQD），as a traditional Chinese herbal formula，has demonstrated significant efficacy in treating metabolic diseases．With advancements in modern research methodologies for Chinese herbal medicine，the therapeutic effects and molecular mechanisms of GQD in metabolic diseases have been progressively uncovered，including the anti-inflammatory properties of its active components such as puerarin，baicalin，and berberine．However，emerging theories and mechanisms in the field of herbal research，such as modulation of gut microbiota，production of plant-derived extracellular vesicles，and self-assembly of components in herbal decoctions，continuously refine our understanding，highlighting the need to update insights into GQD’s mechanisms of action．This review aims to summarize the roles and mechanisms of GQD in metabolic diseases，integrating the latest research progress with a focus on findings related to gut microbiota，plant-derived extracellular vesicles，and self-assembly phenomena．It further seeks to explore potential therapeutic targets and future research directions，thereby providing guidance for clinical applications and fundamental studies．

目的 通过高通量测序法对多重耐药大肠埃希菌HX43进行耐药分子机制的研究。方法 用Illumina Miseq平台对HX43进行高通量测序,用Edena、RAST、ResFinder、MLST和BLAST等生物信息学工具或数据库进行数据分析,获得耐药基因相关序列数据。结果 HX43对多种临床常用抗生素均不敏感,仅对碳氢霉烯类药物敏感。对高通量测序数据的分析研究发现,该菌存在多种耐药基因,包括β-内酰胺类耐药基因3个(bla_CMY-42、bla_CTX-M-14和bla_OXA-30),氨基糖苷类耐药基因5个(aac(3)-IIa、aadA5、 strA、 strB和aac(6′)-Ib-cr),喹诺酮类耐药基因1个(aac(6′)-Ib-cr),磺胺及甲氧苄啶类耐药基因3个(sul1、sul2和dfrA17),四环素耐药基因1个(tet(B)),氯霉素耐药基因2个(catB3和cmlA1),大环内酯类耐药基因2个(erm(B)和mph(A))。对包含bla_CMY-42的contigs进行分析,发现该基因与ISEcp1插入序列、blc和sugE等基因相关联。质粒分型发现HX43携带5种不相容群的质粒。多位点序列分型(MLST)分析发现HX43属于ST3835,为国内外较少见的序列型。结论 高通量测序技术可准确获得临床菌株抗生素耐药的相关基因信息,为临床抗菌治疗提供重要的实验室数据支持。

Objective To investigate the molecular resistance mechanism of Escherichia coli HX43 by high-throughput sequencing. Methods HX43 was sequenced by the Illumina Miseq platform, and sequencing data were analyzed by the Edena, RAST, ResFinder, MLST and BLAST softwares and databases. Results HX43 was resistant to most common clinical antibiotics except carbapenems. Analysis of data revealed resistance genes to β-lactams (bla_CMY-42, bla_CTX-M-14 and bla_OXA-30), aminoglycosides (aac(3)-IIa, aadA5, strA, strB and aac(6′)-Ib-cr), quinolones (aac(6′)-Ib-cr), trimethoprim/sulfonamides(sul1, sul2 and dfrA17), tetracyclines (tet(B)), chloramphenicol (catB3 and cmlA1), macrolides(erm(B) and mph(A)). Sequence analysis of the contig containing bla_CMY-42 identified correlations of the gene with ISEcp1 insertion sequences, blc and sugE genes. Plasmid typing identified 5 plasmid incompatibility groups in HX43. MLST analysis found that HX43 belonged to ST3835, a relatively rare sequence type in the world. Conclusion Information of resistance genes can be obtained by high-throughput sequencing, which provides important experimental data for clinical antimicrobial treatment.

       结直肠癌（CRC）是全球第三大最常见的癌症，也是癌症相关死亡的第二大常见原因。结直肠癌肝转移（CRLM）是导致CRC患者死亡的主要原因，根治性肝切除术是目前有望治愈CRLM的唯一途径，但大部分患者不能进行根治性肝切除术。通过早期发现并进行针对性干预，能够改善患者的治疗效果及预后。文章通过综述CRLM的发病机制、诊疗现状及最新纳米诊疗方法，为深入探索高效诊疗方法提供思路。

      Colorectal cancer（CRC）is the third most common cancer and the second most common cause of cancer-related death worldwide．Colorectal cancer liver metastases（CRLM）are the leading cause of death in patients with CRC．Radical hepatectomy is the only way to cure CRLM so far，while most patients cannot undergo radical hepatectomy．CRLM treatment efficacy and prognosis can be improved by early diagnosis and specialized intervention．This paper reviews the pathogenesis，diagnosis，and treatment status of CRLM and the latest nano-diagnosis and treatment methods so as to provide ideas for in-depth exploration of efficient diagnosis and treatment methods．