目的 探索Nrf2/HO-1通路是否参与远志皂苷元（远志）在脑出血体外细胞模型中对BV2小胶质细胞炎症反应的调控作用。方法 采用红细胞与BV2小鼠小胶质细胞共培养构建体外脑出血模型。分别给予远志单独处理、远志联合Nrf2抑制剂ML385处理，检测炎症因子水平。收集细胞上清制备条件培养基，用于培养SH-SY5Y人神经母细胞瘤细胞，并检测其铁死亡水平。结果 模型组BV2细胞炎症因子（IL-1β，IL-6，TNF-α）水平较对照组显著升高（P＜0.001）；高浓度远志（20 μM）可降低炎症因子水平，并上调Nrf2/HO-1通路蛋白表达，而ML385能逆转该作用。模型组条件培养基可诱导SH-SY5Y细胞铁死亡，而经远志处理的BV2细胞条件培养基则减轻该现象；ML385预处理可削弱远志对SH-SY5Y细胞的保护作用，远志组铁离子、丙二醛、转铁蛋白受体1水平低于远志联合ML385组（P＜0.05），铁转运蛋白、谷胱甘肽和谷胱甘肽过氧化物酶水平高于远志联合ML385组（P＜0.05）。结论 远志皂苷元通过激活Nrf2/HO-1通路抑制BV2小胶质细胞炎症反应，并在脑出血体外模型中发挥神经保护作用。

     Objective To investigate whether the Nrf2/HO1 signaling pathway is involved in the regulatory effect of tenuigenin（TEN）on the inflammatory response of BV2 microglial cells in an in vitro intracerebral hemorrhage（ICH）model．Methods An in vitro ICH model was established by coculturing BV2 murine microglial cells with red blood cells．Cells were treated with TEN alone or in combination with the Nrf2 inhibitor ML385，and the levels of inflammatory factors were measured．The conditioned medium collected from the cell supernatant was used to culture SHSY5Y human neuroblastoma cells，and ferroptosis levels were assessed．Results The levels of inflammatory factors（IL-1β，IL-6，TNF-α）in BV2 cells of the model group were significantly higher than those in the control group（P＜0.001）．High concentration of TEN（20 μM）could reduce the levels of inflammatory factors and up-regulate the expression of Nrf2/HO-1 pathway proteins，while ML385 could reverse this effect．The conditioned medium of the model group could induce ferroptosis in SH-SY5Y cells，while the conditioned medium of BV2 cells treated with TEN could alleviate this phenomenon．Pretreatment with ML385 could weaken the protective effect of TEN on SH-SY5Y cells．The levels of iron ions，malondialdehyde and transferrin receptor protein 1 in the TEN group were lower than those in the TEN combined with ML385 group（P＜0.05），while the levels of ferroportin glutathione and glutathione peroxidase 4 were higher than those in the TEN combined with ML385 group（P＜0.05）．Conclusions TEN inhibits the inflammatory response of BV2 microglial cells by activating the Nrf2/HO1 pathway and exerts a neuroprotective effect in the in vitro ICH model．

       目的   观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法   将80例过敏性鼻炎患者随机分成干预组（40例）和对照组（40例），干预组采用超声引导针刺蝶腭神经节，对照组采用常规方法针刺蝶腭穴，每周2次，持续4周。结果   治疗4周后，干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%，对照组的总有效率为82.50%，差异有统计学意义（P＜0.05）；干预组在鼻症状总分（TNSS）、非鼻症状总分（TNNSS）、视觉模拟量表（VAS）和鼻结膜炎生活质量问卷（RQLQ）等指标上的改善均优于对照组（P＜0.05）。结论   超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。

   Objective  To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound．Methods  A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group．The intervention group was treated with ultrasound guided acupuncture of the sphenopalatine 

ganglion，the control group was treated with conventional acupuncture at sphenopalatine point．The clinical efficacy was determined after the course of treatment．Results  The total effective rate was 92.50% in the intervention group and 82.50% in the control group．The improvement of total nasal symptom score，total non-nasal symptom score，VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions  Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis．

目的 分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法 对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组：侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30 °的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果 所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间（60.65±12.45）min,俯卧位组手术时间（70.58±10.25） min,组间比较差异有统计学意义（t=3.429,P=0.001）。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义（χ²=4.292,P=0.038）。结论 侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。

Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position．Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups（the lateral prone position group and the prone position group,31 patients in each group）．The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation．Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups．Results All patients completed the operation successfully．No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups．No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either．The operation time was（60.65±12.45）min in the lateral prone position group and（70.58±10.25）min in the standard prone position group,respectively,and the difference was statistically significant（t=3.429,P=0.001）．The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group（93.55%）compared with the standard prone position group（77.42%）,and the difference was statistically significant（χ²=4.29,P=0.038）．Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective．Good surgical position nursing can effectively prevent complications．

目的 研究并分析星状神经节阻滞联合银杏叶提取物治疗颈源性头晕的临床效果。方法 选取周口骨科医院100例颈源性头晕的住院患者作为研究对象,于2022年6月—2023年6月期间内收治,根据入院顺序奇偶号将其分为对照组与观察组,各50例,对照组实行星状神经节阻滞治疗,观察组在对照组基础上联合使用银杏叶提取物治疗,对比两组患者的临床症状（头痛、眩晕、耳鸣、视物模糊）改善程度、颈部疼痛量表、临床效果和不良反应发生率。结果 治疗30 d后,观察组临床症状评分低于对照组（P<0.05）。两组治疗前的数字分级法评分差异无统计学意义（P>0.05）,治疗15 d与30 d时,观察组数字分级法评分评分均低于对照组（P<0.05）。观察组患者的治疗总有效率高于对照组（P<0.05）;治疗期间,观察组的并发症发生率低于对照组,比较差异有统计学意义（P<0.05）。结论 颈源性头晕患者使用星状神经节阻滞联合银杏叶提取物治疗,能够明显改善疾病症状,缓解颈部疼痛感,有效提高临床效果,同时降低不良反应发生率。

Objective To analyze the clinical study of stellate ganglion block combined with Ginkgo biloba extract to treat cervical dizziness．Methods A total of 100 hospitalized patients with cervical dizziness at Zhoukou Orthopedic Hospital were selected as the study subjects,who were admitted between June 2022 and June 2023．They were divided into a control group and an observation group based on the odd and even numbers of admission,with 50 cases in each group．The control group received stellate ganglion block treatment,while the observation group received a combination of Ginkgo biloba extract treatment on the basis of the control group,The degree of improvement in clinical symptoms（headache,dizziness,tinnitus,blurred vision）,neck pain scale,clinical efficacy,and incidence of adverse reactions were compared between two groups of patients．Results After 30 days of treatment,the clinical symptom score of the observation group was lower than that of the control group（P<0.05）．There was no statistically significant difference in the numerical grading scores between the two groups before treatment（P>0.05）．On the 15th and 30th day of treatment,the observation group had lower numerical grading scores than the control group（P<0.05）．The total effective rate of treatment in the observation group was higher than that in the control group（P<0.05）．During the treatment period,the incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Conclusions The use of stellate ganglion block combined with Ginkgo biloba extract in the treatment of patients with cervicogenic dizziness can significantly improve their disease symptoms,significantly alleviate their neck pain,effectively improve the clinical effect,while reducing the incidence of adverse reactions．

目的 探讨复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选择2019年6月—2023年1月在河南省许昌中医院诊治的79例缺血性脑卒中患者,按照入院就诊顺序采用奇偶法把患者分为联合组40例与传统组39例。传统组给予阿替普酶静脉溶栓治疗,联合组给予复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗,评价与记录联合组与传统组的疗效与安全性及治疗前、治疗14 d后Fugl-Meyer评定量表（FMA）与改良版Banhel评价指数（MBI）、血清β-内啡肽、前列腺素E2（PGE2）水平变化。结果 治疗14 d后联合组的总有效率更高（97.5% vs 82.1%,P<0.05）,并发症发生率更低（5.0% vs 20.5%,P<0.05）。联合组与传统组治疗14 d后的FMA与MBI评分高于治疗前（P<0.05）,联合组治疗14 d后的FMA评分、MBI评分比传统组提高（P<0.05）。联合组与传统组治疗14 d后的血清β-内啡肽、PGE2水平低于治疗前（P<0.05）,联合组治疗14 d后的血清β-内啡肽、PGE2水平低于传统组（P<0.05）。结论 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中能提高效果,降低患者的肺部感染、尿路感染、静脉血栓、褥疮等并发症发生率,改善患者的运动与日常生活功能,还可降低患者血清β-内啡肽、PGE2水平。

Objective To explore and analysis the efficacy and safety of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods From June 2019 to January 2023,79 patients with ischemic stroke who were diagnosed and treated at Henan Xuchang Traditional Chinese Medicine Hospital were selected as the research subjects．According to the order of admission,the patients were divided into the combination group of 40 cases and the traditional group of 39 cases．The traditional group received intravenous thrombolytic therapy with alteplase,while the combination group received treatment with compound brain peptide ganglioside injection on the basis of the traditional group．The efficacy and safety and changes of the Fugl-Meyer rating Scale（FMA）and modified Banhel Evaluation Index（MBI）,serum β-endorphin,and PGE 2 levels in the combined and traditional groups were evaluated and recorded. Results After 14 days of treatment,the combined group had a higher overall response rate（97.5% vs 82.1%,P<0.05）and a lower complication rate（5.0% vs 20.5%,P<0.05）．FMA scores and MBI scores of the two groups after 14 days of treatment were higher than those before treatment（P<0.05）,and FMA scores and MBI scores of the combined group after 14 days of treatment were higher than those of the traditional group（P<0.05）．The contents of β-endorphin and prostaglandin E2 in two groups after 14 days of treatment were lower than those before treatment（P<0.05）,and the contents of β-endorphin and prostaglandin E2 in combination group after 14 days of treatment were lower than those in traditional group（P<0.05）. Conclusions The combination of compound brain peptide ganglioside injection and alteplase intravenous thrombolysis in the treatment of acute ischemic stroke can improve the treatment effect,reduce the incidence of complications such as pulmonary infections,urinary tract infections,venous thrombosis and bedsores in patients,improve patients' motor and daily life functions,and also reduce patients' serum levels of β-endorphins and prostaglandin E2．

胶质瘤是颅内最常见的原发性恶性肿瘤,其分级对患者治疗方式的选择和预后至关重要。尽管目前组织病理学仍是其最为可靠的分级手段,但需通过有创性手术以获取组织样本,存在一定的风险。相较之下,磁共振成像（MRI）作为一种非侵入性影像诊断工具,在胶质瘤分级中发挥着不可或缺的作用。然而,传统MRI评估受限于医师个体主观性强和可重复性差的问题,一定程度上影响了准确的分级结果。近年来,影像组学技术的崭露头角为解决上述难题开辟了新视角,通过高通量提取影像数据特征捕捉并量化肿瘤的影像学表现,避免因主观因素而导致的不确定性,协助医师更准确地评估肿瘤的恶性程度。本文对近五年来MRI影像组学在胶质瘤术前分级预测方面的相关研究进行了简要综述,旨在为相关领域研究者提供有益的参考和借鉴,以推动MRI影像组学在临床实践中的应用。

Glioma is the most common primary malignant brain tumor,and its grading is crucial for treatment decisions and prognosis．Currently,histopathology remains the gold standard for grading,but it requires invasive procedures and carries inherent risks．In contrast,magnetic resonance imaging（MRI）,a non-invasive diagnostic tool,plays an indispensable role in glioma grading．However,traditional MRI assessment is hampered by interobserver subjectivity and limited repeatability,which compromise grading accuracy．In recent years,radiomics,a burgeoning field,has offered a promising solution to address these challenges．By extracting high-dimensional imaging data features,radiomics enables the quantification of tumor radiological characteristics and elimination of subjectivity-related discrepancies．This technology assists clinicians in more precisely assessing the malignancy of gliomas．This article summarizes relevant studies in the past five years on the application of MRI radiomics in preoperative glioma grading,aiming to provide valuable insights and guidance to researchers in the field and promote the clinician implementation of MRI radiomics．

目的 分析恩格列净对2型心肾综合征（CRS）患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组（44例,给予常规治疗）、实验组（44例,在常规治疗的同时加用恩格列净）,通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组（均P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。

Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome（CRS）．Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group（44 cases,receiving conventional treatment）and experimental group（44 cases,receiving conventional treatment combined with englaglitzin）by computer program．The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions．Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group．The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment（P<0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion．

帕金森病（PD）是一种常见的与年龄相关的神经退行性疾病,其特点是黑质致密部内多巴胺能神经元的进行性丢失以及路易小体的积累。多巴胺能神经元的退化导致纹状体的多巴胺水平降低,最终出现静息性震颤、运动迟缓、肌肉僵硬和姿势不稳等运动症状,以及认知能力下降、嗅觉功能受损、精神异常和睡眠障碍等非运动症状。由于人口结构转变和全球老龄化,PD的不断增加对患者、家庭和社会构成重大负担。尽管广泛的研究已阐明了PD的病因学和潜在机制,但现有治疗主要集中在症状管理,无法阻止疾病的进展。小胶质细胞作为脑内重要的免疫细胞,对维持中枢神经系统的稳态具有关键作用。本文综述了PD研究,包括其病因学因素、分子机制和现有治疗策略。此外,审视了在PD样模型中涉及小胶质细胞的研究,深入探讨了小胶质细胞在疾病进展中的动态,并探究了小胶质细胞在促进或减轻疾病进展方面所扮演的错综角色。通过这样的探讨,本综述旨在为PD复杂的发病机制提供新的洞见和观点,激发出针对性治疗干预的创新思路。

Parkinson's disease（PD）,a prevalent age-related neurodegenerative disorder,is characterized by the progressive loss of dopaminergic neurons within the substantia nigra compacta（SNc）and the accumulation of Lewy bodies．The degeneration of dopaminergic neurons leads to diminished striatal dopamine levels,culminating in motor symptoms such as resting tremors,bradykinesia,muscle rigidity and postural instability,alongside non-motor manifestations encompassing cognitive decline,impaired olfactory function,psychological abnormalities and sleep disturbances．The escalating incidence of PD due to shifting demographics and global aging poses substantial burdens on patients,families and society．Although extensive research has elucidated the etiology and underlying mechanisms of PD,available treatments largely focus on symptom management and lack the capacity to halt disease progression．Microglia,as integral immune cells within the brain,wield pivotal influence over central nervous system homeostasis．This review presents a comprehensive synthesis of PD,encompassing its etiological factors,molecular mechanisms,and existing therapeutic strategies．Furthermore,we scrutinized research involving microglia in PD-like models,delving into the dynamics of microglia in disease progression and probing into the intricate roles that microglia assume in either fostering or mitigating disease advancement．By doing so,this review aims to furnish novel insights and perspectives that shed light on the intricate pathogenesis of PD,potentially sparking innovative concepts for targeted therapeutic interventions．

目的 探究血清C反应蛋白与白蛋白比值(CRP/ALB)、中性粒细胞与淋巴细胞比值(NLR)、血糖不稳定指数(GLI)水平对重症肺炎患者预后的预测价值。方法 将我院2020年1月—2021年5月收治的126例重症肺炎患者作为研究对象,根据入院治疗28 d的预后情况,分为存活组(93例)和死亡组(33例)。对比2组患者的一般资料,采用多因素Logistic分析重症肺炎患者高危因素,应用ROC曲线评估血清CRP/ALB、NLR、GLI水平对重症肺炎患者预后的预测价值。结果 2组患者一般资料对比,NEU、CRP、APACHEⅡ、CRP/ALB、NLR、GLI水平差异有统计学意义(P<0.05);多因素Logistic回归分析显示APACHEⅡ评分、血清CRP/ALB、NLR、GLI水平是重症肺炎患者死亡的危险因素;ROC曲线分析结果显示,CRP/ALB、NLR、GLI曲线下面积分别为0.837,0.826,0.837。结论 CRP/ALB、NLR、GLI水平对重症肺炎患者预后均具有较高的预测价值,其中以CRP/ALB的预测价值最佳。

Objective To explore the prognostic predictive value of serum CRP/ALB, NLR and GLI in patients with severe pneumonia. Methods A total of 126 patients with severe pneumonia treated in our hospital from January 2020 to May 2021 were divided into survival group (93 cases) and death group (33 cases) according to the prognosis of 28 days of hospitalization. The general data of the two groups were compared, the high-risk factors of patients with severe pneumonia were analyzed by multivariate logistic, and the predictive value of serum CRP/ALB, NLR and GLI levels on the prognosis of patients with severe pneumonia was evaluated by ROC curve. Results There were significant differences in the levels of NEU, CRP, APACHE Ⅱ, CRP/ALB, NLR and GLI between the two groups (P<0.05); multivariate logistic regression analysis showed that APACHE Ⅱ score, serum CRP/ALB, NLR and GLI were the risk factors of death in patients with severe pneumonia; ROC curve analysis showed that the areas under CRP/ALB, NLR and GLI curves were 0.837, 0.826 and 0.837 respectively. Conclusions The levels of CRP/ALB, NLR and GLI had high predictive value in the prognosis of patients with severe pneumonia, among which CRP/ALB had the best predictive value.

目的 探讨瑞格列奈联合胰岛素治疗2型糖尿病临床疗效及对患者血糖水平的影响效果。方法 选取我院2019年1月—2021年1月收治的2型糖尿病患者324例,用随机数字法分为两组,每组各52例,对照组应用胰岛素治疗,研究组应用瑞格列奈联合胰岛素治疗。对两组2型糖尿病患者的临床疗效、血糖水平(FPG指数、2 h PG指数、HbA1c指数)以及胰岛素水平(HOMA-β水平、HOMA-IR水平)进行比较。结果 研究组疗效高于对照组(P＜0.05);研究组治疗后血糖指数优于对照组(P＜0.05);研究组治疗后胰岛素水平优于对照组(P＜0.05)。结论 2型糖尿病患者在治疗时,应用瑞格列奈联合胰岛素治疗,可增强治疗疗效,有效控制血糖水平,改善胰岛功能,从而促进疾病转归,具有极大的推广价值。

Objective To investigate the clinical efficacy of repaglinide combined with insulin in the treatment of type 2 diabetes mellitus and its effect blood glucose level. Methods A total of 324 patients with type 2 diabetes admitted to our hospital from January 2019 to January 2021 were randomly divided into two groups with 52 patients in each group. The control group was treated with insulin, and the research group was treated with repaglinide combined with insulin. Clinical efficacy, blood glucose level (FPG index, 2HPG index, HbA1c index) and insulin level (HOMA-β level, HOMA-IR level) of patients with type 2 diabetes were compared between two groups. Results The therapeutic effect of the research group was higher than that of the control group (P<0.05). The glycemic index of the research group was better than that of the control group (P<0.05). The insulin level in the research group was better than that in the control group (P<0.05). Conclusion In the treatment of type 2 diabetes mellitus, the application of repaglinide combined with insulin can enhance the therapeutic effect, effectively control the blood glucose level, improve the islet function, so as to promote the outcome of the disease, which has great promotion value.