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综述

IMB模型应用于日间腹腔镜胆囊切除术患者术后早期康复质量的研究进展

Research progress on the application of IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy

:419-424
 
       本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题,IMB模型通过向患者提供科学的疾病知识,改变其疾病认知与态度,最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示,IMB模型可显著降低患者术后疼痛发生率,并提高患者参与治疗决策的程度,为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考,以便后期实施相关个性化干预措施,并提供相关理论依据。
       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy.The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge,and ultimately promotes their adoption and maintenance of healthy behaviors.It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy,the research background of this study,the current research status at home and abroad,as well as the future development trends and challenges.The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making.This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model,so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis.
专家述评

细胞外囊泡来源异质性在乳腺癌转移中的机制及临床转化潜力

Research progress on heterogeneity of extracellular vesicle origins,metastatic mechanisms and clinical translational potential in breast cancer

:798-810
 
       乳腺癌(BC)发病率持续上升,已成为严重威胁公共健康的重大挑战,转移仍是导致患者死亡的主要原因。目前,切除肿瘤并辅以放化疗后仍有较大几率发生转移。此外,早期转移隐匿性强,干预措施不完善及耐药发生迅速均是预后不良的重要因素。细胞外囊泡(EVs)是由细胞释放的、具有膜结构的纳米级颗粒,是细胞间通讯的重要介质。EVs通过转运膜性组分、胞质蛋白及核酸等,调控乳腺癌的发生、进展及转移定植,其来源异质性决定了其在乳腺癌转移中发挥独特作用。本文重点总结了不同来源EVs作为液体活检标志物在转移预警中的价值,以及靶向EVs分泌或阻断其通讯网络在克服免疫治疗耐药中的潜在临床应用,以期为临床医生提供有价值的诊疗参考。
     The incidence of breast cancer(BC) continues to rise and has become a major public health challenge.Metastasis remains the principal cause of BC-related mortality.Currently,there remains a high probability of metastasis even after surgical tumor resection followed by radiotherapy and chemotherapy.The insidious nature of early metastasis,inadequate intervention strategies,and rapid development of drug resistance are all critical factors contributing to poor prognosis.Extracellular vesicles(EVs) are membrane-enclosed,nanoscale particles released by cells.As mediators of intercellular communication,EVs transfer membrane components,cytosolic proteins,and nucleic acids to recipient cells,thereby modulating BC initiation,progression,and metastatic dissemination.The heterogeneity of EV origins determines their distinct roles in breast cancer metastasis.This review focuses on summarizing the value of EVs from different sources as liquid biopsy biomarkers for metastasis warning,as well as their potential clinical applications in targeting EV secretion or blocking their communication networks to overcome immunotherapy resistance,aiming to provide valuable diagnostic and therapeutic references for clinicians.

综述

肺癌患者术后肺功能预测模型的研究进展

Research progress on predictive models of postoperative lung function in patients with lung cancer

:717-723
 
       肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种,手术是其主要治疗手段。然而,肺切除手术常引起肺功能下降,影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前,研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型,用于评估肺癌患者术后肺功能变化。然而,现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素,并对现有预测模型进行总结与评价,以期为患者术前评估、手术方案选择及术后管理提供参考,进而为改善治疗效果与患者生活质量提供理论依据。

       Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world,and surgery is the main treatment.However,pneumonectomy is often accompanied by the loss of lung function,which seriously affects the recovery of lung function and the  quality of life.Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans,reducing the risk of complications and improving the prognosis of patients.At present,researchers have developed a variety of predictive models that combine clinical indicators,imaging parameters,and biomarkers to evaluate postoperative lung function changes in patients with lung cancer.However,there are still many challenges in the accuracy,specificity,standardization and clinical promotion of existing models.This paper systematically reviews the influencing factors of lung function after lung cancer surgery,and summarizes and evaluates the existing prediction models,in order to provide a reference for preoperative evaluation,surgical plan selection and postoperative management of patients,and then provide theoretical basis for improving treatment effect and quality of life of patients.

综述

克罗恩病肛瘘患者现状及管理的研究进展

Research progress on the current status and management of perianal fistula patients with Crohn's disease

:144-150
 
       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.
专家述评

非编码 RNA 在泛血管疾病中的研究进展

Research progress of non-coding RNAs in panvascular diseases

:122-132
 
       泛血管疾病(PVD)是一类以动脉粥样硬化为共同病理基础、累及心、脑、肾及外周血管系统的临床综合征, 具有多血管床共病特征, 发病率高、致残致死率大。非编码RNA(ncRNA)作为基因表达的重要调控因子, 在PVD的发生发展中发挥关键作用。微小RNA(miRNA)、长链非编码RNA(lncRNA)、环状RNA(circRNA)等ncRNA通过调节炎症反应、内皮功能、血管重塑、代谢稳态等多路径参与PVD的病理过程, 并展现出时空特异性和双向调控特征。最新研究揭示ncRNA在临床中的诊断预测及靶向干预潜力, 包括外泌体载体及circRNA递送系统等新策略。此外, 中医药通过调控ncRNA网络, 干预血瘀、痰浊等证型相关通路, 体现中西医结合治疗的系统优势。本文系统综述了ncRNA在PVD中的作用机制与研究进展, 强调其在精准诊疗与转化研究中的应用前景, 并指出未来需加强基础与临床协同、推进个体化干预策略的落地实施。
       Panvascular diseases(PVD)are a group of clinical syndromes characterized by atherosclerosis as a common pathological foundation, involving heart,brain,kidneys,and peripheral vascular systems.These diseases often exhibit multi-vascular bed comorbidities and are associated with high incidence,disability, and mortality rates.Non-coding RNAs(ncRNAs), as key regulators of gene expression, play a crucial role in the onset and progression of PVD.Various types of ncRNAs—including microRNAs(miRNAs), long non-coding RNAs(lncRNAs), and circular RNAs(circRNAs)—are involved in the pathological processes of PVD through multiple pathways, such as modulation of inflammatory responses, endothelial function, vascular remodeling, and metabolic homeostasis, exhibiting spatiotemporal specificity and bidirectional regulatory effects.Recent studies have highlighted the potential of ncRNAs in clinical diagnosis, prognosis, and targeted therapy,with novel strategies including exosome-based delivery and circRNA-targeting systems.In addition, traditional Chinese medicine(TCM)exerts regulatory effects on ncRNA networks to intervene in syndrome-specific pathways, such as those related to blood stasis and phlegm-dampness, reflecting the systemic advantages of integrating TCM with Western medicine.This review systematically summarizes the regulatory mechanisms and research progress of ncRNAs in PVD,emphasizes their potential in precision medicine and translational research, and proposes the need to strengthen collaboration between basic and clinical studies to facilitate the implementation of personalized therapeutic strategies.
综述

中医药调控 CD4+ T 细胞亚群防治动脉粥样硬化的研究进展

Research progress on the regulation of CD4+ T cell subsets by traditional Chinese medicine for the prevention and treatment of atherosclerosis

:24-29
 
       动脉粥样硬化(AS)是一种起始于炎症介导的内皮损伤的慢性血管疾病,其本质是免疫炎症驱动的病理过程,是众多心血管疾病的病理基础。CD4+  T细胞亚群[包括辅助性T细胞1型(T helper 1 cell,Th1)、Th2、Th17、调节性T细胞等]通过分泌特异性细胞因子参与AS的炎症反应,其中促炎性CD4+  T细胞与抗炎性CD4+  T细胞的抗炎功能失衡是推动斑块进展的关键环节,在AS斑块形成与发展中起关键作用。近年来,多项研究表明某些中药单体、经典复方及其有效成分,具有多靶点、多层次机制调控CD4+  T细胞分化及功能,这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等,延缓AS斑块形成与发展,为AS防治提供了新思路,展现了中医药在该领域的研究展现出独特优势与广阔前景,本文综述了中医药通过干预CD4+  T细胞亚群平衡防治AS的最新研究进展,及其影响相关细胞因子网络及关键信号通路的作用机制,为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。
       Atherosclerosis(AS)is a chronic vascular disease that originates from inflammation mediated endothelial 
damage.Its essence is a pathological process driven by immune inflammation,and it is the pathological basis of many cardiovascular diseases.CD4+  T cell subsets(including Th1,Th2,Th17,Treg,etc.)participate in the inflammatory response of AS by secreting specific cytokines.The imbalance of anti-inflammatory function between pro-inflammatory CD4+  T cells and anti-inflammatory CD4+T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques.In recent years,a number of studies have shown that the monomers,classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target,multi-level mechanism to regulate the differentiation and function of CD4+  T cells.These effects together reduce the inflammatory reaction of vascular endothelium,inhibit the foam formation of macrophages and smooth muscle cell migration,delay the formation and development of AS plaque,provide new ideas for the prevention and treatment of AS,and make the research of Chinese medicine show unique advantages and broad prospects in this field.This article  reviews the latest  research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4+  T cell subsets,as well as the mechanism of its effects on related cytokine networks and key signal pathways.This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages.
综述

缺氧诱导因子调控的铁死亡及其在胃肠道疾病中的作用研究进展

Research progress in hypoxia-inducible factor regulated ferroptosis and its implications in gastrointestinal disease

:16-23
 
       铁死亡是一种以铁依赖性脂质过氧化为特征的程序性细胞死亡形式。近年来研究表明,铁死亡与缺氧应答的关键调控因子——缺氧诱导因子(HIF)存在密切关联。HIF(包括HIF-1α、HIF-2α、HIF-3α三种亚型)调控的铁死亡在结直肠癌、胃癌、溃疡性结肠炎及其他胃肠黏膜损伤性疾病中发挥作用,影响疾病的发生发展。但目前关于HIF-铁死亡通路在不同胃肠道疾病中的差异化作用及调控机制尚未完全阐明。因此,本文对HIF各亚型调控铁死亡的分子机制及其在胃肠道疾病中的作用进行综述,以期为靶向HIF-铁死亡通路治疗相关疾病提供新的思路。
       Ferroptosis is a form of regulated cell death characterized by iron-dependent lipid peroxidation.Recent 
studies have demonstrated a close association between ferroptosis and hypoxia-inducible factor(HIF),the key  regulator of the hypoxic response.Ferroptosis regulated by HIF(comprising three isoforms:HIF-1α,HIF-2α,and HIF-3α)plays a  role in colorectal cancer,gastric cancer,ulcerative colitis,and other gastrointestinal mucosal injury diseases,impacting their initiation and progression.However,the differential roles and regulatory mechanisms of the HIF-ferroptosis pathway in various gastrointestinal diseases remain incompletely elucidated.Therefore,this  review  summarizes the molecular mechanism networks through which individual HIF isoforms regulate ferroptosis and their roles in gastrointestinal diseases,with the aim of providing new perspectives for targeting the HIF-ferroptosis pathway to treat relevant diseases.
综述

减重手术对炎症因子影响的研究进展

Research progress on the impact of bariatric surgery on inflammatory factors

:463-471
 
肥胖是一种以慢性低度炎症为特征的进展性疾病,与多种代谢性疾病的发生、发展密切相关。脂肪组织作为一种内分泌和免疫器官,可分泌多种生物活性物质及炎症因子,参与肥胖患者体内的代谢过程。减重手术是治疗病态性肥胖及相关代谢性疾病的有效方法之一,能够调节机体内的炎症反应、有效改善代谢状态。但减重手术对于炎症因子的作用如何,目前国内外的文献证据仍有争议。本文将系统阐述肥胖与代谢性炎症的关系以及减重手术对炎症因子的影响,旨在为肥胖代谢外科的诊疗过程提供参考。
Obesity is a progressive disease characterized by chronic low-grade inflammation,which is closely related to the occurrence and development of a variety of metabolic diseases.As an endocrine and immune organ,adipose tissue can secrete a variety of bioactive substances and inflammatory factors,which participate in the metabolic process of obese patients.Bariatric surgery is one of the effective methods for the treatment of morbid obesity and related metabolic diseases,which can regulate the inflammatory response in the machine and effectively improve the metabolic state.However,the effect of bariatric surgery on inflammatory factors is still controversial at home and abroad.This article will systematically explain the relationship between obesity and metabolic inflammation and the effect of bariatric surgery on inflammatory factors,aiming to provide a reference for the diagnosis and treatment process of bariatric surgery.
综述

全膝关节置换术中不同胫骨假体旋转对线方法的研究进展

Research progress on different tibial prosthesis rotation alignment methods in total knee arthroplasty

:836-842
 
全膝关节置换术(TKA)是目前治疗终末期膝关节疾病的首选方法,它能够缓解疼痛、改善畸形、恢复力线、增加膝关节活动度及提高患者生活质量。目前,关于胫骨假体旋转对线的方法很多,主要包括胫骨结节、胫骨前后轴、胫骨前皮质、自我形合技术、计算机辅助导航技术、个性化截骨技术等,它们各有优缺点,但在临床上并没有达成共识。该文主要对胫骨近端的解剖学特点和TKA中胫骨假体旋转定位的方法等方面进行综述。旨在为临床骨科医生在行TKA时,选择合适的胫骨假体旋转对线方法提供一些参考。
Total knee replacement(TKA) is currently the preferred treatment for end-stage knee disease,and it can relieve pain,improve deformity,restore strength lines,increase knee range of motion,and improve patients’ quality of life.At present,there are many methods for the rotation of alignment of tibial prosthesis,mainly including tibial tubercles,tibial anteroposterior axes,anterior tibial cortex,self-morphing technology,computer-aided navigation technology,personalized osteotomy technology,etc.Each of the methods above has its advantages and disadvantages,but there is no clinical consensus at present.This article mainly reviews the anatomical characteristics of the proximal tibia and the method of rotational positioning of tibial prosthesis in TKA,which aims to provide some reference for clinical orthopedic surgeons to select the appropriate tibial prosthesis rotation alignment method when performing TKA.
专家述评

运动捕捉技术在步态分析中的研究进展

Research progress of motion capture technology in gait analysis

:826-835
 
运动捕捉技术已经广泛应用于步态分析、运动康复、动作对比、技战术分析、生物运动力学分析、损伤防护、运动装备设计研发等领域,实现了人机交互的全新体验。而步行是人类运动中最基础的动作,在生物力学研究上对异常步态进行分析能够有效改善患者治疗和康复的效果。本文总结了运动捕捉技术在各种异常步态分析中的应用,并对其优缺点进行了总结与展望。检索PubMed、Embase、EBSCO、Web of Science、中国知网,收集2018年1月至2023年12月公开发表的有关有标记运动捕捉及无标记运动捕捉在异常步态的相关研究,进行系统综述。最终纳入了22篇英文文献,这些文献主要集中在神经科学、生物医学工程和临床医学等领域,特别是在步态分析、运动捕捉技术、神经病理学和康复医学等方面的应用。这些研究为我们理解和改善各种神经系统疾病,如帕金森病、多发性硬化症和脑卒中以及骨关节炎等疾病的步态提供了宝贵的见解。利用运动捕捉来进行异常步态分析能有效地给患者提供准确的康复治疗,将结果用于临床诊断、康复规划或研究目的。异常步态分析在评估肌肉骨骼状况、神经系统疾病或干预措施的有效性方面具有重要价值。
Motion capture technology has been widely used in the fields of gait analysis,sports rehabilitation,action comparison,technical and tactical analysis,biomotor mechanics analysis,injury protection,sports equipment design and development,etc.,which realizes a brand-new experience of human-computer interaction.While walking is the most basic action in human movement,the analysis of abnormal gait on biomechanical research can effectively improve the effect of patient treatment and rehabilitation.This paper summarizes the application of motion capture technology in the analysis of various abnormal gaits,and summarizes and prospects its advantages and disadvantages.PubMed,Embase,EBSCO,Web of Science and China Knowledge Network were searched to collect related studies,openly published from January 2018 to December 2023,about labeled motion capture and unlabeled motion capture in abnormal gait for systematic review.Twenty-two English-language papers were finally included,which focused on the fields of neuroscience,biomedical engineering and clinical medicine,especially in the applications of gait analysis,motion capture technology,neuropathology and rehabilitation medicine.These studies provide valuable insights into understanding and improving gait in various neurological disorders such as Parkinson’s disease,multiple sclerosis and stroke and osteoarthritis.The use of motion capture for abnormal gait analysis can be effective in providing accurate rehabilitation to patients,using the results for clinical diagnosis,rehabilitation planning,or research purposes.Abnormal gait analysis is valuable in assessing musculoskeletal conditions,neurological disorders,or the effectiveness of interventions.
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