目的：分析血脑屏障标志物闭合蛋白（Occludin，OCLN）、密封蛋白-5（Claudin-5，CLDN5）与帕金森病（PD）患者神经功能损伤程度及不良预后的关联。方法：研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者，及同期接受检查的180例健康志愿者，将其分别列为病例组、对照组，比较两组OCLN、CLDN5间差异。依据病情严重程度不同，将PD患者分别列为早期组（50例）、中期组（65例）和晚期组（65例），比较三组患者OCLN、CLDN5，神经损伤标志物间差异，分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况，比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异，分析PD患者预后影响因素，验证OCLN、CLDN5对PD患者不良预后的预测效能。结果：病例组的外周血OCLN、CLDN5均高于对照组（t=50.450，51.670；P＜0.05）。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶（NSE）、泛素羧基末端水解酶L1（UCH-L1）、神经丝轻链蛋白（NfL）、胶质纤维酸性蛋白（GFAP）均高于中期组、早期组（F=280.611，378.453，82.254，122.413，185.272，257.733；P＜0.05）。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关（r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503；P＜0.05）。180例PD患者的不良预后发生率为28.89%（52/180）。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组（t=17.096，14.405，7.632，6.903，11.695，10.702；P＜0.05）。Logistic多因素回归分析结果显示，外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验，外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测（DeLong检验，P＜0.05）。结论：外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高，联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。

Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450，51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611，378.453，82.254，122.413，185.272，257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096，14.405，7.632，6.903，11.695，10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.

目的 通过公共数据库筛选急性肺损伤（ALI）及急性呼吸窘迫综合征（ARDS）相关分子标志物,并探索其临床意义。方法 利用基因表达综合数据库（GEO）中有关ALI/ARDS基因表达芯片研究的两个数据集GSE76293和GSE10474,通过STRING网站和Cytoscape软件对差异基因进行蛋白互作网络分析并筛选ALI/ARDS相关关键基因。采用A549细胞构建ALI模型,并通过转录组测序验证关键基因在细胞中的表达差异情况。结果 2个GEO数据集中共筛选出共同上调基因27个,共同下调基因26个。主要参与抗原加工和外源抗原递呈、免疫受体活性调节、内质网膜构成等生物学功能,且与抗原加工、细胞分化等信号通路有关。蛋白互作网络分析共筛选出10个ALI/ARDS相关关键基因,分别为CD4、HLA-DQB1、CD74、HLA-DRA、FCGR2B、TOR1A、RELA、NME8、RNF19B、RHOB。细胞转录组测序结果显示,关键基因的上调或下调特征及表达差异情况与GEO数据集分析结果一致。结论 CD4等关键基因可能参与ALI/ARDS发生、发展的生物学过程,是ALI/ARDS临床诊断及预后预测的潜在个体化分子标志物。

Objective To identify molecular biomarkers associated with acute lung injury（ALI）/ acute respiratory distress syndrome（ARDS）and to explore their clinical significance with public databases. Methods Two datasets GSE76293 and GSE10474 in Gene Expression Omnibus（GEO）database for ALI/ARDS gene expression chip study were used to screen genes with significant differences in both datasets．The protein-protein interaction（PPI）analysis of co-expression genes was performed based on the STRING website and Cytoscape software,and then key genes related to ALI/ARDS were identified with cytoHubba method．The ALI model was constructed using A549 cells cultured in vitro,and the expression differences of key genes in the cells were verified by RNA sequencing. Results A total of 27 up-regulated genes and 26 down-regulated genes were screened in both the two GEO datasets with Venn Diagramm．These co-expression genes were mainly involved in biological functions such as antigen processing and presentation of exogenous peptide antigen,immune receptor activity,integral component of lumenal side of endoplasmic reticulum membrane and were related to signal pathways such as antigen processing and cell differentiation．A total of 10 key genes（CD4,HLA-DQB1,CD74,HLA-DRA,FCGR2B,TOR1A,RELA,NME8,RNF19B,RHOB）related to ALI/ARDS were identified． The results of cell RNA sequencing showed that the up-regulated or down-regulated characteristics and expression differences of key genes were consistent with the results of GEO datasets. Conclusions Several key genes identified in this study may be involved in the biological process of ALI/ARDS development,and may be potential individualized molecular markers for clinical diagnosis and prognosis prediction of ALI/ARDS．

目的 观察超声心动图(UCG)+心肌损伤标志物水平检测在急性心肌梗死(AMI)患者诊断中的应用价值。方法 选取2020年6月—2021年9月我院收治的74例AMI患者为观察组,另选取同期65例疑似AMI患者为对照组,2组均进行UCG检测,并对比入院后0~2 h、2~12 h、12~24 h心肌损伤标志物[肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)、心脏型脂肪酸结合蛋白(H-FABP)]水平,分析心肌损伤标志物与AMI病情程度的关联性及UCG+心肌损伤标志物水平检测对AMI诊断的应用价值。结果 UCG检查结果显示观察组阳性率86.79%高于对照组9.23%(P＜0.001);对照组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平差异无统计学意义(P＞0.05)观察组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平均高于对照组(P＜0.05);Spearman相关分析可知,血清CK-MB、NT-proBNP、cTnI、H-FABP水平与AMI患者病情程度呈正相关(r₁=0.648,r₂=0.692,r₃=0.704,r₄=0.683,P＜0.05);受试者工作特征曲线(ROC)曲线分析显示,UCG+血清CK-MB、NT-proBNP、cTnI、H-FABP联合检测对AMI患者的诊断敏感度(85.14%)、特异度(100.00%)较高(P＜0.05)。结论 UCG+心肌损伤标志物水平检测应用于AMI患者有利于提高诊断敏感度、特异度,诊断价值较高。

目的 分析在胃癌诊断中应用人表皮生长因子受体2（HER-2）结合肿瘤标志物检测的意义。方法 回顾性选取2019年6月—2021年6月我院收治的100例胃癌患者作为胃癌组,另选同期收治的60例胃良性肿瘤患者作为胃良性肿瘤组。比较HER-2与多项肿瘤标志物检测的诊断效能等。结果 胃癌组HER-2、糖类抗原（CA）125、CA72-4及CA19-9浓度与阳性表达率高于胃良性肿瘤组（P<0.05）。对于胃癌诊断,免疫组化指标HER-2检测的敏感度为72.00%,正确率为77.00%;多项肿瘤标志物检测的敏感度为77.00%,正确率为80.00%;二者联合检测的敏感度为89.00%,正确率为90.00%;相较于多项肿瘤标志物与HER-2单一检测,二者联合检验的正确率、敏感度更高（P<0.05）。结论 HER-2结合血清肿瘤标志物检验对胃癌的诊断价值较高。

Objective To analyze the significance of human epidermal growth factor receptor 2（HER-2）combined with tumor marker in the diagnosis of gastric cancer．Methods A total of 100 patients with gastric cancer admitted to our hospital from June 2019 to June 2021 were retrospectively selected as the gastric cancer group, and 60 cases of gastric benign tumor admitted to our hospital during the same period were also selected．The diagnostic efficacy of HER-2 was compared with those of multiple tumor markers．Results The concentration and positive expression rate of HER-2, carbohydrate antigen（CA）125, CA72-4 and CA19-9 in gastric cancer group were higher than those in gastric benign tumor group（P<0.05）．For the diagnosis of gastric cancer, the sensitivity of the immunohistochemical indicator HER-2 detection was 72.00%, and the accuracy rate was 77.00%．The sensitivity and accuracy of detecting multiple tumor markers were 77.00% and 80.00%, respectively．The sensitivity of the combined detection of the two was 89.00%, and the accuracy was 90.00%．Compared to multiple tumor markers and HER-2 single detection, the combined test of the two had a higher accuracy and sensitivity（P<0.05）．Conclusions The detection of HER-2 combined with serum tumor markers has high diagnostic value for gastric cancer．

卵巢扭转（OT）是女性常见急腹症之一,它可发生在任何年龄的女性,在儿童中也较为常见。OT是女童失去卵巢最常见的原因,临床上往往无法第一时间明确诊断,从而导致漏诊、误诊,这将会直接影响女性的内分泌及生殖功能,严重者甚至危及生命。虽然目前临床上普遍通过患者的临床表现及检查进行初步诊断,但多项研究显示,一些血液检验指标对于OT的诊断及与卵巢其他疾病的鉴别同样具有一定的帮助。因此,本文通过总结分析小儿OT的病因、临床表现、实验室检查、治疗及其相关诊断标志物,以提高临床医生对该病的认识。

目的 应用生物信息学的方法筛选参与星型胶质细胞瘤的预后生物标志物。方法 首先,下载GEO(gene expression omnibus,GEO)数据库中星型胶质细胞瘤的基因芯片数据,通过R语言将来自4个数据集的基因芯片数据进行合并,将合并后的194人来源的脑组织样本分为:星型胶质细胞瘤组和正常组。然后对原始基因芯片数据进行批次效应去除和标准化处理,并使用密度图和主成分分析监测处理前后的效果。利用R语言中的limma包对处理后的基因芯片数据进行差异表达分析,从而筛选得到星型胶质细胞瘤组和正常组中之间的差异表达基因(differentially expressed genes,DEGs)。接着对差异表达基因进行GO(gene ontology,GO)分析和KEGG(kyoto encyclopedia of genes and genomes,KEGG)分析,并对所有基因的表达矩阵进行GSEA(gene set enrichment analysis,GSEA)分析。通过STRING数据库构建差异表达基因的蛋白—蛋白相互作用网络(protein-protein interaction,PPI),通过Cytoscape中的cytoHubba插件筛选Hub基因。为了探索Hub基因在星型胶质细胞中的诊断价值和预后价值,我们下载TCGA(the cancer genome atlas,TCGA)数据库中的基因表达数据和临床预后资料,使用ROC曲线评价Hub基因的诊断价值,并对诊断价值较高的Hub基因进行COX回归,筛选HR值最有意义的基因进行总生存分析(overall survival,OS)。结果 通过limma包总共分析得到1 043个差异表达基因。GO分析结果表明差异表达基因主通过影响神经突触的功能而发挥作用。KEGG分析结果显示钙信号通路、cAMP信号通路、MAPK信号通路、PI3K-Akt信号通路、Rap1信号通路和Ras信号通路等通路等在星型胶质细胞瘤中发挥着重要的作用。GSEA富集分析结果主要富集于细胞因子-细胞因子受体相互作用、JAK-STAT信号通路、逆行内源性大麻素信号、神经活性配体-受体相互作用、GABA能突触和钙信号通路等通路。通过PPI网络总共分析得到ADCY1、ANXA1和PENK等20个Hub基因。通过对Hub基因的诊断价值和预后价值进行评价,发现SST在星型胶质细胞瘤既可作为诊断标志物,也可作为预后生物标志物。结论 我们通过生物信息学分析发现SST可作为星型胶质细胞的预后生物标志物,又预测了Rap1信号通路有可能成为星型胶质细胞分子机制中的新通路。

Objective To screen biomarkers involved in the prognosis of astrocytoma by bioinformatics. Methods Firstly,the gene chip data of astrocytoma in GEO database were downloaded. The gene chip data from four data sets were combined by R language. The combined 194 human brain samples were divided into astrocytoma group and normal group. Then,the original microarray data were processed by batch effect removal and standardization,and the effects before and after processing were monitored by density map and principal component analysis. The differentially expression genes (DEGs) between astrocytoma group and normal group were screened by using limma package of R language to analyze the differentially expression of the processed gene chip data. Then gene ontology(GO) analysis and Kyoto encyclopedia of genes and genes (KEGG) analysis were carried out for the differentially expressed genes,and gene set enrichment analysis (GSEA) was carried out for the expression matrix of all genes. The protein-protein interaction (PPI) network of differentially expressed genes was constructed by using string database,and the Hub gene was screened by using the cytohubba plug-in of Cytoscape. In order to explore the diagnostic value and prognostic value of Hub gene in astrocytes,we downloaded the gene expression data and clinical prognostic data in the Cancer Genome Atlas(TCGA) database,used ROC curve to evaluate the diagnostic value of hub gene,and Cox regression for Hub gene with high diagnostic value,and screen the most significant gene of HR value for overall survival(OS) analysis. Results A total of 1 043 differentially expressed genes were obtained by limma analysis. Go analysis showed that the differentially expressed genes played an important role by affecting the function of synapses. KEGG analysis showed that calcium signaling pathway,cAMP signaling pathway,MAPK signaling pathway,PI3K Akt signaling pathway,Rap1 signaling pathway and Ras signaling pathway played an important role in astrocytoma. The results of GSEA enrichment analysis were mainly enriched in cytokine cytokine receptor interaction,JAK-STAT signaling pathway,retrograde endogenous cannabinoid signaling,neuroactive ligand receptor interaction,GABAergic synapse and calcium signaling pathway. A total of 20 Hub genes such as ADCY1,ANXA1 and PINK were obtained by PPI network analysis. By evaluating the diagnostic and prognostic value of hub gene,we found that SST could be used as both a diagnostic marker and a prognostic biomarker in astrocytoma. Conclusion We found that SST could be used as a biomarker for the prognosis of astrocytes by bioinformatics analysis,and predicted that Rap1 signaling pathway may be a new pathway in the molecular mechanism of astrocytes.

目的 探讨高脂血症大鼠模型前后血液中氨基酸代谢谱的变化,寻找高脂血症大鼠血液中氨基酸代谢标志物。方法 将SD大鼠随机分为正常对照组、模型组,连续灌胃给药4周后收集大鼠血液,测定各组大鼠血清中TG、TC、HDL-C、LDL-C含量,并运用超高效液相色谱-四极杆-飞行时间质谱(UPLC-Q-TOF-MS/MS)法测定血清中氨基酸代谢谱,利用统计学分析研究不同组动物间的氨基酸代谢的差异。结果 与正常对照组比较,模型组TG、TC、LDL-C含量升高,HDL-C含量降低,高脂血症大鼠模型建模成功;与正常对照组比较,模型组蛋氨酸、苯丙氨酸、脯氨酸、苏氨酸、缬氨酸、甘氨酸等6种氨基酸发生明显改变(P<0.05)。结论 高脂血症大鼠存在氨基酸代谢的紊乱,其中蛋氨酸、苯丙氨酸、脯氨酸、苏氨酸、缬氨酸、甘氨酸等6种氨基酸为其潜在的生物标志物。

Objective To investigate the amino acid metabolism profiles changes in the serum of SD rats, and identify the potential biomarkers. Methods SD rats were divided into normal group and model group. The contents of TG, TC, HDL-C, and LDL-C in the serum of each group were measured, after 4 weeks of continuous intragastric administration. Ultra performance liquid chromatography coupled with electrospray time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS/MS)was used to determine amino acid metabolism profile in serum, and statistical analysis was applied to determine metabolic differences among different groups of rats. Results As compared with normal group, TG, TC, LDL-C were increased and HDL-C was decreased in model group, hyperlipidemia rat model successfully modeled. As compared with normal group, methionine, phenylalanine, proline, threonine, valine, glycine in the amino acid metabolic profiling were decreased in model group (P＜0.05). Conclusion Hyperlipidemia rats have disorders of amino acid metabolism, of which methionine, phenylalanine, proline, threonine, valine, and glycine are potential biomarkers.

目的 研究EGFR基因突变与系列肿瘤标志物在160例原发性肺癌患者及51例肺部良性占位病变患者中的表达状况,为肺部占位病变的诊断、鉴别诊断和治疗提供参考依据。方法 160例肺癌患者取新鲜病理组织标本,采用扩增阻滞突变系统荧光PCR(ARMS-PCR)技术检测EGER基因突变;160例肺癌患者和51例良性占位病变患者取外周静脉血用化学发光法检测系列肿瘤标志物,用χ²检验统计分析数据。结果 160例肺癌病例中,EGFR基因野生型比率为47.56%(78/164),EGFR基因突变型比率为52.44%(86/164),突变型中21L858R点突变占23.17%(38/164),19Del缺失突变占22.56%(37/164)。肺癌组中系列肿瘤标志物较良性占位组具显著高表达,P＜0.01。差异有统计学意义。结论 肺癌致病与EGFR基因突变、肿瘤标志物高表达有显著正相关,通过肿瘤标志物和EGFR基因突变检测,结合影像学检查,将有助于肺部占位病变诊断和鉴别诊断,并为治疗手段选择提供参考依据。

Objective To research EGFR gene mutation and series of tumor markers expression in 160 patients with primary lung cancer and 51 patients with lung benign placeholder lesions, provide some references for the diagnosis, differential diagnosis and treatment in lung placeholder lesions. Methods We took fresh pathological tissue specimens from 160 cases of patients with lung cancer, Then used ARMS PCR technique to detect EGER gene mutations. We took the peripheral venous blood in 160 patients with lung cancer and 51 patients with lung benign placeholder lesions, with chemiluminescence method to detect series of tumor markers,and used thechi-square test to statistic and analysis data. Results In 160 cases of lung cancer patients,The EGFR gene wild type rate was 47.56%(78/164).The EGFR gene mutation type rate was 52.44%(86/164).In EGFR gene mutation type,The proportion of 21L858R mutation was 23.17%(38/164),19del mutation was 22.56%(37/164). Series of tumor markers had significantly higher expression in lung cancer group than in benign placeholder lesions group. P＜0.01.The difference was statistically significant. Conclusion Lung cancer pathogenesis and EGFR gene mutations, tumor markers high expression was significantly positive correlation. Through a series of tumor markers and EGFR mutation testing, combined with imaging examination, it will contribute to the diagnosis and differential diagnosis in lung placeholder lesions, and provide the basis for treatment.

急性肾损伤(acute kidney injury,AKI)是由各种因素导致的临床综合征,尽管科学在发展,发病率、死亡率一直居高不下,并且严重影响患者的预后,这主要是由于对肾脏损伤的早期诊断缺乏敏感的、特异性的指标,使得患者错过了最佳的治疗窗口。研究发现在AKI的早期给予干预,能够明显提高患者的预后,达到满意的治疗效果。所以AKI的早期诊断是提高患者的生活质量的关键措施,期间出现了一系列AKI 的早期分子标志物,包括NGAL、IL-18、miRNA、KIM-1、NAG、L-FABP、TIMP-1、IGFBP-7、TFF-3、GST-π、MYL12B等。本文就这些AKI分子标志物进行总结,阐述这些分子标志物在AKI 诊断及预后预测中的价值,以便于及早制定有针对性的 AKI 治疗及护理策略,使早期诊断、早期干预 AKI 成为可能。

目的 探讨血浆脑利钠肽前体(proBNP)和心肌损伤标志物(CK-MB和cTnI)联合检测对老年脓毒症患者心肌损伤及预后评估的临床意义。方法 选择60例老年脓毒症患者按病情严重程度分为一般脓毒症组和严重脓毒症组,另选取同期在我院行健康体检的同龄人30例作为对照组。比较三组和不同预后患者血浆proBNP、cTNI、CK-MB水平及急性生理和慢性健康状态评分Ⅱ(APACHE Ⅱ) ,并对各指标进行相关性分析。结果 脓毒症患者血浆proBNP、cTnI水平高于对照组,且严重脓毒症组APACHEⅡ评分高于一般脓毒症组(均P＜0. 05);死亡组患者其血浆中的proBNP,cTNI和CK-MB水平及APACHE Ⅱ评分均高于存活组患者(均P＜0.05),差异有统计学意义;严重脓毒症组患者血浆proBNP 水平与cTnI及CK-MB水平呈正相关性(P＜0.05); 血浆proBNP水平、cTnI水平、CK-MB水平分别与APACHEⅡ评分呈正相关性(P＜0.05)。结论 血浆proBNP 及cTnⅠ水平可有效反映老年脓毒症患者心肌受损程度,早期血浆proBNP、cTnI、CK-MB水平联合检测对老年脓毒症患者预后判断可能有重要临床意义。

Objective To study the clinical significance of cardiac injury biomarkers(CK-MB and cTnI) and pro-brain natriuretic peptide(proBNP) joint detection for prognosis value in Elderly sepsis. Methods Sixty elderly patients with sepsis were selected. According to the severity of disease divided into general and severe sepsis group.Meanwhile, 30 healthy volunteers as a control group. Comparative study of plasma proBNP, cTnI, CK-MB levels and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in three groups;and the correlation analysis of the indicators. Results Compared with control group, the plasma levels of proBNP and cTnI were significantly higher in patients with sepsis; And the APACHEⅡ score in the severe sepsis group was significantly higher than the general sepsis group (P<0. 05). The plasma proBNP, cTnI, CK-MB level and APACHE Ⅱ scores in death group were significantly higher than the survival group (P<0. 05). The proBNP plasma levels, cTnⅠ and CK-MB levels in severe sepsis patients were positively correlated (P<0. 05); They were positively correlated between ProBNP level, cTnⅠ level and the APACHEⅡ score(P<0. 05). Conclusions ProBNP plasma levels and cTnⅠ can effectively reflect the extent of the cardiac damage in elderly sepsis; Early plasma proBNP level, cTnI and CK-MB combined detection of elderly sepsis may have important clinical significance.