目的 回顾性分析采用内镜下氩离子凝固术治疗胃出血的治疗效果,为临床治疗胃出血提供经验及理论基础。方法 选取2010年1月—2014年7月我院收治的胃出血患者199例,随机分为两组,分别对其进行内镜下氩离子凝固术治疗和内镜下高频电凝治疗,总结对比其治疗效果,并对其并发症情况进行统计。结果 经治疗后,A组28例胃黏膜溃烂出血患者未再出血27例(96.43%),E组22例胃黏膜溃烂出血患者未再出血例数17例(77.27%),差异有统计学意义(P<0.05);A组治疗后形成局部炎性肉芽肿及发生胃穿孔的百分比低于E组,差异有统计学意义(P<0.05)。结论 采用内镜下氩离子凝固术治疗胃出血,止血率高,并发症发生率低,效果良好,值得在临床中推广使用。

Objective A retrospective analysis was performed using endoscopic argon plasma coagulation treatment of stomach bleeding, to provide experience and theoretical basis for the clinical treatment of stomach bleeding. Methods January 2010-July 2014 199 cases of bleeding in patients admitted to our hospital.They were randomly divided into two groups and had therapeutic endoscopic argon plasma coagulation. We summarized the treatment effect and its complications statistics. Results After therapy, 27 gastric mucosa fester patients(96.43%) of 28 patients in group A stopped bleeding and 17 gastric mucosa fester patients(77.27%) of 22 patients in group B stopped bleeding and the difference is statistical significance(P<0.05), and the incidence rate of inflammatory granuloma and gastric perforation of group A is significant lower than that of group B (P<0.05). Conclusion Endoscopic argon plasma coagulation therapy is taken to treat gastrorrhagia, hemostasis rate is higher and complication rate is lower. It is worth widely using in the clinic.

目的 对兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗焦虑糜烂性胃炎患者的治疗效果进行研究。方法 选取2013年1月—2015年1月在我院收治的伴有焦虑情绪的糜烂性胃炎患者106例。随机分为对照组,给予兰索拉唑肠溶片治疗,观察组,给予兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗,并且对疗效进行比较。结果 治疗前,两组患者在腹痛、腹胀、反酸、嗳气以及黏膜糜烂各指标评分比较,差异无统计学意义(P>0.05);治疗后,2组患者以上指标均有所改善,并且观察组患者同期指标改善均优于对照组(P<0.05);治疗前,两组患者胃黏膜中PGE2和MDA含量无差异(P>0.05);治疗后,两组患者的PGE2均上升,而MDA则下降,并且观察组患者PGE2含量比对照组高,MDA则比对照组低,差异均有统计学意义(P<0.05);治疗前,两组患者HAMA、HAMD评分差异不明显,无统计学意义(P>0.05);治疗后,两组患者焦虑情况均有所改善,并且观察组患者情绪改善程度优于对照组患者,差异均有统计学意义(P<0.05);观察组不良反应发生率为5.6%,对照组不良反应发生率5.6%,差异无统计学意义,P>0.05。结论 兰索拉唑与氟哌噻吨美利曲辛联合应用有助于改善糜烂性胃炎患者的病情,并且可以缓解患者的焦虑情绪,安全性高,值得临床推广。

Objective To observe the clinical efficacy of lansoprazole enteric-coated tablets combined with flupentixol-melitracen in treating anxiety patients with erosive gastritis. Methods 106 patients with erosive gastritis and anxiety in our hospital from January 2013 to January 2015 were divided into an observation group and a control group, with 53 patients in each group. The control group was given lansoprazole enteric-coated tablets alone, and the observation group was treated with lansoprazole enteric-coated tablets and flupentixol-melitracen. Clinical symptoms and mucosal erosion were compared between the two groups of patients before and after treatment. Gastric mucosa malondialdehyde (MDA) and prostration E2 (PGE2) contents, anxiety and depression status were also assessed. Results After treatment, the scores of abdominal pain, bloating, acid reflux, belching, and mucosal erosions were significantly lower in the observation group than in the control group (P< 0.05). PGE2and MDA contents in the gastric mucosa in the observation group were different from those in the control group(P< 0.05). HAMA and HAMD scores were lower in the observation group than in the control group (P< 0.05). There was no difference of adverse reaction rate between the control group and the observation group (P>0.05). Conclusion Lansoprazole enteric-coated tablets combined with flupentixol-melitracen has better clinical efficacy than lansoprazole enteric-coated tablets only in patients with erosive gastritis and anxiety in terms of the improvement of clinical symptoms and mucosal erosion and the relief of negative emotions.

目的 评估重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白（rhTNRF：Fc）治疗难治性慢性痛风性关节炎的临床疗效及安全性。方法 选取2022年1月一2023年12月广州中医药大学顺德医院风湿科门诊收治的46例难治性痛风性关节炎患者,分为观察组和对照组两组,对照组规范使用降尿酸药物治疗,观察组在对照组治疗的基础上联合使用rhTNRF：Fc至少12周,在0、12、24、48周观察两组的血尿酸（sUA）、肿瘤坏死因子-α（TNF-α）、关节肌肉骨骼超声变化、痛风发作例数、肝肾功能等指标。结果 观察组与对照组sUA无明显差别（P>0.05）,TNF-α水平明显下降（P<0.05）,滑膜炎、关节积液影像表现减少（P<0.05）,痛风发作例数明显减少（P<0.05）,观察期间肝肾功能正常,无患者因不良反应退出研究。结论 rhTNRF：Fc对难治性慢性痛风性关节炎安全有效。

Objective To explore the efficacy and safety of recombinant human type II tumor necrosis factor receptor-antibody fusion protein（rhTNRF：Fc）in refractory chronic gouty arthritis. Methods From January 2022 to December 2023, 46 cases of refractory chronic gouty arthritis in the Rheumatology Outpatient Department,Shunde Hospital Guangzhou University of Chinese Medicine were selected and divided into an observation group and a control group. The control group received routine treatment,while the observation group received rhTNRF：Fc treatment additionally for at least 12 weeks, two groups of indicators such as serum urine acid（sUA）, TNF-α, changes in musculoskeletal ultrasound,number of gout attacks,hepatic and renal function at 0, 12, 24, and 48 weeks were observed. Results There was no significant difference in sUA between the observation group and the control group（P>0. 05）, TNF-α significantly decreased（P<0. 05）, synovitis and joint effusion imaging manifestations reduced（P<0. 05）, number of gout attacks decreased（P<0. 05）. During the observation period, liver and kidney function were normal, and no patients withdrew from the study due to adverse reactions. Conclusions Using rhTNRF：Fc is safe and effective in treating refractory chronic gouty arthritis.

        目的   比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效，以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法   连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例，采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d，阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前（基线）以及连续用药治疗2、4、6周后的PANSS量表评分，以及治疗后的代谢指标［体质量指数（BMI）、血清空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE），并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果   两组的总有效率比较差异无统计学意义（χ ² =1.569，P＞0.05）；两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义（χ ² =0.466、3.640，P=0.926、0.056），时间主效应显著（χ ² =363.24，P＜0.001）。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应（χ ² =7.562、5.991、6.163、6.958、4.397，P=0.006、0.014、0.013、0.008、0.036），两组TG、ApoA时间主效应显著（χ ² =33.473、8.846，P＜0.001、0.003），两组ApoA组别效应显著（χ ² =4.889，P=0.027）。结论   与奥氮平相比，鲁拉西酮治疗女性急性期精神分裂症的疗效相当，且对代谢指标影响更小。

        Objective  To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia，as well as their effects on body mass，glucose and lipid metabolism risk．To provide  reference for the selection of antipsychotic drugs for female patients with acute schizophrenia．Methods  From April 2022 to April 2024，80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study．The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison．The treatment group took oral lorazepine tablets（40 cases；40-80 mg/d），while the positive drug control group took oral olanzapine tablets（40 cases；5-20 mg/d）．The Positive and Negative Symptom Scale（PANSS）scores of two groups before treatment（baseline）and after 2，4，and 6 weeks of continuous medication treatment were measured，as well as metabolic indicators after treatment （body mass index［BMI］，serum fasting blood glucose［FPG］，total cholesterol［TC］，triglycerides［TG］，high-density lipoprotein［HDL］，low-density lipoprotein［LDL］，apolipoprotein A［ApoA］，apolipoprotein B［ApoB］，apolipoprotein E［ApoE］），and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed．Results  The total effective  rate of the two groups was not statistically significant（χ ² =1.569，P＞0.05）．The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant（χ ² =0.466，3.640，P=0.926，0.056），while the time main effect was significant（χ ² =363.24，P＜0.001）．There was a group-time interaction effect between two groups of TG，TC，HDL，ApoA，and ApoB（χ ² =7.562，5.991，6.163，6.958，4.397，P=0.006，0.014，0.013，0.008，0.036）．The time main effect of TG and ApoA was significant in both groups（χ ² =33.473，8.846，P＜0.001，0.003），and the group effect of ApoA was significant in both groups（χ ² =4.889，P=0.027）．Conclusions  Compared with olanzapine，the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable，and it has a smaller impact on metabolic indicators．

        目的   分析刃针联合关节错缝术治疗第三腰椎横突综合征（TLVTPS）的疗效。方法   采用视觉模拟评分法、Oswestry功能障碍指数评分以及腰部活动度，分析2023年1月至10月于广州市第一人民医院就诊的274例TLVTPS患者。其中，对照组（137例）采用刃针治疗，观察组（137例）采用刃针联合关节错缝术，比较两组疗效。结果   观察组的视觉模拟评分（0.46分）和Oswestry功能障碍指数评分（10.32分）低于对照组（P＜0.05）；同时，腰部活动差（53.69 cm）高于对照组（P＜0.05）；此外，痊愈及显效率83.93%（115/137）和总有效率93.42%（128/137）高于对照组（P＜0.05）。结论    刃针联合关节错缝术可有效缓解TLVTPS患者疼痛，改善腰部功能，疗效显著。

       Objective  To analyze the therapeutic effect of blade needle combined with joint misalignment therapy in third lumbar verterbrae transverse process syndrome（TLVTPS）．Methods  This study  retrospectively analyzed 274 TLVTPS patients from January 2023 to October 2023 in Guangzhou First People’s Hospital，using the Visual Analogue Score，Oswestry Disability Index scores，and lumbar range of motion．Among them，the control group（137 patients）were treated with blade needle therapy，while the observation group（137 patients）were treated with blade needle therapy combined with joint misalignment therapy．Results  The Visual Analogue Score（0.46）and Oswestry Disability Index scores（10.32）of the observation group were lower than that of the control group（P＜0.05）．Meanwhile，the lumbar range of motion（53.69 cm）was higher than that of the control group（P＜0.05）．Moreover，the recovery and effective rate was 83.93%（115/137）and the total effective rate was 93.42%（128/137），which were higher than that of the control group（P＜0.05）．Conclusions  The combination of blade needle therapy and joint dislocation manipulation alleviate pain effectively，improve lumbar function，and is clinically effective in patients with TLVTPS．

       目的   分析原发性肾病综合征（PNS）患儿在糖皮质激素（激素）治疗后淋巴细胞亚群及免疫因子的水平变化，以探讨PNS耐药机制。方法   选取PNS患儿共71例，正常对照组108例，收集PNS患者在激素治疗前、后及正常对照组儿童的淋巴细胞亚群［CD4⁺ 、CD8⁺ 、CD4⁺ /CD8⁺ 、CD19⁺ 和自然杀伤（NK）细胞］及免疫因子水平，并分析激素治疗后激素敏感患儿和激素耐药患儿相关指标的差异。结果  PNS患儿淋巴细胞亚群及免疫因子水平异常，激素治疗后PNS患儿总免疫球蛋白E（IgE）水平［767.50（270.25，1 937.50）IU/mL vs 311.00（62.70，757.00）IU/mL］（P=0.008）下降，而CD4⁺ T细胞比例［（33.88±7.42）% vs（38.25±7.16）%］（P=0.004）升高，激素治疗敏感患儿NK细胞比例高于激素治疗耐药患儿［（8.39±4.60）% vs（4.72±1.99）%］（P=0.034），IgE水平低于耐药患儿［311.00（62.70，633.00）IU/mL vs783.00（88.05，1 290.00）IU/mL］（P＜0.001）。结论  PNS患儿淋巴细胞亚群分布及免疫球蛋白水平异常，激素治疗可影响患儿CD4⁺ T细胞比例及IgE水平，并且NK细胞比例和IgE水平与患儿激素耐药相关。

       Objective  To evaluate the changes of lymphocyte subsets and immune factors levels in children with primary nephrotic syndrome（PNS），and explore the pathogenesis of PNS．Methods  A total of 71 patients with PNS and 108 normal control cases were selected．Flow cytometry was used to detect the concentration of lymphocyte subsets（CD4⁺ ，CD8⁺ ，CD4⁺ /CD8⁺ ，CD19⁺  and natural killer［NK］ cells）and immune factors before and after treatment．The difference of  related factors between steroid-sensitive and steroid-resistant children after therapy were analyzed．Results  Lymphocyte subsets and immune molecule levels were abnormal in children with NPS．The level of IgE（767.50［270.25，1 937.50］IU/mL vs 311.00［62.70，757.00］IU/mL，P=0.008）was significantly decreased after therapy（P＜0.05），while CD4⁺  T cells（［33.88±7.42］% vs［38.25±7.16］%，P=0.004）were significantly increased．The level of NK cells in steroid-sensitive children was significantly higher than that in steroid-resistant children（［8.39±4.60］% vs［4.72±1.99］%，P=0.034），while the level of  IgE was significantly lower than that of steroid -resistant children（311.00［62.70，633.00］IU/mL vs 783.00［88.05，1 290.00］IU/mL，P＜0.001）．Conclusions  The distribution of lymphocyte subsets and the level of immune factors in PNS children were abnormal．Steroid therapy could affect the levels of CD4⁺  T cells and IgE，and the levels of NK cells and IgE were related to steroid-resistance in PNS children．

       目的   探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势，为本领域研究者提供借鉴。方法   检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量，运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇，年发文量整体呈现波动上升的趋势；发文量最多的作者为姜之炎；发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队；研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主；研究热点逐渐从临床研究转向作用机制等实验研究；应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

       Objective  To explore the research status，research hotspots，and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children，to provide a reference for researchers in this field．Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1，2005，to January 31，2024．Excel 2019 was applied to analyze the number of published papers，and CiteSpace 6.2.R6 software was applied to analyze its authors，institutions，and keywords．Results  A total of 395 papers were included，and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core  research teams including JIANG Zhiyan，YU Jingmao，and YAN Zhaojun were initially formed．The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods，clinical efficacy．Conclusions  The research content in this field is mainly based on internal treatment，external treatment，and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．

       肿瘤治疗仍然是生物医学研究的一个突出领域。围绕各种化学治疗（化疗）药物和其他治疗药物的不良反应和靶向疗效的研究推动了各种药物载体的发展。这些载体聚焦于提高肿瘤部位的药物浓度，最大限度地减少全身不良反应，并改善治疗效果。在已报道的递送系统中，可注射水凝胶由于其微创的药物递送特性，已成为化疗药物体内递送的重要载体形式。文章系统地总结了可注射水凝胶的类型和特征，并进一步概括了可注射水凝胶装载药物的方式，同时深入讨论可注射水凝胶在治疗肿瘤的各种药物的递送应用。文章对原位注射水凝胶在治疗肿瘤方面存在的潜在性挑战和可能的解决方案提供了动态前瞻性的参考。可注射的水凝胶作为药物传递系统用于肿瘤治疗具有良好的发展前景。

       Tumor treatment remains a prominent area of biomedical research．The  researches surrounding the adverse 

reactions and targeted efficacy of various chemotherapy drugs and other therapeutic drugs have driven the development of various drug carriers．These carriers focus on increasing drug concentration at tumor site，minimizing systemic adverse reactions，and improving treatment outcomes．In the reported delivery systems，injectable hydrogels have become an important carrier for the delivery of chemotherapeutic drugs in vivo due to their minimally invasive characteristics．This review systematically summarized the types and characteristics of injectable hydrogels，and further summarized their drug loading methods．At the same time，the application of injectable hydrogels in the delivery of various drugs for tumor treatment was discussed in depth．This  review provides dynamic and prospective reference for the potential challenges and possible solutions of the in situ injectable hydrogels for tumor therapy．Injectable hydrogels as drug delivery systems are with good prospects for tumor treatment．

        胃食管反流病是一种以烧心和反流为主要症状的胃食管动力障碍性疾病，现有的常规治疗存在药物依赖，手术风险高且易复发等局限性，而经皮电刺激作为一种新兴疗法，在治疗动力障碍性疾病时具有非侵入性、可逆性及调节生理功能的优势。因此本研究为了探讨经皮电刺激治疗胃食管反流病的进展，现从胃食管反流病的神经调控生理、不同经皮电刺激对治疗胃食管反流病的研究以及应用效果等方面进行综述，以期为胃食管反流病提供新的诊断思路和方法。

    In order to discuss the progress of transcutaneous electrical stimulation for the treatment of gastroesophageal reflux disease（GERD），the physiology of neuromodulation of GERD，the research on different transcutaneous electrical stimulation for the treatment of GERD，and the application effect were reviewed，with the aim of providing new diagnostic ideas and methods for GERD．

       糖尿病肾病（DN）是指由糖尿病所致的慢性肾脏疾病，是目前我国和全球范围内慢性肾脏疾病和终末期肾脏疾病的首位病因。DN发病率逐年攀升，且预后不良，已成为我国重大的公共卫生问题之一。DN不仅明显降低了患者的生活质量，还增加了心血管疾病的风险。随着对DN发病机制的深入研究，近十余年来在DN治疗手段方面取得了显著进展，包括新型药物的研发、生活方式的干预及各种新兴疗法的探索。本文旨在系统性综述近年来DN领域的重要治疗进展，阐明这些进展在临床应用中的有效性和适用性，并展望未来的研究方向，以期为临床实践提供参考和指导。

       Diabetic nephropathy（DN）is a form of chronic kidney disease（CKD）induced by diabetes．Diabetic nephropathy represents the leading cause of CKD and end-stage renal disease both in China and globally．The incidence of DN has been steadily increasing and its prognosis remains unfavorable．Diabetic nephropathy has become a major public health concern．Diabetic nephropathy not only significantly affects patients’ quality of life but also increases the risk of cardiovascular diseases．Recent advancements in our understanding of the pathogenesis of DN have facilitated significant progress in treatment options over the past decade．These developments include the introduction of novel pharmacological agents，the implementation of lifestyle modifications，and the exploration of various emerging therapeutic approaches．This  review aims to  systematically expound the significant therapeutic advancements in the field of DN in recent years，evaluate the efficacy and applicability of these advancements in clinical practice，and explore potential future research directions，thereby providing valuable insights andguidance for clinical practice．