慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数（SII）作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。

Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis．As a new type of inflammatory index,the systemic immune inflammatory index（SII）was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields．SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development．

目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%（χ²=3.887,P<0.05）,观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为（3.09±1.25）（4.17±2.24）（3.95±1.53）（4.05±1.77）d,均低于对照组（5.14±2.43）（7.03±3.23）（6.40±2.62）（6.32±1.81）d（t=5.143、4.988、5.536、6.147,P<0.05）,观察组的 C 反应性蛋白（C-reactive protein,CRP）、白细胞介素-6（Interleukin-6,IL-6）以及Toll样受体4（Toll-like receptor 4,TLR-4）水平分别为（3.64±0.87）mg/L、（54.59±10.65）ng/mL、（7.94±1.57）%,均低于对照组（7.51±1.43）mg/L、（87.66±11.17）ng/mL、（12.11±2.48）%（t=15.850、14.690、9.740,P<0.05）,观察组的气道压力、动脉血二氧化碳分压（partial pressure of carbon dioxide in artery,PaCO₂）水平分别为（6.92±3.60）cmH₂O、（43.19±6.29）mmHg,低于对照组（8.68±2.98）cmH₂O、（55.43±5.95）mmHg,观察组动脉氧分压（Partial arterial oxygen pressure,PaO₂）（86.06±5.31）mmHg、血氧饱和度（oxyhemoglobin saturation,SpO₂）（98.03±6.63）%高于对照组（68.04±5.19）mmHg、（90.22±5.51）%要高（t=2.582、9.692、16.638、6.221,P<0.05）,观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义（χ²=2.849,P>0.05）。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。

Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group．The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration．The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group（χ²=3．887,P<0.05）．The relief time of fever,pulmonary rale,cough and sputum in observation group was（3.09±1.25）d,（4.17±2.24）d,（3.95±1.53）d,and（4.05±1.77）d,respectively,which were significantly lower than the control group[（5.14±2.43）d,（7.03±3.23）d,（6.40±2.62）d and（6.32±1.81）d]（t=5.143,4.988,5.536,6.147,P<0.05）．The levels of CRP,IL-6 and TLR-4 in the observation group were（3.64±0.87）mg/L,（54.59±10.65）ng/mL and（7.94±1.57）%,respectively．They were significantly lower than（7.51±1.43）mg/L,（87.66±11.17）ng/mL and（12.11±2.48）% in the control group（t=15.850,14.690,9.740,P<0.05）．The airway pressure and PaCO₂ levels of the observation group were（6.92±3.60）cmH₂O and（43.19±6.29）mmHg,respectively,which were significantly lower than those of the control group[（8.68±2.98）cmH₂O and（55.43±5.95）mmHg]．The levels of PaO₂[（86.06±5.31）mmHg] and SpO₂[（98.03±6.63）%] in the observation group were higher than those in the control group[（68.04±5.19）mmHg and（90.22±5.51）%],and there were statistically significant differences（t=2.582,9.692,16.638,6.221,P<0.05）．The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference（χ²=2.849,P>0.05）. Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients．

炎症性肠病（IBD）作为一种慢性、易复发的炎症性疾病,被世界卫生组织归类为现代医疗领域的难治性疾病之一。其确切发病机制尚不清晰,目前主要认为与肠菌失衡触发宿主过度的肠黏膜免疫反应,进而在遗传易感性的个体中引发肠黏膜的损伤有关。目前,尚无特效的靶点能治愈IBD。过氧化物酶体增殖物激活受体（PPARs）作为核受体超家族的一员,在机体的生长发育、炎症调控以及代谢过程中扮演着重要角色,且被视为治疗包括IBD在内的多种疾病的重要潜在靶点,并被认为与肠道菌群关系密切。文章旨在探讨PPARs与肠道菌群的关系在IBD中的作用,从而挖掘IBD新的潜在诊疗靶点,开发新的治疗策略,为临床上IBD的诊断和治疗提供新的思路和方法。

Inflammatory bowel disease（IBD）,characterized as a chronic and recurrent inflammatory condition,is classified by the World Health Organization as one of the intractable diseases in modern medicine．The precise pathogenesis of IBD remains unclear,but current research widely believes that it is closely related to dysbiosis of the gut microbiota．Imbalance in the gut flora triggers an excessive immune response in the host’s intestinal mucosa,leading to mucosal damage in genetically susceptible individuals．To date,no specific targets have been identified that can cure IBD．Peroxisome proliferator-activated receptors（PPARs）,as members of the nuclear receptor superfamily,play significant roles in growth and development,inflammation regulation,and metabolic processes．They are regarded as potential effective targets for treating various diseases,including IBD,and are closely related to the gut microbiota．This review aims to discuss the progress in understanding the role of the relationship between PPARs and gut microbiota in IBD,so as to find new potential targets for the diagnosis and treatment of IBD,develop new treatment strategies,provide new ideas and methods for the diagnosis and treatment of IBD in clinical practice．

目的 探讨人外周血中炎症因子的表达与炎性衰老的相关性。方法 通过招募年轻和老年志愿者,检测外周血中炎症因子IL-6、IL-8、TNF-α和IL-1β的mRNA表达水平和蛋白水平。结果 显示老年个体组中IL-6,IL-8和TNF-α的mRNA表达水平高于年轻组,且蛋白水平呈现相同的趋势,比较差异均有统计学意义（P<0.05）。此外,通过热图分析了炎症因子mRNA和蛋白水平的相对表达谱,也发现相同的结果。结论 当年龄超过65岁以后,随着年龄的增长,体内的炎症因子表达水平会升高,这一结果具有成为炎性衰老生物标志物的潜力,对评估老年人的健康状况和疾病风险具有重要意义。

Objective To explore the correlation between the expression of inflammatory factors in human peripheral blood and inflamm-aging．Methods In this experiment,the young and old volunteers were recruited to detect mRNA and protein levels of IL-6,IL-8,TNF-α and IL-1β in peripheral blood．Results The results indicated that mRNA expression levels of IL-6,TNF-α and IL-8 in the old individuals were higher than the young individuals,and the protein concentration followed the same trend,with acceptable P value suggesting a great statistically significant difference．In addition,the relative expression profiles of mRNA and protein concentrations of inflammatory cytokines were analyzed by heat map,and the same results were found．Conclusions It shows that the expression level of inflammatory cytokines up-regulates along with age goes on over 65,which has the potential of inflammatory biomarkers of aging．

目的 建立针对炎症性肠病患者的运动锻炼方案。方法 通过系统检索Web of Science、Embase、Cochrane Library等数据库,综合相关文献并由两名研究者独立提取信息,制定出指导患者运动锻炼的方案。检索时间从建库截至2023年9月1日。结果 共筛选出12篇文献,包括指南、专家共识、Meta分析以及RCT试验。最终总结出运动的必要性、作用、适合人群、评估及筛选、运动方式选择、监测以及限制因素等7个方面,共计37条证据。结论 这些证据为轻中度炎症性肠病患者提供了有氧运动联合抗阻运动的最佳实践依据,可指导临床实践,规范运动训练,从而延缓疾病进展。

Objective To establish an exercise program for patients with inflammatory bowel disease（IBD）．Methods A systematic search was conducted in databases such as Web of Science,Cochrane Library,and Embase,with relevant literature being comprehensively reviewed．Information was independently extracted by two researchers to develop a program guiding patients' exercise．Searching terms included both Chinese and English keywords,with the searching period covering from the inception of the databases to September 1,2023．Results A total of 12 articles were screened,including guidelines,expert consensuses,Meta-analyses,and randomized controlled trials．Ultimately,37 pieces of evidence were summarized across seven aspects：the importance of exercise,suitable populations,assessment and screening,choice of exercise modes,monitoring and limiting factors．Conclusions These evidences provide the best practice basis for aerobic and resistance exercises in patients with mild to moderate IBD,guiding clinical practice,standardizing exercise training,and thus delaying disease progression．

目的 研究核因子-κB激活剂1（Act1）对高糖诱导肾小管上皮细胞炎症反应及细胞外基质表达的调控作用。方法 培养肾小管上皮细胞MK2,设置对照组和高糖组,处理12 h、24 h、48 h、72 h后检测细胞中Act1的mRNA和蛋白表达水平;设置si-NC组（5.5 mmol/L葡萄糖培养基中转染NC siRNA）、si-NC+高糖组（30 mmol/L葡萄糖培养基中转染NC siRNA）、si-Act1+高糖组（30 mmol/L葡萄糖培养基中转染Act1 siRNA）,48 h后检测细胞中Act1、E-钙黏蛋白（E-cadherin）、N-钙黏蛋白（N-cadherin）、I型胶原（Col-I）、III型胶原（Col-III）的mRNA和蛋白表达水平以及培养基中肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）、干扰素-γ（IFN-γ）的含量。结果 高糖组处理12 h、24 h、48 h、72 h时细胞中Act1的mRNA和蛋白表达水平均高于对照组（P<0.05）;si-NC+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均高于si-NC组,细胞中E-cadherin的mRNA和蛋白表达水平均低于si-NC组（P<0.05）;si-Act1+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均低于si-NC+高糖组,细胞中E-cadherin的mRNA和蛋白表达水平均高于si-NC+高糖组（P<0.05）。结论 Act1表达增加对高糖诱导肾小管上皮细胞炎症反应激活和细胞外基质增多具有促进作用。

Objective To study the regulation effect of nuclear factors-κB activator 1（NF-κB activator 1,Act1）on high glucose induced inflammatory response and extracellular matrix expression in renal tubular epithelial cells．Methods Renal tubular epithelial cells MK2 were cultured and control group and high glucose group were set．The mRNA and protein expression of Act1 were detected after treatment for 12,24,48 and 72 hours．MK2 were divided into si-NC group（transfected with NC siRNA in 5.5 mmol/L glucose medium）,si-NC+high glucose group（transfected with NC siRNA in 30 mmol/L glucose medium）and si-Act1+high glucose group（transfected with Act1 siRNA in 30 mmol/L glucose medium）．The mRNA and protein expression of Act1,E-cadherin,N-cadherin,type I collagen（Col-I）,and type III collagen（Col-III）and the contents of tumor necrosis factor-α（TNF-α）,interleukin-1β（IL-1β）,interferon-γ（IFN-γ）in culture medium were detected．Results The mRNA and protein expression levels of Act1 in cells of high glucose group were higher than those of control group at 12 h,24 h,48 h and 72 h（P<0.05）．The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-NC+high glucose group were higher than those of si-NC group,the mRNA and protein expression levels of E-cadherin in cells were lower than those of si-NC group at 48 h（P<0.05）．The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-Act1+high glucose group were lower than those of si-NC+high glucose group,the mRNA and protein expression levels of E-cadherin in cells were higher than those of si-NC+high glucose group at 48 h（P<0.05）．Conclusions The increased expression of Act1 promotes the activation of inflammatory response and the increase of extracellular matrix in renal tubular epithelial cells induced by high glucose．

目的 从炎症反应和肠道屏障两个方面探究五味苦参肠溶胶囊对葡聚糖硫酸钠（DSS）诱导的小鼠结肠炎的治疗作用。方法 6~8周龄雄性BALB/c小鼠被随机分为3组,分别为正常组、急性肠炎模型组和五味苦参组。急性肠炎模型组和五味苦参组小鼠予含有3% DSS的饮用水1周诱导急性结肠炎,其后急性肠炎模型组予PBS灌肠,五味苦参组予五味苦参肠溶胶囊制备为灌肠液灌肠。每天称量小鼠体质量,观察大便性状及血便情况,第8天处死小鼠,取结肠组织检测炎症细胞因子和肠屏障因子。结果 与正常组相比,急性肠炎模型组肠道炎症明显,五味苦参组有效缓解肠道炎症和有利于肠上皮屏障修复。表现为五味苦参灌肠液有效缓解小鼠体质量下降,具有较低的DAI评分,有较好的组织学表现,其结肠组织IL-1β,IL-6和TNF-α的相对表达下降,Occludin和ZO-1的相对表达增加（P<0.05）。结论 五味苦参肠溶胶囊制备的灌肠液可减轻DSS诱导的小鼠急性结肠炎。

Objective To explore the therapeutic effect of five-flavor sophora flavescens enteric-coated capsules（FSEC）on dextran sulphate sodium（DSS）-induced colitis in mice from inflammatory response and intestinal barrier．Methods Male BALB/c mice aged 6-8 weeks were randomly divided into three groups,namely normal group,acute colitis group and FSEC group．The mice in acute colitis group and FSEC group were given drinking water containing 3% DSS for one week to induce acute colitis,and then they were given PBS enema or FSEC enema respectively．The mice were administered daily,including weight loss,the stool properties and bloody feces．The mice were sacrificed on the 8th day,and the colon tissue was collected to detect inflammatory cytokines and intestinal barrier cytokines．Results Compared with the normal group,the intestinal inflammation in the acute colitis group was obvious,however the FSEC effectively relieved intestinal inflammation and facilitated the intestinal epithelial barrier repair．It showed that FSEC enema effectively relieved weight loss and had a lower disease activity index score．In addition,FSEC enema group had better histological appearance．Compared to acute colitis group,the relative expression of IL-1β,IL-6 and TNF-α in colon tissue decreased,and the relative expression of Occludin and ZO-1 significantly increased in FSEC group（P<0.05）．Conclusions FSEC enema can alleviate DSS-induced acute colitis in mice．

高压氧治疗是在高于当地压力的环境下,吸入高于当地大气氧浓度的氧来治疗疾病的方法,主要用于缺氧缺血性疾病或与缺氧缺血有关的疾病的治疗。炎症作为机体对刺激的一种防御机制,是感染、损伤、中毒等疾病共同的病理生理基础,在疾病的发生发展中扮演重要角色。高压氧与炎症的关系密切,围绕高压氧与炎症调节相关的研究进行综述,对深入认识高压氧的作用机制具有重要的意义。

Hyperbaric oxygen therapy is the treatment of diseases by inhaling oxygen at a concentration higher than the local atmospheric oxygen concentration in an environment that higher than the local pressure．It is mainly used in the treatment of hypoxic-ischemic diseases or diseases related to hypoxia-ischemia．As a defense mechanism against stimulation,inflammation is the common pathophysiological basis of infection,injury,poisoning and other diseases,which plays an important role in the occurrence and development of diseases．Hyperbaric oxygen is closely related to inflammation．The review on hyperbaric oxygen and inflammation regulation is of great significance to further understand the mechanism of hyperbaric oxygen．

目的 分析早、中期肝细胞癌（HCC）切除术后早期（≤2年）复发的危险因素并探讨术前系统免疫炎症指数（SII）对早、中期HCC术后早期复发的预测价值。方法 回顾性研究2017年10月—2020年10月于我院接受肝癌根治性切除术的238例早中期HCC患者,收集基线资料,通过1∶1倾向性评分匹配（PSM）均衡组间协变量获取早期复发组及未复发组各69例;单因素和多因素Logistic回归分析影响术后早期HCC复发的相关因素,构建列线图模型,临床决策曲线（DCA）评估列线图预测模型在临床的应用效果;受试者操作特征（ROC）曲线评价预测效能,根据最高约登指数确定截断点。结果 单因素及多因素Logistic回归分析结果均提示微血管侵犯（MVI）及术前系统免疫炎症指数（SII）高水平是术后早期复发的独立危险因素;列线图模型有较好的预测效能;ROC曲线计算出SII最佳临界值为696.85×10⁹／L。结论 术前高水平SII可能对预测HCC患者术后早期复发具有潜在价值。

严重烧伤后患者免疫功能的失调,易导致创面感染、全身炎症反应综合征、脓毒症、感染性休克等并发症,增加患者病死率。免疫细胞功能适度的活化将有助于烧伤患者抵御外界病原体的侵袭、促进创面的愈合,但功能过度激活或者功能低下,则会引发一系列严重的后果。本文旨在归纳严重烧伤后中性粒细胞、单核/巨噬细胞、肥大细胞、NK细胞及T淋巴细胞等免疫细胞的功能变化与炎症反应之间的关系,为完善烧伤患者诊疗、减少并发症、改善预后提供新的思路。

The imbalance of immune function in severely burned patients can easily lead to wound infection,systemic inflammatory response syndrome,sepsis,septic shock and other complications,which increase the mortality of patients. Moderate activation of immune cell function will help burned patients to resist the invasion of external pathogens and promote wound healing,but excessive activation or low function can lead to a series of serious consequences. The purpose of this paper is to summarize the relationship between the functional changes of immune cells such as neutrophils,monocytes/macrophages,mast cells,NK cells,T lymphocytes and inflammatory reaction after severe burns,and to provide new ideas for improving the diagnosis and treatment of burned patients,reducing complications and improving the prognosis.