目的 探讨眼底豹纹斑密度（FTD）及视盘旁萎缩弧（PPA）与眼轴长（AL）的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组：A组（AL<23 mm）;B组（23 mm≤AL<24 mm）;C组（24 mm≤AL）。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1％。三组组间AL、AL/CR和SE比较均有统计学差异（P<0.05）。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异（P<0.05）,C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异（P<0.05）,Spearman相关性分析表明,AL与PPA（r=0.443）和FTD（r=0.322）呈正相关（P<0.001）。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关（P=0.028）,B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关（P<0.05）,C组仅PPA与AL呈正相关（P=0.005）。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。

Objective To investigate the correlation between fundus tessellated density（FTD）and peripapillary atrophy（PPA）with axial length（AL）,providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children．Methods This study randomly selected third-grade students from two primary schools in Liwan District,Guangzhou City,as research subjects．Axial length（AL）,corneal radius（CR）,and fundus color photographs were collected simultaneously during the school vision screening process．AI software was utilized to perform quantitative analysis on the fundus color photographs,with quantification indicators including the area size of PPA and FTD in different regions and ranges．Subjects were divided into three groups based on axial length：Group A（AL<23 mm）;Group B（23 mm≤AL<24 mm）;Group C（AL≥24 mm）．Results A total of 398 right eyes were included in the statistical analysis,with an age range of 8 to 11,a median age of 9,and 55.1% were male．There were significant statistical differences in AL,AL/CR,and spherical equivalent（SE）among the three groups（P<0.05）．Compared with Group B,Group A showed significant statistical differences in FTD in the overall posterior pole,the 3 mm diameter area centered on the fovea,and the superior area of the 3 mm foveal center（P<0.05）．Compared with Group B,Group C showed significant differences in PPA area and FTD in the overall posterior pole,the 4.5 mm diameter area centered on the optic disc,and the 3 mm and 6 mm diameter areas centered on the fovea（P<0.05）．Spearman correlation analysis indicated that AL was significantly positively correlated with PPA（r=0.443）and FTD（r=0.322）（P<0.001）．Subgroup correlation analysis showed that in Group A,only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL（P=0.028）．In Group B,PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL（P<0.05）．In Group C,only PPA was significantly positively correlated with AL（P=0.005）．Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children．PPA and FTD show significant positive correlations with AL,with varying degrees of correlation in different regions and ranges of FTD with AL．The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis．FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation,while PPA primarily manifests as a biomarker in the later stages of elongation．

目的 探究血清多配体蛋白聚糖-1（SCD-1）与可溶性血管内皮生长因子受体-2（sVEGFR-2）表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法 选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果 Logistic回归分析显示,心功能分级（OR=3.433,95%CI：0.934~6.431）、B型脑钠肽升高（OR=2.462,95%CI：0.861~4.765）、血清SCD-1升高（OR=3.795,95%CI：0.972~6.894）、血清sVEGFR-2升高（OR=3.842,95%CI：0.942~6.912）为影响老年慢性心力衰竭患者预后不良的重要因素（P<0.05）;联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高（P<0.05）。结论 经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。

Objective To investigate the prognostic value of serum syndecan-1（SCD-1）and soluble vascular endothelial growth factor receptor-2（sVEGFR-2）expression levels in elderly patients with chronic heart failure. Methods A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024．Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure．Multiple logistic regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure. Results According to logistic retrospective analysis,heart function grading（OR=3.433,95%CI：0.934-6.431）,elevated B-type brain natriuretic peptide（OR=2.462,95%CI：0.861-4.765）,elevated serum SCD-1（OR=3.795,95%CI：0.972-6.894）,and elevated serum sVEGFR-2（OR=3.842,95%CI：0.942-6.912）were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05．The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05. Conclusions Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure．It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure．

实体瘤对免疫治疗应答非常有限,因此,如何有效提升肿瘤免疫治疗的疗效,已成为当前肿瘤免疫治疗领域亟待解决的关键难题与挑战。髓系来源抑制性细胞（MDSCs）的趋化募集及其所介导的肿瘤免疫逃逸机制,是制约实体瘤免疫治疗效果的核心因素之一。文章深入探讨了MDSCs的起源、表型特征、其介导肿瘤免疫逃逸的具体机制,以及当前针对MDSCs的靶向治疗策略与将MDSCs靶向疗法与肿瘤免疫治疗相结合的最新研究进展。此外,文章还系统性地分析了靶向MDSCs联合免疫治疗策略所面临的关键挑战,并据此提出了MDSCs的精准靶向策略。这一策略旨在精确激活抗肿瘤免疫反应,为癌症患者提供更为个性化、高效的治疗方案,从而开启肿瘤免疫治疗领域的新纪元,为癌症治疗策略的创新与发展贡献力量。

Solid tumors exhibit a very limited response to immunotherapy．Consequently,effectively enhancing the therapeutic efficacy of tumor immunotherapy has emerged as a critical challenge and problem that urgently needs to be addressed in tumor immunotherapy．The chemotaxis and recruitment of myeloid-derived suppressor cells（MDSCs）and the tumor immune evasion mechanisms mediated by them are one of the core factors that significantly restrict the efficacy of immunotherapy for solid tumors．In this review,we discuss the origins and phenotypic characteristics of MDSCs,the specific mechanisms by which they mediate tumor immune evasion,as well as current targeted therapeutic strategies for MDSCs and the latest research progress in combining MDSC-targeted therapy with tumor immunotherapy．Furthermore,we have systematically analyzed the key challenges faced by the combination of MDSC-targeted and immunotherapy strategies,and accordingly proposed a precise targeting strategy for MDSCs．This strategy aims to precisely activate anti-tumor immune responses,providing more personalized and efficient treatment options for cancer patients,thereby opening a new era in tumor immunotherapy and contributing to the innovation and development of cancer treatment strategies．

CCAAT增强子结合蛋白A（CEBPA）是调节血液发育过程中髓系分化和造血干祖细胞活性的关键转录因子之一。CEBPA基因突变常见于急性髓系白血病（AML）中,最近研究表明CEBPA bZIP框内单位点和经典双等位基因突变AML患者均具有类似的临床特征,已被单独划分为AML亚群。CEBPA bZIP框内突变而非传统的双等位CEBPA基因突变成为AML良好预后的分子指标,表明其在AML疾病进展和治疗预后中的重要性和特殊性。本文将从CEBPA蛋白在血液系统中的功能、CEBPA bZIP框内突变AML的临床特征与分子作用机制、以及伴CEBPA突变AML的治疗现状等方面进行综述,为进一步研究CEBPA bZIP框内突变在AML中的致病性和精准治疗新药物开发提供参考。

CCAAT enhancer-binding protein A（CEBPA）is one of the key transcription factors regulating myeloid differentiation and hematopoietic stem/progenitor cell maintenance during hematopoiesis．CEBPA gene mutations are commonly found in acute myeloid leukemia（AML）．Recent studies have demonstrated that AML patients haboring single CEBPA bZIP in-frame mutations or classical bi-allelic CEBPA mutations show similar clinical features and it has been individually classified as AML subgroup．Additionally,it is CEBPA bZIP in-frame mutations rather than the traditional biallelic CEBPA mutations that have emerged as a molecular indicator of favorable prognosis for clinical AML management,suggesting its importance and specificity in AML disease progression and therapeutic prognosis．Here,we reviewed serval aspects including the hematopoietic function of CEBPA protein,the clinical features and molecular mechanisms of AML with CEBPA bZIP in-frame mutations,and the current status of the treatment of AML with CEBPA mutations,which will provide a reference for further study of the pathogenicity of CEBPA bZIP in-frame mutations in AML and the development of new drugs for precision therapy．

目的 分析类风湿因子（RF）、T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）与类风湿关节炎病情程度的关系。方法 选取2023年1月—2024年4月收治的90例类风湿关节炎患者作为观察组,同期到院的90例健康体检者为对照组,均接受RF、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺检测,并按照类风湿关节炎患者病情评价（DAS28）判定观察组患者病情的严重程度,应用Pearson相关性分析RF、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺与患者病情严重程度的关系。结果 与对照组比较,观察组RF及CD8⁺水平较高,CD3⁺、CD4⁺及CD4⁺/CD8⁺水平较低（P<0.05）;不同病情的RF及CD8⁺水平比较,重度患者最高,其次为中度、轻度,而CD3⁺、CD4⁺及CD4⁺/CD8⁺水平比较,轻度患者最高,其次为中度、重度,两两比较均有差异统计学意义（P<0.05）;经Pearson相关性分析,RF及CD8⁺水平与病情程度呈正相关,CD3⁺、CD4⁺及CD4⁺/CD8⁺水平与病情程度呈负相关（P<0.05）。结论 RF、T淋巴细胞亚群指标与类风湿关节炎发生、发展有密切关系,可为医师准确评估患者病情严重程度提供可靠参考。

Objective To analyze the relationship between rheumatoid factor（RF）,T lymphocyte subsets（CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺）and the severity of rheumatoid arthritis．Methods A total of 90 patients with rheumatoid arthritis from January 2023 to April 2024 were selected as the observation group,and 90 healthy checkup individuals who came to the hospital during the same period were selected as the control group．All patients underwent RF,CD3⁺,CD4⁺,CD8⁺,and CD4⁺/CD8⁺ tests,and the severity of their condition was determined based on the evaluation of rheumatoid arthritis patient condition（DAS28）． Pearson Correlation analysis was used to analyze the relationship between RF,CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺ and the disease severity of the patients．Results Compared with the control group,RF and CD8⁺ levels in the observation group were higher,while the levels of CD3⁺,CD4⁺ and CD4⁺/CD8⁺ were low（P<0.05）．Comparison of RF and CD8⁺ levels for different conditions,the RF and CD8⁺ levels of the severe patients was highest,followed by moderate and mild．However,the CD3⁺,CD4⁺ and CD4⁺/CD8⁺ levels were highest in mild patients,followed by the moderate and sereve patients．Statistical significance was found in both pairwise comparisons（P<0.05）．After the Pearson correlation analysis,RF and CD8⁺ levels were positively correlated with the degree of disease,while CD3⁺,CD4⁺,and CD4⁺/CD8⁺ levels were inversely associated with the degree of disease condition（P<0.05）．Conclusions RF and T lymphocyte subsets are closely related to the occurrence and development of rheumatoid arthritis,and can provide reliable references for physicians to accurately evaluate the severity of patients' conditions．

目的 探讨载脂蛋白E（ApoE）基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法 采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者（脑梗死组）和50例性别、年龄匹配的非缺血性脑卒中患者（对照组）。检测患者的 ApoE 基因型、血脂、美国国立卫生院卒中量表（NIHSS）、卒中后6个月简易智力状态检查量表（MMSE）等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果 ApoE 3/4基因型频率与Ɛ3、Ɛ4等位基因频率,在脑梗死组别中高于对照组（P<0.05）。同时,携带Ɛ3等位基因患者的低密度脂蛋白水平高于携带Ɛ2、Ɛ4等位基因的患者;进一步分析发现含Ɛ3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重（P<0.05）。结论 ApoE基因型为Ɛ3/4、等位基因Ɛ3、Ɛ4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者Ɛ3等位基因的频率较高,可能是卒中后认知障碍的易感因素。

Objective To explore the relationship between ApoE gene polymorphisms and post-stroke cognitive impairment,the severity of large artery atherosclerotic cerebral infarction．Methods A case-control research study was conducted,gathering data from 100 individuals diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University．Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group．The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations．Results Significant differences were observed in the ApoE 3/4 genotype frequency and Ɛ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former．Furthermore,patients carrying the Ɛ3 allele exhibited significantly higher LDL levels than those carrying Ɛ2 or Ɛ4．The analysis also revealed that patients with the Ɛ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment．Conclusions The findings suggest that the ApoE genotype Ɛ3/4 and allele Ɛ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction．Additionally,the Ɛ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment．

长链非编码RNA（lncRNA）是一类长度大于200个核苷酸转录本,通过调控DNA、RNA及蛋白质的表达和功能,参与肿瘤发生、发展并发挥重要作用的RNA,近年来lncRNA成为恶性肿瘤早期诊断和预后标志物研究新的关注方向。Linc-UBC1作为一种新发现的lncRNA,在多种恶性肿瘤如肺癌、胃癌、结直肠癌、宫颈癌、卵巢癌、食管鳞癌等中异常高表达,可通过作为竞争性RNA（ceRNA）、参与信号通路等促进肿瘤细胞的增殖、迁移、侵袭、细胞周期进展、细胞凋亡和上皮间充质转化（EMT）等过程;高表达的linc-UBC1能够增加恶性肿瘤的耐药性,其表达水平与肿瘤分期、淋巴结转移和原发肿瘤远处转移呈正相关;linc-UBC1有望成为许多恶性肿瘤的新型的生物标志物、预后预测因子和治疗靶点,但其具体的调控机制仍处于研究的早期阶段,有待进一步深入研究。文章就目前linc-UBC1在恶性肿瘤发生和发展中的作用研究进展进行综述。

Long non-coding RNA（lncRNA）is a class of transcripts with a length of more than 200 nucleotides．It is involved in the occurrence and development of tumors and plays an important role by regulating the expression and function of DNA,RNA and protein．In recent years,lncRNA has become a new research direction for early diagnosis and prognosis of malignant tumors．As a newly discovered lncRNA,linc-UBC1 is abnormally highly expressed in a variety of malignant tumors such as lung cancer,gastric cancer,colorectal cancer,cervical cancer,ovarian cancer,and esophageal squamous cell carcinoma．It can promote the proliferation,migration,invasion,cell cycle progression,cell apoptosis and EMT of tumor cells by acting as a competing endogenous RNA（ceRNA）and participating in signaling pathways．High expression of linc-UBC1 can increase the drug resistance of malignant tumors,and its expression level is positively correlated with tumor stage,lymph node metastasis and distant metastasis of primary tumors．linc-UBC1 is expected to become a new biomarker,prognostic predictor and therapeutic target for many malignant tumors,while its specific regulatory mechanism is still in the early stage of research and needs further in-depth study．This article reviews the current research progress of linc-UBC1 in the occurrence and development of malignant tumors．

目的 探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法 抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度（CRAMS）评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果 观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义（χ²=2.222,P=0.136）;观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组[（23.64±5.69）、（52.27±12.60）min],差异有统计学意义（t=10.349、8.928,P<0.05）;观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义（χ²=0.346,P=0.556）;治疗后两组患者的CRAMS评分均升高,且观察组（9.87±2.62）分高于对照组（8.60±2.98）分,差异有统计学意义（t=2.024,P=0.046）;观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组（χ²=3.914,P=0.048）。结论 本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。

Objective To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans after ambulance return to the hospital for corresponding injury treatment,the observation group received CRAMS scores at the treatment site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis,corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared,and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant（χ²=2.222,P=0.136）．The time to diagnosis（13.56±2.36）min,time to the operating room（30.42±8.99）min were shorter than that in the control group[（23.64±5.69）,（52.27±12.60）min],with significant difference（t=10.349,8.928,P<0.05）．The consistency between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ²=0.346,P=0.556）．After treatment,the CRAMS scores of both groups of patients increased,the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024,P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%,while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ²=3.914,P=0.048）．Conclusions This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces,aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward,which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．

自发性脑出血（SICH）是脑卒中的一种常见形式,其预后通常较差,因此早期评估和调节患者出血后的免疫状态至关重要。免疫检查点是评估T淋巴细胞活跃性和增殖状态的关键指标,监测这些检查点有助于预测脑出血患者的预后。程序性死亡蛋白1（PD-1）和细胞分化抗原28（CD28）作为两个典型的免疫检查点,它们在脑出血预后评估中的应用正逐渐成为研究的热点。该文综述了脑出血后机体免疫状态的变化,以及PD-1和CD28在脑出血后评估和治疗中的研究进展。

Spontaneous intracerebral hemorrhage（SICH）is a common cause of stroke,with specific outcomes often being poor．Therefore,early assessment and modulation of the immune status after hemorrhage are of critical importance．Immune checkpoints serve as key indicators for assessing the activation and proliferation of T cells,and monitoring these checkpoints can help to predict the outcomes of patients with intracerebral hemorrhage．PD-1（programmed death 1）and CD28（Cluster of Differentiation 28）are two representative immune checkpoints,and their use in prognostic assessment after intracerebral hemorrhage is becoming a focus of research．This article reviews the changes in the immune state of the body after intracerebral hemorrhage,as well as the research progress on the use of PD-1 and CD28 in the evaluation and treatment following intracerebral hemorrhage．

目的 评估医院-社区-家庭一体化康复护理模式对慢性创面患者生活质量及创面愈合的潜在影响。方法 选择2023年1月—2024年6月在广州市第一人民医院接受治疗的慢性创面患者80例作为研究对象,所有患者在住院期间均接受基于溃疡面积、深度及是否合并感染等因素的综合治疗,包括彻底清创、创缘处理、负压治疗、感染控制等治疗,并接受常规护理。出院前,通过随机数字表法将患者分为两组,每组40例。两组患者在住院期间均接受常规护理,出院后,对照组接受延续护理并定期复查。干预组40例患者在出院后接受医院-社区-家庭一体化康复护理模式。入组时及护理3个月后,使用生活质量调查表（SF-36）对患者生活质量和创面愈合率进行评估。结果 干预组创面愈合率为（32.61±4.26）%,高于对照组（11.48±1.04）%,差异具有统计学意义（t=19.473,P<0.05）。两组患者在护理3个月后的数字评定量表评分和创面疼痛频率评分均较入组时降低（P<0.05）。其中干预组护理3个月后的创面VAS评分为（1.82±0.17）分,创面疼痛频率评分为（1.28±0.25）分;而对照组分别为（3.91±0.22）分和（2.63±0.37）分,干预组低于对照组（P<0.05）。此外,干预组在护理后3个月的总体健康、生理功能、生理职能、精神健康、情感功能、社会功能评分均高于对照组（P<0.05）。在居家3个月期间,干预组的感染发生率为5.00%,而对照组为17.50%,干预组感染发生率低于对照组（χ²=3.781,P<0.05）。结论 本研究表明,医院-社区-家庭一体化康复护理模式干预能够促进慢性创面患者的创面愈合,降低居家期间感染的风险,并提升患者的生活质量。

Objective To assess the potential impact of the integrated hospital-community-home rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds．Methods A total of 80 patients with chronic wounds treated at the Guangzhou First People’s Hospital from January 2023 to June 2024 were selected as the study subjects．All patients received comprehensive treatment during their hospital stay,including thorough debridement,edge treatment,vacuum therapy,infection control and routine nursing care．Prior to discharge,the patients were randomly divided into two groups using a random number table,with 40 patients in each group．Both groups received routine nursing care during their hospital stay,and the control group received continuing nursing care and regular follow-up after discharge．Forty patients in the intervention group received the integrated hospital-community-home rehabilitation nursing model after discharge．Quality of life（QoL）and wound healing rates were assessed using the Short Form 36（SF-36）questionnaire at the time of enrollment and 3 months after nursing．Results The wound healing rate in the intervention group was significantly higher than that in the control group （[32.61±4.26]% vs [11.48±1.04]%）,with a statistical difference（t=19.473,P<0.05）．The numerical rating scale（NRS）scores and frequency of wound pain scores decreased in both groups 3 months after nursing compared to the enrollment period（P<0.05）．Specifically,the VAS score for wound pain in the intervention group 3 months after nursing was（1.82±0.17）,and the frequency of wound pain was（1.28±0.25）,in the control group,these scores were（3.91±0.22）and（2.63±0.37）,respectively,with the intervention group scoring significantly lower than the control group（P<0.05）．Furthermore,the scores for overall health,physical function,role physical,mental health,emotional function,and social function in the intervention group were higher than those in the control group 3 months after nursing（P<0.05）．During the 3-month home recovery period,the incidence of infection in the intervention group was 5.00%,whereas it was 17.50% in the control group,with the intervention group showing a lower incidence of infection（χ²=3.781,P<0.05）．Conclusions This study demonstrates that the hospital-community-home integrated rehabilitation care model intervention can promote wound healing in chronic wound patients,reduce the risk of infection during home care,and significantly improve patients’ quality of life．