目的 评价不同间变性淋巴瘤激酶（ALK）抑制剂联合安罗替尼治疗非小细胞肺癌（NSCLC）的疗效。方法 收集ALK突变阳性NSCLC患者的临床资料,筛选服用ALK抑制剂疗效不佳再加用安罗替尼的病例。根据不同的用药方案分为阿来替尼+安罗替尼,塞瑞替尼+安罗替尼和克唑替尼+安罗替尼三个组别。记录患者联合用药前最近一次的影像学检查结果,并以此为基线按Recist1.1评价疗效,以病情进展、患者死亡、停药、改变治疗方案为终点计算各组患者的无事件生存期（EFS）,收集肿瘤标志物、血常规和肝功、心功能、肾功能生化检测等指标数据,统计分析患者联合用药前后各项指标的变化。结果 经筛选,共纳入49例患者的临床数据。阿来替尼+安罗替尼组有23例,疾病控制率（DCR）为86.96%;平均EFS为（10.8±3.6）个月,中位EFS为8.3个月;塞瑞替尼+安罗替尼组有14例,DCR为71.43%;平均EFS为（6.5±2.9）个月,中位EFS为5.6个月;克唑替尼+安罗替尼组有12列,DCR为66.67%;平均EFS为（7.7±3.2）个月,中位EFS为7.2个月。阿来替尼+安罗替尼组的平均EFS长于另外两组（P<0.05）。各研究组肿瘤标志物仅有CyFra21-1在克唑替尼+安罗替尼组在联合用药后升高（P<0.05）,生化检测和血常规指标在用药前后差异无统计学意义（P>0.05）。结论 ALK抑制剂与安罗替尼联用,疗效最好为阿来替尼,其次为塞瑞替尼,最后为克唑替尼。三种ALK抑制剂与安罗替尼联用后,均未导致心、肝、肾功能和血细胞损害。

Objective To evaluate the efficacy of different anaplastic lymphoma kinase（ALK）inhibitors combined with anlotinib in the treatment of non-small cell lung cancer（NSCLC）. Methods Clinical data of drug resistant NSCLC patients with ALK positive mutation was collected who were treated with ALK inhibitors and anlotinib synchronously．According to different regimens,three groups were set,alectinib+anlotinib,ceritinib+anlotinib,and crizotinib+anlotinib．The latest imageological examination results of the patient before the synchronous therapy was set as the baseline to evaluate the therapeutic effect according to Recist1.1．The event free survival（EFS）of each group was calculated with disease progression,patient death,treatment discontinuation and changing regimen as endpoints．Data of tumor markers,hematology test,liver function,cardiac function,renal function biochemical examination was collected and analyzed statistically before and after the combination therapy,with P<0.05 as the statistically significant difference. Results After screening,clinical data of 49 patients were collected．Twenty-three patients in the alectinib+anlotinib group,with a disease control rate（DCR） of 86.96%;mean EFS was（10.8±3.6）months,median EFS of 8.3 months;14 patients in the ceritinib+anlotinib group,with a DCR of 71.43%,mean EFS was（6.5±2.9）months,median EFS was 5.6 months;12 patients in the crizotinib+anlotinib group,with a DCR of 66.67%,mean EFS was（7.7±3.2）months,median EFS was 7.2 months．EFS of alectinib+anlotinib group was longer significantly than the other two groups（P<0.05）．Only CyFra21-1,increased significantly after the combination of crizotinib and anlotinib（P<0.05）．No statistically significant difference in biochemical test and hematology test before and after the treatment（P>0.05）． Conclusions The therapeutic effect of ALK inhibitors with anlotinib was ordered,alectinib being the most effective,followed by ceritinib and finally crizotinib．The combination of ALK inhibitors with anlotinib did not cause any abnormal results in the examination of heart,liver,kidney and blood cells．

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 研究核磁共振（MR）引导的海马保护技术应用于小细胞肺癌全脑放射治疗（放疗）的效果。方法 对确定行全脑放疗的30例小细胞肺癌脑转移患者,行常规放疗CT定位后以定位体位行全头颅MR平扫,将计算机断层扫描（CT）和MR的T1加权像在Monaco 5.1计划系统上进行精准融合,勾画全脑放疗及海马区域,在海马区域三维方向上分别外扩5、15 mm作为海马与计划靶区之间的剂量跌落,每一例患者在Monaco 5.1计划系统上按照不保护海马组织以及外扩5、15 mm进行保护设计3个容积旋转调强技术（VMAT）放疗计划,观察海马组织的平均及最大放疗剂量。结果 增加保护海马组织之后,3个放疗计划的D100均≥95%,每例的3个放疗计划间D100比较差异无统计学意义（P>0.05）;设置外扩5、15 mm的剂量跌落区后,左、右海马的平均剂量、最大剂量均明显降低,而且3个放疗计划的海马平均剂量、最大剂量之间对比差异有统计学意义。结论 小细胞肺癌脑转移患者进行全脑放疗时,利用MR引导的海马保护技术并设置外扩15 mm的剂量跌落区,能够显著降低海马的剂量,达到保护目的。

Objective To explore the application of MR guided hippocampal avoidant whole brain radiotherapy（WBRT）for small cell lung cancer（SCLC）．Methods Thirty SCLC patients with brain metastases who underwent WBRT were enrdled．After routine CT localization was performed,and a head MR was performed in a the same position．T1 weighted images of MR and CT images were accurately fused on the Monaco 5.1 planning system．The entire brain tissue and hippocampus region were delineated． The dose drop areas between the hippocampus and the planned target area were expanded 5mm and 15mm in the three-dimensional direction of the hippocampus,respectively．Three volumetric modulated arc therapy（VMAT）radiotherapy plans were designed for each patient on the Monaco 5.1 planning system based on whether the hippocampal tissue was avoid．The average and maximum doses of hippocampal tissue were observed．Results After the avoidance of hippocampal tissue,the D100 of the three radiotherapy plans reached ≥95%,and there was no significant difference in D100 between the three radiotherapy plans in each case．After setting dose drop areas of 5mm and 15mm for external expansion,the average and maximum doses of the left and right hippocampus were significantly reduced,and there was a significant difference in the comparison between the average and maximum doses in the hippocampus of the three radiotherapy plans．Conclusions MR guided hippocampal avoidant technology and the setting of a 15 mm dose drop area can significantly reduce the dose to the hippocampus in patients with SCLC undergo whole brain radiotherapy．

目的 探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法 对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果 CT增强延迟扫描显示观察组患者分叶征（12.50% vs 53.57%）、内部空泡征数量（6.25% vs 39.29%）低于对照组（χ²=26.560、24.680,P<0.05）,观察组患者边缘毛刺（56.25% vs 17.86%）、胸部凹陷征（59.38% vs 14.29%）、高于对照组（χ²=43.330、64.600,P<0.05）;82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%（79/82）,与病理诊断结果100.00%对比差异无统计学意义（χ²=3.060,P=0.080）;82例非小细胞肺癌平均CT增强值为（39.14±7.31）,不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义（P>0.05）,不同病理类型[腺癌（43.75±7.15）vs 鳞癌（34.74±6.12）]、细胞分化程度[中、低分化（45.71±7.21）vs 高分化（32.81±5.11）]、临床分期[Ⅰ期（31.03±2.12）vs Ⅱ期（36.61±3.13）vs Ⅲa期（46.32±6.83）]患者、淋巴结转移[是（42.75±4.21）vs 否（35.77±8.13）]CT增强值对比差异有统计学意义（t/F=5.243、8.804、84.828、4.378,P<0.05）;Spearman相关分析结果显示：病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05）。结论 CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。

Objective To explore the application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer（NSCLC）．Methods A retrospective analysis was conducted on 82 patients with NSCLC who underwent surgical treatment in a hospital from May 2021 to May 2024．They were included into an observation group and another 82 patients with benign lung tumors were included in the control group．The preoperative CT enhanced delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC．And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC．Results CT enhanced delayed scanning showed that the number of lobular（12.50% vs 53.57%）and internal vacuolar signs（6.25% vs 39.29%）in the observation group was significantly lower than that in the control group（χ²=26.560,24.680,P<0.05）,while the edge spicules（56.25% vs 17.86%）and chest depression signs（59.38% vs 14.29%）in the observation group were significantly higher than that in the control group（χ²=43.330,64.600,P<0.05）．A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%（79/82）,with no significant difference from the pathological diagnosis result of 100.00%（χ²=3.060,P=0.080）．The average CT enhancement value of 82 NSCLC cases was（39.14±7.31）．There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration（P>0.05）．Patients with different pathological types [adenocarcinoma（43.75±7.15）vs squamous cell carcinoma（34.74±6.12）],degree of cell differentiation [moderate,and low differentiation（45.7±7.21）vs high differentiation（32.81±5.11）],clinical stage [I（31.03±2.12）vs II（36.61±3.13）vs IIIa（46.32±6.83）] and lymph node metastasis [yes（42.75±4.21）,vs no（35.77±8.13）] CT enhancement had significant difference（t/F=5.243,8.804,84.828,4.378,P<0.05）．The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008）．Conclusions CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC．Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients．

目的 探讨CT、MRI影像学表现对原发性肝细胞癌（HCC）微血管侵犯（MVI）的诊断价值。方法 选取2018年1月—2024年7月江门市第二人民医院（江门市中心医院蓬江分院）和江门市中心医院120例（共158个病灶）HCC患者,均行上腹部CT、MRI平扫+增强及弥散加权成像（DWI）检查;以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能;分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性;比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数（ADC）值。结果 DWI检查对HCC MVI的诊断效能（灵敏度、特异度、准确度、阳性预测值、阴性预测值）均显著性高于CT、MRI平扫+增强（P<0.05）;CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较,差异均无统计学意义（P>0.05）。在HCC MVI诊断效能中,CT、MRI影像学表现与术后病理确诊结果之间为中度一致性;DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者（P<0.05）。在不同b值（400、800、1 000、1 500 s/mm²）下,HCC MVI患者的ADC值均显著性高于无HCC MVI患者（P<0.05）。结论 CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能,而MRI诊断结果与病理诊断一致性更佳,尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯,有助于指导临床医生建立“个体化”精准诊疗策略。

Objective To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion（MVI）in primary hepatocellular carcinoma（HCC）．Methods A total of 120 patients（158 lesions in total）with HCC in the Second People’s Hospital of Jiangmen（Pengjiang Branch of Jiangmen Central Hospital）and Jiangmen Central Hospital were selected from January 2018 to July 2024,all underwent CT and MRI plain + enhanced and diffusion-weighted imaging（DWI）of the upper abdomen;postoperative pathology Results was used as the diagnostic gold standard．The diagnostic efficacy of CT,MRI plain + enhanced and DWI for HCC MVI was compared．The concordance among CT,MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI．Imaging manifestations and apparent diffusion coefficient（ADC）values in patients with and without HCC MVI were compared．Results Diagnostic effectiveness of DWI examination for HCC MVI（sensitivity,specificity,accuracy,positive predictive value,negative predictive value）were all significantly higher than those of CT and MRI plain + enhanced（P<0.05）;none of the differences were statistically significant（P>0.05）in the comparison of diagnostic effectiveness of CT,MRI,and DWI for the diagnosis of MVI in patients with primary HCC．In HCC MVI diagnostic effectiveness,moderate concordance was found among CT,MRI imaging phenotypes and postoperative pathology Results;high concordance was found between DWI and postoperative pathology Results．In HCC MVI patients,the proportion of non-marginal arterial reinforcement,enhanced envelope,halo reinforcement,nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI（P<0.05）．At different b-values（400,800,1 000,1 500 s/mm²）,ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI（P<0.05）．Conclusions CT,MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI,while MRI diagnostic Results are in better concordance with pathologic diagnosis．In particular,ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC,which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies．

目的 探讨重楼皂苷Ⅰ（PPI）对慢性髓系白血病细胞（K562）细胞的抑制作用及可能的作用机制。方法 采用CCK-8法筛选药物最适浓度,将培养时间为24 h的药物最适浓度作为后续实验的干预浓度。分组如下：（1）空白组;（2）PPI组;（3）抑制剂组;（4）PPI+抑制剂组。采用CCK-8法检测细胞增殖率;AO/EB染色观察细胞形态;流式细胞术检测凋亡率;ROS检测试剂盒检测活性氧（ROS）含量、还原型谷胱甘肽含量检测试剂盒检测谷胱甘肽（GSH）含量、细胞亚铁比色法测试盒检测细胞亚铁（Fe²⁺）含量;qRT-PCR法和蛋白免疫印迹法检测各组肿瘤蛋白53（p53）、钠氯离子依赖性氨基酸转运蛋白11（SLC7A11）、谷胱甘肽过氧化物酶4（GPX4）mRNA及蛋白表达量。结果 PPI抑制K562细胞的生长,且呈一定的剂量及时间依赖性（与同时间段的对照组0μmol/L比较,均P<0.01）。与空白组相比,PPI抑制K562细胞的增殖,提高了凋亡率,而铁死亡抑制剂（Ferrostian-1）的使用逆转了PPI对K562凋亡的促进作用（P<0.01）。与空白组相比,PPI组ROS、Fe²⁺含量升高,GSH含量下降,而铁死亡抑制剂的使用可下调ROS、Fe²⁺,上调GSH的含量（P<0.01）。PPI组较空白组p53 mRNA和蛋白表达水平升高,而SLC7A11、GPX4 mRNA和蛋白表达水平下降（P<0.05）;PPI+抑制剂组细胞较重楼皂苷组p53 mRNA和蛋白表达水平下降,而SLC7A11、GPX4 mRNA和蛋白表达水平升高（P<0.05）。结论 PPI能够有效抑制K562细胞增殖,促进K562细胞铁死亡,其分子机制可能与p53信号通路的调控有关。

Objective To investigate the inhibitory effect of polyphyllin I（PPI）on chronic myeloid leukemia cells（K562）and its possible mechanism．Methods K562 cell line was cultured in suitable environment,and the optimal concentration of the drug was screened by CCK-8 method．The optimal concentration of the drug cultured for 24 hours was used as the intervention concentration of the follow-up experiment．Cells were divided into the following groups：（1）blank group,（2）saponins group,（3）inhibitor group and（4）saponins + inhibitor group．The cell proliferation rate was detected by CCK-8 method．The cell morphology was observed by AO/EB staining．The apoptosis rate was detected by flow cytometry．The contents of reactive oxygen species（ROS）,glutathione（GSH）and ferrous（Fe²⁺）in different groups were detected,and the expression of mRNA and protein in different groups were detected by qRT- PCR and Western blot respectively．Results PPI significantly inhibited the growth of K562 cells in a dose-and time-dependent manner．Compared with the blank group,PPI significantly inhibited the proliferation of K562 cells and increased the apoptosis rate of K562 cells,while the use of ferroptosis inhibitor（Ferrostian-1）reversed the promoting effect of PPI on apoptosis of K562 cells．Compared with the blank group,the contents of reactive oxygen species（ROS）and ferrous iron（Fe²⁺）increased and the content of glutathione（GSH）decreased in the saponins group．The use of Ferrostian-1 could down-regulate the contents of ROS and Fe²⁺ and increase the content of GSH in the cells treated with the drug．Compared with the blank group,the expression of p53 mRNA and protein in the saponins group increased,while the expression of SLC7A11,GPX4 mRNA and protein decreased．The expression of p53 mRNA and protein in the saponins + inhibitor group was lower than that in the saponins group,while the expression levels of SLC7A11,GPX4 mRNA and protein increased．Conclusions PPI can effectively inhibit the proliferation of K562 cells and promote ferroptosis in K562 cells．The molecular mechanism can be related to the regulation of p53 signal pathway．

目的 探讨免疫治疗联合化学治疗（化疗）对晚期非小细胞肺癌（NSCLC）患者淋巴免疫及生活质量的影响,为临床进一步治疗提供参考。方法 选择2021年6月—2023年6月天津市滨海新区大港医院收治的晚期NSCLC患者120例进行研究,按抽签法分为干预组及对照组,每组60例,对照组采取单纯化疗方案,干预组采取免疫联合化疗方案,对比两组临床疗效、药物不良反应,治疗前后免疫功能（CD3⁺、CD4⁺、CD8⁺）、糖类抗原199（CA199）、糖类抗原 125（CA125）、血清癌胚抗原（CEA）水平及健康状态调查表（QOL）评分。结果 干预组患者治疗总有效率高于对照组（68.33%>41.67%,P<0.05）;治疗后干预组患者CD3⁺、CD4⁺比例高于治疗前及对照组治疗后,CD8⁺比例低于治疗前及对照组治疗后（P<0.05）;治疗后干预组血清CA199、CA125、CEA水平均低于治疗前及对照组治疗后（P<0.05）;干预组药物不良反应发生率为16.67％,对照组为36.67％,干预组低于对照组（P<0.05）;治疗后干预组QOL各维度评分高于对照组及治疗前（P<0.05）。结论 与单纯化疗相比,免疫联合化疗治疗晚期NSCLC患者,能有效降低肿瘤标志物水平,改善患者免疫指标,减轻药物不良反应,提高患者疗效及生活质量。

Objective To explore the effect of immunotherapy combined with chemotherapy on lymphatic immunity and quality of life of patients with advanced non-small cell lung cancer（NSCLC）,and to provide reference for further clinical treatment. Methods A total of 120 patients with NSCLC from June 2021 to June 2023 were selected and divided into observation group and control group evenly according to the method of drawing lots,control group was treated with chemotherapy,the observation group was treated with immunotherapy combined with chemotherapy,and the clinical efficacy and adverse drug reactions were compared between the two groups．Before and after treatment,immune function（CD3⁺,CD4⁺,CD8⁺）,carbohydrate antigen 199（CA199）,carbohydrate antigen 125（CA125）,serum carcinoembryonic antigen（CEA）levels and health status questionnaire（QOL-RRB- scores）were measured．Results The total effective rate in the observation group was significantly higher than that in the control group（68.33%>41.67%,P<0.05）．After treatment,the ratios of CD3⁺ and CD4⁺ in the observation group were significantly higher than those before treatment and control group after treatment,and the ratio of CD8⁺ was significantly lower than that before and after treatment in the control group（P<0.05）．After treatment,the serum levels of CA199,CA125 and CEA in the observation group were lower than those before and after treatment in the control group（P<0.05）．The incidence of adverse drug reactions was 16.67% in the observation group and 36.67% in the control group,which was significantly lower in the observation group than in the control group（P<0.05）．After treatment,the QOL scores in the observation group were significantly higher than those in the control group and before treatment（P<0.05）．Conclusions Compared with chemotherapy alone,immunotherapy combined with chemotherapy can effectively reduce the levels of tumor markers,improve the immune indexes of patients,reduce the adverse drug reactions,and improve the efficacy and quality of life of patients with advanced NSCLC．

目的 评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1（sICAM-1）的影响。方法 纳入2022年1月—2024年8月的70例正畸拔牙患者,按照治疗方法分组,即对照组（35例,给予固定矫治）、观察组（35例,给予无托槽隐形矫治）,评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果 治疗结束时,两组均出现牙根吸收情况,但是观察组无牙根吸收>3 mm病例,而对照组存在牙根吸收>3 mm、>4 mm病例,P<0.05。治疗前,两组牙周指标[龈沟出血指数（SBI）、牙龈指数（GI）、菌斑指数（PLI）]、炎症因子[白介素-1β（IL-1β）、sICAM-1]比较差异无统计学意义（P>0.05）。治疗后,两组SBI、GI、PLI、IL-1β、sICAM-1升高,且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组（P<0.05）。与对照组比较,观察组矫治时间更长（P<0.05）。结论 对正畸拔牙患者进行无托槽隐形矫治,虽然治疗时间长,但是可以抑制牙根吸收,减轻炎症反应,提高牙周健康水平。

Objective To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1（sICAM-1）．Methods Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods：a control group（35 cases,receiving fixed orthodontic treatment）and an observation group（35 cases,receiving clear aligner treatment）． The root resorption,periodontal indicators,inflammatory factors,and orthodontic treatment time between groups were evaluated．Results At the end of treatment,both groups showed root resorption,but there were no cases of root resorption>3 mm in the observation group,while there were cases of root resorption>3 mm and>4 mm in the control group,P<0.05．Before treatment,there was no difference in periodontal indicators（gingival bleeding index[SBI],gingival index[GI],plaque index[PLI]）,inflammatory factors（interleukin-1 β[IL-1 β],sICAM-1） between the groups,P>0.05．After treatment,SBI,GI,PLI,IL-1 β,sICAM-1 increased in both groups,but SBI,GI,PLI,IL-1 β,sICAM-1 were lower in the observation group,P<0.05．Compared with the control group,the observation group had a longer orthodontic treatment time,P<0.05．Conclusions Although the clear aligner treatment time for orthodontic extraction patients is longer,it can inhibit root resorption,reduce inflammatory reactions,and improve periodontal health．

目的 探讨长病程2型糖尿病（T2DM）患者体质指数（BMI）与胰岛β细胞功能间的相关关系。方法 选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程（病程≥10年）T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果 三组研究对象在空腹静脉血糖（FPG）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、尿酸（UA）、甘油三酯（TG）等上差异有统计学意义（P<0.05）,在胰岛β细胞功能指数（HOMA-β）比较差异无统计学意义（P>0.05）;肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组（P<0.05）,超重组的UA、TG均高于正常组（P<0.05）,肥胖组的FPG、HOMA-IR、UA高于超重组（P<0.05）,Spearman相关分析结果显示HOMA-β与体质量指数（BMI）无相关性（r=0.046,P=0.461）,HOMA-β与UA（r=0.226,P<0.001）、TG（r=0.148,P=0.017）呈正相关,HOMA-IR与BMI（r=0.279,P<0.001）与、UA相关（r=0.284,P<0.001）及TG（r=0.349,P<0.001）呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素（P<0.05）,BMI、UA、TG是HOMA-IR的影响因素（P<0.05）。结论 长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。

Objective To explore the correlation between body mass index（BMI）and islet β cell function in patients with long course type 2 diabetes mellitus（T2DM）．Methods A total of 260 patients with T2DM with a long course of disease（course≥10 years）admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI．Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed．Results There were statistically significant differences in fasting plasma glucose（FPG）,fasting C peptide（FCP）,homeostasis model assessment-insulin resistance（HOMA-IR）,uric acid（UA）and triglycerides（TG）among the three groups（P<0.05）,but no statistically significant differences in homeostatic model assessment of β-cell function（HOMA-β）（P>0.05）．The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group（P<0.05）;the levels of UA and TG in the overweight group were higher than those in the normal group（P<0.05）;the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight group（P<0.05）．Spearman correlation analysis showed that HOMA-β was not correlated with BMI（r=0.046,P=0.461）,but was positively correlated with UA and TG（r=0.226,P<0.001;r=0.148,P=0.017）,HOMA-IR was positively correlated with BMI,UA and TG（r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001）．Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β（P<0.05）,BMI,UA and TG were the influencing factors of HOMA-IR（P<0.05）． Conclusions In T2DM patients with long disease course,the level of insulin resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant．At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM．

目的 研究SOCS6/STAT6通路在前列腺细胞炎性增殖作用中的调控作用。方法 使用人前列腺细胞株RWPE-1建立炎症模型,将细胞分为对照（CON）组和炎症刺激（INF）组,后者通过添加脂多糖（LPS）模拟炎症环境。采用ELISA检测白细胞介素-1β（IL-1β）-1β、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）表达水平,蛋白免疫印迹法检测细胞因子信号抑制物-6（SOCS6）、信号转导和转录激活因子-6（STAT6）及磷酸化STAT6蛋白的表达水平。结果 经过LPS处理后,RWPE-1细胞中的SOCS6蛋白表达水平显著下降（P<0.01）,而磷酸化STAT6表达水平上升（P<0.01）。结论 SOCS6/STAT6通路可能通过调节炎症环境下STAT6的磷酸化水平,参与调节前列腺细胞的炎性增殖作用。

Objective To explore the regulatory role of SOCS6/STAT6 pathway in the inflammatory proliferation of prostate cells．Methods The human prostate cell line RWPE-1 was used to establish an inflammation model．Cells were divided into a control（CON）group and an inflammation-stimulated（INF）group,with the latter subjected to lipopolysaccharide（LPS）treatment to simulate an inflammatory environment．The expression levels of interleukin（IL）-1β、IL-6 and IL-8 were detected by ELISA,and the expression levels of suppressor of cytokine signaling 6（SOCS6）,signal transducer and activator oftranscription-6,（STAT6）,and phosphorylated STAT6 proteins were detected by Western blot．Results The results showed that after LPS treatment,the expression of SOCS6 protein in RWPE-1 cells significantly decreased,while the expression of phosphorylated STAT6 increased．Conclusions The SOCS6/STAT6 pathway may be involved in regulating the inflammatory proliferation of prostate cells by modulating the phosphorylation level of STAT6 under inflammatory conditions．