意识障碍（Disorders of Consciousness, DoC）是颅脑损伤、脑卒中、缺血缺氧性脑病等严重脑损伤后的常见并发症，其康复治疗是神经科学领域的重大挑战。重复经颅磁刺激（Repetitive Transcranial Magnetic Stimulation, rTMS）作为一种无创神经调控技术，通过调节皮层兴奋性、促进神经可塑性及改善脑血流灌注，在DoC治疗中展现出独特优势。本文系统梳理近年研究，从作用机制、临床证据及未来方向等方面进行综述，旨在为临床精准治疗提供理论依据。
本文提出一个由多种核心变量构成的疾病进程形式化分析框架，命名为CPS框架（Causative-Primary-Secondary）。该框架以矛盾分析为核心逻辑，聚焦疾病从原发单元启动后，经由活性病理产物播散与机体防御系统相互博弈，最终可能在远端靶器官形成独立继发单元的单向级联演进过程，对疾病复杂性的跨系统传播逻辑做出抽象统一的形式化刻画，并选取骨关节炎、结核球、恶性肿瘤、肝性脑病、房颤等不同类型的典型临床案例，尝试验证该框架解释不同疾病进程的合理性与普适性。
本文提出一个由多种核心变量构成的疾病进程形式化分析框架，命名为CPS框架（Causative-Primary-Secondary）。该框架以矛盾分析为核心逻辑，聚焦疾病从原发单元启动后，经由活性病理产物播散与机体防御系统相互博弈，最终可能在远端靶器官形成独立继发单元的单向级联演进过程，对疾病复杂性的跨系统传播逻辑做出抽象统一的形式化刻画，并选取骨关节炎、结核球、恶性肿瘤、肝性脑病、房颤等不同类型的典型临床案例，尝试验证该框架解释不同疾病进程的合理性与普适性。
目的 汇总分析肝硬化患者消化道出血风险预测模型，为今后模型的建立和优化提供参考。方法 系统检索中国知网、维普、PubMed数据库在2025年4月22日前公开发表的所有肝硬化患者消化道出血风险预测模型，按纳入标准筛选文献，对最终纳入文章分析摘录并系统汇总，包括模型特征、危险因素及模型预测评估效果等信息。结果 共检索3 603篇预测模型相关研究论文，最终纳入30篇，其中中国27篇、韩国1篇、印度1篇、埃及1篇。22项研究收集了肝硬化病因，其中病毒性肝病最多（72.94%，2 922/4 006），药物性肝病及非酒精性脂肪性肝病最少（均为0.02%，1/4 006）。在研究类型上，有28篇单中心研究，2篇为多中心研究，其中有12个模型未进行验证，只有1个模型进行了外部验证，其余模型只进行了内部验证，曲线下面积（AUC）范围0.680~0.994。根据模型纳入因素特点，分为血常规指标、凝血指标、生化指标、影像学指标、复合指标、其他指标共6种，其中纳入因素最多为影像学指标，最少为凝血指标。在纳入危险因素中，第1位为门静脉直径，第2位为血小板计数，第3位为血红蛋白水平及脾脏硬度，所有因素中与脾脏相关的指标最多。结论 肝硬化患者消化道出血风险预测模型研究质量有待提升，影像学指标应用最广，脾脏相关指标重要性突出，门静脉直径、血小板计数、血红蛋白水平及脾脏硬度为最常用的危险预测因素。
Objective To summarize and analyze the prediction models for gastrointestinal bleeding risk in patients with cirrhosis，providing references for the establishment and optimization of future models．Methods A systematic search was conducted in CNKI，VIP，and PubMed for all published prediction models for gastrointestinal bleeding risk in patients with cirrhosis before April 22，2025．Articles were screened according to the inclusion criteria，and the finally included articles were analyzed and summarized，including model characteristics，risk factors，and model prediction evaluation effects．Results A total of 3 603 related research papers on prediction models were initially retrieved，and 30 were finally included，with 27 from China，one from South Korea，one from India，and one from Egypt．Among the 22 studies that collected the etiology of cirrhosis，viral hepatitis was the most common（72.94%，2 922/4 006），while drug-induced liver disease and non-alcoholic fatty liver disease were the least common（0.02%，1/4 006）．In terms of study type，28 were single-center studies and two were multicenter studies．Among them，12 models were not validated，only one model was externally validated，and the rest were only internally validated，with an area under the curve range of 0.680-0.994．According to the characteristics of the factors included in the models，they were divided into six types of indicators：blood routine，coagulation，biochemistry，imaging，composite，and others，among which imaging indicators were the most common and coagulation indicators were the least．In the included risk factors，the first was portal vein diameter，the second was platelets count，and the third was hemoglobin level and spleen stiffness，with the most factors related to the spleen．Conclusions The quality of studies on prediction models for gastrointestinal bleeding risk in cirrhosis patients needs to be improved．Imaging indicators are the most widely used，and spleen-related indicators are of prominent importance，with portal vein diameter，platelets count，hemoglobin level，and spleen stiffness being the most commonly used risk prediction factors．
纤毛是细胞表面的重要细胞器，广泛参与细胞运动、感知外界信号和维持器官功能等生理过程。纤毛的形成，即纤毛发生（ciliogenesis）是一个高度复杂且受精密调控的过程，涉及大量与纤毛结构和功能相关基因的表达与调控。近年来，随着基因组学和发育生物学的发展，越来越多的研究揭示了多种关键转录因子在纤毛发生中的调控作用，包括RFX家族、FOXJ1、MCIDAS、GEMC1、MYB、E2F等。这些转录因子共同构成了一个多层次、多通路交织的调控网络，调控纤毛组装、基体复制、纤毛定位和功能维持等多个方面。本文系统综述了纤毛相关基因转录调控的研究进展，特别是关键转录因子的功能、相互作用及其在纤毛病中的作用，为深入理解纤毛的发育机制和疾病治疗提供参考。
Cilia are crucial cell-surface organelles involved in cell movement，signal sensing，and organ function maintenance．Their formation，or ciliogenesis，is a complex and precisely controlled process that requires the expression and regulation of numerous cilia-related genes．Recent advances in genomics and developmental biology have uncovered the regulatory roles of key transcription factors like the RFX family，FOXJ1，MCIDAS，GEMC1，MYB，and E2F in ciliogenesis．These factors form a multi-level，interconnected regulatory network that oversees cilium assembly，basal body replication，ciliary positioning，and function preservation．This review systematically examines current research on transcriptional regulation of ciliary genes，with a focus on the roles，interactions，and contributions of these key transcription factors to ciliopathies，offering insights into ciliary development and disease treatment．
飞秒激光辅助的SMILE因其微创、准确性、安全性、可预测性、稳定性好的特点越来越受患者和术者的欢迎,随着大家对手术的期望值增加,视觉质量成为反应手术效果极其重要的因素之一,而高阶像差又是评定视觉质量尤为重要的指标。本文对飞秒激光SMILE的眼高阶像差及其影响因素进行综述。
Femtosecond laser-assisted SMILE is more and more popular with patients and the operators because of the minimal invasion, efficacy, safety, predictability and stability. But with the increase of people's expectations of the surgery, visual quality become one of the important factors which reacts operation effect extremely, and higher-order aberration is an especially important index when evaluate the visual quality. In this paper, the higher-order aberration and its influence factors of femtosecond laser-assisted SMILE were summarized.
