急性胰腺炎(AP)是一种常见的消化系统急症。随着生活水平的提高,其重症发病率也逐年增加。中西医结合治疗急性胰腺炎在临床实践中展现出优势。近年来,大柴胡汤合大承气汤在治疗急性胰腺炎方面药理机制的研究不断延伸,同时对方药中的药理活性成分也在不断深入研究。该文旨在整理相关研究,综述大柴胡汤合大承气汤治疗急性胰腺炎的理论基础、临床应用、药物活性成分、药理机制等,以期为临床实践和进一步深入研究提供参考。
Acute pancreatitis(AP)is a common gastrointestinal emergency.With the improvement of living standards,the incidence of severe AP has been increasing year by year.The combined treatment of traditional Chinese and Western medicine has shown advantages in the clinical practice of acute pancreatitis.In recent years,the pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis has been continuously studied,and the pharmacological active components in the prescription are also being explored.This article aims to summarize relevant research on the theoretical basis,clinical application,active ingredients and pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis,providing reference for clinical practice and further research.
胰源性门静脉高压(PSPH)是由脾静脉(SV)流通受阻引起的一种临床综合征,在临床较为罕见且对患者造成生命威胁,但却为门静脉高压唯一可治愈的类型。其主要发病诱因是胰腺原发疾病,通常为胰腺急(慢)性炎症、胰腺占位性病变和胰腺手术操作导致。1型孤立性食管胃底静脉曲张、脾大、脾功能亢进是PSPH的主要临床表现特征,其中食管胃底曲张静脉破裂出血是PSPH最为严重的并发症;患者若表现为肝功能正常但出现原因不明脾肿大并伴有消化道出血症状,应考虑可能出现了PSPH。PSPH的治疗可分为胰腺原发病、门静脉高压及并发症的综合性诊治。本文旨在回顾PSPH的相关文献,对其有关临床诊断与治疗现状进行综述,以期指导医务工作者在临床中尽早发现PSPH并对患者及时有效治疗。
Pancreatic segmental portal hypertension(PSPH)is a clinical syndrome caused by spleen vein(SV)occlusion or stenosis.It is a rare and life-threatening hemorrhagic disease of the upper digestive tract,but it is the only curable type of portal hypertension.The main cause is primary pancreatic disease,which is usually due to acute or chronic pancreatic inflammation,pancreatic space-occupying lesions and pancreatic surgery.Type 1 isolated esophagogastric varices,splenomegaly and hypersplenism are the main clinical features of PSPH,and esophagogastric variceal bleeding is the most serious complication of PSPH.PSPH should be considered in patients with normal liver function but unexplained splenomegaly accompanied by gastrointestinal bleeding.The treatment of PSPH can be divided into a comprehensive diagnosis and treatment of primary pancreatic disease,portal hypertension and complications.Therefore,the purpose of this paper is to review relevant literature of PSPH,the relevant clinical diagnosis and treatment status quo were summerized,in order to guide the medical workers in clinical PSPH,early detection and timely and effective treatment for patients.
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 evasionmechanisms 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 therapeuticstrategies 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 strategyfor MDSCs.This strategy aims to precisely activate anti-tumor immune responses,providing more personalized and efficienttreatment options for cancer patients,thereby opening a new era in tumor immunotherapy and contributing to the innovation anddevelopment 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。
CAAT 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.
近年来浆细胞性乳腺炎的发病率逐渐升高,已占乳腺疾病的4%~5%,该病易反复发作,经久不愈,抗生素、糖皮质激素、抗结核药、他莫昔芬等治疗效果不明显,单纯手术切除如切除范围小极易复发,而切除范围大则乳腺外形变化较大,严重者甚至需要切除乳腺。乳腺外形的缺损改变对患者身心健康造成伤害。随着研究不断深入,采用中西医结合治疗浆细胞性乳腺炎,可取得较好的治疗效果,降低复发率,而且对乳腺外观无影响。该文通过对文献的整理,对中西医结合治疗浆细胞性乳腺炎进行论述。
In recent years,the incidence of plasma cell mastitis has gradually increased,accounting for 4 % ~ 5 % of breast diseases.The disease is prone to repeated attacks and unhealed for a long time.The treatment effect of antibiotics,glucocorticoids,anti-tuberculosis drugs and tamoxifen is not obvious.Simple surgical resection is easy to relapse if the resection range is small,while the shape of the breast changes greatly,if the resection range is large.And even the breast needs to be removed in severe cases.The defect change of breast shape is harmful to the physical and mental health of patients.With the deepening of research,the combination of traditional Chinese and Western medicine in the treatment of plasma cell mastitis can achieve better therapeutic effect,reduce the recurrence rate,and has no effect on the appearance of breast.This article discusses the treatment of plasma cell mastitis with integrated traditional Chinese and Western medicine by sorting out the literature.
药源性心脏毒性是临床常见的药物不良反应,是药物研发和临床治疗需面临的严峻考验。对药源性心脏毒性的评价是目前研究的重点,基于其机制复杂多样、临床表现不一、影响因素多,早期评价具有困难。生物标志物是评价心脏毒性的重要指标之一,文章总结了目前已经报道的多种心脏毒性标志物及其潜在的生物标志物,希望能从中找到特异性强、敏感性高的标志物,以贡献于药物心脏安全性评价工作。
As a common clinical adverse reaction,pharmacogenic cardiotoxicity is a severe challenge for drug development and clinical treatment.The evaluation of pharmacogenic cardiotoxicity is the focus of current research,and early evaluation is difficult with its complex and diverse mechanisms,varying clinical manifestations,and numerous influencing factors.Biomarker is an important index to evaluate cardiotoxicity.This article summarizes a variety of cardiotoxicity biomarkers and other potential biomarkers that have been reported so far,hoping to find biomarkers with strong specificity and high sensitivity,so as tocontribute to the evaluation on cardiac safety of drugs.
近年来,人工智能技术(AI)的发展正在逐渐改变传统的医疗行业,机器学习作为人工智能技术中的主流被越来越多地应用于分析复杂的医学数据,为疾病的诊断、预后风险评估、诊疗决策的制定等方面提供了便利。文章对国内外机器学习算法在术后谵妄中的应用进行综述,以期为术后谵妄预测模型的构建提供新的思路,为临床早期评估术后谵妄提供新的依据。
In recent years,the development of artificial intelligence(AI)is gradually changing the traditional medical industry.Machine learning,as the mainstream of artificial intelligence technology,is increasingly applied to analyze complex data in medical research.It provides convenience for disease diagnosis,risk assessment and diagnosis and treatment decision making.This paper reviews the application of machine learning algorithms in postoperative delirium at home and abroad,in order to provide a new idea for the construction of postoperative delirium prediction model and a new basis for early clinical evaluation of postoperative delirium.
近视是一种常见的屈光不正状态,也是全球范围内普遍存在的视觉健康问题,其特征是在眼部调节放松的状态下,平行光线经眼的屈光系统折射后聚焦在视网膜前,导致视远模糊。近视通常在儿童期发生和发展,但在成年期仍可继续发生和发展。本综述对已发表的关于成年人近视发生和进展的文献进行总结,描述成年人近视的流行病学特征,包括近视率、近视发病率、近视进展率及其近视特征(屈光度及眼轴),总结成年人近视发病和进展的危险因素。了解成年人近视的发展特点和管理方式对于近视防控实践具有重要意义。
Myopia is a common refractive error and a universal visual health problem in the world. It is characterized by the fact that parallel light rays refract through the refractive system of the eye and focus in front of the retina when the eye accommodatior is relaxed, resulting in distant blurred vision. Myopia usually occurs and develops in childhood, but can continue to occur and develop in adulthood. This review summarizes the published literature on the occurrence and progression of myopia in adults, describes the epidemiological characteristics of myopia in adults, including myopia rate, myopia incidence rate, myopia progression rate, and myopia characteristics(diopter and ocular axis) ; and summarizes the risk factors for the occurrence and progression of myopia in adults. Understanding the developmental characteristics and management methods of adult myopia is of great significance for myopia prevention and control practice.
近几十年来,全球近视患病率不断上升,已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制,以期为近视防控提供新的思路。
In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control.
乳酸以往被视为不具备生物学功能的代谢废物。随着人们对乳酸的深入研究,发现乳酸有多种作用。乳酸化修饰是近期发现一种与乳酸有关的蛋白质翻译后修饰过程。乳酸化修饰主要有两种,一种是与乳酸相关的直接修饰,另外一种是与丙酮酸相关的间接修饰。这两种乳酸化修饰均可能受到糖酵解、乳酸转运与堆积、蛋白质串扰以及神经系统等多方面的调控。乳酸化修饰可以通过直接或间接修饰组蛋白或非组蛋白,从而在肿瘤组织的代谢重编程、增殖、迁移及免疫逃逸中发挥着重要作用。乳酸化修饰的深入研究,有望为肿瘤的诊断和治疗开辟新的路径。因此,为了明确乳酸化修饰在肿瘤方面的研究进展,本文就蛋白乳酸化修饰的分子机制及其在肿瘤中作用的研究进展作一综述。
Lactic acid was previously regarded as a metabolic waste product with no biological function. As lactic acid has been intensively studied, it has been found to have multiple roles. Lactation modification is a recently discovered protein post-translational modification process related to lactic acid. There are two main types of lactation modification:one is direct modification related to lactic acid and the other is indirect modification related to pyruvate. Both types of lactation modification may be regulated by various aspects such as glycolysis, lactate transport and accumulation, protein crosstalk, and the nervous system. Lactation modification can play an important role in metabolic reprogramming, proliferation, migration, and immune escape of tumor tissues by directly or indirectly modifying histones or non-histone proteins. The in-depth study of lactation modification is expected to find new pathways for tumor diagnosis and treatment. Therefore, in order to clarify the research progress of lactation modification in tumors, this paper presents a review on the molecular mechanism of protein lactation modification and the research progress of its role in tumors.