近年来, 药物递送系统在肿瘤靶向治疗领域取得了显著进展, 已有多种递药系统获批临床应用。其中, 纳米药物因其能够减少传统小分子化疗药物的毒副作用、提高药物生物利用度,并通过增强通透性与滞留效应（EPR效应）实现肿瘤的被动靶向, 从而显著提升治疗效果, 受到广泛关注。尤其是具备尺寸可调、肿瘤特异性聚集、刺激响应性崩解及形貌转变等多功能的智能可变形纳米载体, 已成为当前纳米递药载体研究的热点。这类载体能够感应肿瘤微环境中的特定刺激信号（如酸性pH值、过氧化还原状态、酶活性或过表达细胞因子）, 实现包括尺寸调控、聚集组装、结构崩解与形态重构等在内的多种动态变形行为, 从而提升药物在肿瘤部位的滞留时间、渗透深度及控释能力, 最终获得更优的抗肿瘤疗效。例如在肿瘤组织中实现纳米载体尺寸缩小可增强药物的组织穿透力; 纳米粒子聚集变大会延长药物在病灶处的滞留时间; 而快速响应性崩解则有助于药物在肿瘤局部实现高效释放。这些智能变形策略为纳米药物递送系统提供了更高的治疗可控性与精准性。基于其多样化的响应特性和结构可塑性, 智能变形纳米载体在推动抗肿瘤药物的个体化治疗及联合疗法应用方面展现出巨大潜力。本文综述了近年来基于智能变形纳米载体增强抗肿瘤效果的研究进展,系统梳理了其设计策略, 并深入探讨了其在肿瘤精准治疗中的应用前景。
In recent years, drug delivery systems have made remarkable progress in the field of tumor-targeted therapy, with several platforms already approved for clinical use．Among them, nanomedicines have attracted considerable attention due to their ability to mitigate the side effects of conventional small-molecule chemotherapeutics, improve bioavailability, and passively accumulate at tumor sites via the enhanced permeability and retention（EPR）effect, thereby enhancing therapeutic efficacy．Of particular interest are stimuli-responsive, shape-transformable nanocarriers, which exhibit unique properties such as tunable size, tumor-specific accumulation, and structural adaptability in response to tumor-associated cues．These intelligent deformable nanocarriers are capable of undergoing various dynamic transformations—including aggregation, disassembly, size modulation, and morphological transitions—triggered by specific stimuli in the tumor microenvironment（TME）, such as pH, redox potential,enzymes,or cytokines．Such transformations enhance drug retention at tumor sites, improve intratumoral penetration, and enable spatiotemporally controlled drug release, ultimately resulting in superior antitumor efficacy．For instance, nanosystems that shrink in size at tumor sites can promote deeper tissue penetration, while those that aggregate into larger assemblies can prolong local drug retention．Conversely, carriers that disassemble rapidly under tumor-specific stimuli allow for burst release of the encapsulated payload precisely at the disease site．These adaptive features hold great promise for improving the therapeutic performance of nanomedicines. Furthermore, the multifunctionality of intelligent deformable nanocarriers supports the development of personalized treatment regimens and combination therapies, offering novel strategies for cancer management．This review highlights recent advances in the design and application of shape-transformable nanocarriers for enhanced anticancer drug delivery, summarizing design principles and exploring their emerging potential in precision oncology.
大蒜为百合科葱属植物的地下鳞茎,具有药食两用的价值,其含有大蒜素、二烯丙基硫醚、二烯丙基二硫醚、二烯丙基三硫醚、 硫-烯丙基半胱氨酸等多种生物活性成分,具有抗氧化、抗感染、免疫调节、心血管保护、抗癌等作用。不仅如此,大蒜在糖脂代谢的调节中功效显著,且相关机制日益明晰,主要包括保护胰岛β细胞功能、改善胰岛素抵抗、阻止脂肪细胞生长、抑制脂合成代谢及调节肠道菌群分布等。不同的提取工艺可影响大蒜的功效,其提取手段及药效关系值得进一步研究。
Garlic has values of both medicine and food,with rich allicin,diallyl disulfide（DADS）,diallyl trisulfide（DATS）and other garlic sulfur contents,which have been found to have multiple effets such as antioxidant,anti-infection,immunomodulatory,cardiovascular protection,anti-cancer,etc．Moreover,numerous studies have demonstrated that garlic plays an important role in the regulation of glycose and lipid metabolism,and the relevant mechanisms are becoming better understood,including protecting pancreatic β cells,improving insulin resistance,preventing the growth of fat cells,inhibiting lipid anabolism and adjusting the distribution of intestinal microflora．Different extraction processes can affect the efficacy of garlic,and further investigations are needed to elucidate the relationship between effective extraction methods and pharmacodynamic properties．
肥胖是一种以慢性低度炎症为特征的进展性疾病,与多种代谢性疾病的发生、发展密切相关。脂肪组织作为一种内分泌和免疫器官,可分泌多种生物活性物质及炎症因子,参与肥胖患者体内的代谢过程。减重手术是治疗病态性肥胖及相关代谢性疾病的有效方法之一,能够调节机体内的炎症反应、有效改善代谢状态。但减重手术对于炎症因子的作用如何,目前国内外的文献证据仍有争议。本文将系统阐述肥胖与代谢性炎症的关系以及减重手术对炎症因子的影响,旨在为肥胖代谢外科的诊疗过程提供参考。
Obesity is a progressive disease characterized by chronic low-grade inflammation,which is closely related to the occurrence and development of a variety of metabolic diseases．As an endocrine and immune organ,adipose tissue can secrete a variety of bioactive substances and inflammatory factors,which participate in the metabolic process of obese patients．Bariatric surgery is one of the effective methods for the treatment of morbid obesity and related metabolic diseases,which can regulate the inflammatory response in the machine and effectively improve the metabolic state．However,the effect of bariatric surgery on inflammatory factors is still controversial at home and abroad．This article will systematically explain the relationship between obesity and metabolic inflammation and the effect of bariatric surgery on inflammatory factors,aiming to provide a reference for the diagnosis and treatment process of bariatric surgery．
全膝关节置换术（TKA）是目前治疗终末期膝关节疾病的首选方法,它能够缓解疼痛、改善畸形、恢复力线、增加膝关节活动度及提高患者生活质量。目前,关于胫骨假体旋转对线的方法很多,主要包括胫骨结节、胫骨前后轴、胫骨前皮质、自我形合技术、计算机辅助导航技术、个性化截骨技术等,它们各有优缺点,但在临床上并没有达成共识。该文主要对胫骨近端的解剖学特点和TKA中胫骨假体旋转定位的方法等方面进行综述。旨在为临床骨科医生在行TKA时,选择合适的胫骨假体旋转对线方法提供一些参考。
Total knee replacement（TKA） is currently the preferred treatment for end-stage knee disease,and it can relieve pain,improve deformity,restore strength lines,increase knee range of motion,and improve patients’ quality of life．At present,there are many methods for the rotation of alignment of tibial prosthesis,mainly including tibial tubercles,tibial anteroposterior axes,anterior tibial cortex,self-morphing technology,computer-aided navigation technology,personalized osteotomy technology,etc．Each of the methods above has its advantages and disadvantages,but there is no clinical consensus at present．This article mainly reviews the anatomical characteristics of the proximal tibia and the method of rotational positioning of tibial prosthesis in TKA,which aims to provide some reference for clinical orthopedic surgeons to select the appropriate tibial prosthesis rotation alignment method when performing TKA．
运动捕捉技术已经广泛应用于步态分析、运动康复、动作对比、技战术分析、生物运动力学分析、损伤防护、运动装备设计研发等领域,实现了人机交互的全新体验。而步行是人类运动中最基础的动作,在生物力学研究上对异常步态进行分析能够有效改善患者治疗和康复的效果。本文总结了运动捕捉技术在各种异常步态分析中的应用,并对其优缺点进行了总结与展望。检索PubMed、Embase、EBSCO、Web of Science、中国知网,收集2018年1月至2023年12月公开发表的有关有标记运动捕捉及无标记运动捕捉在异常步态的相关研究,进行系统综述。最终纳入了22篇英文文献,这些文献主要集中在神经科学、生物医学工程和临床医学等领域,特别是在步态分析、运动捕捉技术、神经病理学和康复医学等方面的应用。这些研究为我们理解和改善各种神经系统疾病,如帕金森病、多发性硬化症和脑卒中以及骨关节炎等疾病的步态提供了宝贵的见解。利用运动捕捉来进行异常步态分析能有效地给患者提供准确的康复治疗,将结果用于临床诊断、康复规划或研究目的。异常步态分析在评估肌肉骨骼状况、神经系统疾病或干预措施的有效性方面具有重要价值。
Motion capture technology has been widely used in the fields of gait analysis,sports rehabilitation,action comparison,technical and tactical analysis,biomotor mechanics analysis,injury protection,sports equipment design and development,etc.,which realizes a brand-new experience of human-computer interaction．While walking is the most basic action in human movement,the analysis of abnormal gait on biomechanical research can effectively improve the effect of patient treatment and rehabilitation．This paper summarizes the application of motion capture technology in the analysis of various abnormal gaits,and summarizes and prospects its advantages and disadvantages．PubMed,Embase,EBSCO,Web of Science and China Knowledge Network were searched to collect related studies,openly published from January 2018 to December 2023,about labeled motion capture and unlabeled motion capture in abnormal gait for systematic review．Twenty-two English-language papers were finally included,which focused on the fields of neuroscience,biomedical engineering and clinical medicine,especially in the applications of gait analysis,motion capture technology,neuropathology and rehabilitation medicine．These studies provide valuable insights into understanding and improving gait in various neurological disorders such as Parkinson’s disease,multiple sclerosis and stroke and osteoarthritis．The use of motion capture for abnormal gait analysis can be effective in providing accurate rehabilitation to patients,using the results for clinical diagnosis,rehabilitation planning,or research purposes．Abnormal gait analysis is valuable in assessing musculoskeletal conditions,neurological disorders,or the effectiveness of interventions．
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．
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．
随着糖尿病发病率不断攀升,人们逐渐聚焦于糖尿病合并骨质疏松。围绕此疾病,国内外学者开展了广泛而深入的研究,临床实践聚焦于两点：糖尿病的精准治疗和骨质疏松的有效干预。在确保血糖稳定的基础上,致力于抑制骨吸收、促进骨形成。在此治疗理念指导下,临床医生应当更加全面了解血糖管理与抗骨质疏松药物的作用机制并合理应用,更大程度改善患者的临床症状及预后。然而,药物作用机制复杂,联合应用存在潜在药物相互作用问题。未来研究方向包括探索更安全有效的联合治疗方案,更加精确化地治疗以提高临床疗效。文章分析了降糖药物及抗骨质疏松药物对疾病的疗效,并展望未来的研究方向,旨在为临床实践提供更为深刻与全面的指导。
As the incidence of diabetes mellitus continues to rise,people are also gradually focusing on diabetes mellitus combined with osteoporosis,which puts patients at a higher risk of fragility fracture．Scholars at home and abroad have conducted extensive and in-depth research around this condition,and clinical practice has focused on two points：first,the precise treatment of diabetes,and second,the effective intervention of osteoporosis．On the basis of ensuring blood glucose stabilization,we are committed to inhibiting bone resorption and promoting bone formation．Under the guidance of this therapeutic concept,we should have a more comprehensive understanding of the mechanism of action of blood glucose management and anti-osteoporosis drugs and apply them rationally,aiming to improve the clinical symptoms and prognosis of patients to a greater extent through dual intervention． However,the mechanism of action of different drugs is complex,and there are potential drug-drug interactions and safety issues associated with their combined use．Future research directions should include exploring safer and more effective combination therapies,developing novel drugs,and more precise and individualized treatments to improve clinical efficacy．This article analyzes the efficacy of glucose-lowering drugs and anti-osteoporosis drugs on the disease and looks forward to future research directions,aiming to provide more profound and comprehensive guidance for clinical practice．
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．
