药物递送系统对于各类疾病意义非凡,但传统药物载体面临细胞毒性强、组织相容性低、半衰期短和靶向性弱等诸多挑战。血小板及其相关衍生物作为新型药物载体具有更为显著的优势。由于血小板自身的生理特点,以及在肿瘤、心血管疾病、血栓性疾病、感染等多种疾病中发挥的病理生理作用,血小板能够弥补传统药物载体的缺陷,具有极大的临床转化意义。该文总结了血小板相关药物递送系统目前的研究进展,以期为新型药物载体研究提供参考。

Drug delivery systems are important for various diseases,but conventional therapeutic drug have many shortcomings,such as high cytotoxicity,low histocompatibility,short half-life and weak targeting．Platelets and their derivatives have more significant advantages as novel drug carriers．Platelets play an important role in the pathophysiology of a wide range of diseases including oncology,cardiovascular diseases,thrombosis and infection．In this paper,we summarized the current research progress of platelet-related drug delivery systems to provide a reference for the research of novel drug delivery systems．

目的 分析常规炎性指标与进展性脑梗死（PCI）患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分（NIHSS）结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表（mRS）评分间的差异,并通过绘制受试者操作特征（ROC）曲线、曲线下面积（AUC）评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）分别为（26.44±5.18）mg/L、（95.28±10.46）ng/L、（45.24±10.31）pg/mL,均高于中度组[（23.12±5.46）mg/L、（90.44±10.17）ng/L、（40.25±10.18）pg/mL],轻度组[（20.28±5.33）mg/L、（84.33±10.27）ng/L、（35.62±8.45）pg/mL],差异具有统计学意义（P<0.05）。重度组的神经元特异性烯醇化酶（NSE）、S100钙结合蛋白β（S100β）分别为（25.45±5.69）μg/L、（60.45±10.31）ng/mL,均高于中度组[（22.18±5.36）μg/L、（55.27±10.46）ng/mL],轻度组[（19.44±5.37）μg/L、（50.49±10.25）ng/mL],差异具有统计学意义（P<0.05）。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关（P<0.05）。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为（26.62±5.31）mg/L、（96.77±10.24）ng/L、（47.25±10.33）pg/mL、（4.24±1.33）分,均高于预后良好组[（23.75±5.44）mg/L、（91.25±10.37）ng/L、（41.12±10.44）pg/mL,（3.36±0.27）分],差异具有统计学意义（P<0.05）。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高（AUC均>0.85）。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。

Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction（PCI） patients,as well as predictive efficacy of indicators on prognosis levels．Methods This is a retrospective study,with case enrollment from June 2021 to February 2023．The study subjects were 100 PCI patients．Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group．The neurological function serological and inflammatory indicators of the three groups of patients were compared．The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient．According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group．The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC．Results After testing,the levels of CRP,IL-6 and TNF in the severe group were（26.44±5.18）mg/L,（95.28±10.46）ng/L and（45.24±10.31）pg/mL,respectively,higher than those in the moderate group[（23.12±5.46）mg/L,（90.44±10.17）ng/L and（40.25±10.18）pg/mL]and the mild group[（20.28±5.33）mg/L,（84.33±10.27）ng/L and（35.62±8.45）pg/mL]（P<0.05）．NSE and S100β in the severe group were（25.45±5.69）μg/L and（60.45±10.31）ng/mL,all higher than those in the moderate group[（22.18±5.36）μg/L,（55.27±10.46）ng/mL]and mild group[（19.44±5.37）μg/L,（50.49±10.25）ng/mL]（P<0.05）．According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β（P<0.05）．After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were（26.62±5.31）mg/L,（96.77±10.24）ng/L,（47.25±10.33）pg/mL and（4.24±1.33）scores,respectively,which were higher than those in the group with good prognosis[（23.75±5.44）mg/L,（91.25±10.37）ng/L,（41.12±10.44）pg/mL and（3.36±0.27）scores]（P<0.05）．Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients（AUC>0.85）．Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage．By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients．

脊髓损伤是一种高致残性中枢神经系统疾病,目前缺乏有效的治疗措施。干细胞组织工程兴起和神经调控技术的发展,给脊髓损伤的治疗带来新的希望。目前,多项针对脊髓损伤的干细胞相关治疗项目的临床研究已在全球注册,干细胞疗法是脊髓损伤领域的研究热点,具有良好的应用前景。而神经调控技术一直在临床上脊髓损伤后的康复治疗中发挥着重要作用,特别是靶向神经调控技术近年在脊髓损伤治疗方面取得突破性进展。有研究尝试联合干细胞疗法和神经调控技术应用治疗脊髓损伤,试图取得更好的效果。本文综述了干细胞疗法和神经调控技术在脊髓损伤治疗中的研究进展,旨在探讨其作用效果、修复机制、应用前景以及面临的问题,进一步为脊髓损伤的基础研究和临床转化提供参考。

Spinal cord injury is a highly disabling disease of the central nervous system without effective treatment to date．With the rise of stem cell and tissue engineering,and the breakthrough of neuromodulation technology,it brings new hope to the treatment of spinal cord injury．At present,a number of clinical studies on stem cell-related treatment projects for spinal cord injury have been registered worldwide,which has become a research hotspot．Neuromodulation technology has been playing an important role in the clinical rehabilitation of spinal cord injury．Especially,breakthroughs have been made in the treatment of spinal cord injury by targeted neuromodulation technology in recent years,which is encouraging．Some studies have attempted to combine stem cell therapy and neuromodulation technology to treat spinal cord injuries in an attempt to achieve better effect．This review summarizes the research progress of stem cell therapy and neuromodulation technology in the treatment of spinal cord injury,with the aim of discussing their effect,repair mechanisms,application prospect and various problems to face,and providing further reference for the basic research and clinical transformation of spinal cord injury．

慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数（SII）作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。

Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis．As a new type of inflammatory index,the systemic immune inflammatory index（SII）was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields．SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development．

弥漫性大B细胞淋巴瘤（DLBCL）是最常见的高度异质性非霍奇金淋巴瘤（NHL）,不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植（ASCT）和嵌合抗原受体T细胞免疫治疗（CAR-T）是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。

Diffuse large B-cell lymphoma（DLBCL）is a highly heterogeneous type of non-Hodgkin lymphoma（NHL）and its prognosis is different for different disease stages or clinical subtypes．Radiation therapy（RT）is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL．When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients．Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion．For treating relapsed / refractory DLBCL,autologous stem cell transplantation（ASCT）and chimeric antigen receptor T cell immunotherapy（CAR-T）are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure．With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options．

脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。

Spinal tuberculosis is the most common types of infectious diseases affecting the spine．This article reviews the current status and progress of surgical treatment for spinal tuberculosis．In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life．However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability．In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention．In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread．The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes．However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan．Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved．

在过去的几十年中,随着RNA生物学的深入研究,越来越多的证据表明,非编码RNA（ncRNA）对包括癌症在内的多种疾病进展起着关键作用,同时在作为生物标志物和治疗靶点方面表现出了巨大的潜力。在全球范围内,消化道（GI）肿瘤是肿瘤相关死亡的主要原因,目前消化道肿瘤晚期患者的生存率依然很低。既往大量研究报道了ncRNA中,特别是长链非编码RNA（lncRNA）在消化道肿瘤发生发展中发挥重要作用。本文将着重阐述lncRNA在消化道肿瘤分子生物学中的作用,旨在为深入理解lncRNA在消化道肿瘤发生发展机制以及临床转化应用提供新的思路和线索。

In recent decades,an increasing body of evidence has pointed to the pivotal roles of non-coding RNAs（ncRNAs）,particularly long non-coding RNAs（lncRNAs）,in the development of various diseases,including cancer．Meanwhile,ncRNAs have been shown great potential as biomarker and therapeutic target．Gastrointestinal（GI）cancers are a leading cause of cancer-related mortality globally and the survival rate of advanced GI cancer patients is still very low．Extensive research has underscored the significant involvement of lncRNAs in the initiation and progression of GI cancers．This review aims to offer a comprehensive overview of lncRNAs,shedding light on their roles in the molecular biology of GI cancers．By synthesizing previous studies,this review seeks to provide new insights into the mechanisms underlying lncRNAs' contribution to GI cancer development and their potential clinical applications．

慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。

Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure．Therefore,it usually leads to decreased patient compliance．It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically．However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment．This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade．It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years．This paper is based on “deficiency in origin” and “excess in superficiality” principle．Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality．By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis．It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices．

乳腺癌是女性最常见的原发恶性肿瘤之一。目前,通过采用综合治疗手段,包括手术、新辅助治疗、辅助放化疗等多种手段,乳腺癌已成为疗效最佳的实体肿瘤之一。其中,新辅助治疗（NAT）包括新辅助化疗、靶向治疗和内分泌治疗,目的是使肿瘤降期、保乳、保腋窝,并可观察药物敏感性,是当前乳腺癌综合治疗中非常重要的组成部分,其治疗疗效对患者手术方式的选择和预后至关重要。尽管病理学评价在评估NAT疗效方面被公认为金标准,但其局限性在于只能通过有创手段在治疗后进行,无法在治疗前对患者做出准确预测。磁共振成像（MRI）作为一项广泛使用的乳腺成像技术,在评估NAT疗效中扮演着关键角色。近年来,人工智能技术,尤其是影像组学（Radiomics）和深度学习（Deep Learning）,在医学影像分析领域取得了显著进展。这些技术能够从医学图像中提取大量肉眼难以识别的特征,揭示病变内部的微观结构和生物学行为,全面反映肿瘤的异质性,这不仅有助于临床医生更准确地区分良、恶性肿瘤,还能对恶性肿瘤的预后进行更为精确的评估。本文系统综述了近年来基于MRI的人工智能技术在乳腺癌新辅助治疗疗效评估中的应用研究,旨在促进人工智能在NAT临床实践中的应用和发展,为乳腺癌NAT治疗策略的优化和个性化医疗的实现提供科学依据。

Breast cancer is one of the most common primary malignant tumors in women．Currently,breast cancer has become one of the most effective solid tumors by using comprehensive treatment methods,including surgery,neoadjuvant therapy,adjuvant radiotherapy and chemotherapy．Among them,neoadjuvant therapy（NAT）,including neoadjuvant chemotherapy,targeted therapy and endocrine therapy,is a very important part of the current comprehensive treatment of breast cancer．It aims to reduce the tumor stage,preserve the breast,preserve the armpit,and observe the drug sensitivity．Its therapeutic effect is crucial to the choice of surgical methods and prognosis of patients．Although pathological evaluation is recognized as the gold standard in evaluating the response to NAT,its limitation is that it can only be performed after treatment by invasive means,and cannot accurately predict response before treatment．As a widely used breast imaging technology,magnetic resonance imaging（MRI）plays a key role in evaluating the response to NAT．However,traditional MRI evaluation methods are limited by the individual differences of interobserver and the low repeatability of evaluation results,which affects the accuracy of efficacy evaluation to a certain extent．In recent years,artificial intelligence technology,especially radiomics and deep learning,has made significant progress in the field of medical image analysis．These techniques can extract a large number of features that are difficult to be recognized by the naked eye from medical images,reveal the internal microstructure and biological behavior of the lesion,and fully reflect the heterogeneity of the tumor．This not only helps clinicians to distinguish benign and malignant tumors more accurately,but also makes a more accurate assessment of the prognosis of malignant tumors．This article reviews the application and progress of MRI-based artificial intelligence technology in evaluating the response to neoadjuvant therapy for breast cancer in the past five years,aiming to promote the application and development of artificial intelligence in NAT clinical practice,and provide a scientific basis for the optimization of NAT treatment strategy and the realization of personalized medicine for breast cancer．

蒜氨酸为大蒜氨基酸成分,对机体无毒副作用,在体内代谢酶作用下分解成大蒜素,具有多种药理作用和广阔的临床应用前景。本文就蒜氨酸的分离提取、制剂及生物活性研究现状进行综述,以供参考。

Alliin is an amino acid component of garlic, no toxic side effects to the body. It breaks down into allicin by metabolic enzymes in the body, has a variety of pharmacological effects and broad clinical application prospects. In this paper, the isolation, extraction, preparation and biological activity of alliin were reviewed for reference.