目的 探讨血清白蛋白（ALB）、纤维蛋白原（FIB）、乳酸脱氢酶（LDH）水平联合检测对急性心肌梗死患者短期预后的预测价值，以期为临床早期制定相应干预方案、改善患者预后提供参考。 方法 回顾性选取我院2023年1月~2025年1月收治的132例急性心肌梗死患者，入院后均接受经皮冠脉介入术（PCI）术治疗，根据术后6个月是否发生心血管主要不良事件（MACE）分为预后不良组（n=34）、预后良好组（n=98），比较两组临床资料及入院时血清ALB、FIB、LDH水平，Logistic回归方程分析血清ALB、FIB、LDH水平与急性心肌梗死患者PCI术后预后的关系，受试者工作特征（ROC）曲线分析其预测价值。 结果 两组病变血管支数、Killip分级及入院时血清ALB、FIB、LDH水平比较，差异具有统计学意义（P＜0.05）；入院时血清ALB、FIB、LDH水平与PCI术后预后显著相关，均为其独立影响因素（P＜0.05）；绘制ROC曲线结果显示，入院时血清ALB、FIB、LDH对于PCI术后预后不良的预测AUC分别为0.795、0.856、0.832，联合预测预后不良的AUC为0.927（95%CI：0.892~0.963），大于各方案单独预测，敏感度为91.18%，特异度为89.80%；危险度分析显示，血清ALB低水平患者预后不良风险是高水平患者的6.127倍，血清FIB、LDH高水平患者预后不良风险是低水平患者的10.493、8.170倍（P＜0.05）。 结论 血清ALB、FIB、LDH水平联合检测对急性心肌梗死患者PCI术后预后具有较高预测价值，临床可根据其早期评估患者预后不良风险，以制定个体化干预方案，改善患者预后。
目的 探讨症状性颅内动脉重度狭窄（sICAS）患者接受自膨式支架成形术后预后不良的相关因素，并构建预测模型。方法 回顾性连续纳入2023年1月至2025年6月于本院脑血管病科行自膨式支架联合经皮腔内血管成形支架置入术（PTAS）的重度sICAS患者96例。收集患者一般临床资料、影像学特征、手术相关资料及随访结局。以术后1年内发生主要终点事件（包括缺血性卒中复发、颅内出血、死亡或症状性支架内再狭窄）定义为预后不良。采用单因素及多因素Logistic回归分析筛选独立危险因素，并构建列线图预测模型。通过受试者工作特征曲线（ROC）及校准曲线评估模型效能。结果 96例患者中，术后1年共发生预后不良事件22例（22.9%），其中缺血性卒中复发12例（12.5%），症状性支架内再狭窄8例（8.3%），颅内出血2例（2.1%）。多因素Logistic回归分析显示，糖尿病（OR = 3.21，95% CI：1.28～8.05，P = 0.013）、术前狭窄长度≥10 mm（OR = 2.89，95% CI：1.15～7.28，P = 0.024）、Mori C型病变（OR = 4.12，95% CI：1.52～11.16，P = 0.005）及术后即刻残余狭窄率≥20%（OR = 2.67，95% CI：1.06～6.72，P = 0.037）是预后不良的独立危险因素。基于上述因素构建的预测模型AUC为0.84（95% CI：0.76～0.92），校准曲线显示模型一致性良好。结论 糖尿病、长病变、复杂Mori分型及术后残余狭窄率高是自膨式支架成形术后预后不良的独立预测因素，所构建的预测模型具有较好的区分度与校准度，可用于个体化风险评估。
目的：分析血脑屏障标志物闭合蛋白（Occludin，OCLN）、密封蛋白-5（Claudin-5，CLDN5）与帕金森病（PD）患者神经功能损伤程度及不良预后的关联。方法：研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者，及同期接受检查的180例健康志愿者，将其分别列为病例组、对照组，比较两组OCLN、CLDN5间差异。依据病情严重程度不同，将PD患者分别列为早期组（50例）、中期组（65例）和晚期组（65例），比较三组患者OCLN、CLDN5，神经损伤标志物间差异，分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况，比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异，分析PD患者预后影响因素，验证OCLN、CLDN5对PD患者不良预后的预测效能。结果：病例组的外周血OCLN、CLDN5均高于对照组（t=50.450，51.670；P＜0.05）。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶（NSE）、泛素羧基末端水解酶L1（UCH-L1）、神经丝轻链蛋白（NfL）、胶质纤维酸性蛋白（GFAP）均高于中期组、早期组（F=280.611，378.453，82.254，122.413，185.272，257.733；P＜0.05）。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关（r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503；P＜0.05）。180例PD患者的不良预后发生率为28.89%（52/180）。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组（t=17.096，14.405，7.632，6.903，11.695，10.702；P＜0.05）。Logistic多因素回归分析结果显示，外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验，外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测（DeLong检验，P＜0.05）。结论：外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高，联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。
Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450，51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611，378.453，82.254，122.413，185.272，257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096，14.405，7.632，6.903，11.695，10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.
目的 探讨吲哚布芬联合智能抗阻训练对急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后血小板功能及心功能的影响。方法 选取2024年1月至2025年12月在本院接受PCI支架植入术的60例ACS患者，随机分为观察组和对照组，每组30例。对照组给予常规治疗联合氯吡格雷75 mg/d治疗，观察组给予常规治疗联合吲哚布芬（100mg/次，2次/d）+智能抗阻训练干预，两组均连续干预3个月。比较两组患者干预前、干预1个月、3个月时花生四烯酸（AA）诱导和二磷酸腺苷（ADP）诱导的血小板聚集率，随访3个月不良心血管事件（MACE）发生率，以及干预前后心功能指标[左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）]。结果 干预前两组血小板聚集率、LVEF、LVEDD比较差异无统计学意义（P＞0.05）；干预1个月、3个月时，观察组AA诱导和ADP诱导的血小板聚集率降低幅度均显著大于对照组（P＜0.05）；干预3个月后，观察组LVEF显著高于对照组，LVEDD显著低于对照组（P＜0.05）；随访3个月，两组MACE发生率比较差异无统计学意义（P＞0.05）。结论 吲哚布芬联合智能抗阻训练可更显著地抑制ACS患者PCI术后血小板聚集，更有效地改善心功能指标，且安全性良好。
Objective To explore the effect of indobufen combined with intelligent resistance training on platelet function and cardiac function in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 60 ACS patients who underwent PCI stent implantation in our hospital from January 2024 to December 2025 were selected and randomly divided into an observation group and a control group, with 30 patients in each group. The control group was given conventional treatment combined with clopidogrel 75 mg/d, while the observation group was given conventional treatment combined with indobufen (100 mg/time, twice a day) + intelligent resistance training intervention. Both groups received continuous intervention for 3 months. The arachidonic acid (AA)-induced and adenosine diphosphate (ADP)-induced platelet aggregation rates were compared between the two groups before intervention, 1 month and 3 months after intervention. The incidence of major adverse cardiovascular events (MACE) was followed up for 3 months, and the cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)] were compared before and after intervention. Results Before intervention, there were no significant differences in platelet aggregation rates, LVEF and LVEDD between the two groups (P > 0.05); at 1 month and 3 months after intervention, the reduction amplitudes of AA-induced and ADP-induced platelet aggregation rates in the observation group were significantly greater than those in the control group (P < 0.05); after 3 months of intervention, LVEF in the observation group was significantly higher than that in the control group, and LVEDD was significantly lower than that in the control group (P < 0.05); after 3 months of follow-up, there was no significant difference in the incidence of MACE between the two groups (P > 0.05). Conclusion Indobufen combined with intelligent resistance training can more significantly inhibit platelet aggregation, more effectively improve cardiac function indexes in ACS patients after PCI, and has good safety.
目的 探讨脓毒性休克患者肿瘤坏死因子相关受体6 （TRAF6）、胆碱酯酶（ChE）及急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）对预后不良的预测价值。方法 回顾分析2023年2月—2024年3月于某院ICU病区收治的226例脓毒性休克患者的临床资料，基于患者预后情况分为预后良好组（n=151）以及预后不良组（n=75）。回顾226例脓毒性休克患者入院时及治疗后的TRAF6、ChE表达变化，并记录患者APACHEⅡ评分和序贯器官功能衰竭评估（SOFA）评分动态变化；比较并分析两组患者详尽的临床资料，探讨TRAF6、ChE联合APACHE Ⅱ评分之间的关联性以及上述指标对脓毒性休克患者预后情况的临床评估价值。采用Logistic回归来分析对脓毒性休克患者生存状况产生影响的潜在因素。结果 多因素Logistic回归分析，年龄、APACHE Ⅱ评分、SOFA评分、机械通气时间、TRAF6与ChE表达水平均是影响患者预后的独立危险因素（P＜0.05）；受试者操作特征曲线分析显示，年龄、APACHE Ⅱ评分、机械通气时间、SOFA评分、TRAF6、ChE表达水平联合预测脓毒性休克患者预后不良的曲线下面积为0.925，高于单独检测的0.689、0.783、0.794、0.781、0.708、0.827。结论 临床需要及时识别高龄、长时间机械通气时间、高APACHE Ⅱ与SOFA评分、高TRAF6和ChE表达水平的高风险患者，TRAF6、ChE表达水平、SOFA评分、APACHE Ⅱ评分可作为评估脓毒性休克患者预后情况的临床指标，联合应用能进一步提升临床价值。
Objective To explore the predictive value of tumor necrosis factor receptor associated factor 6（TRAF6），cholinesterase（ChE）and Acute Physiology and Chronic Health Evaluation II scove（APACHE II）for adverse prognosis in patients with septic shock．Methods The clinical data of 226 patients with septic shock admitted to the Intensive Care Unit（ICU） of a hospital from February 2023 to March 2024 were retrospectively analyzed，and the patients were divided into a good prognosis group（n=151）and an adverse prognosis group（n=75）based on their prognosis．The expression of TRAF6 and ChE in 226 patients with septic shock was reviewed at admission and after treatment，while the dynamic changes of APACHE II score and Sequential Organ Failure Assessment（SOFA）score were recorded．Detailed clinical data of the two groups were compared and analyzed to explore the correlation between TRAF6，ChE，APACHE II scores and the clinical evaluation value of the above indexes in the prognosis of patients with septic shock．Logistic regression was used to analyze the potential factors affecting the survival of septic shock patients．Results Multiple Logistic regression analysis revealed that age，APACHE II score，SOFA score，mechanical ventilation time，TRAF6 and ChE expression levels were independent risk factors for prognosis（P＜0.05）．Receiver Operating Characteristic（ROC）curve analysis showed that the area under curve（AUC）was 0.925，which was higher than single index prediction（0.689，0.783，0.794，0.781，0.708 and 0.827）．Conclusions High-risk patients with advanced age，prolonged mechanical ventilation，high APACHE II and SOFA scores，and high TRAF6 and ChE expression levels need to be identified in time．TRAF6，ChE expression levels，SOFA scores，and APACHE II scores can be used as clinical indicators to evaluate the prognosis of septic shock patients．The combined application of those four indicators can further improve the clinical value．
目的 初步探讨生长因子受体结合蛋白14（GRB14）在肺腺癌患者预后中的具体作用机制。方法 通过TIMER数据库、UALCAN数据库及GEPIA数据库，探讨GRB14 mRNA在肺腺癌及正常肺组织中的表达。运用免疫组织化学通过组织芯片（75例肺腺癌患者和75例癌旁组织）检测其蛋白表达水平，收集国外肿瘤研究团队上传至TCGA数据库229例肺腺癌患者的临床数据，分析评估GRB14在肺腺癌患者的表达及其临床特征及生存预后之间的关系。应用TIMER数据库对GRB14肺腺癌患者进行免疫浸润分析。String数据库探讨GRB14与其他蛋白之间是否存在相互作用。结果 TIMER数据库分析显示，相比正常组织，GRB14 mRNA在多种实体肿瘤和肺腺癌组织中高表达（P＜0.05）。使用UALCAN数据库和GEPIA数据库以正常样本为对照组，肺腺癌患者的GRB14的表达均增加（P＜0.01）。免疫组织化学检测组织芯片结果显示，GRB14蛋白在肺腺癌的表达高于正常肺组织（肺腺癌6.07±1.01 vs 癌旁组织4.80±1.22；P＜0.01）。TCGA数据库分析显示，肺腺癌患者中GRB14高表达组和低表达组的中位总生存期分别为（41.59±5.20）月和（88.67±16.69）月；结合TCGA数据库绘制ROC曲线，发现GRB14的表达对肺腺癌患者具有一定的诊断价值。单因素回归分析结果显示，肿瘤分期（Ⅲ-Ⅳ）（P＜0.01）、肿瘤原发灶的情况（T3-4）（P＜0.01）、淋巴结转移（N1-3）（P＜0.01）和GRB14表达（P＜0.01）是影响肺腺癌中位总生存期的因素；Cox多因素回归分析显示，淋巴结转移（N1-3）（P＜0.05）和GRB14表达（P＜0.01）是影响肺腺癌中位总生存时间的因素。TIMER数据库分析显示，GRB14 mRNA 表达与巨噬细胞（r=-0.164，P＜0.01）、中性粒细胞（r=-0.175，P＜0.01）和树突状细胞（r=-0.148，P＜0.01）具有相关性。通过String数据库分析发现与GRB14相互作用的蛋白质包括EGFR、HRAS、FGFR1、INSR、CNGA1、COBLL1、LYPLAL1、TNKS2、TNKS、PRKCZ。结论 GRB14表达增加与肺腺癌患者预后不良相关。
Objective To assess the specific mechanism of growth factor receptor-bound protein 14（GRB14）in the prognosis of lung adenocarcinoma（LUAD）patients．Methods The expression of GRB14 mRNA in LUAD and normal lung tissue was explored using TIMER database，UALCAN database，and GEPIA database．The expression of GRB14 protein was examined by immunohistochemistry using a tissue microarray．Then，the associations of GRB14 expression with clinicopathological features and clinical outcomes of LUAD were validated by analyzing TCGA database at the mRNA level and statistically evaluating the results．TIMER database was used to analyze immune infiltration of GRB14 in LUAD．Protein-protein interaction of GRB14 were analyzed using the String database．Results Using the TIMER database，we found that GRB14 mRNA was highly expressed in various solid tumors and LUAD tissues compared to normal tissues（P＜0.05）．Comparing with the normal group，the expression of GRB14 was increased in LUAD（P＜0.01）via using UALCAN database and GEPIA database．The expression level of GRB14 protein in the LUAD tissues was significantly higher than that in the noncancerous LUAD tissues（LUAD［6.07±1.01］ vs benign，［4.80±1.22］；P＜0.01）in tissue microarray ．Median overall survival in the high and low GRB14 expression groups in LUAD was（41.59±5.2）and（88.67±16.69）months respectively．We plotted the ROC curves of 3-year survival rate and 5-year survival rate which again suggested that the model had good predictive performance．Univariate analysis revealed that individual cancer stages（Ⅲ-IV）（P＜0.01），tumor（T3-4）（P＜0.01），lymph node metastasis（N1-3）（P＜0.05）and GRB14 expression（P＜0.01）were risk factors affecting the median overall survival time of LUAD．According to Cox multiple regression analysis，we found that lymph node metastasis（N1-3）（P＜0.05）and GRB14 expression（P＜0.01）were risk factors affecting the median overall survival time of LUAD．Using TIMER database analysis，the mRNA level of GRB14 was significantly correlated with macrophages（r=-0.164，P＜0.01），neutrophils（r=-0.175，P＜0.01）and dendritic cells（r=-0.148，P＜0.01）．Through analysis of the String database，it was found that proteins that interacted with GRB14 including EGFR，HRAS，FGFR1，INSR，CNGA1，COBLL1，LYPLAL1，TNKS2，TNKS，PRKCZ．Conclusions The results of the present study suggest that GRB14 may efficiently predict poor survival in LUAD patients．
目的 探究血清多配体蛋白聚糖-1（SCD-1）与可溶性血管内皮生长因子受体-2（sVEGFR-2）表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法 选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果 Logistic回归分析显示,心功能分级（OR=3.433,95%CI：0.934~6.431）、B型脑钠肽升高（OR=2.462,95%CI：0.861~4.765）、血清SCD-1升高（OR=3.795,95%CI：0.972~6.894）、血清sVEGFR-2升高（OR=3.842,95%CI：0.942~6.912）为影响老年慢性心力衰竭患者预后不良的重要因素（P<0.05）;联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高（P<0.05）。结论 经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。
Objective To investigate the prognostic value of serum syndecan-1（SCD-1）and soluble vascular endothelial growth factor receptor-2（sVEGFR-2）expression levels in elderly patients with chronic heart failure. Methods A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024．Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure．Multiple logistic regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure. Results According to logistic retrospective analysis,heart function grading（OR=3.433,95%CI：0.934-6.431）,elevated B-type brain natriuretic peptide（OR=2.462,95%CI：0.861-4.765）,elevated serum SCD-1（OR=3.795,95%CI：0.972-6.894）,and elevated serum sVEGFR-2（OR=3.842,95%CI：0.942-6.912）were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05．The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05. Conclusions Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure．It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure．
目的 探讨转录因子E盒结合锌指蛋白1（ZEB1）、溶酶体相关膜蛋白5（LAMP5）在结直肠癌组织中的表达水平分析及预后预测价值。方法 选取驻马店市中心医院2018年1月—2020年1月收治的120例结直肠癌患者,分别采取所有患者的结直肠癌组织及癌旁组织进行免疫组化染色,对比ZEB1、LAMP5阳性率。对比不同病理特征结直肠癌患者ZEB1、LAMP5表达水平差异。对所有患者进行4年随访,依照随访结果将患者分为2个亚组,即预后不良组（n=35）和预后良好组（n=85）,对比两组患者一般临床特征及ZEB1、LAMP5表达水平,应用Logistic回归分析ZEB1、LAMP5对结直肠癌预后的预测价值。结果 结直肠癌组织ZEB1、LAMP5相对表达量（38.26±5.49、26.77±3.85）与ZEB1、LAMP5阳性率（86.67%、72.22%）高于癌旁组织（15.46±2.54、8.04±1.59、23.33%、15.56%],对比差异有统计学意义（t=41.280,χ2=25.437;t=49.255,χ2=16.071;P<0.05）。不同TNM分期[Ⅰ~Ⅱ期（35.55±4.13）、Ⅲ~Ⅳ期（42.32±4.75）]、淋巴结转移患者[是（44.37±4.28）、否（35.84±3.77）]、肿瘤分化程度[低分化（35.27±4.57）、中高分化（41.34±4.60）]ZEB1相对表达量对比差异有统计学意义（t=-8.281,P<0.001;t=10.746,P<0.001;t=-7.253,P<0.001）;不同TNM分期[Ⅱ期（24.88±3.37）、Ⅲ~Ⅳ期（29.61±2.57）]、淋巴结转移[是（30.72±2.19）、否（25.21±3.19）]、肿瘤分化程度[低分化（24.57±3.62）、中高分化（29.04±2.55）]患者LAMP5相对表达量对比差异有统计学意义（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,<0.001）;预后良好组与预后不良组患者性别、年龄、大体类型、肿瘤大小对比差异无统计学意义（P>0.05）,预后良好组与预后不良组患者TNM分期、淋巴结转移、肿瘤分化程度、ZEB1、LAMP5阳性比例对比差异有统计学意义（P<0.05）;Logistic回归分析显示：淋巴结转移、ZEB1阳性、LAMP5阳性为结直肠癌预后不良独立预测因素（P<0.05）。结论 ZEB1、LAMP5在结直肠癌组织中呈现高表达状态,且与结直肠癌的发生有关,同时ZEB1、LAMP5是结直肠癌预后的独立预测因素,两者有希望成为结直肠癌的治疗靶点。
Objective To investigate the expression levels and prognostic value of transcription factor E-box binding to zinc finger protein 1（ZEB1）and lysosomal associated membrane protein 5（LAMP5）in colorectal cancer tissues. Methods A total of 120 colorectal cancer patients admitted to a hospital from January 2018 to January 2020 were selected．Immunohistochemical staining was performed on the colorectal cancer tissues and adjacent tissues of all patients,and the positivity rates of ZEB1 and LAMP5 were compared．The expression levels of ZEB1 and LAMP5 in colorectal cancer patients with different pathological characteristics were compared．All patients were followed up for 4 years and divided into two subgroups based on the follow-up results,namely the poor prognosis group（n=35）and the good prognosis group（n=85）．The general clinical characteristics and expression levels of ZEB1 and LAMP5 were compared between the two groups．Logistic regression analysis was used to evaluate the predictive value of ZEB1 and LAMP5 for the prognosis of colorectal cancer. Results The relative expression level of ZEB 1 and LAMP 5 in colorectal cancer tissues [（38.26±5.49）,（26.77±3.85）] and the positive rate of ZEB 1 and LAMP 5（86.67%,72.22%）were significantly higher than that of adjacent tissues [（15.46±2.54）,（8.04±1.59）,23.33%,15.56%],the contrast difference was statistically significant（t=41.280,χ2=25.437;t=49.255,χ2=16.071;P<0.05）．Relative ZEBI expression levels in different TNM stages [I-Ⅱstage（35.55±4.13）,Ⅲ-Ⅳstage（42.32±4.75）],lymph node metastasis[Yes（44.37±4.28）,No（35.84±3.77）],degree of tumor differentiation [hypodifferentiated（35.27±4.57）,and middle or high differentiated（29.04±2.55）],those differences were statistically significant（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001）．The relative expression of LAMP 5 between different TNM stages [I-Ⅱstage（24.88±3.37）,Ⅲ-Ⅳstage（29.61±2.57）],lymph node metastasis [yes（30.72±2.19）,no（25.21±3.19）],degree of tumor differentiation [hypodifferentiated（24.57±3.62）,and middle or high differentiated（29.04±2.55）],the contrast was statistically significant（t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001）．There were no differences in gender,age,gross type,and tumor size between the good prognosis group and the poor prognosis group（P>0.05）,while there were differences in TNM stages,lymph node metastasis,tumor differentiation degrees,ratio of ZEB 1 and LAMP 5（P<0.05）．Logistic regression analysis showed that TNM stage,lymph node metastasis,ZEB 1 positive,and LAMP 5 positive were independent predictive factors of poor prognosis in colorectal cancer（P<0.05）. Conclusions ZEB1 and LAMP5 are highly expressed in colorectal cancer tissues and closely related to the occurrence and development of colorectal cancer．ZEB1 and LAMP5 are independent prognostic factors for colorectal cancer,and they have the potential to become therapeutic targets for colorectal cancer．
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．
目的 探讨TRIB2在结肠癌中的表达水平及与预后及免疫浸润之间的关系。方法 TIMER数据库分析TRIB2在泛癌种中的表达;TCGA、GSE17538下载结肠癌患者RNA-seq数据和临床信息,评估其与临床病理特征的相关性;生存曲线、单因素和多因素Cox分析探讨TRIB2与预后的相关性,并构建列线图;对TRIB2进行差异基因的富集分析;分析TRIB2表达水平与免疫细胞浸润、免疫检查点、肿瘤突变负荷（TMB）以及免疫治疗敏感性之间的相关性。结果 TRIB2在结肠癌组织中高表达（P<0.05）;CMS1结肠癌患者TRIB2 mRNA表达水平最高;TRIB2是结肠癌患者的独立预后因素（单因素Cox回归分析：HR=1.397,95%CI：1.100~1.774,P=0.006;多因素Cox回归分析：HR=1.502,95%CI：1.158~1.947,P=0.002）;TRIB2与免疫细胞的浸润密切相关,并且与免疫检查点分子表达水平以及TMB正相关（r=0.39,P<0.001）;TRIB2的表达水平与免疫检查点抑制剂的疗效相关。结论 TRIB2在结肠癌中高表达且与结肠癌患者预后差和免疫微环境密切相关。
Objective To explore the expression of TRIB2 in colon cancer and its relationship with prognosis and immune cell infiltration. Methods TIMER database was used to analyse the expression of TRIB2 in pan-cancer．RNA-seq data and clinical information of colon cancer patients were downloaded from TCGA and GSE17538 to assess the correlation between TRIB2 with clinicopathological features．Survival curves,univariate and multivariate COX regression analysis were performed to explore the correlation between TRIB2 and prognosis,and a nomogram was constructed．Gene enrichment analyses were performed for TRIB2．Correlations between TRIB2 expression and immune cell infiltration,immune checkpoints,tumor mutation burden（TMB）,and immunotherapy sensitivity were analyzed．Results TRIB2 was highly expressed in colon cancer tissues（P<0.05）．The highest level of TRIB2 mRNA expression was found in CMS1．TRIB2 was an independent prognostic factor for colon cancer patients（univariate Cox regression analysis：HR=1.397,95%CI：1.100-1.774,P=0.006;multivariate Cox regression analysis：HR=1.502,95%CI：1.158-1.947,P=0.002）．TRIB2 was closely associated with immune cell infiltration and positively correlated with the expression level of immune checkpoint molecules as well as TMB（r=0.39,P<0.001）．The expression of TRIB2 was correlated with the efficacy of immune checkpoint inhibitors．Conclusions TRIB2 is highly expressed in colon cancer and is closely associated with poor prognosis and the immune microenvironment of colon cancer patients．
