目的 对乳腺癌中血管内皮生长因子－C(VEGF－C)的表达与淋巴结转移及预后的关系展开研究分析。方法 随机选取我院接收救治的50例乳腺癌患者,采用免疫组化法检测50例患者乳腺癌中VEGF－C的表达情况,研究乳腺癌VEGF－C的表达与淋巴结转移及预后的关系。结果 50例乳腺癌患者中,淋巴结节转移组,VEGF－C阳性23例,阳性率92.0%;未见淋巴结节转移组,VEGF－C阳性10例,阳性率40.0%;淋巴结节转移组VEGF－C阳性表达率高于未见淋巴结节转移组;不同年龄、肿瘤直径以及病理分型的乳腺癌,VEGF－C阳性表达率差异无统计学意义(P均＞0.05);不同临床分期乳腺癌中,I~II期乳腺癌VEGF－C阳性表达率(58.1%)低于III~IV期VEGF－C阳性表达率(84.2%),数据差异有统计学意义(P＜0.05)。结论 早期检测乳腺癌中VEGF－C表达情况,能够为临床早期判定乳腺癌是否转移提供一项可测参考指标,对临床治疗、预后评估可起到一定参考价值。

Objective To make expand research and analysis for breast cancer and vascular endothelial growthfactor-C(VEGF-C)expression and lymph node metastasis and prognosis. Methods 50 cases of breast cancer patients were random collected in our hospital to detect the expression of VEGF-C in patients with breast cancer using immunohistochemical staining,the relationship between breast cancer VEGF-C expression and lymph node metastasis and prognosis. Results In 50 cases of breast cancer,lymph node metastasis group,VEGF-C positive in 23 cases,the positive rate is 92.0%;no lymph node metastasis group,VEGF-C positive in 10 cases,the positive rate is 40.0%;lymph node metastasis group VEGF-C positive expression rate was significantly higher than that no lymph node metastasis group;different age,tumor size and histological type of breast cancer,the VEGF-C positive expression rate difference was not statistically significant(P＞0.05);different clinical stages of breast cancer,I ~ II breast cancer VEGF-C positive expression rate(58.1%)was significantly lower than the III ~ IV of VEGF-C positive expression rate(84.2%),the data were statistically significant differences(P<0.05). Conclusion Early detection of breast cancer in the expression of VEGF-C can determine for early clinical metastasis of breast cancer,can provide a reference index for clinical treatment and prognosis.

目的 探讨肝脏脂肪变性对肝脏切除手术安全性及预后的影响。方法 选取2012年1月—2014年12月在我院接受肝切除术治疗的肝癌患者172例,根据HE染色结果,172例患者中无脂肪变性106例(对照组),轻度脂肪变性42例(轻度组),中重度脂肪 24例(中重度组),比较各组患者基本资料(性别、年龄等)、手术情况、生化指标、术后并发症、住院时间等。结果 三组患者体重指数(BMI)差异有统计学意义(P＜0.05),中重度组BMI最高,为(26.94±3.14)kg/m²;中重度组患者手术时间、术中出血量、输注红细胞和肝门阻断时间分别为(182.39±42.17)min、(553.07±50.22)mL、(1.18±0.34)U和(20.15±6.07)min,均高于其他两组(P＜0.05);中重度组患者重度并发症发生率为45.83%,高于对照组和轻度组的9.43%和9.52%(P＜0.05);中重度组住院时间和ICU时间分别为(23.06±7.30)d和(3.71±1.03)d,高于其他两组(P＜0.05)。结论 轻度肝脏脂肪变性对手术基本无影响,而中重度脂肪变性会增加手术时间和出血、重度并发症发生较多,不利于手术的安全性以及预后。

Objective To explore the effect of liver steatosis on liver resection safety and the prognosis. Methods Selected from January 2012 to December 2014 in our hospital liver resection of 172 cases of liver cancer patients, according to the results of HE staining, 172 patients without fatty degeneration in 106 cases (control group), 42 cases of mild steatosis (mild steatosis group), 24 cases of severe fatty (moderate and severe steatosis group),observed each group patients the clinical characteristics, surgery situation, biochemical index, postoperative complications, hospitalization time, etc. Results Body mass index(BMI)of patients in the three groups difference was statistically significant (P<0.05), moderate and severe steatosis group had the highest BMI (26.94±3.14)kg/m²; in moderate and severe steatosis group, surgery time, intraoperative bleeding volume, infusion of red blood cells and hepatic portal occlusion time were (182.39±42.17) min, (553.07±50.22) ml, (1.18±0.34) U and (20.15±6.07) min. They were significantly higher than that of the control group and mild steatosis group (P<0.05); moderate and severe steatosis patients with severe complication rate was 45.83%,significantly higher than that in the control group and the mild steatosis 9.43% and 9.52%. The difference was statistically significant (P<0.05); In moderate and severe steatosis group, hospitalization time and ICU were (23.06±7.30) d and(3.71±1.03) d, significantly higher than that in the control group and the mild steatosis group(P<0.05). Conclusion Mild liver steatosis have no effect on the surgery, severe liver steatosis may increase the surgery time and bleeding, severe complications occurred more, is not conducive to the safety of the surgery and prognosis.

      目的    分析拔除导致邻牙牙根外吸收（ERR）的埋伏阻生第三磨牙后ERR患牙的预后情况及影响因素。方法   对32例埋伏阻生第三磨牙挤压致ERR的患牙，在拔除阻生第三磨牙后，通过临床症状、电活力测试观察第二磨牙牙髓的预后，根据其预后不同，分为保髓成功组及保髓失败组，比较两组的基本信息（年龄、性别）、患牙部位、牙根吸收类型，分析影响ERR患牙预后的相关因素。结果   下颌ERR患牙保髓成功率（91.67%）高于上颌ERR患牙（62.50%）（P=0.085），牙根吸收未及髓腔的患牙保髓成功率（100%）高于牙根吸收及髓腔的患牙（70.59%）（P=0.046），两组间的基本信息比较差异无统计学意义（P＞0.05）。结论   当患牙牙根吸收未及牙髓时或患牙位于下颌时，拔除埋伏第三磨牙后ERR患牙预后相对良好，故应尽早拔除已导致ERR发生的埋伏阻生第三磨牙。

       Objective  To analyze the prognosis and influencing factors of external root resorption（ERR）of adjacent teeth after the removal of impacted third molar that caused ERR．Methods  Thirty-two cases of impacted third molars with external root resorption caused by compression were treated．After the extraction of the impacted third molars，the prognosis of the pulp of the second molars was observed through clinical symptoms and electrical activity tests．According to their different prognoses，they were divided into a successful pulp preservation group and a failed pulp preservation group．The basic information（age，gender），affected tooth location，and root resorption type of the two groups were compared，and the relevant factors affecting the prognosis of ERR patients were analyzed．Results  The success rate of pulp preservation for mandibular ERR patients（91.67%）was higher than that for maxillary ERR patients（62.50%）（P=0.085），and the success rate of pulp preservation for ERR not involving pulp cavity（100%）was higher than that for ERR involving pulp cavity（70.59%）（P=0.046）．There was no significant difference in basic information between the two groups（P＞0.05）．Conclusions  When the root resorption of the affected tooth does not reach the pulp or when the affected tooth is located in the lower jaw，the prognosis of the affected tooth after the impacted third molar removed is good．Therefore，the impacted third molar should be removed as soon as possible to prevent ERR from occurring．

       目的   探讨、对比休克指数（SI）与血乳酸水平预测院前创伤性休克患者预后中的应用。方法   于2020年12月—2023年12月收治80例创伤性休克患者，均接受SI、乳酸水平的监测。结合监测的结果进行分组：乳酸正常组：乳酸水平在2 mmol/L以下，升高组：2 mmol/L以上；SI正常组：SI在0.9以下，升高组：SI在0.9以上。观察、记录患者入院7 d后的序贯性器官功能衰竭评分（SOFA），对多器官功能障碍综合征（MODS）情况进行评估。同时观察、记录机械通气、血管活性药物的使用和住院等情况。结果   乳酸水平升高组60例，正常组20组；SI升高组58例，正常组22例，女性乳酸水平、SI，与男性比较差异无统计学意义（P＞0.05）。是否发生多器官功能障碍者的年龄、性别、SI指数比较差异无统计学意义（P＞0.05）；格拉斯哥昏迷评分（GCS）评分［（4.22±1.53）分 vs （9.46±3.82）分，t=7.816，P＜0.001］、住院时间［（23.34±5.71）d vs （12.26±2.11）d，t=11.830，P＜0.001］、基础乳酸值［（4.75±2.36）mmol/L vs （2.04±1.11）mmol/L，t=6.721，P＜0.001］与发生MODS在组间对比差异有统计学意义。SI升高组的容量复苏收缩压＞80 mmHg（%）有27例，与乳酸水平升高组比较差异有统计学意义（P＜0.05）（46.55% vs 18.18%，χ ² =12.237，P＜0.001）。乳酸水平升高组中，11例患者接受机械通气，乳酸水平均升高（P＜0.05）；9例患者使用血管活性药物，乳酸水平均升高，比较差异无统计学意义（P＞0.05）；38例住院患者，24例乳酸水平升高（P＜0.05）。13例患者接受机械通气，12例SI升高，比较差异无统计学意义（P＞0.05）；11例患者接受血管活性物治疗，8例SI升高，比较差异无统计学意义（P＞0.05）；39例患者住院，SI升高22例，比较差异有统计学意义（P＜0.05）。结论   针对重症的创伤性休克患者，当血乳酸水平升高时会大大增加MODS发生的概率，乳酸水平在对重症创伤性休克患者预后进行预测时，应用价值更高。

       Objective  To explore and compare the application of shock index（SI）and  blood lactic acid level in predicting the prognosis of patients with pre-hospital traumatic shock．Methods  From December 2020 to December 2023，80 patients with traumatic shock were enrolled，and their SI and levels of lactic acid were monitored．Patients were grouped according to the monitoring results：normal group：lactic acid level below 2 mmol/L，increased group：above 2 mmol/L；normal group：SI below 0.9，and increased group：SI above 0.9．The sequential organ failure score（SOFA）was observed and recorded 7 days after hospitalization，and the situation of multiple organ dysfunction syndrome（MODS）was evaluated．At the same time，mechanical ventilation，the use of vasoactive substances and hospitalization were observed and recorded．Results  There were 60 cases in the group with increased lactic acid level and 20 cases in the normal group．There were 58 cases of increased SI and 22 cases of normal．The lactic acid level and SI index in women were higher than those in men，with no difference（P＞0.05）．There were no differences in age，sex，SI index and the incidence of MODS（P＞0.05）．GCS score（4.22±1.53 vs 9.46±3.82），hospitalization days（23.34±5.71 vs 12.26±2.11）d，basal lactate value（4.75±2.36 vs 2.04±1.11）mmol L-1 were significantly different from those of MODS（t=11.830，P＜0.001；t=6.721，P＜0.001，P＜0.05）．There were 27 cases with volume  resuscitation systolic blood pressure ＞ 80 mmhg（%）in the group with increased SI，which was different from that of SI and lactic acid（46.55% vs18.18%，χ ² =12.237，P＜0.001；P＜0.05）．Lactic acid increased group：11 patients received mechanical ventilation，and the lactic acid levels of all 11 patients increased（P＜0.05）．Nine patients used vasoactive substances，and their lactic acid levels all increased，with no significant difference（P＞0.05）．Of the 38 inpatients，24 cases had elevated lactic acid levels（P＜0.05）．Thirteen patients received mechanical ventilation，and 12 patients had elevated SI，with no statistical significance（P＞0.05）．Eleven patients were treated with vasoactive agents，and 8 patients had increased SI，with no difference（P＞0.05）．Among the 39 patients hospitalized，22 cases had increased SI，and the difference was statistically significant（P＜0.05）．Conclusions  For patients with severe traumatic shock，when the blood lactic acid level increases，the probability of MODS will be greatly increased．Compared with SI index，lactic acid level has higher application value in predicting the prognosis of patients with severe traumatic shock．

       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．

       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   探讨清醒镇静应用在急性缺血性脑卒中血管内治疗中的效果。方法   选择2020年1月—2023年3月医院接收的急性缺血性脑卒中患者82例进行研究，按随机数表法分为2组，每组各41例，两组采取溶栓与取栓治疗，对照组采取全身麻醉方式，观察组采取清醒镇静方式，记录两组治疗相关参数，比较两组近期疗效、并发症发生情况及预后。结果   观察组入院到腹股沟穿刺时间（95.52±3.63）min、穿刺至血管再通时间（72.25±5.58）min低于对照组（112.25±4.18）min、（102.45±10.63）min（t=19.349，P＜0.05）；观察组ICU时间（7.81±2.63）d、住院时间（13.75±3.64）d，与对照组（8.05±2.81）d、（14.52±4.07）d比较差异无统计学意义（t分别为0.524、0.399、0.902，P分别为0.601、0.690、0.369）。观察组近期总有效39例（95.12%）与对照组37例（90.24%）比较差异无统计学意义（χ ² =0.719，P=0.396）。观察组症状性颅内出血3例（7.32%）与对照组6例（14.63%）比较差异无统计学意义（χ ² =1.123，P=0.289）；观察组脑水肿4例（9.76%）、坠积性肺炎12例（29.27%），低于对照组7例（17.07%）、18例（43.90%）（χ 2分别为4.969、6.962，P分别为0.025、0.008）。观察组预后良好21例（51.22%）高于对照组10例（24.39%）（χ ² =6.275，P=0.012）。结论   急性缺血性脑卒中患者溶栓与取栓治疗中采取清醒镇静方式可获得与全身麻醉相近的疗效，而且可进一步缩短治疗时间，促进血管快速再通，减少相关并发症，使患者获得更好的预后。

       Objective  To investigate the conscious sedation effect of endovascular treatment in acute ischemic stroke．Methods  A total of 82 patients with acute ischemic stroke admitted to the hospital from January 2020 to March 2023 were selected and divided into two groups according to the random number table method，with 41 cases in each group．The two groups were treated with thrombolysis and thrombectomy，the control group was treated with general anesthesia，and the observation group was treated with conscious sedation．The short-term efficacy，complications and prognosis were compared between the two groups．Results  The time from admission to groin puncture ［（95.52±3.63）min］ and time from puncture to vascular  recanalization ［（72.25±5.58）min］ in the observation group were significantly lower than those in the control group ［（112.25±4.18）min，（102.45±10.63）min］（t=19.349，P＜0.05）．Observation group ICU time，length of hospital stay（7.81+2.63）d（13.75+3.64）d，and the control group（8.05+2.81）d，（14.52-4.07）d  had  no  statistically  significant  difference in comparison（t were 0.524，0.399，0.902，P were 0.601，0.690，0.369）．Recent total effective cases observation in group was 39（95.12%）and control group was 37（90.24%），there was no statistically significant difference comparing（χ ² =0.719，P=0.396）．Observation group had symptomatic intracranial hemorrhage in three patients（7.32%）and control group had six cases（14.63%），there was no statistically significant difference（χ ² =1.123，P=0.289）．There were four cases（9.76%）of brain edema and 12 cases（29.27%）of hypostatic pneumonia in the observation group，which were significantly lower than seven cases（17.07%）and 18 cases（43.90%）in the control group（χ ² =4.969，6.962，P=0.025，0.008）．The number of patients with good prognosis in the observation group（21 cases，51.22%）was significantly higher than that in the control group（10 cases，24.39%）（χ ² =6.275，P=0.012）．Conclusions In the treatment of acute ischemic stroke patients with thrombolysis and thrombectomy，conscious sedation can achieve the same efficacy as general anesthesia，and can further shorten the treatment time，promote  rapid recanalization of blood vessels and reduce related complications，so that patients can get a better prognosis．

       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，χ ² =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，P＜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，χ ² =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．

      目的 探讨老年营养风险指数（GNRI）与慢性阻塞性肺疾病者急性加重期患者预后的相关性。方法 选择贵州省六盘水水旷医院2019年1月—2022年1月收治的COPD急性加重期患者，根据GNRI值，分为正常营养组（GNRI＞98）和营养不良组（GNRI≤98），应用生存曲线和Cox比例风险回归评估营养状况与死亡率之间的关联。结果 共纳入198例COPD急性加重期患者，正常营养组90例，营养不良组108例，营养不良发生率为54.5%；Kaplan-Meier曲线表明，营养不良组的全因累积死亡率更高（58.3% vs 35.0%，P＜0.001）。Cox比例风险回归分析显示在未校正模型中，HR为2.31（1.25~4.28），P＜0.001。在完全校正模型中，HR为2.48（1.37~4.51），P=0.005，提示与正常营养状况相比，营养不良与全因死亡风险升高相关。结论  GNRI低是COPD患者急性加重期全因死亡的独立危险因素。

      Objective  To investigate the correlation between elderly nutritional risk index（GNRI）and prognosis of patients with AECOPD．Methods  Patients with AECOPD admitted to our hospital from January 2019 to January 2022 were selected and divided into normal nutrition group（GNRI＞98）and malnutrition group（GNRI≤98）according to GNRI value．Survival curve and Cox regression were used to evaluate the association between nutritional status and mortality．Results  A total of 198 patients with AECOPD were included in this study．According to GNRI scores，90 patients were in the normal nutrition group and 108 were in the malnutrition group，with malnutrition incidence of 54.5%．The Kaplan-Meier curve showed that the cumulative all-cause mortality was higher in the malnutrition group（58.3% vs 35%，P＜0.001）．Cox proportional hazard  regression analysis showed that HR in the uncorrected model was 2.31（1.25-4.28），P＜0.001．In the fully corrected model，HR was 2.4（1.37-4.51）and P=0.005，suggesting that malnutrition was associated with a significantly higher risk of all-cause mortalitycompared with normal nutritional status．Conclusions  Low GNRI is an independent risk factor for all-cause death in AECOPD patients．