目的 探讨载脂蛋白E（ApoE）基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法 采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者（脑梗死组）和50例性别、年龄匹配的非缺血性脑卒中患者（对照组）。检测患者的 ApoE 基因型、血脂、美国国立卫生院卒中量表（NIHSS）、卒中后6个月简易智力状态检查量表（MMSE）等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果 ApoE 3/4基因型频率与Ɛ3、Ɛ4等位基因频率,在脑梗死组别中高于对照组（P<0.05）。同时,携带Ɛ3等位基因患者的低密度脂蛋白水平高于携带Ɛ2、Ɛ4等位基因的患者;进一步分析发现含Ɛ3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重（P<0.05）。结论 ApoE基因型为Ɛ3/4、等位基因Ɛ3、Ɛ4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者Ɛ3等位基因的频率较高,可能是卒中后认知障碍的易感因素。

Objective To explore the relationship between ApoE gene polymorphisms and post-stroke cognitive impairment,the severity of large artery atherosclerotic cerebral infarction．Methods A case-control research study was conducted,gathering data from 100 individuals diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University．Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group．The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations．Results Significant differences were observed in the ApoE 3/4 genotype frequency and Ɛ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former．Furthermore,patients carrying the Ɛ3 allele exhibited significantly higher LDL levels than those carrying Ɛ2 or Ɛ4．The analysis also revealed that patients with the Ɛ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment．Conclusions The findings suggest that the ApoE genotype Ɛ3/4 and allele Ɛ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction．Additionally,the Ɛ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment．

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．

目的 探讨长病程2型糖尿病（T2DM）患者体质指数（BMI）与胰岛β细胞功能间的相关关系。方法 选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程（病程≥10年）T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果 三组研究对象在空腹静脉血糖（FPG）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、尿酸（UA）、甘油三酯（TG）等上差异有统计学意义（P<0.05）,在胰岛β细胞功能指数（HOMA-β）比较差异无统计学意义（P>0.05）;肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组（P<0.05）,超重组的UA、TG均高于正常组（P<0.05）,肥胖组的FPG、HOMA-IR、UA高于超重组（P<0.05）,Spearman相关分析结果显示HOMA-β与体质量指数（BMI）无相关性（r=0.046,P=0.461）,HOMA-β与UA（r=0.226,P<0.001）、TG（r=0.148,P=0.017）呈正相关,HOMA-IR与BMI（r=0.279,P<0.001）与、UA相关（r=0.284,P<0.001）及TG（r=0.349,P<0.001）呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素（P<0.05）,BMI、UA、TG是HOMA-IR的影响因素（P<0.05）。结论 长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。

Objective To explore the correlation between body mass index（BMI）and islet β cell function in patients with long course type 2 diabetes mellitus（T2DM）．Methods A total of 260 patients with T2DM with a long course of disease（course≥10 years）admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI．Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed．Results There were statistically significant differences in fasting plasma glucose（FPG）,fasting C peptide（FCP）,homeostasis model assessment-insulin resistance（HOMA-IR）,uric acid（UA）and triglycerides（TG）among the three groups（P<0.05）,but no statistically significant differences in homeostatic model assessment of β-cell function（HOMA-β）（P>0.05）．The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group（P<0.05）;the levels of UA and TG in the overweight group were higher than those in the normal group（P<0.05）;the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight group（P<0.05）．Spearman correlation analysis showed that HOMA-β was not correlated with BMI（r=0.046,P=0.461）,but was positively correlated with UA and TG（r=0.226,P<0.001;r=0.148,P=0.017）,HOMA-IR was positively correlated with BMI,UA and TG（r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001）．Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β（P<0.05）,BMI,UA and TG were the influencing factors of HOMA-IR（P<0.05）． Conclusions In T2DM patients with long disease course,the level of insulin resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant．At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM．

目的 探讨院外延续性护理联合院内心理指导对重症烧伤患者创伤应激的影响。方法 选取2020年6月—2022年6月南开大学附属医院（天津市第四医院）重症烧伤科收治的86例重度烧伤患者为研究对象,应用随机数字表法将患者分为观察组与对照组,每组各43例。对照组采取常规护理,观察组在常规护理基础上增加院外延续性护理联合院内心理指导,评估患者的创伤应激指标[血清肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、β-内啡肽（β-ep）]、心理韧性程度、应对行为、创伤后成长水平,并分析患者创伤应激与心理韧性的相关性。结果 干预前,两组的TNF-α、IL-6、β-ep水平比较差异无统计学意义（P>0.05）;干预后,两组创伤应激相关指标水平均下降,且观察组降低幅度更大（P<0.05）。干预后,两组患者乐观性、力量性、坚韧性相关中文版创伤后成长评定量表（C-PTGI）评分均升高,且观察组更高（P<0.05）;Pearson相关性分析显示,TNF-α、IL-6、β-ep等创伤应激指标水平与心理韧性水平呈负相关（P<0.05）;干预后,两组患者积极应对特质应对方式问卷（TCSQ）评分均升高,观察组高于对照组,人消极应对评分均降低,观察组低于对照组（P<0.05）;干预后,两组患者人际关系、精神变化、生活欣赏、个人力量、新的可能相关C-PTGI评分分量表得分均升高,观察组高于对照组（P<0.05）。结论 对重度烧伤患者采取院外延续性护理联合院内心理指导能够降低患者的创伤后应激水平、消极应对评分,提升患者心理韧性程度、创伤后成长水平以及积极应对评分,且创伤后应激水平与心理韧性水平呈负相关。

Objective To explore the effect of out-hospital continuous nursing combined with in-hospital psychological guidance on traumatic stress in severe burn patients．Methods A total of 86 patients with severe burn treated in the Affiliated Hospital of Nankai University（Tianjin Fourth Hospital）from June 2020 to June 2022 were selected as the research objects．The patients were divided into observation group and control group by random number table method,with 43 cases in each group．The control group received routine care,and the observation group was supplemented with out-hospital continuous nursing and in-hospital psychological guidance on the basis of routine care．The traumatic stress indexes [serum tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,β-endorphin（β-ep）],psychological toughness,coping behavior and post-traumatic growth level of the patients were evaluated．The correlation between traumatic stress and mental toughness was analyzed．Results Before intervention,the levels of TNF-α,IL-6 and β-ep were not significantly different between the two groups（P>0.05）．After intervention,the levels of traumatic stress-related indicators were decreased between the two groups,and the reduction was greater in the observation group（P<0.05）．After intervention,C-PTGI scores related to optimism,strength and fortitude were increased in both groups,which were higher in observation group（P<0.05）．Pearson correlation analysis showed that the levels of TNF-α,IL-6,β-ep and other traumatic stress indexes were significantly negatively correlated with the levels of mental toughness（P<0.05）．After intervention,the positive coping TCSQ scores of both groups were increased,the observation group was higher,and the negative coping scores were decreased,while the observation group was lower（P<0.05）．After the intervention,the scores of interpersonal relationships,mental changes,life appreciation,personal strength,and new possibly relevant C-PTGI score subscale were increased in both groups,and higher in the observation group（P<0.05）．Conclusions The combination of out-hospital continuous nursing and in-hospital psychological guidance for severe burn patients can reduce the level of post-traumatic stress and negative response score of patients,and improve the level of mental toughness,post-traumatic growth and positive score of patients,and the level of post-traumatic stress is significantly negatively correlated with the level of mental toughness．

目的 分析产后出血预测评分与产妇凝血指标的相关性,以及出血预测评分对阴道分娩产后出血的预测效能。方法 采用回顾性研究,纳入2021年1月—2022年12月河南科技大学第二附属医院收治的136例阴道分娩产妇,根据产后出血情况,将合并产后出血的36例患者列为病例组,其余100例列为对照组,比较两组患者的产后出血预测评分及凝血指标,经Spearman相关性系数验证产后出血预测评分结果与凝血指标的相关性,依据实际出血情况,验证产后出血预测评分、各凝血指标对产后出血的预测效能。结果 病例组患者的产后出血预测评分为（7.33±2.46）分,D-二聚体（D-D）为（2.62±0.41）mg/L,均高于对照组[（6.14±2.06）分、（2.17±0.45）mg/L],纤维蛋白原（FIB）为（4.42±1.25）g/L,低于对照组（5.23±1.16）g/L;活化部分凝血活酶时间（APTT）为（37.44±10.25）s,凝血酶原时间（PT）为（15.45±4.12）s,凝血酶时间（TT）为（16.77±4.25）s,均高于对照组[（30.11±10.12）s、（12.49±4.11）s、（13.34±4.18）s],差异具有统计学意义（P<0.05）。经Spearman相关性系数分析,产后出血预测评分与经阴道分娩产妇的D-D、APTT、PT、TT呈正相关,与FIB呈负相关。通过绘制受试者工作特征曲线（ROC）后得知,产后出血预测评分及凝血指标对产后出血均有一定预测价值,但产后出血预测评分的AUC值大于各凝血指标。结论 产后出血预测评分与产妇凝血功能指标呈正相关,将产后出血预测评分与凝血指标检测相结合能实现对产后出血的早期识别及诊断。

Objective To analyze the correlation between postpartum bleeding prediction score and maternal blood coagulation index and the prediction efficiency of postpartum bleeding in vaginal delivery．Methods This is a retrospective study．The cases were included from January 2021 to December 2022．The subjects of the study were 136 vaginal delivery mothers． According to the delivery situation,36 patients with postpartum bleeding were included in the case group,and the rest 100 patients were included in the control group．The postpartum bleeding prediction score and coagulation indicators of the two groups were compared．The correlation between postpartum bleeding prediction score and coagulation indicators was verified by Spearman correlation coefficient．According to the actual bleeding situation,verify the predictive score for postpartum bleeding and the diagnostic efficacy of various coagulation indicators on postpartum bleeding．Results According to the test,the predictive score for postpartum bleeding in the case group was（7.33±2.46）,D-dimer（D-D）was（2.62±0.41）mg/L,which were higher than those in the control group [（6.14±2.06）,（2.17±0.45）mg/L]．Fibrinogen（FIB）was（4.42±1.25）g/L,lower than the control group（5.23±1.16）g/L,activated partial thromboplastin time（APTT）was（37.44±10.25）s,prothrombin time（PT）was（15.45±4.12）s,and thrombin time（TT）was（16.77±4.25）s．Compared with the control group [（30.11±10.12）s,（12.49±4.11）s,and（13.34±4.18）s）],the above indicators were all higher（P<0.05）．Through Spearman correlation coefficient analysis,the predictive score of postpartum bleeding was positively correlated with the D-D,APTT,PT,TT,negatively correlated with the FIB of the parturient who delivered through vagina．After drawing the ROC curve,it was found that both the postpartum hemorrhage prediction score and coagulation indicators had certain predictive value for postpartum hemorrhage,but the AUC value of the postpartum hemorrhage prediction score was greater than each coagulation indicator．Conclusions The prediction score of postpartum bleeding is positively correlated with the coagulation function indicators of the parturient,combining the score and indicators can achieve early identification and diagnosis of postpartum bleeding．

目的 调查与探讨高龄髋部骨折患者术后谵妄（POD）的发生因素,并提出相关处理对策。方法 选取2019年8月—2022年12月择在南阳市中医院独山院区进行手术治疗的高龄髋部骨折患者82例为研究对象,所有患者在术前1 d进行机械痛阈评定,在术后7 d判定患者的POD发生情况,进行POD与术前痛阈水平的相关性分析,并提出相关的处理对策。结果 术后7 d,82例患者中发生POD 12例（谵妄组）,占比14.6%,未发生POD 70例（非谵妄组）,占比85.37%。谵妄组的性别、体质指数、骨折类型、骨折至手术时间与非谵妄组对比差异无统计学意义（P>0.05）,谵妄组的年龄、术前血红蛋白水平、术前白蛋白水平与非谵妄组对比差异有统计学意义（P<0.05）。谵妄组的术前1 d的痛阈水平低于非谵妄组（P<0.05）。Spearman分析显示,POD与术前痛阈、年龄、术前血红蛋白、术前白蛋白均存在相关性（P<0.05）。Logistic回归分析显示,术前痛阈、年龄、术前血红蛋白、术前白蛋白等都为导致POD发生的影响因素（P<0.05）,要积极加强预防性护理干预。结论 高龄髋部骨折患者POD的发生率较高,患者的术前痛阈、年龄、术前血红蛋白、术前白蛋白等均为导致POD发生的影响因素,要积极加强预防性护理干预。

Objective To investigate and explore the factors leading to postoperative delirium（POD）in elderly patients with hip fractures,and to propose relevant handling measures．Methods From August 2019 to December 2022,82 cases of elderly patients with hip fractures who underwent surgical treatment in Nanyang Hospital of Traditional Chinese Medicine Dushan District were selected as the research subjects．All patients underwent mechanical pain threshold assessment 1 day before surgery,and their postoperative delirium were determined 7 days after surgery,followed by correlation analysis,and relevant handling measures were proposed．Results Seven days after surgery,there were 12 patients（delirium group）of POD,accounted for 14.6%,and 70 patients（non delirium group）without POD,accounted or 85.37%．There was no significant difference in genders,body mass index,fracture types and fracture to surgery time compared between the delirium group and the non delirium group（P>0.05）． However,there were significant differences in ages,preoperative hemoglobin levels and preoperative albumin levels compared between the delirium group and the non delirium group（P<0.05）．The pain threshold level of the delirium group on the first day before surgery was significantly lower than that of the non delirium group（P<0.05）．Spearman analysis showed that POD was associated with preoperative pain threshold,ages,preoperative hemoglobin and preoperative albumin levels（P<0.05）．Logistic regression analysis showed that the preoperative pain threshold level,ages,preoperative hemoglobin and preoperative albumin levels were all independent risk factors for the development of POD（P<0.05）,preventive nursing intervention should be actively strengthened．Conclusions The incidence of POD is high in elderly patients with hip fractures．Preoperative pain threshold level,age,preoperative hemoglobin and preoperative albumin levels are all factors that contribute to the occurrence of POD．It is necessary to actively strengthen preventive nursing interventions．

目的 探讨不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性。方法 选取天津市第一医院2020年10月—2023年10月收治的150例高血压患者作为研究对象,将患者分为：1级组（n=50）,即140~159 mmHg和（或）舒张压90~99 mmHg,2级组（n=60）,即收缩压160~179 mmHg和（或）舒张压100~109 mmHg,3级组（n=40）,即收缩压≥180 mmHg和（或）舒张压≥110 mmHg。测量所有患者收缩压加权标准差（SBP_wSD）和舒张压加权标准差（DBP_wSD）评价血压变异性,检测空腹血糖、空腹甘油三酯水平,计算空腹甘油三酯血糖指数（TyG）,以及记录丙二醛（MDA）、一氧化氮（NO）、内皮素-1（ET-1）、超氧化物歧化酶（SOD）水平对内皮功能进行评价。采用Spearman相关分析法分析血压变异性与空腹TyG及内皮功能的相关性。结果 1级组DBP_wSD、SBP_wSD低于2级组和3级组（P<0.05）;1级组空腹血糖、空腹甘油三酯、TyG低于2级组和3级组（P<0.05）;1级组MDA、ET-1低于2级组和3级组,NO、SOD高于2级组和3级组（P<0.05）; DBPwSD、SBPwSD与空腹血糖、空腹甘油三酯无关（P>0.05）,DBP_wSD、SBP_wSD与NO、SOD水平呈负相关,与TyG、MDA、ET-1呈正相关（P<0.05）。结论 不同血压分级的高血压患者血压变异性、TyG及血管内皮功能具有明显差异,且高血压患者血压变异性与TyG和血管内皮功能具有明显相关性。

Objective To explore the correlation between blood pressure variability and fasting triglyceride blood glucose index and endothelial function in different hypertension grades．Methods A total of 150 hypertensive patients admitted to our hospital from October 2020 to October 2023 were selected as study participants．Patients were classified into group level 1 （n=50）,with systolic blood pressure 140~159 mmHg and/or diastolic blood pressure 90~99 mmHg,group level 2（n=60）,with systolic blood pressure 160~179 mmHg and/or diastolic blood pressure 100~109 mmHg,and group level 3（n=40）,with systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg．SBPwSD and DBP_wSD of all patients were measured to assess their blood pressure variability．Fasting blood glucose and fasting triglyceride levels were measured to calculate TyG．MDA,NO,ET-1 and SOD were used to evaluate endothelial function．The correlation between blood pressure variability and glycemic index and endothelial function was analysed using Spearman correlation analysis．Results The DBP_wSD and SBP_wSD of the group level 1 were significantly lower than those of the groups level 2 and 3（P<0.05）．The fasting blood glucose,fasting triglycerides and TyG in the group level 1 were significantly lower than those in the groups level 2 and 3（P<0.05）．MDA and ET-1 values in the group level 1 were significantly lower than in the groups level 2 and 3,while NO and SOD values in the group level 1 were significantly higher than those in the other two groups（P<0.05）．DBP_wSD and SBP_wSD did not correlate significantly with fasting blood glucose and fasting triglycerides（P>0.05）,while DBP_wSD and SBP_wSD correlated negatively with NO and SOD values and correlated positively with TyG,MDA and ET-1（P<0.05）．Conclusions There are significant differences in blood pressure variability,TyG,and endothelial function among hypertensive patients with different grades,and there is a significant correlation between blood pressure variability and TyG and endothelial function in hypertensive patients．

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．

目的 探究25-羟维生素D[25-（OH）D]水平预测糖尿病周围神经病变发生的相关性。方法 选取2021年6月—2021年12月间在上海市静安区南京西路社区卫生服务中心就诊的200例2型糖尿病患者为研究对象,根据体格检查、血液生化、神经症状评分、肌电图等方法分为无周围神经病变组（n=153）和周围神经病变组（n=47）,对比两组患者的一般资料及血清基线25-（OH）D水平,分析25-（OH）D与糖尿病周围神经病变的相关性,采用Logistic回归分析25-（OH）D对糖尿病周围神经病变的预测价值。结果 两组患者基线25-（OH）D水平、空腹血糖、糖化血红蛋白（HbA_1c）、收缩压对比差异有统计学意义（P<0.001）,而年龄、性别、BMI、腰围、餐后血糖值、谷草转氨酶、空腹C肽、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、血肌酐、血尿酸、舒张压对比无明显差异（P>0.05）;基线25-（OH）D水平与密歇根糖尿病周围神经病变评分（MDNS）呈负相关（r=-0.583,P<0.001）,空腹血糖与MDNS评分呈正相关（r=0.303,P<0.001）;Logistic回归分析提示,25-（OH）D每增加一个单位,糖尿病周围神经病变风险下降25%,校正性别、年龄、HbA_1c、LDL后,相关性依然存在。结论 25-（OH）D水平与糖尿病周围神经病变呈负相关,与该病的发生及发展密切相关,血清25-（OH）D水平可作为预测尿病周围神经病变发生、发展的重要指标。

Objective To explore the correlation of 25-hydroxyvitamin D[25-（OH）D] level in predicting the occurrence of diabetic peripheral neuropathy．Methods A total of 200 patients with type 2 diabetes mellitus（T2DM）who were admitted to Community Health Service Center of West Nanjing Road,Jing’an District,Shanghai from June 2021 and December 2021 were selected as the study subjects．According to physical examination,blood biochemistry,neurological symptom score and electromyography,the patients were divided into two groups：no peripheral neuropathy group（n=153）and peripheral neuropathy group（n=47）．The general data and serum baseline 25-（OH）D levels of the two groups were compared to analyze the correlation between 25-（OH）D and diabetic peripheral neuropathy．The predictive value of 25-（OH）D in diabetic peripheral neuropathy was analyzed by Logistic regression．Results There were significant differences in baseline 25-（OH）D level,fasting blood glucose（FBG）,HbA_1c and SBP between two groups（P<0.001）,but no significant differences in age,sex,BMI,waist circumference,postprandial plasma glucose,AST,C-peptid total cholesterol,HDL-C,triglyceride,LDL-C,Scr,UA and DBP between two groups（P>0.05）．Baseline 25-（OH）D level was negatively correlated with MDNS score（r=-0.583,P<0.001）,and FBG was positively correlated with MDNS score（r=0.303,P<0.001）．Logistic regression analysis showed that the DPN risk decreased by 25% for every unit increase of 25-（OH）D,and the correlation remained after timely adjustment for sex,age,HbA_1c,and LDL-C．Conclusion sThe level of 25-（OH）D is negatively correlated with the occurrence and development of diabetic peripheral neuropathy,and the detection of serum 25-（OH）D level can be used as an important indicator to predict the occurrence and development of urinary peripheral neuropathy．

目的 探讨人外周血中炎症因子的表达与炎性衰老的相关性。方法 通过招募年轻和老年志愿者,检测外周血中炎症因子IL-6、IL-8、TNF-α和IL-1β的mRNA表达水平和蛋白水平。结果 显示老年个体组中IL-6,IL-8和TNF-α的mRNA表达水平高于年轻组,且蛋白水平呈现相同的趋势,比较差异均有统计学意义（P<0.05）。此外,通过热图分析了炎症因子mRNA和蛋白水平的相对表达谱,也发现相同的结果。结论 当年龄超过65岁以后,随着年龄的增长,体内的炎症因子表达水平会升高,这一结果具有成为炎性衰老生物标志物的潜力,对评估老年人的健康状况和疾病风险具有重要意义。

Objective To explore the correlation between the expression of inflammatory factors in human peripheral blood and inflamm-aging．Methods In this experiment,the young and old volunteers were recruited to detect mRNA and protein levels of IL-6,IL-8,TNF-α and IL-1β in peripheral blood．Results The results indicated that mRNA expression levels of IL-6,TNF-α and IL-8 in the old individuals were higher than the young individuals,and the protein concentration followed the same trend,with acceptable P value suggesting a great statistically significant difference．In addition,the relative expression profiles of mRNA and protein concentrations of inflammatory cytokines were analyzed by heat map,and the same results were found．Conclusions It shows that the expression level of inflammatory cytokines up-regulates along with age goes on over 65,which has the potential of inflammatory biomarkers of aging．