目的 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经(PENG)阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例,随机分为两组,A 组(38例)行PENG阻滞联合椎管内麻醉,C 组(38例)行椎管内麻醉。比较两组入室(T0)、摆放体位时(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)静息和活动状态的数字等级评定量表(NRS)疼痛评分;术后非甾体抗炎药及阿片类药物补救次数;术后 6 h、24 h患侧股四头肌徒手肌力分级(MMT);首次下床活动时间、住院时间。结果 A组T1~T4时刻静息状态NRS疼痛评分分别为2(1,3)分、1(1,2)分、2(1,2)分、3(2,4)分均低于C组的5(4,7)分、4(3,5)分、5(3,6)分、4(2,6)分,比较差异有统计学意义(均P<0.001);A组T1~T4时刻活动状态NRS疼痛评分分别为5(4,7)分、3(2,4)分、4(3,5)分、6(4,7)分均低于C组的10(9,10)分、8(6,9)分、8(7,9)分、9(8,10)分,比较差异有统计学意义(均P<0.001)。A组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.01);C组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.05);A组在T1~T4时的活动状态NRS疼痛评分均低于T0时的(均P<0.001);C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的(均P<0.01)。A组术后非甾体抗炎药及额外阿片类药物补救次数为4(0,8)、2(0,3)次,均低于C组的15(7,19)、5(3,7)次,比较差异有统计学意义(均P<0.001)。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义(P>0.05)。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛,不影响其术后下肢肌力。
Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group(PENG)block combined with spinal-epidural anesthesia in hip joint surgery for frail patients.Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups:Group A(38 cases)received PENG block combined with intraspinal anesthesia,while Group C(38 cases)received only intraspinal anesthesia.The numerical rating scale(NRS)pain scores of resting and active states were compared between the two groups at the time of entering the room(T0),placing the position(T1),6 hours after surgery(T2),12 hours after surgery(T3),and 24 hours after surgery(T4).Postoperative non-steroidal drugs and opioids remedy times,muscle strength grading(MMT)of quadriceps femoris at 6 hours and 24 hours after operation,and the first time out of bed activity time,hospitalization time were also compared.Results The resting NRS pain scores at T1-T4 in Group A were 2(1,3),1(1,2),2(1,2)and 3(2,4),respectively,which were lower than 5(4,7),4(3,5),5(3,6)and 4(2,6)in Group C,and the difference was statistically significant(all P<0.001).The NRS pain scores at T1-T4 in Group A were 5(4,7),3(2,4),4(3,5)and 6(4,7),respectively,which were lower than 10(9,10),8(6,9),8(7,9)and 9(8,10)in Group C,and the difference was statistically significant(all P<0.001).The resting NRS pain score of Group A at T1-T4 was lower than that at T0(all P<0.01);the resting NRS pain score of Group C at T1-T4 was lower than that at T0(all P<0.05).The NRS pain scores at T1-T4 in Group A were lower than those at T0(all P<0.001);the NRS pain scores at T1 and T2 in Group C were lower than those at T0(all P<0.01).The number of postoperative non-steroidal drugs and additional opioids in group A(4[0,8],2[0,3])was lower than that in Group C(15[7,19],5[3,7]),and the difference was statistically significant(all P>0.001).There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation,the first time of getting out of bed and the number of days of hospitalization between the two groups(P>0.05).Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength.
目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料,按照7︰3比例随机化分为训练列(293例)和验证队列(126例)。统计基于开发队列数据,采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素,并构建风险预测模型。基于开发队列和验证队列数据,采用校准曲线、受试者操作特征(ROC)曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎,发生率为26.97%。美国国立卫生研究院卒中量表(NIHSS)评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值(NPAR)、中性粒细胞计数与淋巴细胞计数比值(NLR)、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素(P<0.05)。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型,校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近;ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906(95%CI:0.867~0.937)、0.884(95%CI:0.815~0.934);决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。
Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage(ICH)and validate the predictive performance of the model.Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022.They were randomly divided into a development cohort(293 cases)and a validation cohort(126 cases)according to a 7∶3 ratio.The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data,and a risk prediction model was constructed.Based on the development cohort data and validation cohort data,the predictive performance of the model was analyzed using calibration curves,receiver operating characteristic(ROC)curve,and decision curve analysis.Results Among 419 patients,113 developed stroke associated pneumonia,with a rate of 26.97%.The National Institutes of Health Stroke Scale(NIHSS)score,swallowing difficulties,initial hematoma volume,neutrophil percentage to albumin ratio(NPAR),neutrophil count to lymphocyte count ratio(NLR),surgical treatment,endotracheal intubation,and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH(P<0.05).Based on the above influencing factors,a risk prediction model for stroke associated pneumonia in patients with ICH was constructed.The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence.The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906(95%CI:0.867-0.937)and 0.884(95%CI:0.815-0.934),respectively.The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%,and the threshold probability of the validation cohort was between 2%-76%,the intervention using this model was more clinically valuable than all/no intervention.Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score,swallowing difficulties,initial hematoma volume,NPAR,NLR,surgical treatment,tracheal intubation,and indwelling gastric tube has good predictive performance and clinical application value.
目的 分析药品集中带量采购(集采)政策下医院药品供应保障实况,提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据,描述性统计分析集采药品供应情况。结果 采购的416个中标药品中,69个在购销合同期内短缺,短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关,季节性强,以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力,保障供应。
Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement(hereinafter referred to as “central procurement”),and proposes optimization strategies and suggestions for the policy and guarantee.Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024,descriptive statistical analysis of the drug supply situation through centralized procurement was conducted.Results Among the 416 selected drugs purchased,69 were in short supply during the contract period,with a shortage rate of 16.59%.The reasons for the shortage were related to the production capacity of the enterprise,seasonal demand fluctuations,strong seasonality,and mainly chronic diseases and anti-infective.Conclusions It is suggested to build a monitoring platform,improve the reporting system,formulate emergency plans,and evaluate the supply capacity to ensure supply.
心肌纤维化是心力衰竭等心血管疾病演化过程中的关键性病理改变,该病的进展机制依赖巨噬细胞与成纤维细胞的相互调控。现有现代医学研究证实巨噬细胞可凭借M1、M2表型极化行为介导炎症反应与组织修复过程,成纤维细胞能够分化形成肌成纤维细胞并推动细胞外基质异常沉积,两类细胞可依托TGF-β/Smad、CSF-1/CSF-1R等信号通路构建相互调控的作用网络并介导心肌纤维化恶化。中医痰瘀互结病机理论指出痰浊与瘀血可相互滋生、交织阻滞,是各类慢性迁延性疾病的关键发病基础。本文以中医痰瘀互结理论为研究切入点,剖析该病机理论与巨噬细胞、成纤维细胞交互作用的内在关联,整合现代医学关于两种细胞交互作用的现有研究成果,深入分析细胞互作在心肌纤维化发病过程中的协同机制与病理关联,旨在为心肌纤维化的中西医协同防治提供理论依据,为相关动物实验及临床应用研究筑牢研究基础。
Myocardial fibrosis is a key pathological change in the progression of cardiovascular diseases such as heart failure. The progression mechanism of this disease relies on the reciprocal regulation between macrophages and fibroblasts. Current modern medical research has confirmed that macrophages can mediate inflammatory responses and tissue repair processes through M1 and M2 phenotypic polarization behaviors, and fibroblasts can differentiate into myofibroblasts and promote abnormal extracellular matrix deposition. The two types of cells can construct a reciprocal regulatory network through signaling pathways such as TGF-β/Smad and CSF-1/CSF-1R, thereby mediating the deterioration of myocardial fibrosis. The theory of phlegm and blood stasis intermingling in traditional Chinese medicine suggests that phlegm turbidity and blood stasis can mutually generate and interweave to cause obstruction, serving as a key pathological basis for various chronic and persistent diseases. This article takes the traditional Chinese medicine theory of phlegmblood stasis intermingling as a research entry point, analyzes the intrinsic relationship between this pathological theory and the interaction of macrophages and fibroblasts, integrates existing modern medical research findings on the interaction between the two cell types, and deeply analyzes the synergistic mechanisms and pathological correlations of cellcell interactions in the pathogenesis of myocardial fibrosis. The aim is to provide a theoretical basis for the integrated traditional Chinese and Western medicine prevention and treatment of myocardial fibrosis, and also to lay a solid research foundation for related animal experiments and clinical application studies.
心肌纤维化是心力衰竭等心血管疾病演化过程中的关键性病理改变,该病的进展机制依赖巨噬细胞与成纤维细胞的相互调控。现有现代医学研究证实巨噬细胞可凭借M1、M2表型极化行为介导炎症反应与组织修复过程,成纤维细胞能够分化形成肌成纤维细胞并推动细胞外基质异常沉积,两类细胞可依托TGF-β/Smad、CSF-1/CSF-1R等信号通路构建相互调控的作用网络并介导心肌纤维化恶化。中医痰瘀互结病机理论指出痰浊与瘀血可相互滋生、交织阻滞,是各类慢性迁延性疾病的关键发病基础。本文以中医痰瘀互结理论为研究切入点,剖析该病机理论与巨噬细胞、成纤维细胞交互作用的内在关联,整合现代医学关于两种细胞交互作用的现有研究成果,深入分析细胞互作在心肌纤维化发病过程中的协同机制与病理关联,旨在为心肌纤维化的中西医协同防治提供理论依据,为相关动物实验及临床应用研究筑牢研究基础。
Myocardial fibrosis is a key pathological change in the progression of cardiovascular diseases such as heart failure. The progression mechanism of this disease relies on the reciprocal regulation between macrophages and fibroblasts. Current modern medical research has confirmed that macrophages can mediate inflammatory responses and tissue repair processes through M1 and M2 phenotypic polarization behaviors, and fibroblasts can differentiate into myofibroblasts and promote abnormal extracellular matrix deposition. The two types of cells can construct a reciprocal regulatory network through signaling pathways such as TGF-β/Smad and CSF-1/CSF-1R, thereby mediating the deterioration of myocardial fibrosis. The theory of phlegm and blood stasis intermingling in traditional Chinese medicine suggests that phlegm turbidity and blood stasis can mutually generate and interweave to cause obstruction, serving as a key pathological basis for various chronic and persistent diseases. This article takes the traditional Chinese medicine theory of phlegmblood stasis intermingling as a research entry point, analyzes the intrinsic relationship between this pathological theory and the interaction of macrophages and fibroblasts, integrates existing modern medical research findings on the interaction between the two cell types, and deeply analyzes the synergistic mechanisms and pathological correlations of cellcell interactions in the pathogenesis of myocardial fibrosis. The aim is to provide a theoretical basis for the integrated traditional Chinese and Western medicine prevention and treatment of myocardial fibrosis, and also to lay a solid research foundation for related animal experiments and clinical application studies.
冠心病是临床高发的心血管疾病,其病理核心为动脉粥样硬化,而炎症反应异常激活是推动病变进展的关键驱动力。PI3K/Akt通路通过调控炎症反应等,在CHD进程中发挥双向调节作用。现代研究表明,该通路保护性激活不足可加剧血管内皮损伤与斑块不稳定性,而炎症反应的持续又可进一步抑制PI3K/Akt通路活性,形成恶性循环。当动脉粥样斑块破裂,AMI发生后炎症级联反应放大,该通路异常激活,诱发MIRI。“荣泣卫除”出自《黄帝内经》,指营气耗损(荣泣)、卫气失守(卫除),荣卫失和则气血运行不畅、脉络瘀阻。本团队结合该理论与现代研究,认为CHD中PI3K/Akt通路介导的异常炎症反应的病理机制,与“荣泣卫除”理论内涵存在对应关系。研究发现,通过调控PI3K/Akt通路活性,抑制炎症因子激活与炎症蛋白表达,可抑制CHD发生发展进程。故本文基于“荣泣卫除”理论,系统梳理了PI3K/Akt通路介导的炎症反应在CHD中的作用及与中医病机的内在关联,总结中医药防治的研究进展,为中西医结合防治CHD提供参考依据。
Coronary heart disease is a clinically prevalent cardiovascular disease, with atherosclerosis as its core pathology. Abnormal activation of the inflammatory response is a key driving force for disease progression. The PI3K/Akt pathway exerts bidirectional regulatory effects on the progression of CHD by modulating inflammatory responses, among other functions. Modern studies indicate that insufficient protective activation of this pathway can exacerbate vascular endothelial injury and plaque instability, while persistent inflammation further suppresses PI3K/Akt pathway activity, forming a vicious cycle. Following atherosclerotic plaque rupture and the onset of AMI, the inflammatory cascade is amplified, leading to aberrant activation of this pathway and triggering MIRI. The theory of "depletion of nutritive level and exhaustion of defensive level" originates from the?Yellow Emperor's Inner Classic, referring to the depletion of nutritive level (Rong Qi) and the exhaustion of defensive level (Wei Qi), resulting in disharmony between nutritive and defensive levels, which impedes the smooth flow of Qi and blood and causes stasis in the collaterals. By integrating this theory with modern research, our team proposes a correspondence between the pathological mechanism of abnormal PI3K/Akt pathway-mediated inflammatory response in CHD and the theoretical connotation of "depletion of nutritive level and exhaustion of defensive level". Studies have found that modulating PI3K/Akt pathway activity to inhibit the activation of inflammatory factors and expression of inflammatory proteins can suppress the occurrence and progression of CHD. Therefore, based on the theory of "depletion of nutritive level and exhaustion of defensive level", this paper systematically reviews the role of the PI3K/Akt pathway-mediated inflammatory response in CHD and its intrinsic relationship with traditional Chinese medicine pathogenesis, summarizes research progress in TCM prevention and treatment, and provides a reference for the integrated traditional Chinese and Western medicine management of CHD.
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.
目的 基于结构方程模型(SEM)验证早产儿母亲育儿胜任感的多路径作用机制。方法 采用便利抽样法选取2024年6月—2025年6月在莆田学院附属医院分娩的早产儿母亲250例作为研究对象。采用一般资料调查表、中文版育儿胜任感量表(C-PSOC)、婴儿母亲育儿支持问卷(PSM)、角色适应问卷、简式亲职压力量表收集数据。通过单因素分析及多元线性回归分析母亲育儿胜任感的影响因素,使用AMOS软件构建结构方程模型,分析早产儿分娩后母亲育儿胜任感的作用路径。结果 250例早产儿母亲的C-PSOC得分为(61.93±6.02)分,多元线性回归分析结果显示,早产儿母亲育儿胜任感的影响因素包括产次、育儿支持、角色适应、亲职压力(均P<0.05)。结构方程模型拟合良好(χ 2 /df=1.026,GFI=0.987,AGFI=0.978,NFI=0.987,CFI=1.000,RMSEA=0.010),其中角色适应正向预测育儿胜任感(β=0.344),育儿支持(β=-0.477)与亲职压力(β=-0.283)负向预测(均P<0.05),并且角色适应通过育儿支持、亲职压力间接提升育儿胜任感(效应值0.467);产次经角色适应间接降低压力源影响(效应值0.529)。结论 早产儿母亲育儿胜任感受多路径机制调控,临床需针对角色适应、育儿支持及亲职压力设计级联干预策略。
Objective To verify the multi-pathway mechanism of parenting competence of premature infant mothers based on structural equation modeling(SEM).Methods A convenience sampling method was used to select 250 mothers of preterm infants who delivered in Affiliated Hospital of Putian University between June 2024 and June 2025 as the study subjects.Data was collected using a general information survey,the Chinese version of the Parenting Sence of Competence Scale(C-PSOC),the Parenting Support Questionnaire for Infant Mothers(PSM),the Role Adaptation Questionnaire,and the Simplified Parenting Stress Scale.By conducting single factor analysis and multiple linear regression analysis on the influencing factors of maternal parenting competence,a structural equation model was constructed using AMOS software to analyze the pathway of maternal parenting competence after premature birth.Results The C-PSOC score of 250 mothers of premature infants was(61.93±6.02).Multiple linear regression analysis showed that the influencing factors of parenting competence among mothers of premature infants included parity,parenting support,role adaptation,and parental pressure(all P<0.05).The structural equation model fits well(2/df=1.026,GFI=0.987,AGFI=0.978,NFI=0.987,CFI=1.000,RMSEA=0.010),which role adaptation positively predicted parenting competence(β=0.344),parenting support(β=-0.477)and parenting stress(β=-0.283)negatively predicted(all P<0.05),and role adaptation indirectly enhanced parenting competence through parenting support and parenting stress(effect value 0.467).The adaptation of roles during childbirth indirectly reduced the impact of stressors(effect value 0.529).Conclusions The multi-pathway mechanism of parental competence perception regulation in premature infant mothers requires the design of cascading intervention strategies targeting role adaptation,parenting support,and parental stress in clinical practice.
纤毛是细胞表面的重要细胞器,广泛参与细胞运动、感知外界信号和维持器官功能等生理过程。纤毛的形成,即纤毛发生(ciliogenesis)是一个高度复杂且受精密调控的过程,涉及大量与纤毛结构和功能相关基因的表达与调控。近年来,随着基因组学和发育生物学的发展,越来越多的研究揭示了多种关键转录因子在纤毛发生中的调控作用,包括RFX家族、FOXJ1、MCIDAS、GEMC1、MYB、E2F等。这些转录因子共同构成了一个多层次、多通路交织的调控网络,调控纤毛组装、基体复制、纤毛定位和功能维持等多个方面。本文系统综述了纤毛相关基因转录调控的研究进展,特别是关键转录因子的功能、相互作用及其在纤毛病中的作用,为深入理解纤毛的发育机制和疾病治疗提供参考。
Cilia are crucial cell-surface organelles involved in cell movement,signal sensing,and organ function maintenance.Their formation,or ciliogenesis,is a complex and precisely controlled process that requires the expression and regulation of numerous cilia-related genes.Recent advances in genomics and developmental biology have uncovered the regulatory roles of key transcription factors like the RFX family,FOXJ1,MCIDAS,GEMC1,MYB,and E2F in ciliogenesis.These factors form a multi-level,interconnected regulatory network that oversees cilium assembly,basal body replication,ciliary positioning,and function preservation.This review systematically examines current research on transcriptional regulation of ciliary genes,with a focus on the roles,interactions,and contributions of these key transcription factors to ciliopathies,offering insights into ciliary development and disease treatment.