炎症性肠病（IBD）作为一种慢性、易复发的炎症性疾病,被世界卫生组织归类为现代医疗领域的难治性疾病之一。其确切发病机制尚不清晰,目前主要认为与肠菌失衡触发宿主过度的肠黏膜免疫反应,进而在遗传易感性的个体中引发肠黏膜的损伤有关。目前,尚无特效的靶点能治愈IBD。过氧化物酶体增殖物激活受体（PPARs）作为核受体超家族的一员,在机体的生长发育、炎症调控以及代谢过程中扮演着重要角色,且被视为治疗包括IBD在内的多种疾病的重要潜在靶点,并被认为与肠道菌群关系密切。文章旨在探讨PPARs与肠道菌群的关系在IBD中的作用,从而挖掘IBD新的潜在诊疗靶点,开发新的治疗策略,为临床上IBD的诊断和治疗提供新的思路和方法。

Inflammatory bowel disease（IBD）,characterized as a chronic and recurrent inflammatory condition,is classified by the World Health Organization as one of the intractable diseases in modern medicine．The precise pathogenesis of IBD remains unclear,but current research widely believes that it is closely related to dysbiosis of the gut microbiota．Imbalance in the gut flora triggers an excessive immune response in the host’s intestinal mucosa,leading to mucosal damage in genetically susceptible individuals．To date,no specific targets have been identified that can cure IBD．Peroxisome proliferator-activated receptors（PPARs）,as members of the nuclear receptor superfamily,play significant roles in growth and development,inflammation regulation,and metabolic processes．They are regarded as potential effective targets for treating various diseases,including IBD,and are closely related to the gut microbiota．This review aims to discuss the progress in understanding the role of the relationship between PPARs and gut microbiota in IBD,so as to find new potential targets for the diagnosis and treatment of IBD,develop new treatment strategies,provide new ideas and methods for the diagnosis and treatment of IBD in clinical practice．

目的 探讨血清胱抑素C（Cys-C）联合β₂-微球蛋白（β₂-MG）早期诊断糖尿病肾病的应用价值。方法 选择2021年4月—2023年4月医院接收的100例糖尿病患者为对象,根据其有无合并肾脏疾病,将其分为糖尿病组及糖尿病肾病组,各50例,同比例选取同期到我院体检的健康人群50名进行对照研究,检测比较其Cys-C及β₂-MG水平,对比其Cys-C阳性率、β2-MG阳性率及联合检测阳性率,并对比不同疾病分期糖尿病肾病患者的Cys-C、β₂-MG水平。结果 糖尿病肾病患者Cys-C、β₂-MG水平高于糖尿病患者与健康者（P<0.05）。糖尿病患者Cys-C、β₂-MG水平高于健康者（P<0.05）。糖尿病肾病患者Cys-C阳性率64.00%、β₂-MG阳性率72.00%、Cys-C+β₂-MG联合检测阳性率96.00%高于糖尿病6.00%、10.00%、12.00%及健康者0.00%、0.00%、0.00%（P<0.05）;糖尿病Cys-C+β₂-MG联合检测阳性率12.00%高于健康者0.00%（P<0.05）;糖尿病肾病中Cys-C+β₂-MG联合检测阳性率96.00%高于CysC 64.00%、β₂-MG 72.00%（P<0.05）。糖尿病肾病不同分期患者Cys-C、β₂-MG水平比较,Ⅳ期>Ⅲ期>Ⅰ~Ⅱ期（P<0.05）。结论 糖尿病肾病患者Cys-C、β₂-MG水平明显升高,Cys-C、β₂-MG联合诊断更具有优势,而且肾损害越严重,Cys-C、β₂-MG异常程度越高,作为临床诊治的参考依据的价值较高。

Objective To investigate the application value of serum cystatin C（Cys-C）combined with β₂-microglobulin（β₂-MG）in the early diagnosis of diabetic nephropathy．Methods A total of 100 diabetic patients admitted to our hospital from April 2021 to April 2023 were selected as subjects,and divided into diabetes group and diabetic nephropathy group according to whether they have renal diseases or not,with 50 cases in each group．Then,50 healthy people who came to our hospital for physical examination in the same period were selected for comparative study,and their Cys-C and β₂-MG levels were detected and compared,and their Cys-C positive rate,β₂-MG positive rate and combined detection positive rate were compared．Results The levels of Cys-C and β₂-MG in patients with diabetic nephropathy were higher than those in patients with diabetes and healthy controls（P<0.05）．The levels of Cys-C and β₂-MG in diabetic patients were higher than those in healthy controls（P<0.05）．The positive rates of Cys-C（64.00%）,β₂-MG（72.00%）and Cys-C+β₂-MG（96.00%）in patients with diabetic nephropathy were higher than those in patients with diabetes（6.00%,10.00%,12.00%）and healthy subjects（0.00%,0.00%,0.00%）（P<0.05）．The positive rate of combined detection of Cys-C and β₂-MG in diabetic patients（12.00%）was higher than that in healthy subjects（0.00%）（P<0.05）．The positive rate of Cys-C combined with β₂-MG in diabetic nephropathy was 96.00%,which was higher than that of Cys-C 64.00% and β₂-MG 72.00%（P<0.05）．The levels of Cys-C and β₂-MG in patients with stage Ⅳ diabetic nephropathy were higher than those in patients with stage Ⅲ and Ⅰ-Ⅱ diabetic nephropathy（P<0.05）．The levels of Cys-C and β₂-MG in stage Ⅲ patients were higher than those in stage Ⅰ-Ⅱ patients（P<0.05）．Conclusions The levels of Cys-C and β₂-MG are significantly increased in patients with diabetic nephropathy,and the combination of Cys-C and β₂-MG has more advantages．The greater serious renal damage,the greater abnormal degree of Cys-C and β₂-MG,which has a higher value as a reference for clinical diagnosis and treatment．

目的 应用高频超声观察眼轮匝肌的解剖信息和动态特征,探究肉毒毒素注射前超声评估的可行性,为个体化、精准化的治疗提供可能,以实现更加安全、更加高效的治疗效果。方法 采用高频超声获取40名20~30岁健康志愿者的双侧80条眼轮匝肌的长轴、短轴切面声像图,观察其全程形态、内部回声,并测量外眦水平眼轮匝肌最外侧缘与外眦之间的距离、外眦水平眼轮匝肌最厚处的前后径、外眦水平眼轮匝肌最厚处与表皮之间的距离,并对数据进行统计学分析。结果 高频超声可以清晰地显示眼轮匝肌全程的走形和整体肌束结构。微笑时可见外眦外侧的眼轮匝肌向内收缩,并出现不同程度的增厚。男性和女性外眦水平眼轮匝肌最外侧缘与外眦之间的距离分别为左侧（27.50±2.58）（25.32±2.17）mm,右侧（27.35±2.15）（25.11±2.08）mm;外眦水平眼轮匝肌最厚处的前后径分别为左侧（1.055±0.209）（0.770±0.172）mm,右侧（1.010±0.171）（0.775±0.162）mm;外眦水平眼轮匝肌最厚处与表皮之间的距离分别为左侧（2.450±0.274）（2.860±0.375）mm,右侧（2.430±0.252）（2.825±0.424）mm。上述3种指标在左右侧对比差异无统计学意义（P>0.05）。与男性对比,女性外眦水平皮下组织较厚、眼轮匝肌较薄,其最外侧缘与外眦之间的距离较短（P<0.05）。结论 高频超声为观察青年人群眼轮匝肌结构的有效影像学工具,可用于肉毒毒素注射前的面部评估。

Objective To observe the anatomical information and dynamic characteristics of the orbicularis oculi muscle by high-frequency ultrasound,to explor the feasibility of ultrasound evaluation before botulinum toxin injection,and to provide the possibility for personalized and precise treatment to achieve safer and more efficient therapeutic effects．Methods High frequency ultrasound was used to obtain long axis and short axis sectional ultrasound images of 80 bilateral orbicularis oculi muscles from 40 healthy volunteers aged 20-30．The overall morphology and internal echoes were observed,and the distance between the outermost edge of the orbicularis oculi muscle and the outer canthus,the anterior posterior diameter of the thickest part of the orbicularis oculi muscle at the outer canthus level,and the distance between the thickest part of the orbicularis oculi muscle and the epidermis at the outer canthus level were measured．Statistical analysis was performed on the data．Results High frequency ultrasound can clearly display the entire course of the orbicularis oculi muscle and the overall muscle bundle structure．When smiling,the orbicularis oculi muscle on the outer side of the outer canthus can be seen to contract inward and show varying degrees of thickening．The distance between the outermost edge of the orbicularis oculi muscle and the outer canthus of males and females were（27.50±2.58）（25.32±2.17）mm on the left side and（27.35±2.15）（25.11±2.08）mm on the right side,respectively．The anterior posterior diameters of the thickest part of the orbicularis oculi muscle at the level of the outer canthus were left（1.055±0.209）（0.770±0.172）mm and right（1.010±0.171）（0.775±0.162）mm,respectively．The distance between the thickest part of the orbicularis oculi muscle at the level of the outer canthus and the epidermis were（2.450±0.274）（2.860±0.375）mm on the left side and（2.430±0.252）（2.825±0.424）mm on the right side．There was no statistically significant difference in the comparison of the above three indicators on the left and right sides（P>0.05）,while there was a statistically significant difference in the mean values of both males and females（P<0.05）．Compared with males aged 20-30,females had thicker subcutaneous tissue at the level of the outer canthus and thinner orbicularis oculi muscle,with a shorter distance between the outermost edge and the outer canthus． Conclusions High frequency ultrasound is an effective imaging tool for observing the structure of the orbicularis oculi muscle in young population,and can be used for facial assessment before botulinum toxin injection．

目的 探究脐动脉血流动力学指标、血脂、促甲状腺激素(TSH)对妊娠期糖尿病患者分娩结局的影响研究。方法 选取我院2021年1月—2021年11月收治的妊娠期糖尿病患者138例,采用随机数字表法分为对照组和研究组,每组各69例。比较2组患者体内脐动脉血流动力学指标、血脂指标及TSH相关指标表达水平差异及妊娠结局,并通过多元线性回归分析探究脐动脉血流动力学指标、血脂指标、TSH等相关指标与妊娠期糖尿病患者不良妊娠结局的相关性。结果 研究组孕妇脐动脉峰值流速/舒张末期流速(S/D)、阻力指数(RI)、三酰甘油(TG)、低密度脂蛋白(LDL)、TSH水平高于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组(P<0.05);研究组孕妇巨大儿、剖宫产、新生儿低血糖发生率及新生儿体质量均高于对照组(P<0.05);多元线性回归方程显示:S/D、RI、TG、LDL、TSH水平变化均与不良妊娠结局存在相关性(R²=0.224,调整R²=0.201;F=9.504,P<0. 05),且影响顺序由大到小依次为 TG、TSH、RI、S/D、LDL。结论 妊娠期糖尿病孕妇体内的S/D、RI、TG、LDL、TSH水平异常可能会影响妊娠结局,临床可通过监测上述指标的变化,及时采取干预措施。

Objective To investigate the effects of umbilical artery hemodynamic indexes, blood lipids and thyroid stimulating hormone (TSH) on delivery outcomes in patients with gestational diabetes mellitus. Methods A total of 138 patients with gestational diabetes mellitus who were admitted to our hospital from January 2021 to November 2021 were selected and divided into a control group and a study group by random digital table, with 69 cases in each group. The differences in umbilical artery hemodynamic indexes, blood lipid indexes and TSH-related indexes and pregnancy outcomes were compared between the two groups, and multiple linear regression analysis was used to explore the relationship between umbilical artery hemodynamic indexes, blood lipid indexes, TSH, other related indexes and adverse pregnancy outcomes in patients with gestational diabetes mellitus. Results The systolic and diastolic peak volume ratio (S/D), resistive index (RI) of umbilical artery, triglyceride (TG), low density lipoprotein (LDL) and TSH in the study group were higher than those in the control group, while the levels of free triiodothyronine (FT3) and free thyroxine (FT4) were lower than those in the control group (P<0.05). The incidences of macrosomia, cesarean section, neonatal hypoglycemia and neonatal weight in study group were significantly higher than those in the control group (P<0.05). The multiple linear regression equation showed that the adverse pregnancy outcomes were correlated with changes of TG, TSH, RI, S/D, LDL levels (R²=0.224, adjusted R²=0.201; F=9.504, P<0.05), in descending order. Conclusions Abnormal levels of S/D, RI, TG, LDL, TSH and FT4 in pregnant women with gestational diabetes mellitus may affect the pregnancy outcomes. Clinical intervention measures can be taken by monitoring the changes of the above indicators.

目的 探究腔内微波消融(EMA)联合泡沫硬化剂治疗与腔内射频消融(RFA)联合泡沫硬化剂治疗下肢静脉曲张的临床疗效和并发症情况。方法 回顾性选择收集106例下肢静脉曲张患者的临床资料,其中54例患者(观察组)接受EMA联合泡沫硬化剂治疗,52例患者(对照组)接受RFA联合泡沫硬化剂治疗。比较2组患者相关临床指标及并发症发生情况。结果 观察组手术时间(34.92±2.35)min,对照组手术时间(46.33±2.71)min,观察组手术时间较短,差异有统计学意义(P＜0.05),其余手术参数差异不明显(P＞0.05)。观察组的住院费用(21 063.74±850.47)元,对照组住院费用(23 312.40±1 035.86)元,观察组住院费用较低,有统计学差异(P＜0.05)。2组间并发症发生率、总有效率和总满意度均无显著差异。对比2组患者手术前和手术治疗后1年的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分,组间对比没有统计学差异(P＞0.05);而在患者手术1年之后的静脉临床严重程度评分、阿伯丁静脉曲张问卷评分均呈现出明显的下降趋势(P＜0.05)。结论 微波消融是有效治疗下肢静脉曲张的术式,与射频消融比较,具有同样良好的短期效果;微波消融所需的手术时间较短且费用较低。

Objective To compare the clinical efficacy and complications between endovascular microwave ablation (EMA) combined with foam sclerotherapy and radiofrequency ablation (RFA) combined with foam sclerotherapy in patients with varicose veins of lower extremity. Methods A total of 106 patients with varicose veins of lower extremity were included in the retrospective study.Among them, 54 patients (observation group) were treated with EMA combined with foam sclerotherapy, and 52 patients (control group) were treated with RFA combined with foam sclerotherapy.The related clinical indexes and complications between the two groups were compared. Results The observation group had a shorter procedure time than the control group (34.92±2.35 minutes vs 46.33±2.71 minutes, P＜0.05), and no significant differences were observed in the other procedure parameters.The hospitalization cost was (21063.74±850.47) yuan for the observation group and (23312.40±1035.86) yuan for the control group, and the hospitalization cost of the observation group was lower(P＜0.05).No significant differences were found in the total effective rate,total satisfaction and complication rate between the two groups.Comparison of venous clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scores before and one year after operation between the two groups showed no statistical differences (P＞0.05). While the VCSS and AVVQ scores of the patients showed a significant downward trend one year after operation (P＜0.05). Conclusions Microwave ablation is an effective treatment for varicose veins in the lower extremity, which has the same good short-term effect as radiofrequency ablation. Microwave ablation requires a shorter operation time and less cost.

目的 研究白藜芦醇通过抑制T样受体4/核因子-κB(TLR4/NF-κB)通路对呼吸道合胞病毒(RSV)毛细支气管炎小鼠的保护作用。方法 选取30只小鼠随机分为对照组、RSV组、给药组,建立RSV毛细支气管炎小鼠模型,检测小鼠肺组织中TLR4、NF-κB的变化;利用肺组织HE染色、ELISA法检测白藜芦醇给药前后气道炎症病变、IL-6、TNF-α因子水平,Western Blot法及实时定量PCR法检测TLR4、 NF-κB蛋白及基因表达等相关变化。结果 与对照组相比,RSV组小鼠组肺组织中TLR4、NF-κB水平升高,肺组织切片HE染色显示气道炎症细胞浸润加剧,ELISA检测炎性因子IL-6、TNF-α升高;而给药组处理后,肺组织TLR4、NF-κB的表达下调,病理改变减轻,炎性因子IL-6、TNF-α下降。结论 白藜芦醇可通过抑制TLR4/NF-κB通路抑制炎性因子的释放,从而减轻毛细支气管炎小鼠的气道炎症反应。

Objective To study the protective effect of resveratrol on lung tissue of respiratory syncytial virus(RSV) bronchiolitis mice by regulating TLR4/NF-κB pathway. Methods Thirty mice were randomly divided into control group, RSV group and resveratrol group. The mice models of RSV bronchiolitis were established, and the changes of TLR4 and NF-κB levels in lung tissues of mice were detected. HE staining and ELISA were used to detect airway inflammation, IL-6 and TNF-α levels before and after resveratrol administration. TLR4 and NF-κB protein and gene expressions were detected by Western Blot and real-time quantitative PCR. Results Compared with the control group, the levels of TLR4 and NF-κB in the lung tissues of mice with bronchiolitis were significantly increased. Airway inflammatory cell infiltration was aggravated in HE staining of lung tissue sections, and inflammatory factors IL-6 and TNF-α were significantly increased showing by ELISA. The expressions of TLR4 and NF-κB in resveratrol group were down-regulated after treatment. Conclusions Resveratrol can inhibit the release of inflammatory factors by inhibiting the TLR4/NF-κB pathway, play a protective role in mice with bronchiolitis.

目的 探讨进食时机对尿毒症血液透析患者的影响,为临床上此类研究提供参考依据。方法 选取2018年5月—2020年5月于我院进行血液透析的患者42例,根据自身随机对照法分为A组（n=21）和B组（n=21）。A组患者前六次在血液透析1.5 h时进食,后六次在血液透析2.5 h时进食;B组患者前六次在血液透析2.5 h时进食,后六次在血液透析1.5 h时进食。观察比较1.5 h和2.5 h进食的患者在血液透析前以及血液透析中不同时间点的血压和血糖。结果 2组患者在不同时间点的血压值和低血压发生率比较差异无统计学意义（P>0.05）;血液透析1.5 h进食患者在透析2 h和3 h时血糖值明显高于2.5 h进食患者,比较差异具有统计学意义（P<0.05）;血液透析1.5 h进食的患者在透析2 h时低血糖的发生率显著低于2.5 h进食患者,差异具有统计学意义（P<0.05）。结论 对尿毒症血液透析患者来说,于血液透析1.5 h进食能够有效降低患者低血压和低血糖的发生几率。

Objective To discuss the influence of eating timing on uremic hemodialysis patients,and to provide a reference for this kind of clinical research．Methods A total of 42 patients undergoing hemodialysis were selected in our hospital from May 2018 to May 2020 and were divided into group A（n=21）and group B（n=21）according to self randomized control method．Patients in group A ate at 1.5 hour of hemodialysis for the first six times,and at 2.5 hour of hemodialysis for the last six times;patients in group B ate at 2.5 hour of hemodialysis for the first six times,and at 1.5 hour of hemodialysis for the last six times．Observed and compared the blood pressure and blood sugar of patients who eat at 1.5 hour and 2.5 hour before hemodialysis and at different time points during hemodialysis．Results There were no significant differences in blood pressure and the incidence of hypotension between the two groups of patients at different time points（P>0.05）;the blood glucose levels at 2 and 3 hour of the patients who ate at 1.5 hour of hemodialysis was significantly higher than that of the patients who ate at 2.5 hour,and the difference was statistically significant（P<0.05）;the incidence of hypoglycemia at 2 hour of hemodialysis in patients who ate at 1.5 hour was significantly lower than that of patients who ate at 2.5 hour,and the difference was statistically significant（P<0.05）．Conclusions For uremic hemodialysis patients,eating at 1.5 hour of hemodialysis could effectively reduce the incidence of hypotension and hypoglycemia．

目的 调查眼科患者对荧光素眼底血管造影认知情况及健康教育需求,为眼底造影医护人员实施高效、个性化健康教育提供依据。方法 采用自制眼底造影认知及健康教育需求问卷,对本院2021年6月—8月的123例眼底血管造影患者进行问卷调查,使用Spearman相关性分析、非参数秩和检验及多元线性逐步回归分析患者眼底血管造影认知的影响因素。结果 患者荧光素眼底血管造影认知得分为（33.77±8.09）分,其中,患者对于检查中的相关知识认知最低,相对得分为0.59;患者健康教育需求的得分为（43.95±7.63）分,其中,检查后的相关知识需求度最高,相对得分为0.77;不同年龄、文化程度、主要照顾者、眼造影检查次数及是否合并全身病的患者的认知水平差异有统计学意义（P<0.05）。多元线性逐步回归分析表明,眼造影检查史是患者眼底血管造影认知的独立影响因素。结论 眼科患者对荧光素眼底血管造影认知水平较低,健康教育需求高,医护人员应重视健康教育的实施,结合FFA操作流程及患者特点,制定标准化健康教育流程,探索有效的线上+线下的健康教育模式,以提高造影患者认知水平,保障患者安全。

Objective To investigate fundus fluorescein angiography（FFA）cognition and health education needs in ophthalmic patients,and to provide basis for efficient and personalized health education for FFA medical staff．Methods A self-made questionnaire was used in a survey of 123 patients from June to August 2021．The influencing factors of FFA cognition were analyzed by Spearman correlation analysis,non parametric rank sum test and multiple linear stepwise regression．Results The score of FFA cognition was（33.77 ± 8.09）．Patients had the lowest cognition of relevant knowledge during the examination,with a relative score of 0.59．The score of patient's health education needs was（43.95 ± 7.63）,while the score of relevant knowledge needs after examination was the highest,with a relative score of 0.77．There were significant differences in cognitive level among patients with different ages,educational levels,main caregivers,angiographic times,and complication of systemic diseases（P<0.05）．Multiple linear stepwise regression analysis showed that the number of ocular angiography was an independent factor affecting the cognition of FFA．Conclusions Patients with FFA have low cognitive level and high demand for health education．Medical staff should pay attention to the implementation of health education,formulate a standardized health education process with the combination of operation process and patient characteristics,and explore an effective online-to-offline health education mode,so as to improve the cognitive level of angiography patients and ensure the safety of patients．

目的 基于影像组学方法,探讨多层螺旋CT（MSCT）四期增强扫描单一/不同期相及不同容积感兴趣区（VOI）的选择,在术前预测原发性肝细胞癌（HCC）微血管侵犯（MVI）中的价值。方法 回顾性收集88例经手术病理证实为HCC并行术前MSCT四期增强扫描的患者,其中包括47例MVI阳性患者和41例MVI阴性患者。在MSCT增强扫描的动脉早期、动脉晚期、门静脉期及延迟期图像中手动逐层勾画肿瘤ROI,获得瘤体容积感兴趣区VOI（Vt）,然后基于计算机自动膨胀算法将Vt外扩10 mm获得瘤体及瘤周VOI（Vt+Vp）。使用Pyradiomics软件分别从Vt和Vt+Vp中提取影像组学特征,随后采用15种特征选择方法和10种分类器构建150个预测模型,并通过十折交叉检验以验证模型的效能。使用准确度、敏感度、特异度、受试者工作特性曲线下面积（AUC）评估模型的效能,并比较性能最优的前三个预测模型。结果 MSCT四期增强扫描图像中预测HCC MVI状态的影像组学模型在门静脉期的表现优于其它期相及各期相的不同组合,其中最大的AUC值在Vt和Vt+Vp两种ROI中分别为0.768和0.782。此外,基于Vt+Vp的影像组学模型对MVI的预测效能优于基于Vt的影像组学模型,基于Vt+Vp性能最优的预测模型的AUC值、准确度、敏感度和特异度分别0.782、0.728、0.745和0.705。结论 采用影像组学方法术前无创性预测HCC MVI状态首选增强扫描的门静脉期,ROI首选瘤体联合瘤周10 mm区域。

Objective To investigate the value of single or different phases of contrast-enhanced multi-slice spiral CT（MSCT）in different volumetric regions of interest（ROI）to preoperatively predict the state of microvascular invasion in primary hepatocellular carcinoma（HCC）based on radiomics methods．Methods A total of 88 patients with HCC confirmed by surgical pathology who underwent preoperative MSCT quadruple-enhanced scan were retrospectively recruited,including 47 MVI-positive patients and 41 MVI-negative patients．The ROI was manually delineated slice-by-slice in the early arterial phase,late arterial phase,portal venous phase,and equilibrium phase of enhanced MSCT images to obtain the volume of tumor VOI（Vt）,and then Vt was expanded by 10 mm through the computer expansion algorithm automatically to obtain the volume of tumor and peritumor（Vt+Vp）．Pyradiomics software was used to extract radiomic features from Vt and Vt+Vp,followed by 150 discriminant models constructed with 150 feature selection methods and 10 classifiers,and then 10-fold cross-validation was used to evaluate the performance of these models．Using accuracy,sensitivity,specificity,area under the receiver operating characteristic curve（AUC）to assess model performance．The top three predictive models with the best performance were also compared．Results The radiomics model for predicting HCC MVI status in portal venous phase among quadruple-enhanced MSCT images outperformed other phases and different combinations of phases,achieving the highest AUC values of 0.768 and 0.782 in Vt and Vt+Vp respectively．In addition,the prediction performance of the radiomics model based on Vt+Vp was superior to models based on Vt．AUC value,accuracy,sensitivity,and specificity of the model with the best performance based on Vt+Vp were 0.782,0.728,0.745 and 0.705 respectively．Conclusions Radiomics models based on the portal venous phase of contrast-enhanced MSCT and tumor combined with the 10mm peritumoral area were more recommended to be employed to preoperative non-invasively predict the state of HCC MVI．

目的 评价银杏二萜内酯葡胺注射液（DGMI）联合依达拉奉右崁对急性缺血性脑卒中（AIS）的治疗效果。方法 回顾性分析我院2021年3月—2022年6月收治的86例AIS患者,根据治疗方法不同,分为单药组和联合组,每组43例,2组均予以DGMI治疗,联合组加用依达拉奉右崁醇。对比2组的治疗效果。结果 治疗后,联合组美国国立卫生研究院卒中量表（NIHSS）评分低于单药组（P<0.05）,简易智能精神状态检查量表（MMSE）和Barthel指数（BI）得分高于单药组（P<0.05）;联合组治疗后脑血流动力学指标（Q_min和V_min）高于单药组（P<0.05）,而全血还原黏度、血浆黏度和血小板聚集指数低于单药组（P<0.05）;联合组治疗后血清丙二醛（MDA）、超敏C-反应蛋白（hsCRP）和白细胞介素-6（IL-6）低于单药组（P<0.05）,而超氧化物歧化酶（SOD）高于单药组（P<0.05）;联合组治疗总有效率88.37%,高于单药组的67.44%（P<0.05）,且2组不良反应总发生率比较差异无统计学意义（P>0.05）。结论 DGMI联合依达拉奉右崁醇可有效提高AIS患者的神经功能、认知功能及日常生活能力,降低血液高凝状态,改善脑部血流,缓解机体氧化应激及炎症反应,且不良反应发生率较低,安全性良好。

Objective To evaluate the clinical efficacy of diterpene ginkgolides meglumine injection（DGMI）combined with edaravone dextracanthol in the treatment of acute ischemic stroke（AIS）．Methods A total of 86 patients with AIS admitted to our hospital from March 2021 to June 2022 were divided into single drug group and combination group according to different treatment methods,with 43 patients in each group．Both groups were treated with DGMI,and the combination group was added with edaravone dextracanthol．The therapeutic effect,neurological function and adverse reactions of the two groups were compared．Results After treatment,compared with the single drug group,the NIH Stroke Scale（NIHSS）score of the combination group was significantly lower（P<0.05）,and the Mini-Mental State Examination（MMSE）and Barthel index（BI）scores were significantly higher（P<0.05）．After treatment,the cerebral hemodynamic indexes（Q_min and V_min）in the combination group were significantly higher（P<0.05）,while the whole blood reducing viscosity,plasma viscosity and platelet aggregation index were significantly lower（P<0.05）．After treatment,compared with the single drug group,the serum malondialdehyde（MDA）,high sensitive C-reactive protein（hsCRP）and interleukin- 6（IL-6）levels in the combination group were significantly lower（P<0.05）,while the level of superoxide dismutase（SOD）was significantly higher（P<0.05）．The total effective rate of the combination group was 88.37%,which was significantly higher than 67.44% of the single drug group（P<0.05）．The incidence of adverse reaction between two groups was not significant（P>0.05）．Conclusions DGMI combined with edaravone dextracanthol can effectively improve the neurological function,cognitive function and daily living ability of patients with AIS,reduce blood hypercoagulability,improve cerebral blood flow,alleviate oxidative stress and inflammatory reaction,improve the therapeutic effect,without increasing the incidence of adverse reactions,which has good safety．