目的 探讨吲哚布芬联合智能抗阻训练对急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后血小板功能及心功能的影响。方法 选取2024年1月至2025年12月在本院接受PCI支架植入术的60例ACS患者，随机分为观察组和对照组，每组30例。对照组给予常规治疗联合氯吡格雷75 mg/d治疗，观察组给予常规治疗联合吲哚布芬（100mg/次，2次/d）+智能抗阻训练干预，两组均连续干预3个月。比较两组患者干预前、干预1个月、3个月时花生四烯酸（AA）诱导和二磷酸腺苷（ADP）诱导的血小板聚集率，随访3个月不良心血管事件（MACE）发生率，以及干预前后心功能指标[左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）]。结果 干预前两组血小板聚集率、LVEF、LVEDD比较差异无统计学意义（P＞0.05）；干预1个月、3个月时，观察组AA诱导和ADP诱导的血小板聚集率降低幅度均显著大于对照组（P＜0.05）；干预3个月后，观察组LVEF显著高于对照组，LVEDD显著低于对照组（P＜0.05）；随访3个月，两组MACE发生率比较差异无统计学意义（P＞0.05）。结论 吲哚布芬联合智能抗阻训练可更显著地抑制ACS患者PCI术后血小板聚集，更有效地改善心功能指标，且安全性良好。

Objective To explore the effect of indobufen combined with intelligent resistance training on platelet function and cardiac function in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 60 ACS patients who underwent PCI stent implantation in our hospital from January 2024 to December 2025 were selected and randomly divided into an observation group and a control group, with 30 patients in each group. The control group was given conventional treatment combined with clopidogrel 75 mg/d, while the observation group was given conventional treatment combined with indobufen (100 mg/time, twice a day) + intelligent resistance training intervention. Both groups received continuous intervention for 3 months. The arachidonic acid (AA)-induced and adenosine diphosphate (ADP)-induced platelet aggregation rates were compared between the two groups before intervention, 1 month and 3 months after intervention. The incidence of major adverse cardiovascular events (MACE) was followed up for 3 months, and the cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)] were compared before and after intervention. Results Before intervention, there were no significant differences in platelet aggregation rates, LVEF and LVEDD between the two groups (P > 0.05); at 1 month and 3 months after intervention, the reduction amplitudes of AA-induced and ADP-induced platelet aggregation rates in the observation group were significantly greater than those in the control group (P < 0.05); after 3 months of intervention, LVEF in the observation group was significantly higher than that in the control group, and LVEDD was significantly lower than that in the control group (P < 0.05); after 3 months of follow-up, there was no significant difference in the incidence of MACE between the two groups (P > 0.05). Conclusion Indobufen combined with intelligent resistance training can more significantly inhibit platelet aggregation, more effectively improve cardiac function indexes in ACS patients after PCI, and has good safety.

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       目的  压疮是指由于组织受压时间过长引起的严重并发症，2025年的数据显示，压疮在活动受限患者中发生率高。机体代谢紊乱可能会引起压疮，但是否与血清代谢物有因果影响，暂不明确。方法   本文运用孟德尔随机化（MR）方法评价血清代谢物与压疮间风险因素，基于MR方法评价血清代谢物和压疮的因果联系，分别纳入由欧洲人群全基因组关联研究（GWAS）。压疮：FinnGen R10，3 167例；血清代谢物：EMBL-EBI数据库16种代谢物数据作为研究样本；筛选条件：工具变量筛选条件［P＜5×10^-8，连锁不平衡聚类r ² ＜0.001，kb=10 000，F统计量＞10（公式：F=R² ×N-2/1-R² ）］；主要分析方法：使用（IVW）法，辅助采用加权中位数法（WM）、MR-Egger回归法校验；用Benjamini-Hochberg法进行多重检验校正（FDR＜0.05为有统计学意义）。结果  共鉴定出10种代谢物与压疮存在关联（P＜0.01），经FDR校正后4种：代谢物18：2/20：4n6的水平升高（P＜0.000 2）2-Oxopeptide的作用相反，降低压疮的风险（OR=0.73，95%CI：0.59~0.92，P=0.011）；琥珀酸可增加压疮的风险（OR=1.13，95%CI：1.03~1.24，P=0.018）；甘氨酸/丙氨酸比值降低压疮风险（OR=0.849，95%CI：0.76~0.93，P=0.022）。稳定性分析证明上述发现是可信的、稳健的（heterogeneity：P＞0.05，pleoitropy：P＞0.05）。结论  血清代谢物通过调控炎症反应、影响微循环障碍以及干预能量代谢途径，参与压疮的发生发展，可作为构建压疮风险的模型以及制定相关干预策略为压疮评估、治疗、预防提供因果层面的理论依据。

      Objective  Pressure ulcer（PU）is a serious complication caused by prolonged tissue compression．Data of 2025 shows that PUs have a high incidence among patients requiring long-term bed rest．Metabolic disorders may contribute to PU development，but whether serum metabolites causally affect PU risk remains unclear．Methods  this study employed the Mendelian randomization（MR）method to evaluate whether serum metabolites are risk factors for PU．To assess the causal relationship between serum metabolites and PU，data from Genome-Wide Association Studies（GWAS）of European populations were included：PU data from FinnGen R10（3 167 cases）and data on 16 serum metabolites from the EMBL-EBI database．Instrumental variable screening criteria were as follows：P＜5×10^-8，linkage disequilibrium clustering（r ² ＜0.001，kb=10，000），and F-statistic ＞10（Formula：F=［R² ×N-2］/［1-R² ］）．The inverse variance weighting（IVW）method was used as the primary analytical approach，supplemented by the weighted median（WM）method and MR-Egger regression for verification．The Benjamini-Hochberg method was applied for multiple test correction（FDR＜0.05 was considered statistically significant）．Results  A total of 10 metabolites were identified to be associated with PU（P＜0.01），and 4 remained significant after FDR correction：elevated levels of metabolite 18：2/20：4n6（P＜0.0002）；2-Oxopeptide exerted an opposite effect，reducing PU risk（OR=0.73，95%CI：0.59-0.92，P=0.011）；succinic acid increased PU risk（OR=1.13，95%CI：1.03-1.24，P=0.018）；and the glycine/alanine  ratio  reduced PU risk（OR=0.849，95%CI：0.76-0.93，P=0.022）．Stability analysis（PH-TauNE［novel pleiotropy test］） confirmed that the above findings were credible and robust（heterogeneity：P＞0.05，pleiotropy：P＞0.05）．Conclusions  Serum metabolites are involved in the occurrence and development of PU by regulating inflammatory responses，affecting microcirculatory disorders，and interfering with energy metabolism pathways．They can provide causal theoretical basis for constructing PU risk prediction models，formulating relevant intervention strategies，and guiding PU treatment，prevention，and assessment．

       目的  分析对肺癌化学治疗（化疗）患者采取个性化营养干预联合分级步行运动方案的应用价值。方法   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象，通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案，观察组则联合分级步行运动方案，两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏［Piper疲乏修订量表（PFS-R）］、营养状况、睡眠质量［匹茨堡睡眠质量指数（PSQI）］、生活质量［生活质量评估量表（SF-36）］水平予以比较。结果  相较于对照组，干预后观察组PFS-R、PSQI评分较低，白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高（P＜0.05）。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案，有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。

       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy．Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects．They were divided into an observation group and a control group，with 99 cases in each group，by the random number table method．The control group only received individualized nutritional intervention，while the observation group received graded walking exercise additionally．Both groups of patients were enrolled at the same time and received continuous intervention for three months．Cancer-related fatigue（Piper’s Fatigue Scale-Revised［PFS-R］），nutritional status，sleep quality（Pittsburgh Sleep Quality Index［PSQI］），and quality of life（Quality of Life Scale［SF-36］） before and after the intervention were compared between the two groups．Results  Compared with the control group，the observation group had lower PFS-R and PSQI scores and higher albumin，prealbumin，hemoglobin，transferrin levels and SF-36 scores after the intervention（P＜0.05）．Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status，sleep quality and quality of life．

       目的  探讨多组分运动训练对老年慢性阻塞性肺疾病（COPD）稳定期病人骨骼肌功能的影响。方法  前瞻性选择2022年10月—2024年10月90例COPD稳定期患者，采用抽签法随机分为观察组与对照组，对照组45例采取常规运动干预，观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量，四肢肌群力量，运动耐力与肺功能，生活质量。结果 干预后，两组上肢、下肢骨骼肌含量均略增加，观察组高于对照组（P＜0.05）；干预后，两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加，观察组高于对照组（P＜0.05）；干预后，两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高，观察组高于对照组（P＜0.05）；干预后，两组圣乔治呼吸问卷各维度分数及总分均降低，观察组低于对照组（P＜0.05）。结论  针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量，改善患者运动耐力与肺功能，减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。

        Objective  To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease（COPD）．Methods  From October 2022 to October 2024，90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method．The control group consisted of 45 patients who received routine exercise care，while the observation group  consisted of 45 patients who received multi-component exercise training in addition to the routine care．Skeletal muscle content，muscle group strength，exercise endurance，lung function，and quality of life between two groups of patients were compared before and three months after intervention．Results  After intervention，the skeletal muscle content of both upper and lower extremities slightly increased in both groups，with the observation group  being higher than the control group（P＜0.05）．After intervention，the strength of the knee extensor，knee flexor，elbow extensor，and elbow flexor muscle groups increased in both groups，with the observation group  had better results than the control group（P＜0.05）．After intervention，both groups showed an increase in six-minute walking test，forced vital capacity，and forced expiratory volume in first second，with the observation group  had better  results than the control group（P＜0.05）．After intervention，the scores of each dimension and total score of the SGRQ in both groups decreased，and the observation group had lower scores than the control group（P＜0.05）．Conclusions  Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities，enhance exercise endurance and lung function，and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life．

       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者，随机平均分为两组。行常规对症支持治疗的为对照组；在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组；两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标（CD₃⁺  、CD₄⁺、CD₈⁺  、CD₄⁺ /CD₈⁺ ）较治疗前均有明显改善；干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果，提高生活质量和免疫功能，减少不良反应。

       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy．Methods  From June 2023 to June 2025，80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups．The patients who received routine symptomatic supportive treatment were enrolled as the control group．The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group．The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment．Adverse reactions were detected on the day before treatment，theseventh day and 14th day during treatment．Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment．Adverse  reactions occurred less in the intervention group than in the control group．Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer，improve the quality of life and immune function，reduce adverse reactions．

    目的   探讨放血疗法对小儿发热的疗效。方法   检索包括中国生物医学文献数据库（CBM）、CNKI、万方、维普、PubMed、Embase、Web of Science、Cochrane Library等8个中、英文数据库自建库至2025年5月所发表的放血疗法治疗小儿发热的随机对照试验研究（RCT），2名研究人员根据Cochrane系统评价手册（5.1.0版）推荐的偏倚风险评估表对所纳入文献进行质量评估，采用RevMan 5.4软件对纳入文献质量进行系统分析。结果  纳入19项RCT，共2 224例患儿，其中观察组1 118例、对照组1 106例。放血疗法能够提高小儿发热的临床疗效［OR=4.18，95% CI（3.00，5.38），P＜0.001］；降低患儿24 h内高热复发率［OR=0.12，95% CI（0.05，0.34），P＜0.001］；缩短平均退热时间［MD=-1.78，95% CI（-2.56，-1.00），P＜0.001］。结论  放血疗法能够提高小儿发热的临床疗效，降低复发率，缩短退热时间，可作为小儿发热的辅助治疗方法。

       Objective  To explore the efficacy of bloodletting therapy treatment on pediatric fever by meta-analysis．Methods  The randomised controlled trials（RCTs）examining bloodletting therapy for paediatric fever were  retrieved from eight Chinese and English databases—China Biomedical Literature Database（CBM），CNKI，Wanfang，VIP，PubMed，Embase，Web of Science，and Cochrane Library—covering publications from the establishment of each database up to May 2025．Two researchers assessed study quality using the risk of bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews（version 5.1.0）．RevMan 5.4 software was employed for systematic analysis of included studies．Results  Nineteen RCTs involving 2 224 patients were ultimately included，comprising 1 118 patients in the observation group and 1 106 in the control group．Results indicated that bloodletting therapy significantly improved clinical efficacy in paediatric fever（OR=4.18，95% CI［3.00，5.38］，P＜0.001），reduced the recurrence rate of high fever within 24 hours（OR=0.12，95% CI［0.05，0.34］，P＜0.001），and shortened the average time to fever resolution（MD=-1.78，95% CI［-2.56，-1.00］，P＜0.001）．Conclusions  Bloodletting therapy can improve the clinical efficacy of pediatric fever，reduce the recurrence rate and shorten the time of fever reduction，and can be used as an adjunctive treatment for pediatric fever．

      目的 探讨重性抑郁障碍（MDD）患者肠道菌群特征与选择性5-羟色胺再摄取抑制剂（SSRIs）疗效的关联性, 筛选可预测SSRIs疗效的肠道菌群生物标志物。方法 选取2024年5月—2025年5月宁夏回族自治区人民医院收治的90例MDD患者, 根据SSRIs治疗8周后疗效分为应答组56例和无应答组34例, 并选择30例健康对照, 采集基线粪便样本进行16S rRNA基因测序, 分析肠道菌群α多样性、菌属相对丰度差异,并通过相关性分析、多因素Logistic回归及ROC曲线评估菌群标志物对SSRIs疗效的预测价值。结果 MDD患者肠道菌群Chao1指数、Shannon指数低于健康对照（P<0.05）, 应答组与无应答组α多样性无差异（P>0.05）。应答组基线Blautia、双歧杆菌属、粪球菌属丰度高于无应答组（P<0.05）, 大肠杆菌-志贺菌属丰度低于无应答组（P<0.05）。基线Blautia、双歧杆菌属、粪球菌属丰度与SSRIs治疗8周HAMD-17减分率呈正相关（r分别为0.390、0.420、0.350,均P<0.05）, 三者联合预测SSRIs疗效的ROC曲线下面积（AUC）为0.910（灵敏度83.9%,特异度85.3%）。结论 MDD患者存在肠道菌群结构异常, 基线Blautia、双歧杆菌属、粪球菌属丰度可作为SSRIs疗效的潜在预测标志物,为MDD个体化治疗提供实验依据。

       Objective To explore the association between gut microbiota characteristics and the efficacy of selective serotonin reuptake inhibitors（SSRIs）in patients with major depressive disorder（MDD）, and to screen gut microbiota biomarkers for predicting SSRIs efficacy．Methods A total of 90 MDD patients（divided into responders[n=56] and non-responders[n=34] based on 8-week SSRIs efficacy）and 30 healthy controls were enrolled from May 2024 to May 2025．Fecal samples were collected for 16S rRNA gene sequencing to analyze gut microbiota α diversity and genus-level relative abundance．Correlation analysis, multivariate logistic regression, and receiver operating characteristic curve were used to evaluate the predictive value of microbiota markers for SSRIs efficacy．Results The Chao1 and Shannon indices of gut microbiota in MDD patients were significantly lower than those in healthy controls（P<0.05）, with no difference between responders and non-responders（P>0.05）．Responders had higher baseline abundances of Blautia,Bifidobacterium, and Coprococcus（P<0.05）, and lower abundance of Escherichia-Shigella compared to non-responders．Baseline abundances of Blautia,Bifidobacterium（P<0.05）, and Coprococcus were positively correlated with 8-week HAMD-17 reduction rate（r=0.390, 0.420, 0.350; all P<0.05）．The combined prediction of these three genera for SSRIs efficacy showed an area under the curve of 0.910（sensitivity 83.9%, specificity 85.3%）．Conclusions MDD patients exhibit abnormal gut microbiota structure．Baseline abundances of Blautia,Bifidobacterium, and Coprococcus may serve as potential predictive biomarkers for SSRIs efficacy, providing experimental basis for personalized treatment of MDD．

        目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组（30例,常规治疗+四子散中药封包药熨）与对照组（30例,常规治疗）。比较两组治疗前后疼痛评分（NRS-11）、肿胀程度评分、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义（P>0.05）; 治疗1周后,观察组疼痛评分为（2.11±0.48）分、肿胀程度为（0.35±0.43）度、CRP为（12.23±3.12）mg/L、IL-6为（16.03±4.01）ng/L,均低于对照组的（3.54±0.56）分、（1.04±0.58）度、（24.31±4.51）mg/L、（23.19±6.75）ng/L,差异有统计学意义（P<0.001）。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。

       Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery．Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group（30 cases, conventional treatment+Sizi power pack hot compress）and control group（30 cases, conventional treatment）． The pain score（NRS-11）, swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups．Results There was no significant difference in pain and swelling scores between the two groups before treatment（P>0.05）．After 1 week of treatment, the pain score（2.11±0.48）, swelling score（0.35±0.43）, CRP（12.23±3.12 mg/L）, IL-6（16.03±4.01 ng/L）levels in the observation group were significantly lower than those in the control group（3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L）, and the difference was statistically significant（P<0.001）．There were no adverse events in the observation group or the control group．Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety．

       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。

       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．