目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

目的：分析冠状动脉CT血管成像（CTA）联合动态心电图（DCG）与冠心病患者冠脉狭窄程度及预后情况的关联。方法：研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者，分别列为病例组和对照组，比较两组CTA参数、DCG参数间差异。依据入院测得（Gensini）评分不同，将入组患者分别列为轻度组（60例，Gensini评分≤30分）、中度组（75例，Gensini评分＞30分、≤60分）和重度组（75例，Gensini评分＞60分），比较三组CTA参数、DCG参数间差异，分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况，比较不同预后患者CTA参数、DCG参数间差异，归纳冠心病患者预后影响因素，检验CTA参数、DCG参数对患者不良预后的预测效能。结果：病例组的最小管腔直径（MLD）、最小管腔面积（MLA）、血流储备分数（FFR）、正常窦性间期的标准差（SDNN）、每5min平均RR间期的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）均低于对照组，斑块总体积（TPV）、低频/高频比值（LF/HF）均高于对照组（t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389；P＜0.05）。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组，轻度组，TPV、LF-HF均高于中度组，轻度组（F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983；P＜0.05）。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关，TPV、LF-HF均与Gensini评分正相关（r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355；P＜0.05）。经统计，210例冠心病患者的不良预后发生率为38.10%（80/210）。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组，TPV、LF-HF均高于预后良好组（t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465；P＜0.05）。MLA、FFR、SDNN升高为冠心病不良预后的保护因素，LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测（Delong检验，P＜0.05）。结论：CTA、DCG能客观评估冠心病患者冠脉狭窄程度，联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。

Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05）.Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.

目的：描述发病48 h内急性缺血性卒中（acute ischemic stroke，AIS）患者依达拉奉右莰醇真实世界用药特征，探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法：回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者，药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例，排除35例，纳入112例发病至首次用药时间（onset-to-treatment time，OTT）≤48 h者；按预设24 h界值分为24 h内用药组（n=67）和24～48 h用药组（n=45）。主要结局为住院期间美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）变化值（ΔNIHSS=入院NIHSS评分－出院前NIHSS评分）；次要结局包括出院前NIHSS评分、出院改良Rankin量表（modified Rankin Scale，mRS）评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性，并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果：总体OTT为19.65（14.97，34.68）h，疗程12.00（11.00，13.00）d，完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义［8.00（6.00，9.00）分 vs 8.00（6.00，10.00）分，P=0.447］；24 h内用药组出院前NIHSS评分更低［5.00（4.00，6.50）分 vs 6.00（5.00，8.00）分，P=0.025］，ΔNIHSS更高［3.00（2.00，3.00）分 vs 2.00（1.00，2.00）分，P＜0.001］，显著神经功能改善率更高（77.6% vs 60.0%，P=0.045）。多因素校正后，24 h内用药仍与更大的ΔNIHSS相关（β=0.768，95%CI：0.377～1.159，P＜0.001）；Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关（OR=2.475，95%CI：1.047～5.853，P=0.039）。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论：本单中心真实世界队列中，发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低；24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究，结果应解释为关联性证据，需前瞻性、多中心研究及长期功能结局验证。

Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.

目的：分析急性有机磷农药中毒（AOPP）引发缺血缺氧性脑病预后相关因素，建立相关的预后预测模型。方法：回顾性分析90例（33例预后不良、57例预后良好）AOPP致HIE患者（2022年3月～2025年8月）的临床资料、中毒指标和血清学指标，独立危险因素用Logistic回顾分析筛选，并构建预后不良预测模型，采用ROC工具对模型效能进行验证。结果：Logistic 回归分析显示，年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素（P＜0.05）；AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论：高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局，据此构建风险预测模型可有效预测预后不良的发生风险。

To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

虽然高效抗逆转录病毒治疗已经把艾滋病变成了能够长期管理的慢性传染病，可是患者预后的个体差异比较明显。近些年不良环境暴露被发现是影响艾滋病生存质量、免疫重建、疾病进展的重要外源性因素。环境污染物作为广泛存在而且有可预防的外部风险因素，有着低剂量、长时程、多途径暴露的特点，能够通过免疫毒性、氧化应激、慢性炎症激活、代谢紊乱等多种通路，干扰艾滋病患者的免疫重建进程和病毒抑制效果，进而影响其疾病进展、远期生存结局。本文系统综述了大气污染物、重金属、黄曲霉素、多环芳烃等典型环境污染物与艾滋病患者发病进展及预后转归的关联，深入分析人群易感性差异和当前研究存在的局限，可为优化HIV/AIDS患者的健康管理策略、降低环境相关健康风险、改善患者远期预后给予理论参考和实践依据。

Although highly active antiretroviral therapy has turned AIDS into a chronic infectious disease that can be managed for a long time, the individual differences in the prognosis of patients are obvious. In recent years, adverse environmental exposure has been found to be an important exogenous factor affecting the quality of life, immune reconstruction and disease progression of AIDS. As an external risk factor that exists and has potential intervention, environmental pollutants have the characteristics of low-dose, long-term and multi-channel exposure. They can interfere with the immune reconstruction process and virus inhibition effect of AIDS patients through various pathways such as immunotoxicity, oxidative stress, chronic inflammation activation, and metabolic disorders, thereby affecting their disease progression and long-term survival outcomes. This article systematically reviews the association between typical environmental pollutants such as air pollutants, heavy metals, aflatoxins, and polycyclic aromatic hydrocarbons and the progression and prognosis of AIDS patients. In-depth analysis of the differences in population susceptibility and the limitations of current research can provide theoretical reference and practical basis for optimizing the health management strategies of HIV / AIDS patients, reducing environmental-related health risks, and improving the long-term prognosis of patients.

【摘要】目的：基于潜类别增长模型（LCGM）探讨脑出血患者神经功能恢复轨迹及不同轨迹对预后的影响。方法：回顾性采集360例自发性脑出血患者（2023年6月～2025年6月）的临床资料及神经功能评分[美国国立卫生研究院卒中量表（NIHSS）]，并采用LCGM识别神经功能恢复轨迹的潜在类别，分析影响恢复不良型轨迹的危险因素，对比不同轨迹的预后情况[改良Rankin量表（mRS）、格拉斯哥预后评分（GOS）]。结果：LCGM模型拟合结果显示，3类轨迹为最优拟合模型，可将360例自发性脑出血患者分为快速恢复型139例（38.61%）、稳定恢复型154例（42.78%）、恢复不良型67例（18.61%）；入院格拉斯哥昏迷量表（GCS）评分、初始NIHSS评分、机械通气、血管活性药物使用及血肿体积是神经功能恢复不良的独立影响因素（P＜0.05）；预后方面，三组患者mRS、GOS评分存在显著差异（P＜0.05）。结论：基于LCGM可有效识别脑出血患者神经功能恢复的异质性轨迹，同时还能明确影响患者神经功能修复的独立危险因素及不同神经功能恢复轨迹与预后的关联。

Abstract Objective: To explore the trajectory of neurological recovery in patients with cerebral hemorrhage and the impact of different trajectories on prognosis based on latent class growth model (LCGM). Methods: The clinical data and neurological function scores [National Institutes of Health Stroke Scale (NIHSS)] of 360 patients with spontaneous cerebral hemorrhage (June 2023 to June 2025) were retrospectively collected, and LCGM was used to identify potential categories of neurological recovery trajectories, analyze risk factors affecting poor recovery trajectories, and compare the prognosis of different trajectories [modified Rankin Scale (mRS), Glasgow Outcome Score (GOS)]. Results: The LCGM model fitting results showed that the three types of trajectories were the optimal fitting model, and 360 patients with spontaneous cerebral hemorrhage could be divided into 139 cases (38.61%) of rapid recovery type, 154 cases (42.78%) of stable recovery type, and 67 cases (18.61%) of poor recovery type; admission to Glasgow Coma Scale (GCS) score, initial NIHSS score, mechanical ventilation, use of vasoactive drugs and hematoma volume are independent influencing factors of poor neurological recovery (P＜0.05); in terms of prognosis, there were significant differences in mRS and GOS scores among the three groups of patients (P＜0.05).Conclusion: Based on LCGM, it is possible to effectively identify the heterogeneous trajectories of neurological function recovery in patients with intracerebral hemorrhage (ICH), while also identifying independent risk factors influencing neurological function repair and establishing associations between different recovery trajectories and prognosis.

目的：分析血脑屏障标志物闭合蛋白（Occludin，OCLN）、密封蛋白-5（Claudin-5，CLDN5）与帕金森病（PD）患者神经功能损伤程度及不良预后的关联。方法：研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者，及同期接受检查的180例健康志愿者，将其分别列为病例组、对照组，比较两组OCLN、CLDN5间差异。依据病情严重程度不同，将PD患者分别列为早期组（50例）、中期组（65例）和晚期组（65例），比较三组患者OCLN、CLDN5，神经损伤标志物间差异，分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况，比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异，分析PD患者预后影响因素，验证OCLN、CLDN5对PD患者不良预后的预测效能。结果：病例组的外周血OCLN、CLDN5均高于对照组（t=50.450，51.670；P＜0.05）。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶（NSE）、泛素羧基末端水解酶L1（UCH-L1）、神经丝轻链蛋白（NfL）、胶质纤维酸性蛋白（GFAP）均高于中期组、早期组（F=280.611，378.453，82.254，122.413，185.272，257.733；P＜0.05）。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关（r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503；P＜0.05）。180例PD患者的不良预后发生率为28.89%（52/180）。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组（t=17.096，14.405，7.632，6.903，11.695，10.702；P＜0.05）。Logistic多因素回归分析结果显示，外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验，外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测（DeLong检验，P＜0.05）。结论：外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高，联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。

Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450，51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611，378.453，82.254，122.413，185.272，257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096，14.405，7.632，6.903，11.695，10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.

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.

       目的   探讨脓毒性休克患者肿瘤坏死因子相关受体6 （TRAF6）、胆碱酯酶（ChE）及急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）对预后不良的预测价值。方法   回顾分析2023年2月—2024年3月于某院ICU病区收治的226例脓毒性休克患者的临床资料，基于患者预后情况分为预后良好组（n=151）以及预后不良组（n=75）。回顾226例脓毒性休克患者入院时及治疗后的TRAF6、ChE表达变化，并记录患者APACHEⅡ评分和序贯器官功能衰竭评估（SOFA）评分动态变化；比较并分析两组患者详尽的临床资料，探讨TRAF6、ChE联合APACHE Ⅱ评分之间的关联性以及上述指标对脓毒性休克患者预后情况的临床评估价值。采用Logistic回归来分析对脓毒性休克患者生存状况产生影响的潜在因素。结果   多因素Logistic回归分析，年龄、APACHE Ⅱ评分、SOFA评分、机械通气时间、TRAF6与ChE表达水平均是影响患者预后的独立危险因素（P＜0.05）；受试者操作特征曲线分析显示，年龄、APACHE Ⅱ评分、机械通气时间、SOFA评分、TRAF6、ChE表达水平联合预测脓毒性休克患者预后不良的曲线下面积为0.925，高于单独检测的0.689、0.783、0.794、0.781、0.708、0.827。结论   临床需要及时识别高龄、长时间机械通气时间、高APACHE Ⅱ与SOFA评分、高TRAF6和ChE表达水平的高风险患者，TRAF6、ChE表达水平、SOFA评分、APACHE Ⅱ评分可作为评估脓毒性休克患者预后情况的临床指标，联合应用能进一步提升临床价值。

      Objective  To explore the predictive value of tumor necrosis factor receptor associated factor 6（TRAF6），cholinesterase（ChE）and Acute Physiology and Chronic Health Evaluation II scove（APACHE II）for adverse prognosis in patients with septic shock．Methods  The clinical data of 226 patients with septic shock admitted to the Intensive Care Unit（ICU） of a hospital from February 2023 to March 2024 were retrospectively analyzed，and the patients were divided into a good prognosis group（n=151）and an adverse prognosis group（n=75）based on their prognosis．The expression of TRAF6 and ChE in 226 patients with septic shock was reviewed at admission and after treatment，while the dynamic changes of APACHE  II score and Sequential Organ Failure Assessment（SOFA）score were recorded．Detailed clinical data of the two groups were compared and analyzed to explore the correlation between TRAF6，ChE，APACHE II scores and the clinical evaluation value of the above indexes in the prognosis of patients with septic shock．Logistic regression was used to analyze the potential factors affecting the survival of septic shock patients．Results  Multiple Logistic regression analysis revealed that age，APACHE II score，SOFA score，mechanical ventilation time，TRAF6 and ChE expression levels were independent risk factors for prognosis（P＜0.05）．Receiver Operating Characteristic（ROC）curve analysis showed that the area under curve（AUC）was 0.925，which was higher than single index prediction（0.689，0.783，0.794，0.781，0.708 and 0.827）．Conclusions  High-risk patients with advanced age，prolonged mechanical ventilation，high APACHE II and SOFA scores，and high TRAF6 and ChE expression levels need to be identified in time．TRAF6，ChE expression levels，SOFA scores，and APACHE  II scores can be used as clinical indicators to evaluate the prognosis of septic shock patients．The combined application of those four indicators can further improve the clinical value．

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．