本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题,IMB模型通过向患者提供科学的疾病知识,改变其疾病认知与态度,最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示,IMB模型可显著降低患者术后疼痛发生率,并提高患者参与治疗决策的程度,为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考,以便后期实施相关个性化干预措施,并提供相关理论依据。
This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy.The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge,and ultimately promotes their adoption and maintenance of healthy behaviors.It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy,the research background of this study,the current research status at home and abroad,as well as the future development trends and challenges.The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making.This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model,so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis.
巨大/破裂型腰椎间盘突出症(G/RLDH)是腰椎间盘突出症的严重类型,可致剧烈根性疼痛及神经功能障碍。推拿作为非药物中医疗法,广泛应用于腰椎间盘突出症,但治疗G/RLDH的疗效与安全性尚存争议。近年发现G/RLDH具有较高的椎间盘自然重吸收率,为推拿干预提供了病理基础。本文系统检索相关文献,从中医病机、现代医学机制、临床应用及安全性争议等方面进行综述,旨在指导临床诊治并为未来研究提供参考。
Giant/ruptured lumbar disc herniation (G/RLDH) is a severe type of lumbar disc herniation that can cause intense radicular pain and neurological dysfunction. As a non-pharmacological therapy in traditional Chinese medicine, tuina is widely used for lumbar disc herniation; however, its efficacy and safety in treating G/RLDH remain controversial. Recent studies have revealed a relatively high rate of spontaneous resorption of herniated discs in G/RLDH, which provides a pathological basis for tuina intervention. This article systematically reviews the relevant literature, summarizing the traditional Chinese medicine pathogenesis, modern medical mechanisms, clinical application, and safety controversies, aiming to guide clinical diagnosis and treatment and to provide a reference for future research.
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.
动脉粥样硬化(AS)是心血管疾病的病理基础,口腔与肠道通过菌群移位、代谢互作及免疫联动共同构成口腔-肠道微生物轴,其稳态失衡通过菌群易位、代谢紊乱和屏障损伤等促进AS发生发展。中医药以整体观念与辨证论治为指导,多靶点调控口腔-肠道微生物平衡,抑制血管炎症与脂质沉积,发挥抗AS效应。本文系统阐述口腔-肠道微生物与AS的关联,探讨中医药调控微生态防治该病的研究进展,分析当前研究存在的局限并展望未来方向,为中医药防治AS提供新的思路与理论依据。
Atherosclerosis (AS) is the pathological basis of cardiovascular diseases. The oral cavity and the gut together constitute the oral-gut microbial axis through microbial translocation, metabolic interactions, and immune crosstalk. Dysbiosis of this axis promotes the occurrence and development of AS via bacterial translocation, metabolic disorders, and barrier damage. Guided by the holistic concept and syndrome differentiation-based treatment, traditional Chinese medicine (TCM) exerts anti-AS effects by multi-target regulation of the oral-gut microbial balance, inhibiting vascular inflammation and lipid deposition. This article systematically elaborates the association between the oral-gut microbiota and AS, explores the research progress of TCM in modulating microecology for the prevention and treatment of AS, analyzes the limitations of current studies, and prospects future directions, so as to provide new insights and theoretical basis for TCM in preventing and treating AS.
【摘要】 目的 系统分析音乐干预对眼科手术患者围手术期焦虑与生理反应的影响,为其临床应用提供参考。方法 系统检索国内外相关文献,从患者焦虑特征、理论基础、实施方法、干预效果及影响因素等方面进行综合分析。结果 眼科手术患者围术期焦虑发生率较高,焦虑可降低术中配合度、增加麻醉用药等风险。音乐干预通过调节边缘系统及自主神经系统发挥作用,术前、术中持续应用可显著降低焦虑评分,稳定心率、降低血压。听觉敏感性、基线焦虑水平、年龄及干预方案特征是影响干预效果的关键因素。结论 音乐干预能有效缓解眼科手术患者围手术期焦虑,具有良好应用潜力。未来需开展大样本随机对照试验,结合人工智能等技术开发个性化方案,并建立标准化实施方法。
【Abstract】Objective To systematically evaluate the effects of music intervention on perioperative anxiety and physiological responses in ophthalmic surgery patients, and to provide evidence for clinical practice. Methods Domestic and international literature on anxiety characteristics, mechanisms, implementation, efficacy, and influencing factors was systematically searched and reviewed. Results Perioperative anxiety is common in ophthalmic surgery patients and may reduce intraoperative cooperation and increase anesthetic consumption. Music intervention acts on the limbic system and the autonomic nervous system, and can effectively reduce anxiety scores, stabilize heart rate, and lower blood pressure when applied preoperatively and intraoperatively. Key influencing factors include auditory sensitivity, baseline anxiety, age, and intervention features. Conclusions Music intervention safely and effectively relieves perioperative anxiety in ophthalmic surgery patients. Further large-sample randomized controlled trials, AI-based personalized programs, and standardized protocols are needed.
克罗恩病肛瘘在解剖结构、诊治措施及疾病预后上具有与普通肛瘘不同的特点, 它是克罗恩病患者常见且严重的并发症及预后不良的征兆,严重影响患者生活质量。文章概述了克罗恩病肛瘘的概念及诊治现状、患者生活质量、相关评估工具及护理措施, 旨在为此类患者的临床管理及相关研究的开展提供参考依据,以提高其生活质量。
Perianal fistula of Crohn's Disease has different characteristics from common anal fistula in anatomical structure, diagnosis and treatment and prognosis.It is a common and serious complication and a sign of poor prognosis in patients with Crohn's disease, which seriously affects the quality of life of patients.This article summarizes the concept, current status of diagnosis and treatment of perianal fistula in Crohn's Disease, its impact on the quality of life in patients, related assessment tools and nursing measures, so as to provide a reference for the management of such patients and improve their quality of life.
泛血管疾病(PVD)是一类以动脉粥样硬化为共同病理基础、累及心、脑、肾及外周血管系统的临床综合征, 具有多血管床共病特征, 发病率高、致残致死率大。非编码RNA(ncRNA)作为基因表达的重要调控因子, 在PVD的发生发展中发挥关键作用。微小RNA(miRNA)、长链非编码RNA(lncRNA)、环状RNA(circRNA)等ncRNA通过调节炎症反应、内皮功能、血管重塑、代谢稳态等多路径参与PVD的病理过程, 并展现出时空特异性和双向调控特征。最新研究揭示ncRNA在临床中的诊断预测及靶向干预潜力, 包括外泌体载体及circRNA递送系统等新策略。此外, 中医药通过调控ncRNA网络, 干预血瘀、痰浊等证型相关通路, 体现中西医结合治疗的系统优势。本文系统综述了ncRNA在PVD中的作用机制与研究进展, 强调其在精准诊疗与转化研究中的应用前景, 并指出未来需加强基础与临床协同、推进个体化干预策略的落地实施。
Panvascular diseases(PVD)are a group of clinical syndromes characterized by atherosclerosis as a common pathological foundation, involving heart,brain,kidneys,and peripheral vascular systems.These diseases often exhibit multi-vascular bed comorbidities and are associated with high incidence,disability, and mortality rates.Non-coding RNAs(ncRNAs), as key regulators of gene expression, play a crucial role in the onset and progression of PVD.Various types of ncRNAs—including microRNAs(miRNAs), long non-coding RNAs(lncRNAs), and circular RNAs(circRNAs)—are involved in the pathological processes of PVD through multiple pathways, such as modulation of inflammatory responses, endothelial function, vascular remodeling, and metabolic homeostasis, exhibiting spatiotemporal specificity and bidirectional regulatory effects.Recent studies have highlighted the potential of ncRNAs in clinical diagnosis, prognosis, and targeted therapy,with novel strategies including exosome-based delivery and circRNA-targeting systems.In addition, traditional Chinese medicine(TCM)exerts regulatory effects on ncRNA networks to intervene in syndrome-specific pathways, such as those related to blood stasis and phlegm-dampness, reflecting the systemic advantages of integrating TCM with Western medicine.This review systematically summarizes the regulatory mechanisms and research progress of ncRNAs in PVD,emphasizes their potential in precision medicine and translational research, and proposes the need to strengthen collaboration between basic and clinical studies to facilitate the implementation of personalized therapeutic strategies.
动脉粥样硬化(AS)是一种起始于炎症介导的内皮损伤的慢性血管疾病,其本质是免疫炎症驱动的病理过程,是众多心血管疾病的病理基础。CD4+ T细胞亚群[包括辅助性T细胞1型(T helper 1 cell,Th1)、Th2、Th17、调节性T细胞等]通过分泌特异性细胞因子参与AS的炎症反应,其中促炎性CD4+ T细胞与抗炎性CD4+ T细胞的抗炎功能失衡是推动斑块进展的关键环节,在AS斑块形成与发展中起关键作用。近年来,多项研究表明某些中药单体、经典复方及其有效成分,具有多靶点、多层次机制调控CD4+ T细胞分化及功能,这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等,延缓AS斑块形成与发展,为AS防治提供了新思路,展现了中医药在该领域的研究展现出独特优势与广阔前景,本文综述了中医药通过干预CD4+ T细胞亚群平衡防治AS的最新研究进展,及其影响相关细胞因子网络及关键信号通路的作用机制,为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。
Atherosclerosis(AS)is a chronic vascular disease that originates from inflammation mediated endothelialdamage.Its essence is a pathological process driven by immune inflammation,and it is the pathological basis of many cardiovascular diseases.CD4+ T cell subsets(including Th1,Th2,Th17,Treg,etc.)participate in the inflammatory response of AS by secreting specific cytokines.The imbalance of anti-inflammatory function between pro-inflammatory CD4+ T cells and anti-inflammatory CD4+T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques.In recent years,a number of studies have shown that the monomers,classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target,multi-level mechanism to regulate the differentiation and function of CD4+ T cells.These effects together reduce the inflammatory reaction of vascular endothelium,inhibit the foam formation of macrophages and smooth muscle cell migration,delay the formation and development of AS plaque,provide new ideas for the prevention and treatment of AS,and make the research of Chinese medicine show unique advantages and broad prospects in this field.This article reviews the latest research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4+ T cell subsets,as well as the mechanism of its effects on related cytokine networks and key signal pathways.This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages.
铁死亡是一种以铁依赖性脂质过氧化为特征的程序性细胞死亡形式。近年来研究表明,铁死亡与缺氧应答的关键调控因子——缺氧诱导因子(HIF)存在密切关联。HIF(包括HIF-1α、HIF-2α、HIF-3α三种亚型)调控的铁死亡在结直肠癌、胃癌、溃疡性结肠炎及其他胃肠黏膜损伤性疾病中发挥作用,影响疾病的发生发展。但目前关于HIF-铁死亡通路在不同胃肠道疾病中的差异化作用及调控机制尚未完全阐明。因此,本文对HIF各亚型调控铁死亡的分子机制及其在胃肠道疾病中的作用进行综述,以期为靶向HIF-铁死亡通路治疗相关疾病提供新的思路。
Ferroptosis is a form of regulated cell death characterized by iron-dependent lipid peroxidation.Recentstudies have demonstrated a close association between ferroptosis and hypoxia-inducible factor(HIF),the key regulator of the hypoxic response.Ferroptosis regulated by HIF(comprising three isoforms:HIF-1α,HIF-2α,and HIF-3α)plays a role in colorectal cancer,gastric cancer,ulcerative colitis,and other gastrointestinal mucosal injury diseases,impacting their initiation and progression.However,the differential roles and regulatory mechanisms of the HIF-ferroptosis pathway in various gastrointestinal diseases remain incompletely elucidated.Therefore,this review summarizes the molecular mechanism networks through which individual HIF isoforms regulate ferroptosis and their roles in gastrointestinal diseases,with the aim of providing new perspectives for targeting the HIF-ferroptosis pathway to treat relevant diseases.
肥胖是一种以慢性低度炎症为特征的进展性疾病,与多种代谢性疾病的发生、发展密切相关。脂肪组织作为一种内分泌和免疫器官,可分泌多种生物活性物质及炎症因子,参与肥胖患者体内的代谢过程。减重手术是治疗病态性肥胖及相关代谢性疾病的有效方法之一,能够调节机体内的炎症反应、有效改善代谢状态。但减重手术对于炎症因子的作用如何,目前国内外的文献证据仍有争议。本文将系统阐述肥胖与代谢性炎症的关系以及减重手术对炎症因子的影响,旨在为肥胖代谢外科的诊疗过程提供参考。
Obesity is a progressive disease characterized by chronic low-grade inflammation,which is closely related to the occurrence and development of a variety of metabolic diseases.As an endocrine and immune organ,adipose tissue can secrete a variety of bioactive substances and inflammatory factors,which participate in the metabolic process of obese patients.Bariatric surgery is one of the effective methods for the treatment of morbid obesity and related metabolic diseases,which can regulate the inflammatory response in the machine and effectively improve the metabolic state.However,the effect of bariatric surgery on inflammatory factors is still controversial at home and abroad.This article will systematically explain the relationship between obesity and metabolic inflammation and the effect of bariatric surgery on inflammatory factors,aiming to provide a reference for the diagnosis and treatment process of bariatric surgery.