综述

克罗恩病肛瘘患者现状及管理的研究进展

Research progress on the current status and management of perianal fistula patients with Crohn's disease

:144-150
 
       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.
专家述评

肝胆胰外科中吲哚菁绿荧光成像技术的应用研究进展

Progress of indocyanine green fluorescence imaging in hepatobiliary and pancreatic surgery

:133-143
 
        吲哚菁绿(ICG)荧光成像技术基于ICG独特的代谢特性及近红外光激发特性, 通过动态荧光显影成像为手术提供精准导航, 其在肝胆胰外科领域展现出重要的应用价值。随着多版国内外指南的迭代更新, ICG荧光导航技术已被确立为肝胆胰外科手术的重要辅助手段, 其安全性和有效性得到充分验证。文章就ICG荧光成像技术的原理、在肝胆胰外科应用中的现状、在临床应用中面临的问题以及其应用展望展开综述。
       Based on the unique metabolic properties and near-infrared light excitation characteristics of indocyanine green(ICG), the ICG fluorescence imaging technology provides dynamic fluorescence imaging for precise surgical navigation.This technology has demonstrated significant value in hepatobiliary and pancreatic surgery.With iterative updates to international and domestic guidelines, ICG-based fluorescence navigation has been established as an essential adjunctive tool in hepatopancreaticobiliary procedures, with its safety and efficacy validated through extensive clinical research.This review systematically explores the underlying principles of ICG fluorescence imaging, its current applications in liver, biliary, and pancreatic surgeries, the challenges encountered in clinical practice, and future directions for technological optimization and clinical translation
专家述评

非编码 RNA 在泛血管疾病中的研究进展

Research progress of non-coding RNAs in panvascular diseases

:122-132
 
       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.
医学教育

“新医科”背景下《生物化学》教学改革探索与实践

Study and practice of teaching reformation on biochemistry under the background of New Medicine

:117-212
 
      生物化学是临床医学专业的一门重要基础课程,其教学质量可直接影响临床医学生物的培养目标。文章探讨了“新医科”背景下生物化学课程的教学改革,从思政元素融入课堂、教学手段的改革、开放实验平台的搭建和课程考核的改革等方面入手,着力培养学生自主学习的能力,解决临床问题的能力和提升科研素养。
      For students who majored in clinical medicine,biochemistry is a crucial foundation course,and the teaching quality of which directly influence the educational objectives of clinical medicine students.In this study,we explored the teaching reformation methods of biochemistry course under the background of New Medicine.We integrated ideological elements into classroom teaching,and used various teaching methods in the classroom,built an open experiment platform and innovated course assessment mode,for trying to improve the students’ ability of self-study,clinical problems resolving and scientific literacy.
医学教育

基于产教融合的康复治疗学专业创新创业人才培养模式的探索与实践——以广东药科大学为例

Exploration and practice of an industry-education integrated innovation and entrepreneurship talent cultivation model in rehabilitation therapy:A case study of Guangdong Pharmaceutical University

:111-116
 
       文章围绕康复治疗学专业创新创业人才培养模式展开研究,讨论了国内外高校创新创业人才培养现状。从教育理念、课程体系、师资力量、资源配套等方面探讨了人才培养所面临的问题。结合广东药科大学康复治疗学专业培养现状,从管理、教学、平台、服务四大体系明确了具体要求,有望为其他高校康复治疗学专业培养模式改革提供思路。
  The article focuses on innovative and entrepreneurial talent-cultivation models in the Rehabilitation Therapy specialty,discussing the current status of such cultivation in domestic and international universities.It explores challenges in talent development from perspectives including educational philosophy,curriculum system,faculty resources,and resource allocation.Based on the current training status of Guangdong Pharmaceutical University’s Rehabilitation Therapy Program,the study specifies detailed requirements through four major systems:management,teaching,platform,and service.This  research is expected to provide valuable insights for the  reform of talent cultivation models in  rehabilitation therapy programs at other higher education 
institutions.
论著

超声引导下针刺蝶腭神经节治疗过敏性鼻炎的随机对照研究

Ultrasound-guided acupuncture at the sphenopalatine ganglion for the treatment of allergic rhinitis:A randomized controlled study

:105-110
 
       目的   观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法   将80例过敏性鼻炎患者随机分成干预组(40例)和对照组(40例),干预组采用超声引导针刺蝶腭神经节,对照组采用常规方法针刺蝶腭穴,每周2次,持续4周。结果   治疗4周后,干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%,对照组的总有效率为82.50%,差异有统计学意义(P<0.05);干预组在鼻症状总分(TNSS)、非鼻症状总分(TNNSS)、视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)等指标上的改善均优于对照组(P<0.05)。结论   超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。
   Objective  To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound.Methods  A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group.The intervention group was treated with ultrasound guided acupuncture of the sphenopalatine 
ganglion,the control group was treated with conventional acupuncture at sphenopalatine point.The clinical efficacy was determined after the course of treatment.Results  The total effective rate was 92.50% in the intervention group and 82.50% in the control group.The improvement of total nasal symptom score,total non-nasal symptom score,VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions  Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis.
论著

延边州 70 例布鲁氏菌病临床特点分析

Clinical characteristics of 70 cases of brucellosis in Yanbian Prefecture

:100-104
 
      目的   分析布鲁氏菌病的临床表现以及实验室检查结果中的关键特征,系统总结布鲁氏菌病的诊断流程和治疗策略。方法   选择2013年11月—2023年11月在延边大学附属医院通过血清虎红平板凝集试验(RBT)及试管凝集试验(SAT)检测技术确诊的70名布鲁氏菌病住院病例,对患者的流行病学资料、临床表现特征以及常规实验室检查结果进行回顾性分析,进而总结临床特点。结果  70例布鲁氏菌病患者中,男性占84.29%,中位年龄45岁(IQR 35~58岁);91.43%具有牛/羊接触史。急性期占92.86%,主要症状为发热(100%)、多汗(88.57%)、关节痛(84.29%)及肝脾肿大(55.71%),90%为不规则热型。误诊率27.14%,多误诊为败血症或骨关节疾病。联合抗菌药物治疗(利福平+多西环素)有效。结论   延边州布鲁氏菌病非典型症状(如不规则热型)增加导致误诊率高。流行病学史(牛/羊接触史)是诊断关键。需强化对有牛羊接触史人群的防护意识及措施,提高临床对接触史线索和不规则热型等非典型表现的识别能力,规范治疗并控制传染源以遏制疫情。
   Objective  To analyze the clinical manifestations of  brucellosis and the  key characteristics in laboratory testing,and systematically summarize the diagnostic process and treatment strategies of brucellosis.Methods  The 70 patients with brucellosis diagnosed via rose bengal test(RBT)and standard agglutination test(SAT) were at Yanbian University Affiliated 
Hospital from November 2013 to November 2023.This study conducted a retrospective analysis of the epidemiological data,clinical manifestations and routine laboratory pathological examination data of these patients,and the characteristics of clinical changes were summarized.Results  Among the 70 patients with brucellosis,84.29% were male,with a median age of 45(IQR 35-58);91.43% patients had a history of cattle/sheep exposure.The acute phase accounted for 92.86%,and the main symptoms were fever(100%),sweating(88.57%),arthragia(84.29%),hepatosplenomegaly(55.71%),and 90% were irregular fever.The misdiagnosis rate was 27.14%,and most of them were misdiagnosed as sepsis or osteoarthritis.Combined treatment with antibiotics(rifampin + doxycycline)was effective.Conclusions  The increase in atypical symptoms(such as irregular heat type)leads to a high misdiagnosis rate.Epidemiological history(cattle/sheep contact)is the key to diagnosis.It is necessary to strengthen occupational protection and atypical case identification,standardize treatment and control the source of infection to curb the epidemic.
论著

桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床效果观察

Clinical effect observation of individualized intervention of Guizhi plus Shaoyao Decoction in the treatment of functional abdominal pain disorders in children

:95-99
 
        目的   观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法   选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组,益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果   益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降,中医临床症状评分的有效率优于益生菌组。结论   桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。
    Objective  To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders(FAPDs).Methods  A total  of  100  children  diagnosed with  FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected.These children were randomly divided into two groups:the probiotics group(50 cases)and the probiotics+traditional Chinese medicine individualized intervention group(50 cases).Both groups received continuous treatment for 1 week.Parameters including  supine/upright heart rates,supine/upright blood pressure,Rutter Children’s Behavior Questionnaire,and improvements in traditional Chinese clinical symptom scores were recorded.Results  The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group.The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group.Conclusions  Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children.
论著

LAMP3 基因表达与肾癌之间的因果关系:一项基于孟德尔随机化分析的研究

Causal relationship between LAMP3 gene expression and renal cancer:A Mendelian randomization analysis

:88-94
 
       目的   探讨溶酶体相关膜蛋白3(LAMP3)与肾癌发病风险之间的因果关系,为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究(GWAS)数据,采用孟德尔随机化分析方法,评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期(OS)及无病生存期(DFS)的关系。结果  LAMP3基因变异与肾癌风险呈正相关,提示LAMP3的表达可能增加肾癌的发病风险。此外,GEPIA2分析进一步显示,LAMP3的高表达与肾癌患者的低总体生存期(OS)及无病生存期(DFS)显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系,结果表明LAMP3可能是肾癌的潜在致病因子,并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据,并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。
        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis,providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer.Methods  This study utilized data from genome-wide association studies(GWAS)and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer.Additionally,GEPIA2 was used to examine the association between LAMP3 expression and overall survival(OS)and disease-free survival(DFS)in renal cancer patients.Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk,suggesting that LAMP3 expression may increase the likelihood of developing renal cancer.Furthermore,GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients.Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis.The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis.These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future.
论著

孕中晚期口腔二维轴向切面超声诊断唇腭裂类型的价值研究

The value of two-dimensional axial sectional ultrasonography in the diagnosis of cleft lip and palate in the second and third trimesters of pregnancy

:83-87
 
       目的   探讨孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中的应用价值,评估其对唇裂、唇腭裂及继发腭裂的检出率和准确性。方法   本研究为前瞻性研究,共纳入2020年3月—2023年12月在我院超声科行产前超声诊断的3 666例孕中晚期胎儿,其中经超声检查诊断出111例唇腭裂,这些病例归为唇腭裂组,其余3 555例归入正常对照组。所有受试者均通过口腔二维轴向切面超声进行评估,诊断结果经产后随访确认。结果   在正常对照组中,上唇及上牙槽突的评估成功率为100%,软硬腭分界线显示率为99%,软腭显示率为85%。在唇腭裂组中,超声对唇裂、唇腭裂及继发腭裂的检出率分别为45%、48%和7%,且超声诊断的灵敏度、特异度和预测值均超过98%。结论   孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中具有较高的准确性和可靠性,为早期干预和临床管理提供了重要的影像学依据。
       Objective  To explore the application value of two-dimensional axial section ultrasound in prenatal diagnosis of fetal cleft lip and palate in the second and third trimesters of pregnancy,and to evaluate its detection rate and accuracy for cleft lip,cleft lip and palate,and secondary cleft palate.Methods  This study is a prospective study that included 3 666 fetuses in the second and third trimesters of pregnancy.Among them,111 cases of cleft lip and palate were diagnosed by ultrasound examination.These cases were classified as the cleft lip and palate group,and the remaining 3 555 cases were classified as the normal control group.All subjects were evaluated by oral two-dimensional axial section ultrasound,and the diagnostic  results were confirmed by postpartum follow-up.Results  In the normal control group,the success rates of evaluating the upper lip and upper alveolar process were 100%.The present rate of the soft hard palate boundary was 99%,and the present rate of the soft palate was 85%.In the cleft lip and palate group,the detection rates of cleft lip,cleft lip and palate,and secondary cleft palate by ultrasound were 45%,48% and 7% respectively,and the sensitivity,specificity,and predictive value of ultrasound diagnosis exceeded 98%.Conclusions  Two dimensional axial section ultrasound of the oral cavity in second and third trimesters of pregnancy has high accuracy and reliability in prenatal diagnosis of fetal cleft lip and palate,providing strong imaging evidence for early intervention and clinical management.
出版者信息








《广州医药》公众号