目的 通过采用本体感觉神经肌肉刺激技术（PNF）对慢性颈痛患者进行治疗,观察患者颈部肌肉力量是否得到增强,以及颈椎的Cobb角是否得到改善。方法 将符合纳入标准的30例慢性颈痛患者纳入研究对象（PNF组）。研究对象接受为期4周的PNF技术治疗,对比治疗前（基线）和治疗4周后颈部最大等长收缩肌力（MIS）,并比较治疗前后Cobb角。结果 共30例患者完成研究。治疗后颈椎Cobb角明显改善,治疗4周后对比基线Cobb角差异具有统计学意义（t=4.925,P<0.001）。颈椎屈曲和伸展的力量经过4周治疗后都得到明显的改善,颈椎伸展的MIS从（15.8±2.5）lbs增加到（19.3±3.1）lbs,比较基线差异具有统计学意义（t=5.685,P<0.001）。颈椎屈曲的MIS从13.9（10.3,15.6）lbs增加到17.8（15.3,18.8）lbs,治疗4周后对比基线差异具有统计学意义（Z=-4.783,P<0.001）。结论 PNF技术能有效增强颈部肌肉力量,可有效增大颈椎Cobb角,可能为颈椎变直的慢性颈痛患者的治疗带来积极的影响。

Objective To observe whether the strength of the neck muscles and the Cobb angle of the cervical vertebra are improved by proprioceptive neuromuscular facilitation（PNF）in the treatment of patients with chronic neck pain. Methods Thirty patients with chronic neck pain who met the inclusion criteria were included in the study group（PNF group）. They were treated with PNF for four weeks, maximal isometric strength（MIS）and Cobb angle in the neck were compared at before（baseline）and four weeks after treatment. Results A total of 30 participants completed the study. The Cobb angle of cervical spine was significantly improved after treatment,and the Cobb angle before treatment was significantly different from that after four weeks of treatment（t=4. 925, P<0. 001）. The strength of cervical flexion and extension improved significantly after four weeks of treatment,and the MIS of cervical extension increased from（15. 8±2. 5）lbs to（19. 3±3. 1）lbs, which was statistically significant compared to baseline（t=5. 685, P<0. 001）. Cervical flexion MIS increased from 13. 9（10. 3,15. 6）lbs to 17. 8（15. 3,18. 8）lbs,and the difference was statistically significant compared to baseline after four weeks of treatment（Z=-4. 783, P<0. 001）. Conclusions PNF can effectively enhance the strength of neck muscles,and can effectively increase the Cobb angle of cervical spine, which may have a positive impact on the treatment of chronic neck pain patients with cervical straightening.

目的 探讨肝癌根治术后恶心呕吐现状及影响因素。方法 选取2022年5月—2024年5月天津市第二人民医院收治的70例肝癌患者进行回顾性分析,所有患者均行肝癌根治术,分析其术后恶心呕吐情况。并依照恶心呕吐发生情况进行分组,将30例术后发生恶心呕吐的患者分为观察组,其余40例患者为对照组。对比两组患者临床病理特征及围术期指标。并建立Logistic回归模型以术后恶心呕吐为因变量分析肝癌患者手术切除术后恶心呕吐的影响因素。结果 肝癌患者手术切除术后恶心呕吐发生率为42.86%（30/70）,其中Ⅰ度14例（20.00%）、Ⅱ度10例（14.29%）、Ⅲ度4例（5.71%）、Ⅳ度2例（2.86%）;观察组与对照组性别、体质量指数（BMI）、病理类型、临床分期、术前禁食时间对比差异无统计学意义（P>0.05）,观察组与对照组年龄及是否化疗情况对比差异有统计学意义（P<0.05）;观察组与对照组手术时间、术后VAS评分、麻醉方式、术后合并其他并发症情况对比差异无统计学意义（P>0.05）,观察组与对照组肝门阻断时间、术中失血量及术后腹胀情况对比差异有统计学意义（P<0.05）;年龄、是否化学治疗、术中失血量、术后腹胀情况为肝癌患者手术切除术后恶心呕吐的影响因素（P<0.05）。结论 肝癌患者手术切除术后恶心呕吐发生率较高,且年龄、是否化疗、术中失血量及术后腹胀情况可能为恶心呕吐发生的影响因素,针对此类患者高风险患者需及时采取相关措施进行干预,预防患者术后恶心呕吐情况及减轻严重程度。

Objective To explore the status and influencing factors of nausea and vomiting after radical resection of liver cancer. Methods A retrospective analysis was conducted on 70 liver cancer patients admitted to the Second People’s Hospital of Tianjin from May 2022 to May 2024. All patients underwent radical surgery for liver cancer,and their postoperative nausea and vomiting conditions were analyzed. According to the occurrence of nausea and vomiting, 30 patients who experienced nausea and vomiting after surgery were divided into an observation group, and the remaining 40 patients were divided into a control group. The clinical and pathological characteristics as well as perioperative indicators between two groups of patients were compared. A logistic regression model was established to analyze the influencing factors of postoperative nausea and vomiting in liver cancer patients after surgical resection,with postoperative nausea and vomiting as the dependent variable. Results The incidence of postoperative nausea and vomiting in liver cancer patients was 42. 86%（30/70）, including 14 cases of grade I, accounting for 20. 00%, 10 cases of grade II, accounting for 14. 29%, four cases of grade III,accounting for 5. 71%, and two cases of grade IV,accounting for 2. 86%. There were no significant differences in gender,body mass index（BMI）, pathological type,clinical stage,and preoperative fasting time between the observation group and the control group（P>0. 05）. However, there were significant differences in age and chemotherapy status between the observation group and the control group（P<0. 05）. There were no significant differences in the operation time,postoperative VAS score,anesthesia method and postoperative complications between the observation group and the control group（P>0. 05）, but with differences in the portal block time,intraoperative blood loss and postoperative abdominal distension between the observation group and the control group（P<0. 05）. Age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension were independent influencing factors for postoperative nausea and vomiting in liver cancer patients undergoing surgical resection（P<0. 05）. Conclusions The incidence of nausea and vomiting after surgical resection in liver cancer patients is relatively high, with age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension may be influencing factors for nausea and vomiting. Therefore, relevant measures should be taken in a timely manner to intervene in high-risk patients to prevent postoperative nausea and vomiting and reduce its severity.

目的 建立大鼠急性心肌梗死缺血再灌注后无复流模型,并初步验证细胞焦亡在其中的发生情况。方法 选用20只标准成年雄性Sprague Dawley大鼠（体质量260~320 g）,随机分为对照组（n=5）和手术组（n=15）。对照组仅穿线冠状动脉,未行结扎;手术组结扎左前降支0.5 h后解除,进行再灌注4 h,以建立无复流模型。通过Evens blue和硫磺素S染色,评估心肌的正常供血区、再灌注区及无复流区,并对两组大鼠心肌组织进行病理分析。结果 对照组大鼠全部存活,未出现无复流现象,心肌组织中未见细胞焦亡。手术组存活13只,形成明确的正常供血区（n=13）、再灌注区（n=13）和无复流区（n=10）。在无复流区的心肌细胞中均观察到细胞焦亡（n=10）,而正常供血区未见（n=0）,再灌注区部分出现（n=4）,差异具有统计学意义（P<0.05）。结论 细胞焦亡现象主要存在于大鼠急性心肌梗死缺血再灌注后无复流区域中,细胞焦亡可能作为一种区域特异性程序性死亡方式,在心肌无复流的发生与发展中发挥重要作用。

Objective To establish a rat model of myocardial no-reflow after acute myocardial infarction with ischemia-reperfusion injury and to preliminarily explore the occurrence of pyroptosis in the affected myocardium. Methods Twenty adult male Sprague-Dawley rats（260-320 g）were randomly divided into a control group（n=5）and a surgical group（n=15）. In the control group,the coronary artery was encircled with suture but not ligated. In the surgical group,the left anterior descending artery was ligated for 30 minutes, followed by 4 hours of reperfusion to induce the no-reflow model. Evans blue and thioflavin S staining were used to evaluate the normal perfusion area,reperfusion area,and no-reflow area of the myocardium. Histopathological analysis was conducted on myocardial tissues from both groups. Results All rats in the control group survived without evidence of no-reflow or pyroptosis in myocardial tissue. In the surgical group, 13 rats survived and showed distinct regions of normal perfusion, 13 with reperfusion, and 10 with no-reflow. Pyroptosis was observed in all no-reflow areas（n=10）, absent in the normal perfusion zones（n=0）, and partially present in the reperfusion zones（n=4）. The differences were statistically significant（P<0. 05）. Conclusions Pyroptosis predominantly occurs in the no-reflow zones following acute myocardial infarction and ischemia-reperfusion injury in rats. As a region-specific form of programmed cell death, pyroptosis may play an important role in the development of myocardial no-reflow.

目的 探讨基于品管圈活动构建健康体检重要异常结果的追踪管理模式对提高电话随访率的影响。方法 选取2022年5月—2023年4月在中山大学孙逸仙纪念医院健康管理中心体检重要异常结果的328例受检者作为研究对象。成立品管圈活动小组,实施追踪管理模式。干预后时间段为2022年11月—2023年4月,期间针对不同样本分别实施了干预措施一至四及全面实施措施,分析随访1个月后成功随访人数。比较干预前后圈员综合能力变化及患者对健康管理中心的满意度。结果 电话随访率在干预措施一实施后为85.02%,干预措施二实施后为88.59%,干预措施三实施后为90.23%,干预措施四实施后为95.27%,全面实施干预措施一至干预措施四后为95.80%,均较干预措施实施前电话随访率（75.91%）有所增长;干预成功随访人数中,复诊率为84.34%（210/249）,全面实施措施后成功随访人数中复诊率为94.74%（216/228）。相较于干预前,干预后,圈员解决问题能力、责任心、沟通协调、团队凝聚力、积极性、品管手法、自信心、和谐感分值均升高（P<0.05）。干预前患者满意度为85.37%,干预后患者满意度为87.80%,干预后满意度有所升高,差异具有统计学意义（P<0.05）。结论 通过开展品管圈活动,使重要异常结果电话随访率明显提高,有利于提升体检机构的服务质量和服务能力,有利于疾病的早发现、早干预。

Objective Exploring the impact of establishing a tracking and management model for important abnormal results of health check ups based on quality control circle activities on improving telephone follow-up rates. Methods A total of 328 subjects with important abnormal results in Health Management Center of Sun Yat-sen Memorial Hospital of Sun Yat sen University from May 2022 to April 2023 were selected. The quality control circle activity group was set and the tracking management mode was carried out. The post intervention period was from November 2022 to April 2023, during which intervention measures 1-4 and comprehensive implementation measures were implemented for different samples. The number of successful follow-up after 1 month of follow-up was analyzed. Changes in the comprehensive ability of the circle staff before and after the intervention and the patients’ satisfaction with the health management center were compared. Results The telephone follow-up rate after intervention 1 was 85. 02%, 88. 59% after intervention 2,90. 23% after intervention 3,95. 27% after intervention 4 and 95. 80% after all intervention,which was higher than 75. 91% before intervention implementation. Among the single intervention individuals, the re-visit rate was 84. 34%（210/249）, and after the comprehensive implementation of measures, the re-visit rate among the successfully intervened individuals was 94. 74%（216/228）. After the intervention,the problem solving ability,responsibility, communication and coordination,team cohesion, enthusiasm,quality control techniques,self-confidence,and sense of harmony all significantly increased（P<0. 05）. The patient satisfaction rate before intervention was 85. 37%, and after intervention it was 87. 80%. The satisfaction rate increased after intervention, and the difference was statistically significant（P<0. 05）. Conclusions Through the quality control circle activities, the telephone follow-up rate of important abnormal results is significantly improved,which is conducive to improving the service quality and service capacity of physical examination institutions,is conducive to the early detection and early intervention of diseases.

目的 探讨肾移植术后患者膀胱痉挛发生现状及影响因素。方法 选取广州医科大学附属第一医院2022年12月—2024年4月收治的80例肾移植患者为研究对象,记录术后膀胱痉挛发生情况,将15例术后发生膀胱痉挛的患者纳入膀胱痉挛组,其余65例患者纳入非膀胱痉挛组。对比两组一般人口学资料,术前临床资料、术中及术后情况。以合并膀胱痉挛作为因变量纳入Logistics回归模型分析肾移植术后膀胱痉挛发生的影响因素。结果 80例肾移植患者在术后共有15例患者发生膀胱痉挛,占比为18.76%。膀胱痉挛组与非膀胱痉挛组的性别、年龄、体质指数、文化程度、付费方式、家庭收入比较差异无统计学意义（P>0.05）;两组原发疾病、合并基础疾病、透析方式比较差异无统计学意义（P>0.05）,两组患者术前透析时间及术前贫血情况比较差异有统计学意义（P<0.05）;两组手术时间、术中出血量、术后尿管留置时间、术后尿潴留、术后视觉模拟量表评分、C反应蛋白、肿瘤坏死因子-α、白细胞介素-6、碱性磷酸酶、谷草转氨酶、肌酐、尿素氮、胱抑素C比较差异无统计学意义（P>0.05）,两组使用尿管材质、术后7 d平均尿量比较差异有统计学意义（P<0.05）;根据Logistics回归分析结果显示,术前透析时间（95%CI：1.327~9.846,OR：3.614,P=0.012）、术前贫血（95%CI：0.995~1.000,OR：0.997,P=0.045）、尿管材质（95%CI：1.498~3 199.687,OR：69.239,P=0.030）及术后7 d平均尿量（95%CI：1.058~334.543,OR：18.813,P=0.046）为肾移植术后膀胱痉挛发生的独立影响因素（P<0.05）。结论 肾移植患者术前透析时间较长、术前贫血、应用尿管材质较硬、术后尿量少均可增加术后膀胱痉挛发生风险,因此需针对膀胱痉挛高风险患者增加护理评估,监测患者术后尿量,尽量选择软质尿管,预防肾移植术后膀胱痉挛的发生。

Objective To explore the current situation and influencing factors of bladder spasms in patients after kidney transplantation. Methods Selecting 80 kidney transplant patients admitted to the First Affiliated Hospital of Guangzhou Medical University from December 2022 to April 2024 as the research subjects, the occurrence of postoperative bladder spasm was recorded. Fifteen patients who experienced bladder spasm after surgery were included in the bladder spasm group, and the remaining 65 patients were included in the non bladder spasm group. The general demographic data,preoperative clinical data, intraoperative and postoperative conditions between two groups were compared. Incorporating bladder spasm as the dependent variable into the Logistics regression model to analyze the influencing factors of bladder spasm after kidney transplantation. Results A total of 15 out of 80 kidney transplant patients experienced bladder spasms after surgery, accounting for 18. 76%. By comparing general demographic data between the bladder spasm group and the non bladder spasm group, it was found that there were no significant differences in gender, age, Body Mass Index, education level, payment methods, and household income（P>0. 05）. There was no significant differences in primary disease, combined basic disease, and dialysis method between the two groups（P>0. 05）,while there were significant differences in preoperative dialysis time and preoperative anemia between the two groups（P<0. 05）. Surgical time, intraoperative blood loss,postoperative urinary retention, postoperative visual analog scale score, C reactive protein, tumor necrosis factor-α, interleukin-6, alkaline phosphatase, transaminase, creatinine, urea nitrogen, cystatin C were not different between the two groups（P>0. 05）. The difference in the mean urine volume after seven days and urinary catheter material were significant（P<0. 05）. According to the results of the Logistic regression analysis,preoperative dialysis duration（95%CI：1. 327-9. 846,OR：3. 614, P=0. 012）, preoperative anemia（95%CI：0. 995-1. 000,OR：0. 997, P=0. 045）, catheter material（95%CI：1. 498-3 199. 687,OR：69. 239, P=0. 030）, and mean urine output at seven days postoperatively（95%CI：1. 058-334. 543,OR：18. 813, P=0. 046）were identified as independent influencing factors for the occurrence of bladder spasms after kidney transplantation（P<0. 05）. Conclusions Renal transplant patients have a longer preoperative dialysis time, and the use of harder urinary catheter materials and lower postoperative urine output can increase the risk of postoperative bladder spasms. Therefore, it is necessary to increase nursing evaluation for high-risk patients with bladder spasms mentioned above, monitor postoperative urine output, and choose soft urinary catheters as much as possible to prevent the occurrence of bladder spasms after kidney transplantation.

目的 探讨传统术式联合骶主韧带复合体交叉悬吊术与骶棘韧带悬吊术（SSLF）在前盆腔膨出方面的相对疗效与价值。方法 回顾性分析2019年1月—2021年3月安徽医科大学附属六安医院收治的80例重度盆腔器官脱垂（POP）患者临床资料。将接受传统经阴道子宫切除术、阴道前后壁修补术及骶棘韧带悬吊术的40例患者纳入对照组,在上述术式基础上加行骶主韧带复合体交叉悬吊术的40例患者纳入观察组。所有纳入研究的POP患者的盆腔器官脱垂定量评估（POP-Q）评分结果为Ⅱ~Ⅳ度。对比两组患者的围术期指标,包括手术时间、术中出血量、术后病率（定义为术后24 h内连续2次、相隔4 h体温超过38 ℃）、术后留置导尿时间、术后住院时间,以及术中和术后并发症等。此外,术后对患者分别进行了电话随访及门诊复查,随访时间为术后3个月、6个月、1年和2年。生活质量评价采用盆底功能障碍性疾病症状问卷（PFDI-20）和盆底疾病生命质量影响问卷（PFIQ-7）。结果 两组患者手术时间、术中出血量、术后留置导尿时间比较差异均有统计学意义（P<0.05）,观察组术中出血量少于对照组,手术时间短于对照组,尿管留置时间短于对照组;两组患者术后住院时间、术后病率（手术后24 h内连续2次、相隔4 h体温超过38℃）比较差异无统计学意义（P>0.05）。两组间术前PFIQ-7和PFDI-20评分比较差异无统计学意义（P>0.05）;术后2年评分观察组高于对照组（P<0.05）。结论 经阴道子宫切除+阴道前后壁修补+骶棘韧带悬吊术及在上述术式基础上行骶主韧带复合体交叉悬吊术,均为临床治疗重度POP的常用手术方式。后者在治疗重度POP的主、客观治愈率上高于传统修补术式,且复发率更低,疗效更加持久。此外,骶主韧带复合体交叉悬吊术在改善单纯SSLF术后前盆腔膨出方面具有显著优势,为临床上POP的治疗与预后提供了新的思路。

Objective To explore the relative efficacy and value of the combination of traditional surgical methods with cross suspension of the sacro–uterine ligament complex and sacrospinous ligament suspension（SSLF）in preventing the recurrence of anterior pelvic prolapse after surgery. Methods This study retrospectively analyzed the clinical data of 80 patients with severe pelvic organ prolapse in Lu’an Hospital Affiliated to Anhui Medical University from January 2019 to March 2021. In the control group,patients received traditional transvaginal hysterectomy,repair of the anterior and posterior vaginal walls,and sacrospinous ligament suspension, while in the observation group, cross suspension of the sacro–uterine ligament complex was added on the basis of traditional surgical methods. The patients participating in the study were divided into the observation group（40 cases）and the control group（40 cases）according to different surgical methods. All patients with pelvic organ prolapse（POP）included in this study had POP–Q scores of grade II to IV. We compared the perioperative indicators of the two groups,including operation time, intraoperative blood loss, postoperative morbidity （defined as a body temperature exceeding 38°C for two consecutive times within 24 hours after surgery,separated by 4 hours）, postoperative indwelling catheterization time, postoperative hospital stay, and intraoperative and postoperative complications. In addition, patients were followed up by telephone and outpatient reexamination after surgery at 3 months, 6 months, 1 year, and 2 years. The quality of life was evaluated using the Pelvic Floor Dysfunction Symptom Questionnaire （PFDI–20） and the Pelvic Floor Disease Quality of Life Impact Questionnaire （PFIQ–7）. Results Comparing the operation time, intraoperative blood loss, and postoperative indwelling catheterization time of the two groups, there were statistically significant differences, P<0. 05. The intraoperative blood loss in the observation group was less than that in the control group, the operation time was shorter than that in the control group, and the indwelling catheter time was shorter than that in the control group. There was no statistically significant difference in postoperative hospital stay and postoperative morbidity（within 24 hours after surgery, two consecutive times with a body temperature exceeding 38°C separated by 4 hours）between the two groups, P>0. 05. There was no statistically significant difference in preoperative PFIQ–7 and PFDI–20 scores between the two groups（P>0. 05）, however, the scores of the observation group were higher than those of the control group 2 years after surgery, and the difference was statistically significant（P<0. 05）. Conclusions Traditional transvaginal hysterectomy + repair of the anterior and posterior vaginal walls + sacrospinous ligament suspension and cross suspension of the sacro–uterine ligament complex based on traditional surgical methods are both common surgical methods for the clinical treatment of severe pelvic organ prolapse. Studies have shown that the latter has a higher subjective and objective cure rate and a lower recurrence rate in the treatment of severe pelvic organ prolapse, with a more durable therapeutic effect. In addition,cross suspension of the sacro–uterine ligament complex has significant advantages in improving anterior pelvic prolapse after simple SSLF, providing new ideas for the treatment and prognosis of pelvic organ prolapse in clinical practice.

目的 利用可视化软件CiteSpace分析近20年儿童注意缺陷多动障碍（ADHD）及其共患病的相关文献,得出该领域的研究现状和发展趋势,为儿童注意缺陷多动障碍及其共患病的研究和诊疗提供参考。方法 检索2004—2024年发表在中国知网、维普、万方数据库关于儿童注意缺陷多动障碍及其共患病的相关文献,运用CiteSpace软件对纳入文献进行可视化分析,对来源、机构、发文量、作者、关键词绘制科学知识图谱。结果 共纳入383个机构、500个作者、235种期刊、577篇有效文献。自2012年发文量总体上呈波动上升趋势;在发文来源中,《中国儿童保健杂志》以47篇居首;研究机构以北京大学精神卫生研究所为代表;王玉凤作者发文21篇为最多;ADHD患儿的主要共患病为抽动障碍、癫痫、对立违抗障碍、学习障碍;主要治疗药物为托莫西汀;主要影响患儿的执行功能。ADHD患儿共患病研究分为3个阶段,第一阶段为2004—2009年,研究对象主要为品行障碍、对立违抗障碍、学习障碍、焦虑障碍,主要研究内容为患儿的脑损伤与基因;第二阶段为2009—2017年,重视研究患儿的心理问题,如焦虑、抑郁,也重视患儿的生活及家庭环境;第三阶段为2017—2024年,重点研究托莫西汀、阿立哌唑等药物,并重视ADHD共患癫痫的研究。结论 目前对ADHD共患病的研究仍较为局限,主要集中研究共患抽动障碍、对立违抗障碍、癫痫,未来应重视研究其他共患病,进一步探索更好的诊治方法。

Objective To analyze the literature on attention deficit hyperactivity disorder（ADHD）and its comorbidities in children in the past 20 years by using the visualization software CiteSpace, and to obtain the research status and development trend of this field, so as to provide reference for the research, diagnosis and treatment of ADHD and its comorbidities in children. Methods The relevant literature on ADHD and its comorbidities in children published in CNKI, VIP and Wanfang data bases from 2004 to 2024 was searched, and the included literature was visually analyzed by CiteSpace 6. 2R6 software, and the scientific knowledge graph was drawn by the source, institution, number of publications, authors and keywords. Results A total of 383 institutions, 500 authors, 235 journals, and 577 valid articles were included. Since 2012, the number of published documents has fluctuated and increased. Among the sources of publication, the Chinese Journal of Child Health ranked first with 47 articles. The research institutions were represented by the Institute of Mental Health of Peking University. Wang Yufeng was the most prolific author with 21 articles. The main comorbidities of ADHD children were tic disorder, epilepsy, oppositional defiant disorder and learning disorder. The main treatment drug was tomoxetine. It mainly affects the executive function of the children. The study on comorbidity in children with ADHD was divided into three stages. The first stage was from 2004 to 2009. The research objects mainly included conduct disorder, oppositional defiant disorder, learning disorder and anxiety disorder, and the main research content was brain injury and genes in children. The second stage, from 2009 to 2017, focused on the psychological problems of children, such as anxiety and depression, and also paid attention to the life and family environment of children. The third stage was 2017-2024, focusing on tomoxetine, aripiprazole and other drugs, and paying attention to the study of ADHD co-induced epilepsy. Conclusions The current research on ADHD and its comorbidities is still limited, and its pathogenesis should be explored in the future, so as to quickly and accurately identify comorbidities and further study better treatments.

目的 探讨抗增殖蛋白2（PHB2）脓毒症心肌损伤线粒体功能的调控机制。方法 体外培养大鼠心肌细胞株（H9C2）,分为对照组、脂多糖（LPS）组、LPS+PHB2 siRNA（si-PHB2）组。检测氧化应激指标细胞内丙二醛（MDA）水平、荧光探针检测细胞内活性氧（ROS）水平;线粒体指标：三磷酸腺苷（ATP）水平、线粒体膜电位、线粒体电镜、线粒体半定量评分;免疫印迹法检测PHB2、PTEN诱导激酶1（PTNKI）、帕金蛋白（Parkin）、线粒体转录因子（TFAM）的表达。结果 LPS刺激后MDA水平和ROS水平升高、ATP水平低,LPS+si-PHB2组MDA（6.21±0.39 vs 3.59±0.33, P<0.05）、细胞内的ROS（15 131.37±88.72 vs 8 628.67±71.95, P<0.05）的水平较LPS组升高,ATP（3.46±0.34 vs 4.52±0.25, P<0.05）和线粒体膜电位水平（0.33±0.04 vs 0.55±0.09, P<0.05）进一步降低;电镜观察显示与正常组相比,LPS组、LPS+si-PHB2组出现不同程度线粒体损伤,线粒体损伤半定量评分显示LPS+si-PHB2组的损伤较LPS组更为明显（1.42±0.10 vs 0.81±0.04, P<0.05）; 免疫印迹法结果显示LPS处理后PHB2、PINK1、Parkin 表达上调,TFAM表达下调,LPS+si-PHB2组的线粒体自噬相关蛋白PINK1（1.33±0.06 vs 1.79±0.21, P<0.05）、Parkin（1.43±0.08 vs 1.86±0.09, P<0.05）和线粒体生物发生关键蛋白TFAM（0.29±0.01 vs 0.74±0.06, P<0.05）表达均较LPS组降低。结论 LPS可促进大鼠心肌细胞PHB2表达,si-PHB2干扰后线粒体自噬蛋白和生物发生蛋白表达抑制,心肌细胞氧化应激损害和线粒体功能障碍加重,提示PHB2表达上调可能恢复线粒体稳态改善脓毒症心肌损伤的线粒体功能。

Objective To explore the regulatory mechanism of septic myocardial injury by prohibitin 2（PHB2）. Methods Rat myocardial cell lines（H9C2）were cultured in vitro and divided into control group,LPS group,LPS + PHB2 siRNA（si-PHB2） group. The indicators for detecting oxidative stress include the levels of intracellular malondialdehyde（MDA）and reactive oxygen species（ROS）. The indicators for mitochondrial detection include adenosine triphosphate（ATP）levels,mitochondrial membrane potential,mitochondrial electron microscopy,and semi-quantitative mitochondrial scoring. Western blotting was used to detect the expression of PHB2,PTEN induced putative kinase（PINK1）,Parkin,mitochondrial transcription factor A（TFAM）. Results After LPS stimulation,MDA level and intracellular ROS level increased,ATP level decreased. Compared with LPS group,MDA（6. 21±0. 39 vs 3. 59±0. 33, P<0. 05）level and intracellular ROS level（15 131. 37±88. 72 vs 8 628. 67±71. 95, P<0. 05）in LPS + si-PHB2 group increased significantly,while ATP（3. 46±0. 34 vs 4. 52±0. 25, P<0. 05）and MMP（0. 33±0. 04 vs 0. 55±0. 09, P<0. 05）level further decreased. Compared with the normal group,the structure of mitochondria in LPS group and LPS + si-PHB2 group was damaged in different degree. The semi-quantitative score of mitochondrial damage showed that the damage in LPS + si-PHB2 group was more obvious than that in LPS group（1. 42±0. 10 vs 0. 81±0. 04, P<0. 05）. Western blotting showed that the expression of PHB2,PINK1 and Parkin were up-regulated and the expression of TFAM was down-regulated after LPS treatment,mitohagy-related proteins PINK1（1. 33±0. 06 vs 1. 79±0. 21, P<0. 05）,Parkin（1. 43±0. 08 vs 1. 86±0. 09, P<0. 05）and mitochondrial biogenetic protein TFAM（0. 29±0. 01 vs 0. 74±0. 06, P<0. 05）in LPS+si-PHB2 group were lower than those in LPS group. Conclusions LPS can promote the expression of PHB2 in rat cardiomyocytes. After interfering with PHB2 expression,we found that mitochondrial autophagy and biogenesis are inhibited,and mitochondrial dysfunction,oxidative stress exacerbated,suggesting that the up-regulation of PHB2 expression may restore mitochondrial homeostasis and improve mitochondrial function in septic myocardial injury.

与正常组织细胞微环境相比,肿瘤微环境具有一定的异质性,包括偏酸性、氧化还原状态失衡、存在高浓度活性氧以及酶过量表达等。根据以上肿瘤微环境特点,可设计出一系列通过各种特殊微环境响应型连接臂相连的小分子或聚合物前药纳米粒。其中,多柔比星阿霉素作为一类最常见的广谱抗肿瘤药物在治疗肿瘤的过程中发挥重要作用。文章探讨了在肿瘤微环境特异性的生理状态下针对不同微环境所设计的多柔比星前药及其释放特性等,归纳总结了肿瘤微环境响应型多柔比星前药的研究进展。

Compared with normal tissue cell microenvironment, there is some differences in tumor microenvironment, such as partial acidity, imbalance of redox state, high concentration of reactive oxygen species and cathepsin. According to the above characteristics of tumor microenvironment, a series of small molecule or polymer prodrug nanoparticles connected by various special microenvironment responsive structures can be designed. Doxorubicin, as one of the most common broad-spectrum antitumor drugs, plays an important role in the treatment of tumors. This review discusses the doxorubicin prodrug designed for different tumor microenvironments under the physiological state of tumor microenvironment specificity and their release characteristics, and summarizes the research progress of tumor microenvironment-responsive doxorubicin prodrug.

       随着糖尿病患者的增加,因肺炎住院的糖尿病患者数也呈现出明显上升趋势。由于糖代谢紊乱及机体免疫功能下降等因素,细菌在高血糖的机体环境中快速繁殖并分泌大量毒素,增加了抗菌药物使用的时间跨度和细菌清除难度,对患者预后造成了极大的威胁。文章主要对糖尿病合并细菌性肺炎患者的病原学特征、耐药情况及药物治疗等进行阐述,旨在进一步为临床预防和治疗提供参考依据。

        With the increasing incidence in diabetes, the number of hospitalized diabetes patients with pneumonia is also increasing. Due to factors such as glucose metabolism disorders and decreased immune function in the body, bacteria rapidly multiply and secrete a large amount of toxins in the hyperglycemic environment,increasing the duration of antibiotic use and the difficulty of bacterial clearance, posing a great threat to patient prognosis. This article mainly elaborates on the pathogenic characteristics, drug resistance, and drug treatment of diabetes patients with bacterial pneumonia, aiming to provide reference for the clinical prevention and treatment.