摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练（ACBT）在非小细胞肺癌（NSCLC）化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者，采用随机数字表法将所有研究对象分为联合组和常规组，每组49例。常规组给予常规干预，联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后，两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组（P<0.05）；联合组FVC、FEV1、MVV及6MWT均显著高于常规组（P＜0.05）；干预前两组6MWT组间对比差异无统计学意义（P>0.05），干预4周、6周、8周、12周后，两组6MWT均较干预前增加，且联合组远于常规组（P<0.05）；干预12周后，两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升，且联合组高于常规组（P<0.05）。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能，提高生活质量和运动耐力。

Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.

目的 探讨清咳平喘颗粒联合乙酰半胱氨酸对痰热闭肺型大叶性肺炎（LP）患儿的治疗效果。方法 回顾性选取我院收治的118例痰热闭肺型LP患儿（选例时间：2023年1月~2025年11月）为研究对象，根据治疗方案分为参照组（59例，采用乙酰半胱氨酸治疗）、联合组（59例，采用清咳平喘颗粒联合乙酰半胱氨酸治疗）。对比两组临床疗效、不良反应及治疗前、后肺功能［潮气量（VT）、达峰时间比（TPTEF/TE）、吸呼比（Ti/Te）、达峰容积比（VPEF/VE）］、中医证候、免疫功能、炎症因子［白细胞介素-8（IL-8）、趋化因子配体3（CCL3）、肿瘤坏死因子-α（TNF-α）、高迁移率族蛋白B1（HMGB1）］水平。结果 联合组总有效率为96.61%，高于参照组的83.05%（P＜0.05）；与参照组相比，治疗后联合组各中医证候积分均较低（P＜0.05）；联合组治疗后VT、TPTEF/TE、Ti/Te、VPEF/VE水平均较参照组高（P＜0.05）；联合组治疗后CD8+水平较参照组低，CD3+、CD4+、CD4+/CD8+水平较参照组高（P＜0.05）；治疗后联合组血清IL-8、CCL3、TNF-α、HMGB1水平均较参照组低（P＜0.05）；不良反应发生情况组间比较，无明显差异（P＞0.05）。结论 清咳平喘颗粒联合乙酰半胱氨酸可提高痰热闭肺型LP患儿治疗效果，减轻临床症状，改善肺功能、免疫功能，降低机体炎症反应程度。

Objective To explore the therapeutic efficacy of Qingke Pingchuan granules combined with acetylcysteine on children with lobar pneumonia (LP) of phlegm-heat obstructing lung type. Methods A total of 118 children with LP of phlegm-heat obstructing lung type admitted to our hospital from January 2023 to November 2025 were retrospectively selected as the research subjects. According to different treatment regimens, they were divided into the control group (59 cases, treated with acetylcysteine) and the combined group (59 cases, treated with Qingke Pingchuan granules combined with acetylcysteine). The clinical efficacy, adverse reactions, as well as the levels of pulmonary function indicators [tidal volume (VT), time to peak tidal expiratory flow ratio (TPTEF/TE), inspiration-expiration ratio (Ti/Te), volume to peak tidal expiratory flow ratio (VPEF/VE)], traditional Chinese medicine (TCM) syndrome scores, immune function and inflammatory factors [interleukin-8 (IL-8), C-C motif chemokine ligand 3 (CCL3), tumor necrosis factor-α (TNF-α), high mobility group box 1 protein (HMGB1)] before and after treatment were compared between the two groups. Results The total effective rate of the combined group was 96.61%, which was higher than 83.05% of the control group (P<0.05). After treatment, the TCM syndrome scores of the combined group were lower than those of the control group (P<0.05). The levels of VT, TPTEF/TE, Ti/Te and VPEF/VE in the combined group were higher than those in the control group after treatment (P<0.05). After treatment, the level of CD8? in the combined group was lower, while the levels of CD3?, CD4? and CD4?/CD8? were higher than those in the control group (P<0.05). The serum levels of IL-8, CCL3, TNF-α and HMGB1 in the combined group were significantly lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of Qingke Pingchuan granules and acetylcysteine can enhance the therapeutic efficacy on children with LP of phlegm-heat obstructing lung type, relieve clinical symptoms, improve pulmonary function and immune function, and reduce systemic inflammatory response.

目的 编制适用于老年人群的衰弱综合征中医评估量表并检验其信度与效度。方法 通过文献研究及《中华医典》检索构建条目池，采用4轮德尔菲专家咨询及预调查筛选条目形成初量表；便利抽取300例老年患者行横断面调查，以Fried表型衰弱量表为校标，进行项目分析、Cronbach’s α系数、探索性因子分析及ROC曲线分析。 结果 经条目筛选最终形成含5个核心症状条目（表A）及38个证候条目（表B）的量表。表A校标关联效度r=0.929（P＜0.05），AUC=0.957，灵敏度0.949，特异度0.859；表A+B校标关联效度r=0.648（P＜0.05），AUC=0.827，灵敏度0.606，特异度0.911；总量表Cronbach's α=0.872。结论 所研制的衰弱综合征中医量表信效度良好，可用于老年人衰弱状态筛查及中医证型判别。

Objective: To develop a Traditional Chinese Medicine (TCM) assessment scale for frailty syndrome in the elderly and to evaluate its reliability and validity. Methods: An item pool was constructed through literature review and searches of the *Chinese Medical Canon*. A preliminary scale was developed through four rounds of Delphi expert consultation and a pilot survey. A cross-sectional survey was conducted using a convenience sample of 300 elderly patients. Using the Fried Phenotypic Frailty Scale as the gold standard, item analysis, Cronbach’s α coefficient, exploratory factor analysis, and ROC curve analysis were performed. Results: After item screening, the final scale comprised 5 core symptom items (Table A) and 38 syndrome items (Table B). For Table A, the criterion-related validity was r = 0.929 (P < 0.05), AUC = 0.957, sensitivity = 0.949, and specificity = 0.859; Table A+B showed a test-retest reliability of r = 0.648 (P < 0.05), an AUC of 0.827, a sensitivity of 0.606, and a specificity of 0.911; the total scale had a Cronbach’s α of 0.872. Conclusion: The developed Traditional Chinese Medicine (TCM) frailty syndrome scale demonstrates good reliability and validity and can be used for screening frailty in the elderly and for distinguishing TCM syndrome patterns.

目的：探讨维生素B2（VB2）联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法：选取2024年5月—2025年10月收治的150例黄疸患儿，应用随机数字表法分为常规组和试验组，每组75例。常规组接受蓝光照射治疗，试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶（GSH-Px），8羟基脱氧鸟苷（8-OHdG）、晚期蛋白氧化产物（AOPP）、超氧阴离子（O2-）]、肝脏微循环[血管性血友病因子（vWF）、可溶性血栓调节蛋白（sTM）、肝动脉阻力指数（HA-RI）、门静脉血流速度（PVV）]、胆红素排泄[总胆红素（TBil）、间接胆红素（IBil）]、肝脏功能[丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果：治疗后，试验组的GSH-Px高于常规组，8-OHdG、AOPP、O2-均低于常规组（P＜0.05）；试验组的vWF、sTM、HA-RI均低于常规组，PVV高于常规组（P＜0.05）。试验组的TBil、IBil、ALT、AST分别为（80.52±5.47）μmol/L、（68.52±5.49）μmol/L、（30.25±5.48）U/L、（32.14±5.22）U/L，均低于常规组[（85.19±6.44）μmol/L、（74.37±6.52）μmol/L、（35.29±6.17）U/L、（38.55±6.48）U/L]，差异有统计学意义（P＜0.05）。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为（3.05±0.33）d、（4.22±1.39）d、（5.41±1.27）d、（5.12±0.49）d，均低于常规组[（3.68±0.36）d、（5.36±1.45）d、（6.28±1.33）d、（6.51±0.54）d]，差异有统计学意义（P＜0.05）。试验组的不良反应发生率与常规组比较，差异无统计学意义（P＞0.05）。结论：VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环，对促进胆红素排泄、改善肝脏功能均有积极影响，在促进患儿康复同时未显著增加治疗风险。其安全性较高，可进一步推广。

Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.

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 探讨数字减影血管造影（DSA）在冠状动脉病变诊断中的应用价值，并评估血清学参数相对于DSA金标准的诊断效能。方法 本研究纳入100名确诊为冠心病的患者。病例组为100例DSA确诊的冠心病患者，对照组按1:1比例匹配100例同期接受DSA检查排除冠心病的患者。应用DSA技术分别评估冠心病的狭窄程度及部位等指征。回顾性收集并对比分析两组患者的各项血清学参数（cTnI、CK-MB、hs-CRP、LDL-C、TC），计算血清学指标诊断冠心病的效能，并进一步探究以上评估于入组患者性别亚组间的统计学差异。结果 病例组与对照组在性别、年龄、BMI等基线资料上均衡可比（P > 0.05）。以DSA为金标准，cTnI诊断冠心病的灵敏度为82.0%，特异度为85.0%；hs-CRP的灵敏度为85.0%，特异度为75.0%。 cTnI、hs-CRP水平随冠状动脉狭窄程度加重而显著升高（P < 0.05）。且以上冠心病评价指征于患者性别亚组间均无统计学差异（ P <0.05）。结论 DSA技术可用于冠状动脉病变发生的部位、形态、数目等指征的明确评估，且于不同性别亚组间无统计学差异。血清学参数，尤其是cTnI和hs-CRP，对冠心病具有良好的辅助诊断价值，其水平与病变严重程度相关，可作为DSA检查前的有效筛查工具，为后续的治疗提供重要的参考依据。

Objective: To investigate the clinical value of digital subtraction angiography (DSA) in the diagnosis of coronary artery disease (CAD) and to evaluate the diagnostic performance of serological parameters relative to the DSA gold standard. Methods: A total of 100 patients with confirmed CAD were included in this study. The case group comprised 100 patients with CAD confirmed by DSA, while the control group consisted of 100 age- and sex-matched individuals who underwent DSA during the same period and were excluded from CAD. DSA was employed to assess the degree and location of coronary artery stenosis. Retrospective collection and comparative analysis of serological parameters (cTnI, CK-MB, hs-CRP, LDL-C, TC) were performed between the two groups. The diagnostic efficacy of these serological indicators for CAD was calculated, and subgroup analyses were conducted to explore potential sex-related differences. Results: The case and control groups were comparable in baseline characteristics such as sex, age, and BMI (P > 0.05). Using DSA as the gold standard, the sensitivity and specificity of cTnI for diagnosing CAD were 82.0% and 85.0%, respectively; hs-CRP demonstrated a sensitivity of 85.0% and specificity of 75.0%. Levels of cTnI and hs-CRP increased significantly with the severity of coronary stenosis (P < 0.05). No statistically significant differences were observed between male and female subgroups (P > 0.05). Conclusion: DSA provides definitive assessment of lesion location, morphology, and number in coronary artery disease, with no significant sex-related differences. Serological markers, particularly cTnI and hs-CRP, demonstrate good auxiliary diagnostic value for CAD. Their levels correlate with disease severity and may serve as effective screening tools prior to DSA, offering important reference value for subsequent clinical management.

心肌纤维化是心力衰竭等心血管疾病演化过程中的关键性病理改变，该病的进展机制依赖巨噬细胞与成纤维细胞的相互调控。现有现代医学研究证实巨噬细胞可凭借M1、M2表型极化行为介导炎症反应与组织修复过程，成纤维细胞能够分化形成肌成纤维细胞并推动细胞外基质异常沉积，两类细胞可依托TGF-β/Smad、CSF-1/CSF-1R等信号通路构建相互调控的作用网络并介导心肌纤维化恶化。中医痰瘀互结病机理论指出痰浊与瘀血可相互滋生、交织阻滞，是各类慢性迁延性疾病的关键发病基础。本文以中医痰瘀互结理论为研究切入点，剖析该病机理论与巨噬细胞、成纤维细胞交互作用的内在关联，整合现代医学关于两种细胞交互作用的现有研究成果，深入分析细胞互作在心肌纤维化发病过程中的协同机制与病理关联，旨在为心肌纤维化的中西医协同防治提供理论依据，为相关动物实验及临床应用研究筑牢研究基础。

Myocardial fibrosis is a key pathological change in the progression of cardiovascular diseases such as heart failure. The progression mechanism of this disease relies on the reciprocal regulation between macrophages and fibroblasts. Current modern medical research has confirmed that macrophages can mediate inflammatory responses and tissue repair processes through M1 and M2 phenotypic polarization behaviors, and fibroblasts can differentiate into myofibroblasts and promote abnormal extracellular matrix deposition. The two types of cells can construct a reciprocal regulatory network through signaling pathways such as TGF-β/Smad and CSF-1/CSF-1R, thereby mediating the deterioration of myocardial fibrosis. The theory of phlegm and blood stasis intermingling in traditional Chinese medicine suggests that phlegm turbidity and blood stasis can mutually generate and interweave to cause obstruction, serving as a key pathological basis for various chronic and persistent diseases. This article takes the traditional Chinese medicine theory of phlegmblood stasis intermingling as a research entry point, analyzes the intrinsic relationship between this pathological theory and the interaction of macrophages and fibroblasts, integrates existing modern medical research findings on the interaction between the two cell types, and deeply analyzes the synergistic mechanisms and pathological correlations of cellcell interactions in the pathogenesis of myocardial fibrosis. The aim is to provide a theoretical basis for the integrated traditional Chinese and Western medicine prevention and treatment of myocardial fibrosis, and also to lay a solid research foundation for related animal experiments and clinical application studies.

心肌纤维化是心力衰竭等心血管疾病演化过程中的关键性病理改变，该病的进展机制依赖巨噬细胞与成纤维细胞的相互调控。现有现代医学研究证实巨噬细胞可凭借M1、M2表型极化行为介导炎症反应与组织修复过程，成纤维细胞能够分化形成肌成纤维细胞并推动细胞外基质异常沉积，两类细胞可依托TGF-β/Smad、CSF-1/CSF-1R等信号通路构建相互调控的作用网络并介导心肌纤维化恶化。中医痰瘀互结病机理论指出痰浊与瘀血可相互滋生、交织阻滞，是各类慢性迁延性疾病的关键发病基础。本文以中医痰瘀互结理论为研究切入点，剖析该病机理论与巨噬细胞、成纤维细胞交互作用的内在关联，整合现代医学关于两种细胞交互作用的现有研究成果，深入分析细胞互作在心肌纤维化发病过程中的协同机制与病理关联，旨在为心肌纤维化的中西医协同防治提供理论依据，为相关动物实验及临床应用研究筑牢研究基础。

Myocardial fibrosis is a key pathological change in the progression of cardiovascular diseases such as heart failure. The progression mechanism of this disease relies on the reciprocal regulation between macrophages and fibroblasts. Current modern medical research has confirmed that macrophages can mediate inflammatory responses and tissue repair processes through M1 and M2 phenotypic polarization behaviors, and fibroblasts can differentiate into myofibroblasts and promote abnormal extracellular matrix deposition. The two types of cells can construct a reciprocal regulatory network through signaling pathways such as TGF-β/Smad and CSF-1/CSF-1R, thereby mediating the deterioration of myocardial fibrosis. The theory of phlegm and blood stasis intermingling in traditional Chinese medicine suggests that phlegm turbidity and blood stasis can mutually generate and interweave to cause obstruction, serving as a key pathological basis for various chronic and persistent diseases. This article takes the traditional Chinese medicine theory of phlegmblood stasis intermingling as a research entry point, analyzes the intrinsic relationship between this pathological theory and the interaction of macrophages and fibroblasts, integrates existing modern medical research findings on the interaction between the two cell types, and deeply analyzes the synergistic mechanisms and pathological correlations of cellcell interactions in the pathogenesis of myocardial fibrosis. The aim is to provide a theoretical basis for the integrated traditional Chinese and Western medicine prevention and treatment of myocardial fibrosis, and also to lay a solid research foundation for related animal experiments and clinical application studies.

目的：探讨粒细胞集落刺激因子（GCSF）宫腔灌注联合宫腔粘连冷刀分离术治疗薄型子宫内膜的临床效果。方法：选取2023年9月—2025年9月间在桐乡市妇幼保健院妇科因薄型子宫内膜住院并行手术治疗的患者101例，按治疗方式不同，分为对照组（56例）与治疗组（45例）。对照组采用宫腔镜下宫腔粘连冷刀分离术治疗，治疗组采取G-CSF宫腔灌注联合宫腔粘连冷刀分离术的方式治疗。比较两组手术前后的子宫内膜厚度情况、性激素指标水平、子宫动脉血流参数、术后临床妊娠情况。结果：治疗组子宫内膜厚度、子宫内膜厚度改善值、LH、E2、AMH、PSV、EDV、临床妊娠率均高于对照组，RI、PI低于对照组（P＜0.05）。结论：G-CSF宫腔灌注联合宫腔粘连冷刀分离术在治疗薄型子宫内膜中可取得令人满意的效果，能通过改善子宫的血流，促进子宫内膜的生长，而且还可提升性激素水平，对促进术后妊娠率的上升有积极的作用。

【摘要】目的：探究淀粉样蛋白A（serum amyloid?A，SAA）、超敏C反应蛋白（high sensitivity C-reactive protein，hsCRP）、白细胞计数（white blood cell count，WBC）、SAA/hsCRP比值对儿童感染性疾病早期鉴别的临床价值。方法：选取2025年1月--2025年6月我院就诊的感染性疾病患儿296例进行研究，其中细菌感染组86例、病毒感染组180例，另选取同期30例健康体检儿童作为对照组。检测三组SAA、hsCRP、WBC水平，计算SAA/hsCRP比值情况，通过受试者工作特征（receiver operating characteristic curve，ROC）分析各指标单独及联合检测对细菌感染和病毒感染的诊断效能。结果：与对照组比较，细菌感染组和病毒感染组SAA、hsCRP、WBC、SAA/hsCRP比值更高（P<0.05）；与病毒感染组比较，细菌感染组SAA、hsCRP、WBC更高，SAA/hsCRP比值更低（P<0.05）。相关性分析显示，SAA 与 hsCRP、WBC 及 SAA/hsCRP 比值均呈正相关（r=0.417、0.473、0.324，均 P＜0.001）；hsCRP 与 WBC 呈正相关（r=0.408，P＜0.001），与 SAA/hsCRP 比值呈负相关（r=-0.402，P＜0.001）；SAA/hsCRP 比值与 WBC 呈负相关（r=-0.523，P＜0.001）。ROC 曲线分析结果显示，SAA、hsCRP、WBC 及 SAA/hsCRP 比值均可用于儿童细菌感染与病毒感染的鉴别诊断，其 AUC 分别为 0.810、0.879、0.893 和 0.893，联合检测的 AUC 为 0.997，灵敏度为98.80%，特异度为93.89%，诊断效能优于单项指标。结论：SAA、hsCRP、WBC、SAA/hsCRP比值在儿童细菌感染性疾病及病毒感染性疾病鉴别诊断中有一定价值，临床可联合检测上述指标水平以鉴别具体感染类型，为患儿诊断及预后评估提供依据。