目的 探索α-突触核蛋白（α-Syn）干预对人单核细胞白血病细胞系（THP-1）巨噬细胞源性泡沫细胞的影响。方法 通过佛波酯（PMA）和氧化型低密度脂蛋白（ox-LDL）构建THP-1巨噬细胞源性泡沫细胞模型,使用不同浓度（33、66、100、133 nmol/L）α-Syn处理泡沫细胞,随后检测细胞胆固醇含量和炎症因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）及白细胞介素-8（IL-8）的mRNA表达以及核因子κB（NF-κB）和凝集素样氧化低密度脂蛋白受体-1（LOX-1）的蛋白表达变化。结果 高剂量（100和133 nmol/L）α-Syn处理可以减少THP-1巨噬细胞源性泡沫细胞内胆固醇的含量（P<0.05）,并且减少IL-1β、IL-6和IL-8的mRNA表达（P<0.05）。进一步发现（100 nmol/L和133 nmol/L）α-Syn可以降低THP-1巨噬细胞源性泡沫细胞p-NF-κB和LOX-1的蛋白表达（P<0.05）。结论 α-Syn可以降低THP-1源性巨噬细胞泡沫细胞胆固醇蓄积和炎症反应,可能是通过下调p-NF-κB和LOX-1蛋白表达。
Objective To explore the effects of α-synuclein（α-Syn）intervention on human monocytic leukemia cell（THP-1）macrophage-derived foam cells．Methods The THP-1 macrophage-derived foam cell model was constructed by phorbol 12-myristate 13-acetate（PMA）and oxidized low-density lipoprotein（ox-LDL）．Foam cells were treated with different concentrations（33, 66, 100, and 133 nmol/L）of α-Syn, and the cellular cholesterol contents, as well as the mRNA expression of IL-1β、IL-6 and IL-8 were detected．Subsequently,alternation in protein expression of NF-κB and LOX-1 was measured．Results High-dose（100 and 133nmol/L）α-Syn treatment significantly reduced the levels of intracellular cholesterol in THP-1-derived macrophage foam cells（P<0.05）and decreased the mRNA expression of IL-1β、IL-6 and IL-8（P<0.05）．It was further found that（100 nmol/L and 133 nmol/L）α-Syn decreased the protein expression of p-NF-κB and LOX-1 in THP-1 macrophage-derived foam cells（P<0.05）．Conclusions The results of the present study suggest that α-Syn reduces cholesterol accumulation and inflammatory response in THP-1-derived macrophage foam cells, possibly by down-regulating p-NF-κB and LOX-1 protein expression．
目的 分析儿童大环内酯类耐药重症肺炎支原体肺炎（SMPP）的危险因素,构建列线图预测模型。 方法 回顾性收集2023年1月—2024年9月在广州医科大学附属番禺中心医院儿科住院治疗的1 121例大环内酯类耐药肺炎支原体肺炎患儿入院初期的临床资料。按7∶3比例将患儿资料随机分为训练集（784例）和验证集（337例）。采用R4.4.1软件使用10重交叉验证最小绝对收缩与选择算法（LASSO）回归分析进行单因素变量筛选,采用Logistics回归分析建立预测模型, 绘制可视化列线图。使用受试者操作特征曲线（ROC）, 校准曲线、Hosmer-Lemeshow（HL）检验及临床决策曲线（DCA）分别评估模型的区分度、校准度和临床使用价值。 结果 在训练集中, LASSO回归结合Logistics回归分析结果显示,院前发热时间>5.5 d、谷丙转氨酶>14.5 U/L、乳酸脱氢酶>287.5 U/L、C反应蛋白>18.65 mg/L、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的危险因素（P<0.05）, 根据上述危险因素构建列线图预测模型。训练集和验证集ROC曲线下面积分别为0.847和0.822; 校准曲线和HL检验显示模型具有良好的校准度; DCA显示预测模型在风险阈值为0.05~0.95时预测性能最优。 结论 院前发热时间、谷丙转氨酶、乳酸脱氢酶、C反应蛋白、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的影响因素, 基于以上因素构建的列线图模型具有较好的预测效能, 有利于早期识别耐药重症病例, 及早采取有效干预,改善患者预后。
Objective To explore the risk factors and to construct a nomogram prediction model for severe macrolide-resistant Mycoplasma pneumoniae pneumonia（MPP）in children．Methods The clinical data during the initial admission period of 1 121 children with macrolide-resistant MPP who were hospitalized in the Department of Pediatrics of the Affiliated Panyu Central Hospital of Guangzhou Medical University from January 2023 to September 2024 were retrospectively collected．The children data were randomly divided into a training set（n=784）and a validation set（n=337）at a ratio of 7∶3．With R language software（version 4.4.1）, least absolute shrinkage and selection operator（LASSO）regression analysis with tenfold cross-validation was used to screen risk factors, Logistics regression analysis was used to establish prediction model, and a visualization of the risk variables was created using a nomogram．The receiver operating characteristic（ROC）curves, calibration curves, Hosmer-Lemeshow（HL）test and clinical decision curve analysis（DCA）were used to evaluate the discrimination, calibration and clinical application value of the model．Results In the training set, LASSO regression analysis combined with Logistics regression analysis showed that prehospital fever duration > 5.5 days, alanine aminotransferase level> 14.5 U/L, lactate dehydrogenase level> 287.5 U/L, C-reactive protein > 18.65 mg/L, lung consolidation, and co-infection with virus were risk factors for severe macrolide-resistant MPP（P<0.05）．A nomogram prediction model was constructed based on the above risk factors．The area under the ROC curves of the training set and the validation set were 0.847 and 0.822, respectively．The calibration curves and HL test showed that the model had good calibration． The DCA curves showed that the prediction model had the best prediction performance when the risk threshold was between 0.05-0.95．Conclusions Prehospital fever duration, alanine aminotransferase level, lactate dehydrogenase level, C-reactive protein level, lung consolidation and co-infection with virus were risk factors for prediction of severe macrolide-resistant MPP．The nomogram model based on the above factors had a good prediction efficiency, which was conducive to early identification of severe cases with macrolide-resistant, and taking early effective interventions to improve the prognosis．
目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题：多重躯体症状负担持续存在（术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感）; 负性心理情绪困扰（病耻感、疾病不确定感与复发恐惧）; 心理调适过程（诊断冲击与认知失调、角色适应与主动应对）; 创伤后成长与健康行为转变（生命意义感提升、健康促进行为强化）; 强烈的康复信息支持需求（自我保健知识需求、结构化康复锻炼指导需求）。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。
Objective To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions．Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer．Colaizzi's 7-step analysis method was used to summarize and extract themes．Results Five themes and 12 sub-themes were summarized：Persistent burden of multiple physical symptoms（postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue）; negative emotional experiences（stigma of illness, illness uncertainty and fear of recurrence）; psychological adjustment processes（diagnostic shock and denial, role acceptance and active coping）; post-traumatic growth and health behavior transformation（enhanced sense of meaning in life, strengthened health-promoting behaviors）; strong demand for rehabilitation information support（self-care knowledge, rehabilitation exercise knowledge）．Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life．
炎症性肠病是一种慢性复发性疾病, 患者希望水平较低, 可能加剧疾病活动度、降低治疗依从性并降低其生活质量。文章从炎症性肠病患者希望水平的现状、评估工具、影响因素及干预方法四方面进行综述, 剖析现存挑战并提出未来研究方向, 旨在提升医护人员对希望水平管理的重视,为进一步构建科学、合理的炎症性肠病患者希望水平规范化管理方案提供参考。
Inflammatory bowel disease（IBD）is a chronic and frequently recurring disease, and low level of hope in patients may exacerbate disease activity, reduce treatment adherence,and lower their quality of life．This article reviews the current situation of hope level, assessment tools, influencing factors and intervention methods, to analyze the existing challenges and proposes future research directions, aiming to raise the attention of hope level management among healthcare professionals, and to provide reference for the construction of a scientific, reasonable and standardized management plan for hope level of patients with inflammatory bowel disease．
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．
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 educationinstitutions．
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．
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．
目的 探讨临床特征联合外周血血管内皮生长因子（VEGF）与α-羟基丁酸脱氢酶（α-HBDH）对卵巢癌的诊断价值。方法 选取2022年6月—2024年6月在天津市中心妇产科医院妇科接收的84例卵巢癌恶性肿瘤患者纳入观察组，同期选取84例卵巢良性病变患者纳入对照组。对比两组患者临床资料及VEGF、α-HBDH水平的差异，分析VEGF、α-HBDH水平与卵巢癌恶性肿瘤患者临床特征的相关性。采用二元Logistics回归分析卵巢癌恶性肿瘤的独立危险因素，并采用受试者工作特征（ROC）曲线分析VEGF、α-HBDH水平诊断卵巢癌恶性肿瘤的价值。结果 观察组年龄、身体质量指数（BMI）及血清CA125、HE4、VEGF、α-HBDH水平显著高于对照组（P＜0.05），VEGF与α-HBDH水平与国际妇产科联盟（FIGO）分期、分化等级及淋巴结转移均呈正相关关系（P＜0.05）。将年龄、BMI、VEGF、α-HBDH作为自变量纳入二元Logistic回归，结果显示BMI、VEGF、α-HBDH是卵巢癌恶性肿瘤的影响因素（P＜0.05），ROC曲线分析显示，联合检测VEGF和α-HBDH的AUC达0.921，灵敏度和特异度分别为81.0%和91.7%，优于单独检测（VEGF：AUC=0.702；α-HBDH：AUC=0.796）。结论 BMI联合VEGF与α-HBDH检测可为卵巢癌的诊断提供高效、无创的辅助手段，具有重要临床应用潜力。
Objective To explore the diagnostic value of clinical features combined with peripheral blood vascular endothelial growth factor（VEGF）and α-hydroxybutyrate dehydrogenase（α-HBDH）levels in ovarian cancer．Methods A total of 84 patients with malignant ovarian cancer admitted to the gynecology department of Tianjin Central Hospital of Gynecology and Obstetrics from June 2022 to June 2024 were included in the observation group，and 84 patients with benign ovarian lesions during the same period were included in the control group．The clinical data and VEGF，α-HBDH levels of the two groups were compared．Pearson analysis was used to explore the correlation between VEGF，α-HBDH levels，and clinical characteristics of patients with malignant ovarian cancer．Binary Logistic regression analysis was conducted to identify independent risk factors for malignant ovarian cancer，and receiver operating characteristic（ROC） curves were used to analyze the diagnostic value of VEGF and α-HBDH levels for malignant ovarian cancer．Results The observation group had significantly higher age，BMI，and serum CA125，HE4，VEGF，α-HBDH levels compared to the control group（P＜0.05）．VEGF and α-HBDH levels were significantly positively correlated with FIGO stage，differentiation grade，and lymph node metastasis（P＜0.05）．Age，BMI，VEGF，and α-HBDH were included as independent variables in binary Logistic regression，and the results showed that BMI，VEGF，and α-HBDH levelswere independent risk factors for malignant ovarian cancer（P＜0.05）．ROC curve analysis revealed that the AUC for combined detection of VEGF and α-HBDH reached 0.921，with sensitivity and specificity of 81.0% and 91.7%，respectively，significantly superior to individual detection（VEGF：AUC=0.702；α-HBDH：AUC=0.796）．Conclusions The detection of BMI combined with VEGF and α-HBDH levels can provide an efficient and noninvasive auxiliary means for the diagnosis of ovarian cancer，which has important clinical application potential．
目的 评估ChatGPT 4与Llama 3微调模型在乳腺癌诊断中的应用效果，特别是在超声、钼靶及超声联合钼靶的非结构化报告和影像诊断方面。方法 回顾性收集了689例同时接受乳腺超声和钼靶检查的患者数据，比较两种模型在文本和图像模态下的诊断性能，并探讨乳腺密度对模型表现的影响。结果 在文本模态下，微调Llama 3表现优异，联合诊断准确率达91.7%，优于ChatGPT 4的71.7%。图像模态中两模型准确率均低于70%，但ChatGPT 4灵敏度较高（78.3%），Llama 3特异度突出（98.3%）。分组分析表明，在非致密型乳腺中钼靶表现更佳，而致密型乳腺中超声诊断更具优势。结论 大语言模型在医学图像处理和多模态整合方面仍需进一步优化，医学领域微调的大语言模型在处理非结构化临床文本方面具有潜力。
Objective To evaluate the application effectiveness of ChatGPT 4 and the fine-tuned Llama 3 model in breast cancer diagnosis，particularly in processing unstructured reports and diagnostic imaging of ultrasound，mammography，and their combined modalities．Methods Retrospective data from 689 patients who underwent both breast ultrasound and mammography examinations were collected．The diagnostic performance of the two models was compared across text and image modalities，and the impact of breast density on model performance was explored．Results In the text modality，the fine-tuned Llama 3 model performed excellently，achieving a combined diagnostic accuracy of 91.7%，outperforming 71.7% of ChatGPT 4．In the image modality，both models had accuracies below 70%，but ChatGPT 4 exhibited higher sensitivity（78.3%），while Llama 3 demonstrated outstanding specificity（98.3%）．Subgroup analysis indicated that mammography performed better in non-dense breasts，whereas ultrasound was more advantageous in dense breasts．Conclusions The large language models still require further optimization in medical image processing and multimodal integration，but fine-tuned large language models in the medical field show potential in handling unstructured clinical texts．
