[摘要] 目的 对比2种不同表面材质培养瓶培养的人脐带间充质干细胞（human umbilical cord mesenchymal stem cells, hUC-MSCs）的培养特性。 方法 采集10条新鲜脐带，每条脐带用组织块法分离脐带组织并贴壁培养12d，收集原代细胞，分别取2*106个细胞用225cm2高粘培养瓶（简称A组）和225cm2普通瓶子（简称B组）细胞培养72h至P1代,收集P1代细胞继续培养72h至P2代，实验重复五次，观察比较两组实验组的P1和P2代培养瓶的细胞镜下形态、P2代比较两组实验组细胞消化时长、细胞扩增曲线、检测表面标志物、三系分化潜能，分别收集细胞培养至P4代比较SA?β?半乳糖苷酶染色阳性率。结果 2组细胞形态均为扁平长梭形。 P2代A组细胞消化时间为（123.8 ±3.09）s，B组细胞消化时间（38.5 ±2.20）s,差异有统计学意义(P<0.001)。A组的P0到P2代细胞扩增倍数为（129.49±0.89）倍，显著高于B组（101.4±1.67）倍，差异有统计学意义(P<0.001)。A组SA?β?半乳糖苷酶染色阳性率（2.58±0.44）%显著低于B组（4.79±0.33）%，且均符合间充质干细胞的质量标准。结论 相同接种密度的条件下，高粘培养瓶比普通培养瓶扩增倍数更高，且细胞衰老水平更低，优化了培养体系和培养效率，提高了细胞质量。
[Abstract] Objective: To compare the culture characteristics of human umbilical cord mesenchymal stem cells (hUC-MSCs) cultured in two different surface-material flasks. Methods: Ten fresh umbilical cords were collected, and umbilical cord tissue was isolated using the tissue block method and cultured adherently for 12 days. Primary cells were collected, and 2×10^6 cells were respectively seeded into 225 cm2 high-adhesion flasks (Group A) and 225 cm2 ordinary flasks (Group B) for culture for 72 hours until passage 1 (P1). P1 cells were collected and further cultured for 72 hours until passage 2 (P2). The experiment was repeated five times. The morphology of cells at P1 and P2 in both groups was observed under a microscope, and P2 cells were compared for digestion duration, cell growth curves, surface marker expression, and trilineage differentiation potential. Cells were also cultured to P4 to compare the SA?β-galactosidase positivity rate. Results: Cells in both groups displayed a flat spindle-shaped morphology. The digestion time of P2 cells in Group A was (123.8 ± 3.09) seconds, while in Group B it was (38.5 ± 2.20) seconds, showing a statistically significant difference (P<0.001). The cumulative cell amplification from P0 to P2 in Group A was (129.49 ± 0.89)-fold, significantly higher than that in Group B [(101.4 ± 1.67)-fold, P<0.001]. The SA?β-galactosidase positivity rate in Group A was (2.58 ± 0.44)%, significantly lower than in Group B(4.79 ± 0.33)%, and both met the quality standards for mesenchymal stem cells. Conclusion: Under the same seeding density, high-adhesion flasks yield higher cell amplification, lower cell senescence, and optimize the culture system and efficiency, thereby improving cell quality.
本文提出一个由多种核心变量构成的疾病进程形式化分析框架，命名为CPS框架（Causative-Primary-Secondary）。该框架以矛盾分析为核心逻辑，聚焦疾病从原发单元启动后，经由活性病理产物播散与机体防御系统相互博弈，最终可能在远端靶器官形成独立继发单元的单向级联演进过程，对疾病复杂性的跨系统传播逻辑做出抽象统一的形式化刻画，并选取骨关节炎、结核球、恶性肿瘤、肝性脑病、房颤等不同类型的典型临床案例，尝试验证该框架解释不同疾病进程的合理性与普适性。
目的 探讨改良后本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面的变化。方法 2018年9月-2019年9月选取四川大学华西医院2017级临床医学和口腔医学五年制本科生共30名，以及3名授课教师作为研究对象，将既往版、现行版以及改良版教学质量评价量表应用课堂，并采用问卷调查方法对其进行分析评估。评估经改良后的教学质量评价表在及时性、有效性和易用性方面的变化差异。结果 共计向研究对象发放99份教学质量评价量表和33份调查问卷，回收率为100%。针对授课教师能及时获取教学质量反馈，教师认为课后评教工具的最佳评价时机为课后当天晚上12点前（33.3%）或课后24小时内（66.7%），高于课后立即评价（0%）和期末评价（0%）。对三个版本教学评价表问卷调查结果显示，改良版教学评价量表的时效性、有效性和易用性为优的比例分别为86.67%，60%和76.67%，均高于现行版的43.33%，60%和46.67%，同时均高于既往版的23.33%，23.33%和36.67%，差异有统计学意义（P＜0.05）。结论 改良后的本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面均得以显著提高。通过不断优化量表设计和评价指标，可以提高教学质量评价的科学性和准确性。
Objective: To investigate the changes in timeliness, validity, and usability of the modified classroom teaching evaluation scale for undergraduate clinical medical education. Methods: From September 2018 to September 2019, a cohort comprising 30 fifth-year undergraduate students majoring in clinical medicine and stomatology from West China Hospital, Sichuan University, along with three faculty instructors, was enrolled. Three versions of teaching evaluation scales (historical, current, and modified) were implemented in classroom settings, followed by questionnaire-based comparative analyses. The revised scale was systematically assessed for improvements in feedback timeliness, measurement validity, and operational usability. Results: A total of 99 evaluation forms and 33 questionnaires were distributed, with a 100% response rate. Regarding timely feedback acquisition, faculty preferred receiving evaluations by midnight on the teaching day (33.3%) or within 24 hours post-class (66.7%), outperforming immediate
目的 评价不同运动干预对老年肌少性肥胖患者健康状况的干预效果。 方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库、维普数据库中关于运动干预老年肌少性肥胖患者的运动干预的随机对照试验，检索时限为建库至2025年8月。采用RevMan 5.4软件进行统计分析。 结果 共计纳入13篇文献，815名参与者。运动可显著改善患者身体质量指数 (P＜0.0001)、体脂率 (P=0.001)、四肢骨骼肌质量(P＜0.0001)、握力(P=0.007)、步速 (P=0.0003)、起立-行走计时测试用时(P＜0.00001)，提高患者IGF-1水平(P =0.0003)；但IL-6(P =0.96)、血清总胆固醇(P=0.22)未见明显改变。 结论 运动可以有效降低肌少性肥胖患者的身体质量指数、体脂肪, 提高肌少性肥胖患者的身体机能、四肢骨骼肌质量和IGF-1水平,其中多组分运动和抗阻运动效果更加显著。
Objective To evaluate the effect of different exercise intervention on the health status of elderly patients with sarcopenia and obesity. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang database and VIP database were searched for randomized controlled trials on exercise intervention in elderly patients with sarcopenia and obesity until August 2025.Two researchers independently screened the literature, extracted the data, and evaluated the bias risk of the included studies, and then used RevMan 5. 3 software for statistical analysis. Results a total of 13 articles involving 815 participants were included.Exercise significantly reduced body mass index (P < 0.0001), body fat percentage (P = 0.001), and increased limb skeletal muscle mass (P < 0.0001).Exercise significantly improved the patient's grip strength (P = 0.007), pace (P = 0.0003), and decreased the time spent on the timed up-and-go test (P < 0. 00001).Exercise significantly increased serum IGF-1 levels (P = 0.0003), but did not significantly change serum IL-6 (P = 0.96) and serum total cholesterol (P = 0.22). Conclusion Exercise can effectively reduce the body mass index and body fat, and improve the body function, limb skeletal muscle mass and IGF-1 level in patients with sarcopenia obesity, and the effects of multi-component exercise and resistance exercise are more significant.
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.
目的 探讨养血清脑颗粒联合银杏叶提取物注射液对脑梗死（CI）恢复期患者神经功能及认知功能的影响。方法 选取我院2024年7月-2025年11月收治的CI恢复期患者120例，按随机数字表法分2组，各组均60例；对照组予银杏叶提取物注射液治疗，治疗组基于对照组予养血清脑颗粒治疗，治疗周期均2周；对比2组疗效、神经功能、脑动脉血流速度、炎症指标、血液流变学指标、认知功能及不良反应。结果 治疗组总治疗有效率（95.00%）较对照组（81.67%）高，治疗后美国国立卫生研究院卒中量表（NIHSS）评分较对照组低（P＜0.05）；治疗组治疗后脑动脉平均血流速度（Vm）较对照组高，搏动指数（PI）、阻力指数（RI）、C反应蛋白（CRP）、同型半胱氨酸（Hcy）水平、血浆黏度、纤维蛋白原（FIB）水平、血小板最大聚集率水平较对照组低（P＜0.05）；治疗组治疗后简明精神状态检查量表（MMSE）评分较对照组高（P＜0.05）；组间不良反应相比无统计学差异（P＞0.05）。结论 养血清脑颗粒联合银杏叶提取物注射液治疗CI恢复期患者效果较好，可减轻神经功能缺损，提高脑动脉血流速度，降低炎症反应，调节血液流变学，改善认知功能。
目的 分析2016—2024年宜春市5岁以下儿童死亡水平、死因构成、县区分布特征及变化趋势，为制定儿童健康干预策略提供依据。方法 回顾性收集2016—2024年宜春市5岁以下儿童死亡监测资料，统计各年度新生儿、婴儿及5岁以下儿童死亡率，分析死因构成比、顺位变化及县区分布特征，采用线性趋势χ2检验分析死亡率年度变化趋势。结果 2016—2024年宜春市各年龄段儿童死亡率均呈下降趋势（均P＜0.05），新生儿、婴儿、5岁以下儿童9年平均死亡率分别为1.35‰、2.62‰、5.02‰，较2016年分别下降26.79%、43.55%、43.06%。死因顺位整体呈现小幅变迁，肺炎占比逐步下降，溺水、意外窒息等意外伤害相关死因顺位持续前移。各县区死亡率存在差异，高死亡率县区集中在袁州区、奉新县，低死亡率县区以铜鼓县为主。结论 2016—2024年宜春市5岁以下儿童死亡率呈下降趋势，但意外伤害已成为主要死因，县区差异客观存在。应重点加强意外伤害预防工作，针对高死亡率县区实施差异化干预。
目的 探讨紫芪补肾汤联合达格列净治疗脾肾阳虚型糖尿病肾病（DKD）患者的临床疗效，并分析其对糖代谢、肾功能的影响。方法 选取2024年9月～2025年9月于本院就诊的106例DKD患者为研究对象，按照随机数字表法将其分为对照组、研究组，各53例。对照组予以达格列净治疗，研究组予以紫芪补肾汤联合达格列净治疗，连续治疗2个月。统计对比两组临床疗效、不良反应及治疗前后中医证候积分、血糖及糖代谢指标[空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、糖原合酶激酶-3β（GSK-3β）、缺氧诱导因子-1α（HIF-1α）]、肾功能相关指标[血尿素氮（BUN）、血肌酐（SCr）、尿微量白蛋白排泄率（UAER）、估算的肾小球滤过率（eGFR）、同型半胱氨酸（Hcy）、胱抑素C（CysC）、碳水化合物反应元件结合蛋白（ChREBP）]、炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、肿瘤坏死因子1型受体（TNFR1）、趋化因子配体9（CXCL9）]、血管内皮功能[血管生成抑制蛋白-1（VASH-1）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）、一氧化氮（NO）、血栓素B2（TXB2）]。结果 研究组总有效率为90.57%，明显高于对照组的73.58%（P＜0.05）；研究组治疗后中医证候积分低于对照组（P＜0.05）；研究组治疗后FPG、2 h PG、HbA1c、GSK-3β、HIF-1α水平低于对照组（P＜0.05）；研究组治疗后BUN、SCr、UAER、Hcy、CysC、ChREBP水平低于对照组，eGFR高于对照组（P＜0.05）；研究组治疗后血清TNF-α、IL-1β、TNFR1、CXCL9水平低于对照组（P＜0.05）；研究组治疗后VASH-1、NO水平高于对照组，VEGF、ET-1、TXB2水平低于对照组（P＜0.05）；两组不良反应比较无明显差异（P＞0.05）。结论 紫芪补肾汤联合达格列净治疗DKD患者的疗效显著，可降低血糖水平，改善肾功能，抑制炎症反应，减轻血管内皮损伤，且具有一定安全性。
