目的 探讨影响颈内动脉闭塞（ICAO）患者预后的相关因素,为临床改善ICAO患者预后提供理论依据。方法 回顾性分析2017—2022年广西医科大学附属武鸣医院因ICAO入住神经内科的131例患者,根据ICAO发病时间分为急性颈内动脉闭塞（AICAO）和慢性颈内动脉闭塞（CICAO）,根据预后的不同,分为预后良好和预后不良组,比较两组的基本信息（性别、年龄等）、既往病史（包括高血压、糖尿病、冠心病等）、发病时神经功能损害程度（美国国立卫生研究院卒中神经功能缺损评分NIHSS评分）、侧支循环代偿评分、介入手术开通治疗、出血转化之间的差异,分析影响患者预后的相关因素。结果 CICAO患者总体预后良好,AICAO预后良好组患者发病时NIHSS评分<6分、侧支循环代偿良好比例高于预后不良组,而出血转化率低于预后不良组,组间比较差异均有统计学意义（P<0.05）。二分类Logistic回归分析显示,发病时NIHSS评分、侧支循环代偿评分、介入手术开通治疗、出血转化、次全闭塞对AICAO预后影响有统计学意义（P<0.05）。两组间的基本信息、既往病史、介入手术开通治疗等比较差异无统计学意义（P>0.05）。结论 CIACO较AICAO总体预后良好,发病时NIHSS评分<6分、侧支循环代偿良好、无出血转化是IACO预后良好的相关因素。发病时NIHSS评分高、侧支循环代偿不良、出血转化是ACAO预后不良的危险因素

Objective To evaluate the prognostic significance of a group of clinical indices in the patients with internal carotid artery occlusion（ICAO）. Methods From 2017 to 2022,a total of 131 patients with ICAO were enrolled．All eligible patients were divided into acute ICAO（AICAO）and chronic ICAO groups（CICAO）,which were subdivided into good and poor prognosis groups．A respective analysis was performed to identify a practical profile for the outcome prediction of the patients with ICAO. Results The overall prognosis of CIACO was good．The proportion of NIHSS score < 6 in AICAO group with good prognosis and good collateral circulation compensation was significantly higher than that in poor prognosis group,while bleeding conversion was lower than that in poor prognosis group,with statistical significance（P<0.05）．Dichotomous logistic regression analysis showed that the prognostic effects of NIHSS score,collateral circulatory compensation score,interventional initiation,hemorrhagic transformation,and subtotal occlusion on the prognosis of AICAO were statistically significant．There were no significant differences in basic information,past medical history,interventional operation between the two groups（P>0.05）. Conclusions The patients with CICAO have a better prognosis than those with AICAO．NIHSS score < 6,good collateral circulation and no-hemorrhagic transformation may have strong prognostic relevance to ICAO．High NIHSS score,poor collateral circulation and hemorrhagic transformation at the time of onset are risk factors for poor prognosis of ACAO ．

目的 通过公共数据库筛选急性肺损伤（ALI）及急性呼吸窘迫综合征（ARDS）相关分子标志物,并探索其临床意义。方法 利用基因表达综合数据库（GEO）中有关ALI/ARDS基因表达芯片研究的两个数据集GSE76293和GSE10474,通过STRING网站和Cytoscape软件对差异基因进行蛋白互作网络分析并筛选ALI/ARDS相关关键基因。采用A549细胞构建ALI模型,并通过转录组测序验证关键基因在细胞中的表达差异情况。结果 2个GEO数据集中共筛选出共同上调基因27个,共同下调基因26个。主要参与抗原加工和外源抗原递呈、免疫受体活性调节、内质网膜构成等生物学功能,且与抗原加工、细胞分化等信号通路有关。蛋白互作网络分析共筛选出10个ALI/ARDS相关关键基因,分别为CD4、HLA-DQB1、CD74、HLA-DRA、FCGR2B、TOR1A、RELA、NME8、RNF19B、RHOB。细胞转录组测序结果显示,关键基因的上调或下调特征及表达差异情况与GEO数据集分析结果一致。结论 CD4等关键基因可能参与ALI/ARDS发生、发展的生物学过程,是ALI/ARDS临床诊断及预后预测的潜在个体化分子标志物。

Objective To identify molecular biomarkers associated with acute lung injury（ALI）/ acute respiratory distress syndrome（ARDS）and to explore their clinical significance with public databases. Methods Two datasets GSE76293 and GSE10474 in Gene Expression Omnibus（GEO）database for ALI/ARDS gene expression chip study were used to screen genes with significant differences in both datasets．The protein-protein interaction（PPI）analysis of co-expression genes was performed based on the STRING website and Cytoscape software,and then key genes related to ALI/ARDS were identified with cytoHubba method．The ALI model was constructed using A549 cells cultured in vitro,and the expression differences of key genes in the cells were verified by RNA sequencing. Results A total of 27 up-regulated genes and 26 down-regulated genes were screened in both the two GEO datasets with Venn Diagramm．These co-expression genes were mainly involved in biological functions such as antigen processing and presentation of exogenous peptide antigen,immune receptor activity,integral component of lumenal side of endoplasmic reticulum membrane and were related to signal pathways such as antigen processing and cell differentiation．A total of 10 key genes（CD4,HLA-DQB1,CD74,HLA-DRA,FCGR2B,TOR1A,RELA,NME8,RNF19B,RHOB）related to ALI/ARDS were identified． The results of cell RNA sequencing showed that the up-regulated or down-regulated characteristics and expression differences of key genes were consistent with the results of GEO datasets. Conclusions Several key genes identified in this study may be involved in the biological process of ALI/ARDS development,and may be potential individualized molecular markers for clinical diagnosis and prognosis prediction of ALI/ARDS．

阿尔茨海默病（Alzheimer's disease,AD）是一种复杂的、起病隐秘的、病因不明的、缺乏特异性诊断方式的神经退行性病变。面对与日俱增的患病率,却缺乏有效的治疗方式。中医药治疗方式具有多层次、多靶点、多通路的独特优势,中西医结合方式的互补,非药物疗法的辅助,干细胞疗法、新的分子药物、抗体及蛋白疫苗、γ感官刺激等新颖的实验阶段新疗法等方式治疗AD。本文综述近年来的不同治疗方式治疗AD研究新进展,旨在为临床上治疗AD提供新思路、新方法及参考价值。

Alzheimer's disease is a complex,secrectly onset neurodegenerative disease with unknown etiology,and lacking of specific diagnosis．In the face of the increasing prevalence,there is a lack of effective treatment ways．The treatment of traditional Chinese medicine has the unique advantages of multi-level,multi-target,and multi-channel．With the combination of traditional Chinese and Western medicine and supplement to non-drug therapy,stem cell therapy,new molecular drugs,antibodies and protein vaccines,γ sensory stimulation,and other novel experimental stage new therapies are uesd in the treatment of AD．The article focuses on the new progress of different treatment methods in the treatment of AD in recent years,aiming to provide new ideas,new methods,and reference value for the clinical treatment of Alzheimer's disease．

心血管疾病是导致我国居民死亡的首要原因。在2006—2019年间,我国每年因心血管疾病死亡的人数从215万人增加到328万人。斑马鱼因个体小、成本低廉、体外发育、身体透明、基因组与人类高度同源等特点,近年来被广泛应用于医学研究。斑马鱼模型有利于推动心血管疾病领域的基础性研究。该文通过对前期研究进行综述,重点介绍了斑马鱼模型在心血管疾病中基因筛选、心脏再生、药物筛选、毒性评估等方面的研究进展。

Cardiovascular disease is the leading cause of death in China．Between 2006 and 2019,the annual number of deaths due to cardiovascular diseases increased from 2.15 million to 3.28 million．Zebrafish has been widely used in medical research in recent years because of its small individual size,low cost,in vitro development,transparent body and high homology of genome with human．The zebrafish model is conducive to promoting basic research in the field of cardiovascular disease．Based on the review of previous studies,this paper focuses on the research progress of zebrafish model in gene screening,cardiac regeneration,drug screening,toxicity assessment and other aspects of cardiovascular diseases．

胶质瘤是颅内最常见的原发性恶性肿瘤,其分级对患者治疗方式的选择和预后至关重要。尽管目前组织病理学仍是其最为可靠的分级手段,但需通过有创性手术以获取组织样本,存在一定的风险。相较之下,磁共振成像（MRI）作为一种非侵入性影像诊断工具,在胶质瘤分级中发挥着不可或缺的作用。然而,传统MRI评估受限于医师个体主观性强和可重复性差的问题,一定程度上影响了准确的分级结果。近年来,影像组学技术的崭露头角为解决上述难题开辟了新视角,通过高通量提取影像数据特征捕捉并量化肿瘤的影像学表现,避免因主观因素而导致的不确定性,协助医师更准确地评估肿瘤的恶性程度。本文对近五年来MRI影像组学在胶质瘤术前分级预测方面的相关研究进行了简要综述,旨在为相关领域研究者提供有益的参考和借鉴,以推动MRI影像组学在临床实践中的应用。

Glioma is the most common primary malignant brain tumor,and its grading is crucial for treatment decisions and prognosis．Currently,histopathology remains the gold standard for grading,but it requires invasive procedures and carries inherent risks．In contrast,magnetic resonance imaging（MRI）,a non-invasive diagnostic tool,plays an indispensable role in glioma grading．However,traditional MRI assessment is hampered by interobserver subjectivity and limited repeatability,which compromise grading accuracy．In recent years,radiomics,a burgeoning field,has offered a promising solution to address these challenges．By extracting high-dimensional imaging data features,radiomics enables the quantification of tumor radiological characteristics and elimination of subjectivity-related discrepancies．This technology assists clinicians in more precisely assessing the malignancy of gliomas．This article summarizes relevant studies in the past five years on the application of MRI radiomics in preoperative glioma grading,aiming to provide valuable insights and guidance to researchers in the field and promote the clinician implementation of MRI radiomics．

药物治疗抵抗在临床实践中成为肿瘤治疗失败的主因。最近的研究指出,肿瘤细胞的耐药性可能源于其内部高度的细胞异质性,而这种异质性的基础则是肿瘤可塑性。肿瘤细胞可塑性可能引发一系列反应,包括对治疗的耐药性发展、免疫系统逃逸以及对周围组织和血管系统的侵袭和转移等。本文简要介绍肿瘤细胞可塑性的表现形式以及其在药物治疗抵抗的非遗传适应性机制与靶向治疗新策略。

Drug therapy resistance has emerged as a primary cause of treatment failure in cancer management．Recent research indicates that the resistance of tumor cells may stem from their high degree of intracellular heterogeneity,with the underlying basis being tumor plasticity．Tumor cell plasticity can trigger a cascade of responses,including the development of resistance to treatment,evasion of the immune system,and invasion and metastasis into surrounding tissues and the vascular system．This article provides a brief overview of the manifestations of tumor cell plasticity and its non-genetic adaptive mechanisms in drug therapy resistance,along with novel strategies for targeted treatment．

目的 探讨行动研究法的倾向、强化及促成因素（PRECEDE）护理模式在冠心病患者中的应用效果。方法 选取2022年3月—2023年3月新乡市中心医院心内科收治的120例冠心病患者为研究对象,根据其住院ID号,以1：1比例分为对照组与观察组各60例,前者实施PRECEDE护理模式,后者实施基于行动研究法的PRECEDE护理模式,对比两组心功能指标干预前后检测情况、遵医行为及疾病相关知识掌握情况。结果 干预后3个月,观察组左室射血分数（LVEF）高于对照组及干预前,左心室收缩末期容积指数（LVESVⅠ）及左心室舒张末期容积指数（LVEDVⅠ）低于对照组及干预前（P<0.05）。观察组遵医行为比例和相关知识总掌握率均高于对照组（P<0.05）。结论 冠心病患者实施基于行动研究法的PRECEDE护理模式,不仅有助于改善其心功能指标,还能改善其遵医行为,提高其疾病知识掌握率。

目的 探讨系统化护理流程干预对脑出血患者急救效果及预后的影响。方法 采用回顾性分析的方法,选取2022年2月—2023年2月新乡医学院第三附属医院急诊收治的210例脑出血患者,将2022年2月—2022年8月采取常规护理干预的105例患者作为常规组,将2022年9月—2023年2月采取系统化护理流程干预的105例患者作为研究组。对比两组患者抢救效率、急救效果、并发症发生率、预后水平、护理满意度情况。结果 研究组患者抢救总时间、会诊至确诊、分诊至会诊、接诊至分诊以及出诊反应时间短于常规组（P<0.05）;研究组急救总有效率高于常规组,并发症发生率低于常规组（P<0.05）;出院1个月、3个月后,两组患者神经功能缺损量表（NIHSS）评分均降低,简易智能状态检查量表（MMSE）评分升高,研究组变化幅度更大（P<0.05）;研究组患者护理满意度高于常规组（P<0.05）。结论 针对脑出血患者在急救过程中采取系统化护理流程干预能够提升患者的抢救效率和急救效果,并发症发生率低,改善患者的神经功能缺损情况,提升预后水平,且患者满意度较高。

Objective To explore the impact of systematic nursing process intervention on the emergency response and prognosis of patients with cerebral hemorrhage．Methods By retrospective analysis,210 patients with cerebral hemorrhage admitted to the emergency department of the Third Affiliated Hospital of Xinxiang Medical College from February 2022 to February 2023,105 patients with routine nursing intervention from February 2022 to August 2022 were selected as the routine group,and 105 patients with systematic nursing process intervention from September 2022 to February 2023 were selected as the study group．The rescue efficiency,first aid effect,complication rate,prognosis levels and nursing satisfaction of the two groups were compared．Results The total rescue time,consultation to diagnosis,triage to consultation,reception to triage and the response time to visit in the study group were significantly lower（P<0.05）．The total emergency response rate of the study group was higher than that of the conventional group,and the incidence of complications was significantly lower（P<0.05）．One month and 3 months after discharge,NIHSS score decreased in both groups,MMSE score increased,and the change range was greater in the study group（P<0.05）．The nursing satisfaction of the study group was significantly higher（P<0.05）．Conclusions For patients with cerebral hemorrhage,systematic nursing process intervention in the first aid process can improve the rescue efficiency and first aid effect of patients,reduce the incidence of complications,improve the neurological function defect of patients,improve the prognosis level,and the patient satisfaction is higher．

目的 探讨以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响。方法 选择2021年8月—2022年6月在驻马店市中医院诊治的老年稳定性冠心病患者78例,根据1∶1随机数字表法分为两组,每组各39例。常规组给予常规护理,整合组在常规组护理的基础上给予以整合照护理念为基础的综合干预体系,记录两组患者的预后情况。结果 两组患者在护理3个月后的平衡测试评分、座椅站立测试评分均低于护理前,整合组护理3个月后的平衡测试评分、座椅站立测试评分与常规组相比也降低（P<0.05）。整合组护理3个月后的躯体、心理、社会、精神等维度的生活质量评分均高于常规组（P<0.05）。整合组随访1年的靶血管重建、心肌梗死、心源性死亡、冠状动脉再狭窄等主要心血管事件不良事件发生率为5.13%,常规组为25.64%,整合组低于常规组（P<0.05）。结论 以整合照护理念为基础的综合干预体系能缓解老年稳定性冠心病患者的衰弱状况,改善患者的生活质量,降低主要心血管事件不良事件发生率。

Objective To explore and analyze the effects of a comprehensive intervention based on integrated care on the frailty of elderly stable coronary heart disease（CHD）patients．Methods From August 2021 to June 2022,78 cases of elderly stable CHD patients who were diagnosed and treated in Zhumadian City Hospital of Traditional Chinese Medicine were selected．According to a 1：1 random number table method,78 patients were divided into the integrated group and the traditional group,with 39 cases of each group．The traditional group was given routine care,while the integrated group was given a comprehensive intervention based on integrated care concepts on the basis of the traditional group's care,and the patients' prognosis was recorded．Results The balance test scores and chair stand test scores of both groups after 3 months of nursing care were lower than those before nursing care．The balance test scores and chair stand test scores of the integrated group after 3 months of nursing care were also significantly lower than those of the traditional group（P<0.05）．After 3 months of nursing care,the quality of life scores in physical,psychological,social,and spiritual dimensions in the integrated group were significantly higher than those in the traditional group（P<0.05）．The incidence of major cardiovascular adverse events such as cardiac death,myocardial infarction,target vessel reconstruction,and coronary artery restenosis during a one-year follow-up in the integrated group was 5.13%,compared to 25.64% in the traditional group．The integrated group was significantly lower than the traditional group（P<0.05）．Conclusions The application of a comprehensive intervention based on integrated care concept in elderly stable CHD patients can alleviate frailty,improve quality of life,and reduce the incidence of major cardiovascular adverse events．

目的 探讨远程药学管理模式联合延续护理在2型糖尿病（T2DM）合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表（SF-36）]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组（P<0.05）。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组（P<0.05）。相较于干预前,两组患者在干预后的活力（VT）、精神健康（MH）、情感职能（RE）、躯体疼痛（BP）、生理功能（PF）、社会功能（SF）、生理职能（RP）、总体健康（GH）分值均升高,且研究组高于常规组（P<0.05）。研究组与常规组患者心血管不良事件发生率分别为2例（2.00%）、15例（15.09%）,研究组高于常规组（χ²=10.865,P<0.05）。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。

Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus（T2DM）patients with coronary artery disease．Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects．They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods．The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group．Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale（SF-36）] and incidence of adverse cardiovascular events were assessed．Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group（P<0.05）．Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group（P<0.05）．Compared to before intervention,the Vitality（VT）,Mental Health（MH）,Emotional Function（RE）,Physical Pain（BP）,Physiological Function（PF）,Social Function（SF）,Physiological Function（RP）and Overall Health（GH）scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group（P<0.05）．The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases（2.00%）and 15 cases（15.09%）,respectively,with the study group significantly higher than the conventional group（χ²=10.865,P<0.05）．Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events．