约10%~30%的新发结直肠癌患者会出现急性肠梗阻，传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略，展现出显著优势。肠道支架可迅速解除梗阻，改善患者症状，降低手术风险，为肿瘤微创切除创造条件，同时为新辅助化疗提供可能，但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视，且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展，旨在为临床研究和实践提供参考依据。

    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction．Traditional emergency surgical intervention is characterized by high rates of postoperative complications，elevated mortality，and diminished quality of life．Combined stent and curative elective surgery（CSCES）has emerged as a novel therapeutic strategy，exhibiting significant clinical benefits．Intestinal stenting can rapidly alleviate obstruction，thereby improving patient symptoms，reducing surgical risks，and facilitating minimally invasive tumor resection．Additionally，it provides an opportunity for neoadjuvant chemotherapy．However，potential complications，including bleeding，stent migration，recurrent obstruction，and intestinal perforation，must be carefully considered．Moreover，the long-term safety and impact on oncologic outcomes remain to be elucidated．This review aims to provide a comprehensive overview of the current status，controversies，and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer，with the goalof informing clinical research and practice．

      目的 探讨血清乳酸脱氢酶（LDH）在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料，随访截止2025年8月，并记录随访结果，包括患者的疾病缓解情况和死亡情况，以及无疾病进展生存期（PFS）、总生存期（OS）。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线，并通过Log-rank检验比较生存曲线。同时，运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示，在50例肝癌患者中，基线LDH低于200 U/L的有15例，而高于200 U/L的有35例。与基线LDH＜200 U/L组相比，基线 LDH≥200 U/L患者PFS、OS更短，差异均有统计学意义（χ²分别为5.51、15.6，P值分别为0.019、0.017）。治疗8周后，与LDH降低患者相比，LDH升高患者OS更短，差异有统计学意义（χ²=13.2，P=0.04）。多因素Cox比例风险回归分析结果表明，基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素［P=0.035，HR（95%CI）=5.03（1.12，22.54）］。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。 

   Objective To evaluate the prognostic significance of serum lactate dehydrogenase（LDH）levels in patients with advanced hepatocellular carcinoma（HCC）undergoing targeted therapy combined immunotherapy．Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024，diagnosed with pathological and imaging examinations results．Patient baseline data were collected from the hospital’s electronic medical records，with follow-up extending until August 2025．We documented outcomes such as disease response and mortality，along with progression-free survival（PFS）and overall survival（OS）．Kaplan-Meier survival curves were constructed based on baseline LDH levels，and the Log-rank test was employed for comparison．Additionally，multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy．Results Among the 50 patients，15 had baseline LDH levels below 200 U/L，while 35 had levels above．Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH ＜200 U/L（χ²=5.51 and 15.6 for PFS and OS，respectively；P=0.019 and 0.017，respectively）．After 8 weeks of treatment，patients with increased LDH had significantly shorter OS compared with patients with decreased LDH（χ²=13.2，P=0.04）．Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy（P=0.035，HR 5.03［1.12，22.54］）．Conclusions Patients with lower baseline LDH levels demonstrated better OS，suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy．

      目的 系统比较小针刀、局部浸润麻醉及两者联合疗法治疗腰椎间盘突出症（LDH）的临床疗效。方法 采用前瞻性随机对照设计，选取2023年1月—2025年1月收治的120例保守治疗无效的LDH患者，随机分为小针刀组（A组，n=40）、局部浸润麻醉组（B组，n=40）和联合治疗组（C组，n=40）。A组实施标准化小针刀松解术，采用“三点九刀”布点法松解粘连组织；B组采用超声引导下椎间孔外口及关节突关节囊周围利多卡因联合曲安奈德浸润麻醉；C组实施“麻醉-松解序贯疗法”（即先B组方案，后A组方案）。比较三组治疗前后视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、腰椎活动度（ROM）、表面肌电图（sEMG）、疼痛压力阈值（PPT）及改良Macnab优良率。结果 治疗后，三组VAS、ODI评分均较治疗前下降（P＜0.001）。组间比较显示，C组VAS（2.08±0.90分）、ODI（14.65±3.70分）改善显著优于A组（3.80±1.20分，21.00±4.25分）和B组（3.93±1.15分，22.10±4.65分）（均P＜0.05），A、B两组间无统计学差异（P＞0.05）。C组在腰椎前屈ROM（67.78±9.18°）、竖脊肌静息sEMG比值（0.19±0.05）、腰椎旁PPT（4.60±0.91 kg/cm²）上亦显著优于A、B两组（均P＜0.05）。改良Macnab评价显示C组优良率达85.00%（34/40），高于A组的52.50%（21/40）和B组的55.00%（22/40）（P＜0.05）。结论 小针刀与局部浸润麻醉单一疗法对LDH均有效，但联合应用可产生多模式协同效应，通过阻断疼痛传导、调节炎性微环境和改善生物力学失衡，在缓解疼痛、促进功能恢复及改善客观生理指标方面均展现出显著优势，为中西医结合治疗LDH提供了更优化的创新性方案，具有重要临床推广价值。

      Objective To systematically evaluate and compare the clinical effectiveness and mechanistic actions of acupotomy，local infiltration anesthesia，and their combination in treating lumbar disc herniation（LDH）．Methods This prospective，randomized controlled trial included 120 LDH patients unresponsive to conservative management，admitted between January 2023 and January 2025．Participants were randomly allocated to three groups：the Acupotomy Group（Group A，n=40）receiving standardized acupotomy release with a “three-point nine-needle” technique to address adhesions；the Local Infiltration Anesthesia Group（Group B，n=40）receiving ultrasound-guided infiltration of lidocaine combined with triamcinolone acetonide around the extraforaminal outlet and facet joint capsule；and the Combined Therapy Group（Group C，n=40）undergoing a sequential “anesthesia-release” protocol（first applied Group B therapy then Group A therapy）．Assessments conducted before and after treatment included the Visual Analog Scale（VAS），Oswestry Disability Index（ODI），lumbar range of motion（ROM），surface electromyography（sEMG），pain pressure threshold（PPT），and the modified Macnab criteria．Results Following treatment，significant reductions from baseline were observed in VAS and ODI scores across all three groups（P＜0.001）．Between-group comparisons indicated that Group C achieved significantly greater improvement in VAS（2.08±0.90）and ODI scores（14.65±3.70）compared to Group A（3.80±1.20；21.00±4.25）and Group B（3.93±1.15；22.10±4.65）（all P＜0.05），with no significant difference between Groups A and B（P＞0.05）．Group C also showed superior outcomes in lumbar flexion ROM（67.78±9.18°），the resting sEMG amplitude ratio of the erector spinae muscles（0.19±0.05），and paravertebral PPT（4.60±0.91 kg/cm²）compared to the other two groups（all P＜0.05）．Based on the modified Macnab criteria，the excellent-good rate was 85.00%（34/40）in Group C，significantly higher than the rates of 52.50%（21/40）in Group A and 55.00%（22/40）in Group B（P＜0.05）．Conclusions While both acupotomy and local infiltration anesthesia as standalone treatments are effective for LDH，their combined application produces a multimodal synergistic effect．This integrated strategy，which concurrently interrupts pain signaling，modulates the local inflammatory milieu，and ameliorates biomechanical dysfunction，demonstrates significant advantages in pain relief，functional recovery，and normalization of objective physiological measures．The findings present an optimized and novel integrative approach for LDH management，highlighting its considerable potential for broader clinical adoption．

      目的 合并肺纤维化的慢性阻塞性肺疾病（COPD）是COPD的特殊亚型，患者兼具气流受限与肺组织纤维化病理特征，临床症状更严重、肺功能下降更快，且现有单一治疗方案难以同时改善气流受限与纤维化进展，预后较差。基于此，本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响，为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者，采用前瞻性随机对照研究设计，应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗，对照组48例采取尼达尼布治疗，试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后，比较治疗前后症状评分、肺功能、纤维化指标、炎症指标，并分析两组治疗安全性。结果 治疗后，两组CAT评分、mMRC评分及VAS降低（P＜0.05）；且与对照组比较，试验组CAT评分、mMRC评分及咳嗽VAS评分较低（P＜0.05）。治疗后，两组FVC、FEV₁、DLCO及FEV₁/FVC比值均较治疗前改善（P＜0.05）；且与对照组比较，试验组FVC、FEV₁、DLCO及FEV₁/FVC比值较优（P＜0.05）。治疗后，两组血清KL-6、SP-D水平及CT纤维化评分均降低（P＜0.05）；且与对照组比较，试验组血清KL-6、SP-D水平及CT纤维化评分较低（P＜0.05）。治疗后，两组血清IL-6、TNF-α及TGF-β1水平降低（P＜0.05）；且与对照组比较，试验组血清IL-6、TNF-α及TGF-β1水平较低（P＜0.05）。试验组总不良反应发生率为8.33%（4/48），对照组为10.42%（5/48），两组比较差异无统计学意义（P＞0.05）。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好，可减轻患者临床症状，改善肺功能与肺纤维化，降低机体炎症反应，安全性较高。

   Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease（COPD）patients with associated pulmonary fibrosis and its impact on lung function，providing a basis for optimizing clinical treatment strategies．Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected，and divided into experimental group and control group using a random number table method．Using a prospective randomized controlled study design，all patients received conventional treatment，with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide．After 24 weeks of treatment in both groups，the symptom scores，lung function，fibrosis indicators，and inflammation indicators were compared before and post-treatment，and the drug safety of the two groups was analyzed．Results Post-treatment，CAT score，mMRC score and VAS decreased in both groups（P＜0.05）．Compared with the control group，CAT score，mMRC score and cough VAS score were lower in the experimental group（P＜0.05）．Post-treatment，FVC，FEV₁，DLCO and FEV₁/FVC ratio of both groups improved compared with that before treatment（P＜0.05）．Compared with the control group，FVC，FEV₁，DLCO and FEV₁/FVC ratio of the experimental group were better（P＜0.05）．Post-treatment，serum KL-6，SP-D levels and CT fibrosis scores of both groups decreased（P＜0.05）．Compared with the control group，serum KL-6，SP-D levels and CT fibrosis scores of the experimental group were lower（P＜0.05）．Post-treatment，serum IL-6，TNF-α and TGF-β1 levels in both groups decreased（P＜0.05）．Compared with the control group，serum IL-6，TNF-α and TGF-β1 levels in the experimental group were lower（P＜0.05）．The incidence of total adverse reactions in the experimental group was 8.33%（4/48），and that in the control group was 10.42%（5/48）．There was no difference between the two groups（P＞0.05）．Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis，which can alleviate its clinical symptoms，improve lung function and pulmonary fibrosis，reduce the body’s inflammatory response，which is relatively safe．

       常染色体显性多囊肾病（ADPKD）是导致遗传性肾衰竭的主要病因之一，目前仍缺乏有效的手段来逆转其疾病进展。干细胞疗法因其在组织修复和免疫调节方面的潜力，成为研究的热点领域。本研究系统阐述了造血干细胞（HSCs）通过旁分泌作用、代谢重塑及免疫调控干预ADPKD病理进程的机制，并总结了其在急性肾损伤和慢性肾病中的临床转化证据。此外，文章比较分析了间充质干细胞（MSCs）和诱导多能干细胞（iPSCs）在ADPKD治疗中的独特优势与面临的挑战，为多模态干细胞疗法的开发提供理论支持。

    Autosomal dominant polycystic kidney disease（ADPKD）stands as a leading cause of inherited renal failure，with current therapeutic strategies lacking effective means to reverse disease progression．Stem cell therapy，owing to its potential in tissue repair and immunomodulation，has emerged as a focal point of research．This review systematically elucidates the mechanisms by which hematopoietic stem cells（HSCs）intervene in ADPKD pathology through paracrine effects，metabolic reprogramming，and immune regulation．Furthermore，it summarizes clinical translational evidence of HSCs in both acute kidney injury and chronic kidney disease．This article also comparatively analyzes the unique advantages and challenges of mesenchymal stem cells（MSCs）and induced pluripotent stem cells（iPSCs）in the context of ADPKD treatment，thereby providing theoretical support for the development of multimodal stem cell therapies．

       目的 深入分析实时动态血糖监测系统（CGMS）在2型糖尿病患者接受胰岛素泵强化治疗过程中的实际应用意义。方法 本研究采用前瞻性随机对照试验设计，收集2025年1月至2026年3月间收治的80名2型糖尿病患者，运用随机数字表法将其随机分配为两组，每组40名患者。对照组患者接受常规指尖血糖检测与胰岛素泵治疗，研究组采用深圳硅基传感公司生产的GS1型动态血糖监测系统辅助胰岛素泵治疗，两组患者的治疗周期均延长至14天。主要观测指标：目标血糖范围内时间占比（TIR，3.9~10.0 mmol/L）；次要观测指标：糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2 h血糖（2hPBG）等代谢指标，低血糖发生频率、日内血糖波动幅度（MAGE）、日间血糖平均绝对差（MODD）、血糖高于目标范围时间占比（TAR，＞10.0 mmol/L）、血糖低于目标范围时间占比（TBR，＜3.9 mmol/L）。结果 治疗14天后，两组患者的血糖指标均较治疗前改善，研究组主要指标TIR（78.65%±8.23%）高于对照组（62.34%±9.56%）（P＜0.001）；次要指标中，研究组HbAlc、FBG和2hPBG的改善幅度及MAGE、MODD的降低幅度均优于对照组（P＜0.05）；研究组低血糖发生率（2.5%）、TBR（1.82%±0.95%）低于对照组（20%、5.68%±1.32%），TAR（19.53%±7.81%）低于对照组（31.98%±8.64%）（P＜0.05）。研究组动态血糖图谱（AGP）显示血糖波动更平稳，峰值与谷值差异缩小，TIR分布更集中。结论 实时动态血糖监测技术通过提供连续、完整的血糖数据，精准捕捉血糖波动规律，为胰岛素泵参数调整提供科学依据，显著提升目标血糖达标时间占比，优化整体血糖控制效果，同时有效降低低血糖事件及血糖偏离目标范围的风险，是2型糖尿病患者胰岛素泵强化治疗的重要辅助手段。

      Objective To analyze the practical significance of real-time continuous glucose monitoring system（CGMS） in patients with type 2 diabetes mellitus（T2DM） receiving intensive insulin pump therapy．Methods A prospective randomized controlled trial design was used to collect 80 patients with T2DM from January 2025 to March 2026．The patients were randomly divided into two groups by random number table method，with 40 patients in each group．The patients in the control group received routine fingertip blood glucose detection and insulin pump therapy，while the patients in the study group received insulin pump therapy assisted by GS1 type CGMS produced by Shenzhen Sili-based Sensor company．The treatment period of the two groups was extended to 14 days．Primary outcome measures：time in range（TIR，3.9-10.0 mmol/L）；secondary outcomes：hemoglobin A1c（HbAlc），fasting blood glucose（FBG），2-hour postprandial blood glucose（2hPBG），frequency of hypoglycemia，mean amplitude of glycemic excursion（MAGE），mean of daily differences（MODD），time above range（TAR，＞10.0 mmol/L） and time below the target range（TBR，＜3.9 mmol/L），and other metabolic indicators．Results After 14 days of treatment，the blood glucose indexes of the two groups were significantly improved compared with those before treatment．The main index TIR in the study group（78.65%±8.23%） was significantly higher than that in the control group（62.34%±9.56%）（P＜0.001）．Among the secondary indexes，the improvement of HbAlc，FBG and 2hPBG and the reduction of MAGE and MODD in the study group were significantly better than those in the control group（P＜0.05）．The incidence of hypoglycemia（2.5%），TBR（1.82%±0.95%） and TAR（19.53%±7.81%） in the study group were significantly lower than those in the control group（20%，5.68%±1.32%，31.98%±8.64%）（P＜0.05）．The ambulatory glucose profile（AGP） of the study group showed that blood glucose fluctuation was more stable，the difference between peak and trough was reduced，and TIR distribution was more concentrated．Conclusions Real-time CGMS can accurately capture blood glucose fluctuation by providing continuous and complete blood glucose data，provide scientific basis for insulin pump parameter adjustment，significantly improve the proportion of time to reach the target blood glucose，optimize the overall blood glucose control effect，and effectively reduce the risk of hypoglycemia events and blood glucose deviation from the target range．It is an important auxiliary method for intensive insulin pump therapy in patients with type 2 diabetes．

       目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．

       嵌合抗原受体（CAR）T细胞疗法在血液系统恶性肿瘤中疗效显著，但在实体瘤应用中面临肿瘤异质性、免疫抑制微环境和在靶脱瘤毒性等挑战。合成Notch受体（synNotch）作为一种模块化的跨膜信号传导工具，通过将抗原识别与定制化的转录激活程序人工耦联，赋予T细胞整合多重信号、执行布尔逻辑运算的能力。将synNotch与CAR等效应模块结合，可构建“与”、“非”、“或”等逻辑门控回路，可实现对肿瘤微环境的精确识别与响应，极大提升CAR-T细胞的靶向特异性。本文系统综述了synNotch受体的结构演进与逻辑门控设计原理；重点阐明了其在提升细胞疗法靶向特异性、克服实体瘤抗原异质性、动态调控肿瘤微环境以及扩展至其他免疫细胞工程化领域的最新应用进展，并探讨了当前该技术在载体系统构建、受体信噪比优化等方面面临的挑战及未来的发展方向。

   Chimeric antigen receptor（CAR）T-cell therapy has demonstrated remarkable efficacy in hematological malignancies；however，its application in solid tumors is confronted with significant challenges，including tumor heterogeneity，the immunosuppressive microenvironment，and on-target off-tumor toxicity．As a highly modular transmembrane signal transduction tool，the synthetic Notch（synNotch）receptor innovatively links antigen recognition with customized transcriptional activation programs，thereby empowering T cells with the capacity to integrate multiple signals and perform Boolean logic operations．By combining synNotch with effector modules such as CARs，logic-gated circuits，including AND，NOT，and OR gates，can be constructed，which enables precise discrimination of and response to the tumor microenvironment，substantially enhancing the targeting specificity of CAR-T cells．This review systematically summarizes the structural evolution of synNotch receptors and the principles of logic-gated design．Furthermore，it highlights recent advances in their application for enhancing the targeting specificity of cell-based therapies，overcoming solid tumor antigen heterogeneity，dynamically regulating the tumor microenvironment，and extending to the engineering of other immune cell types．Finally，we discuss current challenges，such as the construction of vector systems and the optimization of receptor signal-to-noise ratios，as well as future directions for this technology．

       葛根芩连汤作为一种传统中药复方，在治疗代谢性疾病方面展现出显著的疗效。随着中草药现代研究方法的进步，逐渐揭示了葛根芩连汤在代谢性疾病中的治疗作用及其分子机制，包括葛根素、黄芩苷、小檗碱等活性成分的抗炎作用。然而，中草药研究领域的新理论和新机制被不断发现，如影响肠道菌群、产生植物外囊泡、中药汤剂成分自组装等，使得对葛根芩连汤作用机制的理解亟待更新。本文旨在综述葛根芩连汤在代谢性疾病中的作用及机制，并结合最新的研究成果，重点分析其在肠道菌群、植物外囊泡和中药自组装领域的相关发现，探讨其潜在的治疗靶点和未来研究方向，为临床应用和基础研究提供指导。

      Gegen Qinlian decoction（GQD），as a traditional Chinese herbal formula，has demonstrated significant efficacy in treating metabolic diseases．With advancements in modern research methodologies for Chinese herbal medicine，the therapeutic effects and molecular mechanisms of GQD in metabolic diseases have been progressively uncovered，including the anti-inflammatory properties of its active components such as puerarin，baicalin，and berberine．However，emerging theories and mechanisms in the field of herbal research，such as modulation of gut microbiota，production of plant-derived extracellular vesicles，and self-assembly of components in herbal decoctions，continuously refine our understanding，highlighting the need to update insights into GQD’s mechanisms of action．This review aims to summarize the roles and mechanisms of GQD in metabolic diseases，integrating the latest research progress with a focus on findings related to gut microbiota，plant-derived extracellular vesicles，and self-assembly phenomena．It further seeks to explore potential therapeutic targets and future research directions，thereby providing guidance for clinical applications and fundamental studies．

       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者，随机平均分为两组。行常规对症支持治疗的为对照组；在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组；两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标（CD₃⁺  、CD₄⁺、CD₈⁺  、CD₄⁺ /CD₈⁺ ）较治疗前均有明显改善；干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果，提高生活质量和免疫功能，减少不良反应。

       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy．Methods  From June 2023 to June 2025，80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups．The patients who received routine symptomatic supportive treatment were enrolled as the control group．The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group．The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment．Adverse reactions were detected on the day before treatment，theseventh day and 14th day during treatment．Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment．Adverse  reactions occurred less in the intervention group than in the control group．Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer，improve the quality of life and immune function，reduce adverse reactions．