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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.
脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。
Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients.Warm needling is a characteristic therapy of traditional Chinese medicine.In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice.This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application.
血友病是一种由于X染色体上凝血因子基因突变所致的遗传性出血性疾病,目前主要的治疗方法是凝血因子替代疗法。但长期频繁的注射用药往往导致患者依从性差,容易产生抑制性抗体,从而影响治疗效果。虽然现在延长半衰期的新型凝血因子药物、人源化双特异性抗体以及抗组织因子途径抑制剂单克隆抗体等用于疾病治疗,在给药方式和作用持续时间上已有很大进步,但它们仍无法治愈血友病。因此,以疾病根治为重要目标的基因治疗被设计出来,近年来受到了广泛的关注。该文介绍了血友病基因治疗的原理、基因治疗载体的选择、基因治疗预处理方案,总结了现阶段基因治疗临床应用的安全性和有效性;最后讨论基因治疗目前存在的问题以及未来发展方向。
Hemophilia is a genetic bleeding disorder resulting from mutations in coagulation factor genes on the X chromosome.The mainstay of current treatment is coagulation factor replacement therapy.However,frequent and long-term injections often lead to poor patient compliance,easy inhibitor development,and compromised therapeutic efficacy.Despite advancements in delivery methods and prolonged action of novel agents such as extended half-life coagulation factor concentrates,humanized bispecific antibodies,and anti-tissue factor pathway inhibitor monoclonal antibodies,these approaches still fall short of curing hemophilia.Consequently,gene therapy,aiming for disease eradication,has garnered significant attention in recent years.This review delves into the principles of gene therapy,the selection of gene therapy vectors,and gene therapy preconditioning regimens.It summarizes the safety and efficacy of gene therapy in current clinical applications and discusses challenges and future directions in this field.
肝癌患者因食欲降低、进食减少导致不同程度的营养不良,引发厌食症,甚至恶病质,严重影响患者生存质量。食欲评估是降低营养风险的基础,医护人员可通过食欲症状的评估调整患者饮食及营养指导措施,以改善患者营养状态,提高生存质量。该文对食欲的评估工具、方法及干预在肝癌营养不良患者中的应用现状进行阐述,为肝癌患者的食欲干预提供科学依据。
Hepatocellular carcinoma patients suffer from different degrees of malnutrition due to decreased appetite and eating,which triggers anorexia and even cachexia,seriously affecting the quality of patient survival.Appetite assessment is the basis for reducing nutritional risk,and healthcare professionals can adjust patients’ diet and nutritional guidance measures through the assessment of appetite symptoms in order to improve patients’ nutritional status and survival quality.In this paper,the current status of the assessment tools,methods and interventions of appetite in malnutrition patients with hepatocellular carcinoma are described to provide a scientific basis for appetite interventions.
药物递送系统对于各类疾病意义非凡,但传统药物载体面临细胞毒性强、组织相容性低、半衰期短和靶向性弱等诸多挑战。血小板及其相关衍生物作为新型药物载体具有更为显著的优势。由于血小板自身的生理特点,以及在肿瘤、心血管疾病、血栓性疾病、感染等多种疾病中发挥的病理生理作用,血小板能够弥补传统药物载体的缺陷,具有极大的临床转化意义。该文总结了血小板相关药物递送系统目前的研究进展,以期为新型药物载体研究提供参考。
Drug delivery systems are important for various diseases,but conventional therapeutic drug have many shortcomings,such as high cytotoxicity,low histocompatibility,short half-life and weak targeting.Platelets and their derivatives have more significant advantages as novel drug carriers.Platelets play an important role in the pathophysiology of a wide range of diseases including oncology,cardiovascular diseases,thrombosis and infection.In this paper,we summarized the current research progress of platelet-related drug delivery systems to provide a reference for the research of novel drug delivery systems.
目的 分析常规炎性指标与进展性脑梗死(PCI)患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分(NIHSS)结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表(mRS)评分间的差异,并通过绘制受试者操作特征(ROC)曲线、曲线下面积(AUC)评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)分别为(26.44±5.18)mg/L、(95.28±10.46)ng/L、(45.24±10.31)pg/mL,均高于中度组[(23.12±5.46)mg/L、(90.44±10.17)ng/L、(40.25±10.18)pg/mL],轻度组[(20.28±5.33)mg/L、(84.33±10.27)ng/L、(35.62±8.45)pg/mL],差异具有统计学意义(P<0.05)。重度组的神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)分别为(25.45±5.69)μg/L、(60.45±10.31)ng/mL,均高于中度组[(22.18±5.36)μg/L、(55.27±10.46)ng/mL],轻度组[(19.44±5.37)μg/L、(50.49±10.25)ng/mL],差异具有统计学意义(P<0.05)。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关(P<0.05)。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为(26.62±5.31)mg/L、(96.77±10.24)ng/L、(47.25±10.33)pg/mL、(4.24±1.33)分,均高于预后良好组[(23.75±5.44)mg/L、(91.25±10.37)ng/L、(41.12±10.44)pg/mL,(3.36±0.27)分],差异具有统计学意义(P<0.05)。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高(AUC均>0.85)。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。
Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction(PCI) patients,as well as predictive efficacy of indicators on prognosis levels.Methods This is a retrospective study,with case enrollment from June 2021 to February 2023.The study subjects were 100 PCI patients.Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group.The neurological function serological and inflammatory indicators of the three groups of patients were compared.The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient.According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group.The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC.Results After testing,the levels of CRP,IL-6 and TNF in the severe group were(26.44±5.18)mg/L,(95.28±10.46)ng/L and(45.24±10.31)pg/mL,respectively,higher than those in the moderate group[(23.12±5.46)mg/L,(90.44±10.17)ng/L and(40.25±10.18)pg/mL]and the mild group[(20.28±5.33)mg/L,(84.33±10.27)ng/L and(35.62±8.45)pg/mL](P<0.05).NSE and S100β in the severe group were(25.45±5.69)μg/L and(60.45±10.31)ng/mL,all higher than those in the moderate group[(22.18±5.36)μg/L,(55.27±10.46)ng/mL]and mild group[(19.44±5.37)μg/L,(50.49±10.25)ng/mL](P<0.05).According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β(P<0.05).After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were(26.62±5.31)mg/L,(96.77±10.24)ng/L,(47.25±10.33)pg/mL and(4.24±1.33)scores,respectively,which were higher than those in the group with good prognosis[(23.75±5.44)mg/L,(91.25±10.37)ng/L,(41.12±10.44)pg/mL and(3.36±0.27)scores](P<0.05).Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients(AUC>0.85).Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage.By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients.
脊髓损伤是一种高致残性中枢神经系统疾病,目前缺乏有效的治疗措施。干细胞组织工程兴起和神经调控技术的发展,给脊髓损伤的治疗带来新的希望。目前,多项针对脊髓损伤的干细胞相关治疗项目的临床研究已在全球注册,干细胞疗法是脊髓损伤领域的研究热点,具有良好的应用前景。而神经调控技术一直在临床上脊髓损伤后的康复治疗中发挥着重要作用,特别是靶向神经调控技术近年在脊髓损伤治疗方面取得突破性进展。有研究尝试联合干细胞疗法和神经调控技术应用治疗脊髓损伤,试图取得更好的效果。本文综述了干细胞疗法和神经调控技术在脊髓损伤治疗中的研究进展,旨在探讨其作用效果、修复机制、应用前景以及面临的问题,进一步为脊髓损伤的基础研究和临床转化提供参考。
Spinal cord injury is a highly disabling disease of the central nervous system without effective treatment to date.With the rise of stem cell and tissue engineering,and the breakthrough of neuromodulation technology,it brings new hope to the treatment of spinal cord injury.At present,a number of clinical studies on stem cell-related treatment projects for spinal cord injury have been registered worldwide,which has become a research hotspot.Neuromodulation technology has been playing an important role in the clinical rehabilitation of spinal cord injury.Especially,breakthroughs have been made in the treatment of spinal cord injury by targeted neuromodulation technology in recent years,which is encouraging.Some studies have attempted to combine stem cell therapy and neuromodulation technology to treat spinal cord injuries in an attempt to achieve better effect.This review summarizes the research progress of stem cell therapy and neuromodulation technology in the treatment of spinal cord injury,with the aim of discussing their effect,repair mechanisms,application prospect and various problems to face,and providing further reference for the basic research and clinical transformation of spinal cord injury.
慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数(SII)作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。
Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis.As a new type of inflammatory index,the systemic immune inflammatory index(SII)was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields.SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development.
弥漫性大B细胞淋巴瘤(DLBCL)是最常见的高度异质性非霍奇金淋巴瘤(NHL),不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植(ASCT)和嵌合抗原受体T细胞免疫治疗(CAR-T)是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。
Diffuse large B-cell lymphoma(DLBCL)is a highly heterogeneous type of non-Hodgkin lymphoma(NHL)and its prognosis is different for different disease stages or clinical subtypes.Radiation therapy(RT)is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL.When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients.Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion.For treating relapsed / refractory DLBCL,autologous stem cell transplantation(ASCT)and chimeric antigen receptor T cell immunotherapy(CAR-T)are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure.With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options.