最新刊期
卷 50 ， 期 10 ， 2025
- “在血管战创伤救治领域，专家共识为战场血管损伤处置提供明确参考依据。”
摘要：Vascular trauma in wartime is often accompanied by severe complications such as fractures, visceral injuries, and hemorrhagic shock, and it is a major cause of disability and death on the battlefield. In response to the high incidence and complexity of combat-related vascular trauma, "Chinese expert consensus on the management of vascular combat injuries" has been jointly formulated by the Vascular Surgery Group of the Chinese People's Liberation Army (PLA), the Vascular Medicine Professional Committee of China Research Hospital Association, and the Vascular Devices Branch of China Association for Medical Devices Industry. Leading experts in vascular surgery and medical device development for vascular trauma treatment from the PLA were invited to participate, and they integrated the latest research findings and relevant literature in the field of combat vascular trauma management. After extensive consultation with experts from military medical and research institutions, this consensus focuses on fundamental treatment concepts and principles of vascular trauma care, frontline care, early vascular damage control surgery, and bleeding management protocols for different anatomical regions. The consensus comprises 8 sections with 42 recommendation statements, aiming to establish a comprehensive, highly targeted, and operationally feasible treatment protocol covering the entire continuum of combat vascular trauma care. It provides clear and practical references for managing vascular injuries at different levels and anatomical locations on the battlefield.关键词：vascular injuries;combat wounds;hemorrhagic shock;hemostasis11|0|0更新时间：2025-11-05
Guideline and Consensus
- “在创伤救治领域，专家梳理了创伤局部止血材料的最新研究进展，重点探讨了沸石材料的止血应用，为后续研究提供新思路。”
摘要：Shock and death resulting from traumatic massive hemorrhage have become the leading cause of trauma-related mortality, accounting for over 70% of deaths within 24 hours. Therefore, achieving rapid hemostasis to reduce multiple organ failure caused by excessive blood loss and then improving survival rates has become a critical challenge in trauma care. Common local hemostatic materials for trauma can be categorized by their properties into organic and inorganic materials, or by their mechanism of action into three types: physical adsorbents, biologically active agents, and adhesive sealants. This review summarizes the characteristics and drawbacks of typical representatives from these three categories. It then focuses on discussing the application of zeolite materials in hemostasis, specifically three forms: zeolite particles, zeolite-polymer composites, and bio-based zeolite materials. Furthermore, the latest research progress in the fundamental theory and practical applications of zeolite-based hemostatic materials are reviewed, aiming to provide new insights for future research on zeolite in hemostasis.关键词：trauma;hemostatic materials;zeolite48|0|0更新时间：2025-11-05
Expert Review
- “最新研究利用XGBoost-SHAP模型预测急性主动脉夹层患者术后死亡风险，搭建在线预测平台，提高高危患者识别效率。”
摘要：ObjectiveTo develop a predictive model for postoperative mortality risk in patients with acute aortic dissection (AAD) using the Extreme Gradient Boosting (XGBoost) algorithm combined with Shapley Additive Explanation (SHAP), and to establish a prediction website to serve as a diagnostic and therapeutic support platform for clinicians and patients.MethodsA retrospective cohort study design was adopted. Data from 782 AAD patients who underwent surgical treatment at the Fourth Hospital of Hebei Medical University from January 2013 to December 2023 were collected, including basic information and initial serum biomarker test results. Patients were randomly divided into training and test sets at a 7:3 ratio. An external validation set consisting of 313 AAD patients admitted to the Second Hospital of Hebei Medical University from January 2020 to December 2023 was also established for further model validation. Variables were screened using LASSO regression, and an XGBoost machine learning model was constructed and interpreted using SHAP. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis. Using the Shiny package, the XGBoost model was deployed to shinyapps.io to create a prediction website for postoperative mortality risk in AAD patients. One patient was selected by simple random sampling from the test set and the external validation set respectively for the prediction example on the Shiny webpage.ResultsThe XGBoost model demonstrated high predictive performance for postoperative mortality in AAD patients, with area under the ROC curve (AUC) values of 0.928 (95%CI 0.901-0.956) in the training set, 0.919 (95%CI 0.891-0.949) in the test set, and 0.941 (95%CI 0.915-0.967) in the external validation set. SHAP values indicated the following order of variable importance in the model (from highest to lowest): "lactate dehydrogenase" "blood chlorine" "multiple organ injury" "carbon dioxide combining power" "prothrombin time""α-hydroxybutyric acid" "creatine kinase isoenzyme" "Stanford classification" "combined use of bedside blood purification" "gender" "acute kidney injury" "gastrointestinal bleeding" "brain injury" and "shock". A risk prediction website for adverse postoperative outcomes in AAD patients was developed using XGBoost-SHAP method (https://dun-dunxiaolu.shinyapps.io/document/) and validated with examples. One randomly selected patient from each of the test and external validation sets was applied: the predicted mortality risk value for patient 1 (who died postoperatively) was 0.9539, and that for patient 2 (who survived postoperatively) was 0.0206.ConclusionsThe XGBoost-SHAP model demonstrates high accuracy in predicting postoperative mortality risk for AAD patients. The online prediction tool established based on this model enhances the identification efficiency of high-risk postoperative mortality patients.关键词：machine learning;prediction model;acute aortic dissection;postoperative mortality12|0|0更新时间：2025-11-05 - “深度学习技术在医学领域应用潜力巨大，尤其在股骨头坏死诊疗中展现出巨大潜力，为未来研究提供参考与启示。”
摘要：With the rapid development of deep learning (DL) technology, its potential applications in the medical field have become increasingly prominent. As a refractory disease, osteonecrosis of the femoral head (ONFH) has certain limitations in traditional diagnostic and therapeutic approaches. The application of DL technology is expected to overcome these limitations and improve diagnosis and treatment outcomes. At present, the applications of DL models - including enhancing image clarity, improving diagnostic accuracy and efficiency, conducting prognostic evaluations, optimizing preoperative planning, assisting intraoperative imaging, and customizing personalized treatment plans - have fully demonstrated their tremendous potential in the diagnosis and treatment of ONFH. This review summarizes the current application status of DL in ONFH diagnosis and treatment, aiming to provide references and insights for future related research.关键词：femoral head necrosis;deep learning;convolutional neural network7|0|0更新时间：2025-11-05 -
Application and research progress of artificial intelligence in the assessment of subsolid nodules AI导读
“在肺癌防治领域，AI技术展现出巨大潜力，有效辅助放射科医师诊疗，提高工作效率，降低误诊漏诊率。”
摘要：Lung cancer has the highest incidence and mortality among malignant tumors in China. Persistent subsolid nodules (SSNs) are closely associated with early-stage lung adenocarcinoma. Artificial intelligence (AI), as an emerging technology, is capable of performing in-depth analysis of large-scale imaging data through autonomous learning and possesses the ability to predict outcomes from new data, demonstrating great potential and application prospects in the assessment of SSNs. AI can not only effectively assist radiologists in diagnosis and treatment, but also improve work efficiency while reducing misdiagnosis and missed diagnosis rates. This review summarizes the recent applications and research progress of AI in the assessment of SSNs, to provide new insights for the diagnosis and treatment of SSNs.关键词：artificial intelligence;pulmonary nodules;subsolid nodules11|0|0更新时间：2025-11-05 - “前列腺癌精准诊断技术PSMA PET结合AI，展现了在前列腺癌诊治中的广泛应用前景，为相关研究提供参考。”摘要：Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is currently a precise diagnostic imaging technology for prostate cancer (PCa). Artificial intelligence (AI) technologies, particularly machine learning and deep learning algorithms, when combined with PSMA PET, showed extensive potential applications in various aspects of PCa management. These include the diagnosis and differential diagnosis of primary tumors, staging, recurrence detection, and treatment planning for PCa. At present, a few AI models have received clinical approval. This paper reviews the application progress of AI combined with PSMA PET in the diagnosis and treatment of PCa, explores the current limitations of AI technologies in clinical practice, and aim to provide references to future diagnosis and treatment studies for PCa.关键词：prostate cancer;artificial intelligence;prostate-specific membrane antigen;positron emission tomography7|0|0更新时间：2025-11-05
- “深度学习技术在退行性脊髓型颈椎病辅助诊断领域的研究进展，为智能化诊断提供参考。”摘要：Degenerative cervical myelopathy (DCM) is a group of diseases caused by cervical spine degeneration that compresses the spinal cord. It is a major cause of spinal cord dysfunction in adults, and its incidence is increasing globally. In the late stage, DCM could lead to paralysis due to spinal cord injury, which makes rapid, effective, and accurate medical diagnosis clinically significant. Deep learning (DL) technology can assist physicians in the rapid and accurate diagnosis of DCM by analyzing and processing a large amount of imaging data to extract features of the affected regions. In recent years, DL algorithm models have been leveraged for DCM-related research, which has become a focal point of intelligent medical development. In this review, domestic and international literature is surveyed, and the research progress and application of DL technology in the auxiliary diagnosis and prognosis evaluation of DCM are systematically summarized, aiming to provide a reference for intelligent diagnosis in clinical practice.关键词：deep learning;degenerative cervical myelopathy;artificial intelligence;neural networks10|0|0更新时间：2025-11-05
Special Issue on Application of Artificial Intelligence in Disease Diagnosis and Treatment Ⅱ
- “甘肃中医药大学附属医院研究显示，Perthes病患儿关节液中VEGF、IGF-1、TGF-β1水平升高与术后血运重建效果不佳有关，有望成为预后评估指标。”
摘要：ObjectiveTo explore the relationship between levels of vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), and transforming growth factor-β1(TGF-β1) in the synovial fluid of children with avascular necrosis of the femoral head (also known as Perthes disease) and the efficacy of postoperative revascularization, aiming to provide a basis for subsequent diagnosis and treatment.MethodsA retrospective study was conducted on 262 children with Perthes disease admitted to the Affiliated Hospital of Gansu University of Chinese Medicine from January 2023 to June 2024. Based on postoperative revascularization efficacy, patients were divided into good revascularization group (n=228) and poor revascularization group (n=34). For poor revascularization group, a 1:2 matched case-control design was used to select 68 age-matched children with hip synovitis who underwent hip joint fluid puncture as control group. Additionally, 82 children with Perthes disease treated at the hospital from June 2024 to January 2025 were enrolled as a validation cohort for nomogram model verification. The expression levels of VEGF, IGF-1 and TGF-β1 in the synovial fluid of three groups were compared. Confounding biases were controlled through univariate and stratified analyses. Binary logistic regression analysis was used to identify independent factors affecting the revascularization effect. R software was utilized to draw and verify the nomogram model for predicting the postoperative revascularization effect.ResultsThe levels of VEGF, IGF-1 and TGF-β1 in the synovial fluid of children in poor revascularization group were all higher than those in control group and good revascularization group (P<0.05). After three types of reconstructive surgeries, the levels of VEGF, IGF-1 and TGF-β1 in the synovial fluid of children with poor revascularization were all higher than those in children with good revascularization (P<0.05); however, there was no statistically significant difference in the above indicators among different surgical types (P>0.05). Binary logistic regression analysis showed that the levels of VEGF, IGF-1, and TGF-β1 in the synovial fluid were independent risk factors for poor postoperative revascularization in children with Perthes disease. The area under the ROC curve of the nomogram model established accordingly for predicting poor postoperative revascularization in children with Perthes disease was 0.875 (95%CI 0.805-0.945), with a sensitivity of 0.874 and a specificity of 0.851. Moreover, the calibration curve and decision curve analysis (DCA) indicated that the model had good clinical applicability.ConclusionsThe increased levels of VEGF, IGF-1 and TGF-β1 in synovial fluid are associated with poor postoperative revascularization in children with Perthes disease. These three factors are expected to become prognostic indicators for children with Perthes disease.关键词：ischemic necrosis of femoral head;vascular endothelial growth factor;insulin-like growth factor 1;transforming growth factor-β1;revascularization14|0|0更新时间：2025-11-05 - “在食管胃交界腺癌治疗领域，河南大学淮河医院胸外科专家验证了单一体式经左胸+食管裂孔入路手术的有效性和可行性，为Siewert Ⅱ型AEG患者提供了新的治疗选择。”
摘要：ObjectiveTo explore the validity and feasibility of the left transthoracic and esophageal hiatal approach for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction under a single position.MethodsThe clinical data of 64 patients with Siewert type Ⅱ AEG (single position transthoracic approach group) treated with the left transthoracic and esophageal hiatal approach under a single position and 56 patients with the laparoscopic transesophageal slit approach (transabdominal approach group) in the Department of Thoracic Surgery, Huaihe Hospital of Henan University, from January 2017 to December 2018 were retrospectively analyzed. The clinical and pathological data, perioperative indicators (operation time, intraoperative blood loss, postoperative first ambulation time, postoperative first peristalsis time, postoperative drainage volume at 3 d, incidence of postoperative complications, postoperative hospital stay), postoperative complications (positive surgical margin, proximal esophageal resection margin, tumor diameter, total number of dissected lymph nodes, positive lymph node dissection rate, postoperative histopathology, and TNM staging of tumor pathology), and survival indicators (tumor recurrence and metastasis rate and survival at1 month, 3 months, 6 months, 1 year, 3 years, 5 years after surgery) were compared between the two groups. Kaplan-Meier method was used to analyze the postoperative survival rate of the two groups. Univariate analysis using χ2 test was employed to analyze factors influencing 5-year postoperative survival rate in Siewert type Ⅱ AEG patients.ResultsNo significant difference was observed in clinical and pathological data, such as gender, age, American Society of Anesthesiologists (ASA) grade, tumor differentiation, pTNM stage, and tumor diameter between the two groups (P>0.05). No significant differences were noted in intraoperative blood loss, incidence of postoperative complications, and survival rates at 1 month, 3 months, 6 months, 1 year, and 3 years after surgery between the two groups (P>0.05). The single position transthoracic approach group exhibited a higher postoperative drainage volume at 3 d compared to the transabdominal approach group (P<0.001), a shorter surgical time (P<0.001), a longer time to first mobilization, first intestinal peristalsis, and hospital stay after surgery (P<0.01), a longer proximal esophageal margin (P<0.001), a higher total number of lymph node dissections (P<0.001), and a higher positive lymph node dissection rate (P<0.05) than the transabdominal approach group. The 5-year recurrence-free survival rate of the single position transthoracic approach group was higher than that of the transabdominal approach group, with a statistically significant difference (P=0.013). The Kaplan-Meier survival curve showed no statistically significant difference in the 5-year overall survival rate between the two groups of patients after surgery (P=0.456). The results of univariate analysis indicated that there are significant relationships between tumor differentiation degree, pTNM stage, tumor diameter, and lymph node positivity rate with the 5-year postoperative survival rate in Siewert type Ⅱ AEG patients (P<0.05).ConclusionSiewert type Ⅱ AEG patients can be treated with the left transthoracic and esophageal hiatal approach under a single position, achieving the same effect as laparoscopic transesophageal slit approach, and it can be actively promoted as a complementary choice of operation in the clinic.关键词：single type left thoracic and esophageal hiatal approach;laparoscopic transesophageal slit approach;Siewert type Ⅱ esophagogastric junction adenocarcinoma;orvil tubular anastomosis6|0|0更新时间：2025-11-05 - “乌司奴单克隆抗体治疗中重度克罗恩病疗效显著，药物安全性良好，第14周临床应答与第52周临床缓解相关。”
摘要：ObjectiveTo analyze the efficacy and safety of ustekinumab (UST) in patients with moderate-to-severe Crohn's disease (CD), and to identify factors influencing clinical outcomes.MethodsData were retrospectively collected from patients with moderate-to-severe CD treated with UST in the First Affiliated Hospital of Zhejiang Chinese Medical University and Hangzhou Hospital of Traditional Chinese Medicine between November 2020 and May 2023. Patients were categorized into first-line (not treated with biologic agents, n=68) and second-line (treated with biologic agents, n=66) treatment groups based on prior use of biologic agents. Baseline characteristics, including age, sex, smoking status, disease duration, age at diagnosis, lesion site, disease behavior, perianal disease, history of intestinal surgery, and CD-related drug use, were compared between the two groups. Crohn's disease activity indices (CDAI) were recorded at baseline, week 14, and week 52 to assess the clinical efficacy at weeks 14 and 52. Endoscopic evaluations were performed at baseline and week 52 to evaluate endoscopic efficacy at week 52. The 52-week drug persistence rate and safety profile were also analyzed. Influencing factors related to clinical outcomes were evaluated using univariate and multivariate logistic regression.ResultsA total of 134 patients with moderate-to-severe CD treated with UST were included. At week 14, clinical response and remission rates were 75.4% (101/134) and 33.6% (45/134), respectively, with no significant difference in clinical efficacy between first-line and second-line groups (clinical response rate: 77.9% vs. 72.7%, P=0.484; clinical remission rate: 38.2% vs. 28.8%, P=0.247). At week 52, clinical response and remission rates were 79.9% (107/134) and 56.0% (75/134), respectively. The rates of endoscopic response and remission were 70.9% (95/134) and 38.8% (52/134), respectively. There were no significant differences in clinical efficacy (clinical response rate: 80.9% vs. 78.8%, P=0.763; clinical remission rate: 60.3% vs. 51.5%, P=0.306) and endoscopic efficacy (endoscopic response rate: 76.5% vs. 65.2%, P=0.149; endoscopic remission rate: 42.6% vs. 34.8%, P=0.354) between the two groups. The 52-week drug persistence rate was 85.8% (115/134), and the adverse reaction rate was 4.5% (6/134). Compared with first-line treatment group, biologic-experienced patients had a significantly higher proportion of dose-optimized therapy in second-line treatment group (45.5% vs. 22.1%, P=0.004). Multivariate logistic regression showed that the 14-week clinical response was a significant predictor of 52-week clinical remission, while perianal disease and intestinal surgery history were significant factors associated with treatment failure (P<0.05).ConclusionsUST demonstrates significant efficacy in improving clinical and endoscopic outcomes for moderate-to-severe CD patients, with a favorable safety profile. Clinical response at 14 weeks is strongly predictive of clinical remission at 52 weeks. Patients with perianal disease or a history of intestinal surgery were at higher risk of treatment failure.关键词：Crohn's disease;efficacy;influencing factors;safety;ustekinumab12|0|0更新时间：2025-11-05 - “首都儿科研究所附属儿童医院研究显示，睡眠相关肺泡低通气障碍患儿常见呼吸困难、抽搐、青紫症状，无创正压通气可有效改善症状和睡眠质量。”摘要：ObjectiveTo analyze the clinical characteristics and polysomnographic (PSG) features of children with sleep-related hypoventilation disorder (SRHD), facilitate its auxiliary diagnosis, and explore the therapeutic effects of non-invasive positive pressure ventilation (NPPV) on SRHD children.MethodsA retrospective study was conducted on the medical records of 16 children diagnosed with SRHD who were admitted and treated in the Department of Respiratory Diseases, Children's Hospital Affiliated to Capital Institute of Pediatrics, from July 2016 to June 2024. Additionally, 69 children with severe obstructive sleep apnea (OSA) who visited the Department of Respiratory Diseases and Otolaryngology at the same hospital from July 2021 to June 2022 and met the inclusion criteria were enrolled to compare clinical and PSG characteristics between SRHD and OSA children. The therapeutic effects of NPPV were evaluated.Results(1) Among 16 SRHD children, 4(25.0%) presented with cyanosis, 9(56.3%) with dyspnea, and 5(31.3%) with convulsions. (2) Eleven SRHD children completed PSG+PetCO2, showing PSG characteristics consistent with severe OSA. (3) Compared with severe OSA children, SRHD children had lower proportion of rapid eye movement (REM) sleep, mean and minimum oxygen saturation, and higher obstructive hypopnea index, obstructive apnea-hypopnea index (OAHI), and apnea-hypopnea index (AHI) (P<0.05). (4) When compared with 25 severe OSA children with OAHI >25, the ratio of obstructive apnea to hypoventilation was approximately 1:30 in SRHD children, with more significant decrease in pulse oxygen saturation (P<0.05). (5) After NPPV treatment for 12 SRHD children, clinical symptoms and PSG indicators significantly improved (P<0.05).ConclusionsThe 3 main symptoms in SRHD children are dyspnea, convulsions, and cyanosis. For children with unexplained cyanosis and PSG meeting severe OSA criteria, especially those with predominantly obstructive hypoventilation events and significant SpO2 reduction, PetCO2 monitoring should be performed to detect SRHD early. NPPV improves clinical symptoms, reduces sleep-related events, increases sleep-time SpO2, and enhances sleep safety in SRHD children.关键词：sleep related hypoventilation disorder;clinical characteristics;polysomnography;non-invasive positive pressure ventilation9|0|0更新时间：2025-11-05
- “据最新研究，术前眼内压是视网膜脱离患者玻璃体切割术后继发性青光眼的影响因素和敏感指标。”
摘要：ObjectiveTo investigate the influence and threshold effect of preoperative intraocular pressure (IOP) on secondary glaucoma (SG) after pars plana vitrectomy (PPV).MethodsA retrospective analysis was conducted on 88 patients with retinal detachment who developed SG after PPV (SG group) treatment at Hebei Eye Hospital from January 2020 to January 2024. Meanwhile, 88 patients with retinal detachment who underwent PPV at the same hospital during the same period but did not develop SG postoperatively were selected as non-SG group in a 1:1 ratio. Univariate analysis was used to compare the differences in clinical data between the two groups. A stratified regression model was applied to analyze the correlation between postoperative characteristics and preoperative IOP. Multivariate logistic regression analysis was used to identify the factors affecting the occurrence of SG after PPV, with multicollinearity diagnosis and sensitivity analysis performed for the parameters. Additionally, the threshold effect of preoperative IOP on the risk of postoperative SG was analyzed. A predictive model was constructed based on the results of multivariate logistic regression. The receiver operating characteristic (ROC) curve was employed to evaluate the efficacy and accuracy of the predictive model, while the calibration curve and clinical decision curve were utilized to assess the consistency between the predictive model and actual conditions as well as the clinical practicality of the model.ResultsCompared with non-SG group, SG group had a higher proportion of patients with a history of diabetes, family history of glaucoma, a higher preoperative IOP, higher proportion of postoperative closed anterior chamber angle status, longer silicone oil tamponade duration (≥6 months), higher incidence of silicone oil emulsification (P<0.05). Postoperative anterior chamber angle status (closed) was significantly positively correlated with preoperative IOP levels (P<0.05). Multivariate logistic regression analysis showed that history of diabetes, family history of glaucoma, silicone oil emulsification, postoperative anterior chamber angle closure, silicone oil tamponade duration ≥6 months, and preoperative IOP ≥21 mmHg were independent risk factors for SG after PPV (P<0.05). Multicollinearity diagnosis indicated no significant collinearity among the above variables. Sensitivity analysis showed that the association tended to be null when E=5.014. With the increase of preoperative IOP, the probability of SG after PPV in patients showed an upward trend. The threshold effect analysis revealed that when preoperative IOP ≥19 mmHg, the probability of SG after PPV increased significantly with the elevation of preoperative IOP (OR=2.942, 95%CI 1.794-4.826, P<0.001). After adjusting for covariates, preoperative IOP remained an independent influencing factor for different degrees of SG after PPV (OR=7.392, 95%CI 1.379-12.510, P=0.001). Before and after validation, the area under the ROC curves (AUCs) of the model for predicting SG after PPV were 0.987 (95%CI 0.974-1.000, P<0.001) and 0.989 (95%CI 0.969-1.000, P<0.001), with sensitivities of 0.9332 and 0.9545, and specificities of 0.9981 and 0.9773, respectively. Both the calibration curve and decision curve analysis demonstrated that the predictive model had good discrimination and accuracy.ConclusionPreoperative IOP is an influencing factor and a sensitive indicator for the development of SG after PPV in patients with retinal detachment.关键词：preoperative intraocular pressure;pars plana vitrectomy;secondary glaucoma;threshold effect;predictive value15|0|0更新时间：2025-11-05 - “最新研究发现，基于SLCO1B1和APOE基因多态性检测的个体化他汀类药物治疗方案，可提高PCI术后患者血脂达标率，缩短达标时间，改善预后。”
摘要：ObjectiveTo explore the impact of polymorphisms in the solute carrier organic anion transporter family member 1B1(SLCO1B1) and apolipoprotein E(APOE) genes on statins selection and prognosis in patients after percutaneous coronary intervention (PCI).MethodsThis retrospective study enrolled 612 patients with coronary heart disease hospitalized in Tianjin Beichen Hospital from January 2021 to February 2023. Among them, 411 patients who underwent PCI were assigned to PCI group, and 201 patients who did not undergo PCI were assigned to non-PCI group. According to treatment methods, PCI group was further divided into two subgroups: observation subgroup (n=305) and control subgroup (n=106). Non-PCI group was also divided into two subgroups: observation subgroup (n=147) and control subgroup (n=54). Patients in all observation subgroups underwent the detection of SLCO1B1 and APOE gene polymorphisms before medication, and an initial individualized treatment plan (including the selection of appropriate statins and dosages) was formulated based on the detection results. Patients in control subgroups were given statins at conventional dosages. Basic data before medication, post-medication lipid compliance rates [lipid intention-to-treat (ITT) compliance rate and lipid per-protocol analysis (PP) compliance rate], time to lipid compliance, liver function indicators before and after medication, and prognosis, as well as SLCO1B1 and APOE genotyping and allele frequency distribution were compared between observation subgroup and control subgroup. Conditional logistic regression was used to analyze the relationship between different genotypes and prognostic susceptibility. Multifactor dimensionality reduction (MDR) was applied to analyze the interaction between SLCO1B1 genotype and APOE genotype.ResultsAll genotypes of SLCO1B1 and APOE genes in observation subgroups conformed to the Hardy-Weinberg genetic equilibrium test (P>0.05). Compared with control subgroups, the observation subgroups had significantly higher lipid PP compliance rates after 6 and 12 months of treatment. After 3 months of treatment, the number of completed cases and compliant cases in observation subgroups was significantly higher, and the time to lipid compliance was significantly shorter than that in control subgroups (P<0.05). Compared with before treatment, there were no significant changes in alanine aminotransferase (ALT) and creatine kinase isoenzyme (CK-MB) levels in either observation subgroups or control subgroups (P>0.05); the levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly decreased (P<0.001), while high-density lipoprotein cholesterol (HDL-C) level was significantly increased (P<0.01). After 12 months of treatment, the aspartate aminotransferase (AST) level in observation subgroups was significantly lower than that before medication and also lower than that in the corresponding control subgroups (P<0.05). Within PCI group: there were 1 case and 5 cases of myocardial infarction, 2 cases and 6 cases of target vessel revascularization, 0 cases and 3 cases of stroke, 0 cases and 7 cases of recurrent angina pectoris, 1 case and 5 cases of readmission in observation subgroup and control subgroup, respectively. There were statistically significant differences between observation subgroup and control subgroup (P<0.05). Within non-PCI group: there were 0 cases and 3 cases of cardiogenic death, 2 cases and 6 cases of myocardial infarction, 2 cases and 5 cases of target vessel revascularization, 0 cases and 4 cases of stroke, 0 cases and 8 cases of recurrent angina pectoris, and 2 cases and 4 cases of readmission in observation subgroup and control subgroups, respectively, with statistically significant differences between the two subgroups (P<0.05). In the recessive model, SLCO1B1 and APOE genes were significantly correlated with prognosis in both PCI observation subgroup and non-PCI observation subgroup (P<0.05). MDR analysis of the interaction between SLCO1B1 genotype and APOE genotype in PCI observation subgroup and non-PCI observation subgroup showed that there was a significant interaction between the genotypes, which was closely related to prognosis (P<0.05).ConclusionIndividualized statin treatment regimens based on the detection of SLCO1B1 and APOE gene polymorphisms can improve the lipid compliance rate, shorten the time to lipid compliance, and improve the prognosis of patients after PCI.关键词：apolipoprotein E;gene polymorphism;percutaneous coronary intervention;statins;prognosis;solute carrier organic anion transporter family member 1B110|0|0更新时间：2025-11-05
Clinical Research
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Effect and mechanism of high-glucose environment on osteoblast function and bone quality in mice 增强出版 AI导读
“最新研究发现，高糖环境抑制小鼠成骨细胞增殖分化及迁移能力，糖尿病小鼠骨质量下降、脆性增加。”
摘要：ObjectiveTo explore the effects of different glucose concentrations on the synthesis and secretion of bone collagen in osteoblasts and the impact of diabetes on bone quality in mice.Methods(1) Primary osteoblasts were extracted from the skulls of neonatal mice via collagenase digestion and cultured in four groups under different glucose concentrations: normal glucose (5.5 mmol/L), moderate glucose (11.5 mmol/L), moderate-high glucose (16.5 mmol/L), and high glucose (25 mmol/L). EdU staining was performed to evaluate cell proliferation, while the Transwell assay was used to assess cell migration. Immunofluorescence and Western blotting were performed to detect and quantitatively analyze the content of type Ⅰ collagen (Col-1). Alizarin red S (ARS) staining and alkaline phosphatase (ALP) staining were applied to assess the effects of different glucose concentrations on osteogenic differentiation. (2) Six-week-old male C57BL/6 mice were randomly divided into control group and model group (5 in each group). The model group was fed a high-fat diet for 4 weeks followed by streptozotocin (STZ) injection to establish a diabetic mouse model. The osteogenic differentiation capacity of primary osteoblasts from both groups was assessed.(3) Micro-computed tomography (Micro-CT) was employed to analyze femoral bone mineral density (BMD), bone volume/tissue volume (BV/TV), trabecular number (Tb.N), and trabecular separation (Tb.Sp). Three-point bending test was conducted to evaluate mechanical parameters including maximum load, Young's modulus, fracture energy, and stiffness. RT-qPCR was employed to assess the expression of osteogenic differentiation genes (Alp, Opn, Col1a1, and Lox). Masson staining and Mallory staining were used to evaluate Col-1 content in trabecular bone.Results(1) EdU and Transwell assay results demonstrated that with the gradual increase in glucose concentration, the proliferation and migration abilities of osteoblasts were significantly decreased (P<0.001), and the protein expression levels of Col-1 and lysyl oxidase (LOX) were significantly reduced (P<0.01 or P<0.001). ARS and ALP staining revealed that calcium salt deposition and ALP activity in osteoblasts were significantly decreased with increasing glucose concentration (P<0.05 or P<0.001). (2) Compared with control group, mice in model group exhibited typical "three polies and one weight loss" symptoms (polyuria, polydipsia, polyphagia, and weight loss) of diabetes, and ARS and ALP staining showed a significant reduction in osteoblasts (P<0.001). (3) Micro-CT and three-point bending test results indicated that, compared with control group, mice in model group showed microarchitectural deterioration of bone, decreased Tb.N, increased Tb.Sp, and significantly reduced maximum load, Young's modulus, fracture energy, and stiffness (P<0.05). RT-qPCR results showed that the relative mRNA expression levels of osteogenic differentiation genes (Alp, Opn, Col1a1, and Lox) were significantly decreased in model group compared with control group (P<0.01 or P<0.001). Masson and Mallory staining indicated a significant reduction in collagen content in model group compared with control group (P<0.01).ConclusionsHigh-glucose environment inhibits osteoblast proliferation, differentiation, and migration. Diabetic mice exhibit reduced bone quality and increased bone fragility, potentially mediated by decreased lysyl oxidase and collagen levels.关键词：diabetes mellitus;high-glucose environment;osteoblasts;bone collagen;bone quality10|0|0更新时间：2025-11-05 - “最新研究发现，右美托咪定通过激活JAK2/STAT3信号通路，可有效缓解七氟醚诱导的新生大鼠认知功能障碍。”
摘要：ObjectiveTo investigate the effect and mechanism of dexmedetomidine (Dex) in alleviating sevoflurane (Sev)-induced cognitive dysfunction in neonatal rats via the Janus kinase 2/signal transducer and activators of transcription 3 (JAK2/STAT3) signaling pathway.MethodsA total of 50 neonatal Sprague-Dawley (SD) rats were randomly divided into control group, model group, Dex group, AG490 group, and Colivelin group, with 10 rats in each group. Except for control group, the rats in the other four groups were used to construct a model of cognitive dysfunction in neonatal rats by inhaling Sev. Before modeling, Dex group was intraperitoneally injected with 20 μg/kg Dex; AG490 group was intraperitoneally injected with 20 μg/kg Dex and 1 mg/kg AG490; Colivelin group was intraperitoneally injected with 20 μg/kg Dex, 1 mg/kg AG490, and 1 mg/kg Colivelin; control group and model group were intraperitoneally injected with an equal doses of physiological saline. The novel object recognition test and step-down test were used to detect the cognitive, learning, and memory functions of neonatal rats. TUNEL method was used to detect the cell apoptosis rate in the hippocampus. Rhodamine 123 staining was used to detect the mitochondrial membrane potential in the hippocampus. ELISA method was used to detect the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in the hippocampus. DHE probe method was used to detect the intracellular reactive oxygen species(ROS) content. qRT-PCR was used to detect the mRNA expression levels of phosphorylated JAK2 (p-JAK2), phosphorylated STAT3 (p-STAT3), Synapsin-I, brain-derived neurotrophic factor (BDNF), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax). Western Blotting was used to detect the protein expression levels of p-JAK2, p-STAT3, JAK2, and STAT3 in the hippocampus.ResultsCompared with control group, model group showed cognitive and memory impairment, significantly increased apoptosis rate, increased levels of ROS and MDA, decreased SOD level, decreased mRNA expression levels of p-JAK2, p-STAT3, Synapsin-I, BDNF, and Bcl-2, increased Bax mRNA expression level, decreased ratios of p-JAK2/JAK2 and p-STAT3/STAT3, and decreased mitochondrial membrane potential in the hippocampus (P<0.05). Compared with model group, Dex, AG490, and Colivelin groups showed significantly improved cognitive and memory impairment, significantly decreased apoptosis rate, decreased levels of ROS and MDA, increased SOD level, increased mRNA expression levels of p-JAK2, p-STAT3, Synapsin-I, BDNF, and Bcl-2, decreased Bax mRNA level, increased ratios of p-JAK2/JAK2 and p-STAT3/STAT3, and increased mitochondrial membrane potential in the hippocampus (P<0.05). Compared with Dex group, AG490 and Colivelin groups exhibited cognitive and memory impairment, significantly increased apoptosis rate, increased levels of ROS and MDA, decreased SOD level, decreased mRNA expression levels of p-JAK2 and p-STAT3, Synapsin-I, BDNF, and Bcl-2, increased Bax mRNA expression level, decreased ratios of p-JAK2/JAK2 and p-STAT3/STAT3, and decreased mitochondrial membrane potential in the hippocampus (P<0.05). Compared with AG490 group, Colivelin group showed significantly improved cognitive and memory impairment, significantly decreased apoptosis rate, decreased levels of ROS and MDA, increased SOD level, decreased mRNA expression levels of p-JAK2 and p-STAT3, Synapsin-I, BDNF, and Bcl-2, increased Bax mRNA expression level, decreased ratios of p-JAK2/JAK2 and p-STAT3/STAT3, and increased mitochondrial membrane potential in the hippocampus, with statistically significant differences (P<0.05).ConclusionDex can inhibit the oxidative stress in the hippocampus of brain tissue in Sev-induced neonatal rats and improve their cognitive, learning, and memory impairment, which may be related to the activation of JAK2/STAT3 signaling pathway.关键词：dexmedetomidine;sevoflurane;neonatal rats;cognitive dysfunction;Janus kinase 2/signal transducer and activators of transcription 3 signaling pathway8|0|0更新时间：2025-11-05
Basic Research
- “最新研究发现，线粒体自噬通过调控巨噬细胞功能参与动脉粥样硬化发展，为防治动脉粥样硬化提供新思路。”
摘要：Mitophagy is a specific type of autophagy that selectively eliminates damaged mitochondria to maintain mitochondrial activity and cellular homeostasis. In recent years, regulating mitophagy to preserve normal cellular functions has gradually become an important preventive and therapeutic strategy for many diseases. Macrophages are key participants in the formation of atherosclerosis (AS) plaques. Studies have shown that mitophagy may be involved in the development of AS by regulating macrophage homeostasis and physiological functions. This review summarizes the mechanisms by which mitophagy regulates macrophage lipid metabolism, inflammation, senescence, apoptosis and pyroptosis in AS, aiming to provide a new theoretical basis for mitophagy-mediated regulation in AS.关键词：mitophagy;macrophages;atherosclerosis11|0|0更新时间：2025-11-05 - “蜕膜自然杀伤细胞在妊娠建立与维持中发挥关键作用，其教育缺陷可能导致复发性流产等不良妊娠结局。”摘要：Decidual natural killer (dNK) cells are the most abundant immune cells in the decidua. The functional acquisition during dNK cell development depends on NK cell education, a process in which the highly polymorphic killer cell immunoglobulin-like receptors (KIRs) and CD94/NKG2s expressed on dNK cells bind to major histocompatibility complex (MHC) class Ⅰ molecules expressed by extravillous trophoblast (EVT) cells. This interaction regulates the effector functions of NK cells. dNK cells participate in the establishment and maintenance of pregnancy by modulating immune tolerance at the maternal-fetal interface. Defects in dNK cell education leading to dNK dysfunction are potential pathological mechanisms underlying adverse pregnancy outcomes such as recurrent pregnancy loss (RPL). This review summarizes the characteristics of dNK cells, dNK cell education and its key associated molecules, and the pathological mechanisms by which poorly educated dNK cells contribute to RPL, aiming to offer insights for predicting and improving pregnancy outcomes in RPL patients associated with dNK cell abnormalities.关键词：decidual natural killer cell;recurrent pregnancy loss;maternal-fetal interface;major histocompatibility complex;human leukocyte antigen;killer cell immunoglobulin-like receptor;CD94/NKG212|0|0更新时间：2025-11-05
- “最新研究揭示肠道菌群与外周免疫细胞在阿尔茨海默病中的作用，为预防和治疗提供新思路。”
摘要：Alzheimer's disease (AD) is a common neurodegenerative disease in the elderly. Increasing evidence shows that peripheral immune cells are involved in the occurrence and development of AD. Both gut microbiota dysbiosis and abnormalities of peripheral immune cells occur in the early stage of AD. The gut microbiota can influence the central nervous system through mechanisms such as the gut-brain axis and the regulatory effects on peripheral immune cells. AD treatment methods targeting the gut microbiota and immune cells have been receiving increasing attention. This review summarizes the regulatory effects and mechanisms of the gut microbiota on peripheral immune cells, as well as the research progress on the gut microbiota's roles in the occurrence and development of AD, aiming to provide new ideas for relevant research on the prevention, diagnosis, and treatment of AD.关键词：Alzheimer's disease;immune cells;gut microbiota;blood-brain barrier9|0|0更新时间：2025-11-05
Review
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