最新刊期
卷 50 ， 期 3 ， 2025
- “在高温高湿环境下，热射病对人类健康构成严重威胁。《热射病院前急救专家共识(2024版)》提出了10条推荐意见，旨在规范热射病的院前急救流程。”
摘要：Heatstroke, especially in high-temperature and high-humidity environments, is a life-threatening acute heat-injury disease that seriously endangers human health. Timely and effective on-site treatment is crucial for patients' survival and prognosis. Early recognition, rapid assessment, and on-site cooling are the core of pre-hospital treatment of heatstroke. Currently, there is a lack of standardized application procedures for pre-hospital emergency care of heatstroke. Therefore, the "Expert Consensus on Pre-hospital Emergency Management of Heatstroke (2024 edition)" was initiated by the Expert Group on Heatstroke Prevention of the People's Liberation Army and developed in collaboration with experts from local pre-hospital emergency care, emergency departments, and intensive care units. This consensus focuses on heatstroke prevention, on-site and ambulance-based treatment, and early emergency room interventions, and puts forward 10 evidence-based recommendations, aiming to provide a reference for scientific and standardized pre-hospital emergency care of heatstroke.关键词：heatstroke;prehospital care;early intervention;expert consensus75|30|0更新时间：2025-04-18
Guideline and Consensus
- “据研究，冠心病史和年龄增长是小肠细菌过度生长的危险因素，他汀类药物和BMI升高是保护因素。”
摘要：ObjectiveTo explore the influencing factors of different types of small intestinal bacterial overgrowth (SIBO).MethodsA total of 539 patients who were hospitalized in the Department of Gastroenterology, the Sixth Medical Center of PLA General Hospital from June 2021 to December 2021 and who underwent methane-hydrogen breath test were retrospectively selected. Based on breath test results, patients were divided into SIBO-negative group (n=300) and SIBO-positive group (n=239). The clinical data were compared between two groups. According to the specific values of breath test results, SIBO-positive patients were further divided into hydrogen-producing bacterial overgrowth (hydrogen-positive, n=103), intestinal methanogen overgrowth (methanogen-positive, n=80), and simultaneous methanogen and hydrogen-producing bacterial overgrowth (double positive, n=56) groups. Multivariate logistic regression analysis was employed to identify influencing factors of different SIBO types. Additionally, SIBO-positive patients were categorized by age into <45 years (n=23), 45-60 years (n=82), 60-75 years (n=124), and ≥75 years (n=10) to compare SIBO positivity rates across age groups.ResultsThe patients in SIBO-positive and double positive groups were older and had a lower body mass index (BMI) than those in SIBO-negative group, with statistically significant differences (P<0.05). Compared with the patients in SIBO-negative group, those in hydrogen-positive group showed a higher proportion of history of coronary heart disease, those in methanogen-positive group were older, and higher proportion of statin use, with statistically significant differences(P<0.05). Multivariate logistic regression analysis revealed that, among different SIBO types, a history of coronary heart disease served as an independent risk factor for hydrogen-producing bacterial overgrowth (OR=2.728, 95%CI 1.271-5.857, P=0.010). For methanogen overgrowth, increasing age was identified as an independent risk factor (OR=1.040, 95%CI 1.009-1.063, P=0.010), while the application of statin played the role of an independent protective factor (OR=0.420, 95%CI 0.236-0.754, P=0.003). As for the simultaneous overgrowth of methane-producing and hydrogen-producing bacteria, increased BMI was found to be an independent protective factor (OR=0.870, 95%CI 0.786-0.964, P=0.008). In SIBO-positive group, it was found that for patients aged <45 years, both the methane-positive rate and the double-positive rate were significantly lower than the hydrogen positivity rate (P<0.05). Moreover, among patients aged 45-60 years, the double-positive rate was significantly lower than the hydrogen positivity rate (P<0.01). When it comes to the hydrogen-positive rate, it was significantly lower for patients aged 45-60 and 60-75 years compared with that of patients aged <45 years (P<0.05). In contrast, the methane-positive rate and the double-positive rate were significantly higher for patients aged 45-60 and 60-75 years than those of patients aged <45 years (P<0.01).ConclusionA history of coronary heart disease and increasing age are independent risk factors for intestinal hydrogen-producing bacterial overgrowth and methanogen overgrowth, respectively. The application of statins and increased BMI are independent protective factors for intestinal methanogen simultaneous overgrowth of methanogen and hydrogen-producing bacteria, respectively.关键词：small intestinal bacterial overgrowth;breath test;intestinal methanogen overgrowth;hydrogen-producing bacterial overgrowth;age;coronary disease47|1|0更新时间：2025-04-18 -
Improvement effects of fecal microbiota transplantation on chemotherapy-induced diarrhea in mice AI导读
“最新研究发现，同种菌群移植能改善小鼠化疗相关性腹泻，恢复肠道菌群丰度，保护肠道黏膜。”
摘要：ObjectiveTo investigate the improvement effects of homogeneous fecal microbiota transplantation (FMT) on chemotherapy-induced diarrhea (CID) in mice.MethodsFifteen C57BL/6N mice were divided into control group, CID model group and CID+FMT group according to the random number distribution and remainder grouping method, with 5 mice per group. Control group received no intervention, and their feces were used to prepare fecal bacteria suspension. CID model group was injected intraperitoneally with fluorouracil (65 mg/kg) for 5 consecutive days to construct the CID mouse model, followed by gavage with 0.1 ml of saline on alternate days. CID+FMT group was given 0.1 ml fecal bacteria suspension gavage on alternate days for one week, followed by intraperitoneal injection of fluorouracil (65 mg/kg) for 5 consecutive days to construct the CID mouse model, with the experiment ending on the 14th day. During the experiment, the mice's food intake and body weight were recorded. At the end of the experiment, the mice were euthanized with deep carbon dioxide anesthesia, and the mice colonic specimens from cecum to anus were collected for hematoxylin and eosin (HE) staining and histopathological examination. Fecal samples were collected for 16S rRNA gene sequencing. Shannon index, Simpson index and Chao1 algorithm were used to analyze the α-diversity species of the intestinal flora in each group of mice. Similarity analysis (Anosim) was used to perform non-parametric on the inter-group differences of intestinal flora among the mice. Linear discriminate analysis size effect (LEfSe) and nonmetric multidimensional scaling (NMDS) were employed to analyze the intestinal dominant flora and the similarity classification relationships in each group of mice.ResultsThe colonic specimen's length from cecum to anus in CID model group was significantly shorter than that in control group (P<0.05), while there was no significant difference between CID+FMT group and CID model group (P>0.05). The weight of mice in CID model group decreased by 42.04%, while control group mice gained 10.24%, with a significant difference between the two groups (P<0.05). The weight of mice in CID+FMT group decreased by 8.12%, which was significantly improved compared to CID model group (P<0.05). HE staining results revealed the intestinal mucosal structure in CID model group was severely damaged, with atrophy and deformation, accompanied by inflammatory cell infiltration, and the pathological score was higher than that of control group (P<0.05). Compared with CID model group, the intestinal mucosal integrity and crypt cells in the CID+FMT group were improved, with less damage, and the pathological score was lower than that of CID model group, but the difference was not statistically significant (P>0.05). The α-diversity analysis showed that there were significant differences in the Shannon, Simpson and Chao1 indices among the three groups (P<0.05). ANOSIM and NMDS analysis revealed that the intestinal flora in CID+FMT group was closer to the normal intestinal flora compared to CID model group. LEfSe analysis showed that the intestinal flora in CID model group was enriched in famliy_Bacteroidaceae, and the intestinal flora in CID+FMT group was similar to that of control group, with an enrichenment of familiy_Enterobacteriaceae.ConclusionHomogeneous FMT can improve the abundance of intestinal flora in CID mice, making it more similar to normal intestinal flora, thereby protecting intestinal mucosa, reducing damage and alleviating the severity of CID.关键词：fecal microbiota transplantation;chemotherapy-induced diarrhea;intestinal flora;high-throughput sequencing49|4|0更新时间：2025-04-18 - “最新研究揭示肠道菌群与格雷夫斯眼病发病机制的关联，为诊疗提供新思路。”
摘要：Graves' ophthalmopathy (GO) is a specific autoimmune disease occurring in orbital tissues and is closely related to hyperthyroidism caused by Graves' disease (GD). Its disabling and disfiguring features significantly impact the quality of life of patients. The exact mechanism of GO still remains to be fully elucidated. In recent years, gene sequencing and medical microbiology studies have shown that changes in the gut microbiota may play a role in the development and progression of GO, with gut dysbiosis altering immune system regulatory signals and causing immune damage to organs. Clarifying the correlation between gut microbiota and GO helps to understand the disease's pathogenic mechanism and provides a theoretical basis for the diagnosis and treatment of GO. This review summarizes the impact of gut microbiota dysbiosis in the pathogenesis of GO and promising therapeutic approaches, including research progress in aspects such as gut microbiota experiments, case studies, pathogenesis, and treatment strategies.关键词：Graves' ophthalmopathy;gut microbiota;pathogenesis;treatment44|2|0更新时间：2025-04-18 - “在胃肠道间质瘤治疗领域，专家探讨了肠道菌群与肿瘤耐药的相关性，为临床治疗提供新思路。”摘要：Gastrointestinal stromal tumor (GIST) is the most prevalent mesenchymal tumor of the gastrointestinal tract, with imatinib serving as the first-line drug for metastatic GIST due to its good clinical efficacy. However, the majority of patients exhibit tumor progression within several years of drug therapy, primarily due to the high rate of drug resistance, which significantly impedes drug therapeutic outcome and patient prognosis. Traditional approaches to counteract resistance, including dosage increase and subsequent line therapy yielded suboptimal results. As a research hotspot, intestinal flora has been proven to be closely related to drug resistance of various tumors. In recent years, it has been observed that specific intestinal flora could serve as biomarkers for early GIST patient screening or as potential drug targets, and modulating the intestinal flora through interventions may delay or even reverse the progression of imatinib secondary drug resistance in GIST. This review delineates the drug resistance of GIST, correlations between intestinal flora and drug resistance of tumors, as well as the relationship between intestinal flora and drug resistance of GIST, aiming to provide novel perspectives and methodologies for clinical application.关键词：gastrointestinal stromal tumor;gastrointestinal microbiome;imatinib mesylate;drug resistance45|4|0更新时间：2025-04-18
- “最新研究揭示了系统性红斑狼疮患者肠道菌群的变化，为治疗提供新思路。”
摘要：Systemic lupus erythematosus (SLE) is a chronic diffuse connective tissue disease characterized by abnormal activation of the immune system, which attacks the body's tissues. It has a complex course and its pathological basis is vasculitis. In recent years, research on the relationship between SLE and the gut microbiota has increased significantly, but how to regulate the gut microbiota for the treatment of SLE remains unclear. Studies have found that the intestinal microbiota of SLE patients differs from that of healthy people in terms of Firmicutes, Bacteroidetes, Actinomycetes, and Proteobacteria, etc., and this has been verified in animal experiments. In this review, the changes of intestinal microbiota in SLE patients and their association with the pathogenesis and progression of the disease are systematically reviewed, aiming to provide new insights into the treatment of SLE.关键词：systemic lupus erythematosus;16S DNA;metagene;intestinal flora41|9|0更新时间：2025-04-18
Special Issue on Role of Gut Microbiota in Disease Occurrence and Treatment
- “据最新研究，ICU肺炎克雷伯菌感染患者死亡独立危险因素为年龄大、耐药率高和临床有效率低。血流感染者临床有效率低、病死率高。腹腔及尿路感染者更易发生耐药。”
摘要：ObjectiveTo analyze the epidemiological distribution, microbiological characteristics, drug-resistance status, and risk factors for mortality in adult intensive care unit (ICU) patients with Klebsiella pneumoniae infection.MethodsThis multi-center prospective cohort study included ICU patients with suspected infection from 67 hospitals across 16 Chinese provinces/municipalities between July 1, 2021 and December 31, 2022. Clinical data and microbiological results were collected, and patients were divided into survival and non-survival groups according to their survival status and drug-resistance situation. Risk factors for mortality and drug resistance in ICU patients with Klebsiella pneumonia infection were determined through univariate and multivariate logistic regression analyses.ResultsA total of 2964 ICU-infected patients were enrolled, with 12 175 microbial specimens submitted for testing. Among these, 487 specimens tested positive for Klebsiella pneumoniae. Ultimately, 314 patients with Klebsiella pneumoniae infection were identified, primarily from lung infections, with a drug-resistance rate of 78.3%. The in-hospital mortality rate of ICU patients infected with Klebsiella pneumoniae was 19.8%. Univariate and multivariate logistic regression analyses revealed that older age (P=0.027), high drug-resistance rate (P=0.028), and low clinical-effectiveness rate (P<0.001) were independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. Drug-resistance analysis showed that, compared with non-resistant cases, ICU patients with drug-resistant Klebsiella pneumoniae infection had lower pathogen-clearance rates (P=0.003), clinical-effectiveness rates (P=0.004), and antibiotic-effectiveness rates (P<0.010), and higher mortality rates (P=0.006). Patients with Klebsiella pneumoniae abdominal infection (P=0.003) and urinary tract infection (P=0.007) had higher drug-resistance incidences. There were no statistically significant differences in clinical-effectiveness rate, Klebsiella pneumoniae clearance, drug-resistance incidence, mortality rate, or hospital-stay length between patients with lung infection and those with non-lung infection of Klebsiella pneumoniae (P>0.05). Compared with patients with non-bloodstream infection, patients with bloodstream infection of Klebsiella pneumoniae had lower clinical-effectiveness rates (P=0.027) and higher mortality rates (P=0.021).ConclusionsOlder age, high drug-resistance rate, and low clinical-effectiveness rate are independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. ICU patients with bloodstream infection of Klebsiella pneumoniae may have lower clinical-effectiveness rates and higher mortality rates. ICU patients with abdominal and urinary tract infections caused by Klebsiella pneumoniae are more likely to develop drug resistance.关键词：intensive care unit;infection;Klebsiella pneumoniae33|26|0更新时间：2025-04-18 - “最新研究发现，NLR、HRR等新型炎症标志物对老年慢性心血管疾病患者合并衰弱具有高诊断价值，有望成为有效筛查标志物。”
摘要：ObjectiveTo investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests, namely neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), hemoglobin-to-RDW ratio (HRR) and systemic immune-inflammation index (SII), in elderly patients with chronic cardiovascular disease (CVD) complicated with frailty. MethodsRetrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023. According to the assessment results of the Fried scale, they were divided into three groups: non-frailty group (Fried score=0, n=30), the pre-frailty group (Fried score 1 or 2, n=40) and frailty group (Fried score ≥3, n=40). The differences in general information, the impairment rate of daily living activities, miniature nutritional assessment-short form (MNA-SF) scores, mini-mental state examination (MMSE) scores, and the indicators such as NLR, RDW, HRR, and SII among the three groups were compared. Spearman rank correlation was used to analyze the correlation between NLR, RDW, HRR, SII and frailty scores as well as each frailty indicator. Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD, and the receiver operating characteristic (ROC) curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty.ResultsCompared with non-frailty group and pre-frailty group, patients in frailty group were older, with higher impaired rates of daily living activities, NLR, RDW, and SII, and lower MNA-SF scores, MMSE scores, and HRR, and differences were statistically significant (P<0.05). Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR (rs=0.354, P<0.001), and RDW (rs=0.448, P<0.001), negatively correlated with HRR (rs=-0.232, P=0.024), and had no significant correlation with SII (rs=0.144,P=0.167). Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue (rs=0.228, P=0.017), slowed walking speed (rs=0.299, P<0.001), and low physical function(rs=0.319, P<0.001); RDW was positively correlated with decreased grip strength (rs=0.321, P<0.001), slowed walking speed (rs=0.422,P<0.001), and low physical function (rs=0.246, P=0.001); and HRR was negatively correlated with slowed walking speed (rs=-0.230, P=0.025), and low physical function (rs=-0.299, P=0.003). Multivariate logistic regression analysis showed that MNA-SF score (OR=0.577, 95%CI 0.342-0.973) was an independent protective factor for pre-frailty in elderly patients with chronic CVD (P<0.05); NLR (OR=7.866, 95%CI 1.101-56.185) was an independent risk factor for frailty, while HRR (OR=0.344, 95%CI 0.120-0.983) and MNA-SF score (OR=0.292, 95%CI 0.146-0.580) were independent protective factors for frailty in elderly CVD patients (P<0.05). The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749, respectively. ConclusionNLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD, and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.关键词：frailty;neutrophil-to-lymphocyte ratio;red blood cell distribution width;cardiovascular disease46|6|0更新时间：2025-04-18 - “在重症肺炎领域，专家探讨了C反应蛋白/白蛋白比值与病情严重程度的关系，发现其与患者死亡风险密切相关，为评估病情提供新指标。”
摘要：ObjectiveTo explore the relationship between C-reactive protein/albumin ratio (CAR) and the disease severity in patients with severe pneumonia, and its predictive value for 28-day mortality risk.MethodsA retrospective analysis was conducted on 152 patients with severe pneumonia admitted to Fuyang People's Hospital from January 2020 to January 2022. They were divided into non-critical illness group (n=51), critical illness group (n=63), and extremely critical illness group (n=38) based on the disease severity. The clinical data such as age and gender of patients was collected, and Pearson correlation analysis was used to explore the correlation between CAR and the severity of illness [determined by Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score]. Multivariate logistic regression was employed to identify independent influencing factors of the severity of illness. According to the survival status of patients after 28 days of treatment, they were divided into survival group (n=107) and death group (n=45). CAR was categorized into quintiles (Q1-Q5), and multivariate logistic regression analysis was conducted to explore the correlation between CAR and 28-day mortality risk in severe pneumonia patients. A restricted cubic spline (RCS) model was used to analyze the dose-response relationship between CAR and mortality risk. The predictive value of CAR and related indicators for patient mortality risk was evaluated using the receiver operating characteristic curve (ROC).ResultsCAR was significantly positively correlated with the severity of the disease (APACHE Ⅱ score) (r=0.716, P<0.05). Neutrophil/lymphocyte ratio (NLR), blood lactate (Lac), and high CAR were independent risk factors for the disease severity in patients with severe pneumonia (P<0.05). After adjusting for confounding factors, the mortality risk increased with the increase of CAR (P<0.05). Subgroup analysis of the screened confounding factors revealed that the correlation between CAR and 28-day mortality risk in severe pneumonia patients remained stable across different APACHE Ⅱ scores, GCS scores, SOFA scores, white blood cell counts (WBC), neutrophils (NEU), red cell volume distribution width (RDW), procalcitonin (PCT), and Lac, with interactions observed between NLR and Lac subgroups (P<0.05). The RCS model indicated that there was no non-linear dose-response relationship between CAR and 28-day mortality risk in patients with severe pneumonia of different genders. ROC curve analysis showed that CAR, Lac, and NLR had good predictive value for 28-day mortality in severe pneumonia patients, with the combined predictive efficacy being significantly higher than that of individual indicators.ConclusionThere is a close relationship between CAR and the progression and prognosis of severe pneumonia, making it a new approach to assessing the severity of illness and predicting mortality risk in patients.关键词：C-reactive protein/albumin ratio;severe pneumonia;risk of death;predictive value45|3|0更新时间：2025-04-18 - “据最新报道，解放军南部战区总医院收治一例脊髓梗死患者，通过MRI诊断并给予抗血小板和康复治疗。脊髓梗死是罕见疾病，病因复杂，诊断依赖MRI，目前尚无特效疗法。”
摘要：ObjectiveTo investigate the clinical characteristics and management strategies of spinal infarction (SCI) combined with hypoxic-ischemic encephalopathy (HIE).MethodsWe report a case of SCI induced by cardiopulmonary arrest in a patient admitted to the General Hospital of Southern Theater Command in June 2021. A review of the relevant literature published in PubMed and CNKI from January 2014 to March 2024, was conducted to summarize the etiology, features, and treatment approaches for SCI.ResultsThe patient presented with clinical features of quadriplegia accompanied by paresthesia, lumbar and cervical pain with paresthesia, dysphagia, dysphonia, and urinary and fecal incontinence. Spinal MRI revealed abnormal signals in the anterior and lateral columns at the C2-T1 spinal level, with no enhancement observed in contrast-enhanced scan. The patient was diagnosed as SCI combined with HIE, and was treated with antiplatelet therapy and rehabilitation. Literature review revealed that SCI is a rare central nervous system disease with multiple causes, often related to aortic surgery or pathology, presenting with segmental sensory disturbances among other clinical manifestations. MRI plays a significant role in its diagnosis, and there is currently no specific effective treatment available.ConclusionsSCI has a sudden onset and is often insidious, frequently accompanying other diseases, leading to a high risk of misdiagnosis. In this case, SCI was considered to be caused by low blood pressure and vertebral artery tenuity. Clinical manifestations include paraplegia at the lesion level along with back/neck pain or limb paresthesia. Diagnosis primarily relies on MRI imaging while treatment involves secondary stroke prevention measures, rehabilitation training, complication prevention strategies as well as hyperbaric oxygen therapy.关键词：spinal cord infarction;anterior spinal artery syndrome;spinal cord ischemia;ischemic hypoxic encephalopathy46|2|0更新时间：2025-04-18
Clinical Research
- “据最新研究报道，三维培养的间充质干细胞分泌组物能减轻海水浸泡合并拉伸损伤神经元的损伤，为海水浸泡合并创伤性脑损伤治疗提供新思路。”
摘要：ObjectiveTo investigate the protective effects of secretomes released by three-dimensional cultured mesenchymal stem cells (MSCs) on neurons subjected to seawater immersion (SW) and stretch injury (SI), and to provide new insights into neuronal repair following SW combined with traumatic brain injury (TBI).MethodsMSCs were cultured using the hanging drop method, and the conditioned medium (CM) containing MSCs secretomes was collected. A cellular model combining SW with SI was established using mouse hippocampal neuronal cells (HT22 cells). HT22 cells were randomly assigned to five groups: control, SI, SI+SW, SI+CM, and SI+SW+CM groups. Cell viability was assessed using the CCK-8 assay, apoptosis rate was measured by flow cytometry, cell migration ability was evaluated by scratch assay, and the expression levels of apoptosis-related proteins Bcl-2 and Bcl-2-associated protein (Bax), and ferroptosis-related proteins long-chain acyl-CoA synthetase 4 (ACSL4) and cyclooxygenase-2 (COX-2) were detected by Western blotting.ResultsImmersion in 15% seawater for 12 h significantly decreased HT22 cell viability (P<0.05). The CCK-8 assay indicated that cell viability in both the SI and SI+SW groups was significantly lower than that in control group after 12 h of treatment (P<0.05). Treatment with CM containing MSCs secretomes significantly increased cell viability in SI+CM group compared to SI group (P<0.0001), and in SI+SW+CM group compared to SI+SW group (P<0.001). Flow cytometry results revealed that the apoptosis rate in SI and SI+SW groups was significantly higher than that in control group (P<0.05 or P<0.001), while in SI+CM group was lower than that in SI group (P<0.05), and in SI+SW+CM group was lower than that in SI+SW group (P<0.05). Western blotting showed that compared to control group, SI and SI+SW groups exhibited reduced Bcl-2 expression level (P<0.01 or P<0.0001) and increased expression levels of Bax, ACSL4, and COX-2 (P<0.01 or P<0.0001). Compared to SI group, the SI+CM group displayed increased Bcl-2 expression level (P<0.05) and decreased expression levels of Bax, ACSL4, and COX-2 (P<0.05). Compared to SI+SW group, SI+SW+CM group exhibited increased Bcl-2 expression level (P<0.01) and decreased expression levels of Bax, ACSL4, and COX-2 (P<0.01 or P<0.001). Scratch assay results demonstrated that at both 12 h and 24 h, the cell migration rate in SI and SI+SW groups was significantly lower than that in control group (P<0.01 or P<0.0001), while the migration rate in SI+CM group was significantly higher than that in SI group (P<0.0001 or P<0.01), and the migration rate in SI+SW+CM group was significantly higher than that in SI+SW group (P<0.0001).ConclusionSecretomes derived from MSCs cultured using the hanging drop method can alleviate neuronal damage caused by SW and TBI, potentially offering a therapeutic approach for SW combined with TBI.关键词：mesenchymal stem cells;secretomes;seawater immersion;traumatic brain injury50|1|0更新时间：2025-04-18 - “据最新研究，七氟烷麻醉降低老年小鼠海马SIRT1表达，上调SIRT1可减轻其诱导的神经元死亡和铁死亡。”
摘要：ObjectiveTo explore the role and mechanism of silent information regulator 1 (SIRT1) in postoperative cognitive dysfunction (POCD) of aged mice following sevoflurane (SEV) anesthesia.Methods(1) Fifteen-month-old male C57BL/6 mice were randomly divided into control group (n=8) and SEV group (n=24), and SIRT1 expression in hippocampus of mice was assessed using Western blotting on the 1st, 3rd and 7th day after 2% SEV exposure. (2) Fifteen-month-old male C57BL/6 mice were randomly divided into AAV-GFP, AAV-SIRT1, SEV+AAV-GFP and SEV+AAV-SIRT1 groups (n=20). AAV-SIRT1 and control AAV-GFP vectors were transfected into the brain of mice respectively. Five days after the transfection, the corresponding groups of mice were exposed to 2% SEV for 5 h. Morris water maze test was used to evaluate the spatial memory of mice before and after SEV exposure, TUNEL staining was applied to assess hippocampal neurons apoptosis, and Western blotting was utilized to measure the expression levels of SIRT1, xCT and glutathione peroxidase 4 (GPX4). (3) Hippocampal neurons of mice were divided into control, AAV-SIRT1, Fer-1, SEV, SEV+AAV-SIRT1 and SEV+ferrostatin-1 (Fer-1) groups. Neurons in SEV, SEV+AAV-SIRT1 and SEV+Fer-1 groups were exposed to 5% SEV for 4 h. SEV+AAV-SIRT1 and SEV+Fer-1 groups were transfected with AAV-SIRT1 or treated with Fer-1 respectively prior to SEV exposure. Neuronal death was evaluated via propidium iodide (PI) staining. Malondialdehyde (MDA) level and iron content were determined using ELISA, reactive oxygen species (ROS) level was determined using fluorescence probes.Results(1) Western blotting revealed a significant reduction in SIRT1 protein expression levels in the hippocampus tissue of SEV group mice compared to control group (P<0.05). (2) Morris water maze test results showed that, compared with AAV-GFP group, the escape latency of mice in SEV+AAV-GFP and SEV+AAV-SIRT1 groups significantly prolonged (P<0.05), and the frequency of crossing the platform significantly decreased (P<0.05). Compared with SEV+AAV-GFP group, the escape latency of mice in SEV+AAV-SIRT1 group shortened (P<0.05), and the frequency of crossing the platform on the 7th day increased (P<0.05). TUNEL staining, Western blotting and immunohistochemistry indicated that the apoptosis of hippocampal neurons, Bax and cleaved-caspase-3 protein expression levels significantly increased in SEV+AAV-GFP and SEV+AAV-SIRT1 groups compared with those in AAV-GFP group, while the expression of Bcl-2, GPX4, and xCT protein expression levels significantly decreased (P<0.05 or P<0.01 or P<0.001). Compared with SEV+AAV-GFP group, SEV+AAV-SIRT1 group showed that apoptosis of hippocampal neurons, Bax and cleaved-caspase-3 protein expression levels significantly decreased (P<0.05), while Bcl-2, GPX4, and xCT protein expression levels significantly increased (P<0.05). (3) In vitro, PI staining and ELISA demonstrated significantly increased PI positive rate, MDA level and iron content in hippocampus neurons of SEV group compared to control group (P<0.01). Compared with SEV group, the positive rate of PI staining, MDA level, iron content and ROS level in hippocampus neurons of SEV+AAV-SIRT1 and SEV+Fer-1 groups significantly decreased (P<0.05).ConclusionsSEV anesthesia leads to a decrease in SIRT1 expression in hippocampus and neurons of aged mice, and the upregulation of SIRT1 could alleviate SEV-induced neuronal death and ferroptosis.关键词：silent information regulator of transcription 1;ferroptosis;aged mice;sevoflurane;cognitive function41|338|0更新时间：2025-04-18
Basic Research
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Research progress on correlation of non-steroidal anti-inflammatory drugs and bone stress injury AI导读
“在止痛药物领域，非甾体抗炎药增加军人和运动员应力性骨损伤风险的研究进展，为规范NSAIDs使用和临床管理提供解决方案。”
摘要：Non-steroidal anti-inflammatory drugs (NSAIDs), commonly utilized analgesics, are extensively employed for managing pain associated with musculoskeletal disorders or injuries. Recent clinical studies have demonstrated a heightened risk of bone stress injuries (BSI) in soldiers and athletes, particularly during high-intensity training, due to NSAID usage. Furthermore, the impact of NSAIDs on fracture healing is well-documented; however, the precise mechanism by which their use during training contributes to an increased incidence of stress bone injuries remains unclear. This article aims to summarize potential mechanisms through an extensive review of domestic and international literature in order to standardize the utilization and clinical management of NSAIDs, optimize pain management strategies, and prevent stress bone injuries or fractures in specific populations such as soldiers and elite athletes.关键词：non-steroidal anti-inflammatory drugs;bone stress injuries;bone metabolism;prostaglandin;osteocyte46|2|0更新时间：2025-04-18 - “最新研究揭示子痫前期发病机制复杂性，为临床预防和治疗提供新思路。”
摘要：Preeclampsia (PE) is a severe hypertensive disorder during pregnancy that seriously affects the health of pregnant women and fetuses. Currently, the treatment is merely symptomatic, with unsatisfactory efficacy and often resulting in an increased incidence of therapeutic preterm birth. An increasing number of studies on PE suggest that the "unitary" theory is no longer adequate to elucidate its pathogenesis. PE is regarded as a syndrome influenced by multiple factors, featuring a complex pathogenesis and the potential to affect multiple organs and systems. This review summarizes the latest advancements in the classification, etiology, pathogenesis, and research models (including animal and in vitro models) of PE, aiming to provide references for subsequent research and offer assistance in clinical prevention, screening, and treatment.关键词：preeclampsia;pathogenesis;animal model;in vitro model30|659|0更新时间：2025-04-18 - “脊髓损伤微循环研究进展，为临床治疗提供新思路。”摘要：Spinal cord injury (SCI) is a structural and functional disruption of the spinal cord caused by various factors, leading to neurological dysfunction. As a common central nervous system disorder in clinical practice, SCI poses significant risks to human life and health. Its pathological mechanism is exceedingly complex, involving multiple pathological processes. Given the irreversibility of primary injury, targeting secondary injury has gradually become the main direction for the clinical treatment of SCI in recent years. Recent studies have highlighted the crucial role of blood-spinal cord barrier damage and microvascular dysfunction in the progression of secondary injury following SCI. Therefore, investigating the pathological mechanisms of microcirculation and exploring targeted therapies could provide valuable insights for clinical SCI treatment. This paper aims to provide an objective review of the role of microcirculation in SCI, identify the critical regulators of microvascular function, and summarize strategies for treating SCI by targeting microcirculation. The findings of this study may offer novel references for the clinical management of SCI.关键词：spinal cord injury;microcirculation;blood-spinal cord barrier;regulators;targeted therapy31|2|0更新时间：2025-04-18
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