最新刊期
卷 50 ， 期 7 ， 2025
- “在内分泌科领域，解放军总医院第一医学中心专家通过比较分析原发性双侧肾上腺大结节增生与肾上腺皮质醇分泌腺瘤的临床特征，揭示了两种疾病的差异，为提高疾病认识提供新见解。”
摘要：ObjectiveTo comparatively analyze the clinical characteristics of primary bilateral macronodular adrenal hyperplasia (PBMAH) and adrenal cortisol-producing Adenoma (CPA), and enhance the understanding of two diseases.MethodsThe clinical data of 85 PBMAH patients (PBMAH group) and 195 CPA patients (CPA group) diagnosed at Department of Endocrinology, the First Medical Center of Chinese PLA General Hospital, from September 2014 to August 2024 were retrospectively analyzed. The demographic characteristics, comorbidities, biochemical indicators, adrenocorticotropic hormone-cortisol (ACTH-F) levels, and adrenal imaging features and treatment conditions were compared between the two groups.Results(1) General characteristics: Compared with CPA group, PBMAH group had older age at diagnosis and a higher proportion of male patients. (2) Clinical characteristics: Compared with CPA group, PBMAH group had a longer disease duration, a higher proportion of subclinical Cushing's syndrome (CS), and a higher proportion of hypertension, impaired glucose tolerance/diabetes, bone mass reduction or osteoporosis, with higher serum potassium levels, and the differences were statistically significant (P<0.01). (3) Hormone levels: Both PBMAH and CPA groups showed ACTH-F rhythm disorder, significantly increased cortisol levels and suppressed ACTH. Compared with PBMAH group, CPA group had stronger autonomous cortisol secretion ability, manifested by increased midnight serum cortisol (F0:00), 16:00 serum cortisol (F16:00), 24-hour urinary free cortisol (24 h UFC) levels and lower 8:00 serum ACTH (ACTH8:00) and 16:00 serum ACTH (ACTH16:00) (P<0.01). After low-dose dexamethasone suppression test (LDDST), CPA group showed lower suppression rates of ACTH and cortisol, and higher proportions of paradoxical elevation in serum cortisol and 24 h UFC compared with PBMAH(P<0.01).ConclusionsPBMAH has a longer disease course and higher proportions of comorbid metabolic disorders than CPA, mostly manifested as subclinical Cushing's syndrome. CPA has stronger autonomous cortisol secretion ability, with cortisol less likely to be suppressed after LDDST and more obvious paradoxical elevation of cortisol and 24 h UFC.关键词：Cushing's syndrome;primary bilateral adrenal macronodular adrenal hyperplasia;adrenal cortical-secreting adenoma14|0|0更新时间：2025-08-01 - “在内分泌肿瘤领域，解放军总医院第一医学中心专家分析了肾上腺皮质癌的临床病理特征，发现伴皮质醇增多症患者更易合并高血压、分期更晚，Ki-67指数在晚期明显升高可作为预后指标指导治疗。”
摘要：ObjectiveTo investigate the clinical and pathological characteristics of adrenal cortical carcinoma (ACC), compare differences between hypercortisolism and non-functional ACC, and assess the diagnostic value of indicators such as Ki-67 index.MethodsThe clinical data of 57 ACC patients admitted to the First Medical Center of Chinese PLA General Hospital from January 2015 to March 2025 were retrospectively analyzed. According to the results of endocrine function assessment, 47 of these patients were divided into hypercortisolism group (n=19) and non-functional group (n=28). The differences in clinical and pathological characteristics between the two groups were compared, and non-parametric tests and Spearman correlation analysis were used to explore the relationship between Ki-67 index and tumor stage as well as imaging features.ResultsAmong the 57 patients, there were 20 males and 37 females, with a male-to-female ratio of 1:1.85. The age ranged from 16 to 76 years, and the age at diagnosis was (48.7±13.3) years. The tumor diameter was (10.53±4.14) cm. The tumors were located on the right side in 12 cases (21.1%), on the left side in 34 cases (59.6%), and bilaterally in 11 cases (19.3%). Among them, 16 cases (28.1%) were complicated with glucose metabolism disorders, 31 cases (54.3%) had hypertension, and 20 cases (35.1%) had hypokalemia. According to ENSAT staging, there were 0 cases in stage Ⅰ, 15 cases (26.3%) in stage Ⅱ, 24 cases (42.1%) in stage Ⅲ, and 18 cases (31.6%) in stage Ⅳ. Endocrine function assessment was completed in 47 of the 57 patients, including 28 cases (59.6%) of non-functional ACC and 19 cases (40.4%) of hypercortisolism (including 1 case of hypercortisolism combined with increased sex hormone secretion). Compared with non-functional group, hypercortisolism group had a significantly higher prevalence of hypertension (P=0.014), later ENSAT stage (P=0.010), and a higher proportion of hypervascularization (P=0.048). The median Ki-67 index was 20% (10%-40%), showing no significant correlation with either the maximum tumor diameter or SUVmax value, but it was related to ENSAT staging, with Ki-67 index in stage Ⅳ patients being significantly higher than that in stage Ⅱ (P=0.032). Immunohistochemistry results showed that the positive rate of Inhibin-α was 84.8%, and the positive rate of Melan-A was 40.9%.ConclusionsACC is a rare malignant endocrine tumor. ACC patients with hypercortisolism are more likely to be complicated with hypertension, have later staging, and more common hypervascular manifestations. Clinically, their endocrine function should be prioritized for assessment, and more active treatment strategies should be adopted. Diagnosis should be combined with imaging characteristics (such as hypervascularization) and immunohistochemical indicators (Ki-67, Inhibin-α, Melan-A). The significant increase in Ki-67 is in the advanced stage can serve as an important prognostic indicator to guide individualized treatment.关键词：adrenal cortical carcinoma;hypercortisolism;Ki-67 index;ENSAT staging;imaging characteristics16|0|0更新时间：2025-08-01 - “据研究，不同皮质醇水平的亚临床库欣综合征患者存在年龄、空腹C肽水平及CT值差异，CT值或成评估代谢风险新标志物。”
摘要：ObjectiveTo characterize multimodal metabolic disorders in subclinical Cushing's syndrome (SCS) patients with different cortisol levels, providing a reference for clinical diagnosis and treatment.MethodsA retrospective analysis was conducted on the clinical data of 165 SCS patients diagnosed at the First Medical Center of Chinese PLA General Hospital due to adrenal masses from January 2014 to October 2024. Using the serum cortisol levels after the midnight 1 mg dexamethasone suppression test (1 mg DST) as the cut-off point, SCS patients were divided into high-level group (1 mg DST-F>138 nmol/L, n=96) and low-level group (50 nmol/L<1 mg DST-F≤138 nmol/L, n=69). The differences in age, gender, body mass index (BMI), blood pressure, glucolipid metabolism indices, electrolytes, hormone levels, and imaging features of adrenal adenoma (such as CT values) were compared between the two groups. Multivariate linear regression was used to analyze the correlation between CT values and metabolic indices.ResultsCompared with low-level group, patients in high-level group were younger (54.0±11.3 vs. 57.7±10.3,P=0.034), while there were no statistically significant differences in gender ratio or BMI between the two groups (P>0.05). Both groups exhibited decreased adrenocorticotropic hormone (ACTH) levels and disrupted circadian rhythm. Compared with low-level group, high-level group showed significantly higher F0:00 levels [250.00 (170.07, 422.53) nmol/L vs. 110.00 (82.74, 133.90) nmol/L] and 24-hour urinary free cortisol (24 h UFC) [568.40 (377.80, 875.45) nmol/24 h vs. 369.40 (265.40, 494.69) nmol/24 h] (P<0.001), with no significant differences in serum F8:00, or 1 mg DST ACTH0:00 levels (P>0.05). Except for the fasting C-peptide level in the high-level group being higher than that in low-level group [(2.88±1.01) ng/ml vs. (2.46±0.78) ng/ml, P=0.024], there were no significant differences in blood pressure, blood lipids, glycated hemoglobin (HbA1c), fasting blood glucose, fasting insulin, serum electrolytes, uric acid, and other indices between the two groups (P>0.05). The CT value of adrenal adenoma during contrast-enhanced scanning was higher in high-level group [80.00(17.80, 93.00) Hu vs. 52.00(35.50, 75.00) Hu, P=0.006] compared with low-level group. Multivariate linear regression analysis revealed that diastolic blood pressure was positively correlated with CT values of adrenal adenomas in both plain scanning (β=0.49, 95%CI 0.09-0.90) and contrast-enhanced scanning (β=2.08, 95%CI 0.76-3.39), while triglyceride levels were negatively correlated with plain scanning CT values (β=-5.77, 95%CI -10.88--0.66).ConclusionPatients with SCS at different cortisol levels differ in age, fasting C-peptide levels, and CT values. CT values may serve as potential imaging markers to assess metabolic risk in SCS patients.关键词：subclinical Cushing's syndrome;cortisol;adrenal imaging;CT values14|0|0更新时间：2025-08-01 - “在原发性双侧大结节样肾上腺增生领域，解放军总医院第一医学中心专家通过分析198例患者资料，揭示了临床型与亚临床型库欣综合征患者的不同特点，并验证了手术是治疗PBMAH的有效手段。”
摘要：ObjectiveTo investigate the clinical characteristics of patients with clinical and subclinical Cushing's syndrome caused by primary bilateral macronodular adrenal hyperplasia (PBMAH).MethodsA retrospective analysis was performed on the clinical data of 198 patients with Cushing's syndrome caused by PBMAH diagnosed in the First Medical Center of Chinese PLA General Hospital from January 2004 to October 2024. According to clinical manifestations, the patients were classified into clinical type Cushing's syndrome (n=61) and subclinical type Cushing's syndrome (n=137), and the clinical characteristics of the two types were compared.ResultsThe mean age at diagnosis of patients with PBMAH-induced Cushing's syndrome was (53.5±10.4) years, including 118 males and 80 females, with a male-to-female ratio of 1.475:1. Compared with the subclinical type, the clinical type had a higher proportion of females, higher levels of serum cortisol, 24-hour urine free cortisol (24 h UFC), and inhibited serum cortisol after low-dose dexamethasone suppression. Additionally, the clinical type had lower plasma ACTH, larger adrenal nodules and a higher risk of surgery (P<0.05) compared with those in subclinical type. The incidences of hypertension, dyslipidemia, obesity, diabetes mellitus, hypokalemia, vitamin D deficiency, osteoporosis, coronary heart disease, and cerebrovascular disease in patients with Cushing's syndrome caused by PBMAH were 87.9%, 50.5%, 37.1%, 36.9%, 27.8%, 25.9%, 18.7%, 18.7% and 12.1%, respectively. Among them, compared with subclinical type patients, clinical type patients had higher incidence of hypokalaemia, vitamin D deficiency and osteoporosis (P<0.05), while there were no statistically significant differences in the incidences of other comorbidities between the two types (P>0.05). The results of postoperative follow-up for PBMAH patients showed that the short-term biochemical remission rate of unilateral total adrenalectomy was 41.5% (22/53) and the long-term biochemical remission rate was 32.0% (8/25). The short-term biochemical remission rate of unilateral partial (or nodular) adrenalectomy was 52.9% (9/17), and the long-term biochemical remission rate was 14.3% (1/7). All patients who underwent unilateral total adrenalectomy plus contralateral partial resection developed adrenal insufficiency (3/3), and 1 patient (1/3) relapsed 3.4 years after surgery.ConclusionClinical and subclinical types of Cushing's syndrome caused by PBMAH have their distinct clinical characteristics. Surgery is an effective treatment for PBMAH, but a certain proportion of patients fail to achieve biochemical remission after non-bilateral total adrenalectomy.关键词：primary bilateral macronodular adrenal hyperplasia;adrenal Cushing's syndrome;clinical characteristics;comorbidity13|0|0更新时间：2025-08-01 - “在原发性色素性结节样肾上腺皮质病领域，解放军总医院第一医学中心专家总结了10例患者的临床特点，为诊治提供参考。”
摘要：ObjectiveTo summarize the clinical characteristics of primary pigmented nodular adrenocortical disease (PPNAD) and provide a reference for its clinical diagnosis and treatment.MethodsA retrospective analysis was conducted on the clinical characteristics, laboratory tests, imaging examinations, treatment plans, and follow-up data of 10 PPNAD patients diagnosed and treated at the First Medical Center of Chinese PLA General Hospital from January 2008 to October 2024. Databases including CNKI, Wanfang Data Knowledge Service Platform, and PubMed were searched, and the clinical characteristics of 120 PPNAD patients reported in the literature were summarized in combination with literature reviews.ResultsThe age at diagnosis of the 10 PPNAD patients ranged from 15 to 55 years, with a median age of onset of 21.5 years. Seven patients had the protein kinase A regulatory subunit 1 alpha (PRKAR1A) gene mutations, meeting the diagnosis criteria for Carney syndrome. One patient presented with hypertension only, while the remaining 9 patients showed typical Cushing's syndrome manifestations such as thin skin and moon face, among whom 5 experienced stagnation of height growth. In 7 patients, the adrenocorticotropic hormone (ACTH) levels were<2.2 pmol/L, with the disrupted circadian rhythm of cortisol, and the cortisol levels at midnight ranged from 243.24 to 679.83 pmol/L. None of the patients showed suppression in the low-dose dexamethasone suppression test, and 8 patients had an increase in urinary free cortisol (UFC) after dexamethasone suppression. Adrenal CT showed that 9 patients presented with unilateral adrenal nodules accompanied by contralateral thickening or bilateral adrenal nodular thickening. All 10 patients underwent initial unilateral adrenalectomy, and during follow-up, 4 patients experienced symptom recurrence and underwent contralateral adrenalectomy. Most of the 120 patients reported domestically and internationally showed typical Cushing's syndrome manifestations. Surgical resection of the adrenal gland was the main treatment modality. Gene mutations were predominantly in PRKAR1A, with a few in PDE11A and PRKACA.ConclusionsPPNAD is more likely to occur in adolescents. Patients with typical Cushing's syndrome manifestations should undergo screening. Imaging manifestations are atypical, and a definitive diagnosis depends on pathological and genetic diagnoses. Bilateral adrenalectomy combined with long-term postoperative hormone replacement therapy is the standard treatment protocol. Patients who undergo early unilateral adrenalectomy require long-term follow-up, with contralateral adrenalectomy performed when necessary.关键词：Cushing's syndrome;primary pigmented nodular adrenocortical disease;surgical operation14|0|0更新时间：2025-08-01
Special Issue on Analysis of Clinical Characteristic of Adrenal derived Cushing's Syndrome
- “南京大学医学院附属金陵医院研究发现，重症肺炎合并急性呼吸窘迫综合征患者肺泡巨噬细胞中TRIM21 mRNA表达水平明显增高，与病情严重程度正相关，对患者28天内死亡具有潜在预测价值。”
摘要：ObjectiveTo evaluate the value of tripartite motif-containing protein 21 (TRIM21) mRNA expression in alveolar macrophages for the serverity and prognosis of patients with severe pneumonia complicated by acute respiratory distress syndrome (SP-ARDS).MethodsA retrospective analysis was conducted on 42 SP-ARDS patients (SP-ARDS group) and 15 outpatient healthy controls (control group) admitted to the Department of Respiratory and Critical Care Medicine, Jinling Hospital Affilicated to Medical School of Nanjing University, from November 2023 to June 2024. Bronchoalveolar lavage fluid was collected, and alveolar macrophages were isolated. The expression levels of TRIM21 mRNA were quantified using qPCR. Differences in TRIM21 mRNA expression levels, clinical characteristics, and relevant laboratory test results were compared between the two groups. Correlations between TRIM21 mRNA expression and SP-ARDS severity, 28-day mortality, inflammatory indicators, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, duration of mechanical ventilation, and ICU stay were analyzed using Pearson or Spearman correlation analysis. Logistic regression analysis was used to identify risk factors for 28-day mortality, and the predictive value of each factor was evaluated using receiver operating characteristic (ROC) curves.ResultsCompared with control group, the expression levels of TRIM21 mRNA, white blood cell counts, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), and procalcitonin (PCT) levels increased (P<0.05), and hemoglobin levels decreased (P<0.05) in SP-ARDS group. No significant differences were observed in gender, age, smoking history, alcohol consumption, underlying disease history, and platelet count between the two groups (P>0.05). TRIM21 mRNA expression level in SP-ARDS patients was positively correlated with ARDS severity (P<0.05). Additionally, non-survivors within 28 days had a significantly higher expression level of TRIM21 mRNA compared to survivors (P<0.001). Correlation analysis indicated that the relative expression level of TRIM21 mRNA in SP-ARDS patients was positively correlated with CRP (r=0.309, P<0.05), NLR (r=0.422, P<0.01), PCT (r=0.561, P<0.001), APACHE Ⅱ score (r=0.615, P<0.001), and duration of mechanical ventilation (r=0.665, P<0.001). Logistic regression analysis revealed that elevated expression levels of TRIM21 mRNA (OR=2.886, P=0.043) and higher APACHE Ⅱ scores (OR=1.546, P=0.037) were independent risk factors for 28-day mortality in SP-ARDS patients. The areas under the ROC curves (AUCs) for predicting 28-day mortality using TRIM21 mRNA expression level and APACHE Ⅱ score were 0.889 and 0.874, respectively, with optimal cut-off values of 5.21 and 20.5 points, respectively. The combined AUC for prediction was 0.962.ConclusionIncreased TRIM21 mRNA expression in alveolar macrophages of SP-ARDS patients is positively correlated with disease severity and may serve as a potential predictive marker for 28-day survival in SP-ARDS patients.关键词：severe pneumonia;acute respiratory distress syndrome;tripartite motif-containing protein 21;macrophages;prognosis11|0|0更新时间：2025-08-01 - “在老年创伤患者术后康复领域，解放军总医院第四医学中心专家验证了术前2小时口服简单碳水化合物对缩短术后排气时间、减轻胰岛素抵抗、保护肠道屏障功能的积极作用，为老年患者术后康复提供新方案。”
摘要：ObjectiveTo investigate the effect of simple carbohydrate given 2 h before operation on postoperative insulin resistance and gastrointestinal function in elderly patients with trauma undergoing spinal anesthesia.MethodsThis was a randomized controlled clinical study. A total of 90 elderly patients with intertrochanteric femoral fracture/femoral neck fracture admitted to the Traumatic Orthopedics Department of the Fourth Medical Center of Chinese PLA General Hospital from October 2023 to February 2024 were randomly divided equally into control group (fasting with water before surgery) and carbohydrate group (CHO group, drinking 200 ml of pulsatile water at 2 h before surgery). All the patients received spinal anesthesia. The control group excluded 2 patients who completed surgery and were admitted to the ICU, 2 patients received epidural anesthesia, and finally included 41 patients; 3 patients were excluded from the CHO group under epidural anesthesia, 2 patients underwent surgery under general anesthesia, and finally 40 patients were included. Baseline data of patients were collected, including gender, age, Charlson comorbidity index (CCI), presence or absence of diabetes, body mass index (BMI), American Association of Anesthesiologists (ASA) classification, etc. The patient's surgical time, intraoperative blood loss, first postoperative exhaust time, type of surgery, length of hospital stay, mean arterial pressure (MAP) and heart rate (HR) at four time points during surgery [entry (T1), post-anesthesia (T2), mid-operation (T3), and exit (T4)], perioperative blood glucose, insulin levels, C-reactive protein (CRP), and intestinal barrier function indicators (diamine oxidase, D-lactate, and bacterial endotoxin), as well as self-rating anxiety scale (SAS), visual analogue scale of pain (VAS), and Ramsay scores were recorded. Preoperative and postoperative use of the delirium diagnostic scale (3D-CAM) assessed the presence of delirium in patients.ResultsEighty-one patients aged (77.7±9.5) years were included. Compared with control group, the first exhaust time in CHO group was significantly shorter [4.59(3.25, 7.39) h vs. 10.23(7.97, 14.76) h, P<0.001], postoperative insulin resistance index (HOMA-IR) was significantly decreased [5.13(2.38, 10.30) vs.7.34(2.31, 12.55), P<0.001]. The change rate of HOMA-IR (ΔHOMA-IR) also decreased significantly (P<0.001); There were no significant differences in intestinal barrier function indexes between the two groups (P>0.05); The levels of D-lactic acid and bacterial endotoxin in control group were significantly increased after operation, and the differences were statistically significant (P=0.010, P=0.031), In CHO group, there was no significant difference in preoperative and postoperative indexes (P>0.05). There was no significant difference in the perioperative scale score, incidence of delirium and the length of hospital stay between the two groups (P>0.05).ConclusionsTaking simple carbohydrates 2 h before surgery can significantly shorten the first exhaust time, reduce insulin resistance and the incidence of delirium, and improve gastrointestinal function in elderly trauma patients undergoing spinal anesthesia, thus providing clinical basis for accelerated postoperative rehabilitation in elderly patients.关键词：trauma;advanced age;carbohydrates;insulin resistance;gastrointestinal function17|0|0更新时间：2025-08-01 - “在老年髋部骨折手术领域，研究揭示了术前衰弱与术后急性肾损伤风险的关联，为预防和治疗提供了新视角。”
摘要：ObjectiveTo analyze the relationship between frailty and acute kidney injury (AKI) after hip fracture surgery in the elderly.MethodsA total of 405 elderly patients who underwent hip fracture surgery in Jieyang People's Hospital from August 2021 to January 2023 were retrospectively analysed. According to the modified frailty index (mFI), they were divided into frail group (mFI≥0.27, n=112) and non-frail group (mFI<0.27, n=293). Postoperative AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. After 1:1 propensity score matching (PSM), 100 cases in each group were successfully matched. Univariable and multivariable logistic regression models, propensity score adjustment, PSM, inverse probability of treatment weighting (IPTW), standardized mortality ratio weighting (SMRW), pairwise algorithm (PA) weighting, and overlap weighting (OW) methods were used to analyze the relationship between frailty and postoperative AKI. Stratified analyses were performed according to age (≥80 or <80 years), gender, whether angiotensin-converting enzyme inhibitors (ACEI)/angiotensin Ⅱ receptor antagonists (ARB) were used, and whether intraoperative hypotension occurred.ResultsAfter PSM, there were no significant differences between the two groups in age, sex, surgical type, ACEI/ARB, blood urea nitrogen, serum creatinine, intraoperative blood loss, and intraoperative hypotension [standardized mean difference (SMD) <0.1]. In both the original cohort and the matched cohort, the incidence of AKI was higher in frail group than in non-frail group (25.9% vs. 8.9%, P<0.001; 28.0% vs. 11.0%, P=0.002). Analysis of the risk of postoperative AKI in elderly hip fracture patients in frail group found that compared with the non-frail group, in the univariate logistic regression model the odds ratio (OR) and a 95% confidence interval (CI) for the frail group was 3.59 (2.00-6.43), P<0.001, and in the multivariable logistic regression model, the OR(95%CI) for frail group was 3.04(1.55-5.95), P=0.001. After adjustment for propensity score, the OR(95%CI) for frail group was 2.85(1.52-5.34), P=0.001, and the OR(95%CI) for frail group after PSM was 3.15(1.47-6.75), P=0.003. After IPTW, SMRW, PA weighting, and OW, the OR(95%CI) for frail group were 2.48(1.37-4.50), 2.43(1.41-4.19), 2.63(1.25-5.54), and 2.69(1.07-6.78), respectively, with P<0.05. The interaction tests were not statistically significant for age, sex, use of ACEI/ARB, and intraoperative hypotension (P>0.05).ConclusionIn elderly patients with hip fractures, preoperative frailty may be a risk factor for postoperative AKI.关键词：frailty;modified frailty index;hip fracture;acute kidney injury;propensity score analysis16|0|0更新时间：2025-08-01 - “最新研究发现，外周血sHLA-G水平与肾移植排斥反应相关，sHLA-G/IL-2和sHLA-G/IFN-γ比值在肾移植排斥反应诊断中具有潜在应用价值。”摘要：ObjectiveTo investigate the application value of peripheral blood soluble human leukocyte antigen-G (sHLA-G) combined with immune cytokines in the differential diagnosis of renal transplant rejection.MethodsThis case-control study retrospectively analyzed 81 renal transplant patients hospitalized in the Department of Organ Transplantation, the Second Affiliated Hospital of Naval Medical University from April 2020 to December 2023, due to elevated serum creatinine. Among them, 32 patients were diagnosed with acute rejection (acute rejection group), 29 with chronic rejection (chronic rejection group), and 20 with elevated creatinine due to non-rejection causes (non-rejection group). Fifty renal transplant inpatients and outpatients with normal and stable serum creatinine were selected as control group during the same period. Clinical data such as gender, age, serum creatinine, estimated glomerular filtration rate (eGFR), and urine protein positive rate, etc. were collected. Peripheral blood of patients was sampled to measure the levels of plasma sHLA-G and immune cytokines [interferon-γ (IFN-γ), tumor necrosis factor-β (TNF-β), interleukin (IL)-2, IL-4, IL-10, IL-5, IL-6, IL-17] using enzyme-linked immunosorbent assay (ELISA). Stratify and compare the differences in sHLA-G levels among different groups and all renal transplant inpatients by gender.ResultsCompared with control group, serum creatinine levels and urine protein positive rate were significantly higher in acute rejection group, chronic rejection group, and non-rejection group, while eGFR was significantly lower, serum creatinine levels in chronic rejection group and non-rejection group were higher than those in acute rejection group, while eGFR was lower than that in acute rejection group, with statistically significant differences (P<0.05). No statistically significant differences were observed in gender, age, blood type, body mass index, transplantation duration, and immunosuppressive agent use among acute rejection, chronic rejection, non-rejection, and control groups (P>0.05). Plasma sHLA-G levels in acute rejection and chronic rejection groups were significantly lower than those in control group [(19.665±11.233) U/ml vs. (24.785±21.668) U/ml vs. (44.918±39.898) U/ml, P<0.05]. The sHLA-G/IL-2 ratio in chronic rejection group was significantly higher than that in acute rejection group (5.844±6.248 vs. 1.825±1.574, P<0.05), and the sHLA-G/IFN-γ ratio in non-rejection group was significantly higher than that in chronic rejection group (3.452±3.283 vs. 1.543±2.030, P<0.05). Among 131 renal transplant inpatients, female sHLA-G levels were significantly higher than male (P<0.05). Within each group, female sHLA-G levels in chronic rejection group were significantly higher than male (P<0.05). Although female sHLA-G levels in acute rejection, non-rejection, and control groups were higher than those of male, the gender difference was not statistically significant (P>0.05).ConclusionsPeripheral blood sHLA-G levels are correlated with renal transplantation rejection. The application of sHLA-G/IL-2 and sHLA-G/IFN-γ ratios has potential value in the diagnosis and differentiation of elevated creatinine caused by acute/chronic rejection, chronic rejection and non-rejection causes, respectively.关键词：kidney transplantation;transplant rejection;human leukocyte antigen-G;immune cytokines;major histocompatibility complex10|0|0更新时间：2025-08-01
- “据最新研究，浸润性乳腺癌患者中，年龄小于45岁、非肿块样强化、Ki-67高表达等因素与脉管浸润风险增加相关；Luminal B型、HER-2过表达型和三阴性型患者LVI风险高于Luminal A型。”摘要：ObjectiveTo explore the relationship between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinical pathological features of invasive breast cancer and lymphovascular invasion (LVI).MethodsImaging and clinical pathological data were retrospectively collected from 508 patients with invasive breast cancer who underwent breast DCE-MRI at the First Medical Center of Chinese PLA General Hospital from January 2019 to August 2021. Patients were divided into the LVI-positive (LVI+) group (n=79) and LVI-negative (LVI-) group (n=429) based on postoperative pathological results. Univariate and multivariate logistic regression analyses were used to identify risk factors for LVI.ResultsCompared with LVI- group, LVI+ group had a higher proportion of patients aged <45 years (44.3% vs. 27.0%, P=0.002), non-mass-like enhancement (NME) (31.7% vs. 17.7%, P=0.004), Ki-67 expression rate (40.0% vs. 30.0%, P<0.001), high Ki-67 expression (94.9% vs. 78.1%, P=0.001), Luminal B subtype (76.0% vs. 60.1%, P=0.008), and positive axillary lymph nodes rate (72.2% vs. 31.5%, P<0.001), while the proportion of Luminal A subtype was lower (2.5% vs. 21.5%, P<0.001). Univariate and multivariate logistic regression analyses showed that age ≥45 years (OR=0.468, 95%CI 0.280-0.783, P=0.004) was an independent protective factor for LVI, while NME (OR=1.987, 95%CI 1.126-3.444, P=0.016) was an independent risk factor. Compared with Luminal A subtype, patients with Luminal B subtype (OR=10.482, 95%CI 3.164-64.923, P=0.001), HER-2 overexpression subtype (OR=11.571, 95%CI 2.755-79.341, P=0.003) and triple-negative subtypes (OR=8.433, 95%CI 1.985-57.908, P=0.009) had a higher risk of LVI.ConclusionsAge ≥45 years is an independent protective factor for LVI, while NME is an independent risk factor. Among molecular subtypes, patients with Luminal B, HER-2 overexpression and triple-negative subtypes have a higher risk of LVI compared with the Luminal A subtype.关键词：lymphovascular invasion;dynamic contrast-enhanced magnetic resonance imaging;non-mass enhancement;molecular subtypes;invasive breast cancer9|0|0更新时间：2025-08-01
- “最新研究揭示，烟雾病患者视神经纤维层厚度减少，视野异常、病程、脑血管累及数是独立危险因素，为临床诊断提供新依据。”
摘要：ObjectiveTo investigate the characteristics of thickness changes in peripapillary retinal nerve fiber layer (pRNFL) and identify related risk factors in patients with Moyamoya disease (MMD).MethodsA retrospective study was conducted on 150 MMD patients (150 eyes) aged 6-65 years admitted to the Neurosurgery Department of the Fifth Medical Center, Chinese PLA General Hospital from May 2016 to December 2023 (observation group), and 150 age-matched healthy volunteers (150 eyes) from the hospital's ophthalmology outpatient department (control group). Both groups were subdivided into pediatric(≤18 years), young adult (18-40 years), and middle-aged (40-65 years) subgroups. The pRNFL thickness in four quadrants was measured by optical coherence tomography (OCT): superior (pRNFL-Sup), inferior (pRNFL-Inf), nasal (pRNFL-Nas), temporal (pRNFL-Tmp), and average thickness (pRNFL-Avg). General clinical data and pRNFL thickness were compared between two groups. Univariate and multivariate logistic regression analyses were performed to identify risk factors for pRNFL thinning in MMD patients. The cohort was randomly divided into training (n=210) and validation (n=90) sets at a 7:3 ratio. A predictive model for pRNFL thinning in MMD patients was constructed based on logistic regression results. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), and clinical utility was assessed via decision curve analysis.ResultsCompared with control group, MMD patients exhibited significantly reduced pRNFL-Avg, pRNFL-Sup, pRNFL-Tmp, and pRNFL-Inf thickness (P<0.05 or P<0.001), while pRNFL-Nas showed no significant difference (P>0.05). In the pediatric subgroup, pRNFL-Avg and pRNFL-Inf were thinner (P<0.05). In the young adult subgroup, pRNFL-Avg and pRNFL-Sup were reduced (P<0.001 or P<0.05). In the middle-aged subgroup, pRNFL-Avg, pRNFL-Sup, pRNFL-Inf, and pRNFL-Tmp were all thinner (P<0.05 or P<0.001). Multivariate logistic regression identified visual field defects (OR=15.28, 95%CI 2.95-79.10), disease duration (OR=1.11, 95%CI 1.05-1.18), and the number of involved cerebral vessels (OR=1.49, 95%CI 1.01-2.22) as independent risk factors for pRNFL thinning. The predictive model achieved AUC of 0.94 (95%CI 0.91-0.97) and 0.95 (95%CI 0.91-0.99) in the training and validation sets, respectively. Decision curve analysis confirmed the model's favorable clinical net benefit.ConclusionThinning of pRNFL was observed in Moyamoya disease patients with visual field defects, disease duration, and cerebral vascular involvement identified as independent risk factors for pRNFL atrophy.关键词：Moyamoya disease;retinal nerve fiber layer thickness;peripapillary retinal nerve fiber layer;optical coherence tomography;Suzuki staging15|0|0更新时间：2025-08-01 - “昆明医科大学第一附属医院研究揭示，白内障患者年龄、眼轴长度与眼前房深度、晶状体厚度及术后有效晶状体位置存在相关性。”
摘要：ObjectiveTo analysis the correlations of cataract patients' age, axial length (AL) with anterior chamber depth (ACD), lens thickness (LT), and postoperative effective lens position (ELP).MethodsA retrospective study was employed to analyze the biometric parameters of 7458 cataract patients (7458 eyes) who underwent surgical treatment in the First Affiliated Hospital of Kunming Medical University from January 2016 to December 2022. All measurements were obtained using the Lenstar LS900 optical biometer via optical low-coherence reflectance technology. Pearson or Spearman correlation analyses was performed between patients' age, sex, and AL with ACD, LT, and postoperative ELP measurements.ResultsThe mean AL of patients was 23.41 (22.68, 24.31) mm, categorized into 4 groups: short AL group (AL≤22 mm, 593 cases, 8.0%), normal AL group (AL 22-24 mm, 4520 cases, 60.5%), longer AL group (AL 24-26 mm, 1579 cases, 21.2%), and long AL group (AL>26 mm, 766 cases, 10.3%). The ACD was (2.65±0.43) mm, and the LT was (4.29±0.46) mm. Compared with female patients, male patients had significantly longer AL, deeper ACD, and thicker LT (P<0.001). Postoperative ELPs, measured in 209 eyes 3 months after surgery, was 5.03(4.57, 5.21) mm. Correlation analysis revealed a positive correlation between AL and ACD in short, normal, and longer AL groups (ρ=0.155, ρ=0.311, ρ=0.074, P<0.001 or P<0.05), while a negative correlation was found in the long AL group (ρ=-0.089, P<0.05). No statistically significant correlation was observed between AL and LT in short AL group (P>0.05), but a negative correlation was noted in normal and longer AL groups (ρ=-0.104, ρ=-0.095, P<0.001), and a positive correlation in long AL group (ρ=0.165, P<0.001). In short, normal, and longer AL groups, postoperative ELP was positively correlated with preoperative ACD (ρ=1.000, ρ=0.826, ρ=0.441,P<0.001), with no significant correlation in long AL group (P>0.05).ConclusionsIn cataract patients, AL, ACD, and LT are associated with both age and sex. LT and AL significantly influence ACD, while ACD and AL significantly influence LT. Preoperative ACD is the primary factor affecting postoperative ELP.关键词：axial length;lens thickness;anterior chamber depth;effective lens position;cataract9|0|0更新时间：2025-08-01
Clinical Research
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Therapeutic effects and underlying mechanisms of Ganluqingwen formula on acute lung injury in mice AI导读
“最新研究发现，甘露清瘟方能有效抑制NLRP3/Caspase-1/GSDMD通路，减轻小鼠急性肺损伤。”
摘要：ObjectiveTo investigate the therapeutic effects and underlying mechanisms of Ganluqingwen formula on lipopolysaccharide (LPS)-induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in mice.MethodsFifty ICR mice were randomly divided into five groups: control, model, and Ganluqingwen formula (GLQW) low dose (7.10 g/kg), medium dose (15.21 g/kg), and high dose (30.42 g/kg) groups, with 10 mice per group. On days 1-3, mice in GLQW groups were daily gavaged with the corresponding dose of GLQW, while control and model groups received equal volumes of saline. On day 4, ALI/ARDS was induced in model and GLQW groups using intraperitoneal injection of LPS (20 mg/kg), while control group received an equal volume of PBS. At 24 h post-treatment, survival rate, wet-to-dry weight ratio (W/D) and lung histological changes (HE staining) were observed. Serum levels of tumor necrosis factor (TNF)-α, interferon gamma (IFN-γ), interleukin (IL)-4, IL-10, IL-12, as well as lung tissue levels of TNF-α, IFN-γ, IL-1β, IL-4, IL-6, IL-10 were measured by ELISA. Western blotting was used to determine the expression levels of NOD-like receptor thermal protein domain associated protein 3 (NLRP3), cystatinase-1 (Caspase-1), apoptosis-associated speck-like protein (ASC), and membrane perforating protein Gasdermin D (GSDMD) in lung tissue.ResultsNo significant differences in survival rates were observed among the groups (P>0.05). Compared with control group, ELISA and Western blotting results showed that lung tissue W/D, IFN-γ, TNF-α, IL-4, IL-12, IL-1β, IL-6, NLRP3, ASC, and Caspase-1, GSDMD and serum IFN-γ, TNF-α, IL-4, IL-12 levels were significantly higher (P<0.05), and IL-10 levels in lung tissue and serum were significantly lower in mice of model group (P<0.05). Compared with model group, lung tissue W/D, IFN-γ, TNF-α, IL-1β, IL-4, IL-6, IL-12, NLRP3, ASC, Caspase-1, and GSDMD, and serum IFN-γ, TNF-α, IL-4, and IL-12 levels were significantly lower (P<0.05), and lung tissue IL-10 levels were significantly higher (P<0.05) in GLQW low, medium, and high dose groups, with high-dose group showing significantly higher level in serum IL-10 (P<0.05). Compared with GLQW low-dose group, the lung tissue levels of IFN-γ, IL-6, NLRP3, ASC, Caspase-1, and GSDMD, and serum TNF-α were significantly lower (P<0.05), and lung and serum IL-10 levels were significantly higher in GLQW high-dose group (P<0.05). HE staining results showed that lung structure was clear and normal in control group; part of the lung interstitium was congested and hemorrhagic, and some of the fine bronchial periphery was infiltrated with inflammatory cells in model group; the phenomena of lung interstitial congestion and hemorrhage were reduced, and the degree of infiltration of inflammatory cells was alleviated in GLQW low-, medium-, and high-dose groups.ConclusionGanluqingwen formula can delay the development of ALI/ARDS in mice by inhibiting NLRP3/Caspase-1/GSDMD pathway, thereby suppressing cellular pyroptosis.关键词：Ganluqingwen;lipopolysaccharide;acute lung injury;acute respiratory distress syndrome;pyroptosis13|0|0更新时间：2025-08-01 - “最新研究发现，柴黄清胰活血颗粒能有效减轻重症急性胰腺炎小鼠多器官损伤，降低炎症反应，为治疗提供新途径。”
摘要：ObjectiveTo investigate the effects of Chaihuang Qingyi Huoxue Granules on multiple organ damage induced by caerulein combined with lipopolysaccharide in mice with severe acute pancreatitis (SAP).MethodsTwenty-four C57BL/6J mice were randomly divided into three groups: control (n=8), SAP (n=8) and Chaihuang Qingyi Huoxue Granules (CHQY group, n=8). Mice in SAP and CHQY groups were intraperitoneally injected with caerulein (50 μg/kg) at hourly intervals for 7 consecutive times, followed by an immediate intraperitoneal injection of lipopolysaccharide (10 mg/kg). Mice in control group received an equal volume of normal saline. After the successful establishment of the model, CHQY group mice were administered Chaihuang Qingyi Huoxue Granules [3.185 g/(kg·d)] via gavage, while control and SAP group mice received an equal volume of normal saline. Twenty-four hours post-modeling, mice were anesthetized, and serum was collected and separated for analysis of the activities of amylase (AMY), lipase (LPS), aspartate transaminase (AST), alanine transaminase (ALT) and the contents of creatinine (CREA) and urea (UREA) using an automatic biochemical analyzer. Serum levels of interleukin (IL)-1β, IL-6, IL-8, IL-18, and tumor necrosis factor-α (TNF-α) were measured by ELISA. Tissue samples from pancreas, lung, liver, kidney, and small intestine were collected for histopathological examination using hematoxylin-eosin (HE) staining and scored. The expression of nuclear factor-κB p65 (NF-κB p65) was detected in all tissues by immunohistochemistry.ResultsCompared with control group, the activities of AMY, LPS, AST and ALT, and the contents of CREA, UREA, IL-1β, IL-6, IL-8, IL-18, and TNF-α were increased (P<0.05). Pathological injuries in the pancreas, lung, liver, kidney, and small intestine was significant, with increased pathological scores and a higher proportion of NF-κB p65 positive cells (P<0.05). Compared with SAP group, the activities of AMY, LPS, AST, ALT, and the contents of CREA, UREA, IL-1β, IL-6, IL-8, IL-18, and TNF-α in the serum of CHQY group were decreased (P<0.05). Pathological injuries in the pancreas, lung, liver, kidney and small intestine were reduced, with lower pathological scores and a decreased proportion of NF-κB p65 positive cells (P<0.05).ConclusionChaihuang Qingyi Huoxue Granules have a certain therapeutic effect on SAP model mice, which may be related to reducing inflammation response and improving multiple organ damage such as the pancreas, lung, liver, kidney and small intestine.关键词：Chaihuang Qingyi Huoxue Granules;severe acute pancreatitis;cerulein;lipopolysaccharide;inflammatory response;multiple organ damage14|0|0更新时间：2025-08-01 - “解放军总医院团队从滑膜组织提取外泌体，筛选差异表达miRNA，发现miR-429在颞下颌关节骨关节炎修复中起关键作用。”
摘要：ObjectiveTo explore the role of miR-429 in synovial mesenchymal stem cell-derived exosomes (SMSC-Exos) in repairing cartilage damage in temporomandibular joint osteoarthritis (TMJ OA) by extracting SMSC-Exos from human synovial tissue and screening differentially expressed microRNA (miRNA) through transcriptome sequencing.MethodsHuman synovial tissues were obtained from 6 patients who underwent surgery at the First Medical Center of the Chinese PLA General Hospital from June to December 2023, including 3 patients with osteoarthritis (OA group) and 3 control patients (control group), all of whom were male. SMSC-Exos were extracted from the synovial tissues for miRNA sequencing and differential expression analysis. Further, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the target genes of differentially expressed miRNA to identify key functional miRNA and construct miRNA-target gene regulatory networks and protein-protein interaction (PPI) networks of target genes. An in vitro model of rabbit condylar cartilage cell inflammatory microenvironment induced by interleukin-1β (IL-1β) was established, with the control group cultured in DMEM/F12 basic medium and the inflammation-induced group cultured in DMEM/F12 basic medium containing 10 ng/ml IL-1β. RT-qPCR was used to detect the effects of overexpressed target miRNA on the mRNA expression levels of cartilage phenotype factors such as type Ⅱ collagen α1 chain (Col2a1), aggrecan (Acan), as well as inflammatory factors including a disintegrin and metalloproteinase with thrombospondinmotifs 5 (Adamts5) and cyclooxygenase-2 (Cox-2).Results(1) SMSC-Exos were successfully isolated, cultured, and identified.(2) miRNA sequencing of SMSC-Exos from OA and control groups revealed 16 differentially expressed miRNAs (|log2FC|>2, P<0.05). Compared with control group, 7 miRNAs were up-regulated and 9 were down-regulated in OA group. GO and KEGG analysis indicated that the target genes of miR-429 were mainly involved in development process, anatomical structure development, system development, cell development and differentiation, and were enriched in inflammation-related pathways such as mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt). (3) Functional validation of miR-429 in the rabbit condylar cartilage cell inflammatory model showed that overexpression of miR-429 increased the mRNA expression levels of Col2a1 and Acan (P<0.05) and decreased the mRNA expression levels of Adamts5 and Cox-2 (P<0.05) in the inflammation-induced group.ConclusionsmiRNA sequencing of SMSC-Exos isolated and identified from human synovial tissues reveals a specific miRNA expression profile in OA patients, with miR-429 significantly down-regulated. Functional validation demonstrates that overexpression of miR-429 has reparative and anti-inflammatory effects on condylar cartilage cells in an inflammatory microenvironment.关键词：microRNA;temporomandibular joint;osteoarthritis;cartilage, articular;miR-42913|0|0更新时间：2025-08-01 - “最新研究发现，甲泼尼龙能有效缓解烟雾吸入引起的大鼠急性肺损伤，上调水通道蛋白AQP1和AQP5表达。”
摘要：ObjectiveTo observe the therapeutic effects of different doses of methylprednisolone (MP) on smoke inhalation-induced acute lung injury (SI-ALI) in rats, and to explore the changes in the expression of aquaporins (AQPs) and the underlying mechanisms for alleviating lung injury.MethodsA total of 86 healthy adult male Sprague-Dawley (SD) rats were randomly divided into five groups: control group (n=6), smoke inhalation injury (SI) group (n=20), low-dose MP group (LMP, SI+ 0.4 mg/kg MP, n=20), medium-dose MP group (MMP, SI+4 mg/kg MP, n=20), and high-dose MP group (HMP, SI+ 40 mg/kg MP,n=20). A model of smoke inhalation-induced lung injury was established. The survival status of the rats in each group was monitored. Lung tissues were collected 24 hours after injury to determine the wet-to-dry (W/D) ratio of the lung tissues, arterial oxygen partial pressure (PaO₂), and the expression levels of inflammatory cytokines TNF-α and IL-6. The degree of lung injury was evaluated using HE staining, and the mRNA and protein expression levels of AQP1 and AQP5 in the lung tissues were detected.ResultsCompared with control group, the survival rate of the rats in SI group was significantly decreased (P<0.05); compared with SI group, the survival rates of the rats in MMP and HMP groups were significantly increased (P<0.05). Compared with control group, the PaO₂ of the Rats in SI group was significantly decreased (P<0.05), and the wet-to-dry (W/D) ratio and lung injury scores were significantly increased (P<0.05). Compared with SI group, the PaO₂ of the rats in LMP, MMP, and HMP groups (P<0.05) was significantly increased (P<0.05), and the lung W/D ratio and injury scores in MMP and HMP groups were significantly decreased (P<0.05). ELISA results showed that compared with control group, the serum concentrations of TNF-α and IL-6 in SI group were significantly increased (P<0.05); compared with SI group, the concentrations of TNF-α and IL-6 in MMP and HMP groups were significantly decreased (P<0.05). HE staining revealed that the alveolar structure of the rats in SI group was severely damaged; compared with SI group, the damage to the alveolar structure in MMP and HMP groups was alleviated. Real-time PCR and Western blotting analysis results showed that compared with control group, the mRNA and protein expression levels of AQP1 and AQP5 in lung tissues in SI group were significantly decreased (P<0.05); however, compared with SI group, these levels in LMP, MMP, and HMP groups were significantly increased (P<0.05).ConclusionsSmoke inhalation can induce acute lung injury in rats and down-regulate the expression levels of AQP1 and AQP5 in the lung tissues. Methylprednisolone can alleviate pulmonary edema and tissue damage in rats caused by smoke inhalation, and induce the up-regulation of the expression of AQP1 and AQP5.关键词：acute lung injury;smoke inhalation;aquaporins;methylprednisolone;treatment8|0|0更新时间：2025-08-01
Basic Research
- “据最新研究报道，胆囊收缩素在学习和记忆领域的研究取得进展，为相关药物研发提供理论参考。”
摘要：Learning and memory are basic and important advanced functions of the brain, and have always been a hot and difficult research area in neuroscience. Despite the significant progress in research on learning and memory, the mechanism is still not fully clear. Cholecystokinin (CCK), an early identified brain gut peptide, is widely distributed and involved in regulating a variety of functions in the central nervous system. In recent years, numerous studies have shown that CCK plays an important role in the regulation of learning and memory by affecting the function of neurons and glial cells. This article reviews the role and mechanism of CCK in learning and memory, to provide a theoretical basis for the development of CCK-related drugs and their applications.关键词：cholecystokinin;learning and memory;central nervous system;synapses16|0|0更新时间：2025-08-01 - “在医疗领域，专家综述了麻醉术后膈肌功能障碍的发生机制及超声评估应用，为制定手术方案提供指导，促进术后恢复。”
摘要：Diaphragmatic dysfunction (DD) can be caused by various factors, including anesthesia, surgery, and patient-related conditions. It may lead to adverse events such as prolonged postoperative extubation, weaning failure, postoperative pulmonary complications (PPCs), which can eventually result in patients being transferred to the intensive care unit (ICU), having an extended hospital stay and an increased mortality rate. Thus, it is crucial that the function of the diaphragm be timely and accurately assessed, and its status be reasonably protected for the favorable outcomes of patients after anesthesia and surgery. Recently, point-of-care diaphragmatic ultrasound has been applied in the clinic. However, currently, the assessment of DD is mainly concentrated in the ICU, and its application during the perioperative period is relatively restricted. In the review, the mechanisms of postoperative DD after anesthesia and the application progress of ultrasonography evaluation are summarized. The static and dynamic functions of the diaphragm are monitored via various ultrasound examination methods, and the postoperative changes and recovery of diaphragm function in each patient are observed in real time. In this way, the occurrence of PPCs can be predicted, a reasonable anesthesia and surgery plan can be guided to be developed, the protection and even prerehabilitation of the target organ "diaphragm" can be promoted, DD can be ultimately prevented and treated in a timely manner, and postoperative recovery can be improved.关键词：respiratory muscle;diaphragmatic dysfunction;postoperative pulmonary complications;diaphragmatic ultrasound;postoperative residual curarization14|0|0更新时间：2025-08-01 - “最新研究进展显示，椎体CT值在脊柱外科疾病诊治中具有重要作用，可提高骨质疏松症诊断率，预测术后并发症，为临床应用提供新思路。”摘要：With the aggravation of population aging in our country, the prevalence of osteoporosis (OP) has surged dramatically. Currently, the diagnosis of OP primarily relies on bone mineral density (BMD), and the precise measurement of BMD is crucial in the diagnosis and treatment of spinal surgical diseases. In recent years, computed tomography (CT) has gained widespread attention in clinical diagnosis and treatment due to its unique advantages. Vertebral CT values not only enhance the diagnostic rate of OP but also effectively predict the occurrence of postoperative complications such as adjacent vertebral fractures, fusion device subsidence, and pedicle screw loosening. This article summarizes the research progress of vertebral CT value in the field of spine surgery, and discusses its feasibility in guiding spinal surgery and its correlation with postoperative complications of spine. Additionally, it elaborates on the progress of combining CT with artificial intelligence (AI) to assist in disease diagnosis and treatment, aiming to better promote the clinical application of vertebral CT values.关键词：osteoporosis;CT value, vertebral body;bone density;complications spinal surgery;artificial intelligence12|0|0更新时间：2025-08-01
Review
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