Wnt蛋白家族属于一类具有高度保守半胱氨酸残基的分泌性脂质修饰糖蛋白,其通路是一组高度保守的信号转导通路,能够介导多种生理和病理过程,如参与调控细胞增殖、分化、凋亡、免疫与应激、炎症和纤维化。目前认为Wnt信号通路包括三个分支:经典Wnt信号通路,即Wnt/β-Catenin信号通路;Wnt/PCP通路;Wnt/Ca²⁺通路。Wnt/β-catenin信号途径在心、肝、肺、肾等器官纤维化等病理生理过程中均发挥了重要作用。越来越多的证据表明,Wnt/β-catenin信号通路在糖尿病肾病(diabetic nephropathy, DN)的进展中意义重大。本文就Wnt/β-catenin在系膜细胞凋亡、上皮间充质转变(epithelial mesenchymal transition, EMT)、DN条件下足细胞功能障碍、小管EMT和肾纤维化中的作用进行综述。此外,还介绍了这一过程所涉及的分子机制。这一信息为Wnt/β-catenin保护肾脏损伤和延缓DN进展提供了一个新的分子靶点。

Objective: To study the anti-nonalcoholic steatohepatitis mechanism of total flavonoids from Scabiosa comosa by network pharmacology. Methods: Based on the TCMSP database and literature reports, the main active components of total flavonoids from Scabiosa comosa were obtained. The Swiss Target Prediction server was used to predict the target of its active ingredients according to the reverse pharmacophore matching method, and the targets for improving NASH were screened out through databases such as Genecards, OMIM and Disgenet. The potential targets of drug targets and disease targets were used to make the Venn diagram. The Cytoscape software was used to construct the ' active ingredient-target ' network diagram. The STRING platform was used to construct the protein interaction network. The DAVID database and ClueGO plug-in were used for GO enrichment analysis and KEGG pathway analysis. Results: A total of 43 active components and 439 targets of total flavonoids were screened. The main active components in the network were ononin, camphene -3-O- rutinoside, isorhamnetin, quercetin, luteolin, eupatorium odoratum, etc. The key targets in the protein interaction network were TNF, AKT1, TP53, VEGFA, IL1B, etc. GO enrichment analysis involved 503 biological processes, 54 cellular components and 120 molecular functions. KEGG pathway enrichment analysis screened the top 20 related pathways, mainly acting on VEGF signaling pathway, PPAR signaling pathway, estrogen signaling pathway and so on. Conclusion: The flavonoid components from Scabiosa comosa can play a role in the treatment of nonalcoholic steatohepatitis through multiple targets and multiple pathways. The results provide a scientific basis for further study of the role of Scabiosa comosa in the field of anti-nonalcoholic steatohepatitis.

Microplastics are environmental pollutants that have attracted worldwide attention. In this paper, the toxic effects and mechanism of microplastics were reviewed, and the future research direction was pointed out. Microplastics can penetrate cell membrane directly into cells or tissues and organs, causing damage to digestive system and reproductive system. Nanoscale microplastics can even enter the nucleus, cause DNA damage, induce autophagy and apoptosis of cells, and produce oxidative damage. Current studies on the toxic effects of microplastics mainly use materials prepared in the laboratory. Further studies should be conducted on microplastics in the aging state and natural environment in order to fully understand the possible damage to organisms caused by microplastics.

糖尿病(diabetes mellitus, DM)是目前临床医学中最普遍的代谢性疾病之一,并且已经成为全球关注的公共卫生问题。沉默信息调节因子2相关酶1(silencing information regulator 2 related enzyme 1, SIRT1)是一种腺嘌呤二核苷酸依赖性去乙酰化酶,参与糖代谢和胰岛素的分泌过程,在DM的发病机制中扮演了重要角色。糖尿病主要是由于胰岛素分泌缺乏或者胰岛素抵抗导致的代谢紊乱综合征。SIRT1不仅在β细胞中通过p53、叉头盒转录因子O(forkhead box transcription factor class O, FoxO)、烟酰胺磷酸核糖转移酶(nicotinamide phosphoribose transferase, NAMPT)等相关靶点影响胰岛素分泌;还可以通过胰岛素受体、脂联素影响胰岛素敏感性从而干扰胰岛素抵抗。此外,SIRT1还可以通过抑制NF-κB信号通路,保护胰岛β细胞免受氧化应激和炎症细胞因子的刺激。同时,SIRT1通过促进线粒体的生物发生保证机体内所有细胞活动的供能,并避免脂质的积累。白色脂肪组织(white adipose tissue,WAT)、糖异生功能异常导致的糖尿病也受到SIRT1诸多影响。本文旨在探讨SIRT1与DM的关系及其中涉及的相关信号网络。

铅是一种可以通过呼吸道、消化道和皮肤接触等途径进入体内并蓄积产生毒性的非必需金属,可以对人体的多个系统造成损害,如肾脏、肝脏、神经、血液、生殖、胃肠道等,对肠道菌群也会产生影响。儿童时期正是快速生长发育阶段,是建立肠道微生物群的关键时期,因此儿童受铅暴露的毒性影响更加明显。本文综述了铅对不同动物模型及人的肠道屏障、菌群影响的相关研究成果,并重点强调了铅对儿童肠道的毒性作用。此外,本文分析了改善肠道屏障及菌群的研究,进一步总结了目前通过益生菌防治铅中毒可行和有效的策略。

大肿瘤抑制激酶(Large tumor suppressor kinase,LATS)是Hippo信号通路的核心成员,由于其结构的特殊性,在人体内可以通过对细胞周期、细胞骨架动力学和细胞迁移等方面的调控达到抑癌等作用。已经有研究表明,LATS会影响消化道肿瘤的发生发展。本文就LATS的结构、作用以及与消化道肿瘤的相关性等做一综述,深入了解LATS在消化道肿瘤发生发展过程中所起到的作用。

Objective: To explore the current status and relationship of electronic health literacy , health promotion behavior , and quality of life in elderly patients with chronic diseases. Methods: From August 1,2022 to February 20,2023, 325 chronic disease patients ≥60 years old were randomly selected using convenience sampling method. A structural equation model was constructed to analyze the relationship between electronic health literacy, health promotion behavior and health related quality of life in elderly patients with chronic diseases. Results: The total score of eHEALTH for patients was (18.73±10.64), the total score of health promotion behavior was (124.02±19.63), the total utility value of the European Five Dimensional Health Scale(EQ-5D-5L) was (0.79±0.22), and the EQ-VAS score was (72.35±16.21).The total score of patients' electronic health literacy is positively correlated with the total score of health promotion behavior (r=0.197, P＜0.001); The total score of electronic health literacy is positively correlated with the score of quality of life (r=0.188, P＜0.001), and the total score of health promotion behavior was also positively correlated with EQ-VAS scores (r=0.289, P＜0.001). Structural equation model analysis showed that electronic health literacy in elderly patients with chronic diseases can directly affect their quality of life, with a direct effect of 0.168 (P＜0.05); Electronic health literacy can also indirectly affect patients' quality of life by influencing their health promoting behavior, with an indirect effect of 0.046 (P＜0.05). Conclusion: Medical institutions should attach importance to the level of electronic health literacy of patients, implement targeted health intervention measures, effectively improve the level of electronic health literacy, and thereby enhance their health promotion behavior and quality of life.

Objective: To investigate the protective effect of Dracocephalum moldavica L. on stroke based on network pharmacology. Methods: The effective components of Dracocephalum moldavica L. were searched by NCBI and CNKI. The effective targets of Dracocephalum moldavica L. were predicted by Pubchem and swiss target prediction databases. The target genes related to cerebral stroke were searched by GeneCards and Omim databases. The Venn diagram was constructed to screen the intersection genes. Cytoscape was used to establish and visualize the network diagram of drugs, components, targets and diseases. String software was used to construct the protein network interaction diagram. GO enrichment and KEGG analysis were performed using the DAVID database. Results: A total of 23 effective components of Dracocephalum moldavica L. were found by searching the literature, and there were 1682 corresponding targets. The main molecules were NADPH oxidase 4 (NOX4), xanthine dehydrogenase (XDH), myeloperoxidase (MPO), etc. Through PPI topology analysis, 57 core targets were obtained; GO enrichment analysis showed that 443 biological processes (BP), 104 molecular functions (MF) and 66 cellular components (CC) were involved. The results of KEGG showed that 143 signaling pathways were involved, including cancer pathway (hsa05200: pathways in cancer), PI3K-Akt signaling pathway (hsa04151: PI3K-Aktsignaling pathway), neuroactive ligand-receptor interaction (hsa05022: neuroactive ligand-receptor interaction) and so on. Conclusion: This study preliminarily revealed that Dracocephalum moldavica L. can treat stroke through a variety of targets and pathways, providing a theoretical basis for further scientific experiments.

由于牙齿实际效果和设计移动间存在一定的差异，无托槽隐形矫治技术大部分病例第一序列结束时需要进行精细化调整甚至中期重启。因此，了解隐形矫治技术牙齿移动效率及其影响因素非常重要。本文就无托槽隐形矫治效率影响因素如设计因素(附件、支抗、过矫正、牙齿移动步骤、矫治器步幅、牙齿移动量、初始牙齿角度、矫治器更换频率)、患者年龄及牙周条件、矫治器材料和药物等物理因素等作一综述，为临床选择合适适应证及设计方案提供指导。

目的:评估通过ASPECT评分筛选发病6～24 h急性颅内大血管闭塞的缺血性卒中行血管内治疗的安全性及有效性。方法:本研究回顾性分析2012年1月至2020年10月之间于包头市中心医院神经内科临床诊断为发病24 h内急性颅内大血管闭塞的缺血性卒中并行血管内治疗的患者,详细登记患者基线及血管内治疗相关信息,比较发病6～24 h患者与发病6 h内患者血管内治疗的血管开通、预后以及手术安全性的情况。血管开通成功定义为mTICI分级2b-3级,功能独立的结局定义为mRS评分0-2分,手术安全性指标为术后24 h症状性颅内出血比率,将数据进行相关统计学分析。结果:共有369例患者入组。全部入组患者按发病6 h组及发病6～24 h组经单因素分析均没有差别;在校正了所有单因素分析:90 d功能独立（OR=0.840,95%CI:0.557～1.267;P=0.405）及良好预后（OR=0.968,95%CI:0.623～1.505;P=0.887）仍没有差别,在校正了单因素年龄、性别、NIHSS评分、ASPECT评分后比较两组之间的90 d功能独立（OR=0.696,95%CI:0.439～1.104;P=0.124）及良好预后（OR=0.750,95%CI:0.453～1.241;P=0.264）依然没有差别,在校正了单因素年龄、性别、NIHSS评分,、ASPECT评分、高脂血症、心房颤动、冠心病、进展性卒中、病变部位、存在ICAS、补救支架置入、球囊扩张后比较两组之间90 d功能独立（OR=0.579,95%CI:0.300～1.116;P=0.103）及良好预后（OR=0.965,95%CI:0.482～1.932;P=0.920）没有差别。结论:ASPECT评分用于筛选发病6～24 h的急性颅内大血管闭塞的缺血性脑卒中患者行血管内治疗同样有效,为患者提供及时、安全、可行的治疗。

自噬是真核细胞特有的"自食"现象,也是细胞进行自我保护的代谢途径[1],在多细胞生物遇到危险时可进行应激与防御调控。自噬发生时,胞内需降解的细胞器、蛋白质和部分胞质被膜包裹形成自噬体,而后与溶酶体等结合形成自噬溶酶体并对包裹内容物进行降解与回收,实现物质与细胞器的更新,维持胞内物质与能量供给的平衡[2]。自噬在维持细胞内稳态方面发挥着重要功能:在正常生理条件下,细胞通过较低水平的自噬持续维持细胞内稳态;

雄黄是中医最早使用的矿物药物,也是由我国临床医生最先应用于恶性肿瘤治疗,并取得较好临床疗效的中药。然而,由于雄黄难溶于水、生物利用度低,导致临床使用剂量过大。随着纳米技术的发展,通过各种物理、化学方法制备的纳米雄黄不仅有效提高了雄黄水溶性和生物利用度,而且展示出更强和更广谱的抗肿瘤药效作用。本文对雄黄的传统应用、纳米雄黄的制备及对不同肿瘤细胞的抗肿瘤作用及机制进行文献综述,以利于广大临床科研人员更便捷地了解纳米雄黄来源、制备及抗肿瘤作用的机制等方面研究进展,更好地开发利用纳米雄黄。

目的:观察美沙拉秦缓释颗粒剂联合五味苦参肠溶胶囊治疗湿热内蕴型溃疡性结肠炎(ulcerative colitis,UC)的临床疗效及对T淋巴细胞亚群及血清炎症因子的影响。方法:收集2018年06月至2020年06月在我院脾胃科门诊治疗的UC患者120例为研究对象,随机分为A组(40例,口服美沙拉秦缓释颗粒剂),B组(40例,口服五味苦参肠溶胶囊),C组(40例,联合口服美沙拉秦缓释颗粒剂及五味苦参肠溶胶囊,服药剂量及方法同前)。3个组疗程均为4周,分别于治疗前后采用改良Mayo评分评估临床疗效,检测3个组患者治疗前后T淋巴细胞亚群(CD4+、CD8+)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平及不良反应发生情况。结果:C组临床疗效总有效率为95. 0%(38/40),高于A组的75. 0%(30/40)和B组的70. 0%(28/40)(P <0. 05); A、B、C各组患者治疗后Mayo评分减低(P <0. 05),C组低于A组和B组(P <0. 05); A、B、C各组患者治疗后CD4+高于治疗前(P<0. 05),CD8+低于治疗前(P <0. 05),C组治疗后CD4+水平高于A组和B组(P <0. 05),CD8+水平低于A组和B组(P <0. 05); A、B、C各组患者治疗后血清TNF-α、IL-6、IL-8均低于治疗前(P <0. 05),C组低于A组和B组(P <0. 05); 3个组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论:美沙拉秦缓释颗粒剂联合五味苦参肠溶胶囊可以改善湿热内蕴型UC患者的临床疗效,其机制可能与提升UC患者免疫功能、有下调炎性因子表达有关。?

Objective: To detect the change of breath alcohol level over time in 20 to 22 years old youth by establishing a methodology, and to to reflect blood alcohol concentration, and to compare the sex differences in alcohol metabolism. Methods: The change of end-tidal alcohol concentration over time was detected with police breathalyzer, and the software DAS 3.0 was used to analyze the metabolic kinetics, and the sex differences of alcohol metabolism after drinking among youths aged 20 to 22 years. Results: The coefficient of variation detected by this method was less than 5 %. After drinking 100ml Chinese spirit (52 % alcohol by volume), the area under the curve AUC(0-t) in females was larger than that in males, the MRT(0-t) in vivo of females was significantly longer than that of males, and the clearance rate CLz in females was smaller than that in males. Conclusion: The method is simple, non-invasive, feasible and reproducible. Young males aged 20 to 22 metabolize faster than females of the same age after intaking same amount of liquor. On average, it takes about 3.5 hours for females aged 20 to 22 completely removing alcohol from the body, while it only takes about 2 hours for males in the same age group. Metabolic kinetics of alcohol in this age group was established in this study.

目的:搜集国内外公开发表的应用离散选择实验方法（DCE）研究中国人群对基层医疗卫生服务选择偏好的研究,为医疗服务提供者和决策者了解居民对基层医疗服务的偏好提供信息。方法:以"离散选择实验"、"偏好"、"基层医疗卫生服务"、"discrete choice experiment"、"preference"、"primary healthcare services preferences of Chinese"等为关键词,计算机检索从建库至2019年12月在PubMed、Medline、Embase、Web of Science、中国知网、万方、维普数据库公开发表的利用DCE研究中国人群在基层医疗卫生服务选择偏好中的应用的中英文文献,主要对DCE研究中属性及其水平的确定及偏好结果进行梳理。结果:本研究共纳入7篇研究,6篇发文于2019年,研究对象包括疾病人群、一般人群和基层全科医生。基层医疗服务纳入频次较高的属性包括服务类型、自付费用、医生技术水平、距最近就诊机构的时间、服务方式、医疗药品和设备的丰富程度。就诊咨询和等待时间、距就诊机构时间、医疗设备和药品丰富度、距最近医疗机构时间、医生技术水平、供给层次、预期疗效是影响人群对基层医疗服务选择偏好的最重要属性。结论:我国对特殊人群及基层医疗服务提供者偏好研究较少,离散选择实验设计尚需进一步完善,建议关注特殊人群及基层医疗服务提供者偏好研究,同时可借鉴ISPOR报告提出的开展DCE研究的十项标准,以提高设计的严谨性、保证DCE研究结果的可信性。

目的:研究双氯芬酸钠缓释胶囊联合中医、康复运动训练治疗原发性膝关节骨关节炎的效果。方法:选取2020年9月-2021年5月收治的128例原发性膝关节骨关节炎患者，按照随机数字表法分为对照组和观察组，各64例。对照组应用双氯芬酸钠缓释胶囊治疗，观察组加用综合康复运动训练治疗。对比分析两组治疗前后的血清学指标、中医症候积分、VAS、WOMAC评分。结果:治疗后，观察组患者的MMP、IL-6以及中医症候积分低于对照组，VAS评分、WOMAC评分也低于对照组，临床总有效率高于对照组，差异均具有统计学意义(P<0.05);两组患者的不良反应发生率比较，差异无统计学意义(P>0.05)。结论:应用中西医联合综合康复运动训练治疗原发性膝关节骨关节炎安全有效，可促进临床症状、膝关节功能的改善以及缓解患者疼痛感，降低炎性因子水平。

目的:利用生物信息学预测与M1型巨噬细胞参与炎症反应有关的关键基因，以及调控该基因的miRNA。方法:NCBI-GEO数据库筛选人源单核巨噬细胞表达谱，使用GEO2R筛选差异表达基因，通过WebGestalt数据库对上述基因进行GO和KEGG功能富集分析，STRING 11.0数据库构建蛋白质相互作用网络，并应用Cytoscape 3.7.2软件进行可视化分析，采用Cyto Hubba插件最终圈定HUB基因，利用mirWalk数据库和miRcode数据库预测靶向调控HUB基因的miRNA。结果:(1)GEO数据库共筛选出123个高表达差异基因，7个低表达基因；(2)经Cytoscape分析得到前20个最关键的枢纽基因，并圈定与炎症相关的基因STAT1;(3)mirWalk和mirCode数据库预测miRNAs并进行交集分析，得出STAT1受miR-23a靶向调控。结论:miR-23a靶向调控STAT1抑制M1型巨噬细胞参与的炎性反应。

正>菟丝子为旋花科植物菟丝子的干燥成熟果实,具有补肾益精,安胎明目等功效[1],且具平补阴阳之性,临床多用于治疗不孕、卵巢早衰、反复流产等女性疾病。因上述疾病的发生多与雌性生殖系统功能障碍有关,近年来,国内围绕其对雌性生殖系统功能障碍进行了相关实验研究,取得一定进展。笔者检索国内近20年来菟丝子对雌性生殖系统功能的文献作一综述,希望能为临床或基础研究提供参考。1 菟丝子对生殖内分泌系统的影响既往基于中医学"肾主生殖"的理论,

趋化因子是主要介导各种细胞归巢和迁移的蛋白质家族,CXC趋化因子配体12(CXCL12)作为稳态/炎性两用的趋化因子,通过与CXC趋化因子受体4(CXCR4)结合形成CXCL12/CXCR4轴,参与免疫调节、内分泌调节、炎症性疾病,在肾脏生理发育以及不同肾脏疾病中发挥重要调节作用。CXCL12与CXCR4结合在促进肾脏生长及血管形成有重要作用,然而,该轴在糖尿病肾病的发生发展中起着双重作用。此外,对狼疮性肾炎、肾癌及膜性肾病而言CXCL12/CXCR4是一种新的潜在危险因素。本文就CXCL12/CXCR4在肾脏疾病中的作用及CXCL12/CXCR4轴的拮抗剂治疗肾脏疾病的效果进行综述,有助于指导肾脏疾病的临床研究工作。